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PubMed2004

A community-based walking trial to improve neighborhood quality of life in older adults: a multilevel analysis.

BACKGROUND: Few studies have considered the neighborhood as a context in which to examine the physical activity and quality of life relationship. PURPOSE: The goal of this study was to evaluate the effects of a neighborhood walking program on quality of life among older adults. It was designed as a randomized trial involving a multilevel design with neighborhoods corresponding to primary sampling units and residents to secondary units. METHODS: Five hundred eighty-two community-dwelling senior residents (65 years of age or older) in neighborhoods in the northeast metropolitan area of Portland, Oregon, were recruited through telephone, direct mail, and referrals. The walking intervention was delivered at the neighborhood level. Neighborhoods (N = 56) were randomly assigned to a 6-month, 3 times per week, leader-led walking group activity (n = 28) or an information-only control group (n = 28). Primary outcome measures included SF-12 (Physical, Mental summary scores) and life satisfaction (SWLS); the secondary outcome measure was neighborhood walking activity, assessed at baseline, 3 months, and 6 months of the study period. RESULTS: Compared to the control neighborhoods, results from multilevel, longitudinal analyses indicated significant improvements in the primary outcomes of SF-12 Physical (p < .05), SF-12 Mental (p < .05) summary scores, and SWLS (p < .05), over the course of the 6-month intervention. A significant increase was also observed in the secondary outcome of walking activity (p < .05). CONCLUSIONS: Implementing a neighborhood-based walking program of low to moderate intensity is feasible and beneficial for promoting quality of life among senior residents at a community level.

Age Factors↗
PubMed2001

Walking training of patients with hemiparesis at an early stage after stroke: a comparison of walking training on a treadmill with body weight support and walking training on the ground.

OBJECTIVE: To compare the effect of walking training on a treadmill with body weight support (BWS) and walking training on the ground at an early stage of rehabilitation in patients with hemiparesis after stroke. DESIGN: Randomized controlled experimental study. SETTING: Multicentre design; three departments of rehabilitation medicine. SUBJECTS: Seventy-three consecutive first stroke patients admitted to a rehabilitation clinic were randomized into a treatment group and a control group. INTERVENTIONS: The treatment group received walking training on a treadmill with BWS for 30 minutes, 5 days a week. The control group received walking training according to the Motor Relearning Programme (MRP) on the ground for 30 minutes 5 days a week, not including treadmill training. During the time in the rehabilitation department (about two months), all patients in the study also received professional stroke rehabilitation besides the walking training in the two groups. MAIN OUTCOME MEASURES: Functional Independence Measure (FIM), walking velocity for 10 m, Functional Ambulation Classification (FAC), Fugl-Meyer Stroke Assessment and Berg's Balance Scale. The assessments were performed at admission, at discharge and at 10-month follow-up. RESULTS: There were no statistically significant differences between the groups at discharge or at the 10-month follow-up with regard to FIM, walking velocity, FAC, Fugl-Meyer Stroke Assessment, and Berg's Balance Scale. Patients in both groups improved in these variables from admission to the 10-month follow-up. CONCLUSIONS: Treadmill training with BWS at an early stage of rehabilitation after stroke is a comparable choice to walking training on the ground.

Adult↗
PubMed2001

Clotting and fibrinolytic activity change during the 1 h after a submaximal run.

