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Portacci A, Amendolara M, Quaranta VN, Iorillo I, Buonamico E, Diaferia F, Quaranta S, Locorotondo C, Schirinzi A, Boniello E, Dragonieri S, Carpagnano GE. Can Galectin-3 be a reliable predictive biomarker for post-COVID syndrome development? Respir Med 2024; 226:107628. [PMID: 38615715 DOI: 10.1016/j.rmed.2024.107628] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Revised: 03/19/2024] [Accepted: 04/04/2024] [Indexed: 04/16/2024]
Abstract
BACKGROUND AND OBJECTIVES Reliable biomarkers able to predict post-COVID syndrome development are still lacking. The aim of the study was to evaluate the relationship between Galectin-3 blood concentrations and the development of post-COVID syndrome. METHODS We performed a single-center, prospective, observational study, enrolling 437 consecutive patients attending our outpatient clinic for the post-COVID assessment. For each patient, we recorded the main clinical, functional and radiological findings. We also dosed several blood biomarkers which have been related to COVID-19 disease, including Galectin-3. We performed Receiver Operating Characteristic (ROC) and multivariate regression analysis to evaluate the predictive performance of Galectin-3 for post-COVID syndrome development. RESULTS Among the blood biomarkers tested, Galectin-3 resulted the only one correlated with the outcome, although the insufficient performance of the Cox regression model from a statistical standpoint. Correlation coefficients and ROC curves analysis revealed the close relationship between Galectin-3 levels and the time passed from the acute phase of COVID-19 disease, suggesting a possible predictive role for this biomarker when dosed from 60 to 120 days after the infection. CONCLUSIONS Galectin-3 could play an important role as predictive biomarker for COVID-19 sequelae, but its evaluation must be carefully planned along the follow up to avoid misinterpretations.
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Affiliation(s)
- Andrea Portacci
- Institute of Respiratory Disease, Department of Translational Biomedicine and Neuroscience, University of Medicine "Aldo Moro", Bari, Italy.
| | - Monica Amendolara
- Institute of Respiratory Disease, Department of Translational Biomedicine and Neuroscience, University of Medicine "Aldo Moro", Bari, Italy.
| | - Vitaliano Nicola Quaranta
- Institute of Respiratory Disease, Department of Translational Biomedicine and Neuroscience, University of Medicine "Aldo Moro", Bari, Italy.
| | - Ilaria Iorillo
- Institute of Respiratory Disease, Department of Translational Biomedicine and Neuroscience, University of Medicine "Aldo Moro", Bari, Italy.
| | - Enrico Buonamico
- Institute of Respiratory Disease, Department of Translational Biomedicine and Neuroscience, University of Medicine "Aldo Moro", Bari, Italy.
| | - Fabrizio Diaferia
- Institute of Respiratory Disease, Department of Translational Biomedicine and Neuroscience, University of Medicine "Aldo Moro", Bari, Italy.
| | - Sara Quaranta
- Institute of Respiratory Disease, Department of Translational Biomedicine and Neuroscience, University of Medicine "Aldo Moro", Bari, Italy.
| | - Cristian Locorotondo
- Institute of Respiratory Disease, Department of Translational Biomedicine and Neuroscience, University of Medicine "Aldo Moro", Bari, Italy.
| | - Annalisa Schirinzi
- Institute of Clinical Pathology, University of Medicine "Aldo Moro", Bari, Italy.
| | - Esterina Boniello
- Institute of Respiratory Disease, Department of Translational Biomedicine and Neuroscience, University of Medicine "Aldo Moro", Bari, Italy.
| | - Silvano Dragonieri
- Institute of Respiratory Disease, Department of Translational Biomedicine and Neuroscience, University of Medicine "Aldo Moro", Bari, Italy.
| | - Giovanna Elisiana Carpagnano
- Institute of Respiratory Disease, Department of Translational Biomedicine and Neuroscience, University of Medicine "Aldo Moro", Bari, Italy.
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Hijleh AA, Wang S, Berton DC, Neder-Serafini I, Vincent S, James M, Domnik N, Phillips D, Nery LE, O'Donnell DE, Neder JA. Reference values for leg effort during incremental cycle ergometry in non-trained healthy men and women, aged 19-85. Scand J Med Sci Sports 2024; 34:e14625. [PMID: 38597357 DOI: 10.1111/sms.14625] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 03/19/2024] [Accepted: 03/24/2024] [Indexed: 04/11/2024]
Abstract
Heightened sensation of leg effort contributes importantly to poor exercise tolerance in patient populations. We aim to provide a sex- and age-adjusted frame of reference to judge symptom's normalcy across progressively higher exercise intensities during incremental exercise. Two-hundred and seventy-five non-trained subjects (130 men) aged 19-85 prospectively underwent incremental cycle ergometry. After establishing centiles-based norms for Borg leg effort scores (0-10 category-ratio scale) versus work rate, exponential loss function identified the centile that best quantified the symptom's severity individually. Peak O2 uptake and work rate (% predicted) were used to threshold gradually higher symptom intensity categories. Leg effort-work rate increased as a function of age; women typically reported higher scores at a given age, particularly in the younger groups (p < 0.05). For instance, "heavy" (5) scores at the 95th centile were reported at ~200 W (<40 years) and ~90 W (≥70 years) in men versus ~130 W and ~70 W in women, respectively. The following categories of leg effort severity were associated with progressively lower exercise capacity: ≤50th ("mild"), >50th to <75th ("moderate"), ≥75th to <95th ("severe"), and ≥ 95th ("very severe") (p < 0.05). Although most subjects reporting peak scores <5 were in "mild" range, higher scores were not predictive of the other categories (p > 0.05). This novel frame of reference for 0-10 Borg leg effort, which considers its cumulative burden across increasingly higher exercise intensities, might prove valuable to judging symptom's normalcy, quantifying its severity, and assessing the effects of interventions in clinical populations.
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Affiliation(s)
- Abed A Hijleh
- Respiratory Investigation Unit, Division of Respirology, Department of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Sophia Wang
- Respiratory Investigation Unit, Division of Respirology, Department of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Danilo C Berton
- Pulmonary Function Tests Laboratory, Federal University of Rio Grande to Sul, Porto Alegre, RS, Brazil
| | - Igor Neder-Serafini
- Respiratory Investigation Unit, Division of Respirology, Department of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Sandra Vincent
- Respiratory Investigation Unit, Division of Respirology, Department of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Matthew James
- Respiratory Investigation Unit, Division of Respirology, Department of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Nicolle Domnik
- Respiratory Investigation Unit, Division of Respirology, Department of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Devin Phillips
- School of Kinesiology and Health Science, Faculty of Health, York University, Toronto, Ontario, Canada
| | - Luiz E Nery
- Clinical Exercise Physiology Unit, Division of Pulmonology, Department o Medicine, Federal University of Sao Paulo, São Paulo, Brazil
| | - Denis E O'Donnell
- Respiratory Investigation Unit, Division of Respirology, Department of Medicine, Queen's University, Kingston, Ontario, Canada
| | - J Alberto Neder
- Respiratory Investigation Unit, Division of Respirology, Department of Medicine, Queen's University, Kingston, Ontario, Canada
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Lichti J, Maggioni MA, Balcerek B, Becker PN, Labes R, Gunga HC, Fähling M, Steinach M. The relevance of body composition assessment for the rating of perceived exertion in trained and untrained women and men. Front Physiol 2023; 14:1188802. [PMID: 37593237 PMCID: PMC10431604 DOI: 10.3389/fphys.2023.1188802] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 06/30/2023] [Indexed: 08/19/2023] Open
Abstract
Introduction: Mechanic power output (MPO) and oxygen consumption (VO2) reflect endurance capacity and are often stated relative to body mass (BM) but less often per skeletal muscle mass (SMM). Rating of perceived exertion (RPE) has previously shown conflicting results between sexes at submaximal intensities. Individual body composition, however, largely differs due to sex and training status. It was the aim of this study to evaluate RPE of untrained and trained individuals of both sexes considering body composition and to estimate whether RPE could be improved as a tool to determine endurance capacity. Methods: The study included 34 untrained adults (age 26.18 ± 6.34 years, 18 women) and 29 endurance trained (age 27.86 ± 5.19, 14 women) who were measured for body composition (InBody 770, InBody Europe B.V., Germany) and tested on a treadmill (Pulsar, H/P/Cosmos, Germany) for aerobic capacity (Metalyzer 3B, Cortex Biophysik GmbH, Germany) in an all-out exercise test applying the Bruce-protocol. VO2, MPO, heart rate (HR), and RPE were obtained at each exercise stage. VO2 and MPO were calculated per BM and SMM. RPE values were correlated with absolute VO2 and MPO, as well as relative to BM, and SMM. HR values and the parameters' standardized values served for comparison to standard procedures. Results: VO2 and MPO were higher in men compared to women and in trained compared to untrained participants. No differences between groups and sexes exist when VO2 and MPO were calculated per BM. When calculated per SMM, VO2 and MPO indicate opposite results already at low intensity stages of exercise test. RPE values had highest correlation with MPO per SMM (R2 = 0.8345) compared to absolute MPO (R2 = 0.7609), or MPO per BM (R2 = 0.8176). Agreement between RPE and MPO per SMM was greater than between RPE and HR (p = 0.008). Conclusion: Although RPE represents a subjective value at first glance, it was shown that RPE constitutes a valuable tool to estimate endurance capacity, which can be further enhanced if individual body composition is considered. Furthermore, MPO and VO2 should be considered relative to SMM. These findings might help to avoid over-exertion, especially among untrained people, by adjusting the training intensity for each subject according to the individual strain evaluated in an exercise test based on individual body composition.
