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Antoniadou E, Giusti E, Capodaglio P, Han DS, Gimigliano F, Guzman JM, Oh-Park M, Frontera W. Frailty recommendations and guidelines: an evaluation of the implementability and a critical appraisal of clinical applicability by the ISPRM Frailty Focus Group. Eur J Phys Rehabil Med 2024:S1973-9087.24.08486-7. [PMID: 38656081 DOI: 10.23736/s1973-9087.24.08486-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
INTRODUCTION Aging is associated with an increased burden of multi-morbidity and disease related functional loss and disability, widely impacting patients and health care systems. Frailty is a major actor in age-related disability and is an important target for rehabilitation interventions, considering that is a reversible condition. EVIDENCE ACQUISITION A working group of members of the ISPRM, responding to WHO 2030 call for action to strengthen rehabilitation, was established to assess the quality and implementability of the existing guidelines for the rehabilitation of frailty. Guidelines were retrieved using a systematic search on Pubmed, Scopus and Web of Science and from the reference lists of screened articles. The included guidelines were evaluated using the AGREE II to assess their quality and using the AGREE-REX to assess their clinical credibility and implementability. Guidelines with a score >4 in the AGREE II item evaluating the overall quality of the guideline were considered for endorsement. Finally, nine external reviewers evaluated the applicability of each recommendation from the endorsed guidelines, providing comments about the barriers and facilitators for their implementation in their country. EVIDENCE SYNTHESIS Ten guidelines were retrieved and evaluated by the working group, of which four guidelines, i.e. the WHO Guidelines on Integrated Care for Older People, the FOCUS guidelines, the Asia-Pacific Clinical Practice Guidelines for the Management of Frailty and the ICFSR International Clinical Practice Guidelines for Identification and Management of Frailty, were considered for endorsement. All these guidelines were rated as of adequate quality and implementability. CONCLUSIONS The WHO Guidelines on Integrated Care for Older people (24) the ICFSR International Clinical Practice Guidelines for Identification and management of Frailty (15), the FOCUS guidelines (25) and the Asia Pacific Clinical Practice Guidelines (14) for the Management of Frailty have the best quality and applicability of the existing guidelines on the management of frailty, we suggest that should be employed to define the standards of care for patients with frailty. There are barriers for their implementation, as stated by our experts, to take into account, and some of them are country- or region-specific. Screening for frailty, exercise, nutrition, pharmacological management, social and psychological support, management of incontinence, and an overall comprehensive clinical management are the best tools to face upon frailty.
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Affiliation(s)
- Eleftheria Antoniadou
- Geriatric Rehabilitation Clinic Centre Hospitalier du Nord, Ettelbruck, Luxembourg -
| | - Emanuele Giusti
- EPIMED Research Center, Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Paolo Capodaglio
- Unit of Physical and Rehabilitation Medicine, Department of Surgical Sciences, University of Turin, Turin, Italy
- Unit of Rehabilitation, Istituto Auxologico Italiano IRCCS, Piancavallo, Verbania, Italy
| | - Der-Sheng Han
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan (R.O.C.)
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Bei-Hu Branch, Taipei, Taiwan (R.O.C.)
| | - Francesca Gimigliano
- Dipartimento di Salute Mentale e Fisica e Medicina Preventiva, Università Vanvitelli Campania, Naples, Italy
| | | | - Mooyeon Oh-Park
- Burke Rehabilitation Department of Rehabilitation Medicine, Albert Einstein College of Medicine, Montefiore Health System, New York, NY, USA
| | - Walter Frontera
- Department of Physical Medicine, Rehabilitation, and Sports Medicine, Department of Physiology, University of Puerto Rico School of Medicine, San Juan, Puerto Rico
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Morgenroth DC, Knowlton T, Apkon S, Blauwet CA, Burns AS, Córdova Vallejos C, Frontera W, Hearn SL, Jayabalan P, Lim PA, Moroz A, Perret D, Powell D, Puderbaugh M, Rivers E, Sowa G, Verduzco-Gutierrez M, Celnik PA. Challenges and Opportunities in Academic Physiatry: An Environmental Scan. Am J Phys Med Rehabil 2023; 102:159-165. [PMID: 36634238 PMCID: PMC10233907 DOI: 10.1097/phm.0000000000002127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
ABSTRACT Environmental scans determine trends in an organization's or field's internal and external environment. The results can help shape goals, inform strategic decision making, and direct future actions. The Association of Academic Physiatrists convened a strategic planning group in 2020, composed of physiatrists representing a diversity of professional roles, career stages, race and ethnicity, gender, disability status, and geographic areas of practice. This strategic planning group performed an environmental scan to assess the forces, trends, challenges, and opportunities affecting both the Association of Academic Physiatrists and the entire field of academic physiatry (also known as physical medicine and rehabilitation, physical and rehabilitation medicine, and rehabilitation medicine). This article presents aspects of the environmental scan thought to be most pertinent to the field of academic physiatry organized within the following five themes: (1) Macro/Societal Trends, (2) Technological Advancements, (3) Diversity and Global Outreach, (4) Economy, and (5) Education/Learning Environment. The challenges and opportunities presented here can provide a roadmap for the field to thrive within the complex and evolving healthcare systems in the United States and globally.
