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Daneshgar S, Tvrdy T, Enoka RM. Explaining the influence of practice on the grooved pegboard times of older adults: role of force steadiness. Exp Brain Res 2024; 242:1971-1982. [PMID: 38916760 DOI: 10.1007/s00221-024-06878-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Accepted: 06/18/2024] [Indexed: 06/26/2024]
Abstract
The purpose was to identify the variables that can explain the variance in the grooved pegboard times of older adults categorized as either fast or slow performers. Participants (n = 28; 60-83 years) completed two experimental sessions, before and after 6 practice sessions of the grooved pegboard test. The 2 groups were identified based on average pegboard times during the practice sessions. Average pegboard time during practice was 73 ± 11 s for the fast group and 85 ± 13 s for the slow group. Explanatory variables for the pegboard times before and after practice were the durations of 4 peg-manipulation phases and 12 measures of force steadiness (coefficient of variation [CV] for force) during isometric contractions with the index finger abductor and wrist extensor muscles. Time to complete the grooved pegboard test after practice decreased by 25 ± 11% for the fast group and by 28 ± 10% for the slow group. Multiple regression models explained more of the variance in the pegboard times for the fast group before practice (Adjusted R2 = 0.85) than after practice (R2 = 0.51), whereas the variance explained for the slow group was similar before (Adjusted R2 = 0.67) and after (Adjusted R2 = 0.64) practice. The explanatory variables differed between before and after practice for the fast group but only slightly for the slow group. These findings indicate that performance-based stratification of older adults can identify unique adjustments in motor function that are independent of chronological age.
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Affiliation(s)
- Sajjad Daneshgar
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, 80309, USA
| | - Taylor Tvrdy
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, 80309, USA
| | - Roger M Enoka
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, 80309, USA.
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Lippi L, de Sire A, Folli A, Curci C, Calafiore D, Lombardi M, Bertolaccini L, Turco A, Ammendolia A, Fusco N, Spaggiari L, Invernizzi M. Comprehensive Pulmonary Rehabilitation for Patients with Malignant Pleural Mesothelioma: A Feasibility Pilot Study. Cancers (Basel) 2024; 16:2023. [PMID: 38893142 PMCID: PMC11171244 DOI: 10.3390/cancers16112023] [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: 04/20/2024] [Revised: 05/19/2024] [Accepted: 05/23/2024] [Indexed: 06/21/2024] Open
Abstract
Malignant pleural mesothelioma (MPM) represents a significant health burden, with limited treatment options and poor prognosis. Despite advances in pharmacological and surgical interventions, the role of rehabilitation in MPM management remains underexplored. This study aims to assess the feasibility of a tailored pulmonary rehabilitation intervention addressing physical and respiratory function in MPM patients. A prospective pilot study was conducted on surgically treated MPM patients referred to a cardiopulmonary rehabilitation service. The intervention comprised multidisciplinary educational sessions, physical rehabilitation, and respiratory physiotherapy. Feasibility was evaluated based on dropout rates, adherence to the rehabilitation program, safety, and patient-reported outcomes. Twelve patients were initially enrolled, with seven completing the study. High adherence to physical (T1: 93.43%, T2: 82.56%) and respiratory (T1: 96.2%, T2: 92.5%) rehabilitation was observed, with minimal adverse events reported. Patient satisfaction remained high throughout the study (GPE scores at T1: 1.83 ± 1.17; T2: 2.0 ± 1.15), with improvements noted in physical function, pain management, and health-related quality of life. However, some issues, such as time constraints and lack of continuous supervision, were reported by participants. This pilot study demonstrates the feasibility and potential benefits of a tailored pulmonary rehabilitation intervention in MPM patients. Despite its promising outcomes, further research with larger samples is warranted to validate its efficacy and integrate rehabilitation as a component into the multidisciplinary management of MPM.
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Affiliation(s)
- Lorenzo Lippi
- Department of Scientific Research, Campus LUdeS Lugano (CH), Off-Campus Semmelweis University of Budapest, 1085 Budapest, Hungary;
| | - Alessandro de Sire
- Department of Medical and Surgical Sciences, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy;
- Research Center on Musculoskeletal Health, MusculoSkeletalHealth@UMG, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy
| | - Arianna Folli
- Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy; (A.F.); (A.T.); (M.I.)
| | - Claudio Curci
- Physical Medicine and Rehabilitation Unit, Department of Neurosciences, ASST Carlo Poma, 46100 Mantova, Italy; (C.C.); (D.C.)
| | - Dario Calafiore
- Physical Medicine and Rehabilitation Unit, Department of Neurosciences, ASST Carlo Poma, 46100 Mantova, Italy; (C.C.); (D.C.)
| | - Mariano Lombardi
- Division of Pathology, IEO European Institute of Oncology IRCCS, 20139 Milan, Italy; (M.L.); (N.F.); (L.S.)
| | - Luca Bertolaccini
- Division of Thoracic Surgery, IEO European Institute of Oncology IRCCS, 20139 Milan, Italy;
| | - Alessio Turco
- Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy; (A.F.); (A.T.); (M.I.)
| | - Antonio Ammendolia
- Department of Medical and Surgical Sciences, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy;
- Research Center on Musculoskeletal Health, MusculoSkeletalHealth@UMG, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy
| | - Nicola Fusco
- Division of Pathology, IEO European Institute of Oncology IRCCS, 20139 Milan, Italy; (M.L.); (N.F.); (L.S.)
- Department of Oncology and Hematology-Oncology, University of Milan, 20122 Milan, Italy
| | - Lorenzo Spaggiari
- Division of Pathology, IEO European Institute of Oncology IRCCS, 20139 Milan, Italy; (M.L.); (N.F.); (L.S.)
- Department of Oncology and Hematology-Oncology, University of Milan, 20122 Milan, Italy
| | - Marco Invernizzi
- Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy; (A.F.); (A.T.); (M.I.)
- Translational Medicine, Dipartimento Attività Integrate Ricerca e Innovazione (DAIRI), Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy
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Cossio-Bolaños M, Vidal-Espinoza R, Villar-Cifuentes I, de Campos LFCC, de Lázari MSR, Urra-Albornoz C, Sulla-Torres J, Gomez-Campos R. Functional fitness benchmark values for older adults: a systematic review. Front Public Health 2024; 12:1335311. [PMID: 38577282 PMCID: PMC10993995 DOI: 10.3389/fpubh.2024.1335311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 03/05/2024] [Indexed: 04/06/2024] Open
Abstract
Introduction The use of normative values and/or standards of functional fitness in adults is relevant to overall health and well-being. The objectives of the study were: to identify the physical tests of the senior fitness test (SFT) that have been applied since its proposal and to describe the proposed percentiles according to age, sex and country. Methods A systematic review study was conducted in the Pubmed and Scopus databases. As eligibility criteria, we considered the period from 1999 to 2022 that presented data on SFT test used in the population over 60 years of age and that described normative values through percentiles. MeSH were used as: (1) Physical fitness, Exercise test, Senior Fitness Test, Functional fitness, Cardiorespiratory fitness, (2) older adult, aged, (3) Reference standards, standards, standards of care. Boolean operators "AND" and "OR" were included. Data extracted from the selected studies included: year of publication, country, sample age, sample size, sample sex, fitness component. Results and discussion Seven studies were identified in five countries (03 in China, 01 in Poland, 01 in Portugal, 01 in Spain and 01 in United States). The age range ranged from 60 to 103 years. The studies were conducted in both sexes. The study with the smallest sample size was by Chung et al. (China) with 944 participants and the largest number of participants was the study by Rikli and Jones in the United States with 7,183 participants. In general, no study was able to complete 100% (8 components) of the tests proposed in the SFT. Normative values were presented through percentile distribution (p10, p50 and p90) organized by age ranges. Males presented better performance in FPF tests than females in all tests. Since the first publication of the SFT until 2022, seven articles have been published in countries such as United States, China (three regional studies), Poland, Portugal and Spain. No study has published the complete battery with its eight components. The percentiles of functional fitness reflect decline with advancing age. Systematic review registration PROSPERO (CRD42023441294: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023441294).
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Affiliation(s)
- Marco Cossio-Bolaños
- Departamento de Ciencias de la Actividad Física, Universidad Católica del Maule, Talca, Chile
- Faculty of Education, Psychology and Sport Sciences, University of Huelva, Huelva, Spain
| | | | | | | | | | - Camilo Urra-Albornoz
- Departamento de Ciencias de la Actividad Física, Universidad Católica del Maule, Talca, Chile
| | | | - Rossana Gomez-Campos
- Departamento de Ciencias de la Actividad Física, Universidad Católica del Maule, Talca, Chile
- Faculty of Education, Psychology and Sport Sciences, University of Huelva, Huelva, Spain
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Nguyen DT, Penta M, Questienne C, Garbusinski J, Nguyen CV, Sauvage C. Normative values in healthy adults for the 6-minute and 2-minute walk tests in Belgium and Vietnam: implications for clinical practice. J Rehabil Med 2024; 56:jrm18628. [PMID: 38501732 DOI: 10.2340/jrm.v56.18628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 01/25/2024] [Indexed: 03/20/2024] Open
Abstract
OBJECTIVE To establish reference values for the 6-minute walk test (6MWT) and 2-minute walk test (2MWT) distances, to investigate the correlation between these 2 tests, and to establish prediction equations for these distances in healthy populations of Belgium and Vietnam. DESIGN Cross-sectional study. SUBJECTS AND METHODS The 6MWT and 2MWT were administered to a convenience sample of 239 Belgian and 303 Vietnamese participants between the ages of 18 and 80 years. RESULTS The mean (standard deviation; SD) 2MWT distances were 215 (32.8) m for Belgian participants and 156 (25.5) m for Vietnamese participants. The mean (SD) 6MWT distances were 625 (90.7) m for Belgian participants and 449 (70.4) m for Vietnamese participants. The Pearson correlation coefficient between the 2 tests was 0.901 (p < 0.001) for Belgian participants and 0.871 (p < 0.001) for Vietnamese participants. Age and sex were the 2 most important predictors of walking distance, followed by body mass index for Belgium and height for Vietnam. The adjusted R² ranged from 0.31 to 0.49 across 4 predictive equations. CONCLUSION These results can be used to determine the presence of walking performance deficits and to guide future studies. The 2MWT is suggested as a useful and convenient alternative to the 6MWT for assessing walking performance in clinical practice.
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Affiliation(s)
- Duy Thanh Nguyen
- Faculty of Nursing and Medical Technology, University of Medicine and Pharmacy at Ho Chi Minh City, Vietnam; Faculty of Motricity Sciences, Université Libre de Bruxelles, Belgium.
| | - Massimo Penta
- Institute of NeuroScience, Université catholique de Louvain, Louvain-la-Neuve, Belgium; Arsalis, Glabais, Belgium
| | - Claire Questienne
- Department of Neurorehabilitation, Erasme Hospital, Université Libre de Bruxelles, Belgium
| | - Johanne Garbusinski
- Department of Neurorehabilitation, Erasme Hospital, Université Libre de Bruxelles, Belgium
| | - Chinh Van Nguyen
- Faculty of Nursing and Medical Technology, University of Medicine and Pharmacy at Ho Chi Minh City, Vietnam
| | - Chloé Sauvage
- Faculty of Motricity Sciences, Université Libre de Bruxelles, Belgium; Department of Neurorehabilitation, Erasme Hospital, Université Libre de Bruxelles, Belgium
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Hansen A, Nim CG, O'Sullivan K, O'Neill S. Testing walking performance in patients with low back pain: will two minutes do instead of six minutes? Disabil Rehabil 2024; 46:1173-1177. [PMID: 37026438 DOI: 10.1080/09638288.2023.2194683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 03/18/2023] [Indexed: 04/08/2023]
Abstract
PURPOSE The six-minute walk test (6MWT) can assess walking function but is time-consuming. We investigate the correlation of performance over the first two minutes of the 6MWT (2MWT#) and the 6MWT. We also evaluate the 2MWT#'s ability to predict 6MWT results, assess correlations to secondary explanatory outcomes, and assess the ability to discriminate between clinical subgroups. MATERIAL AND METHODS A cross-sectional study of 124 participants with LBP. Correlations between the 2MWT# and 6MWT and secondary outcomes were evaluated using the Pearson product-moment correlation coefficient. The predictive ability of the 2MWT# was defined as the residual distance between the observed 6MWT and three times the 2MWT#. Differences between clinical subgroups were evaluated using the Wilcoxon rank test. RESULTS The 2MWT# and 6MWT correlated highly (r = 83, 95% CI 0.76 - 0.87). The 2MWT# overestimated 6MWT results with 46.8 meters (SD 67.0). Both tests correlated with secondary outcomes and discriminated similarly between clinical subgroups. CONCLUSIONS The 2MWT# correlates highly with 6MWT but overestimates the observed 6MWT by 9%. Because it is shorter, possibly less burdensome, and with little or no loss of discriminatory ability, we consider it a legitimate alternative to the 6MWT in patients with LBP.Implications for rehabilitationWalking function is often affected in patients with low back pain (LBP).The six-minute walk test (6MWT) is frequently used to assess walking function but is time-consuming.A shorter two-minute walk test is a legitimate alternative in patients with LBP as it correlates highly with the 6MWT and has little or no loss of discriminatory ability between clinical subgroups.
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Affiliation(s)
- Anders Hansen
- Spine Centre of Southern Denmark, University Hospital of Southern Denmark, Middelfart, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Casper Glissmann Nim
- Spine Centre of Southern Denmark, University Hospital of Southern Denmark, Middelfart, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
- Department of Sports Science and Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Kieran O'Sullivan
- School of Allied Health, University of Limerick, Limerick, Ireland
- Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland
- Sports and Human Performance Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Søren O'Neill
- Spine Centre of Southern Denmark, University Hospital of Southern Denmark, Middelfart, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
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Leuschner M, Grauduszus M, Friesen D, Ferrari N, Klaudius M, Joisten C. The 6-minute Run Test: Validation and Reference Equations for Adults. Int J Sports Med 2024; 45:222-230. [PMID: 38113901 PMCID: PMC10907109 DOI: 10.1055/a-2206-5291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 10/11/2023] [Indexed: 12/21/2023]
Abstract
Endurance performance tests directly measuring cardiorespiratory fitness are complex, but field tests indirectly assessing maximum oxygen uptake (VO2max) are an alternative. This study aimed to validate the 6-minute run test in adults, comparing it to the established shuttle run test, and to create reference equations. The cross-over design involved healthy adults aged 18-65 undertaking both tests, separated by a two-hour interval. The 6-minute run test required participants to run around a volleyball court for six minutes, aiming to maximize distance covered. The shuttle run involved participants covering 20 meters in defined time intervals at increasing speeds. Parameters measured included 6-minute run test distance, heart rates, calculated maximum oxygen uptake during the shuttle run, and total shuttle count. The study enrolled 250 participants (134 men and 116 women). Men averaged 1195.7 m (SD=161.4), while women averaged 1051.2 m (SD=148.0) in six minutes. The strongest correlation was found between the distance covered in the 6-minute run test and the total shuttle count (r=0.91, p<0.001). Two predictive models for 6-minute run test distance were developed and normative values for different sex-specific age clusters were established. The study showed that the 6-minute run test is valid as a practical endurance test for adults aged 18-65.
