scholarly journals Differences between Proximal and Distal Muscle Activity of the Lower Limbs of Community-dwelling Women during the 6-minute Walk Test

2012 ◽  
Vol 24 (2) ◽  
pp. 205-209 ◽  
Author(s):  
Hikaru Ihira ◽  
Hiroyuki Shimada ◽  
Megumi Suzukawa ◽  
Taketo Furuna ◽  
Kiyoji Matsuyama ◽  
...  
2015 ◽  
Vol 27 (11) ◽  
pp. 3571-3578 ◽  
Author(s):  
Vicent Benavent-Caballer ◽  
Juan Francisco Lisón ◽  
Pedro Rosado-Calatayud ◽  
Juan José Amer-Cuenca ◽  
Eva Segura-Orti

Biomedicine ◽  
2020 ◽  
Vol 39 (2) ◽  
pp. 310-318
Author(s):  
Logeshwari Selvaraj ◽  
Sakthi J

Introduction and Aim: Balance synergy includes a number of postural response that enable an individual to arise and remain erect during standing and locomotion. Balance deficits causes an insufficient coordination, postural instability and impaired gait. Maintaining the independence in activities of activities of daily living is an important factor for the quality of life. Hence this study is done to promote Hemiplegic Gait in stroke patients. Materials and Methods: 150 community dwelling hemiparetic subjects from Chennai aged <65 both male and female subjects were allocated in three groups (n=50) using convenient sampling method and were followed up for a period of 12 weeks with intervention duration of 45 mins daily and were assessed with POMA, FALL RISK , TUG and 6 minute walk test. Paired‘t’ test was used for assessing pre and post-test values. Results: There was significant difference with p < 0.001 at both Tinetti Performance oriented mobility assessment, Time up and Go Test, Fall Risk and 6 minute walk test minimal significant difference in  chair stand test in both the groups. Conclusion: There was significant difference in POMA, FALL RISK , TUG and 6 minute walk test p<.005 in Group C & Group B.  


Author(s):  
Kathleen K Mangione ◽  
Rebecca L Craik ◽  
Anne Kenny ◽  
Arteid Memaj ◽  
Melissa F Miller ◽  
...  

Abstract Background The impact of frailty on walking recovery after hip fracture has not been reported. We describe the prevalence of frailty approximately 3 months after hip fracture, and identify the impact of baseline frailty on ambulation recovery. Methods Data from the Community Ambulation Project, that examined the effects of 2 multicomponent home exercise programs on 6-minute walk test in participants post hip fracture, were used to reconstruct the 5-item frailty phenotype. We detailed the prevalence of frailty by subgroup and assessed the comparability between frailty groups for the categorical variable of achieving 300 m in 6-minute walk test (community ambulation threshold), and the continuous variable of total distance in 6-minute walk test before and after 16 weeks of intervention. Results Of the 210 participants, 9% were nonfrail, 59% were prefrail, and 32% were frail. The odds of a nonfrail participant achieving the 300-m threshold were 14.4 (95% CI: 2.4–87.6) times the odds of a frail participant, while a prefrail participant’s odds were 6.1 (95% CI: 1.3–28.4) times after controlling for treatment group and baseline walking distance. The nonfrail participants had an increase of 92.1 m from baseline to 16 weeks, the prefrail had a 50.8 m increase, and the frail group had the smallest increase of 36.6 m (p &lt; .001 for all). Conclusions Prefrailty and frailty were highly prevalent in this sample of community-dwelling survivors of a recent hip fracture. Gains in walking distance and attaining a level of community ambulation were affected significantly by the level of baseline frailty.


Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Heather Popp ◽  
Joan Breen ◽  
Tom Ferlito ◽  
Sandy Kiley

The Anti-gravity (AG) treadmill is a new modality, initially used by athletes and astronauts allowing precise unweighting up to 80% of body weight. Patients are enclosed in a cockpit which unweights by filling with air, allowing patients to be safely progressed at higher speed and longer durations than the conventional treadmill. Only a few case studies report outcomes of stroke patients using this system. Methods: We trialled the AG system on 9 (5 men, 4 women) community dwelling, chronic stroke patients between 6/2014 and 8/2014 as part of an outpatient physical therapy (PT) program. 7/9 patients received AG treatment following conventional treadmill training, while 2 began new PT treatments with the AG system. Endurance was measured with the standardized 6 minute walk test before initiation and after completion of AG system treatments. Various other PT and stroke outcomes were measured. Results: 8 ischemic and 1 hemorrhage stroke patients with average age 63 (49-79); average NIHSS of 7.9 (range 3-15) and Modified Rankin Scores of 4 for 5 patients and 3 for 4 were treated an average of 21.4(range 11-86) months post stroke. Patients received an average of 5 sessions (2-8) over an average of 2.8 weeks ((1-4). Blood Pressures monitored pre and post each treatment were stable. No adverse complications or pain occurred. All patients reported subjectively experiencing improvement in gait quality with AG system use. 89% (8/9) patients had improved 6" walk test scores following AG treatments. 7/9 patients had received conventional treadmill training during skilled PT prior to initiation of AG treatments. In the 1 month prior to AG treatment, 3/7 of these patients had worsening of 6" walk scores; 2/7 improved, and 2/7 had no change. Of the 7/9 patients receiving AG treatment following usual treadmill training, 6/7 had improved 6" walk scores (range 2-17%). 6 minute walk scores improved by 81% and 1% in 2 patients initiating AG training without preceding treadmill training. All patients had improved walking duration and speed on AG compared to traditional treadmill. Conclusions: AG treadmill treatment was reported to be positive and led to improved walking and endurance compared to conventional treadmill training in this pilot group of chronic community dwelling stroke patients.