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Affiliation(s)
- David C. Morgenroth
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
- Rehabilitation Care Service, VA Puget Sound Health Care System, Seattle, WA, USA
| | | | - Susan Apkon
- Department of PM&R, Children’s Hospital Colorado/University of Colorado, Aurora, CO, USA
| | - Cheri A. Blauwet
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital/Harvard Medical School, Boston MA, USA
| | - Anthony S. Burns
- Division of Physical Medicine & Rehabilitation, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Cecilia Córdova Vallejos
- Department of Physical Medicine and Rehabilitation, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, USA
| | - Walter Frontera
- Department of Physical Medicine, Rehabilitation and Sports Medicine, University of Puerto Rico School of Medicine, San Juan, Puerto Rico, USA
| | - Sandra L. Hearn
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI, USA
| | - Prakash Jayabalan
- Department of Physical Medicine and Rehabilitation, Northwestern Feinberg School of Medicine, Chicago, IL, USA
| | - Peter A. Lim
- Physical Medicine and Rehabilitation Service, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA
- H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX, USA
| | - Alex Moroz
- Department of Rehabilitation Medicine, New York University Grossman School of Medicine, New York, NY, USA
| | - Danielle Perret
- University of California, Irvine, Department of Physical Medicine and Rehabilitation, Orange, CA, USA
| | - Danielle Powell
- University of Alabama Heersink School of Medicine, Department of Physical Medicine and Rehabilitation, Birmingham, AL, USA
| | - Matt Puderbaugh
- Department of Physical Medicine and Rehabilitation, Hennepin Healthcare, Minneapolis, MN, USA
| | - Evan Rivers
- Physical Medicine and Rehabilitation Service, Tennessee Valley Healthcare System, Nashville, TN, USA
- Department of Physical Medicine and Rehabilitation, Vanderbilt University Medical System, Nashville, TN, USA
| | - Gwendolyn Sowa
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA, USA
- UPMC Rehabilitation Institute, Pittsburgh, PA, USA
| | - Monica Verduzco-Gutierrez
- Department of Rehabilitation Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Pablo A. Celnik
- Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Rodriguez‐Rivera AK, Pérez‐Cardona E, Frontera W, Torres‐Ramos C, Segarra A. Exercise Increases Mitochondrial Biogenesis in Single‐Housed Adolescent Female Rats Treated with Cocaine. FASEB J 2022. [DOI: 10.1096/fasebj.2022.36.s1.l7520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Rios-Russo JL, Lozada-Bado LS, de Mel S, Frontera W, Micheo W. Ulnar-Sided Wrist Pain in the Athlete: Sport-Specific Demands, Clinical Presentation, and Management Options. Curr Sports Med Rep 2021; 20:312-318. [PMID: 34099609 DOI: 10.1249/jsr.0000000000000853] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
ABSTRACT Ulnar-sided wrist injuries are common in sports that require repeated pronosupination, wrist radial/ulnar deviation, axial loading, and gripping equipment. Common anatomic structures affected include the triangular fibrocartilage complex, extensor carpi ulnaris tendon, distal radioulnar and ulnocarpal joints, and hamate bone. Presenting symptoms include pain with activity, swelling, possible snapping or clicking, and reproduction of symptoms with provocative maneuvers. Imaging may confirm or rule out pathologies, but abnormal findings also may present in asymptomatic athletes. Initial treatment is usually nonoperative with splinting, load management, activity modification, strengthening the components of the kinetic chain of the particular sport, and pain management. Surgery is usually indicated in ulnar-wrist pain pathology such as hook of hamate fractures and required in associated instability. Future research should address specific treatment and rehabilitation protocols, emphasizing the complete kinetic chain along with the injured wrist.
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Affiliation(s)
- Jose L Rios-Russo
- Department of Physical Medicine, Rehabilitation and Sports Medicine, University of Puerto Rico, San Juan, PUERTO RICO
| | - Lianette S Lozada-Bado
- Department of Physical Medicine, Rehabilitation and Sports Medicine, University of Puerto Rico, San Juan, PUERTO RICO
| | - Sandra de Mel
- Ponce Health Sciences School of Medicine, Ponce Health Sciences University, Ponce, PUERTO RICO
| | - Walter Frontera
- Department of Physical Medicine, Rehabilitation and Sports Medicine, University of Puerto Rico, San Juan, PUERTO RICO
| | - William Micheo
- Department of Physical Medicine, Rehabilitation and Sports Medicine, University of Puerto Rico, San Juan, PUERTO RICO
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Kara M, Kaymak B, Frontera W, Ata AM, Ricci V, Ekiz T, Chang KV, Han DS, Michail X, Quittan M, Lim JY, Bean JF, Franchignoni F, Özçakar L. Diagnosing sarcopenia: Functional perspectives and a new algorithm from the ISarcoPRM. J Rehabil Med 2021; 53:jrm00209. [PMID: 34121127 PMCID: PMC8814891 DOI: 10.2340/16501977-2851] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/31/2021] [Indexed: 11/27/2022] Open
Abstract
Sarcopenia is an important public health problem, characterized by age-related loss of muscle mass and muscle function. It is a precursor of physical frailty, mobility limitation, and premature death. Muscle loss is mainly due to the loss of type II muscle fibres, and progressive loss of motor neurones is thought to be the primary underlying factor. Anterior thigh muscles undergo atrophy earlier, and the loss of anterior thigh muscle function may therefore be an antecedent finding. The aim of this review is to provide an in-depth (and holistic) neuromusculoskeletal approach to sarcopenia. In addition, under the umbrella of the International Society of Physical and Rehabilitation Medicine (ISPRM), a novel diagnostic algorithm is proposed, developed with the consensus of experts in the special interest group on sarcopenia (ISarcoPRM). The advantages of this algorithm over the others are: special caution concerning disorders related to the renin-angiotensin system at the case finding stage; emphasis on anterior thigh muscle mass and function loss; incorporation of ultrasound for the first time to measure the anterior thigh muscle; and addition of a chair stand test as a power/performance test to assess anterior thigh muscle function. Refining and testing the algorithm remains a priority for future research.
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Affiliation(s)
- Murat Kara
- Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey. E-mail:
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Falgas-Bague I, Ramos Z, del Cueto P, Kim E, Zhen-Duan J, Wong YJ, Chieng CK, Frontera W, Alegría M. Adaptation of an Evidence-Based Intervention for Disability Prevention, Implemented by Community Health Workers Serving Ethnic Minority Elders. Am J Geriatr Psychiatry 2021; 29:260-269. [PMID: 32855041 PMCID: PMC7855421 DOI: 10.1016/j.jagp.2020.07.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 07/27/2020] [Accepted: 07/28/2020] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Changing demographics have created substantial unmet needs for mental health and physical disability services for immigrant and racial/ethnic minority elders. Workforce shortages can be reduced by task-shifting to community health workers (CHWs) who speak the same language and share the culture of these elders. Yet, implementation of interventions offered by CHWs requires adaptations of content and delivery, ideally under clinical supervision. OBJECTIVE To culturally adapt two evidence-based interventions, offered in community settings, to address mental health and physical disability prevention for diverse minority elders. METHODS We followed the Castro-Barrera stepped model for cultural adaptation of two evidence-based interventions into one combined program of disability management and prevention delivered by CHWs. We used feedback from key stakeholders, including four clinical supervisors, 16 CHWs, 17 exercise trainers, and 153 participants, collected at three time points to further adapt the intervention to a diverse population of elders. RESULTS Adaptations for administration by CHWs/exercise trainers included: systematization of supervision process, increased flexibility in sessions offered per participants' needs, inclusion of self-care content, modification of materials to better reflect elders' daily life experiences, and greater focus on patient engagement in care. Areas for additional adaptation included enhancing examples with culturally relevant metaphors, incorporating visual aids, and training CHWs in the importance of building trust. CONCLUSION This study identifies key aspects of the cultural adaptation process that facilitates broader cultural sensitivity of service delivery by CHWs to diverse elders in community settings.