PURPOSE: To determine the changes in clotting and fibrinolytic activity during the 1-h period after an acute submaximal exercise at a specific relative exercise intensity to ascertain whether during this time there is a greater risk for developing a clot formation or thrombus. METHODS: Ten healthy men reported between 0700 and 1000 h and ran at 70-75% VO2max or walked at 1.2 mph for 30 min in a random counter-balanced order. Venous blood was obtained at rest, immediately after, and every 20 min during the 1-h recovery. RESULTS: There were no differences in the resting parameters for each treatment. Walking did not alter the activity of any of the measures analyzed compared with rest. Clotting indicators activated partial thromboplastin time (APTT) was significantly decreased by approximately 2 s and remained at this level during the 1-h recovery, and factor VIII activity was elevated 66% immediately after the run and remained elevated at this level during the 1-h recovery period. Fibrinolytic indicators, t-PA, and D-dimers were significantly increased immediately after the run. However, t-PA demonstrated a quadratic negative slope during the 1-h recovery time. D-dimers remained elevated during the 1-h recovery time. CONCLUSIONS: These results suggest that running at 70-75% VO2max resulted in elevated clotting and fibrinolytic activity. However, the clotting activity was sustained during a time when fibrinolytic activity declined, which suggests a more favorable situation for clot formation during this time after exercise.

Adult↗
PubMed2005

A sharp minimum on the mean number of steps taken in adaptive walks.

It was recently conjectured by H.A. Orr that from a random initial point on a random fitness landscape of alphabetic sequences with one-mutation adjacency, chosen from a larger class of landscapes, no adaptive algorithm can arrive at a local optimum in fewer than on average e-1 steps. Here, using an example in which the mean number of steps to a local optimum equals (A-1)/A, where A is the number of distinct "letters" in the "alphabet" from which sequences are constructed, it is shown that as originally stated, the conjecture does not hold. It is also demonstrated that (A-1)/A is a sharp minimum on the mean number of steps taken in adaptive walks on fitness landscapes of alphabetic sequences with one-mutation adjacency. As the example that achieves the new lower bound has properties that are not often considered as potential attributes for fitness landscapes-non-identically distributed fitnesses and negative fitness correlations for adjacent points-a weaker set of conditions characteristic of more commonly studied fitness landscapes is proposed under which the lower bound on the mean length of adaptive walks is conjectured to equal e-1.

Adaptation, Physiological↗
PubMed2006

Effect of the oral hypoglycaemic sulphonylurea glibenclamide, a blocker of ATP-sensitive potassium channels, on walking distance in patients with intermittent claudication.

AIMS: The oral hypoglycaemic sulphonylurea glibenclamide stimulates endogenous insulin secretion through blockade of ATP-sensitive potassium (KATP) channels on pancreatic beta cells, but also blocks cardiovascular KATP channels, leading to increased peripheral vascular resistance and reduced peripheral blood flow in non-diabetic subjects. Therefore, this study examined whether a single oral dose of glibenclamide adversely affected the pain-free or maximal walking distance in patients with intermittent claudication. METHODS: In a double-blind, randomized crossover study, 12 non-diabetic patients with intermittent claudication were given a single oral dose of glibenclamide (5.25 mg) or placebo separated by a washout period of 1 week. A treadmill test was carried out 180 min after glibenclamide/placebo intake for determination of pain-free and maximal walking distance. Plasma glucose concentrations were kept constant by an euglycemic clamp. Changes in ankle/brachial blood pressure index (ABI), serum insulin, and serum glibenclamide were also assessed. RESULTS: The pain-free walking distance was 62.8 +/- 9.8 metres (mean +/- sem) after glibenclamide and 52.6 +/- 5.9 metres after placebo (P = 0.52). The maximal walking distance was 142.7 +/- 18.7 metres after glibenclamide and 132.6 +/- 16.6 metres after placebo (P = 0.23). The ABI was not significantly changed by glibenclamide compared with placebo. Serum glibenclamide was 0.51 +/- 0.08 microm 180 min after administration of the drug. Glibenclamide produced an 8-fold increase in circulating insulin compared with placebo (P < 0.001). CONCLUSIONS: Glibenclamide given as a single oral dose commonly used in glucose-lowering drug therapy does not reduce pain-free or maximal walking distance in non-diabetic patients with intermittent claudication.

Adenosine Triphosphate↗
PubMedDate not supplied

The acute effects of a rollator in individuals with COPD.

