Muscle activation levels of the gluteus maximus and medius during standing hip-joint strengthening exercises using elastic-tubing resistance.

PubMed

Youdas, James W; Adams, Kady E; Bertucci, John E; Brooks, Koel J; Nelson, Meghan M; Hollman, John H

2014-02-01

No published studies have compared muscle activation levels simultaneously for the gluteus maximus and medius muscles of stance and moving limbs during standing hip-joint strengthening while using elastic-tubing resistance. To quantify activation levels bilaterally of the gluteus maximus and medius during resisted lower-extremity standing exercises using elastic tubing for the cross-over, reverse cross-over, front-pull, and back-pull exercise conditions. Repeated measures. Laboratory. 26 active and healthy people, 13 men (25 ± 3 y) and 13 women (24 ± 1 y). Subjects completed 3 consecutive repetitions of lower-extremity exercises in random order. Surface electromyographic (EMG) signals were normalized to peak activity in the maximum voluntary isometric contraction (MVIC) trial and expressed as a percentage. Magnitudes of EMG recruitment were analyzed with a 2 × 4 repeated-measures ANOVA for each muscle (α = .05). For the gluteus maximus an interaction between exercise and limb factor was significant (F3,75 = 21.5; P < .001). The moving-limb gluteus maximus was activated more than the stance limb's during the back-pull exercise (P < .001), and moving-limb gluteus maximus muscle recruitment was greater for the back-pull exercise than for the cross-over, reverse cross-over, and front-pull exercises (P < .001). For the gluteus medius an interaction between exercise and limb factor was significant (F3,75 = 3.7; P < .03). Gluteus medius muscle recruitment (% MVIC) was greater in the stance limb than moving limb when performing the front-pull exercise (P < .001). Moving-limb gluteus medius muscle recruitment was greater for the reverse cross-over exercise than for the cross-over, front-pull, and back-pull exercises (P < .001). From a clinical standpoint there is no therapeutic benefit to selectively activate the gluteus maximus and gluteus medius muscles on the stance limb by resisting sagittal- and frontal-plane hip movements on the moving limb using resistance supplied by elastic tubing.

Wii balance board exercise improves balance and lower limb muscle strength of overweight young adults.

PubMed

Siriphorn, Akkradate; Chamonchant, Dannaovarat

2015-01-01

[Purpose] The potential health benefits of the Nintendo Wii balance board exercise have been widely investigated. However, no study has been conducted to examine the benefits of Wii exercise for overweight young adults. The aim of this study was to investigate the effect of exercise performed on a Nintendo Wii balance board on the balance and lower limb muscle strength in overweight young adults. [Subjects and Methods] Within-subject repeated measures analysis was used. Sixteen young adults (aged 21.87±1.13 years, body mass index 24.15 ± 0.50 kg/m(2)) were recruited. All subjects performed an exercise program on a Wii balance board for 8 weeks (30 min/session, twice a week for 8 weeks). A NeuroCom Balance Master and a hand-held dynamometer were used to measure balance performance and lower limb muscle strength. [Results] According to the comparison of pre- and post-intervention measurements, the Wii balance board exercise program significantly improved the limit of stability parameters. There was also a significant increase in strength of four lower-limb muscle groups: the hip flexor, knee flexor, ankle dorsiflexor and ankle plantarflexor. [Conclusion] These findings suggest that a Wii balance board exercise program can be used to improve the balance and lower limb muscle strength of overweight young adults.

Effect of lower limb compression on blood flow and performance in elite wheelchair rugby athletes

PubMed Central

Vaile, Joanna; Stefanovic, Brad; Askew, Christopher D.

2016-01-01

Objective To investigate the effects of compression socks worn during exercise on performance and physiological responses in elite wheelchair rugby athletes. Design In a non-blinded randomized crossover design, participants completed two exercise trials (4 × 8 min bouts of submaximal exercise, each finishing with a timed maximal sprint) separated by 24 hr, with or without compression socks. Setting National Sports Training Centre, Queensland, Australia. Participants Ten national representative male wheelchair rugby athletes with cervical spinal cord injuries volunteered to participate. Interventions Participants wore medical grade compression socks on both legs during the exercise task (COMP), and during the control trial no compression was worn (CON). Outcome Measures The efficacy of the compression socks was determined by assessments of limb blood flow, core body temperature, heart rate, and ratings of perceived exertion, perceived thermal strain, and physical performance. Results While no significant differences between conditions were observed for maximal sprint time, average lap time was better maintained in COMP compared to CON (P<0.05). Lower limb blood flow increased from pre- to post-exercise by the same magnitude in both conditions (COMP: 2.51 ± 2.34; CON: 2.20 ± 1.85 ml.100 ml.−1min−1), whereas there was a greater increase in upper limb blood flow pre- to post-exercise in COMP (10.77 ± 8.24 ml.100 ml.−1min−1) compared to CON (6.21 ± 5.73 ml.100 ml.−1min−1; P < 0.05). Conclusion These findings indicate that compression socks worn during exercise is an effective intervention for maintaining submaximal performance during wheelchair exercise, and this performance benefit may be associated with an augmentation of upper limb blood flow. PMID:25582434

Does lower limb exercise worsen renal artery hemodynamics in patients with abdominal aortic aneurysm?

PubMed

Sun, Anqiang; Tian, Xiaopeng; Zhang, Nan; Xu, Zaipin; Deng, Xiaoyan; Liu, Ming; Liu, Xiao

2015-01-01

Renal artery stenosis (RAS) and renal complications emerge in some patients after endovascular aneurysm repair (EVAR) to treat abdominal aorta aneurysm (AAA). The mechanisms for the causes of these problems are not clear. We hypothesized that for EVAR patients, lower limb exercise could negatively influence the physiology of the renal artery and the renal function, by decreasing the blood flow velocity and changing the hemodynamics in the renal arteries. To evaluate this hypothesis, pre- and post-operative models of the abdominal aorta were reconstructed based on CT images. The hemodynamic environment was numerically simulated under rest and lower limb exercise conditions. The results revealed that in the renal arteries, lower limb exercise decreased the wall shear stress (WSS), increased the oscillatory shear index (OSI) and increased the relative residence time (RRT). EVAR further enhanced these effects. Because these parameters are related to artery stenosis and atherosclerosis, this preliminary study concluded that lower limb exercise may increase the potential risk of inducing renal artery stenosis and renal complications for AAA patients. This finding could help elucidate the mechanism of renal artery stenosis and renal complications after EVAR and warn us to reconsider the management and nursing care of AAA patients.

Effect of chronic ethanol ingestion and exercise training on skeletal muscle in rat.

PubMed

Vila, L; Ferrando, A; Voces, J; Cabral de Oliveira, C; Prieto, J G; Alvarez, A I

2001-09-01

The aim of this study was to investigate the interactive effects of exercise training and chronic ethanol consumption on metabolism, capillarity, and myofibrillar composition in rat limb muscles. Male Wistar rats were treated in separate groups as follows: non exercised-control; ethanol (15%) in animals' drinking water for 12 weeks; exercise training in treadmill and ethanol administration plus exercise for 12 weeks. Ethanol administration decreased capillarity and increased piruvate kinase and lactate dehydrogenase activities in white gastrocnemius; in plantaris muscle, ethanol increased citrate synthase activity and decreased cross-sectional area of type I, IIa, and IIb fibres. Exercise increased capillarity in all four limb muscles and decreased type I fibre area in plantaris. The decreased capillarity effect induced by ethanol in some muscles, was ameliorated when alcohol was combined with exercise. While alcoholic myopathy affects predominantly type IIb fibres, ethanol administration and aerobic exercise in some cases can affect type I and type IIa fibre areas. The exercise can decrease some harmful effects produced by ethanol in the muscle, including the decrease in the fibre area and capillary density.

Exercise and fall prevention self-management to reduce mobility-related disability and falls after fall-related lower limb fracture in older people: protocol for the RESTORE (Recovery Exercises and STepping On afteR fracturE) randomised controlled trial.

PubMed

Sherrington, Catherine; Fairhall, Nicola; Kirkham, Catherine; Clemson, Lindy; Howard, Kirsten; Vogler, Constance; Close, Jacqueline C T; Moseley, Anne M; Cameron, Ian D; Mak, Jenson; Sonnabend, David; Lord, Stephen R

2016-02-02

Lasting disability and further falls are common and costly problems in older people following fall-related lower limb and pelvic fractures. Exercise interventions can improve mobility after fracture and reduce falls in older people, however the optimal approach to rehabilitation after fall-related lower limb and pelvic fracture is unclear. This randomised controlled trial aims to evaluate the effects of an exercise and fall prevention self-management intervention on mobility-related disability and falls in older people following fall-related lower limb or pelvic fracture. Cost-effectiveness of the intervention will also be investigated. A randomised controlled trial with concealed allocation, assessor blinding for physical performance tests and intention-to-treat analysis will be conducted. Three hundred and fifty people aged 60 years and over with a fall-related lower limb or pelvic fracture, who are living at home or in a low care residential aged care facility and have completed active rehabilitation, will be recruited. Participants will be randomised to receive a 12-month intervention or usual care. The intervention group will receive ten home visits from a physiotherapist to prescribe an individualised exercise program with motivational interviewing, plus fall prevention education through individualised advice from the physiotherapist or attendance at the group based "Stepping On" program (seven two-hour group sessions). Participants will be followed for a 12-month period. Primary outcome measures will be mobility-related disability and falls. Secondary outcomes will include measures of balance and mobility, falls risk, physical activity, walking aid use, frailty, pain, nutrition, falls efficacy, mood, positive and negative affect, quality of life, assistance required, hospital readmission, and health-system and community-service contact. This study will determine the effect and cost-effectiveness of this exercise self management intervention on mobility-related disability and falls in older people who have recently sustained a fall-related lower limb or pelvic fracture. The results will have implications for the design and implementation of interventions for older people with fall related lower limb fractures. The findings of this study will be disseminated in peer-reviewed journals and through professional and scientific conferences. Australian New Zealand Clinical Trials Registry: ACTRN12610000805077.

Physical exercises for breast cancer survivors: effects of 10 weeks of training on upper limb circumferences

PubMed Central

Di Blasio, Andrea; Morano, Teresa; Bucci, Ines; Di Santo, Serena; D’Arielli, Alberto; Castro, Cristina Gonzalez; Cugusi, Lucia; Cianchetti, Ettore; Napolitano, Giorgio

2016-01-01

[Purpose] The aims of this study were to verify the effects on upper limb circumferences and total body extracellular water of 10 weeks of Nordic Walking (NW) and Walking (W), both alone and combined with a series of exercises created for breast cancer survivors, the ISA method. [Subjects and Methods] Twenty breast cancer survivors were randomly assigned to 4 different training groups and evaluated for upper limb circumferences, total body and extracellular water. [Results] The breast cancer survivors who performed NW, alone and combined with the ISA method, and Walking combined with the ISA method (but not alone) showed significantly reduced arm and forearm circumferences homolateral to the surgical intervention. [Conclusion] For breast cancer survivors, NW, alone and combined with the ISA method, and Walking combined with the ISA method should be prescribed to prevent the onset and to treat light forms of upper limb lymphedema because Walking training practiced alone had no significant effect on upper limb circumference reduction. PMID:27821934

Combining Manual Lymph Drainage with Physical Exercise after Modified Radical Mastectomy Effectively Prevents Upper Limb Lymphedema.