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Affiliation(s)
- Irene Falgas-Bague
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA; Department of Medicine, Harvard Medical School, Boston, MA.
| | - Zorangeli Ramos
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Paola del Cueto
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Emily Kim
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Jenny Zhen-Duan
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA,Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Yankau Josephine Wong
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Ching-King Chieng
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Walter Frontera
- Departments of Physical Medicine, Rehabilitation and Sports Medicine and Physiology and Biophysics, University of Puerto Rico, Río Piedras, Puerto Rico
| | - Margarita Alegría
- Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA,Department of Medicine, Harvard Medical School, Boston, MA, USA,Department of Psychiatry, Harvard Medical School, Boston, MA, USA
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7
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Negrini S, Chan L, Ferriero G, Frontera W, Heinemann A. Current evidence from the Randomized Controlled Trials Rehabilitation Checklist (RCTRACK) reporting guideline project. Eur J Phys Rehabil Med 2020; 56:787-789. [PMID: 33047946 PMCID: PMC8603787 DOI: 10.23736/s1973-9087.20.06635-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Stefano Negrini
- Department of Biomedical, Surgical and Dental Sciences, University "La Statale", Milan, Italy -
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy -
| | - Leighton Chan
- Department of Rehabilitation Medicine, Clinical Center, National Institutes of Health, Bethesda, MD, USA
| | - Giorgio Ferriero
- Physical and Rehabilitation Medicine Unit, Scientific Institute of Tradate, Istituti Clinici Scientifici Maugeri IRCCS, Tradate, Varese, Italy
- Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy
| | - Walter Frontera
- Department of Physical Medicine, Rehabilitation, and Sports Medicine, University of Puerto Rico School of Medicine, San Juan, Puerto Rico
- Department of Physiology, University of Puerto Rico School of Medicine, San Juan, Puerto Rico
| | - Allen Heinemann
- Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, and Shirley Ryan AbilityLab, Chicago, IL, USA
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Abstract
OBJECTIVE Impairment of physical function is the main determinant of morbidity/mortality in sarcopenia and frailty. Physical function tests are performed by the movement around the joints, and skeletal muscles are the main generators of the forces required to perform these functional tasks. However, the central nervous system, which initiates and coordinates muscle movements, controls the magnitude and temporal parameters of muscle forces. METHODS Non-systematic literature review was performed about the effects of aging on neuromotor control. RESULT The ability of a muscle to produce force by aging is deteriorated not only by muscle structural changes, but also by neuromotor control dysfunction. With aging, changes in muscle structure and loss of volumes in brain structures related with movement and cognition have been shown. Age-related cognitive impairment can have considerable negative effects on the force generating capacity of skeletal muscles. In this sense, the relationship has been found between handgrip strength, gait speed, and cognition. CONCLUSION Treatments targeting muscle mass only would be insufficient unless we address the impairment of neurocognitive functions. It is essential that prescribing life-long exercise is important for healthy aging including the preservation of muscle mass/strength, physical and cognitive functioning, and independent living.
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Affiliation(s)
- Murat Kara
- Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey
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Ramirez-Marrero FA, Amalbert-Birriel MA, Santana-Bagur JL, Wojna V, Frontera W. Mechanical Efficiency After High Intensity Interval Training In Hiv+ Hispanic Women. Med Sci Sports Exerc 2019. [DOI: 10.1249/01.mss.0000562104.95940.de] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Esquenazi A, Frontera W. 7.3 The organizations of physical and rehabilitation medicine in the world: Physical and rehabilitation medicine in the Americas. J Int Soc Phys Rehabil Med 2019. [DOI: 10.4103/jisprm.jisprm_32_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Gimigliano F, Lains J, Li J, Li L, Wu S, Gorringe L, Bosschers L, Frontera W. The international society of physical and rehabilitation medicine: The past, present, and way forward-III. J Int Soc Phys Rehabil Med 2019. [DOI: 10.4103/ijprm.ijprm_7_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Stucki G, Frontera W, Gimigliano F, Melvin J, Li J, Li L, Lains J. ClinFIT: ISPRM's Universal Functioning Information Tool based on the WHO's ICF. J Int Soc Phys Rehabil Med 2019. [DOI: 10.4103/jisprm.jisprm_36_19] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Laffont I, Lains J, Frontera W, Yelnik A, Thevenon A. ISPRM-France 2018: A winning and so promising experience! Ann Phys Rehabil Med 2018; 61:361-362. [PMID: 30145240 DOI: 10.1016/j.rehab.2018.08.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 08/10/2018] [Indexed: 11/30/2022]
Affiliation(s)
- I Laffont
- PRM Department, Montpellier University Hospital, Euromov, IFRH, University of Montpellier, France.