PURPOSE: To investigate whether the acute benefits of rollator use are consistent over time in individuals with moderate to severe chronic obstructive pulmonary disease. METHODS: Thirty-one stable subjects with chronic obstructive pulmonary disease (13 men, 18 women), aged 68 +/- 8 years, with a forced expiratory volume in 1 second of 0.7 +/- 0.2 L (33% +/- 12% predicted) and a baseline 6-minute walk (6MW) of 261 +/- 68 m, were recruited from a respiratory clinic after completion of a pulmonary rehabilitation program. Two 6MWs were performed at baseline, 4 weeks, and 8 weeks, one walking unaided and the other walking with the assistance of a rollator. The test order was randomly chosen at baseline, and the same test order was used at each time point. The primary outcome measures were distance walked in 6 minutes (meters), perceived dyspnea using a modified Borg scale, and number of rests taken. RESULTS: Subjects achieved higher 6MW distances during assisted compared with unassisted walking at baseline (292 +/- 67 vs 263 +/- 67 m), 4 weeks (296 +/- 62 vs 275 +/- 63m), and 8 weeks (283 +/- 65 vs 259 +/- 68 m) (P = .013), with no time effect (P = .5). In addition, use of a rollator resulted in a significant improvement in dyspnea (P = .004) at baseline, 4 weeks, and 8 weeks, with no time effect (P = .7). The use of a rollator also reduced the number of rests taken during the 6MW (P < .001), with no time effect (P = .9). CONCLUSIONS: Rollator use resulted in improvements in performance in the 6MW, which were consistent over time among individuals with moderate to severe chronic obstructive pulmonary disease who walk less than 375 m during an unaided 6MW.

Aged↗
PubMed2007

The effect of supervised exercise and cilostazol on coagulation and fibrinolysis in intermittent claudication: a randomized controlled trial.

BACKGROUND: The prothrombotic, hypofibrinolytic state that develops in patients with intermittent claudication (IC) upon walking due to ischemia-reperfusion injury (IRI) of the leg muscles may contribute to the high incidence of life- and limb-threatening thrombotic events observed in this patient group. Treatments, such as angioplasty, that obtund the IRI also ameliorate the procoagulant diathesis. The effect on this diathesis of supervised exercise and cilostazol, both of which provide symptomatic benefit in IC, but without significantly obtunding IRI, is unknown. METHODS: Thirty-four patients (27 men and 7 women; median age, 67 years; range, 63-72 years) were randomized to receive best medical therapy (BMT) plus supervised exercise (n = 9), BMT plus cilostazol (n = 9), BMT plus supervised exercise plus cilostazol (n = 7), or BMT alone (n = 9) in a 2 x 2 factorial design. Thrombin-antithrombin complex and prothrombin fragments 1 and 2, both markers of thrombin generation; plasminogen activator inhibitor antigen and tissue plasminogen activator antigen, both markers of fibrinolysis; ankle-brachial pressure index (ABPI); and initial and absolute claudication distance (ACD) were measured at baseline and then 3 and 6 months after randomization. RESULTS: At 6 months, when compared with receiving BMT only, supervised exercise and cilostazol resulted in improvements in ABPI of 18% and 13% and in ACD of 40% and 64%, respectively. The effects on ABPI and ACD of combining supervised exercise and cilostazol were additive. Supervised exercise, cilostazol, and supervised exercise combined with cilostazol had no significant effect on any of the four hemostatic markers. CONCLUSIONS: Treatment of IC by supervised exercise or cilostazol results in significant improvements in ABPI and ACD but has no demonstrable effect on the prothrombotic diathesis. This suggests that supervised exercise and cilostazol, unlike angioplasty, are unlikely to have a long-term beneficial effect on the thrombotic risks faced by these patients.

Aged↗
PubMed1998

Knee osteoarthritis and high-heeled shoes.

