scholarly journals Exploring Decisions to Undertake a Marathon and Adherence Challenges in a Novice Runner With Parkinson

2017 ◽  
Vol 5 (2) ◽  
pp. 127-133
Author(s):  
Bhanu Ramaswamy ◽  
Christian Johnson
Keyword(s):  
Muscle Tone ◽  
Activity Level ◽  
Exercise Science ◽  
Vigorous Exercise ◽  
Technological Support ◽  
Nutritional Advice ◽  
Before And After ◽  
Sports And Exercise ◽  
And Function ◽  
Novice Runner

Evidence endorses the benefits of more vigorous exercise for people with Parkinson's, particularly following diagnosis, yet is not clear which style is optimal. The authors share perspectives and decisions made as a physiotherapist (assisted by a sports and exercise science student) and a novice runner with Parkinson's in his late 50s, respectively. The exercise goal chosen by the runner (the case report participant) to minimize the degenerative effects of the progressive condition was to complete a marathon. Methods: This coauthored report evaluates the participant’s progress utilizing physical fitness assessment data plus reflections on his training regime and notes from training diaries for the year before and after the marathon. Results: The participant received nutritional advice for weight management as exercise increased and physiotherapy for injuries from mounting activity level on Parkinsonian muscle tone. Fitness and function improved or were maintained (leg power, flexibility, timed functional walking, and balance). Most, however, returned to baseline within 6 months following the marathon as training intensity dropped. Conclusions: Physical function can be improved or maintained in individuals with neurodegenerative conditions with correct exercise and nutritional advice. The participant’s choice of running was based on recommendations for condition maintenance and not enjoyment, so adherence and completion of the marathon goal required professional, family, and technological support.

EFEITOS DO DEEP RUNNING SOBRE A AMPLITUDE DE MOVIMENTO E A CAPACIDADE FUNCIONAL DOS MEMBROS SUPERIORES DE MULHERES MASTECTOMIZADAS: RELATO DE CASOS

2019 ◽  
pp. 121-131
Keyword(s):  
Range Of Motion ◽  
Upper Limb ◽  
Functional Capacity ◽  
External Rotation ◽  
Treatment Protocol ◽  
Range Of Movement ◽  
Flexion Extension ◽  
Before And After ◽  
In The Beginning ◽  
And Function

Introduction: Breast cancer is the most common type of cancer among women in Brazil and in the worl. The surgical treatment procedure may cause severe morbidity in the upper limb homolateral to surgery, including the reduction of the range of motion, with consequent impairment of function. A physiotherapeutic approach has an important role in the recover range of motion and the functionality of these women, guaranteeing the occupational, domestestic, familiar and conjugated activities, and, in this way, also improving the quality of life. Objectives: To analyse chances in the shoulder's range of motion and the functional capacity of the upper limbs, promoted by the deep running procedure in women with late postoperative mastectomy. Methods: All the patients were submitted to an evaluation in the beginning and end of the treatment, including: goniometry of flexion, extension, abduction, adduction, internal and external rotation of the shoulder joint; and function capacity analysis in activities that involve the upper members by DASH questionnaire. The treatment protocol includes twelve sessions of deep running, realized twice a week, in deep pool, for 20-minute during six weeks. Results: Were submitted to treatment a total of 4 patients. Despite the improvement in the numerical values, statistically significant differences were not found on the range of movements and in the functional capacity of upper members before and after the deep running sessions in post-mastectomy women. Conclusion: Deep running had effects on the numerical values of range of movement and upper limb functionality in women in the late postoperative period of the mastectomy procedure, but without statistically significant differences.

scholarly journals Decision Making for Treatment After ACL Injury From an Orthopaedic Surgeon and Patient Perspective: Results From the NACOX Study

2021 ◽  
Vol 9 (4) ◽  
pp. 232596712110050
Author(s):  
Hanna Tigerstrand Grevnerts ◽  
Sofi Sonesson ◽  
Håkan Gauffin ◽  
Clare L. Ardern ◽  
Anders Stålman ◽  
...  
Keyword(s):  
Decision Making ◽  
High Activity ◽  
Treatment Decision ◽  
Acl Injury ◽  
Treatment Decisions ◽  
Activity Level ◽  
Knee Instability ◽  
Acl Injuries ◽  
Patient Reported ◽  
And Function