PubMed

Zhang, Lijuan; Fan, Aiqun; Yan, Jun; He, Yan; Zhang, Huiting; Zhang, Huizhen; Zhong, Qiaoling; Liu, Feng; Luo, Qinghua; Zhang, Liping; Tang, Hailin; Xin, Mingzhu

2016-06-01

Upper limb lymphedema is a common complication after radical mastectomy in patients with breast cancer. In this study, we examined the efficacy of self-manual lymph drainage (MLD) after modified radical mastectomy for the prevention of upper limb lymphedema, scar formation, or shoulder joint dysfunction in breast cancer patients. Breast cancer patients scheduled for modified radical mastectomy were randomly apportioned to undergo physical exercise only (PE group, the control; n = 500) or self-MLD as well as exercise (MLD group; n = 500) after surgery. In the PE group, patients started to undertake remedial exercises and progressive weight training after recovery from anesthesia. In the MLD group, in addition to receiving the same treatments as in the PE group, the patients were trained to perform self-MLD on the surgical incision for 10 min/session, 3 sessions/day, beginning after suture removal and incision closure (10 to 30 days after the surgery). Scar formation was evaluated at one week, and 1, 3, 6, and 12 months after the surgery, respectively. Upper limb circumference and shoulder abduction were measured 24 h before surgery, and at one week, and 1, 3, 6 and 12 months after the surgery. Compared to those in the PE group, patients in MLD group experienced significant improvements in scar contracture, shoulder abduction, and upper limb circumference. Self-MLD, in combination with physical exercise, is beneficial for breast cancer patients in preventing postmastectomy scar formation, upper limb lymphedema, and shoulder joint dysfunction.

A tailored workplace exercise program for women at risk for neck and upper limb musculoskeletal disorders: a randomized controlled trial.

PubMed

Rasotto, Chiara; Bergamin, Marco; Sieverdes, John C; Gobbo, Stefano; Alberton, Cristine L; Neunhaeuserer, Daniel; Maso, Stefano; Zaccaria, Marco; Ermolao, Andrea

2015-02-01

The aim of this study was to evaluate a tailored physical activity protocol performed in a work environment with a group of female workers employed in manual precision tasks to reduce upper limb pain. Sixty female subjects were randomly assigned to an intervention group or a control group. The IG was administered of a 6-month, twice-a-week, tailored exercise program, whereas the CG received no intervention. The IG showed a reduction on shoulder pain accompanied by increases on the range of motion measures. In addition, reductions in upper limb pain and neck disability were detected with concomitant increases in grip strength. This study indicated positive effects of a tailored workplace exercise protocol in female workers exposed to moderate risk for work-related musculoskeletal disorders, showing clinically meaningful reductions of pain symptoms and disability on upper limb and neck regions.

Preterm Infant Weight Gain is Increased by Massage Therapy and Exercise Via Different Underlying Mechanisms

PubMed Central

Diego, Miguel A.; Field, Tiffany; Hernandez-Reif, Maria

2014-01-01

Objective To compare the effects of massage therapy (moderate pressure stroking) and exercise (flexion and extension of limbs) on preterm infants’ weight gain and to explore potential underlying mechanisms for those effects. Methods Weight gain and parasympathetic nervous system activity were assessed in 30 preterm infants randomly assigned to a massage therapy group or to an exercise group. Infants received 10 minutes of moderate pressure massage or passive flexion and extension of the limbs 3 times per day for 5 days, and EKGs were collected during the first session to assess vagal activity. Results Both massage and exercise led to increased weight gain. However, while exercise was associated with increased calorie consumption, massage was related to increased vagal activity. Conclusion Taken together, these findings suggest that massage and exercise lead to increased preterm infant weight gain via different underlying mechanisms. PMID:24480603

Effectiveness of Aquatic Exercise in Improving Lower Limb Strength in Musculoskeletal Conditions: A Systematic Review and Meta-Analysis.

PubMed

Heywood, Sophie; McClelland, Jodie; Mentiplay, Benjamin; Geigle, Paula; Rahmann, Ann; Clark, Ross

2017-01-01

To investigate the effectiveness of aquatic exercise in improving lower limb strength in people with musculoskeletal conditions. A systematic search used 5 databases, including MEDLINE, CINAHL, Embase, SPORTDiscus, and The Cochrane Library. Randomized controlled trials evaluating aquatic exercise with a resistance training component for adults with musculoskeletal conditions compared with no intervention or land-based exercise were identified. Fifteen studies from the initial yield of 1214 met these criteria. Data related to participant demographics, study design, and methods, interventions, and outcomes, including numerical means and SDs, were extracted independently by 2 reviewers. Nine of the 15 studies were of high quality, scoring at least 6 on the Physiotherapy Evidence Database Scale. Limited consideration of the prescription of resistance in the aquatic exercise and application of resistance training principles existed. Low- or very low-quality evidence indicates there was no difference in average effect between aquatic exercise and no exercise in improving hip abductor strength (standardized mean difference [SMD], .28; 95% confidence interval [CI], -.04 to .59), knee extensor strength (SMD, .18; 95% CI, -.03 to .40), knee flexor strength (SMD, .13; 95% CI, -.20 to .45), or lower limb endurance (SMD, .35; 95% CI, -.06 to .77). Low-quality evidence indicates no difference in average effect between aquatic and land exercise for knee extensor (SMD, -.24; 95% CI, -.49 to .02) or flexor strength (SMD, -.15; 95% CI, -.53 to .22). It is likely that the inadequate application of resistance in water is a significant contributor to the limited effectiveness of aquatic exercise interventions in improving hip and knee muscle strength in people with musculoskeletal conditions. Future research is needed to quantify resistance with aquatic exercises and to determine if using opportunities for greater resistance in aquatic rehabilitation and appropriate resistance training principles can be more effective in improving muscle strength. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

The Effect of Chinese Traditional Exercise-Baduanjin on Physical and Psychological Well-Being of College Students: A Randomized Controlled Trial.

PubMed

Li, Moyi; Fang, Qianying; Li, Junzhe; Zheng, Xin; Tao, Jing; Yan, Xinghui; Lin, Qiu; Lan, Xiulu; Chen, Bai; Zheng, Guohua; Chen, Lidian

2015-01-01

The physical and mental health of college students tends to continuously decline around the world, therefore, it is important to improve their health during college period. Baduanjin, a traditional Chinese exercise which combines movements with breath and mind, may be one of the selectable effective exercises. However, the effect of Baduanjin exercise on college students has not been established. In this study, we systematically assessed the effectiveness and safety of Baduanjin exercise on physical and mental health of college students by a rigorous randomized, parallel-controlled design. A total of 222 college students from Fujian University of Traditional Chinese Medicine were recruited and randomly allocated at an equal ratio into control or Baduanjin training. Participants in control group were informed to maintain their original activity habit, and those in Baduanjin exercise group received a 12-week Baduanjin exercise training with a frequency of 1 hour per day and 5 days per week on the basis of their original activity habit. The physical and psychological outcomes, including lumbar muscle strength, lower limb proprioception function, physical fitness, as well as self-reported symptom intensity, stress, self-esteem, mood, quality of life, quality of sleep, and adverse events, were evaluated at baseline, 13 weeks (at the end of 12-week intervention), and 25 weeks (after the 12-week follow-up period). Intention-to-treat analysis was performed for the above outcomes. Compared with controls, significant improvements in Baduanjin exercise group at the end of 12-week intervention period were found on lower limb proprioception function (the rate of average trace error on right lower limb (%): control 23.50±5.50, Baduanjin 21.92±6.54, P=0.004; the rate of average trace error on left lower limb (%): control 22.32±6.62, Baduanjin 20.63±4.62, P=0.046), cardiorespiratory endurance (step test index: control 47.66±5.94, Baduanjin 50.07±9.30, P=0.025), flexibility (control 14.35±7.26cm, Baduanjin 15.39±6.43cm, P=0.009) and explosive force of lower limb (standing long jump test (m): control 1.77±0.24, Baduanjin 1.79±0.22, P=0.005 for adjustment baseline) in physical outcomes, and attention (Schulte Grid test (second): control 210.4±51.15, Baduanjin 192.4±47.14, P=0.034) in mental outcome. Lumbar muscle strength in Baduanjin group had been moderately enhanced but no significant difference compared to controls. No significant changes in other physical and mental outcomes, including vital capacity, blood pressure, heart rate, hand grip force, self-symptom intensity, stress, self-efficacy, quality of life, and quality of sleep, were found between groups. No adverse event was reported during the study period. Regular Baduanjin exercise had an advantage for college students on improvement of lower limb proprioception, enhance of cardiorespiratory endurance, flexibility, explosive force of lower limb and attention, compared with usual exercise. Chinese Clinical Trial Registry ChiCTR-TRC-13003329 http://www.chictr.org.

Kangaroo rat bone compared to white rat bone after short-term disuse and exercise

USGS Publications Warehouse

Muths, E.; Reichman, O. J.

1996-01-01

Kangaroo rats (Dipodomys ordii) were used to study the effects of confinement on mechanical properties of bone with a long range objective of proposing an alternative to the white rat model for the study of disuse osteoporosis. Kangaroo rats exhibit bipedal locomotion, which subjects their limbs to substantial accelerative forces in addition to the normal stress of weight bearing. We subjected groups of kangaroo rats and white rats (Rattus norvegicus) to one of two confinement treatments or to an exercise regime; animals were exercised at a rate calculated to replicate their (respective) daily exercise patterns. White laboratory rats were used as the comparison because they are currently the accepted model used in the study of disuse osteoporosis. After 6 weeks of treatment, rats were killed and the long bones of their hind limbs were tested mechanically and examined for histomorphometric changes. We found that kangaroo rats held in confinement had less ash content in their hind limbs than exercised kangaroo rats. In general, treated kangaroo rats showed morphometric and mechanical bone deterioration compared to controls and exercised kangaroo rats appeared to have slightly “stronger” bones than confined animals. White rats exhibited no significant differences between treatments. These preliminary results suggest that kangaroo rats may be an effective model in the study of disuse osteoporosis.

Effects of Strength Training Combined with Specific Plyometric exercises on body composition, vertical jump height and lower limb strength development in elite male handball players: a case study.

PubMed

Carvalho, Alberto; Mourão, Paulo; Abade, Eduardo

2014-06-28

The purpose of the present study was to identify the effects of a strength training program combined with specific plyometric exercises on body composition, vertical jump (VJ) height and strength development of lower limbs in elite male handball players. A 12-week program with combined strength and specific plyometric exercises was carried out for 7 weeks. Twelve elite male handball players (age: 21.6 ± 1.73) competing in the Portuguese Major League participated in the study. Besides the anthropometric measurements, several standardized jump tests were applied to assess VJ performance together with the strength development of the lower limbs in an isokinetic setting. No significant changes were found in body circumferences and diameters. Body fat content and fat mass decreased by 16.4 and 15.7% respectively, while lean body mass increased by 2.1%. Despite small significance, there was in fact an increase in squat jump (SJ), counter movement jump (CMJ) and 40 consecutive jumps after the training period (6.1, 3.8 and 6.8%, respectively). After the applied protocol, peak torque increased in lower limb extension and flexion in the majority of the movements assessed at 90ºs-1. Consequently, it is possible to conclude that combining general strength-training with plyometric exercises can not only increase lower limb strength and improve VJ performance but also reduce body fat content.