| | - J Lains
- Centro de Medicina de Reabilitação Região Centro, Rovisco Pais and Universidade Católica Portuguesa, Portugal
| | - W Frontera
- Department of PM&R, University of Puerto Rico School of Medicine, San Juan, PR
| | - A Yelnik
- PRM Department, GH St. Louis-Lariboisière-F. Widal, AP-HP, Paris Diderot University, 200, rue du Faubourg-St-Denis, 75010 Paris, France
| | - A Thevenon
- PRM department, CHU, 59000 Lille, France; URePSS, Lille University, 59000 Lille, France
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Romero-Reyes A, Ramirez-Marrero FA, Amalbert-Birriel M, Medina-Encarnacion A, Santana-Bagur J, Frontera W, Wojna V. Feasibility Of A Low Volume HIIT Intervention In HIV+ Hispanic Women With Neurocognitive Impairment. Med Sci Sports Exerc 2018. [DOI: 10.1249/01.mss.0000536663.83324.d9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Ramirez-Marrero FA, Frontera W, Santana-Bagur J, Wojna V. Considering Cardiorespiratory Fitness Relative to Lean Body Mass in HIV+ compared with HIV- Hispanic Women. Med Sci Sports Exerc 2018. [DOI: 10.1249/01.mss.0000536258.35964.46] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Javadov S, Jang S, Rodriguez-Reyes N, Rodriguez-Zayas AE, Soto Hernandez J, Krainz T, Wipf P, Frontera W. Mitochondria-targeted antioxidant preserves contractile properties and mitochondrial function of skeletal muscle in aged rats. Oncotarget 2016; 6:39469-81. [PMID: 26415224 PMCID: PMC4741839 DOI: 10.18632/oncotarget.5783] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Accepted: 08/31/2015] [Indexed: 12/27/2022] Open
Abstract
Mitochondrial dysfunction plays a central role in the pathogenesis of sarcopenia associated with a loss of mass and activity of skeletal muscle. In addition to energy deprivation, increased mitochondrial ROS damage proteins and lipids in aged skeletal muscle. Therefore, prevention of mitochondrial ROS is important for potential therapeutic strategies to delay sarcopenia. This study elucidates the pharmacological efficiency of the new developed mitochondria-targeted ROS and electron scavenger, XJB-5-131 (XJB) to restore muscle contractility and mitochondrial function in aged skeletal muscle. Male adult (5-month old) and aged (29-month old) Fischer Brown Norway (F344/BN) rats were treated with XJB for four weeks and contractile properties of single skeletal muscle fibres and activity of mitochondrial ETC complexes were determined at the end of the treatment period. XJB-treated old rats showed higher muscle contractility associated with prevention of protein oxidation in both muscle homogenate and mitochondria compared with untreated counterparts. XJB-treated animals demonstrated a high activity of the respiratory complexes I, III, and IV with no changes in citrate synthase activity. These data demonstrate that mitochondrial ROS play a causal role in muscle weakness, and that a ROS scavenger specifically targeted to mitochondria can reverse age-related alterations of mitochondrial function and improve contractile properties in skeletal muscle.
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Affiliation(s)
- Sabzali Javadov
- Department of Physiology, School of Medicine, University of Puerto Rico, San Juan, PR, USA
| | - Sehwan Jang
- Department of Physiology, School of Medicine, University of Puerto Rico, San Juan, PR, USA
| | | | - Ana E Rodriguez-Zayas
- Department of Physiology, School of Medicine, University of Puerto Rico, San Juan, PR, USA
| | - Jessica Soto Hernandez
- Department of Physiology, School of Medicine, University of Puerto Rico, San Juan, PR, USA
| | - Tanja Krainz
- Department of Chemistry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Peter Wipf
- Department of Chemistry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Walter Frontera
- Department of Physiology, School of Medicine, University of Puerto Rico, San Juan, PR, USA.,Department of Physical Medicine and Rehabilitation, Vanderbilt University School of Medicine, Nashville, TN, USA
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Srinivasa S, Suresh C, Mottla J, Hamarneh SR, Irazoqui JE, Frontera W, Torriani M, Stanley T, Makimura H. FNDC5 relates to skeletal muscle IGF-I and mitochondrial function and gene expression in obese men with reduced growth hormone. Growth Horm IGF Res 2016; 26:36-41. [PMID: 26774404 PMCID: PMC4716612 DOI: 10.1016/j.ghir.2015.12.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Revised: 12/14/2015] [Accepted: 12/14/2015] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To investigate the relationship of skeletal muscle FNDC5 mRNA expression and circulating irisin to the GH/IGF-I axis and to skeletal muscle mitochondrial function and mitochondria-related gene expression in obese men. DESIGN Fifteen abdominally obese men with reduced growth hormone received 12weeks of recombinant human GH (rhGH). Before and after treatment, they underwent (31)P-magnetic resonance spectroscopy to evaluate phosphocreatine (PCr) recovery as a measure of mitochondrial function and skeletal muscle biopsy to assess expression of mitochondrial-related genes. Serum irisin and IGF-I and skeletal muscle FNDC5 and IGF-I mRNA were measured. RESULTS At baseline, skeletal muscle FNDC5 mRNA was significantly and positively associated with IGF-I mRNA (ρ=0.81, P=0.005) and rate of PCr recovery (ρ=0.79, P=0.006). Similar relationships of circulating irisin to IGF-I mRNA (ρ=0.63, P=0.05) and rate of PCr recovery (ρ=0.48, P=0.08) were demonstrated, but were not as robust as those with muscle FNDC5 expression. Both serum irisin and skeletal muscle FNDC5 mRNA were significantly associated with PPARγ (ρ=0.73, P=0.02 and ρ=0.85, P=0.002), respectively. In addition, FNDC5 mRNA was correlated with skeletal muscle PGC-1α (ρ=0.68, P=0.03), NRF1 (ρ=0.66, P=0.04) and TFAM (ρ=0.79, P=0.007) mRNA. Neither serum irisin nor muscle mRNA expression of FNDC5 changed with rhGH treatment. CONCLUSION These novel data in skeletal muscle demonstrate that local expression of FNDC5 is associated with mRNA expression of IGF-I and mitochondrial function and mitochondria-related gene expression in obese subjects with reduced growth hormone and suggest a potential role for FNDC5 acting locally in muscle in a low GH state. Further studies are needed to clarify the relationship between the GH/IGF-I axis and irisin.