Background: In the treatment of anterior cruciate ligament (ACL) injuries, there is little evidence of when and why a decision for ACL reconstruction (ACLR) or nonoperative treatment (non-ACLR) is made. Purpose: To (1) describe the key characteristics of ACL injury treatment decisions and (2) compare patient-reported knee instability, function, and preinjury activity level between patients with non-ACLR and ACLR treatment decisions. Study Design: Cohort study; Level of evidence, 2. Methods: A total of 216 patients with acute ACL injury were evaluated during the first year after injury. The treatment decision was non-ACLR in 73 patients and ACLR in 143. Reasons guiding treatment decision were obtained from medical charts and questionnaires to patients and orthopaedic surgeons. Patient-reported instability and function were obtained via questionnaires and compared between patients with non-ACLR and ACLR treatment decisions. The ACLR treatment group was classified retrospectively by decision phase: acute phase (decision made between injury day and 31 days after injury), subacute phase (decision made between 32 days and up to 5 months after injury), and late phase (decision made 5-12 months after injury). Data were evaluated using descriptive statistics, and group comparisons were made using parametric or nonparametric tests as appropriate. Results: The main reasons for a non-ACLR treatment decision were no knee instability and no problems with knee function. The main reasons for an ACLR treatment decision were high activity demands and knee instability. Patients in the non-ACLR group were significantly older ( P = .031) and had a lower preinjury activity level than did those in the acute-phase ( P < .01) and subacute-phase ( P = .006) ACLR decision groups. There were no differences in patient-reported instability and function between treatment decision groups at baseline, 4 weeks after injury, or 3 months after injury. Conclusion: Activity demands, not patient-reported knee instability, may be the most important factor in the decision-making process for treatment after ACL injury. We suggest a decision-making algorithm for patients with ACL injuries and no high activity demands; waiting for >3 months can help distinguish those who need surgical intervention from those who can undergo nonoperative management. Registration: NCT02931084 ( ClinicalTrials.gov identifier).

scholarly journals Are Three Weeks of Oral Anticoagulation Sufficient for Safe Cardioversion in Atrial Fibrillation?

Medicina ◽  
2021 ◽  
Vol 57 (6) ◽  
pp. 554
Author(s):  
Stefan Naydenov ◽  
Nikolay Runev ◽  
Emil Manov
Keyword(s):  
Atrial Fibrillation ◽  
Sinus Rhythm ◽  
Oral Anticoagulation ◽  
Left Atrial ◽  
Left Atrial Volume ◽  
Open Label ◽  
Before And After ◽  
Individualized Approach ◽  
Baseline Factors ◽  
And Function

Background and Objectives: Patients with atrial fibrillation (AF), lasting >48 h, considered for cardioversion, are recommended ≥3 weeks of oral anticoagulation before sinus rhythm restoration because of high risk of development of left atrial thrombosis (LAT) and stroke. However, the optimal duration of anticoagulation in the presence of overt LAT is unknown. Materials and Methods: An open-label study aimed to investigate the prevalence of spontaneous echo contrast (SEC) and LAT before and after 3 weeks of direct oral anticoagulant (DOAC) treatment. We included 51 consecutive patients (50.9% males), mean age 69.3 ± 7.4 years with paroxysmal/unknown duration of AF, considered for cardioversion, who agreed to have transesophageal echocardiography at enrollment and 3 weeks later. Results: At baseline SEC was present in 26 (50.9%) and LAT in 10 (19.6%) of 51 patients. After 3 weeks on DOAC, SEC persisted in 12 (25.0%) and LAT in 7 (14.5%) of 48 patients, p < 0.05 vs. baseline. Factors, associated most strongly with persistence of SEC/LAT, were left atrial appendage (LAA) emptying velocity <20 cm/s (OR = 2.82), LAA lobes >2 (OR = 1.84), and indexed left atrial volume ≥34 mL/m2 (OR = 1.37). Conclusions: In our study the incidence of SEC/LAT, particularly in AF with unknown duration, was not as low as we expected. The prevalence of SEC/LAT seemed to be dependent on factors not routinely evaluated in AF patients planned for cardioversion (indexed LA volume, LAA morphology and number of lobules, LAA emptying velocity, etc.). Our data suggested an individualized approach for DOAC duration in AF patients before an attempt for restoration of sinus rhythm is made, taking into consideration the LAA morphology and function.