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Affiliation(s)
- Malte Leuschner
- Institute of Movement and Neurosciences, Department for physical
activity in public health, Deutsche Sporthochschule Köln, Köln,
Germany
| | - Martin Grauduszus
- Institute of Movement and Neurosciences, Department for physical
activity in public health, Deutsche Sporthochschule Köln, Köln,
Germany
| | - David Friesen
- Institute of Movement and Neurosciences, Department for physical
activity in public health, Deutsche Sporthochschule Köln, Köln,
Germany
| | - Nina Ferrari
- Institute of Movement and Neurosciences, Department for physical
activity in public health, Deutsche Sporthochschule Köln, Köln,
Germany
- Cologne Centre for Prevention in Childhood and Youth/Heart
Centre Cologne, Uniklinik Köln, Köln, Germany
| | - Marlen Klaudius
- Institute of Movement and Neurosciences, Department for physical
activity in public health, Deutsche Sporthochschule Köln, Köln,
Germany
| | - Christine Joisten
- Institute of Movement and Neurosciences, Department for physical
activity in public health, Deutsche Sporthochschule Köln, Köln,
Germany
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Sato K, Yamazaki Y, Kameyama Y, Watanabe K, Kitahara E, Haruyama K, Takahashi Y, Fujino Y, Yamaguchi T, Matsuda T, Makabe H, Isayama R, Murakami Y, Tani M, Honaga K, Hatori K, Oji Y, Tomizawa Y, Hatano T, Hattori N, Fujiwara T. Factor analysis for construct validity of a trunk impairment scale in Parkinson's disease: a cross-sectional study. Front Neurol 2024; 14:1303215. [PMID: 38234977 PMCID: PMC10791816 DOI: 10.3389/fneur.2023.1303215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 12/04/2023] [Indexed: 01/19/2024] Open
Abstract
Objectives To investigate the construct validity of the Trunk Impairment Scale (TIS), which was developed to assess trunk impairment in patients with stroke, in patients with Parkinson's disease (PD). Design This retrospective, cross-sectional study enrolled consecutive PD inpatients. Correlation analysis was performed to clarify whether the TIS assessment was related to other balance functions, lower extremity muscle strength, or walking ability. Factor analysis was performed to see how the background factors of TIS differ from balance function, lower limb muscle strength, and walking ability. Results Examining the data of 471 patients with PD, there were relationships between TIS and the Mini-Balance Evaluation Systems Test (r = 0.67), Barthel Index (r = 0.57), general lower limb extension torque (r = 0.51), two-minute walk test (r = 0.54), Hoehn and Yahr stage (r = -0.61), and Movement Disorder Society Unified Parkinson's Disease Rating Scale part III total points (r = -0.59). Factor analysis showed that TIS items were divided into three factors (an abdominal muscles and righting reflex component; a perception and verticality component; and a rotational component), differing from other scales that included clinical assessment items. Conclusion The TIS can be useful for assessing the underlying trunk impairment as a basis for activities of daily living, gait function, and balance ability in patients with PD.
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Affiliation(s)
- Kazunori Sato
- Department of Rehabilitation Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yuta Yamazaki
- Department of Rehabilitation Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yoshihiro Kameyama
- Department of Rehabilitation Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Koji Watanabe
- Department of Rehabilitation Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Eriko Kitahara
- Department of Rehabilitation Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Koshiro Haruyama
- Department of Physical Therapy, Faculty of Health Science, Juntendo University, Tokyo, Japan
| | - Yoko Takahashi
- Department of Physical Therapy, Faculty of Health Science, Juntendo University, Tokyo, Japan
| | - Yuji Fujino
- Department of Physical Therapy, Faculty of Health Science, Juntendo University, Tokyo, Japan
| | - Tomofumi Yamaguchi
- Department of Physical Therapy, Faculty of Health Science, Juntendo University, Tokyo, Japan
| | - Tadamitsu Matsuda
- Department of Physical Therapy, Faculty of Health Science, Juntendo University, Tokyo, Japan
| | - Hitoshi Makabe
- Department of Physical Therapy, Faculty of Health Science, Juntendo University, Tokyo, Japan
| | - Reina Isayama
- Department of Rehabilitation Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yuhei Murakami
- Department of Rehabilitation Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Mami Tani
- Department of Rehabilitation Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Kaoru Honaga
- Department of Rehabilitation Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Kozo Hatori
- Department of Rehabilitation Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yutaka Oji
- Department of Neurology, Juntendo University Hospital, Tokyo, Japan
| | - Yuji Tomizawa
- Department of Neurology, Juntendo University Hospital, Tokyo, Japan
| | - Taku Hatano
- Department of Neurology, Juntendo University Hospital, Tokyo, Japan
| | - Nobutaka Hattori
- Department of Neurology, Juntendo University Hospital, Tokyo, Japan
| | - Toshiyuki Fujiwara
- Department of Rehabilitation Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Physical Therapy, Faculty of Health Science, Juntendo University, Tokyo, Japan
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Ibrahim A, Mat Ludin AF, Shahar S, Hamzah NH, Chin AV, Singh DKA. Association between maximal oxygen consumption and physical performance tests among older adults with cognitive frailty. Exp Gerontol 2023; 184:112326. [PMID: 37967590 DOI: 10.1016/j.exger.2023.112326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 11/06/2023] [Accepted: 11/08/2023] [Indexed: 11/17/2023]
Abstract
INTRODUCTION Cardiorespiratory fitness has an inverse relationship with cognitive impairment and frailty in older adults. Direct assessment of maximal oxygen consumption (VO2 max) is the gold standard to assess cardiorespiratory fitness. However, it is costly and requires a laboratory setting. Therefore, VO2 max estimation among older adults with cognitive frailty (CF) will allow the assessment of aerobic capacity, which is commonly overlooked due to the complexity of the test. AIM This study aims to determine the use of one of three physical performance tests (2-minute step, 2-minute walk, and 1-minute sit to stand) to effectively estimate cardiorespiratory fitness among older adults with CF. METHODS In this cross-sectional study, community-dwelling individuals aged 60 years old and above in Klang Valley were screened for CF. The participants performed three physical performance tests (2-minute walk, 2-minute step, and 1-minute sit to stand) followed by treadmill-based maximal exercise testing on another day. RESULTS A total of 32 older adults with cognitive frailty (mean age; SD: 67.1;4.7 years) participated in this study. Nearly half of them had hypertension (43.5 %), hypercholesterolemia (43.5 %), and multimorbidity (47.8 %). Among the endurance tests performed, only the 2-minute walk test independently predicted VO2 max by sex-specific with men (R2 = 0.58, p = 0.03) and women (R2 = 0.34, p = 0.01). The 2-minute walk test had good agreement with VO2 max (ICC = 0.77, 95 % CI: -3.1-2.4). CONCLUSION The 2-minute walk test is a valid tool for estimating cardiorespiratory fitness among older adults with CF. However, it should be further tested across a larger population.
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Affiliation(s)
- Azianah Ibrahim
- Centre for Healthy Ageing and Wellness (HCARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Malaysia
| | - Arimi Fitri Mat Ludin
- Centre for Healthy Ageing and Wellness (HCARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Malaysia
| | - Suzana Shahar
- Centre for Healthy Ageing and Wellness (HCARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Malaysia
| | - Noor Hazfalinda Hamzah
- Center for Diagnostic, Therapeutic & Investigative Studies (CODTIS), Forensic Science, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Malaysia
| | - Ai-Vyrn Chin
- Geriatric Division, Faculty of Medicine, University Malaya Medical Center, Kuala Lumpur, Malaysia
| | - Devinder Kaur Ajit Singh
- Centre for Healthy Ageing and Wellness (HCARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Malaysia.
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Daneshgar S, Tvrdy T, Enoka RM. Practice-Induced Changes in Manual Dexterity of Older Adults Depend on Initial Pegboard Time. Med Sci Sports Exerc 2023; 55:2045-2052. [PMID: 37379250 DOI: 10.1249/mss.0000000000003245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/30/2023]
Abstract
INTRODUCTION The purpose of our study was to determine the influence of practice on the pegboard times and peg-manipulation phases of older adults who were classified as having either slow or fast initial pegboard times. METHODS Participants ( n = 26, 70 ± 6.6 yr) completed two evaluation sessions and six practice sessions in which they performed 25 trials (5 blocks of 5 trials) of the grooved pegboard test. All practice sessions were supervised, and the time to complete each trial was recorded. In each evaluation session, the pegboard was mounted on a force transducer so that the downward force applied to the board could be measured. RESULTS Participants were stratified into two groups based on the initial time to complete the grooved pegboard test: a fast group (68.1 ± 6.0 s) and a slow group (89.6 ± 9.2 s). Both groups exhibited the classic two-phase profile (acquisition + consolidation) for learning a de novo motor skill. Despite the similar learning profile for the two groups, there were differences between groups in the phases of the peg-manipulation cycle that became faster with practice. The fast group seemed to reduce trajectory variability when transporting the peg, whereas the slow group seemed to exhibit both a decrease in trajectory variability and greater precision when inserting pegs into the holes. CONCLUSIONS The changes underlying practice-induced decreases in grooved pegboard time differed for older adults who initially had either a fast or a slow pegboard time.
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Affiliation(s)
- Sajjad Daneshgar
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO
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Reinmann A, Koessler T, Bodmer A, Baud-Grasset A, Mentha G, Gligorov J, Bruyneel AV. Feasibility, criterion and construct convergent validity of the 2-minute walk test and the 10-meter walk test in an oncological context. Heliyon 2023; 9:e22180. [PMID: 38045222 PMCID: PMC10692807 DOI: 10.1016/j.heliyon.2023.e22180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 11/02/2023] [Accepted: 11/06/2023] [Indexed: 12/05/2023] Open
Abstract
Objective To examine the feasibility, the criterion, and the construct convergent validity of the 2-Minute Walk Test (2MWT) and the 10-Meter Walk Test (10MeWT) against the 6-Minute Walk Test (6MWT) to assess walking capacity in people with cancer. The criterion concurrent validity of a self-test version of the 10MeWT (10MeWTself-test) was also evaluated against the 10MeWT. Methods Fifty-six people with cancer performed the 2MWT, the 10MeWT at comfortable and fast speeds, the 6MWT, and the 10MeWTself-test. The feasibility of the tests was assessed using safety, adverse events, space requirements, time taken to administer and interpret the tool, equipment or training required, cost, and portability as criteria. Validity was assessed using Pearson correlation coefficients and Bland Altman plots. Results The 2MWT, 6MWT, 10MeWT, and 10MeWTself-test were feasible for people with cancer. The 2MWT and the 10MeWT results were moderately to strongly correlated with the 6MWT results (0.61 < r < 0.84, p < 0.001). The 10MeWTself-test results were strongly correlated with the 10MeWT results at comfortable and fast speeds (r = 0.99, p < 0.001). Conclusions The 2MWT, 10MeWT, and 10MeWTself-test are simple, rapid, and feasible tests for use in people with cancer. The strong correlation between the 2MWT and 6MWT results indicates that the 2MWT can be used as an alternative walking capacity assessment tool. The 10MeWT results moderately correlated with those of the other two tests, suggesting that it partially measures the same construct of walking capacity in walking-independent outpatients with cancer. The 10MeWTself-test showed promising results but needs further investigations in ecological settings.
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Affiliation(s)
- Aline Reinmann
- Geneva School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Geneva, Switzerland
- Sorbonne University, INSERM U938, Centre de Recherche Saint Antoine, CRSA, Paris, France
| | - Thibaud Koessler
- Service of Oncology, Geneva University Hospitals, Geneva, Switzerland
- University of Geneva, Geneva, Switzerland
| | - Alexandre Bodmer
- Service of Oncology, Geneva University Hospitals, Geneva, Switzerland
- University of Geneva, Geneva, Switzerland
| | - Axelle Baud-Grasset
- Geneva School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Geneva, Switzerland
| | - Géraldine Mentha
- Geneva School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Geneva, Switzerland
| | - Joseph Gligorov
- Sorbonne University, INSERM U938, Centre de Recherche Saint Antoine, CRSA, Paris, France
- University Institute of Cancerology AP-HP Sorbonne University, Medical Oncology site Tenon, Paris, France
| | - Anne-Violette Bruyneel
- Geneva School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Geneva, Switzerland
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Varesco G, Luneau E, Millet GY, Féasson L, Lapole T, Rozand V. Age-Related Differences between Old and Very Old Men in Performance and Fatigability Are Evident after Cycling but Not Isometric or Concentric Single-Limb Tasks. Med Sci Sports Exerc 2023; 55:1641-1650. [PMID: 37580874 DOI: 10.1249/mss.0000000000003181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/16/2023]
Abstract
PURPOSE This study aimed to compare performance and fatigability between young (n = 13; 18-30 yr), old (n = 13; 60-80 yr), and very old (n = 12; >80 yr) men during a single-joint isometric (ISO) and concentric (CON) task performed on an isokinetic dynamometer and a cycling (BIKE) task. METHODS Participants randomly performed incremental tasks consisting of stages of 75 contractions (i.e., 120 s, 0.8 s on/0.8 s off) for ISO and CON and 120 s at 37.5 rpm (similar duty cycle) for BIKE. Increments were set as a percentage of body weight. Knee extensor maximal force, voluntary activation, and twitch amplitude were measured at baseline, after each stage, and at task failure (five out of eight contractions below the target force or 6 s in a row at a cadence <37.5 rpm). RESULTS Compared with young men, performance (number of stages) was 24% and 40% lower in old and very old men in ISO, 54% and 59% lower in CON, and 36% and 60% lower in BIKE (all P < 0.05). Performance of old and very old differed only in BIKE (P < 0.01). For the last common stages performed, compared with young, force loss was greater for very old men in ISO and for old and very old men in BIKE (all P < 0.05). Overall, for the last common stage performed and task failure, old and very old men presented similar force loss, alterations in voluntary activation, and twitch amplitude. CONCLUSIONS Our findings reveal that, with workloads relative to body weight, differences in performance between old and very old men could only be observed during BIKE (i.e., the more ecologically valid task). Results from isometric or concentric conditions might not be transferable to dynamic exercise with large muscle masses.