Effects of Strength Training Combined with Specific Plyometric exercises on body composition, vertical jump height and lower limb strength development in elite male handball players: a case study

PubMed Central

Carvalho, Alberto; Mourão, Paulo; Abade, Eduardo

2014-01-01

The purpose of the present study was to identify the effects of a strength training program combined with specific plyometric exercises on body composition, vertical jump (VJ) height and strength development of lower limbs in elite male handball players. A 12-week program with combined strength and specific plyometric exercises was carried out for 7 weeks. Twelve elite male handball players (age: 21.6 ± 1.73) competing in the Portuguese Major League participated in the study. Besides the anthropometric measurements, several standardized jump tests were applied to assess VJ performance together with the strength development of the lower limbs in an isokinetic setting. No significant changes were found in body circumferences and diameters. Body fat content and fat mass decreased by 16.4 and 15.7% respectively, while lean body mass increased by 2.1%. Despite small significance, there was in fact an increase in squat jump (SJ), counter movement jump (CMJ) and 40 consecutive jumps after the training period (6.1, 3.8 and 6.8%, respectively). After the applied protocol, peak torque increased in lower limb extension and flexion in the majority of the movements assessed at 90ºs-1. Consequently, it is possible to conclude that combining general strength-training with plyometric exercises can not only increase lower limb strength and improve VJ performance but also reduce body fat content. PMID:25114739

Do whole body vibration exercises affect lower limbs neuromuscular activity in populations with a medical condition? A systematic review.

PubMed

Dionello, Carla Fontoura; de Souza, Patrícia Lopes; Sá-Caputo, Danubia; Morel, Danielle Soares; Moreira-Marconi, Eloá; Paineiras-Domingos, Laisa Liane; Frederico, Eric Heleno Freire Ferreira; Guedes-Aguiar, Eliane; Paiva, Patricia de Castro; Taiar, Redha; Chiementin, Xavier; Marín, Pedro J; Bernardo-Filho, Mario

2017-01-01

The use of surface electromyography (sEMG) to evaluate muscle activation when executing whole body vibration exercises (WBVE) in studies provide neuromuscular findings, in healthy and diseased populations. Perform a systematic review of the effects of WBVE by sEMG of lower limbs in non-healthy populations. The search using the defined keywords was performed in PubMed, PEDRo and EMBASE databases by three independent researchers. Applying the PRISMA statement several studies were selected according to eligibility criteria and organized for the review. Full papers were included if they described effects of WBVE for the treatment of illnesses, evaluated by sEMG of lower limbs independently on the year of the publication; in comparison or associated with other treatment and evaluation techniques. Seven publications were selected; two in spinal cord injury patients, one in Friedreich's ataxia patients, three in stroke patients and one study in breast cancer survivors. Reported effects of WBV in were muscle activation by sEMG and also on strength, blood flow and exercise resistance; even in paretic limbs. By the use of sEMG it was verified that WBVE elicits muscle activation in diseased population. These results may lead to the definition of exercise protocols to maintain or increase muscular activation. However, due to the heterogeneity of methods among studies, there is currently no consensus on the sEMG signal processing. These strategies might also induce effects on muscle strength, balance and flexibility in these and other illnesses.

Phase II Pragmatic Randomized Controlled Trial of Patient-Led Therapies (Mirror Therapy and Lower-Limb Exercises) During Inpatient Stroke Rehabilitation.

PubMed

Tyson, Sarah; Wilkinson, Jack; Thomas, Nessa; Selles, Ruud; McCabe, Candy; Tyrrell, Pippa; Vail, Andy

2015-10-01

Patient-led therapy has the potential to increase the amount of therapy patients undertake during stroke rehabilitation and to enhance recovery. Our objective was to assess the feasibility and acceptability of 2 patient-led therapies during the acute stages of stroke care: mirror therapy for the upper limb and lower-limb exercises for the lower limb. This was a blind assessed, multicenter, pragmatic randomized controlled trial of patient-led upper-limb mirror therapy and patient-led lower leg exercises. Stroke survivors with upper and lower limb limitations, undergoing inpatient rehabilitation and able to consent were recruited at least 1 week poststroke. Both interventions proved feasible, with >90% retention. No serious adverse events were reported. Both groups did less therapy than recommended; typically 5 to 15 minutes for 7 days or less. Participants receiving mirror therapy (n = 63) tended to do less practice than those doing lower-limb exercises (n = 31). Those with neglect did 69% less mirror therapy than those without (P = .02), which was not observed in the exercise group. Observed between-group differences were modest but neglect, upper-limb strength, and dexterity showed some improvement in the mirror therapy group. No changes were seen in the lower-limb group. Both patient-led mirror therapy and lower-limb exercises during inpatient stroke care are safe, feasible, and acceptable and warrant further investigation. Practice for 5 to 15 minutes for 7 days is a realistic prescription unless strategies to enhance adherence are included. © The Author(s) 2015.

Effectiveness of postoperative physical therapy for upper-limb impairments after breast cancer treatment: a systematic review.

PubMed

De Groef, An; Van Kampen, Marijke; Dieltjens, Evi; Christiaens, Marie-Rose; Neven, Patrick; Geraerts, Inge; Devoogdt, Nele

2015-06-01

To systematically review the effectiveness of various postoperative physical therapy modalities and timing of physical therapy after treatment of breast cancer on pain and impaired range of motion (ROM) of the upper limb. We searched the following databases: PubMed/MEDLINE, Cumulative Index to Nursing and Allied Health Literature, Embase, Physiotherapy Evidence Database, and Cochrane. Articles published until October 2012 were included. Only (pseudo) randomized controlled trials and nonrandomized experimental trials investigating the effectiveness of passive mobilization, manual stretching, myofascial therapy, and/or exercise therapy and timing of physical therapy after treatment for breast cancer are reviewed. Primary outcomes are pain of the upper limb and/or ROM of the shoulder. Secondary outcomes are decreased shoulder strength, arm lymphedema, limitations in activities of daily living, decreased quality of life, and wound drainage volume. Physical therapy modalities had to be started in the first 6 weeks after surgery. Articles were selected by 2 independent researchers in 3 phases and compared for consensus. First the titles were analyzed, and then the selected abstracts and finally the full texts were reviewed. Eighteen randomized controlled trials were included in the review. Three studies investigated the effect of multifactorial therapy: 2 studies confirmed that the combination of general exercises and stretching is effective for the treatment of impaired ROM another study showed that passive mobilization combined with massage had no beneficial effects on pain and impaired ROM. Fifteen studies investigated the effectiveness of a single physical therapy modality. One study of poor quality found evidence supporting the beneficial effects of passive mobilization. The only study investigating the effect of stretching did not find any beneficial effects. No studies were found about the effectiveness of myofascial therapy in the postoperative phase. Five studies found that active exercises were more effective than no therapy or information on the treatment of impairments of the upper limb. Three studies supported the early start of exercises for recovery of shoulder ROM, whereas 4 studies supported the delay of exercises to avoid prolonged wound healing. Multifactorial physical therapy (ie, stretching, exercises) and active exercises were effective to treat postoperative pain and impaired ROM after treatment for breast cancer. High-quality studies are necessary to determine the effectiveness of passive mobilization, stretching, and myofascial therapy as part of the multifactorial treatment. In addition, the appropriate timing and content of the exercise programs need to be further investigated. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Effects of whole-body vibration on balance and mobility in institutionalized older adults: a randomized controlled trial.

PubMed

Lam, Freddy Mh; Chan, Philip Fl; Liao, L R; Woo, Jean; Hui, Elsie; Lai, Charles Wk; Kwok, Timothy Cy; Pang, Marco Yc

2018-04-01

To investigate whether a comprehensive exercise program was effective in improving physical function among institutionalized older adults and whether adding whole-body vibration to the program conferred additional therapeutic benefits. A single-blinded randomized controlled trial was conducted. This study was carried out in residential care units. In total, 73 older adults (40 women, mean age: 82.3 ± 7.3 years) were enrolled into this study. Participants were randomly allocated to one of the three groups: strength and balance program combined with whole-body vibration, strength and balance program without whole-body vibration, and social and recreational activities consisting of upper limb exercises only. All participants completed three training sessions per week for eight weeks. Assessment of mobility, balance, lower limb strength, walking endurance, and self-perceived balance confidence were conducted at baseline and immediately after the eight-week intervention. Incidences of falls requiring medical attention were recorded for one year after the end of the training period. A significant time × group interaction was found for lower limb strength (five-times-sit-to-stand test; P = 0.048), with the exercise-only group showing improvement (pretest: 35.8 ± 16.1 seconds; posttest: 29.0 ± 9.8 seconds), compared with a decline in strength among controls (pretest: 27.1 ± 10.4 seconds; posttest: 28.7 ± 12.3 seconds; P = 0.030). The exercise with whole-body vibration group had a significantly better outcome in balance confidence (pretest: 39.2 ± 29.0; posttest: 48.4 ± 30.6) than the exercise-only group (pretest: 35.9 ± 24.8; posttest: 38.2 ± 26.5; P = 0.033). The exercise program was effective in improving lower limb strength among institutionalized older adults but adding whole-body vibration did not enhance its effect. Whole-body vibration may improve balance confidence without enhancing actual balance performance.

Low-Volume Intense Exercise Elicits Post-exercise Hypotension and Subsequent Hypervolemia, Irrespective of Which Limbs Are Exercised.

PubMed

Graham, Matthew J; Lucas, Samuel J E; Francois, Monique E; Stavrianeas, Stasinos; Parr, Evelyn B; Thomas, Kate N; Cotter, James D

2016-01-01

Exercise reduces arterial and central venous blood pressures during recovery, which contributes to its valuable anti-hypertensive effects and to facilitating hypervolemia. Repeated sprint exercise potently improves metabolic function, but its cardiovascular effects (esp. hematological) are less well-characterized, as are effects of exercising upper versus lower limbs. The purposes of this study were to identify the acute (<24 h) profiles of arterial blood pressure and blood volume for (i) sprint intervals versus endurance exercise, and (ii) sprint intervals using arms versus legs. Twelve untrained males completed three cycling exercise trials; 50-min endurance (legs), and 5(*)30-s intervals using legs or arms, in randomized and counterbalanced sequence, at a standardized time of day with at least 8 days between trials. Arterial pressure, hemoglobin concentration and hematocrit were measured before, during and across 22 h after exercise, the first 3 h of which were seated rest. The post-exercise hypotensive response was larger after leg intervals than endurance (AUC: 7540 ± 3853 vs. 3897 ± 2757 mm Hg·min, p = 0.049, 95% CI: 20 to 6764), whereas exercising different limbs elicited similar hypotension (arms: 6420 ± 3947 mm Hg·min, p = 0.48, CI: -1261 to 3896). In contrast, arterial pressure at 22 h was reduced after endurance but not after leg intervals (-8 ± 8 vs. 0 ± 7 mm Hg, p = 0.04, CI: 7 ± 7) or reliably after arm intervals (-4 ± 8 mm Hg, p = 0.18 vs. leg intervals). Regardless, plasma volume expansion at 22 h was similar between leg intervals and endurance (both +5 ± 5%; CI: -5 to 5%) and between leg and arm intervals (arms: +5 ± 7%, CI: -8 to 5%). These results emphasize the relative importance of central and/or systemic factors in post-exercise hypotension, and indicate that markedly diverse exercise profiles can induce substantive hypotension and subsequent hypervolemia. At least for endurance exercise, this hypervolemia may not depend on the volume of post-exercise hypotension. Finally, endurance exercise led to reduced blood pressure the following day, but sprint interval exercise did not.

Dynamic inter-limb resistance exercise device for long-duration space flight

NASA Technical Reports Server (NTRS)

Schwandt, Douglas F.; Watenpaugh, Donald E.; Parazynski, Scott E.; Hargens, Alan R.

