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Omar A, Ferreira ADS, Hegazy FA, Alaparthi GK. Cardiorespiratory Response to Six-Minute Step Test in Post COVID-19 Patients-A Cross Sectional Study. Healthcare (Basel) 2023; 11:healthcare11101386. [PMID: 37239672 DOI: 10.3390/healthcare11101386] [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] [Received: 03/06/2023] [Revised: 04/26/2023] [Accepted: 05/08/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND AND PURPOSE New coronavirus disease 2019 (COVID-19) can cause persistent symptoms and physical weakness that can lead to a limitation in activities of daily living (ADL). There is a lack of evidence about the performance in the six-minute step test (6MST) of post-COVID-19 patients and healthy subjects. The aim of this study is to investigate the cardiorespiratory response induced by the 6MST in post-COVID-19 patients and compare it with the response of the six-minute walk test (6MWT). METHODS This cross-sectional study was conducted on 34 post-COVID-19 patients and 33 healthy subjects. The assessment was performed at one month from a non-severe SARS-CoV-2 infection. Both groups were assessed by using the 6MST, 6MWT, and the pulmonary function test (PFT). Post COVID functional status (PCFS) scale was used for the post-COVID-19 group to assess functional status. Physiological responses; heart rate (HR), respiratory rate (RR), oxygen saturation (SpO2), blood pressure (BP), and Borg scale for fatigue and dyspnea were recorded before and after the 6MST and 6MWT. RESULTS the performance of the post-COVID-19 group was worse than the healthy group in both tests. In 6MWT, the distance walked by the post-COVID-19 group (423 ± 7) was 94 m less than the healthy group, and the number of climbed steps in the 6MST (121 ± 4) was 34 steps less than the healthy group. Both results were statistically significant (p < 0.001). There was a moderate positive correlation between the 6MST and 6MWT in walked distance versus steps number (r = 0.5, p < 0.001). In addition, there was a moderate correlation between the two tests in the post (HR, RR, SpO2, systolic blood pressure SBP, diastolic blood pressure DBP, dyspnea, and fatigue) with p < 0.001. CONCLUSIONS Six-minute step tests produced similar cardiorespiratory responses when compared to a 6MWT. The 6MST can be used as an assessment tool for COVID-19 patients to evaluate their functional capacity and ADL.
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Affiliation(s)
- Amna Omar
- Department of Physiotherapy, College of Health Science, University of Sharjah, Sharjah 27272, United Arab Emirates
| | - Arthur de Sá Ferreira
- Postgraduate Program in Rehabilitation Sciences, Augusto Motta University Center, UNISUAM, Rua Dona Isabel 94, Bonsucesso, Rio de Janeiro 21032-060, Brazil
| | - Fatma A Hegazy
- Department of Physiotherapy, College of Health Science, University of Sharjah, Sharjah 27272, United Arab Emirates
- Faculty of Physical Therapy, Cairo University, Cairo 12613, Egypt
| | - Gopala Krishna Alaparthi
- Department of Physiotherapy, College of Health Science, University of Sharjah, Sharjah 27272, United Arab Emirates
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Rebecca JW, Alison MB, Ryan JW, Claudia RS, Donovan JL, Ann TH, Kirsten LZ, Sean CF, William DR, Dah-Jyuu W, Erika LF, Gihan IT, Michael JD, William TT, Glenn AW, Krista V. Development of Contractures in DMD in Relation to MRI-Determined Muscle Quality and Ambulatory Function. J Neuromuscul Dis 2022; 9:289-302. [PMID: 35124659 DOI: 10.3233/jnd-210731] [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: 11/15/2022]
Abstract