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Affiliation(s)
- Julia Lichti
- Charité—Universitätsmedizin Berlin, Institute of Translational Physiology, Berlin, Germany
- Charité—Universitätsmedizin Berlin, Institute of Physiology, Center for Space Medicine and Extreme Environments Berlin, Berlin, Germany
| | - Martina Anna Maggioni
- Charité—Universitätsmedizin Berlin, Institute of Physiology, Center for Space Medicine and Extreme Environments Berlin, Berlin, Germany
- Department of Biomedical Sciences for Health, Università Degli Studi di Milano, Milan, Italy
| | - Björn Balcerek
- Charité—Universitätsmedizin Berlin, Institute of Translational Physiology, Berlin, Germany
| | - Philipp Nils Becker
- Charité—Universitätsmedizin Berlin, Institute of Translational Physiology, Berlin, Germany
| | - Robert Labes
- Charité—Universitätsmedizin Berlin, Institute of Translational Physiology, Berlin, Germany
| | - Hanns-Christian Gunga
- Charité—Universitätsmedizin Berlin, Institute of Physiology, Center for Space Medicine and Extreme Environments Berlin, Berlin, Germany
| | - Michael Fähling
- Charité—Universitätsmedizin Berlin, Institute of Translational Physiology, Berlin, Germany
| | - Mathias Steinach
- Charité—Universitätsmedizin Berlin, Institute of Physiology, Center for Space Medicine and Extreme Environments Berlin, Berlin, Germany
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Hashizaki T, Nishimura Y, Kinoshita T, Minami K, Kawanishi M, Umemoto Y, Tajima F. Case report: Rehabilitation course in thrombocytopenia, anasarca, fever, reticulin fibrosis/renal failure, and organomegaly syndrome complicated by cerebral infarction in the left parabolic coronary region. Front Neurol 2023; 14:1153941. [PMID: 37521296 PMCID: PMC10381932 DOI: 10.3389/fneur.2023.1153941] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 06/27/2023] [Indexed: 08/01/2023] Open
Abstract
Although thrombocytopenia, anasarca, fever, reticulin fibrosis/renal failure, and organomegaly (TAFRO) syndrome was first reported in 2010, its pathogenesis and prognosis are still unknown. Moreover, reports on rehabilitation in patients with TAFRO are limited. In severe cases, dyspnea and muscle weakness could impede improvements in activities of daily living (ADL). However, reports on exercise intensity showed no worsening of TAFRO within the load of 11-13 on the Borg scale. Herein, we describe the rehabilitation and progress in a 61-year-old woman with TAFRO syndrome complicated by cerebral infarction from early onset to discharge. After cerebral infarction onset in the perforating artery, she was admitted to the intensive care unit due to decreased blood pressure and underwent continuous hemodiafiltration. Two weeks following transfer to a general ward, the patient started gait training using a brace due to low blood pressure, respiration, and tachycardia. After initiating gait training, increasing the amount of training was difficult due to a high Borg scale of 15-19, elevated respiratory rate, and worsening tachycardia. Furthermore, there was little improvement in muscle strength on the healthy side after continuous training, owing to long-term steroid administration. On day 100 after transfer, the patient was discharged home with a T-cane gait at a monitored level. The patient had severe hemiplegia due to complications with severe TAFRO syndrome delaying early bed release and gait training; tachycardia; and respiratory distress. Additionally, delayed recovery from muscle weakness on the non-paralyzed side made it difficult for the patient to walk and perform ADLs. Despite these issues, low-frequency rehabilitation was useful. However, low-frequency rehabilitation with gait training, using a Borg scale 15-19 orthosis, did not adversely affect the course of TAFRO syndrome.
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Affiliation(s)
- Takamasa Hashizaki
- Department of Rehabilitation Medicine, Wakayama Medical University, Wakayama, Japan
- Division of Rehabilitation, Wakayama Medical University Hospital, Wakayama, Japan
| | - Yukihide Nishimura
- Department of Rehabilitation Medicine, Iwate Medical University, Shiwa-gun, Japan
| | - Tokio Kinoshita
- Department of Rehabilitation Medicine, Wakayama Medical University, Wakayama, Japan
- Division of Rehabilitation, Wakayama Medical University Hospital, Wakayama, Japan
| | - Kohei Minami
- Department of Rehabilitation Medicine, Wakayama Medical University, Wakayama, Japan
- Division of Rehabilitation, Wakayama Medical University Hospital, Wakayama, Japan
| | - Makoto Kawanishi
- Department of Rehabilitation Medicine, Wakayama Medical University, Wakayama, Japan
- Division of Rehabilitation, Wakayama Medical University Hospital, Wakayama, Japan
| | - Yasunori Umemoto
- Department of Rehabilitation Medicine, Wakayama Medical University, Wakayama, Japan
| | - Fumihiro Tajima
- Department of Rehabilitation Medicine, Wakayama Medical University, Wakayama, Japan
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Zhao H, Seo D, Okada J. Validity of using perceived exertion to assess muscle fatigue during back squat exercise. BMC Sports Sci Med Rehabil 2023; 15:14. [PMID: 36739396 PMCID: PMC9899404 DOI: 10.1186/s13102-023-00620-8] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 01/20/2023] [Indexed: 02/06/2023]
Abstract
The rating of perceived exertion (RPE) scale has been found to reflect physiological responses, and this study aimed to assess the validity of using the Borg CR-10 scale and velocity loss to evaluate muscle fatigue quantified by surface electromyography during back squat (BS) exercise. A total of 15 collegiate male athletes underwent three non-explosive BS tasks comprising low, medium, and high volumes at 65% of their one-repetition maximum. RPEs, spectral fatigue index (SFI), and velocity loss during BS exercise were assessed throughout the trials. Significant differences in overall RPE (p < 0.001) and average SFI (p < 0.05) were observed between the conditions, whereas no significant difference was observed in average velocity loss. Significant increases in RPE and SFI (p < 0.001) were observed within the exercise process, whereas a significant increase in velocity loss was not observed. Correlation analyses indicated a significant correlation between RPE and SFI obtained during exercise (r = 0.573, p < 0.001). However, no significant correlation was observed between velocity loss and SFI. These results demonstrated that RPE could be used as a muscle fatigue predictor in BS exercise, but that velocity loss may not reflect muscle fatigue correctly when participants cannot and/or are not required to perform BS explosively. Furthermore, practitioners should not use velocity loss as a muscle fatigue indicator in some resistance exercise situations, such as rehabilitation, beginner, and hypertrophy programs.
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Affiliation(s)
- Hanye Zhao
- grid.5290.e0000 0004 1936 9975Graduate School of Sport Sciences, Waseda University, Tokorozawa, Saitama Japan ,grid.5290.e0000 0004 1936 9975Graduate School of Sport Sciences, Waseda University, Mikajima 2-579-15, Tokorozawa, Saitama 359-1192 Japan
| | - Dasom Seo
- grid.5290.e0000 0004 1936 9975Graduate School of Sport Sciences, Waseda University, Tokorozawa, Saitama Japan
| | - Junichi Okada
- grid.5290.e0000 0004 1936 9975Faculty of Sport Sciences, Waseda University, Tokorozawa, Saitama Japan
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Zhao H, Nishioka T, Okada J. Validity of using perceived exertion to assess muscle fatigue during resistance exercises. PeerJ 2022; 10:e13019. [PMID: 35251786 PMCID: PMC8896022 DOI: 10.7717/peerj.13019] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [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: 11/29/2021] [Accepted: 02/07/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND The rating of perceived exertion (RPE) is correlated with physiological variables. The purpose of this study was to assess the validity of using the Borg CR-10 scale and velocity to predict muscle fatigue assessed by surface electromyography during single joint resistance exercises. METHODS Fifteen healthy males underwent different fatigue levels of unilateral elbow flexion (EF) and knee extension (KE), consisting of low, medium, and high volumes at 65% of their one-repetition maximum. The RPEs, spectral fatigue index (SFI), and mean velocity of the experimental exercises were assessed throughout the trials. RESULTS Significant differences in overall RPE (p < 0.001) and average SFI (p < 0.001) were observed between the conditions in both exercises. Significant changes in RPE and SFI (p < 0.001) were observed throughout the EF, whereas a SFI increase (p < 0.001) was only observed at the end point of KE. Multiple regression analyses revealed two significant models (p < 0.001) for the prediction of muscle fatigue during EF (R2 = 0.552) and KE (R2 = 0.377). CONCLUSIONS Muscle fatigue resulted in similar increases in perceptual responses, demonstrating that RPE is useful for assessing fatigue when resistance exercise is performed. However, velocity changes may not reflect muscle fatigue correctly when exercise is no longer performed in an explosive manner. We recommend combining RPE responses with velocity changes to comprehensively assess muscle fatigue during clinical and sports situations.