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Affiliation(s)
- Suman Srinivasa
- Program in Nutritional Metabolism, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
| | - Caroline Suresh
- Program in Nutritional Metabolism, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Jay Mottla
- Georgetown University, School of Medicine, Washington, DC, USA
| | - Sulaiman R Hamarneh
- Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Javier E Irazoqui
- Laboratory of Comparative Immunology, Center for the Study of Inflammatory Bowel Disease, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Walter Frontera
- Department of Physical Medicine and Rehabilitation, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Physical Medicine and Rehabilitation, Harvard Medical School/Spaulding Rehabilitation Hospital, Boston, MA, USA; Department of Physiology, University of Puerto Rico School of Medicine, Puerto Rico
| | - Martin Torriani
- Division of Musculoskeletal Imaging and Intervention, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Takara Stanley
- Program in Nutritional Metabolism, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; Department of Pediatrics, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Hideo Makimura
- Program in Nutritional Metabolism, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
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Hamarneh SR, Murphy CA, Shih CW, Frontera W, Torriani M, Irazoqui JE, Makimura H. Relationship between serum IGF-1 and skeletal muscle IGF-1 mRNA expression to phosphocreatine recovery after exercise in obese men with reduced GH. J Clin Endocrinol Metab 2015; 100:617-25. [PMID: 25375982 PMCID: PMC4318910 DOI: 10.1210/jc.2014-2711] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
CONTEXT GH and IGF-1 are believed to be physiological regulators of skeletal muscle mitochondria. OBJECTIVE The objective of this study was to examine the relationship between GH/IGF-1 and skeletal muscle mitochondria in obese subjects with reduced GH secretion in more detail. DESIGN Fifteen abdominally obese men with reduced GH secretion were treated for 12 weeks with recombinant human GH. Subjects underwent (31)P-magnetic resonance spectroscopy to assess phosphocreatine (PCr) recovery as an in vivo measure of skeletal muscle mitochondrial function and percutaneous muscle biopsies to assess mRNA expression of IGF-1 and mitochondrial-related genes at baseline and 12 weeks. RESULTS At baseline, skeletal muscle IGF-1 mRNA expression was significantly associated with PCr recovery (r = 0.79; P = .01) and nuclear respiratory factor-1 (r = 0.87; P = .001), mitochondrial transcription factor A (r = 0.86; P = .001), peroxisome proliferator-activated receptor (PPAR)γ (r = 0.72; P = .02), and PPARα (r = 0.75; P = .01) mRNA expression, and trended to an association with PPARγ coactivator 1-α (r = 0.59; P = .07) mRNA expression. However, serum IGF-1 concentration was not associated with PCr recovery or any mitochondrial gene expression (all P > .10). Administration of recombinant human GH increased both serum IGF-1 (change, 218 ± 29 μg/L; P < .0001) and IGF-1 mRNA in muscle (fold change, 2.1 ± 0.3; P = .002). Increases in serum IGF-1 were associated with improvements in total body fat (r = -0.53; P = .04), trunk fat (r = -0.55; P = .03), and lean mass (r = 0.58; P = .02), but not with PCr recovery (P > .10). Conversely, increase in muscle IGF-1 mRNA was associated with improvements in PCr recovery (r = 0.74; P = .02), but not with body composition parameters (P > .10). CONCLUSION These data demonstrate a novel association of skeletal muscle mitochondria with muscle IGF-1 mRNA expression, but independent of serum IGF-1 concentrations.
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Affiliation(s)
- Sulaiman R Hamarneh
- Department of Surgery (S.R.H.), Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts 02114; Program in Nutritional Metabolism (C.A.M., C.W.S., H.M.), Massachusetts General Hospital, Boston, Massachusetts 02114; Harvard College (C.W.S.), Boston, Massachusetts 02138; Department of Physical Medicine and Rehabilitation (W.F.), Vanderbilt University Medical Center, Nashville, Tennessee 37212; Department of Physical Medicine and Rehabilitation (W.F.), Harvard Medical School/Spaulding Rehabilitation Hospital, Boston, Massachusetts 02114; Department of Physiology (W.F.), University of Puerto Rico School of Medicine, San Juan, Puerto Rico 00936; and Department of Radiology (M.T.), Laboratory of Comparative Immunology, Center for the Study of Inflammatory Bowel Disease (J.E.I.), and Neuroendocrine Unit (H.M.), Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts 02114
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Bristo M, Blauwet CA, Frontera W, Tolchin DW, Stein MA, Hoppe KM, Wu SSH, Kirschner KL. The Convention on the Rights of Persons with Disabilities: what is at stake for physiatrists and the patients we serve. PM R 2015; 6:356-62. [PMID: 24766853 DOI: 10.1016/j.pmrj.2014.03.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2014] [Accepted: 03/06/2014] [Indexed: 11/18/2022]
Affiliation(s)
- Marca Bristo
- Access Living, Chicago, IL, United States International Council on Disabilities, Washington, DC(∗)
| | - Cheri A Blauwet
- Department of Physical Medicine and Rehabilitation, Rehabilitation Institute of Chicago-Northwestern University Feinberg School of Medicine, Chicago, IL(†)
| | - Walter Frontera
- Department of Physical Medicine and Rehabilitation, Vanderbilt University Medical Center, Nashville, TN(‡)
| | | | - Michael Ashley Stein
- Harvard Law School Project on Disability, Harvard Law School, Cambridge, MA; and William and Mary Law School, Williamsburg, VA(‖)
| | - Kurtis M Hoppe
- Physical Medicine and Rehabilitation, Mayo Clinic College of Medicine(¶)
| | - Sam S H Wu
- Department of Physical Medicine and Rehabilitation, Geisinger Health System, Danville, PA; Department of Physical Medicine and Rehabilitation, Rutgers-New Jersey Medical School, Newark, NJ; and Department of Physical Medicine and Rehabilitation, Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ(#)
| | - Kristi L Kirschner
- Medical Humanities and Bioethics, and Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Schwab Rehabilitation Hospital, Chicago, IL(∗∗).