BACKGROUND Joint contractures are common in boys and men with Duchenne muscular dystrophy (DMD), and management of contractures is an important part of care. The optimal methods to prevent and treat contractures are controversial, and the natural history of contracture development is understudied in glucocorticoid treated individuals at joints beyond the ankle. OBJECTIVE To describe the development of contractures over time in a large cohort of individuals with DMD in relation to ambulatory ability, functional performance, and muscle quality measured using magnetic resonance imaging (MRI) and spectroscopy (MRS). METHODS In this longitudinal study, range of motion (ROM) was measured annually at the hip, knee, and ankle, and at the elbow, forearm, and wrist at a subset of visits. Ambulatory function (10 meter walk/run and 6 minute walk test) and MR-determined muscle quality (transverse relaxation time (T2) and fat fraction) were measured at each visit. RESULTS In 178 boys with DMD, contracture prevalence and severity increased with age. Among ambulatory participants, more severe contractures (defined as greater loss of ROM) were significantly associated with worse ambulatory function, and across all participants, more severe contractures significantly associated with higher MRI T2 or MRS FF (ρ: 0.40-0.61 in the lower extremity; 0.20-0.47 in the upper extremity). Agonist/antagonist differences in MRI T2 were not strong predictors of ROM. CONCLUSIONS Contracture severity increases with disease progression (increasing age and muscle involvement and decreasing functional ability), but is only moderately predicted by muscle fatty infiltration and MRI T2, suggesting that other changes in the muscle, tendon, or joint contribute meaningfully to contracture formation in DMD.
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Affiliation(s)
| | | | - J Wortman Ryan
- Tulane University School of Medicine, New Orleans, LA, USA
| | | | | | - T Harrington Ann
- Children's Hospital of Philadelphia, Philadelphia, PA, USA.,Arcadia University, Glennside, PA, USA
| | - L Zilke Kirsten
- Shriners Hospitals for Children -Portland, OR, USA.,Oregon Health and Science University, Portland, OR, USA
| | | | | | - Wang Dah-Jyuu
- Children's Hospital of Philadelphia, Philadelphia, PA, USA
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Yeo J, Kim JY, Kim MH, Park JW, Park JK, Lee EB. Utility of the breath-holding test in patients with systemic sclerosis. Rheumatology (Oxford) 2022; 61:4113-4118. [PMID: 35040945 PMCID: PMC9536778 DOI: 10.1093/rheumatology/keac020] [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: 09/16/2021] [Revised: 12/27/2021] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVES Cardiopulmonary involvement is a major cause of death in patients with SSc. This study evaluated the clinical utility and reliability of breath-holding test (BHT) in evaluating cardiopulmonary function in patients with SSc. METHODS Seventy-two prospectively enrolled patients with SSc underwent BHT and the 6 min walk test (6MWT), along with measurements of the Borg dyspnoea scale and Scleroderma Health Assessment Questionnaire (SHAQ). Data on pulmonary function test and echocardiography were also collected. Validity was assessed based on the correlations between the best BHT and relevant clinical parameters. To assess the reliability of BHT, an additional 31 patients with SSc underwent BHTs twice within 2 week intervals. RESULTS Mean (s.d.) best BHT time was 38.4 (15.7) s, and 6MWT distance was 473.5 (95.5) m. BHT showed significant correlations with the Borg dyspnoea scale before (r = -0.367, P < 0.001) and after (r = -0.285, P = 0.016) testing, whereas 6MWT were correlated with the Borg dyspnoea scale after (r = -0.351, P = 0.002) but not before (r = -0.113, P = 0.343) testing. BHT time was correlated with diffusing capacity for carbon monoxide (%, r = 0.426, P < 0.001), forced vital capacity (litres, r = 0.373, P = 0.001), pulmonary arterial systolic pressure (mmHg, r = -0.272, P = 0.031) and SHAQ score (r = -0.470, P < 0.001), but not with left ventricular ejection fraction (%, r = -0.135, P = 0.263). BHT showed excellent reliability, with an intraclass correlation coefficient (2, 1) of 0.943 (95% CI: 0.88, 0.97). CONCLUSION BHT, a simple and less time-consuming test, shows excellent reliability and significant correlation with the Borg scale, SHAQ and pulmonary parameters. These results suggest that BHT might be a useful surrogate marker of pulmonary capacity in SSc patients. TRIAL REGISTRATION NUMBER NCT04484948.
