Indication of Treatment For Children And Adolescents With Postural Tachycardia Syndrome By Intravenous Saline Infusion

Background: Intravenous saline infusion is considered effective for the treatment of postural tachycardia syndrome (POTS) in adults. However, few studies have assessed the efficacy of intravenous saline infusion for POTS in children and adolescents. Aim: This study aimed to evaluate the efficacy of intravenous saline infusion in children and adolescents with POTS.Methods: A total of 107 children with POTS (median age: 13 years, range: 10–15 years) were enrolled. Eighty-eight children were in the intravenous saline infusion group and 19 children were in the comparison group. Blood pressure (BP) and pulse rate (PR) were recorded before and after standing. A standing test was performed early in the morning for 2 consecutive days. A volume of 1.5 L of saline was administered intravenously to each participant in the intervention group for a mean duration of 17 hours between the two standing tests.Results: The mean change in PR was significantly lower in the intervention group than in the comparison group during the second test (36.9 vs. 52.8 beats/minute, p<0.001). Additionally, the mean change in PR was significantly lower in the second test than in the first test (44.7 beats/minute) in the intervention group (p<0.001). However, the mean change in systolic BP was not different before and after intravenous saline infusion between the two groups or between the two tests in each group.Conclusion: Intravenous saline infusion reduces the increased PR on standing in children with POTS. Intravenous saline infusion improves tachycardia in children with POTS when standing.

Parameters of Vascular Tone Regulation and Gene Polymorphism Associated With Cardiovascular Risk in Young Subjects

Introduction. Dysregulation of vascular tone (VT) is one of the cardiovascular risk factors that significantly worsens the quality of life, and can be a predictor for persistent hypertension (HTN). The identification of preclinical stages of vascular pathology is the most promising for prevention of hypertension. Therefore, it is important to investigate the polymorphism of genes which end products are involved in the regulation of blood pressure (BP) and predispose to VT dysregulation.Objective. To investigate the clinical and prognostic significance of the AGT and AGTR1 polymorphic variants associated with increased cardiovascular risk in young and relatively healthy subjects and patients with HTN. Materials and methods. The study involved 90 young healthy subjects and 62 patients with hypertension. The exclusion criteria for young subjects were as follows: organic cardiovascular and central nervous system disorders and smoking. The exclusion criteria for patients with HTN were identical. Additionally, the patients with uncontrolled HTN were not included. The VT regulation was assessed by the active standing test in which the changes in blood pressure (BP) and heart rate (HR) were measured. The polymorphism was identified using DNA pyrosequencing.Results. The relationship between BP and HR and the AGTR1 A1666C A>C and AGT M268T T>C variants was established. Both in young subjects and hypertensive patients was found that the C allele of the AGTR1 A1666C A>C variant was associated with lower HR in supine compared with subjects without this allele. The risk allele C of the M268T T>C polymorphism was associated with lower sBP and dBP during the 1st minute of upright posture. The identified features can probably be explained by the vascular tone increased at baseline in the presence of these polymorphic variants which was manifested by smaller changes in BP and HR during the active standing test compared to subjects without these allelic variants. The C allele of the AGTR1 A1666C A>C variant was associated with earlier onset of HTN.Conclusion. The identification of the AGTR1 A1666C A>C and AGT M268T T>C variants can be informative for clarifying the risk of HTN when the young subjects are examined, as well as the probability of early onset of hypertension.

HUBUNGAN ANTARA DAYA TAHAN OTOT CORE DENGAN KEMAMPUAN OLAH KAKI, KESEIMBANGAN STATIS, DAN KESEIMBANGAN DINAMIS PEMAIN BULUTANGKIS LAKI-LAKI USIA MUDA DI KOTA DENPASAR

Bulutangkis merupakan olahraga raket yang banyak dimainkan di dunia. Dalam menunjang performa dan pencegahan cedera, pemain bulutangkis memerlukan kemampuan olah kaki (footwork) dan keseimbangan yang baik. Daya tahan otot core merupakan upaya pencegahan cedera dan peningkatan performa pemain. Tujuan dari penelitian ini adalah untuk mengetahui hubungan antara daya tahan otot core dengan kemampuan olah kaki, keseimbangan statis, dan keseimbangan dinamis pemain bulutangkis laki-laki usia muda di Kota Denpasar. Rancangan penelitian ini adalah observasional analitik dengan desain cross sectional. Pengambilan sampel dilakukan dengan teknik total sampling dengan sampel sebanyak 51 orang pemain bulutangkis laki-laki yang berusia 8-14 tahun. Penelitian ini terdiri dari satu variabel bebas yaitu daya tahan otot core yang diukur dengan tes plank serta tiga buah variabel bebas yaitu kemampuan olah kaki yang diukur dengan tes olah kaki, keseimbangan statis yang diukur dengan stork standing test, dan keseimbangan dinamis yang diukur dengan modiffied bass test. Hasil penelitian menunjukkan bahwa terdapat hubungan yang signifikan antara daya tahan otot core dengan kemampuan olah kaki dengan nilai p= 0,018 r= 0,330, daya tahan otot core dengan keseimbangan statis dengan nilai p= 0,024 r= 0,316, serta daya tahan otot core dengan keseimbangan dinamis dengan nilai p= 0,016 r= 0, 334. Simpulan yang didapatkan yakni terdapat hubungan antara daya tahan otot core dengan kemampuan olah kaki, keseimbangan statis, dan keseimbangan dinamis pada pemain bulutangkis laki-laki usia muda di Kota Denpasar. Kata Kunci: Bulutangkis, core, footwork, keseimbangan