BACKGROUND: Little is known about the effects of walking in high heels on joints in the legs. Since osteoarthritis of the knee is twice as common in women as in men, we investigated torques (forces applied about the leg joints) of women who wore high-heeled shoes. METHODS: We studied 20 healthy women who were comfortable wearing high-heeled shoes. The women walked with their own high-heeled shoes and barefoot. Data were plotted and qualitatively compared; major peak values for high-heeled and barefoot walking were statistically compared. Bonferroni adjustment was made for multiple comparisons. FINDINGS: Measurement showed increased force across the patellofemoral joint and a greater compressive force on the medial compartment of the knee (average 23% greater forces) during walking in high heels than barefoot. INTERPRETATION: The altered forces at the knee caused by walking in high heels may predispose to degenerative changes in the joint.

Adult↗
PubMed1998

The effect of walking aids on exercise capacity and oxygenation in elderly patients with chronic obstructive pulmonary disease.

BACKGROUND: high walking frames may improve exercise capacity in young patients with chronic obstructive pulmonary disease (COPD). We have assessed the effect of Zimmer, rollator and gutter frames on 6-min walking distance and on arterial oxygenation during exercise in elderly patients with COPD. METHODS: 27 out-patients (15 men) aged 70-82 (mean 75) years were recruited. Exclusions comprised: COPD exacerbation or oral steroid use within 6 weeks, confusional state, participation in a pulmonary rehabilitation programme and exercise limitation by other diseases. Subjects completed 6-min walk tests unaided and with the three frames on four separate days in random order 30 min after nebulized salbutamol (5 mg) and ipratropium (0.5 mg) and were accompanied by an investigator blinded to results of all other walk tests undertaken. Oxygen saturation (SaO2) was monitored by finger probe during exercise. Grouped t-tests were used to compare distances and reductions in SaO2. RESULTS: Unaided, the mean (SEM) 6-min walk distance was 210 (16) m and fall in oxygen saturation was 6.0 (1.1)%. Use of a rollator frame did not significantly affect either of these values. Using the Zimmer frame reduced the mean distance to 165 (13) m (t=5.2, P < 0.001 vs unaided walk) with an SaO2 fall similar to that recorded during the unaided walk. Using the gutter frame increased the mean distance to 234 (150) m (t=3. 1, P=0.004 vs unaided walk) and reduced the fall in SaO2 to 3.7 (0.8)% (t=2.3, P=0.03 vs unaided walk). CONCLUSIONS: gutter frames improve exercise capacity and SaO2 during exercise in elderly COPD patients who remain symptomatic on optimal therapy, whereas unwheeled Zimmer frames have a deleterious effect in such patients.

Aged↗
PubMed2001

Sagittal plane head stabilization during level walking and ambulation on stairs.

BACKGROUND AND PURPOSE: Head stabilization in space provides a stable reference frame for visual and vestibular systems during locomotor tasks. The purpose of the present study was to examine upper body movement patterns used to maintain head stability in response to the increased challenge of stair ambulation. METHOD: A repeated-measures study design was used and the order of conditions was randomized for each subject. Eight healthy, non-disabled, young adults walked 10 metres on a level surface, ascended and descended four steps. Head, neck and trunk angular positions in space were obtained for three trials of each condition. Significant differences in mean head, neck and trunk angular orientation in space and segment excursions were determined. Cross-correlation analyses between head and neck, neck and trunk, and head and trunk determined movement patterns used for maintaining head stability. The chi-square test examined the homogeneity of movement pattern distributions for each segment pair across conditions. RESULTS: Head in space flexion orientation and angular excursions were greater during stair ascent and greater still during stair descent as compared to level walking. This indicates a progressively significant increase in the challenge to head stability. Neck flexion orientation in space and angular excursion were greater during stair descent as compared to level walking. Movement patterns between segment pairs demonstrated phase leads and lags between segments when threats to head stability were minimal. With increased challenge to head stability, segments moved synchronously in opposite directions to maintain balance. With further challenges to head stability, segments moved synchronously in the same direction to maintain body segment alignment. CONCLUSIONS: Head stabilization was significantly challenged when ascending stairs and is further challenged while descending stairs. Movement patterns reflected changes associated with challenges to head stability. Increased head excursion during stair ambulation may reflect the need to orient vision for foot placement. Results suggest that individuals with visual or vestibular deficits may be at risk for falls during stair ambulation.