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Affiliation(s)
- Hanye Zhao
- Graduate School of Sport Sciences, Waseda University, Tokorozawa, Saitama, Japan
| | - Takuya Nishioka
- Graduate School of Sport Sciences, Waseda University, Tokorozawa, Saitama, Japan
| | - Junichi Okada
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Saitama, Japan
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Shankar S, Naveenkumar R, Nithyaprakash R, Narmatha S, Sai RR, Nandhakumar M. Impact of digital boards on hand and neck muscle activity during online teaching process. Educ Inf Technol (Dordr) 2022; 27:5627-5640. [PMID: 35035258 PMCID: PMC8747848 DOI: 10.1007/s10639-021-10854-z] [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] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Accepted: 12/06/2021] [Indexed: 06/14/2023]
Abstract
Academicians across the globe due to Covid 19 shifted to online teaching as a mainstream method by replacing the chalk and talk method. The main objective of this study is to find the impact of different sizes of digital boards used for online teaching on muscle activity and muscle fatigue, and then results are compared with conventional writing. Initially, a questionnaire survey is conducted among 100 college professors about the issue they faced while using online teaching methods. Experimental analysis are then conducted using electromyography sensor (sEMG) among ten college professors and their muscle activity on the dominant hand and neck while writing on two commercially available digital boards namely Type 1 (small writing area) and Type 2 (large writing area). Four muscles namely Flexor carpi radialis, Extensor carpi radialis, Biceps brachii, and Sternocleidomastoid (SCM) are chosen for the study. The results are then compared with muscle activity while writing on conventional A4 sheets. Normalized root mean square (RMS) is used to assess the muscle activity and the trend line of MPF value is utilized to assess the muscle fatigue. The results show that SCM muscle has more muscle activation compared to other selected muscles followed by flexor carpi radialis. Subjective analysis is carried out using the Borg scale, which has reported that Type 2 digital board having larger working area was preferred by the participants as it reduces muscle fatigue.
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Affiliation(s)
- S. Shankar
- Department of Mechatronics Engineering, Kongu Engineering College, Erode, Tamil Nadu 638060 India
| | - R. Naveenkumar
- Department of Mechanical Engineering, Kongu Engineering College, Erode, Tamil Nadu 638060 India
| | - R. Nithyaprakash
- Department of Mechatronics Engineering, Kongu Engineering College, Erode, Tamil Nadu 638060 India
| | - S. Narmatha
- Department of Mechatronics Engineering, Kongu Engineering College, Erode, Tamil Nadu 638060 India
| | - R. Rithic Sai
- Department of Mechatronics Engineering, Kongu Engineering College, Erode, Tamil Nadu 638060 India
| | - M. Nandhakumar
- Department of Mechatronics Engineering, Kongu Engineering College, Erode, Tamil Nadu 638060 India
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Nessizius S, Oelinger L, Mur E, Joannidis M. [Lactate changes during mobilization of intensive care patients : A retrospective observational study]. Med Klin Intensivmed Notfmed 2021. [PMID: 34734298 DOI: 10.1007/s00063-021-00885-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 08/13/2021] [Accepted: 10/12/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND For intensive care patients the return to normal life is usually a long and strenuous journey. In addition to the severity of the underlying disease, possible comorbidities, sedation and pain management as well as the use of various drugs together with the length of stay in the intensive care unit are factors that strongly influence the course of early rehabilitation and thus the functional outcome. Intensive care patients in particular are exposed to extreme stress during mobilization and often reach their cardiopulmonary stress limit. In order to determine such limits, lactate measurement is used in the performance diagnostics of athletes. METHODS In a retrospective study 20 intensive care patients were mobilized up to their subjective maximum load capacity during physiotherapy (sitting on the edge of the bed n = 6, standing n = 12 and walking n = 2). The lactate value was determined from the routine arterial blood gas analysis and then an attempt was made to establish a correlation between the subjectively perceived change in exercise load (Borg CR10) and the changes in lactate measurements. RESULTS Changes in the sense of an increase in stress occurred in both in the Borg scale and in the lactate measurements. The subjective maximum load capacity increased on average by 4.85 points (p = 0.13, 95% confidence interval, CI 4.58-5.12). In addition, a significant mean increase in lactate by 10.8 mg/dl (p < 0.001, 95% CI 9.73-11.87) was observed. No positive correlation between the load-induced changes in Borg values and the development of lactate values was shown (Pearson correlation: r = 0.123). CONCLUSION The subjective load increase in the Borg CR10 observed in all 20 intensive care patients included in the study and the associated significant increase in lactate after mobilization, suggest that an efficient load in the sense of a training-desired supercompensation was achieved through mobilization. The tendency towards a correlation between the changes in Borg CR10 and the lactate values can be interpreted as an indication that the development of lactate values can also be used in intensive care patients to avoid overloading of patients in early rehabilitation.
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Jinbo R, Fujita T, Kasahara R, Morishita S, Yamamoto Y, Jinbo K, Takano A, Kubota J, Takahashi S, Shiga Y, Kimura H, Furukawa M, Kai T. Physical therapy for multiple myeloma patients with severely hindered daily living activities due to bone lesions: a report of two cases. J Phys Ther Sci 2021; 33:795-800. [PMID: 34658526 PMCID: PMC8516610 DOI: 10.1589/jpts.33.795] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Accepted: 07/01/2021] [Indexed: 11/24/2022] Open
Abstract
[Purpose] Physical therapy for patients with multiple myeloma requires appropriate
exercise intensity and risk management due to osteolytic lesions. However, the optimal
strategy for setting exercise intensity remains unclear. We report cases in which physical
therapy was performed using the Borg scale and the Common Terminology Criteria for Adverse
Events v4.0 as indicators of improvement in the performance of activities of daily living
without causing adverse events. [Participants and Methods] Two patients with multiple
myeloma, whose performance status was 4, underwent resistance training of the upper and
lower limbs and activities of daily living practice in stages according to their
functional status. Each exercise was performed for 20 to 40 minutes twice a day for 6 days
a week. The exercise intensity was set to 13 on the Borg scale as a guide, and the
allowable bone pain was up to Grade 1 according to Common Terminology Criteria for Adverse
Events v4.0. [Results] No adverse events occurred in either patient, and the performance
status improved to 1 or 2. Subsequently, autologous peripheral hematopoietic stem cell
transplantation was performed. [Conclusion] Physical therapy with exercise intensity set
to 13 on the Borg scale and Grade 1 per Common Terminology Criteria for Adverse Events
v4.0 may safely improve the performance of activities of daily living of patients with
multiple myeloma.