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Affiliation(s)
- Giorgio Varesco
- Université Jean Monnet Saint-Etienne, Lyon 1, Université Savoie Mont-Blanc, Laboratoire Interuniversitaire de Biologie de la Motricité, F-42023, Saint-Etienne, FRANCE
| | - Eric Luneau
- Université Jean Monnet Saint-Etienne, Lyon 1, Université Savoie Mont-Blanc, Laboratoire Interuniversitaire de Biologie de la Motricité, F-42023, Saint-Etienne, FRANCE
| | | | | | - Thomas Lapole
- Université Jean Monnet Saint-Etienne, Lyon 1, Université Savoie Mont-Blanc, Laboratoire Interuniversitaire de Biologie de la Motricité, F-42023, Saint-Etienne, FRANCE
| | - Vianney Rozand
- Université Jean Monnet Saint-Etienne, Lyon 1, Université Savoie Mont-Blanc, Laboratoire Interuniversitaire de Biologie de la Motricité, F-42023, Saint-Etienne, FRANCE
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12
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Gacto-Sánchez M, Lozano-Meca JA, Lozano-Guadalajara JV, Montilla-Herrador J. Concurrent validity of the 2-and 6-minute walk test in knee osteoarthritis. Knee 2023; 43:34-41. [PMID: 37269795 DOI: 10.1016/j.knee.2023.05.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 04/14/2023] [Accepted: 05/11/2023] [Indexed: 06/05/2023]
Abstract
BACKGROUND The 6-Minute Walk Test (6MWT) is frequently used for the assessment of walking distances in several conditions, as knee osteoarthritis, but it can be both time-consuming for the researcher or clinician, and exhausting of painful for the subject suffering from this condition. The objective of our study was to analyze the concurrent validity of the 2-Minute Walk Test (2MWT) for patients with knee osteoarthritis compared to the 6-Minute Walk Test (6MWT). METHODS Cross-sectional validation study. Scores from the 6MWT of 42 ambulatory patients affected by knee osteoarthritis were compared to those from the shorter 2MWT. An initial correlation test was used to assess correlation between both measures, and a subsequent univariate regression analysis was performed with the aim of comparing the estimated outcomes of the 6MWT versus the actual 6MWT. RESULTS The scores from the 2MWT and 6MWT showed excellent correlation (Pearson's correlation coefficient r = 0.976; p-value < 0.001); the predictive equation based on the scores from the 2MWT (R2 = 0.952, p-value < 0.001) estimates the 6MWT scores with a relative error of 3.23%. CONCLUSIONS The 2MWT may be a practical assessment tool in replacement for the 6MWT in clinical assessment due to its low burden on patients and as a means of improving efficiency in a timely manner.
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Affiliation(s)
- Mariano Gacto-Sánchez
- Department of Physical Therapy, Faculty of Medicine, CEIR Campus Mare Nostrum (CMN), University of Murcia, Instituto Murciano de Investigación Biosanitaria-Virgen de la Arrixaca (IMIB-Arrixaca), El Palmar, Murcia, Spain.
| | - José Antonio Lozano-Meca
- Department of Physical Therapy, Faculty of Medicine, CEIR Campus Mare Nostrum (CMN), University of Murcia, Instituto Murciano de Investigación Biosanitaria-Virgen de la Arrixaca (IMIB-Arrixaca), El Palmar, Murcia, Spain.
| | | | - Joaquina Montilla-Herrador
- Department of Physical Therapy, Faculty of Medicine, CEIR Campus Mare Nostrum (CMN), University of Murcia, Instituto Murciano de Investigación Biosanitaria-Virgen de la Arrixaca (IMIB-Arrixaca), El Palmar, Murcia, Spain.
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13
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Talbot LA, Webb L, Morrell C, Enochs K, Hillner J, Fagan M, Metter EJ. Electromyostimulation With Blood Flow Restriction for Patellofemoral Pain Syndrome in Active Duty Military Personnel: A Randomized Controlled Trial. Mil Med 2023; 188:e1859-e1868. [PMID: 36807977 DOI: 10.1093/milmed/usad029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 01/13/2023] [Accepted: 01/25/2023] [Indexed: 02/22/2023] Open
Abstract
INTRODUCTION The high prevalence of patellofemoral pain in military service members results in strength loss, pain, and functional limitations during required physical performance tasks. Knee pain is often the limiting factor during high-intensity exercise for strengthening and functional improvement, thus limiting certain therapies. Blood flow restriction (BFR) improves muscle strength when combined with resistance or aerobic exercise and may serve as a possible alternative to high-intensity training during recovery. In our previous work, we showed that Neuromuscular electrical stimulation (NMES) improves pain, strength, and function in patellofemoral pain syndrome (PFPS), which led us to ask whether the addition of BFR to NMES would result in further improvements. This randomized controlled trial compared knee and hip muscle strength, pain, and physical performance of service members with PFPS who received BFR-NMES (80% limb occlusion pressure [LOP]) or BFR-NMES set at 20 mmHg (active control/sham) over 9 weeks. METHODS This randomized controlled trial randomly assigned 84 service members with PFPS to one of the two intervention groups. In-clinic BFR-NMES was performed two times per week, while at-home NMES with exercise and at-home exercise alone were performed on alternating days and omitted on in-clinic days. The outcome measures included strength testing of knee extensor/flexor and hip posterolateral stabilizers, 30-second chair stand, forward step-down, timed stair climb, and 6-minute walk. RESULTS Improvement was observed in knee extensor (treated limb, P < .001) and hip strength (treated hip, P = .007) but not flexor over 9 weeks of treatment; however, there was no difference between high BFR (80% LOP) and BFR-sham. Physical performance and pain measures showed similar improvements over time with no differences between groups. In analyzing the relationship between the number of BFR-NMES sessions and the primary outcomes, we found significant relationships with improvements in treated knee extensor strength (0.87 kg/session, P < .0001), treated hip strength (0.23 kg/session, P = .04), and pain (-0.11/session, P < .0001). A similar set of relationships was observed for the time of NMES usage for treated knee extensor strength (0.02/min, P < .0001) and pain (-0.002/min, P = .002). CONCLUSION NMES strength training offers moderate improvements in strength, pain, and performance; however, BFR did not provide an additive effect to NMES plus exercise. Improvements were positively related to the number of BFR-NMES treatments and NMES usage.
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Affiliation(s)
- Laura A Talbot
- Department of Neurology, College of Medicine, University of Tennessee Health Science Center, Memphis, TN 38163, USA
| | - Lee Webb
- Physical Therapy, La Pointe Health Clinic, Fort Campbell, KY 42240, USA
| | - Christopher Morrell
- Department of Mathematics and Statistics, Loyola University Maryland, Baltimore, MD 21210, USA
| | - Kayla Enochs
- Department of Neurology, College of Medicine, University of Tennessee Health Science Center, Memphis, TN 38163, USA
| | - Jesse Hillner
- Department of Neurology, College of Medicine, University of Tennessee Health Science Center, Memphis, TN 38163, USA
| | - Mathias Fagan
- Department of Neurology, College of Medicine, University of Tennessee Health Science Center, Memphis, TN 38163, USA
| | - E Jeffrey Metter
- Department of Neurology, College of Medicine, University of Tennessee Health Science Center, Memphis, TN 38163, USA
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14
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The 2-min walk test could replace the 6-min walk test in ambulant persons with subacute or chronic stroke: a two-stage retrospective study. Int J Rehabil Res 2023; 46:41-45. [PMID: 36417386 DOI: 10.1097/mrr.0000000000000556] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The 6-minute walk test (6MWT) is widely used to assess walking capacity among persons with stroke. Whether a shorter and more convenient test, the 2-minute walk test (2MWT) could replace it, was tested. Two retrospective analyses were conducted. The first one was performed on a sample of 20 persons with stroke who performed both the 2MWT and the 6MWT, and the second one, on a group of 82 persons with stroke who performed the 6MWT while measuring the distance covered each minute. Linear regression models were applied to test the validity of 2MWT with regard to 6MWT. In the first group, distances covered during the 2MWT were highly predictive of the distances covered during the 6MWT (estimated adjusted R ² = 0.98; P < 0.001). In the second group, distances covered by participants during the first 2 min of the 6MWT were highly and linearly related to the distances they covered during the whole 6MWT (estimated adjusted R ² = 0.98; P < 0.001). Furthermore, the distance covered during the first 2 min of the whole 6MWT allowed us to predict 98% of the variance of the 6MWT. Given its good metric properties and its practical advantages, clinicians and researchers could reasonably use the 2MWT when assessing the walking capacity of persons with stroke, instead of the 6MWT.
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15
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Kirker K, Masaracchio MF, Loghmani P, Torres-Panchame RE, Mattia M, States R. Management of lumbar spinal stenosis: a systematic review and meta-analysis of rehabilitation, surgical, injection, and medication interventions. Physiother Theory Pract 2023; 39:241-286. [PMID: 34978252 DOI: 10.1080/09593985.2021.2012860] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND Lumbar spinal stenosis (LSS) has a substantial impact on mobility, autonomy, and quality of life. Previous reviews have demonstrated inconsistent results and/or have not delineated between specific nonsurgical interventions. OBJECTIVE The purpose of this systematic review is to assess the effectiveness of interventions in the management of LSS. METHODS Eligible studies were randomized controlled trials (RCTs) or prospective studies, included patients with LSS, assessed the effectiveness of any interventions (rehabilitation, surgical, injection, medication), included at least two intervention groups, and included at least one measure of pain, disability, ambulation assessment, or LSS-specific symptoms. Eighty-five articles met inclusion criteria. Meta-analyses were conducted across outcomes. Effect sizes were calculated using Hedge's g and reported descriptively. Formal grading of evidence was conducted. RESULTS Meta-analysis comparing rehabilitation to no treatment/placebo demonstrated significant effects on pain favoring rehabilitation (mean difference, MD -1.63; 95% CI: -2.68, -0.57; I2 = 71%; p = .002). All other comparisons to no treatment/placebo revealed nonsignificant findings. The level of evidence ranged from very low to high for rehabilitation and medication versus no treatment/placebo for pain, disability, ambulation ability, and LSS symptoms. CONCLUSIONS Although the findings of this review are inconclusive regarding superiority of interventions, this accentuates the value of multimodal patient-centered care in the management of patients with LSS.
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Affiliation(s)
- Kaitlin Kirker
- Department of Physical Therapy, Long Island University, Brooklyn, NY, USA
| | | | - Parisa Loghmani
- Department of Physical Therapy, Long Island University, Brooklyn, NY, USA
| | | | - Michael Mattia
- Department of Allied Health, Kingsborough Community College, Brooklyn, NY, USA
| | - Rebecca States
- Department of Physical Therapy, Long Island University, Brooklyn, NY, USA
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16
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Chrzanowski SM, Nagy JA, Pandeya S, Rutkove SB. Electrical Impedance Myography Correlates with Functional Measures of Disease Progression in D2-mdx Mice and Boys with Duchenne Muscular Dystrophy. J Neuromuscul Dis 2023; 10:81-90. [PMID: 36442205 DOI: 10.3233/jnd-210787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Sensitive, objective, and longitudinal outcome measures applicable to both pre-clinical and clinical interventions are needed to assess muscle health in Duchenne muscular dystrophy (DMD). Electrical impedance myography (EIM) has the potential to non-invasively measure disease progression in mice and boys with DMD. OBJECTIVE We sought to evaluate how electrical impedance values (i.e., phase, reactance, and resistance) correlate to established measures of disease in both D2-mdx and wild type (WT) mice and boys with and without DMD. METHODS Histological, functional, and EIM data collected from previous studies of WT and D2-mdx mice at 6, 13, 21 and 43 weeks of age were reanalyzed. In parallel, previously collected functional outcome measures and EIM values were reanalyzed from boys with and without DMD at four different age groups from 2 to 14 years old. RESULTS In mice, disease progression as detected by histological, functional, and EIM measures, was appreciable over this time period and grip strength best correlated to longitudinal phase and reactance impedance values. In boys, disease progression quantified through commonly utilized functional outcome measures was significant and longitudinal phase demonstrated the strongest correlation with functional outcome measures. CONCLUSION Similar changes in EIM values, specifically in longitudinal reactance and phase, were found to show significant correlations to functional measures in both mice and boys. Thus, EIM demonstrates applicability in both pre-clinical and clinical settings and can be used as a safe, non-invasive, and longitudinal proxy biomarker to assess muscle health in DMD.
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Affiliation(s)
- Stephen M Chrzanowski
- Department of Neurology, Boston Children's Hospital, Boston, MA, USA.,Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Janice A Nagy
- Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Sarbesh Pandeya
- Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Seward B Rutkove
- Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA
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17
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Hannaford A, Vucic S, van Alfen N, Simon NG. Muscle ultrasound in hereditary muscle disease. Neuromuscul Disord 2022; 32:851-863. [PMID: 36323605 DOI: 10.1016/j.nmd.2022.09.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 09/27/2022] [Accepted: 09/29/2022] [Indexed: 12/31/2022]
Abstract
In this review we summarise the key techniques of muscle ultrasound as they apply to hereditary muscle disease. We review the diagnostic utility of muscle ultrasound including its role in guiding electromyography and muscle biopsy sampling. We summarize the different patterns of sonographic muscle involvement in the major categories of genetic muscle disorders and discuss the limitations of the technique. We hope to encourage others to adopt ultrasound in their care for patients with hereditary muscle diseases.
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Affiliation(s)
- Andrew Hannaford
- Brain and Nerve Research Center, Concord Clinical School, University of Sydney, Sydney, Australia
| | - Steve Vucic
- Brain and Nerve Research Center, Concord Clinical School, University of Sydney, Sydney, Australia
| | - Nens van Alfen
- Department of Neurology and Clinical Neurophysiology, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Neil G Simon
- Northern Beaches Clinical School, Macquarie University, Suite 6a, 105 Frenchs Forest Rd W, Frenchs Forest, Sydney, NSW 2086, Australia.
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18
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Lau SCL, Connor LT, Baum CM. Subjective and objective assessments are associated for physical function but not cognitive function in community-dwelling stroke survivors. Disabil Rehabil 2022; 44:8349-8356. [PMID: 34904503 DOI: 10.1080/09638288.2021.2012845] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
PURPOSE To investigate the relation between subjectively and objectively assessed cognitive and physical functioning among community-dwelling stroke survivors, and to examine the association of stroke severity with subjectively and objectively assessed cognitive and physical impairments. MATERIALS AND METHODS Secondary data analysis was conducted with 127 community-dwelling stroke survivors. For cognitive functioning, objective measures included the NIH Toolbox Cognition Battery and the Executive Function Performance Test; subjective measures included the Quality of Life in Neurological Disorders Applied Cognition. Objective and subjective physical functioning was measured by the NIH Toolbox 2-Minute Walk Test and the Patient-Reported Outcomes Measurement Information System Physical Function, respectively. RESULTS A positive correlation was observed between subjective and objective physical functioning, whereas the correlation between subjective and objective cognitive functioning was nonsignificant. Stroke severity was associated with objective cognitive impairment and objective and subjective physical impairment, but not subjective cognitive impairment. CONCLUSIONS The lack of association between objective and subjective cognitive functioning challenges the conventional assumption that perceived functioning reflects actual performance. We recommend using both objective and subjective measures to accurately identify cognitive and physical impairment following stroke.Implications for RehabilitationSubjective cognitive functioning is not associated with objective cognitive functioning, suggesting that solely relying on stroke patients' reports is inadequate and may inaccurately estimate patients' actual deficits.Both objective and subjective measures should be used to accurately identify cognitive and physical impairment following stroke.Practitioners should be cognizant of stroke patients' behavioral signs associated with underlying cognitive problems that warrant further evaluation.
