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Sadowsky CL. Targeting Sarcopenia as an Objective Clinical Outcome in the Care of Children with Spinal Cord-Related Paralysis: A Clinician's View. CHILDREN (BASEL, SWITZERLAND) 2023; 10:837. [PMID: 37238385 PMCID: PMC10217275 DOI: 10.3390/children10050837] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 04/27/2023] [Accepted: 04/29/2023] [Indexed: 05/28/2023]
Abstract
Muscle loss is consistently associated with immobility and paralysis and triggers significant metabolic and functional changes. The negative effects of sarcopenia are amplified in children who are in the process of building their muscle mass as part of development. Because muscle mass loss is consistently associated with increased morbidity and mortality throughout life, optimizing the size and health of muscles following a neurologic injury is an objective target for therapeutic interventions. This review hypothesizes that muscle mass correlates with functional outcomes in children with paralysis related to spinal cord-related neurologic deficits. We propose that the measurement of muscle mass in this population can be used as an objective outcome for clinical long-term care. Finally, some practical clinical approaches to improving muscle mass are presented.
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Affiliation(s)
- Cristina L. Sadowsky
- International Center for Spinal Cord Injury, Kennedy Krieger Institute, Baltimore, MD 21205, USA;
- Department of Physical Medicine and Rehabilitation, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
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Varahra A, Ahmed H, Lindsay S. Exploring Direct and Indirect Associations of Exercise and Sport Participation with Employment among Individuals with Disabilities: A Scoping Review. JOURNAL OF OCCUPATIONAL REHABILITATION 2022; 32:44-54. [PMID: 33956265 DOI: 10.1007/s10926-021-09962-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/13/2021] [Indexed: 06/12/2023]
Abstract
Purpose Exercise and sports have many positive benefits for persons with or without a disability. Despite this, the contribution of exercise and sport participation to employment is less documented. The purpose of this scoping review was to provide insight into the direct and indirect associations of exercise and sport participation with employment among persons with disabilities. Methods Six databases were searched (MEDLINE, Embase, Scopus, PsychINFO, CINAHL, and HealthStar) from their inception date to March 20, 2020. Peer-reviewed English and French articles were included if at least one outcome measure on employment or work-related outcomes as a result of participation in, or benefits of exercise and sport participation was the focus of the study. Results The research identified 2796 hits. Of which, 23 published between 1992 and 2019 met eligibility criteria. Seven studies identified a direct association between exercise and sport participation with employment and full-time positions. Sixteen studies reported on improved health/work-related outcomes such as occupational performance (i.e., self-care, functional independence), physical fitness (i.e., upper extremity strength, endurance) and psychological well-being (i.e., self-efficacy). Conclusions This scoping review highlights that exercise and sport participation have associations with employment and work-related outcomes. Benefits of exercise and sports may be considered to a greater extent, than in the past, in programs that facilitate employment for persons with disabilities. Additional research using longitudinal design should be conducted to further understand the strength of these associations and evaluate whether exercise and sport participation should be incorporated more intensely in vocational programs.
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Affiliation(s)
- Azar Varahra
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada.
| | - Hiba Ahmed
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | - Sally Lindsay
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
- Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, Canada
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Comparison of the functional and cardiovascular effects of home-based versus supervised hospital circuit training exercises in male wheelchair users with chronic paraplegia. Turk J Phys Med Rehabil 2021; 67:275-282. [PMID: 34870113 PMCID: PMC8606995 DOI: 10.5606/tftrd.2021.6533] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 12/14/2020] [Indexed: 12/03/2022] Open
Abstract
Objectives
The aim of this study was to compare the efficacy of home-based upper extremity circuit training exercises (CTEs) with supervised hospital program in male patients with traumatic complete paraplegia.
Patients and methods
Twenty men with paraplegia (mean age: 38±10.1 years; range, 30 to 43 years) between January 2007 and November 2007 were randomized into two groups. The first group had supervised hospital CTE program, whereas the second group had home-based CTE. The effects of the upper extremity CTE by using elastic bands 60 min per day, five days a week, for a total of eight weeks (70% maximal oxygen consumption [VO2max]) were examined. The Cybex was used for the isokinetic testing of the upper extremities. The VO2max and maximum heart rate (HR) were assessed using an arm ergometer. The Craig Handicap Report Technique Short Form (CHART-SF) was used for the evaluation of functional independence and mobility. Serum lipid profiles were measured.
Results
The mean injury duration was 7.9±2 years. The peak torque values of the upper extremities, VO2max, maximum HR, CHART-SF physical independence and mobility scores, and serum lipid profile were all improved in both groups (p<0.05). There were no significant differences in terms of the increase in the muscle strength and serum lipid levels between the groups (p>0.05). The improvement in the VO2max, physical independence, and mobility scores were greater in the supervised exercise group.
Conclusion
Upper extremity strength, cardiovascular endurance, and lipid profile were improved after supervised and home-based CTE in the men with paraplegia. Home-based exercise programs may be good alternatives to the hospital rehabilitation for this patient population.
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Matizanadzo JT, Paudyal P. The delivery of obesity interventions to children and adolescents with physical disabilities: a systematic review. J Public Health (Oxf) 2021; 44:685-693. [PMID: 33864087 DOI: 10.1093/pubmed/fdab096] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 02/18/2021] [Accepted: 03/09/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND To examine the process and mechanisms of delivering obesity interventions to physically disabled children/adolescents. METHODS PubMed, Medline, CINAHL Plus, Embase, Cochrane Library, Google Scholar, ClinicalTrials.gov, Science Direct were systematically and manually searched for studies conducted in physically disabled children/adolescents (0-18 years). Included interventions were physical activity, diet and obesity prevention education. Included outcomes were body mass index (BMI)/weight and obesity prevention knowledge. The Mixed Methods Appraisal Tool aided methodological quality assessments. Data were extracted and delivery models were synthesized and narratively summarized using the social ecological model. RESULTS Seven studies of low (n = 4) and moderate (n = 3) scoring on methodological quality were eligible for inclusion. Study duration was 5 months or less (n = 5), 8 months (n = 1) and 2 years (n = 1). Interventions were delivered at home, school, hospital and rehabilitation centre through the internet, face-to-face and parents. No intervention was delivered at three or more levels of individual, interpersonal, institutional or community levels. No study reported significant outcomes on reduction in BMI/weight, or increase in obesity prevention knowledge. CONCLUSIONS Evidence reviewed in this study shows that obesity interventions for physically disabled children/adolescents lack both in delivery and design. Gaps revealed should be considered when developing interventions for this special population.