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Affiliation(s)
- Ryohei Jinbo
- Department of Rehabilitation, Kita-Fukushima Medical Center: 23-1 Aza-higashi, Hakozaki, Date-shi, Fukushima 960-0502, Japan
| | - Takaaki Fujita
- Department of Occupational Therapy, School of Health Sciences, Fukushima Medical University, Japan
| | - Ryuichi Kasahara
- Department of Rehabilitation, Kita-Fukushima Medical Center: 23-1 Aza-higashi, Hakozaki, Date-shi, Fukushima 960-0502, Japan
| | - Shinichiro Morishita
- Department of Physical Therapy, School of Health Sciences, Fukushima Medical University, Japan
| | - Yuichi Yamamoto
- Department of Rehabilitation, Kita-Fukushima Medical Center: 23-1 Aza-higashi, Hakozaki, Date-shi, Fukushima 960-0502, Japan
| | - Kazumi Jinbo
- Department of Rehabilitation, Kita-Fukushima Medical Center: 23-1 Aza-higashi, Hakozaki, Date-shi, Fukushima 960-0502, Japan
| | - Aya Takano
- Department of Rehabilitation, Kita-Fukushima Medical Center: 23-1 Aza-higashi, Hakozaki, Date-shi, Fukushima 960-0502, Japan
| | - Junko Kubota
- Department of Rehabilitation, Kita-Fukushima Medical Center: 23-1 Aza-higashi, Hakozaki, Date-shi, Fukushima 960-0502, Japan
| | - Shoko Takahashi
- Department of Rehabilitation, Kita-Fukushima Medical Center: 23-1 Aza-higashi, Hakozaki, Date-shi, Fukushima 960-0502, Japan
| | - Yutaka Shiga
- Department of Hematology, Kita-Fukushima Medical Center, Japan
| | - Hideo Kimura
- Department of Hematology, Kita-Fukushima Medical Center, Japan
| | - Miki Furukawa
- Department of Hematology, Kita-Fukushima Medical Center, Japan
| | - Tatsuyuki Kai
- Department of Hematology, Kita-Fukushima Medical Center, Japan
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Jo D, Bilodeau M. Rating of perceived exertion (RPE) in studies of fatigue-induced postural control alterations in healthy adults: Scoping review of quantitative evidence. Gait Posture 2021; 90:167-178. [PMID: 34492503 DOI: 10.1016/j.gaitpost.2021.08.015] [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] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 07/12/2021] [Accepted: 08/22/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Amongst the literature researching the effects of exercise-induced fatigue on postural control in healthy adults, many studies have used the Borg scales to document the rating of perceived exertion (RPE) and have shown a broad range of RPE values. Our main aim was to map fatigue-induced RPE values in included publications. Secondary aims were to summarize the preference and purpose for the use of Borg scales within the included publications and to explore the potential associations between fatigue-induced RPE values and postural control changes. METHODS Five databases (Ovid Medline, PubMed, CINAHL, Scopus, and SPORTDiscus) were systematically searched for synthesizing data among the publications that reported RPE values on the Borg RPE- and Category-Ratio (CR) 10 scales and also found fatigue effects on postural control in healthy adults. Spearman's rank correlations were conducted to assess potential associations between fatigue-induced RPE values and maximal postural control changes across the included publications (group data). RESULTS 45 of 51 studies included in this review reported maximal RPE values following exercise and ranged from 10.4-20 (6-20 Borg RPE) or 0.9-10 (CR10) indicating "very light" or "very weak" to "maximal" exertions. The 6-20 Borg and CR10 scales were mainly used to assess cardiovascular and muscular exertion, respectively. The scales were used mostly to estimate fatigue levels (n = 45), and to a lesser extent to produce a specific exercise intensity (n = 5) and as the criterion for exercise termination (n = 1). In general, there was no significant association between RPE and postural control changes across studies. CONCLUSION The broad range of RPE values and weak correlations may suggest that various fatigue levels can lead to postural control changes. However, one should be careful in comparing the extent of fatigue from RPE values and its potential effect on postural control in the light of many confounding factors.
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Affiliation(s)
- Donguk Jo
- School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, 451 Smyth Road, Ottawa, ON, K1H 8M5, Canada; Aging and Movement Laboratory, Bruyère Research Institute, 43 Bruyère St, Ottawa, ON, K1N 5C8, Canada.
| | - Martin Bilodeau
- School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, 451 Smyth Road, Ottawa, ON, K1H 8M5, Canada; Human Kinetics, Faculty of Health Sciences, University of Ottawa, 451 Smyth Road, Ottawa, ON, K1H 8M5, Canada; Aging and Movement Laboratory, Bruyère Research Institute, 43 Bruyère St, Ottawa, ON, K1N 5C8, Canada.
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Machała E, Redynk M, Gruchała A, Kołomecki K. Analysis of exercise tolerance on the basis of six-minute walk test - 6MWT and Borg RPE scale in men with inguinal hernia before and after Lichtenstein repair. Pol Przegl Chir 2021; 93:1-8. [PMID: 33729176 DOI: 10.5604/01.3001.0014.4207] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
<b>Introduction:</b> Assessment of exercise tolerance (ET) plays an important role in qualifications for treatment and rehabilitation. <br><b>Aim: </b>The aim of the study was to assess ET in patients before and after inguinal hernia operations with Lichtenstein method. <br><b>Material and methods:</b> The cohort study included men with inguinal hernia divided into the study group (SG) (n = 50) and control (CG) (n = 50) undergone the Lichtenstein surgery. Patients from the SG met the criterion of coexistence of cardiovascular and respiratory diseases. Day before and on the second day after surgery, patients performed 6MWT and subjectively rate the exertion according to Borg- RPE- Scale (before, immediately after and 10 minutes after the test). 6MWT distance, Borg scale ratings were analysed. On the second day after surgery 66% of patients from the SG and 58% from the CG did not complete the test. Patients from the SG before (500,07 ± 40,38 m) and on the second day after surgery (243,46 ± 18,18 m) achieved shorter distances compared to the CG (565,93 ± 20,41 m; 249,47 ± 26,66 m), p < 0,001 i p = 0,481. A statistically significant negative correlation between 6MWT distance before surgery and age of the patients was confirmed. Patients who did not develop complications achieved significantly longer distances on admission (p = 0,003 for SG, p = 0,004 for CG). For 6MWT before surgery and 2 days after surgery, patients from the SG showed a significantly higher level of fatigue compared to the CG after the test (before: p = 0,001, after: p = 0,001). Patients form the SG often discontinued 6MWT and less tolerated effort compared to the CG. Hence, 6MWT is useful tool for ascertaining physical capacity and ET.
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Affiliation(s)
- Ewa Machała
- Department of Endocrine, General and Vascular Surgery Medical University of Lodz
| | - Magdalena Redynk
- Department of Endocrinological, General and Oncological Surgery, Provincial Multispecialist Center of Oncology and Traumatology named after M. Kopernika in Lodz
| | - Aneta Gruchała
- Department of Psychodermatology, Department of Clinical Immunology and Rheumatology, Medical University of Lodz
| | - Krzysztof Kołomecki
- Department of Endocrine, General and Vascular Surgery Medical University of Lodz
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Sala E, Lopomo NF, Tomasi C, Romagnoli F, Morotti A, Apostoli P, De Palma G. Importance of Work-Related Psychosocial Factors in Exertion Perception Using the Borg Scale Among Workers Subjected to Heavy Physical Work. Front Public Health 2021; 9:678827. [PMID: 33996736 PMCID: PMC8116491 DOI: 10.3389/fpubh.2021.678827] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 03/31/2021] [Indexed: 12/19/2022] Open
Abstract
Objective: This study aimed to analyse the role of several environmental and time variables, as well as individual and psychosocial factors, on the perception of exertion, expressed by using the Borg scale, on logistics workers performing heavy manual tasks. Materials and Methods: We enrolled 56 subjects working in logistics sector that were interviewed on the perceived exertion required to execute a task of manual lifting of heavy loads, by using the Borg scale. The interviews were carried out during different shifts, at different times during the shifts and during several different months of the year. We also assessed the workers' anthropometric characteristics, length of service, any musculoskeletal diseases, and physical activity outside work. Workers were also interviewed using the structured OREGE questionnaire, in order to evaluate the main symptoms of stress and work-related psychosocial risk factors. Results: Overall, the subjective perception of the strength exerted by the workers exposed to a high risk of manual handling of loads was moderate. The rating attributed using the Borg scale showed no correlation with any of the investigated variables. 100% of the workers denied to suffer from symptoms of stress, whereas in terms of psychosocial factors, the workload was globally perceived as positive. Conclusion: The study results support the hypothesis that optimal work conditions-from a psychosocial point of view-reduce the subjective perception of exertion by workers even if exposed to a high risk of biomechanical overload.
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Affiliation(s)
- Emma Sala
- Unit of Occupational Health, Hygiene, Toxicology and Occupational Prevention, University Hospital Spedali Civili, Brescia, Italy
| | | | - Cesare Tomasi
- Unit of Occupational Health and Industrial Hygiene, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Francesco Romagnoli
- Unit of Occupational Health and Industrial Hygiene, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Alberto Morotti
- Unit of Occupational Health and Industrial Hygiene, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Pietro Apostoli
- Unit of Occupational Health and Industrial Hygiene, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Giuseppe De Palma
- Unit of Occupational Health, Hygiene, Toxicology and Occupational Prevention, University Hospital Spedali Civili, Brescia, Italy.,Unit of Occupational Health and Industrial Hygiene, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
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13
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Persiyanova-Dubrova AL, Marphina TV, Badalov NG. [Water aerobics training: selection and control of the exercise intensity using the Borg scale]. Vopr Kurortol Fizioter Lech Fiz Kult 2021; 98:39-44. [PMID: 33899451 DOI: 10.17116/kurort20219802139] [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] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To evaluate the opportunity of Borg scale using for applying and monitoring the aerobic training intensity in the pool as well as the relationship between the Borg scale and the heart rate (HR) in the aquatic environment. MATERIAL AND METHODS The study involved 11 healthy individuals (mean age 46.4±7.5 years). After a cardiopulmonary test on a treadmill and a probation lesson the training was conducted in the pool using a set of basic aerobic exercises lasting 45 minutes. During training the subjects had to maintain a load level corresponding to 12-14 points on the Borg scale. Every 10 minutes of the main training part the heart rate was calculated and the rating of perceived exertion (RPE) was determined according to the Borg scale. RESULTS The average heart rate in the main part of the training was 126.8±14.0 beats/min. The intensity of aerobic exercise was 82% of the maximum heart rate determined during the cardiopulmonary test and 68% of the reserve heart rate which corresponded to a high level of intensity. Between the heart rate and the Borg scale a significant correlation was found in the first period of training (r=0.67, p<0.02). At RPE 12-13 in almost 1/2 cases the subjects felt a subjectively lower intensity of the load than they actually performed (by heart rate) while at RPE 14 a high percentage of coincidences was observed between different measurement methods (p<0.05). CONCLUSION During water aerobics training the use of the Borg scale to prescribe and maintain a level of exercise allows to achieve a sufficient intensity level which is necessary to improve cardiorespiratory fitness and physical performance in order to influence risk factors for cardiovascular disease. The Borg Scale as a stand-alone method of controlling intensity when using water-based aerobic training, especially with high-intensity training should be used with caution. Further investigation is needed to determine the relation between subjective measures of exercise intensity and HR and validity of their use during water aerobics training.