The Effects of Exergaming Training on Balance in Healthy Elderly Women—A Pilot Study

Our aim was to observe, through objective testing using an assessment module incorporated in a new exergaming system, whether elderly people’s static and functional balance is improved by a balance exergaming training program based on movements performed in everyday life. Thirteen healthy elderly women participated in 12 sessions of balance-based exergaming training (three times a week, 30 min per session). All objective outcomes, the quiet standing test, functional balance test (FBT), and limit of stability (LOS) test, were measured on three occasions: before intervention, after six training sessions, and after the completion of the four-week program. The results showed a significant improvement in LOS performance after the intervention. In FBT, participants exhibited a significant decrease (p < 0.01; Kendall’s W = 0.5) in the average time to target hit after six trainings. The average center of pressure velocity increased after six and 12 sessions, however did not reach significance (p = 0.053); nevertheless the size of the effect was large (ηp2 = 0.22). The parameters of the quiet standing test were not significantly affected by the training. The results support the need for more definite and objective studies assessing exergaming for balance in elderly.

INFLUENCE OF THE AGE ON BAROREFLEX SYNCHRONIZATION OF ARTERIAL PRESSURE AND HEART RATE DURING THE PASSIVE STANDING TEST

Age-related changes in phase synchronization of spontaneous blood pressure (BP) and heart rate (HR) fluctuations within the baroreflex wave range (about 0.1 Hz) were studied in 66 subjects aged 20 to 52 years. Measurements performed during the head-up tilt test included continuous BP monitoring using the volume-compensation method, ECG recording for ensuing HR calculation, and breathing rate recording. The phase synchronization index (PSI) was used for evaluation of BP-HR coupling. In supine position, phase synchronization in the subjects over 40 years was higher as compared with their counterparts at the age of 20 to 24 years. Along with that, less pronounced PSI increase in people over 40 in response to the tilt test suggests a decline of the baroreflex activity with aging.

Virtual Reality Gait Training to Promote Balance and Gait Among Older People: A Randomized Clinical Trial

Falls are the leading cause of injury and injury-related death in the elderly. This study evaluated the effect of virtual reality gait training (VRGT) with non-motorized treadmill on balance and gait ability of elderly individuals who had experienced a fall. Fifty-six elderly individuals living in local communities participated in this study. Subjects who met the selection criteria were randomly divided into a VRGT group (n = 28) and a control group (n = 28). The VRGT group received VRGT with non-motorized treadmill for 50 min a day for 4 weeks and 5 days a week. The control group received non-motorized treadmill gait training without virtual reality for the same amount of time as the VRGT group. Before and after the training, the one-leg-standing test, Berg Balance Scale, Functional Reach test, and Timed Up and Go test were used to assess balance ability, and the gait analyzer system was used to evaluate the improvement in gait spatiotemporal parameters. In the VRGT group, the balance ability variable showed a significant decrease in the one-leg-standing test and a significant improvement in the Timed Up and Go test. With respect to spatiotemporal gait parameters, velocity and step width decreased significantly in the VRGT group (p < 0.05), and stride length and step length were significantly improved in the VRGT group (p < 0.05). VRGT with non-motorized treadmill has been shown to improve balance and gait ability in the elderly. This study is expected to provide basic data on exercise programs for the elderly to prevent falls.

Canan Outdoor Multisurface Terrain Enhance the Effects of Fall Prevention Exercise in Older Adults? A Randomized Controlled Trial

Walking on complex surface conditions in outdoor environments is important for active aging. This study aimed at examining whether fall prevention exercise integrated with an outdoor multisurface terrain compared with indoor solid ground was more beneficial for older adults. Twenty-two older nursing home residents were randomly assigned to outdoor multisurface terrain (n = 11, 79.5 ± 2.1 years) or indoor solid ground (n = 11, 78.8 ± 5.2 years) groups. Training occurred five times per week (30 min) for 3 weeks. The following performance test outcomes were measured: 10 m walk test (10 mWT), multisurface terrain walk test (MTWT), 2 min walk test (2 MWT), timed up and go test (TUGT), single-leg standing test with eyes open (SLSTEO), single-leg standing test with eyes closed (SLSTEC), and closed cycles test (CCT). Compared with baseline, the outdoor multisurface terrain training significantly improved performance in all tests (p < 0.01). The improvements of the outdoor multisurface terrain group after intervention were significantly higher than those of the indoor solid group in the 10 mWT (p = 0.049), MTWT (p = 0.02), and 2 MWT (p = 0.000). Exercise combined with outdoor multisurface terrain training may be an efficacious approach and a feasible environmental intervention for fall prevention in older adults.