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Affiliation(s)
- Joshua T Matizanadzo
- Brighton and Sussex Medical School, Division of Medical Education, Department of Public Health and Primary Care, Watson Building, University of Brighton, Falmer, Brighton, East Sussex, BN1 9PH, UK
| | - Priyamvada Paudyal
- Brighton and Sussex Medical School, Division of Medical Education, Department of Public Health and Primary Care, Watson Building, University of Brighton, Falmer, Brighton, East Sussex, BN1 9PH, UK
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Liu S, Wang Y, Niebauer J. Effect of Exercise on Cardiovascular Function Following Spinal Cord Injury: A REVIEW. J Cardiopulm Rehabil Prev 2021; 41:13-18. [PMID: 32796491 DOI: 10.1097/hcr.0000000000000534] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Spinal cord injury (SCI) is associated with a reduced level of physical activity, deterioration of patient body composition, metabolic profile, quality of life, and psychological functioning. As a result, risk of cardiovascular disease (CVD) increases and CVD-related death occurs at an earlier age than in individuals without SCI. Regular participation in exercise has been shown to exert beneficial effects also in patients with SCI. In this review, we analyze and discuss the effects of regular exercise training in SCI on cardiovascular function, autonomic function of the cardiovascular system, arterial stiffness, metabolism, inflammation, and gene expression.
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Affiliation(s)
- Shujia Liu
- Departments of Spine and Spinal Cord Surgery (Dr Liu) and Clinical Laboratory (Dr Wang), Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing, China; Faculty of Rehabilitation Medicine, Capital Medical University, Beijing, China (Drs Liu and Wang); Research Institute of Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University, and Institute of Sports Medicine, Prevention and Rehabilitation, University Hospital Salzburg, Salzburg, Austria (Dr Niebauer)
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Washburn RA, Ptomey LT, Gorczyca AM, Smith PR, Mayo MS, Lee R, Donnelly JE. Weight management for adults with mobility related disabilities: Rationale and design for an 18-month randomized trial. Contemp Clin Trials 2020; 96:106098. [PMID: 32768682 DOI: 10.1016/j.cct.2020.106098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 07/10/2020] [Accepted: 07/27/2020] [Indexed: 10/23/2022]
Abstract
Adults with mobility related disabilities (MRDs) represent an underserved group with a high prevalence of overweight/obesity and limited options for weight management. We previously demonstrated clinically meaningful 12-month weight loss in adults with MRDs (-6.2%, 36% ≥5% of baseline weight) using an enhanced Stop Light Diet (eSLD) delivered using at home face-to-face behavioral sessions and optional physical activity. However, the costs/logistics associated with intervention delivery by individual home visits limits the potential for scaling and implementation of this approach. Thus, we will conduct a two-arm randomized trial in 128 overweight/obese adults with MRDs to compare weight loss (6 mos.) and maintenance (12 mos.) between interventions utilizing the eSLD, behavioral counseling, and increased physical activity delivered to individual participants in their homes or delivered to groups of participants in their homes remotely via video conferencing. The primary aim will compare weight loss between interventions arms across 6 months. Secondarily, we will compare weight loss (0-18 mos.), the proportion of participants who achieve clinically meaningful weight loss (≥5%) from 0 to 6 and 0 to18 months, and changes in quality of life from 0 to 6 and 0 to 18 months between interventions arms. We will also conduct cost, cost-effectiveness and contingent valuation comparisons and explore the influence of behavioral session attendance, compliance with the recommendations for diet and physical activity, self-monitoring of diet and physical activity, barriers to physical activity, sleep quality, and medications on weight change across 6 and 18 months. NCT REGISTRATION: NCT04046471.
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Affiliation(s)
- Richard A Washburn
- Department of Internal Medicine, The University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS 66160, USA.
| | - Lauren T Ptomey
- Department of Internal Medicine, The University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS 66160, USA.
| | - Anna M Gorczyca
- Department of Internal Medicine, The University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS 66160, USA.
| | - Patricia R Smith
- Department of Internal Medicine, The University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS 66160, USA.
| | - Matthew S Mayo
- Department of Biostatistics and Data Science, The University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS 66160, USA.
| | - Robert Lee
- Department of Population Health, The University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS 66160, USA.
| | - Joseph E Donnelly
- Department of Internal Medicine, The University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS 66160, USA.
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McPherson AC, Chen L, O'Neil J, Vanderbom KA. Nutrition, metabolic syndrome, and obesity: Guidelines for the care of people with spina bifida. J Pediatr Rehabil Med 2020; 13:637-653. [PMID: 33325412 PMCID: PMC7838992 DOI: 10.3233/prm-200753] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Nutritional challenges and a lack of activity can lead to health problems across the lifespan for people with spina bifida. Children and adults with spina bifida are also at greater risk of being classified as overweight or obese compared to their peers without the condition. Therefore, early recognition of nutrition problems, weight management counseling, and timely referrals for evaluation and management of diet and activity can help those with spina bifida and their families achieve a healthy lifestyle. This article details the development of the Nutrition, Metabolic Syndrome and Obesity Guidelines, which are part of the 2018 Spina Bifida Association's Fourth Edition of the Guidelines for the Care of People with Spina Bifida. It discusses the identification and management of poor nutrition and prevention of obesity for children, adolescents, and adults with spina bifida and highlights areas requiring further research.