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Affiliation(s)
| | - T V Marphina
- Center of Medical Prevention of Department of Health of Moscow, Moscow, Russia
| | - N G Badalov
- L.I. Shvetsova Scientific and Practical Center for Medical and Social Rehabilitation, Moscow, Russia.,I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
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Marcin T, Trachsel LD, Dysli M, Schmid JP, Eser P, Wilhelm M. Effect of self-tailored high-intensity interval training versus moderate-intensity continuous exercise on cardiorespiratory fitness after myocardial infarction: A randomized controlled trial. Ann Phys Rehabil Med 2021; 65:101490. [PMID: 33450366 DOI: 10.1016/j.rehab.2021.101490] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 10/30/2020] [Accepted: 11/18/2020] [Indexed: 10/19/2022]
Abstract
BACKGROUND Whether high-intensity interval training (HIIT) is more efficient than moderate-intensity continuous exercise (MICE) to increase cardiorespiratory fitness in patients with acute coronary syndrome at moderate-to-high cardiovascular risk is controversial. The best approach to guide training intensity remains to be determined. OBJECTIVE We aimed to assess intensities achieved with self-tailored HIIT and MICE according to perceived exertion and to compare the effect on cardiorespiratory fitness in patients early after ST-elevation myocardial infarction (STEMI). METHODS We included 69 males starting cardiac rehabilitation within 4 weeks after STEMI. After a 3-week run-in phase with MICE, 35 patients were randomized to 9 weeks of HIIT (2×HIIT and 1×MICE per week) and 34 patients to MICE (3×MICE). Training workload for MICE was initially set at the patients' first ventilatory threshold (VT). HIIT consisted of 4×4-min intervals with a workload above the second VT in high intervals. Training intensity was adjusted weekly to maintain the perceived exertion (Borg score 13-14 for MICE, ≥15 for HIIT). Session duration was 38 min in both groups. Peak oxygen consumption (VO2) was measured by cardiopulmonary exercise testing pre- and post-intervention. RESULTS Both groups improved peak VO2 (ml/kg/min) (HIIT +1.9, p<0.001; MICE +3.2, p<0.001, Cohen's d -0.4), but changes in VO2 were not significantly different between groups (p=0.104). Exercise regimes did not differ between groups in terms of energy expenditure or training time, but perceived exertion was higher with HIIT. CONCLUSIONS Self-tailored HIIT was feasible in patients early after STEMI. It was more strenuous but not superior nor more time efficient than MICE in improving peak VO2.
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Affiliation(s)
- Thimo Marcin
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Switzerland, Freiburgstrasse 46, 3010 Bern, Switzerland
| | - Lukas D Trachsel
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Switzerland, Freiburgstrasse 46, 3010 Bern, Switzerland
| | - Michelle Dysli
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Switzerland, Freiburgstrasse 46, 3010 Bern, Switzerland
| | - Jean Paul Schmid
- Clinic Barmelweid, Department of Cardiology, Barmelweid, Switzerland, Klinik Barmelweid, 5017 Barmelweid, Switzerland
| | - Prisca Eser
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Switzerland, Freiburgstrasse 46, 3010 Bern, Switzerland
| | - Matthias Wilhelm
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Switzerland, Freiburgstrasse 46, 3010 Bern, Switzerland.
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Morishita S, Tsubaki A, Hotta K, Kojima S, Sato D, Shirayama A, Ito Y, Onishi H. Relationship Between the Borg Scale Rating of Perceived Exertion and Leg-Muscle Deoxygenation During Incremental Exercise in Healthy Adults. Adv Exp Med Biol 2021; 1269:95-9. [PMID: 33966201 DOI: 10.1007/978-3-030-48238-1_15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
INTRODUCTION The Borg scale rating of perceived exertion is a reliable indicator and widely used to monitor and guide exercise intensity. We aimed to evaluate the relationships between the Borg scale score and oxygenated hemoglobin (O2Hb) and deoxygenated hemoglobin (HHb) concentrations in the leg muscle as measured by near-infrared spectroscopy (NIRS) during cardiopulmonary exercise testing (CPET) in healthy adult men. We also investigated the relationships between the Borg scale score and the work rate (WR), heart rate (HR), oxygen uptake (VO2), and minute ventilation (VE). METHODS Participants comprised 12 healthy men. Cardiopulmonary and NIRS parameters were assessed during each minute of CPET and at the end of the test. RESULTS The Borg scale score was significantly correlated with cardiopulmonary parameters including WR, HR, VO2, and VE during CPET (Rs = 0.87-0.95; p < 0.05). Furthermore, the Borg scale score was significantly correlated with NIRS parameters including O2Hb and HHb levels during CPET (Rs = -0.48 and 0.45, respectively; p < 0.05). DISCUSSION The Borg scale score is significantly correlated with cardiopulmonary parameters (WR, HR, VO2, and VE), as well as with leg-muscle oxygenation parameters as assessed by NIRS, during CPET in healthy adults. The correlation coefficients obtained from NIRS parameters were lower than those of cardiopulmonary parameters. CONCLUSIONS The Borg scale score might better reflect cardiopulmonary responses than muscle deoxygenation during exercise. These results can aid in the planning of rehabilitation programs for healthy adults.
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Braccioni F, Bottigliengo D, Ermolao A, Schiavon M, Loy M, Marchi MR, Gregori D, Rea F, Vianello A. Dyspnea, effort and muscle pain during exercise in lung transplant recipients: an analysis of their association with cardiopulmonary function parameters using machine learning. Respir Res 2020; 21:267. [PMID: 33059678 PMCID: PMC7559436 DOI: 10.1186/s12931-020-01535-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 06/11/2020] [Accepted: 10/05/2020] [Indexed: 01/05/2023] Open
Abstract
Background Despite improvement in lung function, most lung transplant (LTx) recipients show an unexpectedly reduced exercise capacity that could be explained by persisting peripheral muscle dysfunction of multifactorial origin. We analyzed the course of symptoms, including dyspnea, muscle effort and muscle pain and its relation with cardiac and pulmonary function parameters during an incremental exercise testing. Methods Twenty-four bilateral LTx recipients were evaluated in an observational cross-sectional study. Recruited patients underwent incremental cardio-pulmonary exercise testing (CPET). Arterial blood gases at rest and peak exercise were measured. Dyspnea, muscle effort and muscle pain were scored according to the Borg modified scale. Potential associations between the severity of symptoms and exercise testing parameters were analyzed using a Forest-Tree Machine Learning approach, which accomplishes for a ratio between number of observations and number of screened variables less than unit. Results Dyspnea score was significantly associated with maximum power output (WR, watts), and minute ventilation (VE, L/min) at peak exercise. In a controlled subgroup analysis, dyspnea score was a limiting symptom only in LTx recipients who reached the higher levels of WR (≥ 101 watts) and VE (≥ 53 L/min). Muscle effort score was significantly associated with breathing reserve as percent of maximal voluntary ventilation (BR%MVV). The lower the BR%MVV at peak exercise (< 32) the higher the muscle effort perception. Muscle pain score was significantly associated with VO2 peak, arterial [HCO3−] at rest, and VE/VCO2 slope. In a subgroup analysis, muscle pain was the limiting symptom in LTx recipients with a lower VO2 peak (< 15 mL/Kg/min) and a higher VE/VCO2 slope (≥ 32). Conclusions The majority of our LTx recipients reported peripheral limitation as the prevalent reason for exercise termination. Muscle pain at peak exercise was strictly associated with basal and exercise-induced metabolic altered pathways. The onset of dyspnea (breathing effort) was associated with the intensity of ventilatory response to meet metabolic demands for increasing WR. Our study suggests that only an accurate assessment of symptoms combined with cardio-pulmonary parameters allows a correct interpretation of exercise limitation and a tailored exercise prescription. The role and mechanisms of muscle pain during exercise in LTx recipients requires further investigations.