1991-01-01

Essential for fitness on Earth, resistive exercise is even more important for astronauts, who must maintain muscle and bone strength in the absence of gravity. To meet this need, designers and scientists at NASA Ames Research Center, Life Science Division, have worked to develop more effective exercise devices for long-duration exposure to microgravity. One of these concepts is the Inter-Limb Resistance Device which allows the subject to exercise one limb directly against another, strengthening muscle groups in the arms, legs, and back. It features a modular harness with an inelastic cable and instrumented pulley. Forces similar to other high resistance exercise equipment are generated. Sensors in the pulley measure force and velocity for performance feedback display and data acquisition. This free-floating apparatus avoids vibration of sensitive experiments on board spacecraft. Compact with low mass, this hardware is also well suited for a 'safe haven' from radiation on board Space Station Freedom, and may prove useful in confined environments on Earth, such as Antarctic stations, submarines, and other underwater habitats. Potential spin-offs of this technology include products for personal strengthening and cardiovascular conditioning, rehabilitation of hospital patients, fitness exercise for the disabled, and retraining after sports injuries.

Modeling rate sensitivity of exercise transient responses to limb motion.

PubMed

Yamashiro, Stanley M; Kato, Takahide

2014-10-01

Transient responses of ventilation (V̇e) to limb motion can exhibit predictive characteristics. In response to a change in limb motion, a rapid change in V̇e is commonly observed with characteristics different than during a change in workload. This rapid change has been attributed to a feed-forward or adaptive response. Rate sensitivity was explored as a specific hypothesis to explain predictive V̇e responses to limb motion. A simple model assuming an additive feed-forward summation of V̇e proportional to the rate of change of limb motion was studied. This model was able to successfully account for the adaptive phase correction observed during human sinusoidal changes in limb motion. Adaptation of rate sensitivity might also explain the reduction of the fast component of V̇e responses previously reported following sudden exercise termination. Adaptation of the fast component of V̇e response could occur by reduction of rate sensitivity. Rate sensitivity of limb motion was predicted by the model to reduce the phase delay between limb motion and V̇e response without changing the steady-state response to exercise load. In this way, V̇e can respond more quickly to an exercise change without interfering with overall feedback control. The asymmetry between responses to an incremental and decremental ramp change in exercise can also be accounted for by the proposed model. Rate sensitivity leads to predicted behavior, which resembles responses observed in exercise tied to expiratory reserve volume. Copyright © 2014 the American Physiological Society.

Compelled weightbearing in persons with hemiparesis following stroke: the effect of a lift insert and goal-directed balance exercise.

PubMed

Aruin, A S; Hanke, T; Chaudhuri, G; Harvey, R; Rao, N

2000-01-01

The hypotheses have been tested that 1) symmetry of weightbearing in persons who have sustained a stroke could be improved by the addition of a lift to the shoe on the non-paretic lower limb and 2) compelled weightbearing resulting from the addition of a lift in conjunction with targeted exercise helps to overcome the learned disuse of the paretic limb. Weightbearing on the paretic side was measured in eight persons with hemiparesis during quiet standing and in conditions of compelled weight shift. Compelled weight shifts were applied with special lifts to the shoe on the non-paretic limb of the subjects. An increase in symmetrical weightbearing was recorded in conditions of compelled weight shifts: 10-mm lift provided the best symmetry of bipedal standing. We suggest that improved symmetry of bipedal standing obtained with the lift of the non-paretic limb would help in overcoming the learned disuse of the affected limb. Pre- and post-test results of a person with hemiparesis who was wearing a shoe lift on the non-paretic limb during a 6-week physical therapy program showed statistically significant improvement of walking speed, stride length, and weightbearing. Such findings support the idea of using compelled weightbearing via lifting and targeted exercise during treatment.

A Pilates exercise program with pelvic floor muscle contraction: Is it effective for pregnant women? A randomized controlled trial.

PubMed

Dias, Naiara T; Ferreira, Letícia R; Fernandes, Mariana G; Resende, Ana Paula M; Pereira-Baldon, Vanessa S

2018-01-01

The aim of this study was to evaluate the effectiveness of a Pilates exercise program with pelvic floor muscle (PFM) contraction compared to a conventional intervention in pregnant women. Fifty primiparous women, without gestational alterations, were randomized to the Pilates group (n = 25) and control group (n = 25). Interventions for both groups consisted of twice-weekly sessions of 1 h each during the period between the 14-16th and 32-34th gestational weeks. The Pilates group performed a Pilates exercises program with the addition of voluntary PFM contraction. Mat-based Pilates exercises were performed involving movement of the upper limbs, lower limbs and trunk in all sessions. The Control group walked for 10 min and performed strengthening exercises of the lower limbs, upper limbs, and trunk with resistance from an elastic band and body weight. Each woman was evaluated by an unblinded physiotherapist before and after intervention for primary (PFM strength using a manometer) and secondary (PFM strength using Oxford Scale, endurance and repeatability) outcomes. Covariance analysis (ANCOVA) was used to compare the groups using the baseline values as a covariate. Thirty-six women were included in the analysis. There were no differences between the groups for manometry. An increase in the PFM strength, endurance, and repeatability was only observed in the Pilates group. In addition, the Pilates group showed greater adherence to the intervention. Pilates exercise program with PFM contraction is not able to change the PFM strength assessed by manometer in pregnant women, but it improved adherence to the intervention. © 2017 Wiley Periodicals, Inc.

Residual limb skin temperature and thermal comfort in people with amputation during activity in a cold environment.

PubMed

Segal, Ava D; Klute, Glenn K

2016-01-01

Thermal comfort remains a common problem for people with lower-limb amputation. Both donning a prosthesis and engaging in activity at room temperature can increase residual limb skin temperature; however, the effects of activity on skin temperature and comfort in more extreme environments remain unknown. We examined residual limb skin temperatures and perceived thermal comfort (PTC; 11-point Likert scale) of participants with unilateral transtibial amputation (n = 8) who were snowshoeing in a cold environment. Residual limb skin temperature increased by 3.9°C [3.0°C to 4.7°C] (mean difference [95% confidence interval (CI)], p < 0.001) after two 30 min exercise sessions separated by a 5 min rest session. Minimal cooling (-0.2°C [-1.1°C to 0.6°C]) occurred during the rest period. Similar changes in PTC were found for the residual limb, intact limb, and whole body, with a mean scale increase of 1.6 [1.1 to 2.1] and 1.3 [0.8 to 1.8] for the first and second exercise sessions, respectively (p < 0.001). Activity in a cold environment caused similar increases in residual limb skin temperature as those found in studies conducted at room temperature. Participants with amputation perceived warming as their skin temperature increased during exercise followed by the perception of cooling during rest, despite minimal associated decreases in skin temperature.

Effects of home-based tele-exercise on sarcopenia among community-dwelling elderly adults: Body composition and functional fitness.

PubMed

Hong, Jeeyoung; Kim, Jeongeun; Kim, Suk Wha; Kong, Hyoun-Joong

2017-01-01

This study aims to develop a form of tele-exercise that would enable real-time interactions between exercise instructors and community-dwelling elderly people and to investigate its effects on improvement of sarcopenia-related factors of body composition and functional fitness among the elderly. Randomized, controlled trial, with a 12-week intervention period. Community-dwelling senior citizens in Gangseo-gu, Seoul, South Korea. The participants were 23 elderly individuals (tele-exercise group: 11, control group: 12), aged 69 to 93years. The tele-exercise program was developed utilizing a 15-in. all-in-one PC and video conferencing software (Skype™), with broadband Internet connectivity. The tele-exercise group performed supervised resistance exercise at home for 20-40min a day three times per week for 12weeks. The remote instructor provided one-on-one instruction to each participant during the intervention. The control group maintained their lifestyles without any special intervention. The sarcopenia-related factors of body composition and functional fitness were examined prior to, as well as following, a 12-week intervention period. The data were analyzed with a two-way repeated measures ANOVA. There were significant improvements in lower limb muscle mass (p=0.017), appendicular lean soft tissue (p=0.032), total muscle mass (p=0.033), and chair sit-and-reach length (p=0.019) for the tele-exercise group compared to the control group. No group×time interaction effects were detected for the 2-min step, chair stand, and time effects (p<0.05). Video conferencing-based supervised resistance exercise had positive effects on sarcopenia-related factors such as total-body skeletal muscle mass, appendicular lean soft tissue, lower limb muscle mass, and the chair sit-and-reach scores among community-dwelling elderly adults. These results imply that tele-exercise can be a new and effective intervention method for increasing skeletal muscle mass and the physical functioning of the lower limbs from the perspective of sarcopenia improvement among the elderly. Copyright © 2016 Elsevier Inc. All rights reserved.

Supplementation with beta-hydroxy-beta-methylbutyrate (HMB) and alpha-ketoisocaproic acid (KIC) reduces signs and symptoms of exercise-induced muscle damage in man.

PubMed

van Someren, Ken A; Edwards, Adam J; Howatson, Glyn

2005-08-01

This study examined the effects of beta-hydroxyl-beta-methylbutyrate (HMB) and alpha-ketoisocaproic acid (KIC) supplementation on signs and symptoms of exercise-induced muscle damage following a single bout of eccentrically biased resistance exercise. Six non-resistance trained male subjects performed an exercise protocol designed to induce muscle damage on two separate occasions, performed on the dominant or non-dominant arm in a counter-balanced crossover design. Subjects were assigned to an HMB/KIC (3 g HMB and 0.3 g alpha-ketoisocaproic acid, daily) or placebo treatment for 14 d prior to exercise in the counter-balanced crossover design. One repetition maximum (1RM), plasma creatine kinase activity (CK), delayed onset muscle soreness (DOMS), limb girth, and range of motion (ROM) were determined pre-exercise, at 1h, 24 h, 48 h, and 72 h post-exercise. DOMS and the percentage changes in 1RM, limb girth, and ROM all changed over the 72 h period (P < 0.05). HMB//IC supplementation attenuated the CK response, the percentage decrement in 1RM, and the percentage increase in limb girth (P < 0.05). In addition, DOMS was reduced at 24 h post-exercise (P < 0.05) in the HMB/KIC treatment. In conclusion, 14 d of HMB and KIC supplementation reduced signs and symptoms of exercise-induced muscle damage in non-resistance trained males following a single bout of eccentrically biased resistance exercise.

An isoenergetic high-protein, moderate-fat diet does not compromise strength and fatigue during resistance exercise in women.

PubMed

Dipla, Konstantina; Makri, Maria; Zafeiridis, Andreas; Soulas, Dimitrios; Tsalouhidou, Sofia; Mougios, Vassilis; Kellis, Spyros

2008-08-01

Resistance exercise is recommended to individuals following high-protein diets in order to augment changes in body composition. However, alterations in macronutrient composition may compromise physical performance. The present study investigated the effects of an isoenergetic high-protein diet on upper and lower limb strength and fatigue during high-intensity resistance exercise. Ten recreationally active women, aged 25-40 years, followed a control diet (55, 15 and 30 % of energy from carbohydrate, protein and fat, respectively) and a high-protein diet (respective values, 30, 40 and 30) for 7 d each in a random counterbalanced design. Each participant underwent strength testing of upper limb (isometric handgrip strength and endurance) and lower limb (four sets of sixteen maximal knee flexions and extensions on an isokinetic dynamometer) before and after applying each diet. Body weight, body fat and RER were significantly reduced following the high-protein diet (P < 0.05). No differences were found between diets in any of the strength performance parameters (handgrip strength, handgrip endurance, peak torque, total work and fatigue) or the responses of heart rate, systolic and diastolic arterial pressure, blood lactate and blood glucose to exercise. Women on a short-term isoenergetic high-protein, moderate-fat diet maintained muscular strength and endurance of upper and lower limbs during high-intensity resistance exercise without experiencing fatigue earlier compared with a control diet.