Adult↗
PubMed2001

Randomized trial of 4-aminopyridine in patients with chronic incomplete spinal cord injury.

OBJECTIVE: To test the efficacy of 4-aminopyridine (4-AP) on functional status, walking speed and vibration perception in patients with chronic, incomplete spinal cord injury. METHODS: Twenty SCI patients were randomized in a trial with a double-blind, crossover design to receive four weeks of orally administered 4-AP, followed by a two-week wash-out period and four weeks of placebo, or vice versa. The total daily dose of 4-AP during the four weeks of treatment was systematically increased to a maximum of 0.5 mg/kg body weight. Evaluation of (side-)effects took place at the beginning, after one week, and at the end of each four-week study period. RESULTS: No significant benefit was found on functional status (COOP-WONCA). A statistically significant treatment effect was found on the vibration perception threshold (VPT) in the left fingers, during the first study period. On average, patients receiving 4-AP treatment responded less favourably (mean increase in VPT of 0.29 (0.31) microm) than patients receiving placebo (mean decrease in VPT of 0.05 (0.35) microm) (p=0.04). Neither comfortable nor maximum walking speed altered significantly following 4-AP treatment. CONCLUSIONS: No statistically significant, functional benefit from 4-AP was found for patients in the present study. Furthermore, no support was found for the possibility that an a priory selection of responsive patients would have yielded more favourable results.

4-Aminopyridine↗
PubMed2001

Sciatic nerve transection in adult and young rats: abnormal EMG patterns during locomotion.

Transections of peripheral nerves usually lead to serious handicaps. In order to enhance insights into the poor functional recovery, we studied the effects of a unilateral sciatic nerve lesion in adult and young rats. Electromyographic (EMG) patterns of the tibialis anterior (a hindlimb flexor) and the gastrocnemius muscle (a hindlimb extensor) during walking were recorded after transecting the sciatic nerve at adult age and at the 10th postnatal day. After recovery periods lasting up to 21 weeks, EMG patterns in the hindleg muscles during locomotion were highly abnormal, irrespective of the age at lesioning. Electromyographic bursts were markedly irregular and, generally, coactivation of these antagonists was observed during walking. Other evidence has shown that after peripheral nerve transection, nerves randomly reinnervate their target muscles and we conclude that the patterns of muscle activity may be associated with the properties of foreign, as well as genuine, motor nerves. Behaviourally, walking patterns after a transection at adult age are markedly abnormal but, after transection at the 10th day, locomotion is much less disturbed. The finding of a discrepancy between a near normal walking pattern in rats operated on at a young age and severely disturbed EMG activity may be due to subtle readjustments in the force recruitment in the respective muscles, despite a random reinnervation by the sciatic nerve branches. These compensatory readjustments are particularly prominent after transection at an early age.

Age Factors↗
PubMed2001

Prognostic usefulness of the six-minute walk in patients with advanced congestive heart failure secondary to ischemic or nonischemic cardiomyopathy.

Clinicians have relied on history and results from physical examinations to guide treatment of patients with advanced congestive heart failure, but these results may not reflect disease severity or hemodynamic status. We assessed how the distance walked in 6 minutes relates to clinical outcomes and symptoms of such patients. We compared the rates of death, hospitalization, and their composite at 1 year by the distance walked in 6 minutes at baseline and at 1 month, and by the change in distance between baseline and 1 month in 440 patients enrolled in a randomized trial. We also assessed the relations of baseline distance walked to symptom score and New York Heart Association class. The median distance increased from 218 m at baseline to 280 m at 1 month. Of 365 patients able to perform the baseline walk, 121 (33%) died and 217 (60%) were hospitalized compared with 46 (61%) and 34 (45%) of 75 patients unable to walk at baseline. Baseline distance significantly predicted mortality (hazard ratio 0.58/100-m increase, 95% confidence interval 0.50 to 0.68, p <0.001), even after adjustment. Baseline distance also significantly predicted hospitalization and the composite end point, as did the 1-month distance walked. The change in distance walked from baseline to 1 month did not predict any end point. Baseline distance correlated only moderately with symptom score (r = -0.385, p <0.001) and New York Heart Association class (r = -0.468, p <0.001). Distance walked during 6 minutes independently and strongly predicts mortality and hospitalization in patients with advanced congestive heart failure. This may be a simple, noninvasive, objective way to risk-stratify these patients and standardize their treatment.