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Affiliation(s)
- Fausto Braccioni
- Division of Respiratory Pathophysiology, Department of Cardio-Thoracic, Vascular and Public Health Sciences, University Hospital of Padova, Padova, Italy.
| | - Daniele Bottigliengo
- Division of Biostatistics, Epidemiology and Public Health, Department of Cardio-Thoracic, Vascular and Public Health Sciences, University Hospital of Padova, Padova, Italy
| | - Andrea Ermolao
- Division of Sport and Exercise Medicine, Department of Medicine, University Hospital of Padova, Padova, Italy
| | - Marco Schiavon
- Division of Thoracic Surgery, Department of Cardio-Thoracic, Vascular and Public Health Sciences, University Hospital of Padova, Padova, Italy
| | - Monica Loy
- Division of Thoracic Surgery, Department of Cardio-Thoracic, Vascular and Public Health Sciences, University Hospital of Padova, Padova, Italy
| | - Maria Rita Marchi
- Division of Respiratory Pathophysiology, Department of Cardio-Thoracic, Vascular and Public Health Sciences, University Hospital of Padova, Padova, Italy
| | - Dario Gregori
- Division of Biostatistics, Epidemiology and Public Health, Department of Cardio-Thoracic, Vascular and Public Health Sciences, University Hospital of Padova, Padova, Italy
| | - Federico Rea
- Division of Thoracic Surgery, Department of Cardio-Thoracic, Vascular and Public Health Sciences, University Hospital of Padova, Padova, Italy
| | - Andrea Vianello
- Division of Respiratory Pathophysiology, Department of Cardio-Thoracic, Vascular and Public Health Sciences, University Hospital of Padova, Padova, Italy
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Boswell-Ruys CL, Lewis C, McBain RA, Gandevia SC, Butler JE. The reliability of inspiratory resistive load magnitude and detection testing. Respir Physiol Neurobiol 2020; 281:103490. [PMID: 32712538 DOI: 10.1016/j.resp.2020.103490] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 06/21/2020] [Accepted: 07/05/2020] [Indexed: 01/10/2023]
Abstract
OBJECTIVES To assess the test-retest reliability of inspiratory load detection and load magnitude perception tests in healthy volunteers. DESIGN Cohort of convenience. SETTING Respiratory physiology laboratory. PARTICIPANTS Twenty healthy adults. INTERVENTIONS On two separate occasions participants performed tests of inspiratory loading. Participants breathed through custom made resistive tubing and were asked to indicate when they detected a different resistance during inspiration. In a second test participants rated the magnitude of presented inspiratory loads using the modified Borg score. MAIN OUTCOME MEASURES Intra-class Correlation Coefficient (ICC2,1) values for repeated tests of inspiratory load detection threshold and load magnitude rating. RESULTS ICC2,1 values ranged from 0.657-0.786 for load detection testing and 0.739 to 0.969 for rating of load magnitude. CONCLUSIONS The tests are simple and reliable measures of inspiratory load detection and magnitude rating. They can be used in future research to determine the effectiveness of interventions to reduce the effort of breathing in health and disease.
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Affiliation(s)
- Claire L Boswell-Ruys
- Neuroscience Research Australia, Randwick, 2031, Australia; University of New South Wales, Sydney, 2052, Australia; Prince of Wales Hospital, Randwick, 2031, Australia.
| | - Chaminda Lewis
- Neuroscience Research Australia, Randwick, 2031, Australia; University of New South Wales, Sydney, 2052, Australia; Prince of Wales Hospital, Randwick, 2031, Australia
| | - Rachel A McBain
- Neuroscience Research Australia, Randwick, 2031, Australia; University of New South Wales, Sydney, 2052, Australia
| | - Simon C Gandevia
- Neuroscience Research Australia, Randwick, 2031, Australia; University of New South Wales, Sydney, 2052, Australia; Prince of Wales Hospital, Randwick, 2031, Australia
| | - Jane E Butler
- Neuroscience Research Australia, Randwick, 2031, Australia; University of New South Wales, Sydney, 2052, Australia
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Romano E, Caruso L, Longo D, Vitale E, Schillaci G, Rapisarda V. Investigation of hand forces applied to a pruning tool - pilot study. Ann Agric Environ Med 2019; 26:472-478. [PMID: 31559806 DOI: 10.26444/aaem/109751] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
INTRODUCTION Winter pruning is a cultivation practice necessary for maintaining the balance between the vegetative and the productive activity of plants and requires many working days using hand scissors. This operation involves the subjects carrying out a series of gestures that are repeated with considerable frequency, which are all musculo-skeletal disorders risk factors (MSDs) for the hand-wrist area. OBJECTIVE The aim of this study was to investigate the forces applied to pruning tools. MATERIAL AND METHODS Using a sensor matrix, peak and average forces were measured which are exerted while cutting branches of 3 different diameters, from 5 wine-grape cultivars. Samples were tested on 8 participants using sensored scissors to record, in 6 hand areas, the forces necessary to cut. RESULTS Results showed that while cutting, the factors which can impact the force employed (peak and average forces) by the subjects are branch diameter and percentage of branch humidity. Cut duration was inversely related to the size of the subject's hand. The middle finger area of the hand recorded the highest force average and peak levels, while the hand region least affected during the cuts was the farthest from the thumb. CONCLUSIONS The study enabled the highlighting of which factors influence the forces employed by the operator while cutting grape branches, and to identify the hand regions where muscle activation is at its most. These findings can be relevant in preventing MSDs. Further studies need to be conducted with a larger number of subjects.
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Affiliation(s)
- Elio Romano
- Consiglio per la ricerca in agricoltura e l'analisi dell'economia agraria (CREA); Laboratory of Treviglio, Bergamo, Italy
| | | | | | - Ermanno Vitale
- Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, Italy
| | | | - Venerando Rapisarda
- Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, Italy
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Lacroix J, Daviet JC, Salle JY, Borel B, Compagnat M, Mandigout S. Effort Assessment of Stroke Patients in Physiotherapy Session by Accelerometry and Perceived Exertion Score: Preliminary Study. Ann Rehabil Med 2019; 43:262-268. [PMID: 31311247 PMCID: PMC6637063 DOI: 10.5535/arm.2019.43.3.262] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 06/18/2018] [Indexed: 11/13/2022] Open
Abstract
Objective To determine whether post-stroke patient’s perceived exertion correlates with effort intensity score as measured by a wearable sensor and to assess whether estimates of perceived exertion are correlated to the cerebral hemisphere involved in the stroke. Methods We evaluated the effort intensity score during physiotherapy sessions using a wearable sensor and subjects assessed their perceived exertion using the modified Borg CR10 Scale. Results Fifty-seven subacute stroke patients participated in the study. The correlation between perceived exertion rating and measured effort intensity was insignificant—mean (r=-0.04, p=0.78) and peak (r=-0.05, p=0.70). However, there was a significant difference (p<0.02) in the perceived exertion ratings depending on the cerebral hemisphere where the stroke occurred. Patients with left-hand side lesions rated their perceived exertion as 4.5 (min–max, 0.5–8), whereas patients with right-hand side lesions rated their perceived exertion as 5.0 (2–8). Conclusion While there was an insignificant correlation between perceived exertion and effort intensity measured by a wearable sensor, a consistent variations in perceived exertion estimates according to the side of the cerebral lesion was identified and established.