Recovery of peripheral muscle function from fatiguing exercise and daily physical activity level in patients with multiple sclerosis: a case-control study.

PubMed

Ickmans, Kelly; Simoens, Fauve; Nijs, Jo; Kos, Daphne; Cras, Patrick; Willekens, Barbara; Meeus, Mira

2014-07-01

Delayed recovery of muscle function following exercise has been demonstrated in the lower limbs of patients with multiple sclerosis (MS). However, studies examining this in the upper limbs are currently lacking. This study compared physical activity level (PAL) and recovery of upper limb muscle function following exercise between MS patients and healthy inactive controls. Furthermore, the relationship between PAL and muscle recovery was examined. PAL of 19 MS patients and 32 controls was measured using an accelerometer for 7 consecutive days. Afterwards, recovery of muscle function was assessed by performing a fatiguing upper limb exercise test with subsequent recovery measures. Muscle recovery of the upper limb muscles was similar in both groups. Average activity counts were significantly lower in MS patients than in the control group. MS patients spent significantly more time being sedentary and less time on activities of moderate intensity compared with the control group. No significant correlation between PAL and recovery of muscle function was found in MS patients. Recovery of upper limb muscle function following exercise is normal in MS patients. MS patients are less physically active than healthy inactive controls. PAL and recovery of upper limb muscle function appear unrelated in MS patients. Copyright © 2014 Elsevier B.V. All rights reserved.

Limb congestion enhances the synchronization of sympathetic outflow with muscle contraction

NASA Technical Reports Server (NTRS)

Mostoufi-Moab, S.; Herr, M. D.; Silber, D. H.; Gray, K. S.; Leuenberger, U. A.; Sinoway, L. I.

2000-01-01

In this report, we examined if the synchronization of muscle sympathetic nerve activity (MSNA) with muscle contraction is enhanced by limb congestion. To explore this relationship, we applied signal-averaging techniques to the MSNA signal obtained during short bouts of forearm contraction (2-s contraction/3-s rest cycle) at 40% maximal voluntary contraction for 5 min. We performed this analysis before and after forearm venous congestion; an intervention that augments the autonomic response to sustained static muscle contractions via a local effect on muscle afferents. There was an increased percentage of the MSNA noted during second 2 of the 5-s contraction/rest cycles. The percentage of total MSNA seen during this particular second increased from minute 1 to 5 of contraction and was increased further by limb congestion (control minute 1 = 25.6 +/- 2.0%, minute 5 = 32.8 +/- 2.2%; limb congestion minute 1 = 29.3 +/- 2.1%, minute 5 = 37.8 +/- 3.9%; exercise main effect <0.005; limb congestion main effect P = 0.054). These changes in the distribution of signal-averaged MSNA were seen despite the fact that the mean number of sympathetic discharges did not increase over baseline. We conclude that synchronization of contraction and MSNA is seen during short repetitive bouts of handgrip. The sensitizing effect of contraction time and limb congestion are apparently due to feedback from muscle afferents within the exercising muscle.

Intensive strength and balance training with the Kinect console (Xbox 360) in a patient with CMT1A.

PubMed

Pagliano, Emanuela; Foscan, Maria; Marchi, Alessia; Corlatti, Alice; Aprile, Giorgia; Riva, Daria

2017-08-01

Effective drugs for type 1A Charcot-Marie-Tooth (CMT1A) disease are not available. Various forms of moderate exercise are beneficial, but few data are available on the effectiveness of exercise in CMT1A children. To investigate the feasibility and effectiveness of exercises to improve ankle strength and limb function in a child with CMT1A. Outpatient clinic. Nine-year-old boy with CMT1A. The rehabilitation program consisted of ankle exercises and Kinect videogame-directed physical activities (using an Xbox 360 console/movement sensor) that aimed to improve balance and limb strength. The program was given 3 times a week for 5 weeks. The child was assessed at baseline, after 5 weeks, and 3 and 6 months after. By the end of follow-up, child balance and endurance had improved, but ankle strength did not. The encouraging results for balance and endurance justify further studies on videogame-directed activities in CMT1A children/adolescents.

Effects of posture on upper and lower limb peripheral resistance following submaximal cycling.

PubMed

Swan, P D; Spitler, D L; Todd, M K; Maupin, J L; Lewis, C L; Darragh, P M

1989-09-01

The purpose of this study was to determine postural effects on upper and lower limb peripheral resistance (PR) after submaximal exercise. Twelve subjects (six men and six women) completed submaximal cycle ergometer tests (60% age-predicted maximum heart rate) in the supine and upright seated positions. Each test included 20 minutes of rest, 20 minutes of cycling, and 15 minutes of recovery. Stroke volume and heart rate were determined by impedance cardiography, and blood pressure was measured by auscultation during rest, immediately after exercise, and at minutes 1-5, 7.5, 10, 12.5, and 15 of recovery. Peripheral resistance was calculated from values of mean arterial pressure and cardiac output. No significant (p less than 0.05) postural differences in PR were noted during rest for either limb. Immediately after exercise, PR decreased (55% to 61%) from resting levels in both limbs, independent of posture. Recovery ankle PR values were significantly different between postures. Upright ankle PR returned to 92% of the resting level within four minutes of recovery, compared to 76% of the resting level after 15 minutes in the supine posture. Peripheral resistance values in the supine and upright arm were not affected by posture and demonstrated a gradual pattern of recovery similar to the supine ankle recovery response (85% to 88% of rest within 15 minutes). The accelerated recovery rate of PR after upright exercise may result from local vasoconstriction mediated by a central regulatory response to stimulation from gravitational pressure on lower body circulation.

Divergent Systemic and Local Inflammatory Response to Hind Limb Demand Ischemia in Wild Type And ApoE−/− Mice

PubMed Central

Crawford, Robert S.; Albadawi, Hassan; Robaldo, Alessandro; Peck, Michael A.; Abularrage, Christopher J.; Yoo, Hyung-Jin; LaMuraglia, Glenn M.; Watkins, Michael T.

2013-01-01

Introduction Studies were designed to determine whether the ApoE−/− phenotype modulates the local skeletal muscle and systemic inflammatory (plasma) responses to lower extremity demand ischemia. The ApoE−/− phenotype is an experimental model for atherosclerosis in humans. Methods Aged female ApoE −/− and C57BL6 mice underwent femoral artery ligation, then divided into sedentary and demand ischemia (exercise) groups on day 14. Baseline and post exercise limb perfusion and hind limb function were assessed. On day 14, animals in the demand ischemia group underwent daily treadmill exercise through day 28. Sedentary mice were not exercised. On day 28, plasma and skeletal muscle from ischemic limbs were harvested from sedentary and exercised mice. Muscle was assayed for angiogenic and pro-inflammatory proteins, markers of skeletal muscle regeneration, and evidence of skeletal muscle fiber maturation. Results Hind limb ischemia was similar in ApoE −/− and C57 mice prior to the onset of exercise. Under sedentary conditions, plasma VEGF, IL-6, but not KC or MIP-2 were higher in ApoE (P<0.0001). Following exercise, plasma levels of VEGF, KC and MIP-2, but not IL-6 were lower in ApoE (P<0.004). The cytokines KC and MIP-2 in muscle was greater in exercised ApoE−/− mice as compared to C57BL6 mice (p=0.01). Increased PAR activity, and mature muscle regeneration was associated with demand ischemia in the C57BL6 mice as compared to the ApoE −/− mice (p=0.01). Conclusion Demand limb ischemia in the ApoE−/− phenotype exacerbated the expression of select systemic cytokines in plasma and blunted indices of muscle regeneration. PMID:23528286

Lower limb power rehabilitation (LLPR) using interactive video game for improvement of balance function in older people.

PubMed

Chen, Po-Yin; Wei, Shun-Hwa; Hsieh, Wan-Ling; Cheen, Jang-Rong; Chen, Liang-Kung; Kao, Chung-Lan

2012-01-01

Declined balance functions have adverse effects on elderly population. Lower limbs muscle power training is currently an emerging concept in rehabilitation on individuals with decreased balance and mobility. In this prospective, controlled study, we used a human-computer interactive video-game-based rehabilitation device (LLPR) for training of lower limb muscle power in the elderly. Forty (aged >65 years) individuals were recruited from the community. Twenty participants in the exercise group received 30-min training, twice a week, using the LLPR system. The LLPR system allows participants to perform fast speed sit-to-stand (STS) movements. Twenty age-matched participants in the control group performed slow speed STS movements, as well as strengthening and balance exercises, with the same frequency and duration. The results were compared after 12 sessions (6 weeks) of training. The mechanical and time parameters during STS movement were measured using the LLPR system. Modified falls efficacy scale (MFES), Tinetti Performance-Oriented Mobility Assessment (POMA), function reach test, five times sit to stand (FTSS) and Timed Up and Go (TUG) were administered to participants as clinical assessments. Results showed that in the exercise group, all the mechanical and time parameters showed significant improvement. In control group, only the maximal vertical ground reaction force (MVGRF) improved significantly. For clinical assessments (balance, mobility, and self-confidence), exercise group showed significantly better scores. The STS movements in video-game-based training mimic real life situations which may help to transfer the training effects into daily activities. The effectiveness of lower limb muscle training is worthy of further investigation. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Time course of upper limb function and return-to-work post-radiotherapy in young adults with breast cancer: a pilot randomized control trial on effects of targeted exercise program.

PubMed

Ibrahim, Marize; Muanza, Thierry; Smirnow, Nadia; Sateren, Warren; Fournier, Beatrice; Kavan, Petr; Palumbo, Michael; Dalfen, Richard; Dalzell, Mary-Ann

2017-12-01

Breast cancer (BC) diagnosis in young adults (YA) is rising, and both disease and treatments are aggressive in this population. Evidence supports the use of physical activity in reducing shoulder dysfunction, which is common among BC survivors. A pilot randomized clinical trial was performed to determine the effectiveness of a 12-week post-radiation exercise program in minimizing upper extremity dysfunction in YA with BC. Participants were randomized to either an exercise arm or a control arm receiving standard care. Data was collected over six time points using: the Disability of Arm, Shoulder, and Hand (DASH); the Metabolic Equivalent of Task-hours per week (MET-hours/week), and a post hoc questionnaire on return to work. In total, 59 young women participated in the study (n = 29 exercise; n = 30 control). No statistically significant differences were found in overall DASH results between groups; however, those who underwent total mastectomy had residual upper limb dysfunction (p < 0.05). Both groups returned to pre-diagnosis activity levels by 18 months. Final evaluation showed that 86% of the women returned to work, and 89% resumed prior work activities with a decrease of 8.5 h/week. Although the short-term targeted exercise program had no effect on long-term upper limb function post-radiation, timing and program specificity may require consideration of tissue healing post-radiation and surgery type. The majority of participants returned to work, however not returning to pre-diagnosis work hours. Exercise interventions alone may not reverse the long-term sequelae of breast cancer treatment and allow young adult patients to return to work.

The Interaction of Fatigue and Potentiation Following an Acute Bout of Unilateral Squats.