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Affiliation(s)
- Stephen C L Lau
- Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO, USA
| | - Lisa Tabor Connor
- Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO, USA.,Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
| | - Carolyn M Baum
- Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO, USA.,Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA.,Brown School of Social Work, Washington University in St. Louis, St. Louis, MO, USA
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19
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Lenert ME, Gomez R, Lane BT, Dailey DL, Vance CGT, Rakel BA, Crofford LJ, Sluka KA, Merriwether EN, Burton MD. Translating Outcomes from the Clinical Setting to Preclinical Models: Chronic Pain and Functionality in Chronic Musculoskeletal Pain. PAIN MEDICINE (MALDEN, MASS.) 2022; 23:1690-1707. [PMID: 35325207 PMCID: PMC9527603 DOI: 10.1093/pm/pnac047] [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] [Received: 10/27/2021] [Revised: 03/11/2022] [Accepted: 03/15/2022] [Indexed: 11/13/2022]
Abstract
Fibromyalgia (FM) is a chronic pain disorder characterized by chronic widespread musculoskeletal pain (CWP), resting pain, movement-evoked pain (MEP), and other somatic symptoms that interfere with daily functioning and quality of life. In clinical studies, this symptomology is assessed, while preclinical models of CWP are limited to nociceptive assays. The aim of the study was to investigate the human-to-model translatability of clinical behavioral assessments for spontaneous (or resting) pain and MEP in a preclinical model of CWP. For preclinical measures, the acidic saline model of FM was used to induce widespread muscle pain in adult female mice. Two intramuscular injections of acidic or neutral pH saline were administered following baseline measures, 5 days apart. An array of adapted evoked and spontaneous pain measures and functional assays were assessed for 3 weeks. A novel paradigm for MEP assessment showed increased spontaneous pain following activity. For clinical measures, resting and movement-evoked pain and function were assessed in adult women with FM. Moreover, we assessed correlations between the preclinical model of CWP and in women with fibromyalgia to examine whether similar relationships between pain assays that comprise resting and MEP existed in both settings. For both preclinical and clinical outcomes, MEP was significantly associated with mechanical pain sensitivity. Preclinically, it is imperative to expand how the field assesses spontaneous pain and MEP when studying multi-symptom disorders like FM. Targeted pain assessments to match those performed clinically is an important aspect of improving preclinical to clinical translatability of animal models.
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Affiliation(s)
- Melissa E Lenert
- Neuroimmunology and Behavior Laboratory, Department of Neuroscience, Center for Advanced Pain Studies (CAPS), School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, Texas, USA
| | - Rachelle Gomez
- Inclusive and Translational Research in Pain Lab, Department of Physical Therapy, Steinhardt School of Culture, Education, and Human Development, New York University, New York, New York, USA
| | - Brandon T Lane
- Neuroimmunology and Behavior Laboratory, Department of Neuroscience, Center for Advanced Pain Studies (CAPS), School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, Texas, USA
| | - Dana L Dailey
- Neurobiology of Pain Lab, Department of Physical Therapy and Rehabilitation Science, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA
- Department of Physical Therapy, Center for Health Sciences, St. Ambrose University, Davenport, Iowa, USA
| | - Carol G T Vance
- Neurobiology of Pain Lab, Department of Physical Therapy and Rehabilitation Science, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA
| | - Barbara A Rakel
- College of Nursing, University of Iowa, Iowa City, Iowa, USA
| | - Leslie J Crofford
- Division of Rheumatology and Immunology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Kathleen A Sluka
- Neurobiology of Pain Lab, Department of Physical Therapy and Rehabilitation Science, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA
| | - Ericka N Merriwether
- Inclusive and Translational Research in Pain Lab, Department of Physical Therapy, Steinhardt School of Culture, Education, and Human Development, New York University, New York, New York, USA
| | - Michael D Burton
- Neuroimmunology and Behavior Laboratory, Department of Neuroscience, Center for Advanced Pain Studies (CAPS), School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, Texas, USA
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20
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Zhang J, Zou Y, Wang Z, Chen X, Pan J, Yu H, Li E, Zou H. Two-minute walk distance reference equations for middle-aged and elderly Chinese individuals with obesity. PLoS One 2022; 17:e0273550. [PMID: 36001629 PMCID: PMC9401169 DOI: 10.1371/journal.pone.0273550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 08/11/2022] [Indexed: 11/19/2022] Open
Abstract
Background and objective While the six-minute walk test (6MWT) is often used to assess exercise capacity, the less well-known two-minute walk test (2MWT) is more feasible for some patients. In previous studies, we developed reference equations for the two-minute walk distance (2MWD) for healthy Chinese adults. However, our study did not recruit people with obesity, and the reference equations did not apply to participants with a body mass index (BMI) > 30 kg/m2. The main objective of this study was to establish reference equations for the 2MWD among middle-aged and elderly Chinese individuals with obesity. Methods A total of 295 individuals were recruited. The participants underwent two 2MWTs, with the longer of the two 2MWDs used for further analyses. The reference equations for the 2MWD were developed using stepwise multiple regression analysis. The newly established equations for the 2MWD were then compared with the existing equations. Results The mean 2MWD of the participants was 176±20 m. Age and BMI were identified as independent factors that influenced the 2MWD and explained 28% and 32% of the variance in walking distance for the male and female groups, respectively. The reference equations for the 2MWD were as follows: Conclusion This study resulted in the development of reference equations for predicting 2MWD among middle-aged and elderly Chinese people with obesity. These equations will be a clinically valuable tool for evaluating functional capacity, determining prognoses and monitoring treatment in middle-aged and elderly Chinese people with obesity.
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Affiliation(s)
- Jia Zhang
- Department of Medical Inspection, Wenzhou People’s Hospital, The Wenzhou Third Clinical Institute Affiliated with Wenzhou Medical University, Wenzhou, Zhejiang, China
- School of Laboratory Medicine and Life Sciences, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yingying Zou
- Digestive System Department, The Third Affiliated Hospital of Qiqihar Medical College, Qiqihar, Heilongjiang, China
| | - Zibin Wang
- Obstetrics Department, Wenzhou People’s Hospital, The Wenzhou Third Clinical Institute Affiliated with Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Xiaoshu Chen
- Department of Cardiovascular Medicine, Wenzhou People’s Hospital, The Wenzhou Third Clinical Institute Affiliated with Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Jingye Pan
- Department of General and Intensive Medical Care, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Haizhu Yu
- Department of General Practice, Zhejiang Hospital, Hangzhou, Zhejiang, China
| | - Enci Li
- Nursing Department, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - He Zou
- Department of Cardiovascular Medicine, Wenzhou People’s Hospital, The Wenzhou Third Clinical Institute Affiliated with Wenzhou Medical University, Wenzhou, Zhejiang, China
- * E-mail:
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21
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Pouplier A, Winther H, Christensen J, Schmidt-Andersen P, Zhang H, Frandsen TL, Schmiegelow K, Fridh MK, Larsen HB. Rehabilitation Including Structured Active Play for Preschoolers With Cancer (RePlay)-Study Protocol for a Randomized Controlled Trial. Front Pediatr 2022; 10:834512. [PMID: 35615627 PMCID: PMC9124960 DOI: 10.3389/fped.2022.834512] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 03/31/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Children diagnosed with cancer experience muscle weakness and impaired physical function caused by treatment and related immobility. The situation forces them into a negative cycle of diminished participation in physical and leisure activities and isolation from peers; inhibiting the natural development of social and gross motor skills. This manuscript presents a protocol for a study that explores the effects of using structured active play to maintain preschoolers' age specific gross motor function and social and personal skills while undertaking intensive cancer treatment. METHODS The study is a two-arm, superiority randomized controlled trial with an intervention and a control group designed to evaluate the effects of a structured active play intervention on gross motor function. Gross motor subtests of the Peabody Developmental Motor Scales, Second Edition (PDMS-2) are used for measurement; with the primary end-point at 6 months post-treatment initiation. Eighty-four preschool children (aged 1-5 years), newly diagnosed with cancer at the Copenhagen University Hospital are randomly assigned to either an intervention or control group, using a 1:1 allocation. The intervention group receives a combined in-hospital and home-based program that includes structured active play activities, while the control group receives standard care, including physiotherapy. During hospital admission, the intervention group undertakes 45-min structured active play group sessions three times weekly, conducted by exercise professionals. Parents receive training and supervision to facilitate daily individual sessions outside of group sessions. Secondary study outcomes target the children's overall function level in everyday life, general physical performance, and health-related quality of life. As well, children's and parents' experiences within the intervention are explored and the children's social and personal development is observed. DISCUSSION Limited evidence exists regarding the effectiveness of rehabilitation interventions, particularly those including active play, for preschoolers diagnosed with cancer. This manuscript reporting on a study protocol will enhance clarity and transparency in reporting and offer insights for others with interest in this same topic. Once completed, findings from this study could extend knowledge about the conduct and measurement of effectiveness in rehabilitation initiatives. If study findings suggest that the intervention is effective, structured active play may become a standard part of rehabilitation. TRIAL REGISTRATION ClinicalTrials.gov: NCT04672681. Registered December 17, 2020. https://clinicaltrials.gov/ct2/show/NCT04672681.
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Affiliation(s)
- Anna Pouplier
- Department for Pediatrics and Adolescent Medicine, The Juliane Marie Center, Copenhagen University Hospital, Copenhagen, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Helle Winther
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Jan Christensen
- Department of Occupational and Physiotherapy, Center of Head and Orthopedics, Copenhagen University Hospital, Copenhagen, Denmark
| | - Peter Schmidt-Andersen
- Department for Pediatrics and Adolescent Medicine, The Juliane Marie Center, Copenhagen University Hospital, Copenhagen, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Department of Occupational and Physiotherapy, Center of Head and Orthopedics, Copenhagen University Hospital, Copenhagen, Denmark
| | - He Zhang
- Department for Pediatrics and Adolescent Medicine, The Juliane Marie Center, Copenhagen University Hospital, Copenhagen, Denmark
| | - Thomas Leth Frandsen
- Mary Elizabeth's Hospital, Rigshospitalet for Children, Teens and Expecting Families, Copenhagen University Hospital, Copenhagen, Denmark
| | - Kjeld Schmiegelow
- Department for Pediatrics and Adolescent Medicine, The Juliane Marie Center, Copenhagen University Hospital, Copenhagen, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Martin Kaj Fridh
- Department for Pediatrics and Adolescent Medicine, The Juliane Marie Center, Copenhagen University Hospital, Copenhagen, Denmark
| | - Hanne Bækgaard Larsen
- Department for Pediatrics and Adolescent Medicine, The Juliane Marie Center, Copenhagen University Hospital, Copenhagen, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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22
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Wolf C, Betz U, Huthwelker J, Konradi J, Westphal RS, Cerpa M, Lenke L, Drees P. Evaluation of 3D vertebral and pelvic position by surface topography in asymptomatic females: presentation of normative reference data. J Orthop Surg Res 2021; 16:703. [PMID: 34863230 PMCID: PMC8642978 DOI: 10.1186/s13018-021-02843-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 11/15/2021] [Indexed: 11/18/2022] Open
Abstract
Background Deviations from a conventional physiologic posture are often a cause of complaint. According to current literature, the upright physiological spine posture exhibits inclinations in the sagittal plane but not in the coronal and transverse planes, but individual vertebral body positions of asymptomatic adults have rarely been described using surface topography. Therefore, this work aims to form a normative reference dataset for the thoracic and lumbar vertebral bodies and for the pelvis in all three planes in asymptomatic women. Methods In a prospective, cross-sectional, monocentric study, 100 pain-free asymptomatic women, aged 20–64 years were enrolled. Habitual standing positions of the trunk were measured using surface topography. Data were analyzed in all three planes. Age sub-analysis was: 1) ages ≤ 40 years and 2) ages ≥ 41 years. Two-sample t-tests were used for age comparisons of the vertebral bodies, vertebra prominence (VP)–L4, and global parameters. One-sample t-tests were used to test deviations from symmetrical zero positions of VP–L4. Results Coronal plane: on average, the vertebral bodies were tilted to the right between the VP and T4 (maximum: T2 − 1.8° ± 3.2), while between T6 and T11 they were tilted to the left (maximum: T7 1.1° ± 1.9). T5 and L2 were in a neutral position, overall depicting a mean right-sided lateral flexion from T2 to T7 (apex at T5). Sagittal plane: the kyphotic apex resided at T8 with − 0.5° ± 3.6 and the lumbar lordotic apex at L3 with − 2.1° ± 7.4. Transverse plane: participants had a mean vertebral body rotation to the right ranging from T6 to L4 (maximum: T11 − 2.2° ± 3.5). Age-specific differences were seen in the sagittal plane and had little effect on overall posture. Conclusions Asymptomatic female volunteers standing in a habitual posture displayed an average vertebral rotation and lateral flexion to the right in vertebral segments T2–T7. The physiological asymmetrical posture of women could be considered in spinal therapies. With regard to spinal surgery, it should be clarified whether an approximation to an absolutely symmetrical posture is desirable from a biomechanical point of view? This data set can also be used as a reference in clinical practice. Trial registration: This study was registered with WHO (INT: DRKS00010834) and approved by the responsible ethics committee at the Rhineland–Palatinate Medical Association (837.194.16). Supplementary Information The online version contains supplementary material available at 10.1186/s13018-021-02843-2.