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Affiliation(s)
- Amy C McPherson
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
| | - Lorry Chen
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | - Joseph O'Neil
- Indiana University School of Medicine, Riley Hospital for Children Indiana University Health, Indianapolis, IN, USA
| | - Kerri A Vanderbom
- National Center on Health, Physical Activity and Disability, University of Alabama at Birmingham/Lakeshore Research Collaborative, Birmingham, AL, USA
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McIntyre A, Marrocco SL, McRae SA, Sleeth L, Hitzig S, Jaglal S, Linassi G, Munce S, Wolfe DL. A Scoping Review of Self-Management Interventions Following Spinal Cord Injury. Top Spinal Cord Inj Rehabil 2020; 26:36-63. [PMID: 32095066 PMCID: PMC7015175 DOI: 10.1310/sci2601-36] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Objective: To conduct a scoping review to identify what components of self-management are embedded in self-management interventions for spinal cord injury (SCI). Methods: In accordance with the approach and stages outlined by Arksey and O'Malley (2005), a comprehensive literature search was conducted using five databases. Study characteristics were extracted from included articles, and intervention descriptions were coded using Practical Reviews in Self-Management Support (PRISMS) (Pearce et al, 2016), Barlow et al (2002), and Lorig and Holman's (2003) taxonomy. Results: A total of 112 studies were included representing 102 unique self-management programs. The majority of the programs took an individual approach (52.0%) as opposed to a group (27.4%) or mixed approach (17.6%). While most of the programs covered general information, some provided specific symptom management. Peers were the most common tutor delivering the program material. The most common Barlow components included symptom management (n = 44; 43.1%), information about condition/treatment (n = 34; 33.3%), and coping (n = 33; 32.4%). The most common PRISMS components were information about condition and management (n = 85; 83.3%), training/rehearsal for psychological strategies (n = 52; 51.0%), and lifestyle advice and support (n = 52; 51.0%). The most common Lorig components were taking action (n = 62; 60.8%), resource utilization (n = 57; 55.9%), and self-tailoring (n = 55; 53.9%). Conclusion: Applying self-management concepts to complex conditions such as SCI is only in the earliest stages of development. Despite having studied the topic from a broad perspective, this review reflects an ongoing program of research that links to an initiative to continue refining and testing self-management interventions in SCI.
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Affiliation(s)
- Amanda McIntyre
- Lawson Health Research Institute, Parkwood Institute, Ontario, Canada
| | | | | | - Lindsay Sleeth
- Lawson Health Research Institute, Parkwood Institute, Ontario, Canada
| | - Sander Hitzig
- St. John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Ontario, Canada
- Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of Toronto, Ontario, Canada
- Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Susan Jaglal
- Department of Physical Therapy, University of Toronto, Ontario, Canada
- Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Ontario, Canada
| | - Gary Linassi
- Department of Physical Medicine and Rehabilitation, College of Medicine, University of Saskatchewan, Saskatchewan, Canada
| | - Sarah Munce
- Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Ontario, Canada
- Department of Occupational Science and Occupational Therapy, University of Toronto
| | - Dalton L. Wolfe
- Lawson Health Research Institute, Parkwood Institute, Ontario, Canada
- Health Sciences, Western University, Ontario, Canada
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Holm NJ, Møller T, Adamsen L, Dalsgaard LT, Biering-Sorensen F, Schou LH. Health promotion and cardiovascular risk reduction in people with spinal cord injury: physical activity, healthy diet and maintenance after discharge- protocol for a prospective national cohort study and a preintervention- postintervention study. BMJ Open 2019; 9:e030310. [PMID: 31892644 PMCID: PMC6955524 DOI: 10.1136/bmjopen-2019-030310] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 10/24/2019] [Accepted: 11/05/2019] [Indexed: 12/22/2022] Open
Abstract
INTRODUCTION Spinal cord injury (SCI) predisposes those who suffer from it to physical inactivity and weight gain; consequently, death due to cardiovascular diseases is more frequent among people with SCI than in the general population. The literature documents a consensus about an interdisciplinary multimodal approach for the prevention and treatment of cardiovascular risk factors including overweight and obesity in people with SCI, focusing on diet, physical activity (PA) and behavioural interventions. This study will investigate implementation of recommendations from a recent clinical practice guideline for identification and management of cardiometabolic risk after SCI through multimodal patient education in a subacute clinical setting. METHODS AND ANALYSIS All patients who are aged 18 years or older with an SCI within the previous 12 months and admitted to highly specialised rehabilitation are included, regardless of SCI aetiology or neurological level. A primary study designed as a controlled, pragmatic, preintervention- postintervention study with 6-month follow-up evaluates the effect of the clinical intervention; a prospective national cohort study on body mass index (BMI) serves as a historical control. The intervention consists of a standardised approach to patient education about cardiovascular risk factors, PA and a healthy diet that begins at the outset of primary SCI rehabilitation and is integrated into existing settings and workflows. Outcome measures are collected at admission, discharge and 6 months after discharge and include peak oxygen uptake (VO2peak) (primary outcome), BMI, body composition, metabolic profile, neurological status, level of functioning, depression, quality of life, objective PA (accelerometry), self-reported PA, self-assessed PA ability, shared decision making, and dietary habits. Test-retest reliability of four VO2peak test protocols are investigated, as is test-retest reliability of a multisensor accelerometer in a rehabilitation setting. ETHICS AND DISSEMINATION The project is approved by the Committees on Health Research Ethics in the Capital Region of Denmark on 10 July 2018 (Journal-nr.: H-18018325). The principal investigator obtains informed consent from all participants. The interventions in the project are closely related to existing rehabilitation care, and the risk of pain and discomfort is considered modest. Any unintended events related to the elements of the intervention are reported, according to existing regional procedures. Data are stored in a secure web-based database (Redcap). The primary study and prospective cohort study are registered at Clinicaltrials.gov. Positive and negative results will be submitted to relevant scientific journals related to SCI for publication. Important protocol modifications are reported to the Committees on Health Research Ethics in the Capital Region of Denmark. TRIAL REGISTRATION NUMBERS NCT03689023 and NCT03369080.