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Affiliation(s)
- Jina Yeo
- Division of Rheumatology, Department of Internal Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon,Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital
| | - Ju Yeon Kim
- Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital
| | - Mi Hyeon Kim
- Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital
| | - Jun Won Park
- Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital
| | - Jin Kyun Park
- Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital,Department of Internal Medicine, Seoul National University College of Medicine
| | - Eun Bong Lee
- Correspondence to: Eun Bong Lee, Division of Rheumatology, Department of Internal Medicine, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea. E-mail:
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Ciurzyński M, Chrzanowska A, Bienias P, Domienik-Karłowicz J, Sobieraj P, Dąbrowska K, Dudzik-Niewiadomska I, Kurnicka K, Kisiel B, Pruszczyk P. Left ventricular diastolic dysfunction and diseases severity contribute to impaired exercise capacity in systemic lupus erythematosus. Lupus 2021; 30:1154-1162. [PMID: 33853418 DOI: 10.1177/09612033211006900] [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] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Patients with systemic lupus erythematosus (SLE) have a higher risk of myocardial involvement, which can result in ventricular dysfunction. The aim of our study was to estimate potential relationship between exercise capacity assessed by six minute walk test (6MWT) and echocardiographic parameters of left and right ventricular function in SLE patients. METHODS We prospectively studied 66 SLE patients (57 F, age 44 (20-75) years) and 27 age matched healthy subjects. In addition to routine evaluation, 6MWT and transthoracic echocardiography including LV diastolic dysfunction parameters (E/A, E/É) were performed. RESULTS While E/A was similar in both groups, E/E' was higher in patients with SLE than in controls, 7.5 (4-22) vs 6.8 (1.6-9.4), p = 0.018. The mean 6MWT distance was significantly shorter in SLE (561.6 ± 150.7 vs 682.6 ± 98.1 m, p < 0.002). Among SLE patients only 53 (80.3%) were capable to walk at least 450 m, while in controls 27 (100%) (p = 0.013). We observed significant correlations between 6MWT distance and SLICC/ACR-DI (rho=-0.44, p < 0.001), E/A (rho = 0.30, p = 0.004), E/E' (rho=-0.36, p < 0.001) in SLE patients. Univariable logistic regression models revealed that SLICC/ACR-DI, E/E', tricuspid regurgitant peak gradient (TRPG), and right ventricular systolic pressure (RVSP) were associated with 6MWT distance lower than < 450 m. ROC curves shown high predictive value of E/E' ratio, TRPG, RVSP in the prediction for 6MWT distance < 450 m. CONCLUSION Impaired exercise tolerance seems to result mainly from the severity of SLE and LV diastolic dysfunction.