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Affiliation(s)
- Claudia Wolf
- Institute of Physical Therapy, Prevention and Rehabilitation, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstrasse 1, 55131, Mainz, Germany
| | - Ulrich Betz
- Institute of Physical Therapy, Prevention and Rehabilitation, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstrasse 1, 55131, Mainz, Germany.
| | - Janine Huthwelker
- Institute of Physical Therapy, Prevention and Rehabilitation, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstrasse 1, 55131, Mainz, Germany
| | - Jürgen Konradi
- Institute of Physical Therapy, Prevention and Rehabilitation, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstrasse 1, 55131, Mainz, Germany
| | - Ruben Sebastian Westphal
- Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg University Mainz, Obere Zahlbacher Straße 69, 55131, Mainz, Germany
| | - Meghan Cerpa
- Department of Orthopedic Surgery, Columbia University Medical Center, 5141 Broadway, New York, NY, 10034, USA
| | - Lawrence Lenke
- Department of Orthopedic Surgery, Columbia University Medical Center, 5141 Broadway, New York, NY, 10034, USA
| | - Philipp Drees
- Department of Orthopedics and Trauma Surgery, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstrasse 1, 55131, Mainz, Germany
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23
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Brightwell CR, Kulkarni AS, Paredes W, Zhang K, Perkins JB, Gatlin KJ, Custodio M, Farooq H, Zaidi B, Pai R, Buttar RS, Tang Y, Melamed ML, Hostetter TH, Pessin JE, Hawkins M, Fry CS, Abramowitz MK. Muscle fibrosis and maladaptation occur progressively in CKD and are rescued by dialysis. JCI Insight 2021; 6:150112. [PMID: 34784301 PMCID: PMC8783691 DOI: 10.1172/jci.insight.150112] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 11/11/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Skeletal muscle maladaptation accompanies chronic kidney disease (CKD) and negatively impacts physical function. Emphasis in CKD has historically been placed on muscle fiber intrinsic deficits, such as altered protein metabolism and atrophy. However, targeted treatment of fiber intrinsic dysfunction has produced limited improvement, whereas alterations within the fiber extrinsic environment have scarcely been examined. METHODS We investigated alterations to the skeletal muscle interstitial environment with deep cellular phenotyping of biopsies from patients with CKD compared to age-matched control participants and performed transcriptome profiling to define the molecular underpinnings of CKD-associated muscle impairments. We further examined changes in the observed muscle maladaptation following initiation of dialysis therapy for kidney failure. RESULTS Patients with CKD exhibited a progressive fibrotic muscle phenotype, which was associated with impaired regenerative capacity and lower vascular density. The severity of these deficits was strongly associated with the degree of kidney dysfunction. Consistent with these profound deficits, CKD was associated with broad alterations to the muscle transcriptome, including altered extracellular matrix organization, downregulated angiogenesis, and altered expression of pathways related to stem cell self-renewal. Remarkably, despite the seemingly advanced nature of this fibrotic transformation, dialysis treatment rescued these deficits, restoring a healthier muscle phenotype. Furthermore, after accounting for muscle atrophy, strength and endurance improved after dialysis initiation. CONCLUSION These data identify a dialysis-responsive muscle fibrotic phenotype in CKD and suggest that the early dialysis window presents a unique opportunity of improved muscle regenerative capacity during which targeted interventions may achieve maximal impact. TRIAL REGISTRATION NCT01452412FUNDING. NIH.
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Affiliation(s)
- Camille R Brightwell
- Department of Athletic Training and Clinical Nutrition, University of Kentucky, Lexington, United States of America
| | - Ameya S Kulkarni
- Department of Medicine, Albert Einstein College of Medicine, Bronx, United States of America
| | - William Paredes
- Department of Medicine, Albert Einstein College of Medicine, Bronx, United States of America
| | - Kehao Zhang
- Department of Medicine, Albert Einstein College of Medicine, Bronx, United States of America
| | - Jaclyn B Perkins
- Department of Nutrition and Metabolism, The University of Texas Medical Branch, Galveston, United States of America
| | - Knubian J Gatlin
- Department of Nutrition and Metabolism, The University of Texas Medical Branch, Galveston, United States of America
| | - Matthew Custodio
- Department of Medicine, Albert Einstein College of Medicine, Bronx, United States of America
| | - Hina Farooq
- Department of Medicine, Albert Einstein College of Medicine, Bronx, United States of America
| | - Bushra Zaidi
- Department of Medicine, Albert Einstein College of Medicine, Bronx, United States of America
| | - Rima Pai
- Department of Medicine, Albert Einstein College of Medicine, Bronx, United States of America
| | - Rupinder S Buttar
- Department of Medicine, Albert Einstein College of Medicine, Bronx, United States of America
| | - Yan Tang
- Department of Medicine, Albert Einstein College of Medicine, Bronx, United States of America
| | - Michal L Melamed
- Department of Medicine, Albert Einstein College of Medicine, Bronx, United States of America
| | - Thomas H Hostetter
- Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, United States of America
| | - Jeffrey E Pessin
- Department of Medicine, Albert Einstein College of Medicine, Bronx, United States of America
| | - Meredith Hawkins
- Department of Medicine, Albert Einstein College of Medicine, Bronx, United States of America
| | | | - Matthew K Abramowitz
- Department of Medicine, Albert Einstein College of Medicine, Bronx, United States of America
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24
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Serpas DG, Zettel-Watson L, Cherry BJ. Fibromyalgia status and depressive symptoms are linked to body mass index and physical performance in mid to late life. PSYCHOL HEALTH MED 2021; 28:1230-1243. [PMID: 34758657 DOI: 10.1080/13548506.2021.2002379] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Fibromyalgia (FM) is a chronic pain condition that is frequently accompanied by comorbid conditions, including depression. Depression is associated with reduced physical functioning and health, disproportionately affecting middle-aged and older adults with FM. This study examined associations between FM status and depressive symptoms with body mass index (BMI) and several physical performance indicators among middle-aged and older adults. Participants included 239 community-dwelling middle-aged and older adults with or without FM. Depressive symptoms were measured using the Beck Depression Inventory-II (BDI-II), BMI was objectively assessed, and physical performance was measured using the Fullerton Advanced Balance scale, 6-minute walk test, 30-second chair stand, and 8-foot up and go test. A path model using structural equation modeling yielded good fit and revealed that, compared to pain-free adult controls, participants with FM reported more depressive symptoms, which were in turn associated with reduced physical performance across all indicators except BMI, after adjusting for age and symptom severity. Findings suggest that individuals with FM demonstrate disproportionately higher depressive symptoms compared to non-FM controls, which may diminish physical performance after accounting for ageand symptom severity. This study supports FM status and depressive symptoms as important considerations when evaluating the health and disability risk of aging adults.
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Affiliation(s)
- Dylan G Serpas
- Department of Psychology, California State University, Fullerton, CA, USA
| | - Laura Zettel-Watson
- Department of Psychology, California State University, Fullerton, CA, USA.,Aging Studies Academic Program, California State University, Fullerton, CA, USA
| | - Barbara J Cherry
- Department of Psychology, California State University, Fullerton, CA, USA.,Aging Studies Academic Program, California State University, Fullerton, CA, USA
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25
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Talbot LA, Webb L, Ramirez VJ, Morrell C, Bryndziar M, Enochs K, Metter E. Non-pharmacological Home Therapies for Subacute Low Back Pain in Active Duty Military Personnel: A Randomized Controlled Trial. Mil Med 2021; 188:12-19. [PMID: 34510214 PMCID: PMC8499864 DOI: 10.1093/milmed/usab382] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 09/01/2021] [Indexed: 01/11/2023] Open
Abstract
INTRODUCTION Low back pain (LBP) is a major cause of visits to ambulatory care, missed duty time, and disability discharge. The subacute phase of LBP presents an opportune time to prevent chronicity and lessen recurrence. The goal of this randomized controlled trial (RCT) was to determine the relative effectiveness of neuromuscular electrical stimulation (NMES) training and a progressive exercise program (PEP) on improving physical performance, pain, and torso strength in U.S. service members with subacute LBP, compared to standard primary care management (PCM) alone. METHODS This is an Institutional Review Board-approved protocol for an RCT conducted with active duty military personnel (n = 128) at Fort Campbell, Kentucky, between April 2018 and March 2020. Participants were randomized to receive NMES (n = 43), PEP (n = 42), or PCM (n = 43) for 9 weeks. Outcome measures of physical performance (sit-ups, push-ups, walking, and torso endurance), torso muscle strength (flexion and extension), and pain were assessed at baseline and after 3, 6, and 9 weeks. Analysis was intent-to-treat using linear mixed effects models. A sensitivity analysis was performed to address the protocol deviations that occurred in response to coronavirus disease 2019 pandemic, which required rescheduling 17 in-person study visits to home assessments at 9-week testing. RESULTS Evidence was found for group differences in physical performance for sit-ups and push-ups, with NMES showing greater improvement than PCM. The two groups showed similar improvements in torso muscle strength, although the NMES groups may show better improvement during early treatment. No group differences in pain levels were observed during the intervention, and all groups improved during the course of the study period. The amount of NMES muscle stimulation was directly related to the level of improvement, which was not the case for the hours reported for PEP exercise. CONCLUSION In an active duty population with subacute LBP, integrating NMES strength training into the rehabilitation therapy may offer a modest benefit for increasing sit-ups and push-ups and improving torso strength.
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Affiliation(s)
- Laura A Talbot
- Department of Neurology, College of Medicine, University of Tennessee Health Science Center, Memphis, TN 38163, USA
| | - Lee Webb
- Physical Therapy, La Pointe Health Clinic, Fort Campbell, KY 42240, USA
| | - Vanessa J Ramirez
- Physical Therapy, La Pointe Health Clinic, Fort Campbell, KY 42240, USA
| | - Christopher Morrell
- Department of Mathematics and Statistics, Loyola University Maryland, Baltimore, MD 21210, USA
| | - Martina Bryndziar
- Department of Neurology, College of Medicine, University of Tennessee Health Science Center, Memphis, TN 38163, USA
| | - Kayla Enochs
- Department of Neurology, College of Medicine, University of Tennessee Health Science Center, Memphis, TN 38163, USA
| | - e.jeffrey Metter
- Department of Neurology, College of Medicine, University of Tennessee Health Science Center, Memphis, TN 38163, USA
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26
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The Effects of a Science-Based Community Intervention on Health Outcomes in Minority Children: The Translational Health in Nutrition and Kinesiology Program. J Phys Act Health 2021; 18:1074-1081. [PMID: 34172591 DOI: 10.1123/jpah.2020-0622] [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: 09/17/2020] [Revised: 05/04/2021] [Accepted: 05/05/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND This study evaluated the effects of a novel nutrition and movement science after-school program integrating laboratory experiences for minority children. Laboratory experiences demonstrated how the body moves, functions, and performs in response to exercise and healthy nutrition. METHODS A total of 76 children from 4 after-school programs that were primarily Latino and black were randomly assigned to either an experimental translational health in nutrition and kinesiology (THINK; n = 46) or standard curriculum that served as the control group (CON; n = 30). An analysis of covariance controlling for baseline values was used to compare differences between THINK and CON after the 4-month intervention. RESULTS Following the program, THINK participants evidenced lower triceps and subscapular skinfold thickness (P < .01 and <.05, respectively). THINK students showed greater improvements in aerobic fitness, grip strength, and agility than CON (P < .01, <.01, and <.05, respectively). Participants in THINK also demonstrated higher scores on their nutrition habits/behaviors questionnaire (P < .01), nutrition science (P < .05), and exercise fitness tests (P < .001) than CON. CONCLUSION An innovative curriculum featuring nutrition and kinesiology education interfaced with hands-on laboratory experiences and physical activities can improve physical outcomes and health-related behaviors in after-school programs serving minority children.
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27
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Argento O, Spanò B, Pisani V, Incerti CC, Bozzali M, Foti C, Caltagirone C, Nocentini U. Dual-Task Performance in Multiple Sclerosis' Patients: Cerebellum Matters? Arch Clin Neuropsychol 2021; 36:517-526. [PMID: 33067615 DOI: 10.1093/arclin/acaa089] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 08/07/2020] [Accepted: 09/16/2020] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE Gait, cognitive impairments, and their mutual influence in dual tasking (cognitive-motor dual tasking, CM-DT) are important to address therapeutic approaches in patients with multiple sclerosis (PMS). CM-DT correlates have been widely investigated with variable and dissimilar results, due to differences in methods. However, although the cerebellum has recently shown to be involved in both motor and cognitive functions, few studies have explored its role in the integration of the concurrent execution of gait and cognition. This case-control study aims to explore the effects of adding a cognitive task to walking in PMS and to investigate the role of the cerebellum in the interfering process. METHODS In total, 20 patients and 18 healthy controls (HC) underwent clinical assessments, dual task (DT), and 3 T magnetic resonance imaging (MRI). DT was composed by three 2-min trials requiring fast walking. In 2 of them 2 different cognitive tasks were added. RESULTS Both groups evidenced the presence of cognitive-motor interference (CMI) for both cognitive conditions with a greater effect of word list generation task in PMS. Analysis of variance between HC and patients with high or low performances showed a significantly increased volume in Vermis lobules VIIIa and IX of high performers compared with HC. CONCLUSION Our results show that CMI is also present in healthy individuals but is significantly more disabling in PMS. Furthermore, MRI data point to the existence of an initial mechanism of cerebellar reorganization in PMS with lower interference. Subsequently, the failure of this mechanism due to the progression of disability leads to a more evident expression of symptoms.
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Affiliation(s)
- Ornella Argento
- Neurology and Neurorehabilitation Unit, I.R.C.C.S. "Santa Lucia" Foundation, Rome, Italy
| | - Barbara Spanò
- Neuroimaging Unit, I.R.C.C.S. "Santa Lucia" Foundation, Rome, Italy
| | - Valerio Pisani
- Neurology and Neurorehabilitation Unit, I.R.C.C.S. "Santa Lucia" Foundation, Rome, Italy
| | - Chiara C Incerti
- Neurology and Neurorehabilitation Unit, I.R.C.C.S. "Santa Lucia" Foundation, Rome, Italy
| | - Marco Bozzali
- Neuroimaging Unit, I.R.C.C.S. "Santa Lucia" Foundation, Rome, Italy.,Department of Neuroscience "Rita Levi Montalcini", University of Turin, Turin, Italy.,Department of Neuroscience, Brighton and Sussex Medical School, University of Sussex, Brighton, UK
| | - Calogero Foti
- Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Carlo Caltagirone
- Clinical and Behavioural Neurology Unit, I.R.C.C.S. "Santa Lucia" Foundation, Rome, Italy
| | - Ugo Nocentini
- Neurology and Neurorehabilitation Unit, I.R.C.C.S. "Santa Lucia" Foundation, Rome, Italy.,Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Rome, Italy
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28
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Vancampfort D, Kimbowa S, Basangwa D, Hallgren M, Van Damme T, Rosenbaum S, Mugisha J. Test-retest reliability, concurrent validity and correlates of the two-minute walk test in outpatients with alcohol use disorder. Alcohol 2021; 90:74-79. [PMID: 33422571 DOI: 10.1016/j.alcohol.2020.12.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 11/18/2020] [Accepted: 12/04/2020] [Indexed: 02/07/2023]
Abstract
We investigated the test-retest reliability of the 2-min walk test (2MWT) and its concurrent validity with the 6-min walk test (6MWT) in Ugandan outpatients with alcohol use disorder (AUD). We also explored practice effects, and assessed the minimal detectable change (MDC) and correlations with the 2MWT. Fifty outpatients [7 women; median age = 32.0 years] performed the 2MWT twice, the 6MWT once, and completed the Simple Physical Activity Questionnaire, Brief Symptoms Inventory-18 (BSI-18), and Alcohol Use Disorders Identification Test. The median (interquartile) 2MWT score on the first and second test were 162.0 (49.0) meters and 161.0 (58.0) meters, respectively, without significant difference between the two trials (p = 0.20). The intraclass correlation between the two 2MWTs was 0.96 (95% confidence interval = 0.94-0.98). The Spearman Rho correlation between the second 2MWT and the 6MWT was 0.91 (p < 0.001). The MDC for the 2MWT was 18 m. There was no evidence of a practice effect. Variance in BSI-18 depression and the presence of leg pain following the 2MWT explained 18.7% of 2MWT score variance. The 2MWT is a reliable and valid fitness test, which can be conducted without any special equipment or substantial time demands in outpatients with AUD.