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Affiliation(s)
- Justine Lacroix
- HAVAE EA6310, Institut GEIST, University of Limoges, Limoges, France
| | - Jean-Christophe Daviet
- HAVAE EA6310, Institut GEIST, University of Limoges, Limoges, France.,Department of Physical Medicine and Rehabilitation, Jean Rebeyrol Hospital, CHU Limoges, Limoges, France
| | - Jean-Yves Salle
- HAVAE EA6310, Institut GEIST, University of Limoges, Limoges, France.,Department of Physical Medicine and Rehabilitation, Jean Rebeyrol Hospital, CHU Limoges, Limoges, France
| | - Benoit Borel
- HAVAE EA6310, Institut GEIST, University of Limoges, Limoges, France
| | - Maxence Compagnat
- HAVAE EA6310, Institut GEIST, University of Limoges, Limoges, France.,Department of Physical Medicine and Rehabilitation, Jean Rebeyrol Hospital, CHU Limoges, Limoges, France
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Mendes V, Bruyere F, Escoffre JM, Binet A, Lardy H, Marret H, Marchal F, Hebert T. Experience implication in subjective surgical ergonomics comparison between laparoscopic and robot-assisted surgeries. J Robot Surg 2020; 14:115-21. [PMID: 30863913 DOI: 10.1007/s11701-019-00933-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Accepted: 02/18/2019] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Laparoscopic surgery (LS) may lead to musculoskeletal disorders (MSDs) and an increase in physical and mental workloads to the surgeon. Robot-assisted surgery (RAS) should improve the ergonomy of the surgeon. This study assesses the experience influence in surgical ergonomics between LS and RAS. METHODS LS and RAS lasting more than 60 min of effective operative time were compared. During the surgical procedure, the physical discomfort was evaluated using the Borg scale. At the end, the mental workload was evaluated using the NASA-TLX index. After global analysis, the experienced and young surgeons were assessed. RESULTS 88 RAS and 82 LS were evaluated. During LS, the physical discomfort was significantly higher in all segments, and the pain increased significantly during the procedure in all segments compared to that evaluated in the RAS (p < 0.05). Forearms and the back were the most painful. The young surgeons did not display any improvement in the physical ergonomics of the RAS compared to the LS. Concerning the mental ergonomics, the overall workload and performance were significantly greater during the LS compared to the RAS (p < 0.05). For the young surgeons, the overall workload, the effort, the mental and the physical demands were greater during LS (p < 0.05). For the experienced surgeons, the physical demand was lower during the RAS compared to the LS (p < 0.05). However, the experienced surgeons expressed a feeling of greater performance after the LS (p < 0.01). RAS significantly reduces the onset of MSDs compared to LS, especially for the experienced surgeons. CONCLUSION RAS significantly reduces the onset of MSDs compared to LS, especially for the experienced surgeons.
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Ahmad I, Kim JY. Assessment of Whole Body and Local Muscle Fatigue Using Electromyography and a Perceived Exertion Scale for Squat Lifting. Int J Environ Res Public Health 2018; 15:ijerph15040784. [PMID: 29670002 PMCID: PMC5923826 DOI: 10.3390/ijerph15040784] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/04/2018] [Revised: 04/13/2018] [Accepted: 04/16/2018] [Indexed: 11/30/2022]
Abstract
This research study aims at addressing the paradigm of whole body fatigue and local muscle fatigue detection for squat lifting. For this purpose, a comparison was made between perceived exertion with the heart rate and normalized mean power frequency (NMPF) of eight major muscles. The sample consisted of 25 healthy males (age: 30 ± 2.2 years). Borg’s CR-10 scale was used for perceived exertion for two segments of the body (lower and upper) and the whole body. The lower extremity of the body was observed to be dominant compared to the upper and whole body in perceived response. First mode of principal component analysis (PCA) was obtained through the covariance matrix for the eight muscles for 25 subjects for NMPF of eight muscles. The diagonal entries in the covariance matrix were observed for each muscle. The muscle with the highest absolute magnitude was observed across all the 25 subjects. The medial deltoid and the rectus femoris muscles were observed to have the highest frequency for each PCA across 25 subjects. The rectus femoris, having the highest counts in all subjects, validated that the lower extremity dominates the sense of whole body fatigue during squat lifting. The findings revealed that it is significant to take into account the relation between perceived and measured effort that can help prevent musculoskeletal disorders in repetitive occupational tasks.
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Affiliation(s)
- Imran Ahmad
- Department of Industrial Management Engineering, Hanyang University, Ansan 15588, Korea.
| | - Jung-Yong Kim
- Department of Industrial Management Engineering, Hanyang University, Ansan 15588, Korea.
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Morishita S, Wakasugi T, Tanaka T, Harada T, Kaida K, Ikegame K, Ogawa H, Domen K. Changes in Borg scale for resistance training and test of exercise tolerance in patients undergoing allogeneic hematopoietic stem cell transplantation. Support Care Cancer 2018; 26:3217-3223. [PMID: 29626261 DOI: 10.1007/s00520-018-4168-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 03/12/2018] [Indexed: 02/06/2023]
Abstract
PURPOSE We aimed to investigate the relationship between Borg scale and intensity of resistance training in patients who had undergone allogeneic hematopoietic stem cell transplantation (allo-HSCT). Furthermore, the relationship between Borg scale, heart rate (HR), and intensity of exercise tolerance test was also studied. METHODS The study included 28 patients (19 men and 9 women) who had undergone allo-HSCT between June 2015 and February 2017. Their knee extension strengths and exercise tolerances were evaluated. Patients were asked to grade between 0 and 10 on Borg scale based on the level of difficulty experienced during exercising, after 10 repetitions in randomized 20, 40, and 60% resistance training for knee extension. Additionally, we evaluated Borg scale, HR, and load intensity during exercise tolerance test, every minute of the exercise for 2 weeks before and 3 weeks after HSCT. RESULTS Knee extension strength and exercise tolerance were significantly decreased 3 weeks after HSCT from those before HSCT (p < 0.01). Additionally, rise in Borg scale with increase in load intensity during knee extension resistance training, both before and after HSCT (p < 0.01), was noted. Furthermore, Borg scale was found to be associated with HR and load intensity during exercise tolerance test in patients both before and after HSCT (p < 0.01). CONCLUSIONS A correlation was found between Borg scale with intensity of resistance training and exercise tolerance in patients who had undergone allo-HSCT. Therefore, Borg scale could be useful to determine the intensity of physical exercise in patients who have undergone allo-HSCT.
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Affiliation(s)
- Shinichiro Morishita
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan. .,Department of Physical Medicine and Rehabilitation, Hyogo College of Medicine, Nishinomiya, Japan.
| | - Tatsushi Wakasugi
- Department of Rehabilitation, Hyogo College of Medicine Hospital, Nishinomiya, Japan
| | - Takashi Tanaka
- Department of Rehabilitation, Hyogo College of Medicine Hospital, Nishinomiya, Japan
| | - Tetsuya Harada
- Department of Rehabilitation, Hyogo College of Medicine Hospital, Nishinomiya, Japan
| | - Katsuji Kaida
- Division of Hematology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan
| | - Kazuhiro Ikegame
- Division of Hematology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan
| | - Hiroyasu Ogawa
- Division of Hematology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan
| | - Kazuhisa Domen
- Department of Physical Medicine and Rehabilitation, Hyogo College of Medicine, Nishinomiya, Japan
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Compagnat M, Salle JY, Mandigout S, Lacroix J, Vuillerme N, Daviet JC. Rating of perceived exertion with Borg scale in stroke over two common activities of the daily living. Top Stroke Rehabil 2017; 25:145-149. [PMID: 29105582 DOI: 10.1080/10749357.2017.1399229] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Background The Borg Scale for the rating of perceived exertion (RPE) is recommended to measure the intensity of physical exercise during stroke rehabilitation, but its reliability in activities of daily living is not explored. Objective To evaluate the correlation between the RPE using the Borg Scale (6-20) and the intensity of effort as measured by the Total Energy Expenditure per minute (TEE.min-1) in a post-stroke population for two tasks: walking at spontaneous comfortable speed and walking up and down stairs. Methods A cross-sectional study has been conducted. Any post-stroke subjects able to walk without being helped were recruited. Subjects were asked to walk at their spontaneous comfortable walking speed for 6 min and then to walk up and down stairs with a portable gas analyzer to measure the TEE.min-1. The RPE was evaluated by the Borg scale (6-20). The correlation between the RPE and the TEE.min-1 for each subject's walking task and stairs task was calculated with the Pearson coefficient. Results Twenty subjects were included. TEE.min-1 averaged at 5.6 (±1.2 kcal.min-1) for the walking task and 9.58 (±4.3 kcal.min-1) for the stairs task. The median RPE was 11 (min 6; max 15) for the walking task and 11 (min 6; max 16) for the stairs task. The correlation coefficient between the RPE and TEE.min-1 was r = 0.12 (p = 0.25). Conclusion Our work has not determined a correlation between the RPE and TEE.min-1 for two common activities of daily living in post-stroke subjects.