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Affiliation(s)
- Michał Ciurzyński
- Department of Internal Medicine and Cardiology, Medical University of Warsaw, Warsaw, Poland
| | - Anna Chrzanowska
- Department of Internal Medicine and Cardiology, Medical University of Warsaw, Warsaw, Poland
| | - Piotr Bienias
- Department of Internal Medicine and Cardiology, Medical University of Warsaw, Warsaw, Poland
| | | | - Piotr Sobieraj
- Department of Internal Medicine, Hypertension and Vascular Diseases, Medical University of Warsaw, Warsaw, Poland
| | - Katarzyna Dąbrowska
- Department of Internal Medicine and Cardiology, Medical University of Warsaw, Warsaw, Poland
| | | | - Katarzyna Kurnicka
- Department of Internal Medicine and Cardiology, Medical University of Warsaw, Warsaw, Poland
| | - Bartłomiej Kisiel
- Department of Internal Diseases and Rheumatology, Military Institute of Medicine, Warsaw, Poland
| | - Piotr Pruszczyk
- Department of Internal Medicine and Cardiology, Medical University of Warsaw, Warsaw, Poland
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Nambi G, Abdelbasset WK, Elshehawy AA, Eltrawy HH, Abodonya AM, Saleh AK, Hussein RS. Yoga in Burn: Role of pranayama breathing exercise on pulmonary function, respiratory muscle activity and exercise tolerance in full-thickness circumferential burns of the chest. Burns 2020; 47:206-214. [PMID: 32709430 DOI: 10.1016/j.burns.2020.06.033] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 03/03/2020] [Revised: 06/18/2020] [Accepted: 06/29/2020] [Indexed: 01/12/2023]
Abstract
BACKGROUND Circumferential burn of chest (CBC) is a significant type of burn and considers as a major cause of restrictive lung disease (RLD). Patient who has CBC with RLD leads to respiratory symptoms such as breathing difficulty, airway obstruction, reduced exercise capacity and altered pulmonary functions. However, studies examining the role of pranayama breathing exercise on pulmonary function, respiratory muscle activity and exercise tolerance in full thickness circumferential burn of chest are lacking. OBJECTIVE To find the short term effects of pranayama breathing exercise on pulmonary function, respiratory muscle activity and exercise tolerance in full thickness circumferential burns of chest. METHODS Through simple random sampling method thirty subjects (N = 30) with RLD following CBC were allocated to pranayama breathing exercise group (PBE-G; n = 15) and conventional breathing exercise group (CBE-G; n = 15). They received pranayama breathing exercise and conventional breathing exercise for 4 weeks respectively. All the subjects received chest mobility exercise as common treatment. Primary (Numeric Pain Rating Scale - NPRS, forced expiratory volume (FEV1), forced vital capacity (FVC) and maximum voluntary ventilation (MVV) and secondary (Electromyogram of sternocleidomastoid, scalene, external intercostal and diaphragm muscle, 6 min walk test & Global Rating of Change - GRC) outcome measures were measured at baseline, after four weeks and after three months follow up. RESULTS Baseline demographic and clinical variables show homogenous distribution between the groups (p > 0.05). Four weeks following different breathing exercises, PBE-G group shows more significant changes in pain intensity, pulmonary function, respiratory muscle activity, exercise tolerance and global rating of change than CBE-G group (p ≤ 0.05) at four weeks and three months follow up. CONCLUSION Both groups showed improvement over time. However, differences between the groups were noticed small. Still physiotherapy management, which included pranayama breathing exercises with chest mobilization program, had an effective strategy in the treatment of restrictive lung disease following circumferential burn of chest.
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Affiliation(s)
- Gopal Nambi
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia.
| | - Walid Kamal Abdelbasset
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia; Department of Physical Therapy, Kasr Al-Aini Hospital, Cairo University, Giza, Egypt
| | - Ahmed A Elshehawy
- Department of Physical Therapy for Cardiovascular/Respiratory Disorder and Geriatrics, Faculty of Physical Therapy, Cairo University, Giza, Egypt; Department of Physical Therapy, Faculty of Applied Medical Sciences, Tabuk University, Tabuk, Saudi Arabia
| | - Heba H Eltrawy
- Department of Chest Diseases, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
| | - Ahmed M Abodonya
- Department of Anesthesia and Intensive Care, Faculty of Medicine, Al-Azhar University, Cairo, Egypt; Department of Surgery, College of Medicine, Prince Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia
| | - Ayman K Saleh
- Department of Surgery, College of Medicine, Prince Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia; Department of Orthopedic, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
| | - Ramadan S Hussein