Aged↗
PubMed1993

A follow-up study on the effects of training on the fitness and habitual activity patterns of 60- to 70-year-old women.

This study investigated the aerobic fitness, body composition, spirometric variables, Human Activity Profile, and level of adherence to physical activity subsequent to completion of a progressive walking program of six month's duration (T1). Sixty-six women previously randomized to training (TG) and control (CG) groups were reassessed six months after finishing the six month walking program (T2). During the follow-up period, 77.8% of the TG subjects continued with exercise and maintained lower (p < 0.005) exercise heart rates compared to the CG. A Mann-Whitney U test on the difference scores (T2-T1) revealed no difference (p > 0.05) between the TG and CG for changes in Maximum Current Activity and Normative Impairment Index, which are both components of the Human Activity Profile, with the earlier increases (p < 0.05) in these parameters by the TG having been maintained. Participation in a previous low frequency training regimen therefore resulted in elderly women adopting and sustaining a higher level of habitual physical activity. This is important because a favorable modification of lifestyle factors is likely to be indicative of an enhanced outlook for independence.

Aged↗
PubMed2001

Improved efficiency with a wheelchair propelled by the legs using voluntary activity or electric stimulation.

OBJECTIVE: To determine whether a new leg-propelled wheelchair provides enhanced efficiency and mobility to wheelchair users. DESIGN: Observational; subjects were tested while wheeling with the arms and legs and while walking (where possible) for 4-minute periods in random order with approximately 10-minute rest periods between exercise sets. SETTING: Tests were done on an indoor 200-meter track. PATIENTS: Group 1, 13 controls; group 2, 9 persons with complete spinal cord injury (SCI); group 3, 13 persons with other motor disorders (retaining some voluntary control of the legs). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Physiological Cost Index (PCI), (computed as change in heart rate divided by velocity of movement) and oxygen consumption (VO(2)) RESULTS: Arm wheeling took significantly more effort (mean PCI =.52 beats/m) than walking (.33 beats/m) in control subjects. Leg wheeling was most efficient (.23), requiring less than half the effort of arm wheeling and 30% less effort than walking. For SCI subjects, leg wheeling with functional electric stimulation (FES) required less than half the effort (.18) of arm wheeling (.40). The FES group could not walk. Subjects in group 3 could walk, but with substantial effort (1.81) compared with arm (.76) or leg wheeling (.64). Results for VO(2) were similar. CONCLUSIONS: Better wheelchair efficiency can be obtained for many disabled individuals, by moving the leg muscles voluntarily or with FES.

Adult↗
PubMed1994

Long-term evaluation of treatment for chronic heart failure: a 1 year comparative trial of flosequinan and captopril.

Two hundred and nine patients with moderate to severe chronic heart failure, all of whom remained symptomatic despite at least 80 mg of frusemide daily, were randomized to 12 months treatment with flosequinan or captopril. The patients were stratified into two groups, a treadmill group and a corridor walk test group, depending upon their exercise capability. Sixty-five out of 102 patients randomized to flosequinan and 43 out of 107 randomized to captopril (p < 0.001) did not complete the study. There was no difference between the groups in mortality: 19 patients died while taking flosequinan and 15 while taking captopril. Both drugs had similar effects on treadmill exercise tolerance; the mean increase at week 52 was 117 seconds in the flosequinan group and 156 seconds (p = 0.57) for the captopril group. For those patients stratified to the corridor walk test only, there was also very little difference in the improvement at 52 weeks; the mean increase for patients randomized to flosequinan was 61 meters and captopril was 75 meters (p = 0.65). However, when the walk tests from all patients are examined, captopril produced a significant improvement compared with flosequinan at week 52 (p = 0.015). Flosequinan has similar long-term efficacy to captopril but is associated with a higher incidence of adverse events.