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Affiliation(s)
- Nicolaj Jersild Holm
- Neuroscience Center, Clinic for Spinal Cord Injuries, Rigshospitalet, Hornbæk, Denmark
| | - Tom Møller
- Department 9701, The University Hospitals Centre for Health Research, UCSF Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Lis Adamsen
- Department 9701, The University Hospitals Centre for Health Research, UCSF Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Line Trine Dalsgaard
- Neuroscience Center, Clinic for Spinal Cord Injuries, Rigshospitalet, Hornbæk, Denmark
| | - Fin Biering-Sorensen
- Neuroscience Center, Clinic for Spinal Cord Injuries, Rigshospitalet, Hornbæk, Denmark
| | - Lone Helle Schou
- Department of Nursing and Nutrition, University College Copenhagen, Copenhagen, Denmark
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Crytzer TM, Keramati M, Anthony SJ, Cheng YT, Robertson RJ, Dicianno BE. Exercise Prescription Using a Group-Normalized Rating of Perceived Exertion in Adolescents and Adults With Spina Bifida. PM R 2018; 10:738-747. [PMID: 29408563 DOI: 10.1016/j.pmrj.2018.01.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2017] [Revised: 01/12/2018] [Accepted: 01/20/2018] [Indexed: 11/18/2022]
Abstract
BACKGROUND People with spina bifida (SB) face personal and environmental barriers to exercise that contribute to physical inactivity, obesity, risk of cardiovascular disease, and poor aerobic fitness. The WHEEL rating of perceived exertion (RPE) Scale was validated in people with SB to monitor exercise intensity. However, the psycho-physiological link between RPE and ventilatory breakpoint (Vpt), the group-normalized perceptual response, has not been determined and would provide a starting point for aerobic exercise in this cohort. OBJECTIVES The primary objectives were to determine the group-normalized RPE equivalent to Vpt based on WHEEL and Borg Scale ratings and to develop a regression model to predict Borg Scale (conditional metric) from WHEEL Scale (criterion metric). The secondary objective was to create a table of interchangeable values between WHEEL and Borg Scale RPE for people with SB performing a load incremental stress test. DESIGN Cross-sectional observational. SETTING University laboratory. PARTICIPANTS Twenty-nine participants with SB. METHODS Participants completed a load incremented arm ergometer exercise stress test. WHEEL and Borg Scale ratings were recorded the last 15 seconds of each 1-minute test phase. OUTCOME MEASURES WHEEL and Borg Scale ratings, metabolic measures (eg, oxygen consumption, carbon dioxide production). Determined Vpt via plots of oxygen consumption and carbon dioxide production against time. RESULTS Nineteen of 29 participants achieved Vpt (Group A). The mean ± standard deviation peak oxygen consumption at Vpt for Group A was 61.76 ± 16.26. The WHEEL and Borg Scale RPE at Vpt were 5.74 ± 2.58 (range 0-10) and 13.95 ± 3.50 (range 6-19), respectively. A significant linear regression model was developed (Borg Scale rating = 1.22 × WHEEL Scale rating + 7.14) and used to create a WHEEL-to-Borg Scale RPE conversion table. CONCLUSION A significant linear regression model and table of interchangeable values was developed for participants with SB. The group-normalized RPE (WHEEL, 5.74; Borg, 13.95) can be used to prescribe and self-regulate arm ergometer exercise intensity approximating the Vpt. LEVEL OF EVIDENCE III.
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Affiliation(s)
- Theresa M Crytzer
- Human Engineering Research Laboratories, Veterans Affairs Pittsburgh Healthcare System; and Department of Rehabilitation Science and Technology, School of Health and Rehabilitation Sciences, University of Pittsburgh, Bakery Square, 6425 Penn Avenue, Suite 400, Pittsburgh, PA 15206
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh, School of Medicine, Pittsburgh, PA
- Endocrine and Metabolism Laboratory, School of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA
- Department of Rehabilitation Science and Technology, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA
- Center for Exercise and Health-Fitness Research, School of Education, University of Pittsburgh, Pittsburgh, PA
- Human Engineering Research Laboratories, Veterans Affairs Pittsburgh Healthcare System; Department of Rehabilitation Science and Technology, School of Health and Rehabilitation Sciences, University of Pittsburgh; and Department of Physical Medicine and Rehabilitation School of Medicine, University of Pittsburgh, Pittsburgh, PA
| | - Mariam Keramati
- Human Engineering Research Laboratories, Veterans Affairs Pittsburgh Healthcare System; and Department of Rehabilitation Science and Technology, School of Health and Rehabilitation Sciences, University of Pittsburgh, Bakery Square, 6425 Penn Avenue, Suite 400, Pittsburgh, PA 15206
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh, School of Medicine, Pittsburgh, PA
- Endocrine and Metabolism Laboratory, School of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA
- Department of Rehabilitation Science and Technology, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA
- Center for Exercise and Health-Fitness Research, School of Education, University of Pittsburgh, Pittsburgh, PA
- Human Engineering Research Laboratories, Veterans Affairs Pittsburgh Healthcare System; Department of Rehabilitation Science and Technology, School of Health and Rehabilitation Sciences, University of Pittsburgh; and Department of Physical Medicine and Rehabilitation School of Medicine, University of Pittsburgh, Pittsburgh, PA
| | - Steven J Anthony
- Human Engineering Research Laboratories, Veterans Affairs Pittsburgh Healthcare System; and Department of Rehabilitation Science and Technology, School of Health and Rehabilitation Sciences, University of Pittsburgh, Bakery Square, 6425 Penn Avenue, Suite 400, Pittsburgh, PA 15206
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh, School of Medicine, Pittsburgh, PA
- Endocrine and Metabolism Laboratory, School of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA
- Department of Rehabilitation Science and Technology, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA
- Center for Exercise and Health-Fitness Research, School of Education, University of Pittsburgh, Pittsburgh, PA
- Human Engineering Research Laboratories, Veterans Affairs Pittsburgh Healthcare System; Department of Rehabilitation Science and Technology, School of Health and Rehabilitation Sciences, University of Pittsburgh; and Department of Physical Medicine and Rehabilitation School of Medicine, University of Pittsburgh, Pittsburgh, PA
| | - Yu-Ting Cheng
- Human Engineering Research Laboratories, Veterans Affairs Pittsburgh Healthcare System; and Department of Rehabilitation Science and Technology, School of Health and Rehabilitation Sciences, University of Pittsburgh, Bakery Square, 6425 Penn Avenue, Suite 400, Pittsburgh, PA 15206