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29
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Burnfield JM, Cesar GM, Buster TW. Feasibility of motor-assisted elliptical to improve walking, fitness and balance following pediatric acquired brain injury: A case series. J Pediatr Rehabil Med 2021; 14:539-551. [PMID: 33935119 DOI: 10.3233/prm-200717] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
PURPOSE Walking, fitness, and balance deficits are common following acquired brain injury (ABI). This study assessed feasibility, acceptability, and usefulness of a modified motor-assisted elliptical (ICARE) in addressing walking, fitness, and balance deficits in children with chronic ABIs. METHODS Three children (> 5 years post-ABI) completed 24 ICARE exercise sessions (exercise time, speed, and time overriding motor-assistance gradually increased) to promote mass repetition of gait-like movements and challenge cardiorespiratory fitness. Parents' and children's perceptions of ICARE's safety, comfort, workout, and usability were assessed. Cardiovascular response, gait and balance outcomes were assessed. RESULTS No adverse events occurred. Parent's Visual Analogue Scale (VAS) scores of perceived device safety (range 80-99), workout (range 99-100), and usability (range 75-100) were high, while comfort were 76-80 given commercial harness fit and arm support. Children's VAS scores all exceeded 89. Comfortable walking velocity, 2-Minute Walk Test, fitness, and Pediatric Balance Scale scores improved post-training, with many outcomes surpassing established minimal clinically important differences. CONCLUSION Following engagement in moderate- to vigorous-intensity exercise promoting repetitive step-like movements on a specially adapted motor-assisted elliptical, three children with chronic ABI demonstrated improvements in walking, fitness and balance. Future research in community-based environments with a larger cohort of children with ABI is needed.
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Affiliation(s)
- Judith M Burnfield
- Institute for Rehabilitation Science and Engineering, Madonna Rehabilitation Hospitals, Lincoln, NE, USA
| | - Guilherme M Cesar
- Institute for Rehabilitation Science and Engineering, Madonna Rehabilitation Hospitals, Lincoln, NE, USA
| | - Thad W Buster
- Institute for Rehabilitation Science and Engineering, Madonna Rehabilitation Hospitals, Lincoln, NE, USA
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30
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Helper N, Kodesh E, Sokol G, Hakimi R, Vilozni D, Efrati O. The benefits of mechanical insufflator-exsufflator compared to autogenic drainage in adults with cystic fibrosis. Pediatr Pulmonol 2020; 55:3046-3052. [PMID: 32776649 DOI: 10.1002/ppul.25020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 07/21/2020] [Accepted: 08/01/2020] [Indexed: 11/11/2022]
Abstract
BACKGROUND Autogenic drainage (AD) is used for airway clearance in individuals with cystic fibrosis (CF). The mechanical insufflator-exsufflator (MI-E) device is commonly used in patients with neuromuscular diseases for airway clearance by increasing inspiratory volume and expiratory flow. MI-E use has not been studied extensively in CF patients. OBJECTIVES To examine whether there are advantages to using the MI-E device in patients with CF. SUBJECTS Fourteen males and eight females from the national center for CF, with an average FEV1 of 54% were recruited DESIGN: Prospective cross-over trial (IRB 3009-16-SMC). INTERVENTION Subjects received either AD or MI-E in a random order. Sputum was collected and weighed immediately after treatment. Subjects performed lung function tests at baseline, 20 minutes after and 1 hour after treatment; additionally, a 2-minute walk test was performed at the end of all lung function tests. Saturation, dyspnea scores while resting and after a 2-minute walk and subjective fatigue were recorded. RESULTS Thirty-six percent more sputum was collected following MI-E than AD treatment (P < .0001). A significant difference in saturation in response to the 2MWT was noted in both treatments significantly less desaturation was recorded after the 2MWT in the MI-E treatment (P < .01). CONCLUSIONS Treatment with the MI-E was more effective for clearing sputum in CF subjects, initial evidence suggests that the MI-E may be successfully incorporated into treatment protocols. Further studies are needed to assess the long-term benefits of MI-E in patients with CF.
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Affiliation(s)
- Nir Helper
- Pediatric Pulmonary Unit, The National Center for Cystic Fibrosis, The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Ramat Gan, Israel.,Department of Physical Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Einat Kodesh
- Department of Physical Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Gil Sokol
- Pediatric Pulmonary Unit, The National Center for Cystic Fibrosis, The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Ramat Gan, Israel
| | - Ran Hakimi
- Pediatric Pulmonary Unit, The National Center for Cystic Fibrosis, The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Ramat Gan, Israel
| | - Daphna Vilozni
- Pediatric Pulmonary Unit, The National Center for Cystic Fibrosis, The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Ramat Gan, Israel
| | - Ori Efrati
- Pediatric Pulmonary Unit, The National Center for Cystic Fibrosis, The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Ramat Gan, Israel
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Haufe FL, Schmidt K, Duarte JE, Wolf P, Riener R, Xiloyannis M. Activity-based training with the Myosuit: a safety and feasibility study across diverse gait disorders. J Neuroeng Rehabil 2020; 17:135. [PMID: 33032627 PMCID: PMC7545901 DOI: 10.1186/s12984-020-00765-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 09/24/2020] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Physical activity is a recommended part of treatment for numerous neurological and neuromuscular disorders. Yet, many individuals with limited mobility are not able to meet the recommended activity levels. Lightweight, wearable robots like the Myosuit promise to facilitate functional ambulation and thereby physical activity. However, there is limited evidence of the safety and feasibility of training with such devices. METHODS Twelve participants with diverse motor disorders and the ability to walk for at least 10 m were enrolled in this uncontrolled case series study. The study protocol included five training sessions with a net training time of 45 min each. Primary outcomes were the feasibility of engaging in training with the Myosuit, the occurrence of adverse events, and participant retention. As secondary outcomes, we analyzed the walking speed using the 10-m Walk Test (10MWT) and for three participants, walking endurance using the 2-min Walk Tests. RESULTS Eight out of 12 participants completed the entire study protocol. Three participants withdrew from the study or were excluded for reasons unrelated to the study. One participant withdrew because of an unsafe feeling when walking with the Myosuit. No adverse events occurred during the study period for any of the participants and all scheduled trainings were completed. For five out of the eight participants that completed the full study, the walking speed when using the Myosuit was higher than to their baseline walking speed. CONCLUSIONS Activity-based training with the Myosuit appears to be safe, feasible, and well-tolerated by individuals with diverse motor disorders.
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Affiliation(s)
- Florian Leander Haufe
- Sensory-Motor Systems (SMS) Lab, Institute of Robotics and Intelligent Systems (IRIS), ETH Zurich, Zurich, Switzerland.
| | - Kai Schmidt
- Sensory-Motor Systems (SMS) Lab, Institute of Robotics and Intelligent Systems (IRIS), ETH Zurich, Zurich, Switzerland.,MyoSwiss AG, Zurich, Switzerland
| | | | - Peter Wolf
- Sensory-Motor Systems (SMS) Lab, Institute of Robotics and Intelligent Systems (IRIS), ETH Zurich, Zurich, Switzerland
| | - Robert Riener
- Sensory-Motor Systems (SMS) Lab, Institute of Robotics and Intelligent Systems (IRIS), ETH Zurich, Zurich, Switzerland.,Spinal Cord Injury Center, Balgrist University Hospital, Medical Faculty, University of Zurich, Zurich, Switzerland
| | - Michele Xiloyannis
- Sensory-Motor Systems (SMS) Lab, Institute of Robotics and Intelligent Systems (IRIS), ETH Zurich, Zurich, Switzerland
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Mazzoni G, Myers J, Sassone B, Pasanisi G, Mandini S, Raisi A, Pizzolato M, Franchi M, Caruso L, Missiroli L, Chiaranda G, Grazzi G. A moderate 200-m walk test estimates peak oxygen uptake in elderly outpatients with cardiovascular disease. J Sports Med Phys Fitness 2020; 60:786-793. [PMID: 32438791 DOI: 10.23736/s0022-4707.20.10387-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND A moderate 1-km treadmill walk test (1k-TWT) has been demonstrated to be a valid tool for estimating peak oxygen uptake (VO2peak) in outpatients with cardiovascular disease (CVD). The results obtained by the 1k-TWT predict survival and hospitalization in men and women with CVD. We aimed to examine whether shorter versions of the full 1k-TWT equally assess VO2peak in outpatients with CVD. METHODS One hundred eighteen outpatients with CVD, aged 70±9 years, referred to an exercise-based secondary prevention program, performed a moderate and perceptually-regulated (11-13/20 on the Borg Scale) 1k-TWT. Age, height, weight, heart rate, time to walk 100-m, 200-m, 300-m, and 400-m, and the full 1000-m, were entered into equations to estimate VO2peak. RESULTS The minimal distance providing similar VO2peak results of the full 1k-TWT was 200-m: 23.0±5.3 mL/kg/min and 23.0±5.5 mL/kg/min, respectively. The concordance correlation coefficient between the two was 0.97 (95%CI 0.96 to 0.98, P<0.0001). The slope and the intercept of the relationship between the values obtained by the 200-m and the full 1k-TWT were not different from the line of identity. Bland-Altman analysis did not show systematic or proportional error. CONCLUSIONS A moderate 200-m treadmill-walk is a reliable method for estimating VO2peak in elderly outpatients with CVD. A 200-m walk enables quick and easy cardiorespiratory fitness assessment, with low costs and low burden for health professionals and patients. These findings have practical implications for the transition of patients from clinically-based programs to fitness facilities or self-guided exercise programs.
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Affiliation(s)
- Gianni Mazzoni
- Center for Exercise Science and Sport, University of Ferrara, Ferrara, Italy.,Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy.,Department of Public Health, AUSL Ferrara, Ferrara, Italy
| | - Jonathan Myers
- Division of Cardiology, VA Palo Alto Health Case System, Palo Alto, CA, USA.,Stanford University School of Medicine, Stanford, CA, USA
| | - Biagio Sassone
- Division of Cardiology, Department of Medicine, AUSL Ferrara, Ferrara, Italy
| | - Giovanni Pasanisi
- Division of Cardiology, Department of Medicine, AUSL Ferrara, Ferrara, Italy
| | - Simona Mandini
- Center for Exercise Science and Sport, University of Ferrara, Ferrara, Italy - .,Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy
| | - Andrea Raisi
- Center for Exercise Science and Sport, University of Ferrara, Ferrara, Italy
| | - Matteo Pizzolato
- Center for Exercise Science and Sport, University of Ferrara, Ferrara, Italy
| | - Michele Franchi
- Center for Exercise Science and Sport, University of Ferrara, Ferrara, Italy
| | - Lorenzo Caruso
- Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy
| | - Loretta Missiroli
- Unit of Bibliometric and Dataset, Research Office, University of Ferrara, Ferrara, Italy
| | - Giorgio Chiaranda
- Department of Public Health, AUSL Ferrara, Ferrara, Italy.,Department of Public Health and Integration Policy, Emilia-Romagna Region, Bologna, Italy
| | - Giovanni Grazzi
- Center for Exercise Science and Sport, University of Ferrara, Ferrara, Italy.,Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy.,Department of Public Health, AUSL Ferrara, Ferrara, Italy
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Ishihara T, Miyazaki A, Tanaka H, Matsuda T. Identification of the brain networks that contribute to the interaction between physical function and working memory: An fMRI investigation with over 1,000 healthy adults. Neuroimage 2020; 221:117152. [PMID: 32668299 DOI: 10.1016/j.neuroimage.2020.117152] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 06/30/2020] [Accepted: 07/05/2020] [Indexed: 12/14/2022] Open
Abstract
There is a growing consensus regarding the positive relationship between physical function and working memory; however, explanations of task-evoked functional activity regarding this relationship and its differences in physical function domains remain controversial. This study illustrates the cross-sectional relationships between cardiorespiratory fitness, gait speed, hand dexterity, and muscular strength with working memory task (N-back task) performance and the mediating effects of task-evoked functional activity in 1033 adults aged between 22 and 37 years. The results showed that cardiorespiratory fitness and hand dexterity were independently associated with N-back task performance to a greater extent and in contrast to gait speed and muscular strength. These relationships were mediated by task-evoked functional activity in a part of the frontoparietal network (FPN) and default mode network (DMN). Superior cardiorespiratory fitness could contribute to working memory performance by enhancing the compensational role of FPN-related broader region activation. Hand dexterity was associated with moderation of the interaction in terms of task-evoked activation between the FPN and DMN, which in turn, improved N-back task performance. Based on these findings, we conclude that cardiorespiratory fitness and hand dexterity have common and unique mechanisms enhancing working memory.
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Affiliation(s)
- Toru Ishihara
- Tamagawa University Brain Science Institute, Tokyo, Japan; Japan Society for the Promotion of Science, Tokyo, Japan
| | | | - Hiroki Tanaka
- Tamagawa University Brain Science Institute, Tokyo, Japan; Japan Society for the Promotion of Science, Tokyo, Japan
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Senefeld JW, D’Astice SE, Harmer AR, Hunter SK. Increased Cardiovascular Response to a 6-Minute Walk Test in People With Type 2 Diabetes. Diabetes Spectr 2020; 33:104-110. [PMID: 32116462 PMCID: PMC7026755 DOI: 10.2337/ds19-0002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND AND OBJECTIVE Exercise is a cornerstone of management for type 2 diabetes; however, little is known about the cardiovascular (CV) response to submaximal functional exercise in people with type 2 diabetes. The aim of this study was to compare performance and CV response during a 6-minute walk test (6MWT) between people with type 2 diabetes and matched control subjects. METHODS CV response and distance walked during the 6MWT were assessed in 30 people with type 2 diabetes, matched for age, body composition, physical activity, and estimated aerobic capacity with 34 control subjects (type 2 diabetes group: 16 men, 59.8 ± 8.8 years of age, 33.3 ± 10.9% body fat, physical activity of 7,968 ± 3,236 steps·day-1, estimated aerobic capacity 31.9 ± 11.1 mLO2·kg-1·min-1; control group: 19 men, 59.3 ± 8.8 years of age, 32.7 ± 8.5% body fat, physical activity 8,228 ± 2,941 steps·day-1, estimated aerobic capacity 34.9 ± 15.4 mLO2·kg-1·min-1). RESULTS People with type 2 diabetes walked a similar distance (590 ± 75 vs. 605 ± 69 m; P = 0.458) compared with control subjects during the 6MWT and had similar ratings of perceived exertion (RPE) after the 6MWT (4.19 ± 1.56 vs. 3.65 ± 1.54, P = 0.147). However, at the end of the 6MWT, people with type 2 diabetes had a higher heart rate (108 ± 23 vs. 95 ± 18 beats·min-1; P = 0.048), systolic blood pressure (169 ± 26 vs. 147 ± 22 mmHg, P = 0.003), and rate-pressure product (18,762 ± 5,936 vs. 14,252 ± 4,330, P = 0.009) than control subjects. CONCLUSION Although people with type 2 diabetes had similar performance and RPE during the 6MWT compared with control subjects, the CV response was greater for people with type 2 diabetes, indicating greater cardiac effort for similar perceived effort and performance of 6MWT. These data suggest that observation and prescription of exercise intensity should include both perceived effort and CV response.