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Ramírez-Marrero FA, Santana-Bagur JL, Joyner MJ, Rodríguez-Zayas J, Frontera W. Metabolic syndrome in relation to cardiorespiratory fitness, active and sedentary behavior in HIV+ Hispanics with and without lipodystrophy. P R Health Sci J 2014; 33:163-169. [PMID: 25563033 PMCID: PMC4329015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVE Hispanics in Puerto Rico (PR) have a high prevalence of metabolic syndrome (met-syn), partially explained by low physical activity (PA) and possibly low cardiorespiratory fitness (VO2peak). Met-syn is also associated with lipodystrophy in HIV infected (HIV+) adults taking antiretroviral therapies. However, associations between met-syn, VO2peak, PA, sedentary behavior and lipodystrophy among HIV+ Hispanics have not been adequately reported. We tested the following hypotheses: 1) HIV+ Hispanics with lipodystrophy (HIV-Lipo) would have a higher prevalence of met-syn, lower VO2peak and PA, and higher sedentary behavior compared with those without lipodystrophy (HIV-no-Lipo) and without HIV infection (Non-HIV); and 2) met-syn would be inversely associated with VO2peak and PA, and directly associated with sedentary behavior. METHODS Ninety Hispanic adults (32 HIV-Lipo, 28 HIV-no-Lipo, 30 Non-HIV) completed measurements of VO2,peak, anthropometry, PA and sedentary behavior with accelerometry, blood pressure, fasting glucose, insulin, and lipids. ANOVA and chi-square tests were used to detect differences between groups, and regression analyses to test associations between variables. RESULTS More HIV-Lipo (69%) had met-syn compared with HIV-no-Lipo (39%) and Non-HIV (37%) (P = 0.002). Sedentary behavior and PA were not different, but VO2peak differed between all groups: lowest in HIV-Lipo and highest in non-HIV. PA and sedentary behavior were not associated with met-syn, but PA was directly associated with VO2peak (R2 = 0.26, p < 0.01). Also, a lower odds ratio for met-syn was observed with higher VO2peak (0.87; 95% CI: 0.83-0.95). CONCLUSION Met-syn is related to lipodystrophy in HIV+ Hispanics in PR, and high VO2peak may protect against met-syn in this population.
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Imamura M, Gutenbrunner C, Stucki G, Li J, Lains J, Frontera W, Olver J, Özçakar L, DeLisa J, Battistella L, Melvin J. The International Society of Physical and Rehabilitation Medicine: The way forward – II. J Rehabil Med 2014; 46:97-107. [DOI: 10.2340/16501977-1277] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Özçakar L, Franchignoni F, Frontera W, Negrini S. Writing a case report for the American Journal of Physical Medicine and Rehabilitation and the European Journal of Physical and Rehabilitation Medicine. Eur J Phys Rehabil Med 2013; 49:223-226. [PMID: 24558650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Case reports (CR) have led to the description and discovery of new diseases, syndromes, therapeutic complications or side-effects, and previously unknown potential benefits of pharmacologic agents. CRs may also be used as an effective training strategy for novice authors to develop the skills needed for medical writing. Yet, too often, CRs do not follow standards for excellence in scientific writing. Therefore, in this article, the American Journal of Physical Medicine and Rehabilitation (AJPMR) and the European Journal of Physical and Rehabilitation Medicine (EJPRM) collaborate with the purpose of providing guidance to authors in selecting CRs that might be appropriate for publication. In addition, we discuss different aspects of the preparation of a well-written CR in accordance with the mission and editorial views of both journals.
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Estape E, de Laurido LES, Shaheen M, Quarshie A, Frontera W, Mays MH, Harrigan R, White R. A Multiinstitutional, Multidisciplinary Model for Developing and Teaching Translational Research in Health Disparities. Clin Transl Sci 2012. [DOI: 10.1111/j.1752-8062.2011.00374_1.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Estape E, Laurido LESD, Shaheen M, Quarshie A, Frontera W, Mays MH, Harrigan R, White R. A multiinstitutional, multidisciplinary model for developing and teaching translational research in health disparities. Clin Transl Sci 2011; 4:434-8. [PMID: 22212225 DOI: 10.1111/j.1752-8062.2011.00346.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Health disparities may affect any person in any community in the world, resulting from a multitude of factors including socioeconomic status, race, ethnicity, environment, and genetics. The impact of health disparities is felt by affected individuals, their families, communities, and the greater health care system. There is a critical need to increase health disparities research activities. This may be achieved by expanding and strengthening the training, education and career development of motivated clinicians, physicians and basic scientists, engaging them in clinical and translational research. Translational research relies on collaboration across disciplines, facilitating the dissemination and transfer of knowledge to populations for the overall improvement of health while decreasing the economic burden of health care. The University of Puerto Rico Medical Sciences Campus (UPR-MSC), Schools of Health Professions and Medicine joint initiatives, Clinical Research Education and Career Development (CRECD) and Hispanics in Research Capability (HiREC) programs, convened health disparities experts, faculty and scholars from multiple disciplines, cultural backgrounds and institutions. Together, they created a model for teaching translational research in health disparities that spans disciplines without boundaries.
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Affiliation(s)
- Estela Estape
- School of Health Professions, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico.
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Ramírez-Marrero FA, De Jesús E, Santana-Bagur J, Hunter R, Frontera W, Joyner MJ. Prevalence of cardiometabolic risk factors in Hispanics living with HIV. Ethn Dis 2010; 20:423-428. [PMID: 21305832 PMCID: PMC3071519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023] Open
Abstract
OBJECTIVE Human immunodeficiency virus (HIV) infection and antiretroviral treatment are associated with metabolic and cardiovascular complications that resemble metabolic syndrome (MetS) and potentially increase the risk of diabetes and cardiovascular disease in this population. The purpose of this study was to determine the prevalence of MetS and its individual components among Hispanics living with HIV in Puerto Rico. METHODS Data from 909 clinical records were extracted and the prevalence of MetS determined using the NCEP-ATPIII criteria. Fisher's exact test was used to detect sex differences, and logistic regression to examine the effect of age, sex, smoking, years of HIV infection, antiretroviral therapy, and Hepatitis C coinfection. RESULTS The prevalence of MetS in our study group (35.4%) was higher than previously reported in the United States, but not higher than in the general population in Puerto Rico. Females had a higher prevalence of MetS (44.2%) than males (30.5%); mostly explained by high body mass index and waist circumference. Age and sex were associated with the presence of MetS. CONCLUSION Understanding ethnic and sex differences in the prevalence of metabolic risk factors is essential for the implementation of specific targeted interventions to prevent subsequent vascular morbidity and mortality in this population.