- Department of Surgery, College of Medicine, Prince Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia
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Abstract
Context: The global scenario of illness is shifting from infectious diseases to non-communicable diseases, with chronic conditions such as heart diseases, stroke and Chronic Obstructive Pulmonary Disease (COPD) now being chief causes of death globally and more than 90% of deaths due to COPD occur in low and midline income countries.[1] Low serum vitamin D level is associated with various lung diseases and decreased lung function.[2] Aims: This study was designed to study the serum vitamin D level and its correlation with severity of COPD as assessed by spirometry, COPD assessment test (CAT) and exercise capacity and BMI of COPD patients. Settings and Design: Observational cross sectional study conducted on patients of COPD attending the outpatient department. Materials and Methods: One hundred sixty consecutive patients of COPD attending the outpatient Department were included in the study. Pack years, CAT score, 6 minute walk distance, post bronchodilator spirometry values and BMI was recorded along with complete history and physical examination. Statistical Analysis Used: Data analysis was done using IBM SPSS 23 software. Descriptive statistics, Independent sample t test, ANOVA and Pearson correlation were applied. Results: A significant positive correlation was found between FeV1% of predicted and serum Vitamin D level(r = 0.291; P < 0.001). A negative correlation was found between serum Vitamin D level and severity of COPD as assessed by CAT score (r = -0.355; P < 0.001). Also, a significant positive correlation was found between vitamin D levels and exercise capacity as assessed by 6 minute walk test (6MsWT) (r = 0.648; P < 0.001). Conclusions: COPD patients with more severe disease tend to have lower serum Vitamin D levels. As it is an immunomodulator affecting various inflammatory pathways, it is imperative that we give due consideration to Vitamin D levels in managing patients of COPD.
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Affiliation(s)
- Ummul Baneen
- Department of Tuberculosis and Respiratory Medicine, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - Sufia Naseem
- Department of Biochemistry, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
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Pera MC, Luigetti M, Sivo S, Lapenta L, Granata G, Antonaci L, Coratti G, Forcina N, Pane M, Mercuri E. Does albuterol have an effect on neuromuscular junction dysfunction in spinal muscular atrophy? Neuromuscul Disord 2018; 28:863-4. [PMID: 30177455 DOI: 10.1016/j.nmd.2018.07.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Accepted: 07/27/2018] [Indexed: 11/23/2022]
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Alfonso M, Bustamante V, Cebollero P, Antón M, Herrero S, Gáldiz JB. Assessment of dyspnea and dynamic hyperinflation in male patients with chronic obstructive pulmonary disease during a six minute walk test and an incremental treadmill cardiorespiratory exercise test. Rev Port Pneumol (2006) 2017; 23:266-72. [PMID: 28579149 DOI: 10.1016/j.rppnen.2017.04.007] [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: 08/30/2016] [Revised: 04/09/2017] [Accepted: 04/17/2017] [Indexed: 11/22/2022] Open
Abstract
The six minute walk test (6MWT) is a standardized test that provides information on exercise capacity in patients with COPD. It is considered a submaximal test in opposition to incremental cardiopulmonary exercise tests (CPET) that provide valuable information on all the systems involved in exercise. OBJECTIVES 1. To compare the perceptive, physiological responses and degree of dynamic hyperinflation during two exercise tests: the 6MWT and the incremental CPET on a treadmill. 2. To evaluate how dyspnea is related to dynamic hyperinflation (DH) and other functional parameters in both tests. METHODS 29 stable COPD male patients, age 68±5.8 years, mean post-bronchodilator FEV1 57±11%, were recruited. To evaluate dynamic hyperinflation, inspiratory capacity (IC) was measured at rest and upon completing each one of the tests. At the same time, perceived dyspnea and leg discomfort were rated on specific modified Borg scales. RESULTS The mean walk distance in 6MWT was 494±88m. The Borg scale rating for shortness of breath upon completing the test was 4.7±2, whilst 2.9±2 for leg discomfort. IC changed from 2.53±0.63l before to 2.34±0.60l after completion of the test. In the treadmill CPET, maximal oxygen consumption (V˙O2max) was 21.8±5mL/kg/min with 6.6±2 dyspnea and 4.3±2 leg discomfort on Borg scales. IC changed from 2.17±0.53l to 1.20±0.43l. CONCLUSIONS Dynamic hyperinflation occurs in male COPD patients during submaximal exercise such as the 6MWT. This phenomenon is more pronounced after incremental CPET on a treadmill. Despite being dyspnea the dominant limiting symptom for both tests, we observed different physiological responses.