Effects of pharyngeal lubrication on the opening of obstructed upper airway

1992 ◽  
Vol 72 (6) ◽  
pp. 2311-2316 ◽  
Author(s):  
H. Miki ◽  
W. Hida ◽  
Y. Kikuchi ◽  
T. Chonan ◽  
M. Satoh ◽  
...  
Keyword(s):  
Hypoglossal Nerve ◽  
Muscle Tone ◽  
Upper Airway ◽  
Intraluminal Pressure ◽  
Lower Airway ◽  
Before And After ◽  
Airway Opening ◽  
Cervical Trachea ◽  
Artificial Surfactant ◽  
Stimulation Of

We examined the effect of electrical stimulation of the hypoglossal nerve and pharyngeal lubrication with artificial surfactant (Surfactant T-A) on the opening of obstructed upper airway in nine anesthetized supine dogs. The upper airway was isolated from the lower airway by transecting the cervical trachea. Upper airway obstruction was induced by applying constant negative pressures (5, 10, 20, and 30 cmH2O) on the rostral cut end of the trachea. Peripheral cut ends of the hypoglossal nerves were electrically stimulated by square-wave pulses at various frequencies from 10 to 30 Hz (0.2-ms duration, 5–7 V), and the critical stimulating frequency necessary for opening the obstructed upper airway was measured at each driving pressure before and after pharyngeal lubrication with artificial surfactant. The critical stimulation frequency for upper airway opening significantly increased as upper airway pressure became more negative and significantly decreased with lubrication of the upper airway. These findings suggest that greater muscle tone of the genioglossus is needed to open the occluded upper airway with larger negative intraluminal pressure and that lubrication of the pharyngeal mucosa with artificial surfactant facilitates reopening of the upper airway.

Abstract 17266: Right Atrial Volumes Changes in Tetralogy of Fallot

Circulation ◽  
2018 ◽  
Vol 138 (Suppl_1) ◽  
Author(s):  
Ashish Patel ◽  
Divya Shakti ◽  
Chad Blackshear
Keyword(s):  
Diastolic Dysfunction ◽  
Diastolic Function ◽  
Tetralogy Of Fallot ◽  
Surgical Repair ◽  
Left Ventricular ◽  
Right Atrial ◽  
Before And After ◽  
Ventricular Diastolic Dysfunction ◽  
And Function ◽  
Averaged Model

Introduction & Hypothesis: There is limited information on right atrial (RA) function in the congenital heart defects. RA volume and function may give insight into the right ventricle (RV) diastolic function. We sought to assess RA function in tetralogy of Fallot (TOF) patients prior to and after complete surgical repair. Methods: Infants with TOF prior to complete repair were included for retrospective chart review and offline analysis of 2-dimensional echocardiograms (echo) before and after surgical repair. RA phasic volumes and stroke volumes were calculated. All volumes were indexed to body surface area. Results: There were 40 infants with TOF (45% females), of which 70% had pulmonary stenosis, 30% pulmonary atresia. Roughly 85% and 60% had 3, or more, echo available pre- and postoperatively. Table 1 (attached) shows the patient characteristics and phasic RA volumes. The indexed RA phasic volumes were in normal range in initial echo prior to surgery. We used normal index RA phasic volumes published by European Society of Echocardiography. There was the increasing trend of indexed RA phasic volume on follow up echo immediately before TOF repair. These phasic volumes continued to remain elevated after complete surgical repair (Table 1). Trends in RA stroke volumes for all available echos before and after surgery were modeled using a population-averaged model with an exchangeable within-panel correlation structure (Figure 2), showing no statistically significant difference after surgery. But there was statistical significance noted in RA ejection fraction. Please see attached image for statistical analysis and results of the study. Conclusions: The indexed RA phasic volumes in children with TOF are normal initially and increases before TOF repair and it continued to increase after TOF repair. The increase RA phasic volumes suggest RV diastolic dysfunction similar to the findings of LA phasic volumes and left ventricular diastolic dysfunction. Our findings indicate slow worsening RV diastolic function in patients with TOF after surgical repair. RA volume and function can be the novel marker to diagnose and monitor right ventricular diastolic dysfunction.

Wipe and flexion reflexes of the frog. II. Response to perturbations

1993 ◽  
Vol 69 (5) ◽  
pp. 1736-1748 ◽  
Author(s):  
J. L. Schotland ◽  
W. Z. Rymer
Keyword(s):  
External Load ◽  
Hind Limb ◽  
Joint Angle ◽  
Activity Level ◽  
Temporal Organization ◽  
Emg Activity ◽  
Relative Timing ◽  
Before And After ◽  
Movement Segment ◽  
Initial Movement