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Affiliation(s)
- Farah A Ramírez-Marrero
- Department of Physical Medicine, Rehabilitation and Sports Medicine, University of Puerto Rico School of Medicine, San Juan.
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Negrini S, Frontera W. The Euro-American Rehabilitation Focus: a cultural bridge across the ocean. Eur J Phys Rehabil Med 2008; 44:109-110. [PMID: 18418328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
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Fleischman A, Johnsen S, Systrom DM, Hrovat M, Farrar CT, Frontera W, Fitch K, Thomas BJ, Torriani M, Côté HCF, Grinspoon SK. Effects of a nucleoside reverse transcriptase inhibitor, stavudine, on glucose disposal and mitochondrial function in muscle of healthy adults. Am J Physiol Endocrinol Metab 2007; 292:E1666-73. [PMID: 17284576 PMCID: PMC3206591 DOI: 10.1152/ajpendo.00550.2006] [Citation(s) in RCA: 129] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Mitochondrial dysfunction may contribute to the development of insulin resistance and type 2 diabetes. Nucleoside reverse transcriptase inhibitors (NRTIs), specifically stavudine, are known to alter mitochondrial function in human immunodeficiency virus (HIV)-infected individuals, but the effects of stavudine on glucose disposal and mitochondrial function in muscle have not been prospectively evaluated. In this study, we investigated short-term stavudine administration among healthy control subjects to determine effects on insulin sensitivity. A secondary aim was to determine the effects of stavudine on mitochondrial DNA (mtDNA) and function. Sixteen participants without personal or family history of diabetes were enrolled. Subjects were randomized to receive stavudine, 30-40 mg, twice a day, or placebo for 1 mo. Insulin sensitivity determined by glucose infusion rate during the hyperinsulinemic euglycemic clamp was significantly reduced after 1-mo exposure in the stavudine-treated subjects compared with placebo (-0.8 +/- 0.5 vs. +0.7 +/- 0.3 mg.kg(-1).min(-1), P = 0.04, stavudine vs. placebo). In addition, muscle biopsy specimens in the stavudine-treated group showed significant reduction in mtDNA/nuclear DNA (-52%, P = 0.005), with no change in placebo-treated subjects (+8%, P = 0.9). (31)P magnetic resonance spectroscopy (MRS) studies of mitochondrial function correlated with insulin sensitivity measures (r2 = 0.5, P = 0.008). These findings demonstrate that stavudine administration has potent effects on insulin sensitivity among healthy subjects. Further studies are necessary to determine whether changes in mtDNA resulting from stavudine contribute to effects on insulin sensitivity.
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Affiliation(s)
- Amy Fleischman
- Program In Nutritional Metabolism, Massachusetts General Hospital, 55 Fruit St., LON 207, Boston, MA 02114, USA
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Dolan SE, Frontera W, Librizzi J, Ljungquist K, Juan S, Dorman R, Cole ME, Kanter JR, Grinspoon S. Effects of a supervised home-based aerobic and progressive resistance training regimen in women infected with human immunodeficiency virus: a randomized trial. ACTA ACUST UNITED AC 2006; 166:1225-31. [PMID: 16772251 PMCID: PMC3205443 DOI: 10.1001/archinte.166.11.1225] [Citation(s) in RCA: 132] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND Women infected with human immunodeficiency virus (HIV) increasingly demonstrate abnormalities in fat distribution and metabolism; however, the effects of a home-based exercise regimen in this group have not been investigated. METHODS We conducted a 16-week randomized intervention study of a supervised home-based progressive resistance training and aerobic exercise program in 40 HIV-infected women with increased waist-hip ratio and self-reported fat redistribution. Cross-sectional muscle area and muscle attenuation were measured by computed tomography. Cardiorespiratory fitness was determined by calculated maximum oxygen consumption (VO2max) and strength by 1-repetition maximum. RESULTS Cardiorespiratory fitness (VO2max) was markedly lower at baseline (median [95% confidence interval], 15.4 [8.3-25.2] mL x kg(-1) x min(-1)) than reported values for healthy female subjects (26-35 mL x kg(-1) x min(-1)). Subjects randomized to exercise had significant improvement in mean +/- SEM VO2max (1.5 +/- 0.8 vs -2.5 +/- 1.6 mL x kg(-1) x min(-1); P<.001) and endurance (1.0 +/- 0.3 vs -0.6 +/- 0.3 minute; P<.001). Strength increased at the knee extensors, pectoralis, knee flexors, shoulder abductors, ankle plantar flexors, and elbow flexors (all P<.001). Total muscle area (6 +/- 1 vs 2 +/- 1 cm2; P = .02) and attenuation (2 +/- 1 vs -1 +/- 1 Hounsfield unit; P = .03) increased in the exercise group. No significant difference was seen in lipid levels, blood pressure, or abdominal visceral fat between the groups, but subjects randomized to exercise reported improved energy and appearance. CONCLUSIONS A 16-week, supervised, home-based exercise regimen improved measures of physical fitness in HIV-infected women. The effects on strength were most significant, but improvements in cardiorespiratory fitness, endurance, and body composition were also seen.