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Jones C, Eddleston J, McCairn A, Dowling S, McWilliams D, Coughlan E, Griffiths RD. Improving rehabilitation after critical illness through outpatient physiotherapy classes and essential amino acid supplement: A randomized controlled trial. J Crit Care 2015; 30:901-7. [PMID: 26004031 DOI: 10.1016/j.jcrc.2015.05.002] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Revised: 04/09/2015] [Accepted: 05/05/2015] [Indexed: 11/19/2022]
Abstract
PURPOSE Patients recovering from critical illness may be left with significant muscle mass loss. This study aimed to evaluate whether a 6-week program of enhanced physiotherapy and structured exercise (PEPSE) and an essential amino acid supplement drink (glutamine and essential amino acid mixture [GEAA]) improves physical and psychological recovery. MATERIALS AND METHODS Intensive care patients aged 45 years or older, with a combined intensive care unit stay/pre-intensive care unit stay of 5 days or more were recruited to a randomized controlled trial examining the effect of PEPSE and GEAA on recovery. The 2 factors were tested in a 2 × 2 factorial design: (1) GEAA drink twice daily for 3 months and (2) 6-week PEPSE in first 3 months. Primary efficacy outcome was an improvement in the 6-minute walking test at 3 months. RESULTS A total of 93 patients were randomized to the study. Patients receiving the PEPSE and GEA had the biggest gains in distance walked in 6-minute walking test (P < .0001). There were also significant reductions in rates of anxiety in study groups control supplement/PEPSE (P = .047) and GEAA supplement/PEPSE (P = .036) and for GEAA supplement/PEPSE in depression (P = .0009). CONCLUSION Enhanced rehabilitation combined with GEAA supplement may enhance physical recovery and reduce anxiety and depression.
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Affiliation(s)
- C Jones
- Critical Care, Ward 4E, Whiston Hospital, Prescot, UK; Musculoskeletal Biology, Institute of Ageing & Chronic Disease, University of Liverpool, Liverpool, UK.
| | - J Eddleston
- ICU, Manchester Royal Infirmary, Manchester, UK
| | - A McCairn
- Critical Care, Ward 4E, Whiston Hospital, Prescot, UK
| | - S Dowling
- Critical Care, Ward 4E, Whiston Hospital, Prescot, UK
| | | | - E Coughlan
- ICU, Manchester Royal Infirmary, Manchester, UK
| | - R D Griffiths
- Musculoskeletal Biology, Institute of Ageing & Chronic Disease, University of Liverpool, Liverpool, UK
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Kumar D, Wyatt C, Chiba K, lee S, Nardo L, Link TM, Majumdar S, Souza RB. Anatomic correlates of reduced hip extension during walking in individuals with mild-moderate radiographic hip osteoarthritis. J Orthop Res 2015; 33:527-34. [PMID: 25678302 PMCID: PMC4376613 DOI: 10.1002/jor.22781] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [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: 04/19/2014] [Accepted: 10/30/2014] [Indexed: 02/04/2023]
Abstract
To identify radiographic and MR features of hip osteoarthritis (OA) related to reduced hip extension during walking. Sixty six subjects, were stratified into those with (n = 36, KL = 2, 3) and without (n = 30, KL = 0, 1) radiographic hip OA. Cartilage and labrum lesions were graded semi-quantitatively on hip MRI. Alpha angle and lateral center edge (LCE) angle were measured. Sagittal kinematics and kinetics were calculated during walking at speed of 1.35 m/s using 3-D motion capture. All subjects completed Hip disability and Osteoarthritis Outcome Score (HOOS), timed up and go, and 6 min walk tests. Variables were compared between the two groups using one-way ANOVA (adjusting for age). Correlations of radiographic and MR parameters with peak hip extension were calculated. The OA group was older, had greater pain, and limitation of function. They also had lower peak hip extension and higher peak hip flexion; and worse acetabular and femoral cartilage lesions. Peak hip extension and flexion correlated with KL grade, cartilage lesions in the inferior and posterior femur. Reduced hip extension and greater hip flexion during walking are present in high functioning (HOOS > 85%) individuals with mild-moderate hip OA, and are associated with cartilage lesions.