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Affiliation(s)
- Jonathon W. Senefeld
- Exercise Science Program, Department of Physical Therapy, Marquette University, Milwaukee, WI
| | - Sarah E. D’Astice
- Exercise Science Program, Department of Physical Therapy, Marquette University, Milwaukee, WI
| | - Alison R. Harmer
- Musculoskeletal Health Research Group, Faculty of Health Sciences, The University of Sydney, Lidcombe, Australia
| | - Sandra K. Hunter
- Exercise Science Program, Department of Physical Therapy, Marquette University, Milwaukee, WI
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Chrzanowski SM, Darras BT, Rutkove SB. The Value of Imaging and Composition-Based Biomarkers in Duchenne Muscular Dystrophy Clinical Trials. Neurotherapeutics 2020; 17:142-152. [PMID: 31879850 PMCID: PMC7007477 DOI: 10.1007/s13311-019-00825-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
As the drug development pipeline for Duchenne muscular dystrophy (DMD) rapidly advances, clinical trial outcomes need to be optimized. Effective assessment of disease burden, natural history progression, and response to therapy in clinical trials for Duchenne muscular dystrophy are critical factors for clinical trial success. By choosing optimal biomarkers to better assess therapeutic efficacy, study costs and sample size requirements can be reduced. Currently, functional measures continue to serve as the primary outcome for the majority of DMD clinical trials. Quantitative measures of muscle health, including magnetic resonance imaging and spectroscopy, electrical impedance myography, and ultrasound, sensitively identify diseased muscle, disease progression, and response to a therapeutic intervention. Furthermore, such non-invasive techniques have the potential to identify disease pathology prior to onset of clinical symptoms. Despite robust supportive evidence, non-invasive quantitative techniques are still not frequently utilized in clinical trials for Duchenne muscular dystrophy. Non-invasive quantitative techniques have demonstrated the ability to quantify disease progression and potential response to therapeutic intervention, and should be used as a supplement to current standard functional measures. Such methods have the potential to significantly accelerate the development and approval of therapies for DMD.
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Affiliation(s)
- Stephen M Chrzanowski
- Department of Medicine, Boston Children's Hospital, 300 Longwood Ave., Boston, MA, 02115, USA.
| | - Basil T Darras
- Department of Neurology, Boston Children's Hospital, Boston, MA, USA
| | - Seward B Rutkove
- Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA
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Grazzi G, Myers J, Arena R, Kaminsky L, Mazzoni G, Chiaranda G. Reply to commentary on: Prediction of VO 2peak by an endurance test and prognostic value of the FRIEND equation. Eur J Prev Cardiol 2019; 27:2054-2056. [PMID: 31787025 DOI: 10.1177/2047487319892121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Giovanni Grazzi
- Center for Exercise Science and Sport, University of Ferrara, Italy.,Public Health Department, AUSL Ferrara, Italy
| | - Jonathan Myers
- Division of Cardiology, VA Palo Alto, USA.,Stanford University School of Medicine, USA
| | - Ross Arena
- Department of Physical Therapy, University of Illinois at Chicago, USA
| | - Leonard Kaminsky
- Clinical Exercise Physiology Laboratory, Ball State University, USA
| | - Gianni Mazzoni
- Center for Exercise Science and Sport, University of Ferrara, Italy.,Public Health Department, AUSL Ferrara, Italy
| | - Giorgio Chiaranda
- Public Health Department, AUSL Piacenza, Italy.,General Directorship for Public Health and Integration Policy, Italy
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Vancampfort D, Kimbowa S, Basangwa D, Smith L, Stubbs B, Van Damme T, De Hert M, Mugisha J. Test-retest reliability, concurrent validity and correlates of the two-minute walk test in outpatients with psychosis. Psychiatry Res 2019; 282:112619. [PMID: 31648142 DOI: 10.1016/j.psychres.2019.112619] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 10/12/2019] [Accepted: 10/12/2019] [Indexed: 12/30/2022]
Abstract
The aim of this study was to investigate the test-retest reliability of the 2-minute walk test (2MWT) and the concurrent validity with the 6-minute walk test (6MWT) in outpatients with psychosis. We also explored whether there was a practice effect, determined minimal detectable changes (MDC) and assessed which factors are associated with the 2MWT performance. Fifty outpatients [22 women; 33.5 (14.3) years] performed the 2MWT twice and the 6MWT once and completed the Simple Physical Activity Questionnaire (SIMPAQ) and Brief Symptoms Inventory -18. The median (interquartile) 2MWT score on the first and second test were 128.0 (44.0) meters and 128.0 (31.5) meters, without significant difference between the two trials. The intraclass coefficient was 0.94 (95% confidence interval=0.91-0.97). The significant Spearman Rho correlation between the second 2MWT and the 6MWT was 0.69. The MDC was 22 m for men and 21 m for women. There was no evidence for a practice effect. Variability in SIMPAQ sedentary, exercise, incidental physical activity and leg pain following the test explained 54.6% of the variance in 2MWT score. The current study demonstrates that the 2MWT is a reliable, valid and clinically feasible tool for assessing and evaluating the functional exercise capacity in outpatients with psychosis.
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Affiliation(s)
- Davy Vancampfort
- KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium; University Psychiatric Centre KU Leuven, Kortenberg, Belgium.
| | - Samuel Kimbowa
- Butabika National Referral and Mental Health Hospital, Kampala, Uganda
| | - David Basangwa
- Butabika National Referral and Mental Health Hospital, Kampala, Uganda
| | - Lee Smith
- Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, United Kingdom
| | - Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, United Kingdom; Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, United Kingdom
| | - Tine Van Damme
- KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium
| | - Marc De Hert
- University Psychiatric Centre KU Leuven, Kortenberg, Belgium; Antwerp Health Law and Ethics Chair, University of Antwerp, Belgium
| | - James Mugisha
- Butabika National Referral and Mental Health Hospital, Kampala, Uganda; Kyambogo University, Kampala, Uganda
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Assessing manual dexterity: Comparing the WorkAbility Rate of Manipulation Test with the Minnesota Manual Dexterity Test. J Hand Ther 2019; 31:339-347. [PMID: 28501480 DOI: 10.1016/j.jht.2017.03.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Revised: 03/25/2017] [Accepted: 03/30/2017] [Indexed: 02/03/2023]
Abstract
STUDY DESIGN Cross-sectional study. INTRODUCTION The WorkAbility Rate of Manipulation Test (WRMT), an adaptation of the Minnesota Manual Dexterity Test (MMDT), contains a revised board and protocols to improve its utility for therapy or fitness assessment. PURPOSE OF THE STUDY To describe the development and preliminary psychometric properties of WRMT. METHODS Sixty-six healthy participants completed MMDT and WRMT in a random order followed by a user experience survey. We compared tests using repeated-measures analysis of variance, test-retest reliability, and examined agreement between tests. RESULTS Despite the similarities of these 2 instruments, the different administration protocols resulted in statistically different score distributions (P < .001). Results supported good test-retest reliability of WRMT (placing test ICC = 0.88-0.90 and turning test ICC = 0.68-0.82). The WRMT correlated moderately with MMDT (r = 0.81 in placing test and r = 0.44-0.57 in turning test). Bland-Altman plot showed that the differences in completion time were 3.8 seconds between placing tests and 19.6 (both hands), 0.3 (right hand), and 3.9 (left hand) seconds between turning tests. Overall, participants felt that the instruction of WRMT was easier to follow (44%) and preferred its setup, color, and depth of the test board (49%). Time required to complete 1 panel of 20 disks correlated highly with the time needed to finish a complete trial of 60 disks in both MMDT (r = 0.91-0.97) and WRMT (r = 0.88-0.95). CONCLUSIONS Caution is warranted in comparing scores from these 2 test variants. LEVEL OF EVIDENCE 3b.
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Hoskens J, Goemans N, Feys H, De Waele L, Van den Hauwe M, Klingels K. Normative data and percentile curves for the three-minute walk test and timed function tests in healthy Caucasian boys from 2.5 up to 6 years old. Neuromuscul Disord 2019; 29:585-600. [DOI: 10.1016/j.nmd.2019.06.597] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 06/06/2019] [Accepted: 06/25/2019] [Indexed: 10/26/2022]
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40
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Witherspoon JW, Vasavada R, Logaraj RH, Waite M, Collins J, Shieh C, Meilleur K, Bönnemann C, Jain M. Two-minute versus 6-minute walk distances during 6-minute walk test in neuromuscular disease: Is the 2-minute walk test an effective alternative to a 6-minute walk test? Eur J Paediatr Neurol 2019; 23:165-170. [PMID: 30449663 PMCID: PMC6423958 DOI: 10.1016/j.ejpn.2018.10.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 10/01/2018] [Accepted: 10/02/2018] [Indexed: 11/25/2022]
Abstract
Functional tests such as Motor Function Measure-32 (MFM-32), supine to stand, ascend/descend stairs permit the assessment of task-specific motor function in neuromuscular disease (NMD). The 6-min walk test (6MWT), though functional, is primarily used to assess endurance and disease progression in children with neuromuscular disorders. Barriers to 6MWT administration, in this population, can include reduced attention span due to age and inability to tolerate test length due to weakness. We propose task-specific functional deficits are related to endurance. Additionally, the 2-min walk test (2MWT) could effectively replace the 6MWT in this population. Seventy-seven participants, ages 5-18, with a variety of neuromuscular disorders performed the 6MWT, timed functional tests (TFT), and the MFM-32. Correlation and paired t-test analyses were used to compare the distance walked in the first 2 min (2MWD) to the distance walked in the entire 6 min (6MWD) and to the functional outcome measures above. The 2MWD strongly correlated with 6MWD and the other outcome measures. Paired t-test analysis also showed that the 2MWD did not differ from the distance walked in the last 2 min of the 6MWT. Although equivalence testing could not reject the claim that this difference exceeded the upper practical limit of 9.5 m, it only showed a modest overestimation of the 4-6MWD compared with the 2MWD. Together, our results support the ability of the 2MWD to predict the 6MWD, specifically in the pediatric neuromuscular disease population.
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Affiliation(s)
- J W Witherspoon
- National Institute of Nursing Research/Tissue Injury Branch/Neuromuscular Symptoms Unit, National Institutes of Health, Bethesda, MD, 20814, USA.
| | - R Vasavada
- Clinical Research Center, Rehabilitation Medicine Department, National Institutes of Health, Bethesda, MD, 20814, USA.
| | - R H Logaraj
- Clinical Research Center, Rehabilitation Medicine Department, National Institutes of Health, Bethesda, MD, 20814, USA.
| | - M Waite
- Clinical Research Center, Rehabilitation Medicine Department, National Institutes of Health, Bethesda, MD, 20814, USA.
| | - J Collins
- Department of Rehabilitation Science, George Mason University, Fairfax, VA, 22030, USA.
| | - C Shieh
- Office of Research on Women's Health, National Institutes of Health, Bethesda, MD, 20814, USA.
| | - K Meilleur
- National Institute of Nursing Research/Tissue Injury Branch/Neuromuscular Symptoms Unit, National Institutes of Health, Bethesda, MD, 20814, USA.
| | - C Bönnemann
- Neuromuscular and Neurogenetic Disorders of Childhood Section, Neurogenetics Branch, National Institutes of Health, Bethesda, MD, 20814, USA.
| | - M Jain
- Clinical Research Center, Rehabilitation Medicine Department, National Institutes of Health, Bethesda, MD, 20814, USA.
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Cesar GM, Buster TW, Burnfield JM. Cardiorespiratory fitness, balance and walking improvements in an adolescent with cerebral palsy (GMFCS II) and autism after motor-assisted elliptical training. EUROPEAN JOURNAL OF PHYSIOTHERAPY 2018. [DOI: 10.1080/21679169.2018.1536764] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Affiliation(s)
- Guilherme M. Cesar
- Institute for Rehabilitation Science and Engineering, Madonna Rehabilitation Hospitals, Lincoln, NE, USA
| | - Thad W. Buster
- Institute for Rehabilitation Science and Engineering, Madonna Rehabilitation Hospitals, Lincoln, NE, USA
| | - Judith M. Burnfield
- Institute for Rehabilitation Science and Engineering, Madonna Rehabilitation Hospitals, Lincoln, NE, USA
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Abramowitz MK, Paredes W, Zhang K, Brightwell CR, Newsom JN, Kwon HJ, Custodio M, Buttar RS, Farooq H, Zaidi B, Pai R, Pessin JE, Hawkins M, Fry CS. Skeletal muscle fibrosis is associated with decreased muscle inflammation and weakness in patients with chronic kidney disease. Am J Physiol Renal Physiol 2018; 315:F1658-F1669. [PMID: 30280599 DOI: 10.1152/ajprenal.00314.2018] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Muscle dysfunction is an important cause of morbidity among patients with chronic kidney disease (CKD). Although muscle fibrosis is present in a CKD rodent model, its existence in humans and its impact on physical function are currently unknown. We examined isometric leg extension strength and measures of skeletal muscle fibrosis and inflammation in vastus lateralis muscle from CKD patients ( n = 10) and healthy, sedentary controls ( n = 10). Histochemistry and immunohistochemistry were used to assess muscle collagen and macrophage and fibro/adipogenic progenitor (FAP) cell populations, and RT-qPCR was used to assess muscle-specific inflammatory marker expression. Muscle collagen content was significantly greater in CKD compared with control (18.8 ± 2.1 vs. 11.7 ± 0.7% collagen area, P = 0.008), as was staining for collagen I, pro-collagen I, and a novel collagen-hybridizing peptide that binds remodeling collagen. Muscle collagen was inversely associated with leg extension strength in CKD ( r = -0.74, P = 0.01). FAP abundance was increased in CKD, was highly correlated with muscle collagen ( r = 0.84, P < 0.001), and was inversely associated with TNF-α expression ( r = -0.65, P = 0.003). TNF-α, CD68, CCL2, and CCL5 mRNA were significantly lower in CKD than control, despite higher serum TNF-α and IL-6. Immunohistochemistry confirmed fewer CD68+ and CD11b+ macrophages in CKD muscle. In conclusion, skeletal muscle collagen content is increased in humans with CKD and is associated with functional parameters. Muscle fibrosis correlated with increased FAP abundance, which may be due to insufficient macrophage-mediated TNF-α secretion. These data provide a foundation for future research elucidating the mechanisms responsible for this newly identified human muscle pathology.