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh, School of Medicine, Pittsburgh, PA
- Endocrine and Metabolism Laboratory, School of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA
- Department of Rehabilitation Science and Technology, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA
- Center for Exercise and Health-Fitness Research, School of Education, University of Pittsburgh, Pittsburgh, PA
- Human Engineering Research Laboratories, Veterans Affairs Pittsburgh Healthcare System; Department of Rehabilitation Science and Technology, School of Health and Rehabilitation Sciences, University of Pittsburgh; and Department of Physical Medicine and Rehabilitation School of Medicine, University of Pittsburgh, Pittsburgh, PA
| | - Robert J Robertson
- Human Engineering Research Laboratories, Veterans Affairs Pittsburgh Healthcare System; and Department of Rehabilitation Science and Technology, School of Health and Rehabilitation Sciences, University of Pittsburgh, Bakery Square, 6425 Penn Avenue, Suite 400, Pittsburgh, PA 15206
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh, School of Medicine, Pittsburgh, PA
- Endocrine and Metabolism Laboratory, School of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA
- Department of Rehabilitation Science and Technology, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA
- Center for Exercise and Health-Fitness Research, School of Education, University of Pittsburgh, Pittsburgh, PA
- Human Engineering Research Laboratories, Veterans Affairs Pittsburgh Healthcare System; Department of Rehabilitation Science and Technology, School of Health and Rehabilitation Sciences, University of Pittsburgh; and Department of Physical Medicine and Rehabilitation School of Medicine, University of Pittsburgh, Pittsburgh, PA
| | - Brad E Dicianno
- Human Engineering Research Laboratories, Veterans Affairs Pittsburgh Healthcare System; and Department of Rehabilitation Science and Technology, School of Health and Rehabilitation Sciences, University of Pittsburgh, Bakery Square, 6425 Penn Avenue, Suite 400, Pittsburgh, PA 15206
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh, School of Medicine, Pittsburgh, PA
- Endocrine and Metabolism Laboratory, School of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA
- Department of Rehabilitation Science and Technology, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA
- Center for Exercise and Health-Fitness Research, School of Education, University of Pittsburgh, Pittsburgh, PA
- Human Engineering Research Laboratories, Veterans Affairs Pittsburgh Healthcare System; Department of Rehabilitation Science and Technology, School of Health and Rehabilitation Sciences, University of Pittsburgh; and Department of Physical Medicine and Rehabilitation School of Medicine, University of Pittsburgh, Pittsburgh, PA
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Determinants of health knowledge and health perceptions from the perspective of health-related education of patients with spinal cord injury: a systematic review. Int J Rehabil Res 2018; 40:97-106. [PMID: 28106617 DOI: 10.1097/mrr.0000000000000215] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Appropriate health knowledge (HK) and health perceptions (HP) of patients with spinal cord injury (SCI) are linked to health-related behaviors, compliance, the involvement of caregivers and efficacy of prophylaxis, and management of secondary conditions. The significance of factors determining the efficacy of educational interventions in patients with SCI is underestimated. This systematic literature review aims at identification of determinants of HK and HP among patients with SCI. We identified 16 papers with quantitative HK and HP measurements conclusive in the identification of HK and HP determinants in individuals with SCI. Better HK and HP correlated with health condition-related variables (traumatic SCI, history of secondary conditions, except depression), body functions and structures (tetraplegia, incomplete deficit), activities (independence in daily living activities, ability of locomotion on a wheelchair, inability to walk), social and vocational participation, environmental factors (access to a computer with Internet connection, living in a big city, being married, healthcare recently received), and personal factors (younger age among adults, living with SCI for a longer time, younger age at SCI onset, higher educational level, internal locus of control). Limitations encountered included high nonresponse rates among the patients enrolled, and use of heterogeneous and nonvalidated tools. The results of these studies do not cover the entire scope of possible interactions and exclusively apply univariate correlations. The paucity and methodological limitations of studies conclusive in the identification of HK and HP determinants in SCI patients and the development of new approaches to information and education warrant more high-quality research on the basis of multivariate analyses.
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Sabour H, Javidan AN, Soltani Z, Pakpour AH, Yekaninejad MS, Mousavifar SA. The effect of behavioral intervention and nutrition education program on serum lipid profile, body weight and blood pressure in Iranian individuals with spinal cord injury: A randomized clinical trial. J Spinal Cord Med 2018; 41:28-35. [PMID: 27560256 PMCID: PMC5810803 DOI: 10.1080/10790268.2016.1209890] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
OBJECTIVE The efficacy of nutrition education on body weight and serum lipids has not yet been described in patients with spinal cord injury (SCI). In the present study, we examined the effect of a 7-month nutrition education program on lipid profile and body weight in individuals with SCI. DESIGN Randomized clinical trial. SETTING A tertiary rehabilitation center. PARTICIPANTS Patients with SCI who were referred to Brain and Spinal Cord Injury Research Center. INTERVENTION The nutrition education program consisted of 5 education sessions during a period of 7 months. OUTCOME MEASURES Body weight and serum concentrations of total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) were measure at the beginning of the trial and after 7 months. Two-way repeated measure analysis of variance (ANOVA) was used. RESULTS Total of 57 patients (27 in control group and 30 in education group) participated. Nutrition education program showed no significant effect on the levels of TC, TG, LDL-C and HDL-C (P: 0.224, 0.172, 0.107 and 0.081, respectively). No significant changes in weight and waist circumflex have been observed as well (P: 0.970 and 0.361, respectively). CONCLUSION Our findings do not support a significant influence of nutrition education program on weight and lipid profile. It seems that the nutrition education program alone is not adequately effective to have beneficial influence on weight and lipid profile. Clinical trial registration No.: IRCT201406215968N3.