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Affiliation(s)
- Sara E Dolan
- Program in Nutritional Metabolism and Neuroendocrine Unit, Massachusetts General Hospital, Boston 02114, USA
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Frontera W. The importance of technology in rehabilitation. IEEE Eng Med Biol Mag 2003; 22:25. [PMID: 12845814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Affiliation(s)
- Walter Frontera
- Harvard Medical School, Spaulding Rehabilitation Hospital, USA
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Bean JF, Kiely DK, Leveille SG, Herman S, Huynh C, Fielding R, Frontera W. The 6-minute walk test in mobility-limited elders: what is being measured? J Gerontol A Biol Sci Med Sci 2002; 57:M751-6. [PMID: 12403805 DOI: 10.1093/gerona/57.11.m751] [Citation(s) in RCA: 104] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The 6-minute walk (6mw) is a well-established measure of aerobic capacity in elders with cardiorespiratory and peripheral vascular disease and may be an accurate measure of functional performance in healthy elders. In mobility-limited elders, a population at risk for disability, impairments in strength and power are predictive of performance-based measures of function. Though commonly utilized as an outcome measure among otherwise healthy mobility-limited elders, it is not clear whether the 6mw best represents a measure of functional limitation, aerobic capacity, or both. METHODS We hypothesized that the 6mw would be strongly representative of performance-based measures of function being determined by impairments in muscle strength and power. We performed a cross-sectional analysis of 45 community-dwelling elders with mild to moderate mobility limitations. RESULTS The 6mw was strongly associated with established functional measures (r =.61-.83; p <.001), but was poorly associated with indirect measures of aerobic capacity (r <.25; p >.05). Multivariate linear regression models demonstrated that impairments in leg strength and power, especially those at the knee and ankle, were predictive of 6mw performance. CONCLUSIONS These findings emphasize the 6mw as a measure of functional limitation among mobility-limited elders without cardiorespiratory or peripheral vascular disease.
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Affiliation(s)
- Jonathan F Bean
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital, Boston, Massachusetts, USA.
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Abstract
OBJECTIVE Ankle-foot orthoses (AFOs) can lower energy expenditure in patients with hemiplegia by 10%-13%. Review of the lower motor injury literature reveals insufficient physiologic evidence supporting the use or modification of AFOs in patients with lower motor neuron injury and, specifically, progressive conditions such as Charcot-Marie-Tooth disease. We sought to test the hypothesis that optimal AFOs would improve submaximal aerobic performance and submaximal perceived exertion, while producing no change in maximal aerobic capacity. DESIGN In an individual with Charcot-Marie-Tooth disease, a single-subject design study was used. An A-B-A design was used, with "A" corresponding to use of the patient's old AFOs and "B" corresponding to the newly prescribed AFOs. The subject underwent treadmill exercise tolerance testing using a modified Balke protocol. Indirect calorimetry was used to measure oxygen consumption per unit time (VO2), and the Borg scale was used to measure perceived exertion. RESULTS At the same submaximal exercise intensities, VO2, rate-pressure product, and perceived exertion were all reduced when using the modified AFOs. Additionally, these conditions allowed the subject to conduct the treadmill exercise test 20% longer. Maximal VO2 remained constant under all conditions. CONCLUSION Optimizing the AFO prescription in a patient with Charcot-Marie-Tooth disease can enhance physiologic performance and perceived exertion at submaximal activity levels. Larger controlled trials are necessary to further demonstrate such benefits in patients with progressive neuropathy and other causes of lower motor neuron injury.
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Affiliation(s)
- J Bean
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, and Spaulding Rehabilitation Hospital, Boston, Massachusetts, USA
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Fairfield WP, Treat M, Rosenthal DI, Frontera W, Stanley T, Corcoran C, Costello M, Parlman K, Schoenfeld D, Klibanski A, Grinspoon S. Effects of testosterone and exercise on muscle leanness in eugonadal men with AIDS wasting. J Appl Physiol (1985) 2001; 90:2166-71. [PMID: 11356779 DOI: 10.1152/jappl.2001.90.6.2166] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Loss of lean body and muscle mass characterizes the acquired immunodeficiency syndrome (AIDS) wasting syndrome (AWS). Testosterone and exercise increase muscle mass in men with AWS, with unclear effects on muscle composition. We examined muscle composition in 54 eugonadal men with AWS who were randomized to 1) testosterone (200 mg im weekly) or placebo and simultaneously to 2) resistance training or no training in a 2 × 2 factorial design. At baseline and after 12 wk, we performed assessments of whole body composition by dual-energy X-ray absorptiometry and single-slice computed tomography for midthigh cross-sectional area and muscle composition. Leaner muscle has greater attenuation. Baseline muscle attenuation correlated inversely with whole body fat mass ( r = −0.52, P = 0.0001). This relationship persisted in a model including age, body mass index, testosterone level, viral load, lean body mass, and thigh muscle cross-sectional area ( P = 0.02). Testosterone ( P = 0.03) and training ( P = 0.03) increased muscle attenuation. These data demonstrate that thigh muscle attenuation by computed tomography varies inversely with whole body fat and increases with testosterone and training. Anabolic therapy in these patients increases muscle leanness.
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Affiliation(s)
- W P Fairfield
- Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts 02114, USA
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Andres LP, Provost S, Roubenoff R, Frontera W, Sacheck J, Brown WF. CENTRAL AND PERIPHERAL ADAPTATION TO RESISTANCE TRAINING OF THE THENAR MUSCLES IN ELDERLY MEN. Med Sci Sports Exerc 1999. [DOI: 10.1097/00005768-199905001-01654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Micheo WF, Frontera W. Fitness and the disabled. Bol Asoc Med P R 1989; 81:447-50. [PMID: 2532512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
With improved long-term survival of the disabled patient the incidence of cardiovascular disease is increasing in this population. One important factor is the low level of physical activity of disabled individuals. Disabled patients respond similarly to their able-bodied counterparts to training programs of a frequency, intensity, and duration which permit improving their level of fitness. Training programs should include aerobic and strengthening exercises with goals of reducing the risk of cardiovascular disease and increasing the level of functional independence. This review will discuss the rationale for improving fitness levels in the disabled as well as exercise testing and training in this population.
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Mayol PM, Rodríguez Santana JR, Frontera W, Sifontes JE. Exercise, sports and pulmonary ailments in children. Bol Asoc Med P R 1988; 80:377-83. [PMID: 3063276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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O??Reilly K, Worhal M, Meredith C, Frontera W, Fielding R, Patton J, Evans W. IMMEDIATE AND DELAYED ULTRASTIUJCTURAL CHANGES IN SKELETAL MUSCLE FOLLOWING ECCENTRIC EXERCISE. Med Sci Sports Exerc 1986. [DOI: 10.1249/00005768-198604001-00209] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Micames C, Jaume F, Frontera W. Serial P wave changes in the electrocardiogram of the acute myocardial infarction. Bol Asoc Med P R 1982; 74:70-2. [PMID: 6957197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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