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Affiliation(s)
| | - William Paredes
- Department of Medicine, Albert Einstein College of Medicine, Bronx, New York
| | - Kehao Zhang
- Department of Medicine, Albert Einstein College of Medicine, Bronx, New York
| | - Camille R Brightwell
- Department of Nutrition and Metabolism, University of Texas Medical Branch , Galveston, Texas
| | - Julia N Newsom
- Department of Nutrition and Metabolism, University of Texas Medical Branch , Galveston, Texas
| | - Hyok-Joon Kwon
- Department of Medicine, Robert Wood Johnson Medical School, Rutgers-The State University of New Jersey , New Brunswick, New Jersey
| | - Matthew Custodio
- Department of Medicine, Albert Einstein College of Medicine, Bronx, New York
| | - Rupinder S Buttar
- Department of Medicine, Albert Einstein College of Medicine, Bronx, New York
| | - Hina Farooq
- Department of Medicine, Albert Einstein College of Medicine, Bronx, New York
| | - Bushra Zaidi
- Department of Medicine, Albert Einstein College of Medicine, Bronx, New York
| | - Rima Pai
- Department of Medicine, Albert Einstein College of Medicine, Bronx, New York
| | - Jeffrey E Pessin
- Department of Medicine, Albert Einstein College of Medicine, Bronx, New York.,Department of Molecular Pharmacology, Albert Einstein College of Medicine, Bronx, New York
| | - Meredith Hawkins
- Department of Medicine, Albert Einstein College of Medicine, Bronx, New York
| | - Christopher S Fry
- Department of Nutrition and Metabolism, University of Texas Medical Branch , Galveston, Texas
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Walking and Fitness Improvements in a Child With Diplegic Cerebral Palsy Following Motor-Assisted Elliptical Intervention. Pediatr Phys Ther 2018; 30:E1-E7. [PMID: 30277973 DOI: 10.1097/pep.0000000000000541] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To quantify effects of motor-assisted elliptical (Intelligently Controlled Assistive Rehabilitation Elliptical [ICARE]) training on walking and fitness of a child with cerebral palsy (CP). KEY POINTS A 12-year-old boy with walking limitations due to spastic diplegic CP (Gross Motor Function Classification System II) participated in 24 sessions of primarily moderate- to vigorous-intensity ICARE exercise. Fitness improvements were evidenced clinically across sessions by the child's capacity to train for longer periods, at faster speeds, and while overriding motor's assistance. Postintervention, the child walked faster with greater stability and endurance and more rapidly completed the modified Time Up and Go test. CONCLUSION The child's fitness and gait improved following engagement in a moderate- to vigorous-intensity gait-like exercise intervention. RECOMMENDATIONS FOR CLINICAL PRACTICE Integration of moderate- to vigorous-intensity motor-assisted elliptical training can promote simultaneous gains in fitness and function for children with CP.
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Hayes HA, Dibella D, Crockett R, Dixon M, Butterfield RJ, Johnson NE. Stepping Activity in Children With Congenital Myotonic Dystrophy. Pediatr Phys Ther 2018; 30:335-339. [PMID: 30277969 DOI: 10.1097/pep.0000000000000537] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
PURPOSE The purpose of this study was to investigate the physical activity levels in children with congenital myotonic dystrophy (CDM), and to examine whether patient clinical and functional characteristics correlated to physical activity. METHODS Twenty-five children with CDM were assessed on functional measures, clinical measures, and physical activity levels. RESULTS Results support that children with CDM spend the majority of their time inactive. There was a negative correlation between inactivity and cytosine-thymine-guanine repeats, suggesting increased inactivity with increased CDM severity. Age, body mass index, and lean muscle mass may be factors influencing activity levels. CONCLUSIONS Children in this study received one-third the recommended steps per day. The number of steps per day is not correlated with clinical measures.
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Affiliation(s)
- Heather A Hayes
- Department of Physical Therapy and Athletic Training (Dr Hayes) and Department of Neurology (Mss Dibella and Crockett and Drs Dixon, Butterfield, and Johnson), University of Utah, Salt Lake City, Utah
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Joosen P, Piette D, Buekers J, Taelman J, Berckmans D, De Boever P. A smartphone-based solution to monitor daily physical activity in a care home. J Telemed Telecare 2018; 25:611-622. [PMID: 30068250 DOI: 10.1177/1357633x18790170] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION In an ageing population, increasing chronic disease prevalence puts a high economic burden on society. Physical activity plays an important role in disease prevention and should therefore be promoted in the elderly. METHODS In this study, a mobile health (mHealth) system was implemented in a care home setting to monitor and promote elderly peoples' daily activity. The physical activity of 20 elderly people (8 female and 12 male, aged 81 ± 9 years old) was monitored over 10 weeks using the mHealth system, consisting of a smartphone and heart rate belt. Feedback on physical activity was provided weekly. A reference performance test battery derived from the Senior Fitness Test determined the participants' physical fitness. RESULTS Activity levels increased from week 1 onwards, peaking at week 5, and decreasing slightly until week 10. This illustrates that the use of mHealth and feedback on physical activity can motivate the elderly to become more active, but that the effect is transient without other incentives. Bio-data from the mHealth system were translated into a fitness score explaining 65% of the test battery's variance. After separating the elderly into three groups depending on physical fitness determined from the test battery, classification based on the fitness score resulted in a correct classification rate of 67.3%. DISCUSSION This study demonstrates that an mHealth system can be implemented in a care home setting to motivate activity of the elderly, and that the bio-data can be translated in a fitness score predicting the outcome of labour-intensive tests.
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Affiliation(s)
| | - Deborah Piette
- M3-BIORES, Division Animal and Human Health Engineering, Department of Biosystems, KU Leuven, Belgium
| | - Joren Buekers
- M3-BIORES, Division Animal and Human Health Engineering, Department of Biosystems, KU Leuven, Belgium.,Environmental Risk and Health, VITO, Belgium.,Centre for Environmental Sciences, Hasselt University, Hasselt, Belgium
| | | | - Daniel Berckmans
- BioRICS, Heverlee, Belgium.,M3-BIORES, Division Animal and Human Health Engineering, Department of Biosystems, KU Leuven, Belgium
| | - Patrick De Boever
- Environmental Risk and Health, VITO, Belgium.,Centre for Environmental Sciences, Hasselt University, Hasselt, Belgium
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Witherspoon JW, Vasavada RP, Waite MR, Shelton M, Chrismer IC, Wakim PG, Jain MS, Bönnemann CG, Meilleur KG. 6-minute walk test as a measure of disease progression and fatigability in a cohort of individuals with RYR1-related myopathies. Orphanet J Rare Dis 2018; 13:105. [PMID: 29970108 PMCID: PMC6029052 DOI: 10.1186/s13023-018-0848-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Accepted: 06/20/2018] [Indexed: 11/22/2022] Open
Abstract
Background RYR1-related Myopathies (RYR1-RM) comprise a group of rare neuromuscular diseases (NMDs) occurring in approximately 1/90000 people in the US pediatric population. RYR1-RM result from pathogenic mutations in the ryanodine receptor isoform-1 (RYR1) gene where consequent RyR1 protein calcium dysregulation leads to impaired excitation-contraction coupling, oxidative and nitrosative stress, and mitochondrial depletion. These physiological deficits perpetuate RyR1 dysfunction causing further muscle injury, muscle weakness, and muscle fatigue. Muscle weakness and fatigue are two primary complaints in patients with RYR1-RM and are major symptoms that limit the ability of individuals to perform activities of daily living. The six-minute walk test (6MWT) is an endurance test with high reliability and validity used to measure walking capacity, disease progression, and more recently, fatigability in NMDs with limited results in RYR1-RM. Therefore, the purpose of our study is to objectively assess disease progression and fatigability in RYR1-RM affected individuals using the 6MWT. We hypothesized that 6MWT distance and fatigability would not change significantly between 0 and 6-month visits in RYR1-RM patients, given the clinically reported stable or slowly progressive nature of the disease. We also hypothesized participants would show fatigability during the 6MWT, given muscle weakness and fatigue are the two primary complaints of affected individuals. Results As expected, paired t-test analyses revealed no significant difference between total distance traveled (p = .608) or percent change in speed (p = .141) at 0-months compared with the 6-month visit. Fatigability was observed given the decline in speed between the first and last minute of the 6MWT at the 6-month time point (p ≤ .0005,). Although this decline was not significant at baseline, a significant decline in speed from the 1st minute did occur at minutes 2, 3, and 4 during the baseline visit. Conclusion In this RYR1-RM cohort, the 6MWT showed disease stability over a 6-month period but revealed fatigability during the test. Given these results, the 6MWT may be a promising endpoint for evaluating fatigability and therapeutic efficacy in the 6-month treatment phase of our current n-acetylcysteine trial in this population. Improvement post intervention could be attributed to the intervention rather than variability in disease progression. Trial Registration Clinical Trials.gov, NCT02362425, Registered 13 February 2015-Prospectively registered.
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Affiliation(s)
| | | | | | - Monique Shelton
- National Institute of Nursing Research, NIH, Bethesda, MD, USA
| | | | - Paul G Wakim
- Biostatistics and Clinical Epidemiology, NIH, Bethesda, MD, USA
| | | | - Carsten G Bönnemann
- National Institute of Neurological Disorders and Stroke, NIH, Bethesda, MD, USA
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Perception of Physical Fitness and Exercise Self-Efficacy and Its Contribution to the Relationship between Body Dissatisfaction and Physical Fitness in Female Minority Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15061187. [PMID: 29882789 PMCID: PMC6025461 DOI: 10.3390/ijerph15061187] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 05/23/2018] [Accepted: 05/24/2018] [Indexed: 11/17/2022]
Abstract
Body Dissatisfaction (BD) and low physical self-concept and exercise efficacy have been linked to poor physical fitness levels and adverse health outcomes in children. The purpose of this study was to examine the relationship between BD, physical fitness, exercise self-efficacy, and self-Perception of Physical Fitness (PFP) in Latina and Black female children. Twenty-eight Latina and Black children enrolled in an elementary afterschool program, aged 8–12, completed surveys evaluating body dissatisfaction, exercise efficacy, PFP, and measures of physical fitness. Subjects exhibited moderate but significant inverse relationships between BD and PFP in strength (r = −0.459), agility (r = −0.382), aerobic fitness (r = −0.354), and flexibility (r = −0.461) (p < 0.05 for all). There was a significant negative correlation between exercise efficacy and BD (r = −4.2; p < 0.05). Power (r = 0.51) and flexibility (r = 0.42) were the only physical fitness measures significantly and positively related to children’s PFP (p < 0.05). A significant medium inverse relationship was also found between BD and aerobic fitness scores (r = −0.381; p < 0.05). However, after controlling for exercise efficacy or perception of physical fitness, the relationship between BD and aerobic fitness was not significant (p > 0.05). Findings suggest that positive PFP and positive performance in several physical fitness measures are associated with lower levels of BD in minority female children. Furthermore, evidence suggests exercise efficacy and PFP can mediate the relationship body image and aerobic fitness. These findings suggest that PFP, more so than measured physical fitness, was associated with lower levels of BD in minority female children. These results have important implications for programs designed to improve physical fitness and mental health in minority children.
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The Use of a Wheelchair Propulsion Field Test to Determine Peak Heart Rate in Children and Adolescents With Myelomeningocele. Pediatr Exerc Sci 2018; 30:251-258. [PMID: 29485935 DOI: 10.1123/pes.2017-0094] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
PURPOSE We analyzed the evolution and pattern of heart rate (HR) during the 12-minute wheelchair propulsion field test (WPFT) and compared the peak HR (HRpeak) from the WPFT to the HRpeak obtained in the progressive cardiopulmonary exercise test on arm cranking ergometer (ACT). We aimed to determine if the field test detects the HRpeak consistently and could be used in clinical practice. METHODS Eleven wheelchair-using children and adolescents with myelomeningocele (aged 8-15 y) performed a maximal ACT and a 12-minute WPFT. HR was recorded continuously at rest, during each minute of the tests, and at recovery. Mixed analysis of variance was used to compare the variables at rest and peak. Bland-Altman plot and Lin's concordance correlation coefficient were used to show agreement between the tests. RESULTS During minute 2 of the WPFT, participants reached 73%-96% of the HRpeak values recorded in the ACT. From minutes 4 to 12, participants reached HRpeak values ranging 86%-109% of the values recorded in the ACT. There is agreement between the ACT and the WPFT tests. CONCLUSION WPFT with minimal duration of 4 minutes may be an alternative tool to obtain HRpeak in children and adolescents with myelomeningocele.
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Measuring physical capacity and performance in older people. Best Pract Res Clin Rheumatol 2017; 31:243-254. [PMID: 29224699 DOI: 10.1016/j.berh.2017.11.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Accepted: 11/03/2017] [Indexed: 01/06/2023]
Abstract
We highlight the important differences between the concepts of capacity and performance and highlight the development of measures and their application in common conditions encountered in health care practice with older people. A number of expert consensus projects have concluded that mobility, balance, muscle strength and dexterity are core domains for capacity measurement in older people. Instruments with evidence of adequate psychometric properties for the evaluation of capacity in response to intervention programmes include the Short Physical Performance Battery, hand grip strength, mini-BEST and 9-hole pegboard test. Measures that can track individual change and convey information that can be used to inform clinical decision-making, individual prognosis or prediction of events require greater precision. However, few such measures are available. Performance measurement usually focuses on basic or instrumental (advanced) Activities of Daily Living performed by people in their usual environments. Finally, we discuss the limitations of physical performance and capacity measures and future developments that may enhance the use of these measures in health and clinical care.
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Rodríguez-Grande EI, Osma-Rueda JL, Serrano-Villar Y, Ramírez C. Effects of pulsed therapeutic ultrasound on the treatment of people with knee osteoarthritis. J Phys Ther Sci 2017; 29:1637-1643. [PMID: 28932004 PMCID: PMC5599837 DOI: 10.1589/jpts.29.1637] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2017] [Accepted: 06/15/2017] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The aim was to evaluate the effect of therapeutic ultrasound on the pain, joint mobility, muscle strength, physical function, and quality of life of people with knee OA. [Subjects and Methods] One-site, one-arm, before-after study that included people with Grade II or III tibiofemoral osteoarthritis. Ten therapeutic ultrasound sessions (duty cycle=20%, ERA=10 cm2, BNR=6:1, SATP=2.2 W/cm2, SATA=0.44 W/cm2, frequency=1 MHz, time=4 minutes) were applied. Assessments of primary outcome variables: pain intensity and function, and secondary variables: joint mobility, muscle strength and quality of life, were performed at onset and end of therapy; an additional intermediate evaluation was included for the primary variables. [Results] Means of repeated measurements of pain intensity (pain at rest, pain on palpation and pain after functional activities) and function showed significant differences. There was a significant reduction in pain intensity at the end of functional activities as well as a significant increase in function and in quadriceps muscle strength. [Conclusion] Therapeutic ultrasound applied in accordance with the parameters used, could be recommended during the treatment of individuals with knee osteoarthritis, because it significantly decreased the intensity of pain after the 5th session, and this reduction was maintained until the end of the intervention.
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Affiliation(s)
- Eliana-Isabel Rodríguez-Grande
- Universidad del Rosario, Escuela de Medicina y Ciencias de la Salud, GI Ciencias de la Rehabilitación: Bogota, Cundinamarca, Colombia
| | - Jose-Luis Osma-Rueda
- Department of Surgery and Orthopedics, School of Medicine, Universidad Industrial de Santander, Colombia
| | | | - Carolina Ramírez
- School of Physiotherapy, Universidad Industrial de Santander, Colombia
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