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Affiliation(s)
- Hadis Sabour
- Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran,Correspondence to: Hadis Sabour, Brain and Spinal Cord Injury Research Center, Imam Khomeini Hospital, Po. Box: 6114185, Gharib Street, Keshavarz Boulevard, Tehran, Iran.
| | - Abbas Norouzi Javidan
- Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Soltani
- Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir H Pakpour
- Department of Public Health, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Mir Saeed Yekaninejad
- Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyedeh A Mousavifar
- Tehran School of Medical Education, Tehran University of Medical Sciences, Tehran, Iran
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Capelari TV, Borin JS, Grigol M, Saccani R, Zardo F, Cechetti F. EVALUATION OF MUSCLE STRENGTH IN MEDULLAR INJURY: A LITERATURE REVIEW. COLUNA/COLUMNA 2017. [DOI: 10.1590/s1808-185120171604179802] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Objective: To identify the tools used to evaluate muscle strength in subjects with spinal cord injury in both clinical practice and scientific research. Methods: Initially, the literature review was carried out to identify the tools used in scientific research. The search was conducted in the following databases: Virtual Health Library (VHL), Pedro, and PubMed. Studies published between 1990 and 2016 were considered and selected, depicting an evaluation of muscle strength as an endpoint or for characterization of the sample. Next, a survey was carried out with physiotherapists to identify the instruments used for evaluation in clinical practice, and the degree of satisfaction of professionals with respect to them. Results: 495 studies were found; 93 were included for qualitative evaluation. In the studies, we verified the use of manual muscle test with different graduation systems, isokinetic dynamometer, hand-held dynamometer, and manual dynamometer. In clinical practice, the manual muscle test using the motor score recommended by the American Spinal Cord Injury Association was the most used method, despite the limitations highlighted by the physiotherapists interviewed. Conclusion: In scientific research, there is great variation in the methods and tools used to evaluate muscle strength in individuals with spinal cord injury, differently from clinical practice. The tools available and currently used have important limitations, which were highlighted by the professionals interviewed. No instrument depicts direct relationship of muscle strength and functionality of the subject. There is no consensus as to the best method for assessing muscle strength in spinal cord injury, and new instruments are needed that are specific for use in this population.
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Affiliation(s)
| | | | - Melissa Grigol
- Pontifícia Universidade Católica do Rio Grande do Sul, Brazil
| | | | - Franciele Zardo
- Universidade Federal de Ciências da Saúde de Porto Alegre, Brazil
| | - Fernanda Cechetti
- Universidade Federal de Ciências da Saúde de Porto Alegre, Brazil; Universidade Federal de Ciências da Saúde de Porto Alegre, Brazil
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Şimşek TT, Türkücüoğlu B, Tezcan S. Examination of the relationship between body mass index (BMI) and functional independence level in children with spina bifida. Dev Neurorehabil 2015; 18:149-54. [PMID: 23869723 DOI: 10.3109/17518423.2013.796419] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
OBJECTIVE The aim of this study is to examine the relationship between body mass index (BMI) and functional independence level in children with spina bifida (SB). METHODS The study included 116 children between 5 and 18 years. Subjects' socio-demographic characteristics, BMI values and functional independence levels were recorded. RESULTS There was negative correlation between BMI and communication and social cognition in girls (p < 0.05). No correlation was found between BMI and WeeFIM in boys (p > 0.05). CONCLUSION The results indicated that body weight in children with SB affected functional independency and that precautions to control weight important in these children.
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Affiliation(s)
- Tülay Tarsuslu Şimşek
- Dokuz Eylül University, School of Physical Therapy and Rehabilitation , İzmir , Turkey
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Personal and environmental factors to consider when aiming to improve participation in physical activity in children with Spina Bifida: a qualitative study. BMC Neurol 2015; 15:11. [PMID: 25886148 PMCID: PMC4336512 DOI: 10.1186/s12883-015-0265-9] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Accepted: 01/20/2015] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Youth with spina bifida (SB) are less fit and active than other groups with childhood disability. While recent studies have shown benefits of exercise training, the increased fitness levels do not sustain or lead to increased levels of physical activity (PA) in these children. Therefore, it seems important to explore which factors are associated with participation in PA (or lack of) in youth with SB. The objective of this study is to describe both personal and environmental factors that are important for participation in physical activity as experienced by these children and their parents, in order to better develop intervention strategies to improve participation in PA in youth with SB. METHODS Eleven semi-structured interviews with parents of children with SB aged 4-7 years, nine focus groups with youth with SB (n = 33, age 8-18 years) and eight focus groups with their parents (n = 31) were conducted, recorded and transcribed verbatim. Two independent researchers analyzed the data. Central themes for physical activity were constructed, using the model for Physical Activity for Persons with a Disability (PAD model) as a background scheme. RESULTS Data showed that youth with SB encountered both personal and environmental factors associated with participation in PA on all levels of the PAD model. Bowel and bladder care, competence in skills, sufficient fitness, medical events and self-efficacy were important personal factors. Environmental factors that were associated with physical activity included the contact with and support from other people, the use of assistive devices for mobility and care, adequate information regarding possibilities for adapted sports and accessibility of playgrounds and sports facilities. CONCLUSIONS Our findings suggest that a variety of both personal and environmental factors were either positively or negatively associated with participation in PA. An individual approach, assessing possibilities rather than overcoming barriers within and surrounding the child may be a good starting point when setting up intervention programs to improve participation in PA. Therefore, assessment of both personal and environmental factors associated with physical activity should be standard care within multidisciplinary intervention programs aimed to encourage healthy active lifestyles in youth with SB.
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The scope of pediatric physical therapy practice in health promotion and fitness for youth with disabilities. Pediatr Phys Ther 2015; 27:2-15. [PMID: 25521261 DOI: 10.1097/pep.0000000000000098] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE The purpose of this report is to discuss the scope of pediatric physical therapy practice in health promotion and fitness for youth with disabilities. SUMMARY OF KEY POINTS Evidence is provided that supports integration of health promotion and fitness strategies in physical therapy clinical management. Physical therapists' roles in community-based adapted sports and fitness interventions and reimbursement considerations are discussed. CONCLUSIONS Physical therapists are in a unique position to provide expertise in the design and implementation of health promotion and fitness programs for youth with disabilities. These programs are important to promote active, healthy lifestyles and reduce comorbidities associated with sedentary behaviors and unhealthy weight, which are often seen in youth with disabilities. RECOMMENDATIONS FOR CLINICAL PRACTICE Pediatric physical therapists should incorporate health promotion and fitness strategies into practice.