PubMed

Andrews, Samantha K; Horodyski, Jesse M; MacLeod, Daniel A; Whitten, Joseph; Behm, David G

2016-12-01

A prior conditioning resistance exercise can augment subsequent performance of the affected muscles due to the effects of post-activation potentiation (PAP). The non-local muscle fatigue literature has illustrated the global neural effects of unilateral fatigue. However, no studies have examined the possibility of acute non-local performance enhancements. The objective of the study was to provide a conditioning stimulus in an attempt to potentiate the subsequent jump performance of the affected limb and determine if there were performance changes in the contralateral limb. Using a randomized allocation, 14 subjects (6 females, 8 males) completed three conditions on separate days: 1) unilateral, dominant leg, Bulgarian split squat protocol with testing of the exercised leg, 2) unilateral, dominant leg, Bulgarian split squat protocol with testing of the contralateral, non-exercised leg and 3) control session with testing of the non-dominant leg. Pre- and post-testing consisted of countermovement (CMJ) and drop jumps (DJ). The exercised leg exhibited CMJ height increases of 3.5% (p = 0.008; d = 0.28), 4.0% (p = 0.011; d = 0.33) and 3.2% (p = 0.013; d = 0.26) at 1, 5, and 10 min post-intervention respectively. The contralateral CMJ height had 2.0% (p = 0.034; d = 0.18), 1.2% (p = 0.2; d = 0.12), and 2.1% (p = 0.05; d = 0.17) deficits at 1, 5, and 10 min post-intervention respectively. Similar relative results were found for CMJ power. There were no significant interactions for DJ measures or control CMJ measures. The findings suggest that PAP effects were likely predominant for the exercised leg whereas the conditioning exercise provided trivial magnitude although statistically significant neural impairments for the contralateral limb.

Wearable Inertial Sensor Systems for Lower Limb Exercise Detection and Evaluation: A Systematic Review.

PubMed

O'Reilly, Martin; Caulfield, Brian; Ward, Tomas; Johnston, William; Doherty, Cailbhe

2018-05-01

Analysis of lower limb exercises is traditionally completed with four distinct methods: (1) 3D motion capture; (2) depth-camera-based systems; (3) visual analysis from a qualified exercise professional; and (4) self-assessment. Each method is associated with a number of limitations. The aim of this systematic review is to synthesise and evaluate studies which have investigated the capacity for inertial measurement unit (IMU) technologies to assess movement quality in lower limb exercises. A systematic review of studies identified through the databases of PubMed, ScienceDirect and Scopus was conducted. Articles written in English and published in the last 10 years which investigated an IMU system for the analysis of repetition-based targeted lower limb exercises were included. The quality of included studies was measured using an adapted version of the STROBE assessment criteria for cross-sectional studies. The studies were categorised into three groupings: exercise detection, movement classification or measurement validation. Each study was then qualitatively summarised. From the 2452 articles that were identified with the search strategies, 47 papers are included in this review. Twenty-six of the 47 included studies were deemed as being of high quality. Wearable inertial sensor systems for analysing lower limb exercises is a rapidly growing field of research. Research over the past 10 years has predominantly focused on validating measurements that the systems produce and classifying users' exercise quality. There have been very few user evaluation studies and no clinical trials in this field to date.

Achilles tendinopathy modulates force frequency characteristics of eccentric exercise.

PubMed

Grigg, Nicole L; Wearing, Scott C; O'Toole, John M; Smeathers, James E

2013-03-01

Previous research has demonstrated that ground reaction force (GRF) recorded during eccentric ankle exercise is characterized by greater power in the 8- to 12-Hz bandwidth when compared with that recorded during concentric ankle exercise. Subsequently, it was suggested that vibrations in this bandwidth may underpin the beneficial effect of eccentric loading in tendon repair. However, this observation has been made only in individuals without Achilles tendinopathy. This research compared the force frequency characteristics of eccentric and concentric exercises in individuals with and without Achilles tendinopathy. Eleven male adults with unilateral midportion Achilles tendinopathy and nine control male adults without tendinopathy participated in the research. Kinematics and GRF were recorded while the participants performed a common eccentric rehabilitation exercise protocol and a concentric equivalent. Ankle joint kinematics and the frequency power spectrum of the resultant GRF were calculated. Eccentric exercise was characterized by a significantly greater proportion of spectral power between 4.5 and 11.5 Hz when compared with concentric exercise. There were no significant differences between limbs in the force frequency characteristics of concentric exercise. Eccentric exercise, in contrast, was defined by a shift in the power spectrum of the symptomatic limb, resulting in a second spectral peak at 9 Hz, rather than 10 Hz in the control limb. Compared with healthy tendon, Achilles tendinopathy was characterized by lower frequency vibrations during eccentric rehabilitation exercises. This finding may be associated with changes in neuromuscular activation and tendon stiffness that have been shown to occur with tendinopathy and provides a possible rationale for the previous observation of a different biochemical response to eccentric exercise in healthy and injured Achilles tendons.

[The effect of neurorehabilitation on the functional state and muscle tone of upper limb in patients after ischaemic stroke].

PubMed

Klimkiewicz, Paulina; Kubsik, Anna; Jankowska, Agnieszka; Woldańska-Okońska, Marta

2014-03-01

Rehabilitation of upper limb in patients after ischemic stroke is a major challenge for modern neurorehabilitation. Function of upper limb of patients after ischemic stroke returns on the end of the rehabilitation comparing with another parts of the body. Below presents two groups of patients after ischemic stroke who were rehabilitated with use of the following methods: kinesiotherapy combined with NDT- Bobath method and kinesiotherapy only. The aim of this study was to assess the impact of kinesiotherapy only and NDT- Bobath method combined with kinesiotherapy on the functional state and muscle tone of upper limb in patients after ischemic stroke. The study involved a group of 40 patients after ischemic stroke with motor control and muscle tone problems of upper limb. Patients were divided into two groups, each of them included 20 people. Upper limb in group I was rehabilitated with the use of kinesiotherapy exercise however group II with the use of kinesiotherapy exercise combined with NDT- Bobath method (Neurodevelopmental Treatment Bobath). To evaluate the patients before and after rehabilitation muscle tone Asworth scale was used and to assess functional status Rivermead Motor Assessment (RMAIII) scale was used. After 5 weeks of rehabilitation in group II in majority patients were observed decrease of muscle tone and improvement in upper limb functional status. In group I the muscle tone were also decreased and functional status were better but in smaller impact than in II group. Classical kinesiotherapy combined with the NDT-Bobath method gives better results in neurorehabilitation of upper limb than the use of kinesiotherapy exercises only in patients after ischemic stroke.

Exercise-induced muscle fatigue in the unaffected knee joint and its influence on postural control and lower limb kinematics in stroke patients.

PubMed

Park, Sun Wook; Son, Sung Min; Lee, Na Kyung

2017-05-01

This study aimed to investigate the effects of exercise-induced muscle fatigue in the unaffected knee joint on postural control and kinematic changes in stroke patients. Forty participants (20 stroke patients, 20 age-matched healthy participants) were recruited. To induce fatigue, maximum voluntary isometric contractions were performed in the unaffected knee joint in a Leg Extension Rehab exercise machine using the pneumatic resistance. We measured static and dynamic balance and lower-limb kinematics during gait. Changes in postural control parameters anteroposterior sway speed and total center of pressure distance differed significantly between the stroke and control groups. In addition, changes in gait kinematic parameters knee and ankle angles of initial contact differed significantly between stroke (paretic and non-paretic) and control groups. Muscle fatigue in the unaffected knee and ankle impaired postural control and debilitates kinematic movement of ipsilateral and contralateral lower limbs, and may place the fatigued stroke patients at greater risk for falls.

P-31 Magnetic Resonance Spectroscopy (MRS) of limb muscles during bedrest with exercise countermeasures

NASA Technical Reports Server (NTRS)

Berry, P.; Berry, I.; Arnaud, S.; Moseley, M.

1987-01-01

Nineteen volunteers in bed with head down tilt (-6 deg) for 1 month and doing or not exercise training while in bed (lido or ergometer) had their limb muscle studied by magnetic resonance spectroscopy. A protocol of repetitive exercise in the magnet was set and a wooden probe designed to support the limb and to allow exercise. Spectra were recorded continuously during the protocol. In each spectrum, inorganic phosphate, phosphocreatin, adenosin triphosphate, and pH were measured. All the subjects were studied before, after bedrest, and 6 weeks later. After 1 month, the lido group show no changes in the spectra of their leg muscles while the group doing no exercise or ergometer do. For the arms, a loss of muscle function is only seen in the group doing no exercise.

The effect of intermittent lower limb occlusion on recovery following exercise-induced muscle damage: A randomized controlled trial.

PubMed

Page, Will; Swan, Rachael; Patterson, Stephen D

2017-08-01

The purpose of this investigation was to examine the effectiveness of intermittent lower limb occlusion in augmenting recovery from exercise induced muscle damage (EIMD) in physically active males. Randomized controlled trial, double blind. Sixteen healthy recreationally active male participants were randomly assigned to an intermittent occlusion (OCC; n=8) or control (SHAM; n=8) group. The EIMD protocol comprised of 100 drop-jumps, from a 0.6m box. Indices of muscle damage were creatine kinase (CK), thigh-circumference (TC), muscle soreness (DOMS), counter-movement jump (CMJ) and maximal isometric voluntary contraction (MIVC). Measurements were assessed pre, 24h, 48h and 72h following exercise. There was a significant time effect for all indices of muscle damage suggesting EIMD was present following the exercise protocol. The decrease in MIVC was significantly attenuated in the OCC group compared to the SHAM group at 24 (90.4±10.7 vs. 81.5±6.7%), 48 (96.2±6.1 vs. 84.5±7.1%) and 72h (101.1±4.2 vs. 89.7±7.5%). The CK response was reduced in the OCC group at 24 (335±87 vs. 636±300 IU) and 48h (244±70 vs. 393±248 IU), compared to the SHAM group. DOMS was significantly lower in the OCC compared to the SHAM group at 24, 48 and 72h post EIMD. There was no effect of OCC on CMJ or TC. This investigation shows that intermittent lower limb occlusion administered after a damaging bout of exercise reduces indices of muscle damage and accelerates the recovery in physically active males. Copyright © 2017 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

The PACT trial: PAtient Centered Telerehabilitation: effectiveness of software-supported and traditional mirror therapy in patients with phantom limb pain following lower limb amputation: protocol of a multicentre randomised controlled trial.

PubMed

Rothgangel, Andreas Stefan; Braun, Susy; Schulz, Ralf Joachim; Kraemer, Matthias; de Witte, Luc; Beurskens, Anna; Smeets, Rob Johannes

2015-01-01

Non-pharmacological interventions such as mirror therapy are gaining increased recognition in the treatment of phantom limb pain; however, the evidence in people with phantom limb pain is still weak. In addition, compliance to self-delivered exercises is generally low. The aim of this randomised controlled study is to investigate the effectiveness of mirror therapy supported by telerehabilitation on the intensity, duration and frequency of phantom limb pain and limitations in daily activities compared to traditional mirror therapy and care as usual in people following lower limb amputation. A three-arm multi-centre randomised controlled trial will be performed. Participants will be randomly assigned to care as usual, traditional mirror therapy or mirror therapy supported by telerehabilitation. During the first 4 weeks, at least 10 individual sessions will take place in every group. After the first 4 weeks, participants will be encouraged to perform self-delivered exercises over a period of 6 weeks. Outcomes will be assessed at 4 and 10 weeks after baseline and at 6 months follow-up. The primary outcome measure is the average intensity of phantom limb pain during the last week. Secondary outcome measures include the different dimensions of phantom limb pain, pain-related limitations in daily activities, global perceived effect, pain-specific self-efficacy, and quality of life. Several questions concerning the study design that emerged during the preparation of this trial will be discussed. This will include how these questions were addressed and arguments for the choices that were made. Copyright © 2014 Australian Physiotherapy Association. Published by Elsevier B.V. All rights reserved.