1. To evaluate the hypothesis that the neural control of sensorimotor transformations may be simplified by using a single control variable, we compared the movement kinematics and muscle activity patterns [electromyograms (EMGs)] of the frog during flexion withdrawal and the hind limb-hind limb wipe reflex before and after adding an external load. In addition, the flexibility of spinal cord circuitry underlying the hind limb-hind limb wipe reflex was evaluated by comparing wipes before and after removal of one of the contributing muscles by cutting a muscle nerve. 2. The kinematics of the movements were recorded using a WATSMART infrared emitter-detector system and quantified using principal-components analysis to provide a measure of the shape (eigenvalues) and orientation (eigenvector coefficients) of the movement trajectories. The neural pattern coordinating the movements was characterized by the latencies and magnitudes of EMGs of seven muscles acting at the hip, knee, and ankle. These variables were compared 1) during flexion withdrawal and the initial movement segment of the limb during the hind limb-hind limb wipe reflex in both unrestrained movements and in movements executed when a load equal to approximately 10% of the animal's body weight was attached to a distal limb segment and 2) during the initial movement segment of the wipe reflex before and after cutting the nerve to the knee flexor-hip extensor, iliofibularis. 3. Addition of the load had no discernible effect on the end-point position of the foot during either reflex. However, during the loaded flexion reflex, the ankle joint did not move until after the hip and knee joints had moved to their normal positions. This delayed flexion of the ankle was accompanied by large increases in the magnitude of EMG activity in two ankle muscles that exceeded the levels found during unrestrained movements. Significant changes in the temporal organization of the EMG pattern accompanied the change in joint angle relations during flexion withdrawal. 4. Despite the addition of an external load, all animals successfully and reliably removed the stimulus during the wipe reflex, and the relative timing of both the EMG pattern and joint angle motion was preserved. 5. Immediately after section of the nerve to a single muscle (iliofibularis), all animals successfully and reliably removed the stimulus during the wipe reflex. The relative timing of muscle activation was preserved, accompanied by a reduction in the activity level of gluteus magnus, a muscle with action reciprocal to iliofibularis.(ABSTRACT TRUNCATED AT 400 WORDS)

The effects of Acute and Chronic β-Adrenoceptor Blockade on the Myofibrillar Contractile System in the Dog Heart

1984 ◽  
Vol 67 (2) ◽  
pp. 259-267 ◽  
Author(s):  
M. K. Davies ◽  
P. Cummins ◽  
W. A. Littler
Keyword(s):  
Calcium Sensitivity ◽  
Maximal Activity ◽  
Biopsy Specimens ◽  
Contractile System ◽  
Chronic Therapy ◽  
Before And After ◽  
Adaptive Effect ◽  
Electrophoretic Techniques ◽  
Myocardial Contractile ◽  
And Function

1. Electrophoretic and enzyme techniques have been used to study the structure and function of the contractile protein system in the myocardium of dogs before and after β-adrenoceptor blockade. Animals were examined after acute β-adrenoceptor blockade by using intravenous atenolol (0.2 mg/kg) and following chronic therapy with oral atenolol (100 mg twice daily) for a mean period of 106 days. 2. Two-dimensional polyacrylamide-gel electrophoretic techniques were used to examine the myocardial contractile and regulatory proteins present in endomyocardial biopsy specimens obtained after acute and chronic β-adrenoceptor blockade. No differences in charge, molecular weight or the relative proportions of actin, myosin light chains, tropomyosin or troponin-C were seen after either acute or chronic β-adrenoceptor blockade. 3. The maximal activity and calcium sensitivity of the myofibrillar adenosine triphosphatase (ATPase) was also unchanged after acute and chronic atenolol therapy. 4. It is concluded that β-adrenoceptor blockade has no significant adaptive effect on the structural or functional properties of the myofibril.

scholarly journals The inherent mutational tolerance and antigenic evolvability of influenza hemagglutinin

eLife ◽  
2014 ◽  
Vol 3 ◽  
Author(s):  
Bargavi Thyagarajan ◽  
Jesse D Bloom
Keyword(s):  
Amino Acid ◽  
H1n1 Influenza ◽  
Influenza Hemagglutinin ◽  
Functional Variants ◽  
Viral Hemagglutinin ◽  
Before And After ◽  
Amino Acid Mutations ◽  
And Function ◽  
Phylogenetic Models ◽  
Better Than

Influenza is notable for its evolutionary capacity to escape immunity targeting the viral hemagglutinin. We used deep mutational scanning to examine the extent to which a high inherent mutational tolerance contributes to this antigenic evolvability. We created mutant viruses that incorporate most of the ≈104 amino-acid mutations to hemagglutinin from A/WSN/1933 (H1N1) influenza. After passaging these viruses in tissue culture to select for functional variants, we used deep sequencing to quantify mutation frequencies before and after selection. These data enable us to infer the preference for each amino acid at each site in hemagglutinin. These inferences are consistent with existing knowledge about the protein's structure and function, and can be used to create a model that describes hemagglutinin's evolution far better than existing phylogenetic models. We show that hemagglutinin has a high inherent tolerance for mutations at antigenic sites, suggesting that this is one factor contributing to influenza's antigenic evolution.

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