2010 ◽  
Vol 13 (1) ◽  
pp. 31 ◽  
Author(s):  
Federico Benetti ◽  
Ernesto Pe�herrera ◽  
Teodoro Maldonado ◽  
Yan Duarte Vera ◽  
Valvanur Subramanian ◽  
...  

Background: End-stage heart failure (HF) is refractory to current standard medical therapy, and the number of donor hearts is insufficient to meet the demand for transplantation. Recent studies suggest autologous stem cell therapy may regenerate cardiomyocytes, stimulate neovascularization, and improve cardiac function and clinical status. Although human fetal-derived stem cells (HFDSCs) have been studied for the treatment of a variety of conditions, no clinical studies have been reported to date on their use in treating HF. We sought to determine the efficacy and safety of HFDSC treatment in HF patients.Methods and Results: Direct myocardial transplantation of HFDSCs by open-chest surgical procedure was performed in 10 patients with HF due to nonischemic, nonchagasic dilated cardiomyopathy. Before and after the procedure, and with no changes in their preoperative doses of medications (digoxin, furosemide, spironolactone, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, betablockers), patients were assessed for New York Heart Association (NYHA) class, performance in the exercise tolerance test (ETT), ejection fraction (EF), left ventricular end-diastolic dimension (LVEDD) via transthoracic echocardiography, performance in the 6-minute walk test, and performance in the Minnesota congestive HF test. All 10 patients survived the operation. One patient had a stroke 3 days after the procedure, and although she later recovered, she was unable to perform the follow-up tests. Another male patient experienced pericardial effusion 3 weeks after the procedure. Although it resolved spontaneously, the patient abandoned his control tests and died 5 months after the procedure. An autopsy of the myocardium suggested that new young cells were present in the cardiomyocyte mix. At 40 months, the mean (SD) NYHA class decreased from 3.4 0.5 to 1.33 0.5 (P = .001); the mean EF increased 31%, from 26.6% 4% to 34.8% 7.2% (P = .005); and the mean ETT increased 291.3%, from 4.25 minutes to 16.63 minutes (128.9% increase in metabolic equivalents, from 2.46 to 5.63) (P < .0001); the mean LVEDD decreased 15%, from 6.85 0.6 cm to 5.80 0.58 cm (P < .001); mean performance in the 6-minute walk test increased by 43.2%, from 251 113.1 seconds to 360 0 seconds (P = .01); the mean distance increased 64.4%, from 284.4 144.9 m to 468.2 89.8 m (P = .004); and the mean result in the Minnesota test decreased from 71 27.3 to 6 5.9 (P < .001).Conclusion: Although these initial findings suggest direct myocardial implantation of HFDSCs is feasible and improves cardiac function in HF patients at 40 months, more clinical research is required to confirm these observations.


2020 ◽  
Vol 28 (3) ◽  
pp. 290-299
Author(s):  
Kira A. Ageeva ◽  
Evgenii V. Filippov

Aim. To study the prognostic value of the results of dynamic capnography in the complex assessment of parameters of the respiratory system in 6-minute walk test in patients with chronic heart failure (CHF). Materials and Methods. 73 Patients were examined: the group of study included 48 patients with IIA or IIB stage CHF (mean age 57.94.6 years, 23 men), the control group included 25 practically healthy volunteers (mean age 47.63.5 years, 9 men). The patients were conducted complex determination of parameters of the respiratory system: clinical scaling before and after 6-minute walk test (6MWT), instrumental examinations including spirometry, capnography and pulse oximetry before, during and after physical activity. The analysis of survival was conducted on the basis of the dynamic follow-up of patients within 5 years (60 months). Results. In the analysis of parameters of dyspnea at rest, all the parameters were higher in the group of patients with CHF (р0.05). The distance walked by the patients with CHF in 6 minutes was 488.2390.84 m, which was significantly less than in the control group (815.6053.89 m, р=0.009). Dyspnea as the cause of stoppage/slowing down of walking in 6MWT, was also more often recorded in patients with CHF (93.83.0% and 48.05.1%, р=0.049). Besides, in 6MWT the patients noted: weakness in legs (50.15.0% in the group of CHF and 40.05.0% in the control group, р=0.014), palpitation (29.04.6% and 20.04.1%, respectively, р=0.004). Worsening of dyspnea parameters in 6MWT was more evident in patients with CHF than in the control group (р0.01). In the CHF group, hypocapnic type of ventilation was revealed in 6MWT, analysis of РЕТСО2 trend graphs revealed a wave-like increase in the parameters, the so called periodic breathing (PB). CO2 trend was recorded in CHF group in 58.31.0% of cases (the difference with the control group with р=0.046), the trend of heart rate in 18.80.3% of cases (р=0.027). Cox proportional hazards regression analysis of mortality in patients with CHF showed a prognostic significance of a complex model comprising the following parameters of a patient: body mass index (р=0.005), left ventricular end-diastolic dimension (р=0.034), left ventricular end-systolic dimension (р=0.002), left ventricular ejection fraction (р=0.041), 6MWT distance (р=0.004), desaturation (р=0.009), and the presence of signs of PB during 6MWT (р=0.005). Model coefficients were statistically significant at р0.0001. Conclusions. Dynamic capnography and pulse oximetry allow to identify signs of PB in patients with CHF during 6MWT which may deepen a complex assessment of parameters of the cardio-respiratory system in patients with CHF in order to determine tolerance to physical exercise as well as the effectiveness of the conducted treatment. Complex assessment of survival of patients with CHF showed prognostic significance of the following parameters of a patient: body mass index, left ventricular end-diastolic dimension, left ventricular end-systolic dimension, left ventricular ejection fraction, 6MWT distance, desaturation, PB during 6MWT.


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