Force and power characteristics of a resistive exercise device for use in space

NASA Astrophysics Data System (ADS)

Berg, Hans E.; Tesch, Per A.

We have developed a non-gravity dependent mechanical device, which provides resistance during coupled concentric and eccentric muscle actions, through the inertia of a spinning fly-wheel (Fly-Wheel Ergometry; FWE). Our research shows that lower-limb FWE exercise can produce forces and thus muscular stress comparable to what is typical of advanced resistance training using free weights. FWE also offers greater training stimuli during eccentric relative to concentric muscle actions, as evidenced by force and electromyographic (EMG) measurements. Muscle use of specific muscle groups, as assessed by the exercise-induced contrast shift of magnetic resonance images, is similar during lower-limb FWE and the barbell squat. Unlike free-weight exercise, FWE allows for maximal voluntary effort in each repetition of an exercise bout. Likewise, FWE exercise, not unassisted free-weight exercise, produces eccentric "overload". Collectively, the inherent features of this resistive exercise device and the results of the physiological evaluations we have performed, suggest that resistance exercise using FWE could be used as an effective exercise counter-measure in space. The flywheel principle can be employed to any exercise configuration and designed into a compact device allowing for exercises stressing those muscles and bone structures, which are thought to be most affected by long-duration spaceflight.

Differences in muscle strength after ACL reconstruction do not influence cardiorespiratory responses to isometabolic exercise

PubMed Central

Andrade, Marília S.; Lira, Claudio A. B.; Vancini, Rodrigo L.; Nakamoto, Fernanda P.; Cohen, Moisés; Silva, Antonio C.

2014-01-01

Objectives To investigate whether the muscle strength decrease that follows anterior cruciate ligament (ACL) reconstruction would lead to different cardiorespiratory adjustments during dynamic exercise. Method Eighteen active male subjects were submitted to isokinetic evaluation of knee flexor and extensor muscles four months after ACL surgery. Thigh circumference was also measured and an incremental unilateral cardiopulmonary exercise test was performed separately for both involved and uninvolved lower limbs in order to compare heart rate, oxygen consumption, minute ventilation, and ventilatory pattern (breath rate, tidal volume, inspiratory time, expiratory time, tidal volume/inspiratory time) at three different workloads (moderate, anaerobic threshold, and maximal). Results There was a significant difference between isokinetic extensor peak torque measured in the involved (116.5±29.1 Nm) and uninvolved (220.8±40.4 Nm) limbs, p=0.000. Isokinetic flexor peak torque was also lower in the involved limb than in the uninvolved limb (107.8±15.4 and 132.5±26.3 Nm, p=0.004, respectively). Lower values were also found in involved thigh circumference as compared with uninvolved limb (46.9±4.3 and 48.5±3.9 cm, p=0.005, respectively). No differences were found between the lower limbs in any of the variables of the incremental cardiopulmonary tests at all exercise intensities. Conclusions Our findings indicate that, four months after ACL surgery, there is a significant deficit in isokinetic strength in the involved limb, but these differences in muscle strength requirement do not produce differences in the cardiorespiratory adjustments to exercise. Based on the hypotheses from the literature which explain the differences in the physiological responses to exercise for different muscle masses, we can deduce that, after 4 months of a rehabilitation program after an ACL reconstruction, individuals probably do not present differences in muscle oxidative and peripheral perfusion capacities that could elicit higher levels of peripheral cardiorepiratory stimulus during exercise. PMID:24838811

Effects of a progressive resistance exercise program with high-speed component on the physical function of older women with sarcopenic obesity: a randomized controlled trial.

PubMed

Vasconcelos, Karina S S; Dias, João M D; Araújo, Marília C; Pinheiro, Ana C; Moreira, Bruno S; Dias, Rosângela C

2016-07-11

Sarcopenic obesity is associated with disability in older people, especially in women. Resistance exercises are recommended for this population, but their efficacy is not clear. To evaluate the effects of a progressive resistance exercise program with high-speed component on the physical function of older women with sarcopenic obesity. Twenty-eight women 65 to 80 years old, with a body mass index ≥30kg/m2 and handgrip strength ≤21kg were randomly allocated to two groups. The experimental group underwent a 10-week resistance exercise program designed to improve strength, power, and endurance of lower-limb muscles, with open chain and closed chain exercises. The control group had their health status monitored through telephone calls. The primary outcomes were lower limb muscle performance measured by knee extensor strength, power and fatigue by isokinetic dynamometry, and mobility measured by the Short Physical Performance Battery and by gait velocity. The secondary outcome was health-related quality of life assessed by the SF-36 Questionnaire. The average rate of adherence was 85%, with few mild adverse effects. There were no significant between-group differences for any of the outcomes. In this study, a progressive resistance exercise program with high-speed component was not effective for improving the physical function of older women with sarcopenic obesity.

Daily muscle stretching enhances blood flow, endothelial function, capillarity, vascular volume and connectivity in aged skeletal muscle.

PubMed

Hotta, Kazuki; Behnke, Bradley J; Arjmandi, Bahram; Ghosh, Payal; Chen, Bei; Brooks, Rachael; Maraj, Joshua J; Elam, Marcus L; Maher, Patrick; Kurien, Daniel; Churchill, Alexandra; Sepulveda, Jaime L; Kabolowsky, Max B; Christou, Demetra D; Muller-Delp, Judy M

2018-05-15

In aged rats, daily muscle stretching increases blood flow to skeletal muscle during exercise. Daily muscle stretching enhanced endothelium-dependent vasodilatation of skeletal muscle resistance arterioles of aged rats. Angiogenic markers and capillarity increased in response to daily stretching in muscles of aged rats. Muscle stretching performed with a splint could provide a feasible means of improving muscle blood flow and function in elderly patients who cannot perform regular aerobic exercise. Mechanical stretch stimuli alter the morphology and function of cultured endothelial cells; however, little is known about the effects of daily muscle stretching on adaptations of endothelial function and muscle blood flow. The present study aimed to determine the effects of daily muscle stretching on endothelium-dependent vasodilatation and muscle blood flow in aged rats. The lower hindlimb muscles of aged Fischer rats were passively stretched by placing an ankle dorsiflexion splint for 30 min day -1 , 5 days week -1 , for 4 weeks. Blood flow to the stretched limb and the non-stretched contralateral limb was determined at rest and during treadmill exercise. Endothelium-dependent/independent vasodilatation was evaluated in soleus muscle arterioles. Levels of hypoxia-induced factor-1α, vascular endothelial growth factor A and neuronal nitric oxide synthase were determined in soleus muscle fibres. Levels of endothelial nitric oxide synthase and superoxide dismutase were determined in soleus muscle arterioles, and microvascular volume and capillarity were evaluated by microcomputed tomography and lectin staining, respectively. During exercise, blood flow to plantar flexor muscles was significantly higher in the stretched limb. Endothelium-dependent vasodilatation was enhanced in arterioles from the soleus muscle from the stretched limb. Microvascular volume, number of capillaries per muscle fibre, and levels of hypoxia-induced factor-1α, vascular endothelial growth factor and endothelial nitric oxide synthase were significantly higher in the stretched limb. These results indicate that daily passive stretching of muscle enhances endothelium-dependent vasodilatation and induces angiogenesis. These microvascular adaptations may contribute to increased muscle blood flow during exercise in muscles that have undergone daily passive stretch. © 2018 The Authors. The Journal of Physiology © 2018 The Physiological Society.

The Interaction of Fatigue and Potentiation Following an Acute Bout of Unilateral Squats

PubMed Central

Andrews, Samantha K.; Horodyski, Jesse M.; MacLeod, Daniel A.; Whitten, Joseph; Behm, David G.

2016-01-01

A prior conditioning resistance exercise can augment subsequent performance of the affected muscles due to the effects of post-activation potentiation (PAP). The non-local muscle fatigue literature has illustrated the global neural effects of unilateral fatigue. However, no studies have examined the possibility of acute non-local performance enhancements. The objective of the study was to provide a conditioning stimulus in an attempt to potentiate the subsequent jump performance of the affected limb and determine if there were performance changes in the contralateral limb. Using a randomized allocation, 14 subjects (6 females, 8 males) completed three conditions on separate days: 1) unilateral, dominant leg, Bulgarian split squat protocol with testing of the exercised leg, 2) unilateral, dominant leg, Bulgarian split squat protocol with testing of the contralateral, non-exercised leg and 3) control session with testing of the non-dominant leg. Pre- and post-testing consisted of countermovement (CMJ) and drop jumps (DJ). The exercised leg exhibited CMJ height increases of 3.5% (p = 0.008; d = 0.28), 4.0% (p = 0.011; d = 0.33) and 3.2% (p = 0.013; d = 0.26) at 1, 5, and 10 min post-intervention respectively. The contralateral CMJ height had 2.0% (p = 0.034; d = 0.18), 1.2% (p = 0.2; d = 0.12), and 2.1% (p = 0.05; d = 0.17) deficits at 1, 5, and 10 min post-intervention respectively. Similar relative results were found for CMJ power. There were no significant interactions for DJ measures or control CMJ measures. The findings suggest that PAP effects were likely predominant for the exercised leg whereas the conditioning exercise provided trivial magnitude although statistically significant neural impairments for the contralateral limb. Key points Post-activation potentiation of unilateral CMJ height was achieved following 5 sequential squats at 50% 1RM, 2 squats at 70% 1RM, 1 squat at 90% 1RM with 3 min rest periods. The conditioning exercises did not elicit significant drop jump improvements, likely due to balance challenges. In contrast to the potentiation of the affected leg, there were statistically significant impairments of contralateral CMJ height suggesting the co-existence of post-activation potentiation (affected limb) and crossover neural fatigue. PMID:27928208

Effect of low-cost resistance training on lower-limb strength and balance in institutionalized seniors.

PubMed

Motalebi, Seyedeh Ameneh; Cheong, Loke Seng; Iranagh, Jamileh Amirzadeh; Mohammadi, Fatemeh

2018-01-01

Background/Study Context: Given the rapid increase in the aging population worldwide, fall prevention is of utmost importance. It is essential to establish an efficient, simple, safe, and low-cost intervention method for reducing the risk of falls. This study examined the effect of 12 weeks of progressive elastic resistance training on lower-limb muscle strength and balance in seniors living in the Rumah Seri Kenangan, social welfare home in Cheras, Malaysia. A total of 51 subjects qualified to take part in this quasi-experimental study. They were assigned to either the resistance exercise group (n = 26) or control group (n = 25). The mean age of the 45 participants who completed the program was 70.7 (SD = 6.6). The exercise group met twice per week and performing one to three sets of 8 to 10 repetitions for each of nine lower-limb elastic resistance exercises. All exercises were conducted at low to moderate intensities in sitting or standing positions. The subjects were tested at baseline and 6 and 12 weeks into the program. The results showed statistically significant improvements in lower-limb muscle strength as measured by five times sit-to-stand test (%Δ = 22.6) and dynamic balance quantified by the timed up-and-go test (%Δ = 18.7), four-square step test (%Δ = 14.67), and step test for the right (%Δ = 18.36) and left (%Δ = 18.80) legs. No significant changes were observed in static balance as measured using the tandem stand test (%Δ = 3.25), and one-leg stand test with eyes opened (%Δ = 9.58) and eyes closed (%Δ = -0.61) after completion of the program. The findings support the feasibility and efficacy of a simple and inexpensive resistance training program to improve lower-limb muscle strength and dynamic balance among the institutionalized older adults.

The effects of a single bout of exercise on motor memory interference in the trained and untrained hemisphere.