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McPherson AC, Keith R, Swift JA. Obesity prevention for children with physical disabilities: a scoping review of physical activity and nutrition interventions. Disabil Rehabil 2013; 36:1573-87. [DOI: 10.3109/09638288.2013.863391] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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Pellicane AJ, Millis SR, Zimmerman SE, Roth EJ. Calorie and protein intake in acute rehabilitation inpatients with traumatic spinal cord injury versus other diagnoses. Top Spinal Cord Inj Rehabil 2013; 19:229-35. [PMID: 23960707 DOI: 10.1310/sci1903-229] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Obesity and its consequences affect patients with spinal cord injury (SCI). There is a paucity of data with regard to the dietary intake patterns of patients with SCI in the acute inpatient rehabilitation setting. Our hypothesis is that acute rehabilitation inpatients with SCI consume significantly more calories and protein than other inpatient rehabilitation diagnoses. OBJECTIVE To compare calorie and protein intake in patients with new SCI versus other diagnoses (new traumatic brain injury [TBI], new stroke, and Parkinson's disease [PD]) in the acute inpatient rehabilitation setting. METHODS The intake of 78 acute rehabilitation inpatients was recorded by registered dieticians utilizing once-weekly calorie and protein intake calculations. RESULTS Mean ± SD calorie intake (kcal) for the SCI, TBI, stroke, and PD groups was 1,967.9 ± 611.6, 1,546.8 ± 352.3, 1,459.7 ± 443.2, and 1,459.4 ± 434.6, respectively. ANOVA revealed a significant overall group difference, F(3, 74) = 4.74, P = .004. Mean ± SD protein intake (g) for the SCI, TBI, stroke, and PD groups was 71.5 ± 25.0, 61.1 ± 12.8, 57.6 ± 16.6, and 55.1 ± 19.1, respectively. ANOVA did not reveal an overall group difference, F(3, 74) = 2.50, P = .066. CONCLUSIONS Given the diet-related comorbidities and energy balance abnormalities associated with SCI, combined with the intake levels demonstrated in this study, education with regard to appropriate calorie intake in patients with SCI should be given in the acute inpatient rehabilitation setting.
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Affiliation(s)
- Anthony J Pellicane
- Department of Physical Medicine and Rehabilitation at the Rehabilitation Institute of Michigan in the Detroit Medical Center, Wayne State University , Detroit, Michigan
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19
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The association of obesity with cardiovascular events in patients with peripheral artery disease. Atherosclerosis 2013; 228:316-23. [DOI: 10.1016/j.atherosclerosis.2013.03.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2012] [Revised: 03/04/2013] [Accepted: 03/04/2013] [Indexed: 02/03/2023]
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Serra-Añó P, Pellicer-Chenoll M, García-Massó X, Morales J, Giner-Pascual M, González LM. Effects of resistance training on strength, pain and shoulder functionality in paraplegics. Spinal Cord 2012; 50:827-31. [DOI: 10.1038/sc.2012.32] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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McDonald JW, Sadowsky CL, Stampas A. The changing field of rehabilitation: optimizing spontaneous regeneration and functional recovery. HANDBOOK OF CLINICAL NEUROLOGY 2012; 109:317-336. [PMID: 23098722 DOI: 10.1016/b978-0-444-52137-8.00020-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
For neurorehabilitation of patients with spinal cord injury (SCI), the traditional emphasis on social adaptation is being expanded to include strategies that promote plasticity and regeneration in the central nervous system. Such strategies are needed to optimize recovery of neurological function. For example, the known dependence of most cellular processes on physical activity has led to the novel concept that activity is important in neural repair. This hypothesis has given rise to activity-based restoration therapies (ABRT), which aim to optimize neural activity in the damaged spinal cord, particularly below the injury level. Here, we review the basic science and clinical evidence supporting the lifelong use of ABRT for recovery from spinal cord injury. We define and describe ABRT, and discuss its components, its clinical applications, its relationship to medical management of spinal cord injury, and the potential influences of medications on recovery. We also discuss the health benefits of ABRT under physiological and pathological conditions. We stress that lifelong ABRT is required to optimize return of function and to allow patients to benefit from any "cures" that will be discovered.
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Affiliation(s)
- John W McDonald
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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Vogel LC, Betz RR, Mulcahey MJ. Spinal cord injuries in children and adolescents. HANDBOOK OF CLINICAL NEUROLOGY 2012; 109:131-48. [PMID: 23098710 DOI: 10.1016/b978-0-444-52137-8.00008-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
This chapter provides an overview of spinal cord injuries (SCI) in children and adolescents, including epidemiology, medical and musculoskeletal complications, rehabilitation and psychosocial aspects. Males are more commonly affected than females during adolescence; however, as the age at injury decreases, the preponderance of males becomes less marked, and by 3 years of age the number of females with SCIs equals that of males. The neurologic level and degree of completeness varies with age; among children injured prior to 12 years of age approximately two-thirds are paraplegic and approximately two-thirds have complete lesions. Among adolescents, approximately 50% have paraplegia and 55% have complete lesions. Management of pediatric-onset SCI should be family centered and developmentally based, responsive to the dynamic changes that occur during growth and development. Distinctive anatomical and physiological features of children and adolescents, along with growth and development, are responsible for unique manifestations and complications of pediatric SCI. SCI without radiological abnormalities (SCIWORA), birth injuries, lap-belt injuries, upper cervical injuries, and the delayed onset of neurological deficits are relatively unique to pediatric SCI. Children who sustain their SCI before puberty experience a higher incidence of musculoskeletal complications, such as scoliosis and hip dislocation.
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Gélis A, Stéfan A, Colin D, Albert T, Gault D, Goossens D, Perrouin-Verbe B, Fattal C, Pelissier J, Coudeyre E. Therapeutic education in persons with spinal cord injury: A review of the literature. Ann Phys Rehabil Med 2011; 54:189-210. [DOI: 10.1016/j.rehab.2011.03.004] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2010] [Revised: 03/13/2011] [Accepted: 03/17/2011] [Indexed: 11/24/2022]
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Abstract
PURPOSE To summarize and discuss current evidence and understanding of clinical pediatric exercise physiology focusing on the work the research group at Utrecht and others have performed in the last decade in a variety of chronic childhood conditions as a continuation of the legacy of Dr Bar-Or. KEY POINTS The report discusses current research findings on the cardiopulmonary exercise performance of children (and adolescents) with juvenile idiopathic arthritis, osteogenesis imperfecta, achondroplasia, hemophilia, cerebral palsy, spina bifida, cystic fibrosis, and childhood cancer. Exercise recommendations and contraindications are provided for each condition. Implications for clinical practice and future research in this area are discussed for each of the chronic conditions presented. CLINICAL IMPLICATIONS The authors provide a basic framework for developing an individual and/or disease-specific training program, introduce the physical activity pyramid, and recommend a core set of clinical measures to be used in clinical research.