Blood Pressure↗
PubMed2003

Prevention of venous thromboembolism in medical patients with enoxaparin: a subgroup analysis of the MEDENOX study.

The Medical Patients with Enoxaparin (MEDENOX) trial was a randomized, placebo-controlled study that defined the risk of venous thromboembolism (VTE) in acutely ill, immobilized, general medical patients and the efficacy of the low-molecular-weight heparin, enoxaparin, in preventing thrombosis. We performed a post-hoc analysis to evaluate the effect of 40 mg enoxaparin once daily on MEDENOX patient outcome in different types of acute medical illness (heart failure, respiratory failure, infection, rheumatic disorder and inflammatory bowel disease) and pre-defined risk factors (chronic heart and chronic respiratory failure, age, immobility, previous VTE and cancer). The primary outcome was the occurrence of documented VTE between days 1 and 14. The relative risk reduction [95% confidence intervals (CI)] for VTE comparing 40 mg enoxaparin with placebo in the subgroups were: acute heart failure, 0.29 (95% CI, 0.10-0.84); acute respiratory failure, 0.25 (95% CI, 0.10-0.65); acute infectious disease, 0.28 (95% CI, 0.09-0.81); and acute rheumatic disorder, 0.48 (95% CI, 0.11-2.16). The relative risk reduction for VTE in the pre-defined risk factor subgroups were: chronic heart failure, 0.26 (95% CI, 0.08-0.92); chronic respiratory failure, 0.26 (95% CI, 0.10-0.68); age, 0.22 (95% CI, 0.09-0.51); immobility, 0.53 (95% CI, 0.14-1.72); previous VTE, 0.49 (95% CI, 0.15-1.68); and cancer, 0.50 (95%o CI, 0.14-1.72). The beneficial effects of enoxaparin extend to a wide range of acutely ill medical patients.

Aged↗
PubMedDate not supplied

Randomized, controlled, six-month trial of yoga in healthy seniors: effects on cognition and quality of life.

CONTEXT: There are potential benefits of mind-body techniques on cognitive function because the techniques involve an active attentional or mindfulness component, but this has not been fully explored. OBJECTIVE: To determine the effect of yoga on cognitive function, fatigue, mood, and quality of life in seniors. DESIGN: Randomized, controlled trial comparing yoga, exercise, and wait-list control groups. PARTICIPANTS: One hundred thirty-five generally healthy men and women aged 65-85 years. INTERVENTION: Participants were randomized to 6 months of Hatha yoga class, walking exercise class, or wait-list control. Subjects assigned to classes also were asked to practice at home. MAIN OUTCOME MEASURES: Outcome assessments performed at baseline and after the 6-month period included a battery of cognitive measures focused on attention and alertness, the primary outcome measures being performance on the Stroop Test and a quantitative electroencephalogram (EEG) measure of alertness; SF-36 health-related quality of life; Profile of Mood States; Multi-Dimensional Fatigue Inventory; and physical measures related to the interventions. RESULTS: One hundred thirty-five subjects were recruited and randomized. Seventeen subjects did not finish the 6-month intervention. There were no effects from either of the active interventions on any of the cognitive and alertness outcome measures. The yoga intervention produced improvements in physical measures (eg, timed 1-legged standing, forward flexibility) as well as a number of quality-of-life measures related to sense of well-being and energy and fatigue compared to controls. CONCLUSIONS: There were no relative improvements of cognitive function among healthy seniors in the yoga or exercise group compared to the wait-list control group. Those in the yoga group showed significant improvement in quality-of-life and physical measures compared to exercise and wait-list control groups.

Aged↗