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Affiliation(s)
- Maxence Compagnat
- a HAVAE EA6310 (Handicap, Aging, Autonomy, Environment) , University of Limoges , Limoges , France.,b Department of Physical Medicine and Rehabiliation , University Hospital Center of Limoges , Limoges , France
| | - Jean Yves Salle
- a HAVAE EA6310 (Handicap, Aging, Autonomy, Environment) , University of Limoges , Limoges , France.,b Department of Physical Medicine and Rehabiliation , University Hospital Center of Limoges , Limoges , France
| | - Stephane Mandigout
- a HAVAE EA6310 (Handicap, Aging, Autonomy, Environment) , University of Limoges , Limoges , France
| | - Justine Lacroix
- c EA 4324 ORPHY, Biology Department , European University of Brittany, University of Brest , Brest , France
| | - Nicolas Vuillerme
- d University Grenoble Alpes, AGEIS, Grenoble, France & Institut Universitaire de France , Paris , France
| | - Jean Christophe Daviet
- a HAVAE EA6310 (Handicap, Aging, Autonomy, Environment) , University of Limoges , Limoges , France.,b Department of Physical Medicine and Rehabiliation , University Hospital Center of Limoges , Limoges , France
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PENKO AMANDAL, BARKLEY JACOBE, KOOP MANDYMILLER, ALBERTS JAYL. Borg scale is valid for ratings of perceived exertion for individuals with Parkinson's disease. Int J Exerc Sci 2017; 10:76-86. [PMID: 28479949 PMCID: PMC5213192] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Parkinson's disease is a neurodegenerative disease that has traditionally been treated with anti-parkinsonian medication. There is increasing evidence that exercise is beneficial to those with PD, therefore, it is necessary to validate a measure of exertion that can be implemented across exercise settings that may not have the capability to actively monitor heart rate. The aim of this project was to determine the validity of the Borg RPE scale in individuals with PD undergoing a maximal progressive cycling exercise test. Thirty-eight males and females (58.5 ± 8.1 yrs) with a clinical diagnosis of idiopathic PD, Hoehn and Yahr stage II-III, completed a maximal exercise test. Heart rate was monitored continuously, with RPE being recorded during the last minute of each stage of the test. Correlation analysis was used to evaluate the relationship between RPE and continuous heart rate monitoring. A significant, positive correlation was present between RPE and heart rate and RPE and workload, r = 0.61 and r = 0.77 respectively. A separate mixed effects model regression analyses indicated that RPE was a significant predictor of heart rate (p < 0.001) and workload (p < 0.001). The results of a mixed effect models that RPE scores indicated that RPE values at commonly prescribed workout intensities were not associated with age, gender, or disease severity (p>0.05). Significant, positive correlation between RPE and HR indicates that the Borg category ratio scale may be used in individuals with Parkinson's disease in which formal exercise testing may not be available.
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Affiliation(s)
- AMANDA L. PENKO
- Department of Biomedical Engineering, Cleveland Clinic, Cleveland, OH, USA,College of Health and Human Services, Kent State University, Kent, OH USA
| | - JACOB E. BARKLEY
- College of Health and Human Services, Kent State University, Kent, OH USA
| | - MANDY MILLER KOOP
- Department of Biomedical Engineering, Cleveland Clinic, Cleveland, OH, USA
| | - JAY L. ALBERTS
- Department of Biomedical Engineering, Cleveland Clinic, Cleveland, OH, USA,Center for Neurological Restoration, Cleveland Clinic, Cleveland, OH USA
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Mahmoud K, Kassem HH, Baligh E, ElGameel U, Akl Y, Kandil H. The effect of ivabradine on functional capacity in patients with chronic obstructive pulmonary disease. Clin Med (Lond) 2016; 16:419-422. [PMID: 27697801 PMCID: PMC6297290 DOI: 10.7861/clinmedicine.16-5-419] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Increased sympathetic tone and use of bronchodilators increase heart rate and this may worsen functional capacity in patients with chronic obstructive pulmonary disease (COPD). The aim of this study was to look at the short-term effect of the heart rate lowering drug ivabradine on clinical status in COPD patients.We randomised 80 COPD patients with sinus heart rate ≥90 bpm into either taking ivabradine 7.5 mg twice per day or placebo for two weeks. We assessed all patients using the modified Borg scale and 6-minute walk test at baseline and then again 2 weeks after randomisation.There were no significant differences in age, sex, severity of airway obstruction (measured using forceful exhalation), severity of diastolic dysfunction or pulmonary artery systolic pressure between the two groups. The ivabradine group showed significant improvement in 6-minute walk distance (from 192.6±108.8 m at baseline to 285.1±88.9 m at the end of the study) compared with the control group (230.6±68.4 at baseline and 250.4±65.8 m at the end of study) (p<0.001). This improvement in the drug group was associated with significant improvement of dyspnea on modified Borg scale (p=0.007).Lowering heart rate with ivabradine can improve exercise capacity and functional class in COPD patients with resting heart rate >90 bpm.
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Affiliation(s)
| | | | - Essam Baligh
- Faculty of Medicine, Cairo University, Cairo, Egypt
| | | | - Yosri Akl
- Faculty of Medicine, Cairo University, Cairo, Egypt
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Hampton S, Armstrong G, Ayyar MS, Li S. Quantification of perceived exertion during isometric force production with the Borg scale in healthy individuals and patients with chronic stroke. Top Stroke Rehabil 2014; 21:33-9. [PMID: 24521838 DOI: 10.1310/tsr2101-33] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND The Borg Rating of Perceived Exertion (RPE) scale is widely used for many patient populations, but the ability of patients to accurately report their RPE without visual feedback has not been studied. OBJECTIVE The objective was to determine whether the Borg scale could be used as a measure of perceived isometric exertion in healthy subjects and patients with stroke. METHODS In experiment 1, young healthy subjects (n = 15) were instructed to perform spontaneous pushes (ie, self-selected effort) without visual feedback and to produce and hold self-determined isometric finger flexion at 5 Borg levels without visual feedback. In experiment 2, subjects with chronic stroke (n = 10) were instructed to produce self-determined isometric elbow flexion at 4 perceptual levels on the impaired and nonimpaired sides. RESULTS In experiment 1, young healthy subjects, asked to self-select without visual feedback (spontaneous push), tended to exert at a "somewhat hard" level, about 12% of maximal voluntary contraction (MVC). Self-selection of forces ranged from 2% of MVC (ie, very light) to 39% of MVC (ie, very hard). In experiment 2, subjects with stroke were able to distinguish different levels of perceived exertion among light (19% MVC), somewhat hard (33% MVC), and hard (63% MVC) levels; this ability was not different for the impaired and nonimpaired limbs. CONCLUSION Both healthy subjects and subjects with stroke are able to differentiate distinct levels of perceived exertion during isometric force when prompted with the Borg scale. Efforts at lower percentages of MVC are perceived by subjects with stroke as greater-than-normal Borg RPE levels.
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Affiliation(s)
- Stephen Hampton
- Department of Physical Medicine and Rehabilitation, University of Texas Health Science Center at Houston, Houston, Texas Neurorehabilitation Research Laboratory, TIRR Memorial Hermann Hospital, Houston, Texas
| | - Gina Armstrong
- Department of Physical Medicine and Rehabilitation, University of Texas Health Science Center at Houston, Houston, Texas Neurorehabilitation Research Laboratory, TIRR Memorial Hermann Hospital, Houston, Texas
| | - Monika Shah Ayyar
- Rehabilitation Unit, Houston Methodist Hospital, Houston, Texas Clinical Rehabilitation Medicine, Weill Cornell Medical College, Houston Methodist Hospital, Houston, Texas
| | - Sheng Li
- Department of Physical Medicine and Rehabilitation, University of Texas Health Science Center at Houston, Houston, Texas Neurorehabilitation Research Laboratory, TIRR Memorial Hermann Hospital, Houston, Texas
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Hareendran A, Leidy NK, Monz BU, Winnette R, Becker K, Mahler DA. Proposing a standardized method for evaluating patient report of the intensity of dyspnea during exercise testing in COPD. Int J Chron Obstruct Pulmon Dis 2012; 7:345-55. [PMID: 22745534 PMCID: PMC3379870 DOI: 10.2147/copd.s29571] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [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] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Measuring dyspnea intensity associated with exercise provides insights into dyspnea-limited exercise capacity, and has been used to evaluate treatment outcomes for chronic obstructive pulmonary disease (COPD). Three patient-reported outcome scales commonly cited for rating dyspnea during exercise are the modified Borg scale (MBS), numerical rating scale for dyspnea (NRS-D), and visual analogue scale for dyspnea (VAS-D). Various versions of each scale were found. Our objective was to evaluate the content validity of scales commonly used in COPD studies, to explore their ability to capture patients' experiences of dyspnea during exercise, and to evaluate a standardized version of the MBS. METHODS A two-stage procedure was used, with each stage involving one-on-one interviews with COPD patients who had recently completed a clinic-based exercise event on a treadmill or cycle ergometer. An open-ended elicitation interview technique was used to understand patients' experiences of exercise-induced dyspnea, followed by patients completing the three scales. The cognitive interviewing component of the study involved specific questions to evaluate the patients' perspectives of the content and format of the scales. Results from Stage 1 were used to develop a standardized version of the MBS, which was then subjected to further content validity assessment during Stage 2. RESULTS Thirteen patients participated in the two-stage process (n = 6; n = 7). Mean forced expiratory volume in 1 second (FEV(1)) percent predicted was 40%, mean age 57 years, and 54% were male. Participants used a variety of terms to describe the intensity and variability of exercise-induced dyspnea. Subjects understood the instructions and format of the standardized MBS, and were able to easily select a response to report the level of dyspnea associated with their recent standardized exercise. CONCLUSION This study provides initial evidence in support of using a standardized version of the MBS version for quantifying dyspnea intensity associated with exercise in patients with COPD.
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