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Reinehr T, Dobe M, Winkel K, Schaefer A, Hoffmann D. Obesity in disabled children and adolescents: an overlooked group of patients. DEUTSCHES ARZTEBLATT INTERNATIONAL 2010; 107:268-75. [PMID: 20458368 PMCID: PMC2864441 DOI: 10.3238/arztebl.2010.0268] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2009] [Accepted: 08/24/2009] [Indexed: 01/21/2023]
Abstract
BACKGROUND There is an ongoing debate concerning the relationship between disability and obesity in childhood and adolescence. METHODS The literature available in Medline was selectively searched for the terms: "(children /OR/ adolescents) /AND/ disability /AND/ (overweight /OR/ obesity)". This search was complemented by inspection of journals in the fields of obesity, pediatrics, and neurology. RESULTS A total of 38 relevant articles were identified. All studies agreed that the prevalence of overweight and obesity in children with disabilities was almost twice that in their non-disabled peers. No effective, long-lasting interventions for obesity in disabled children and adolescents have been published. CONCLUSION Since a high proportion of disabled children and adolescents are overweight or obese, effective strategies for preventing and managing excess weight need to be developed so as not to further endanger their social participation. Moreover, risk factors for overweight in disabled children and adolescents should be identified and their weight status carefully monitored.
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Affiliation(s)
- Thomas Reinehr
- Institut für Pädiatrische Ernährungsmedizin, Vestische Kinder- und Jugendklinik Datteln, Universität Witten/Herdecke, 5711 Datteln, Germany.
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Buchholz AC, Martin Ginis KA, Bray SR, Craven BC, Hicks AL, Hayes KC, Latimer AE, McColl MA, Potter PJ, Wolfe DL. Greater daily leisure time physical activity is associated with lower chronic disease risk in adults with spinal cord injury. Appl Physiol Nutr Metab 2009; 34:640-7. [PMID: 19767799 DOI: 10.1139/h09-050] [Citation(s) in RCA: 112] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The objective of this study was to examine the relationship between leisure time physical activity (LTPA) and common risk factors for cardiovascular disease (CVD) and type 2 diabetes in community-dwelling adults with chronic spinal cord injury (SCI). LTPA was measured using the Physical Activity Recall Assessment for People with SCI in 76 men and women with chronic (> or =1 year) paraplegia or tetraplegia, living in or near Hamilton, Ontario. Body mass index (BMI), waist circumference, body composition (fat mass (FM) and fat-free mass (FFM)), blood pressure, and biochemical data were collected. Thirty-seven percent (n = 28 participants) were inactive, reporting no LTPA whatsoever, and were compared with an equal-sized group consisting of the most active study participants (> or =25 min of LTPA per day). After adjusting for significant covariates, BMI (18.7%), %FM (19.4%), and C-reactive protein (143%) were all lower, and %FFM was higher (7.2%), in active participants (all p < or = 0.05). Ten percent of active participants vs. 33% of inactive participants were insulin resistant (p = 0.03). Waist circumference (17.6%) and systolic blood pressure (15.3%) were lower in active vs. inactive participants with paraplegia (both p < or = 0.05), but not tetraplegia. In conclusion, greater daily LTPA is associated with lower levels of selected CVD and type 2 diabetes risk factors in individuals living with SCI. Whether this relationship translates into a lower incidence of these chronic diseases has yet to be determined.
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Affiliation(s)
- Andrea C Buchholz
- Department of Family Relations and Applied Human Nutrition, University of Guelph, Guelph, ON N1G 2W1, Canada.
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Sabet Sarvestani R, Jamalfard MH, Kargar M, Kaveh MH, Tabatabaee HR. Effect of dietary behaviour modification on anthropometric indices and eating behaviour in obese adolescent girls. J Adv Nurs 2009; 65:1670-5. [PMID: 19493149 DOI: 10.1111/j.1365-2648.2009.05029.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM This paper is a report of a study conducted to evaluate the effects of behaviour modification on anthropometric indices and to explore if behaviour modification could improve eating behaviour in adolescents. BACKGROUND Obesity is currently the most important nutritional disease of children and adolescents. To date, several attempts to achieve weight loss in children have been made, but little is known about their effects on improving eating behaviours. METHOD Sixty obese adolescent girls participated in a behaviour modification program which was held for 16 weeks in 2007. The participants were randomly selected from two different schools and were assigned to an experimental and control group (30 participants each). Anthropometric indices and eating behaviours were assessed before and after the program. Eating behaviour was assessed using the Dutch Eating Behaviour Questionnaire. RESULT There were statistically significant differences in changes in body weight (-2.75 kg vs. 0.62 kg), body mass index (-1.07 kg/m(2) vs. 0.24 kg/m(2)) and arm circumference (-2.31 cm vs. 0.5 cm) in the experimental group in contrast to controls (P < 0.001). There were also statistically significant differences in scores for eating behaviour, emotional eating (0.63, 0.17), external eating (0.99, 0.05) and restrained eating (0.72, 0.03) in the experimental vs. the control group respectively (P < 0.001). CONCLUSION Nurses, more than other healthcare professionals, can address obesity in adolescents and they should not concentrate solely on weight reduction, but also encourage children to acquire a healthy lifestyle.
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Bibliography. Current world literature. Nutrition and metabolism. Curr Opin Lipidol 2009; 20:63-72. [PMID: 19106709 DOI: 10.1097/mol.0b013e32832402a2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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De Groot JF, Takken T, Schoenmakers MAGC, Vanhees L, Helders PJM. Limiting factors in peak oxygen uptake and the relationship with functional ambulation in ambulating children with Spina Bifida. Eur J Appl Physiol 2008; 104:657-65. [DOI: 10.1007/s00421-008-0820-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/27/2008] [Indexed: 11/29/2022]
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