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Affiliation(s)
| | - Cory Wyatt
- 1700 4 St, Suite 203, Byers Hall, Mission Bay, University of California, San Francisco, CA 94158
| | - Ko Chiba
- Department of Orthopedic Surgery, Nagasaki University School of Medicine
| | - Sonia lee
- 185 Berry St, Suite 350, UCSF China Basin, San Francisco, CA, 94107
| | - Lorenzo Nardo
- 185 Berry St, Suite 350, UCSF China Basin, San Francisco, CA, 94107
| | - Thomas M. Link
- 185 Berry St, Suite 350, UCSF China Basin, San Francisco, CA, 94107
| | - Sharmila Majumdar
- 1700 4 Street, Suite 203, Byers Hall, UCSF Mission Bay, San Francisco, CA 94158
| | - Richard B. Souza
- 185 Berry St, Suite 350, UCSF China Basin, San Francisco, CA, 94107
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Budeus M, Buck T, Wieneke H, Erbel R, Sack S. Single-chamber versus dual-chamber implantable cardioverter defibrillators: do we need physiologic pacing in the course? Indian Pacing Electrophysiol J 2006; 6:153-62. [PMID: 16943965 PMCID: PMC1513535] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Many patients with ICD receive different antiarrhythmic drugs (e.g. sotalol, amiodarone, beta-blockers) because of ventricular or atrial tachycardias. These drugs can cause AV-block or chronotropic incompetence resulting in a higher percentage of ventricular pacing. METHODS We analyzed in a retrospective study the impact of DDD(R) versus VVI(R) mode on subjective (NYHA classification) and objective parameters [brain natriuretic peptide (BNP), 6 minute walk test, echocardiography] in 12 of 120 patients (age 60.2 +/- 11.2 years; 10 males, 2 females) who needed an upgrading of a single to a dual chamber ICD. The ICD had to be upgraded because of chronotropic incompetence in all patients with signs of progressing heart failure. Data were collected in VVI(R)-pacing and after 6 and 12 months in DDD(R)-pacing with a long AV-interval and AV hysteresis to reduce ventricular pacing. RESULTS The 6 minute walk test (392.4 +/- 91.4 vs. 324.6 +/- 93.3 m, P < 0.001), NYHA-classification (1.4 +/- 0.3 vs. 2.6 +/- 0.8, P < 0.0001), BNP (234.1 +/- 73.5 vs. 410.4 +/- 297.0 pg/ml, P < 0.001), left ventricular ejection fraction (49.8 +/- 9.6 vs. 36.5 +/- 10.9 %, P < 0.0001) and A-wave (73.6 +/- 13.7 vs. 41.0 +/- 14.0 cm/sec, P < 0.0001) improved with DDD(R)-pacing after 12 months. The ventricular pacing decreased (84.2 +/- 18.1 vs. 1.1 +/- 1.7 %, P < 0.0001) after 12 months by DDD(R)-pacing with long AV-interval (220.0 +/- 10.4 ms) and AV hysteresis. CONCLUSION Our data show a superiority of DDD(R) mode versus VVI(R) mode regarding subjective and objective parameters as NYHA-classification, BNP, 6 minute walk test, left ventricular ejection fraction and left ventricular endsystolic volume after 12 months. The improvements seem to depend on the reduction of ventricular pacing with advanced atrial contraction. But only a small number of patients needed the upgradation.
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Affiliation(s)
- Marco Budeus
- Department of Cardiology, West-German Heart Centre, University of Duisburg-Essen, Germany.
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