PubMed

Lauber, Benedikt; Franke, Steffen; Taube, Wolfgang; Gollhofer, Albert

2017-04-07

Increasing evidence suggests that cardiovascular exercise has positive effects on motor memory consolidation. In this study, we investigated whether a single session of high-intensity interval training (HIIT) mitigates the effects of practicing an interfering motor task. Furthermore, learning and interference effects were assessed in the actively trained and untrained limb as it is known that unilateral motor learning can cause bilateral adaptations. Subjects performed a ballistic training and then the HIIT either before (HIIT_before) or after (HIIT_after) practicing an interfering accuracy task (AT). The control group (No_HIIT) did not participate in the HIIT but rested instead. Performance in the ballistic task (BT) was tested before and after the ballistic training, after the exercise and practice of the AT and 24h later. After ballistic training, all groups showed comparable increases in performance in the trained and untrained limb. Despite the practice of the AT, HIIT_before maintained their BT performance after the high-intensity interval training whereas HIIT_after (trend) & No_HIIT showed prominent interference effects. After 24h, HIIT_before still did not show any interference effects but further improved ballistic motor performance. HIIT_after counteracted the interference resulting in a comparable BT performance after 24h than directly after the ballistic training while No_HIIT had a significantly lower BT performance in the retention test. The results were similar in the trained and untrained limb. The current results imply that a single session of cardiovascular exercise can prevent motor interference in the trained and untrained hemisphere. Overall learning was best, and interference least, when HIIT was performed before the interfering motor task. Copyright © 2017 IBRO. Published by Elsevier Ltd. All rights reserved.

Tendon vibration attenuates superficial venous vessel response of the resting limb during static arm exercise.

PubMed

Ooue, Anna; Sato, Kohei; Hirasawa, Ai; Sadamoto, Tomoko

2012-11-07

The superficial vein of the resting limb constricts sympathetically during exercise. Central command is the one of the neural mechanisms that controls the cardiovascular response to exercise. However, it is not clear whether central command contributes to venous vessel response during exercise. Tendon vibration during static elbow flexion causes primary muscle spindle afferents, such that a lower central command is required to achieve a given force without altering muscle force. The purpose of this study was therefore to investigate whether a reduction in central command during static exercise with tendon vibration influences the superficial venous vessel response in the resting limb. Eleven subjects performed static elbow flexion at 35% of maximal voluntary contraction with (EX + VIB) and without (EX) vibration of the biceps brachii tendon. The heart rate, mean arterial pressure, and rating of perceived exertion (RPE) in overall and exercising muscle were measured. The cross-sectional area (CSAvein) and blood velocity of the basilic vein in the resting upper arm were assessed by ultrasound, and blood flow (BFvein) was calculated using both variables. Muscle tension during exercise was similar between EX and EX + VIB. However, RPEs at EX + VIB were lower than those at EX (P <0.05). Increases in heart rate and mean arterial pressure during exercise at EX + VIB were also lower than those at EX (P <0.05). CSAvein in the resting limb at EX decreased during exercise from baseline (P <0.05), but CSAvein at EX + VIB did not change during exercise. CSAvein during exercise at EX was smaller than that at EX + VIB (P <0.05). However, BFvein did not change during the protocol under either condition. The decreases in circulatory response and RPEs during EX + VIB, despite identical muscle tension, showed that activation of central command was less during EX + VIB than during EX. Abolishment of the decrease in CSAvein during exercise at EX + VIB may thus have been caused by a lower level of central command at EX + VIB rather than EX. Diminished central command induced by tendon vibration may attenuate the superficial venous vessel response of the resting limb during sustained static arm exercise.

Extracting time-frequency feature of single-channel vastus medialis EMG signals for knee exercise pattern recognition.

PubMed

Zhang, Yi; Li, Peiyang; Zhu, Xuyang; Su, Steven W; Guo, Qing; Xu, Peng; Yao, Dezhong

2017-01-01

The EMG signal indicates the electrophysiological response to daily living of activities, particularly to lower-limb knee exercises. Literature reports have shown numerous benefits of the Wavelet analysis in EMG feature extraction for pattern recognition. However, its application to typical knee exercises when using only a single EMG channel is limited. In this study, three types of knee exercises, i.e., flexion of the leg up (standing), hip extension from a sitting position (sitting) and gait (walking) are investigated from 14 healthy untrained subjects, while EMG signals from the muscle group of vastus medialis and the goniometer on the knee joint of the detected leg are synchronously monitored and recorded. Four types of lower-limb motions including standing, sitting, stance phase of walking, and swing phase of walking, are segmented. The Wavelet Transform (WT) based Singular Value Decomposition (SVD) approach is proposed for the classification of four lower-limb motions using a single-channel EMG signal from the muscle group of vastus medialis. Based on lower-limb motions from all subjects, the combination of five-level wavelet decomposition and SVD is used to comprise the feature vector. The Support Vector Machine (SVM) is then configured to build a multiple-subject classifier for which the subject independent accuracy will be given across all subjects for the classification of four types of lower-limb motions. In order to effectively indicate the classification performance, EMG features from time-domain (e.g., Mean Absolute Value (MAV), Root-Mean-Square (RMS), integrated EMG (iEMG), Zero Crossing (ZC)) and frequency-domain (e.g., Mean Frequency (MNF) and Median Frequency (MDF)) are also used to classify lower-limb motions. The five-fold cross validation is performed and it repeats fifty times in order to acquire the robust subject independent accuracy. Results show that the proposed WT-based SVD approach has the classification accuracy of 91.85%±0.88% which outperforms other feature models.

Creatine Supplementation and Lower Limb Strength Performance: A Systematic Review and Meta-Analyses.

PubMed

Lanhers, Charlotte; Pereira, Bruno; Naughton, Geraldine; Trousselard, Marion; Lesage, François-Xavier; Dutheil, Frédéric

2015-09-01

Creatine is the most widely used supplementation to increase strength performance. However, the few meta-analyses are more than 10 years old and suffer from inclusion bias such as the absence of randomization and placebo, the diversity of the inclusion criteria (aerobic/endurance, anaerobic/strength), no evaluation on specific muscles or group of muscles, and the considerable amount of conflicting results within the last decade. The objective of this systematic review was to evaluate meta-analyzed effects of creatine supplementation on lower limb strength performance. We conducted a systematic review and meta-analyses of all randomized controlled trials comparing creatine supplementation with a placebo, with strength performance of the lower limbs measured in exercises lasting less than 3 min. The search strategy used the keywords "creatine supplementation" and "performance". Dependent variables were creatine loading, total dose, duration, the time-intervals between baseline (T0) and the end of the supplementation (T1), as well as any training during supplementation. Independent variables were age, sex, and level of physical activity at baseline. We conducted meta-analyses at T1, and on changes between T0 and T1. Each meta-analysis was stratified within lower limb muscle groups and exercise tests. We included 60 studies (646 individuals in the creatine supplementation group and 651 controls). At T1, the effect size (ES) among stratification for squat and leg press were, respectively, 0.336 (95 % CI 0.047-0.625, p = 0.023) and 0.297 (95 % CI 0.098-0.496, p = 0.003). Overall quadriceps ES was 0.266 (95 % CI 0.150-0.381, p < 0.001). Global lower limb ES was 0.235 (95 % CI 0.125-0.346, p < 0.001). Meta-analysis on changes between T0 and T1 gave similar results. The meta-regression showed no links with characteristics of population or of supplementation, demonstrating the creatine efficacy effects, independent of all listed conditions. Creatine supplementation is effective in lower limb strength performance for exercise with a duration of less than 3 min, independent of population characteristic, training protocols, and supplementary doses and duration.

Inhibition of α-adrenergic tone disturbs the distribution of blood flow in the exercising human limb.

PubMed

Heinonen, Ilkka; Wendelin-Saarenhovi, Maria; Kaskinoro, Kimmo; Knuuti, Juhani; Scheinin, Mika; Kalliokoski, Kari K

2013-07-15

The role of neuronal regulation of human cardiovascular function remains incompletely elucidated, especially during exercise. Here we, by positron emission tomography, monitored tissue-specific blood flow (BF) changes in nine healthy young men during femoral arterial infusions of norepinephrine (NE) and phentolamine. At rest, the α-adrenoceptor agonist NE reduced BF by ~40%, similarly in muscles (from 3.2 ± 1.9 to 1.4 ± 0.3 ml·min(-1)·100 g(-1) in quadriceps femoris muscle), bone (from 1.1 ± 0.4 to 0.5 ± 0.2 ml·min(-1)·100 g(-1)) and adipose tissue (AT) (from 1.2 ± 0.7 to 0.7 ± 0.3 ml·min(-1)·100 g(-1)). During exercise, NE reduced exercising muscle BF by ~16%. BF in AT was reduced similarly as rest. The α-adrenoceptor antagonist phentolamine increased BF similarly in the different muscles and other tissues of the limb at rest. During exercise, BF in inactive muscle was increased 3.4-fold by phentolamine compared with exercise without drug, but BF in exercising muscles was not influenced. Bone and AT (P = 0.055) BF were also increased by phentolamine in the exercise condition. NE increased and phentolamine decreased oxygen extraction in the limb during exercise. We conclude that inhibition of α-adrenergic tone markedly disturbs the distribution of BF and oxygen extraction in the exercising human limb by increasing BF especially around inactive muscle fibers. Moreover, although marked functional sympatholysis also occurs during exercise, the arterial NE infusion that mimics the exaggerated sympathetic nerve activity commonly seen in patients with cardiovascular disease was still capable of directly limiting BF in the exercising leg muscles.

Balance and agility training does not always decrease lower limb injury risks: a cluster-randomised controlled trial.

PubMed

Goodall, Rodney L; Pope, Rodney P; Coyle, Julia A; Neumayer, Robert

2013-01-01

The objective of this study was to examine the effects on lower limb injury rates of adding structured balance and agility exercises to the 80-day basic training programme of army recruits. A blocked (stratified), cluster-randomised controlled trial was employed, with one intervention group (IG) and one control group (CG), in which 732 male and 47 female army recruits from the Australian Army Recruit Training Centre participated through to analysis. The IG performed specified balance and agility exercises in addition to normal physical training. The incidence of lower limb injury during basic training was used to measure effect. Analysis, which adhered to recommendations for this type of trial, used a weighted paired t-test based on the empirical logistic transform of the crude event rates. The intervention had no statistically significant effect on lower limb injury incidence (RR = 1.25, 95% CI 0.97-1.53, 90% CI 1.04-1.47), on knee and ankle injury incidence (RR = 1.08, 95% CI 0.83-1.38), and on knee and ankle ligament injury incidence (RR = 0.98, 95% CI 0.64-1.47). We conclude that the intervention, implemented in this fashion, is possibly harmful, with our best estimate of effect being a 25% increase in lower limb injury incidence rates. This type of structured balance and agility training added to normal military recruit physical training did not significantly reduce lower limb, knee and ankle, or knee and ankle ligament injury rates. Caution needs to be used when adding elements to training programmes with the aim of reducing injury, as fatigue associated with the addition may actually raise injury risk.

Effects of a progressive resistance exercise program with high-speed component on the physical function of older women with sarcopenic obesity: a randomized controlled trial

PubMed Central

Vasconcelos, Karina S. S.; Dias, João M. D.; Araújo, Marília C.; Pinheiro, Ana C.; Moreira, Bruno S.; Dias, Rosângela C.

2016-01-01

ABSTRACT Background Sarcopenic obesity is associated with disability in older people, especially in women. Resistance exercises are recommended for this population, but their efficacy is not clear. Objective To evaluate the effects of a progressive resistance exercise program with high-speed component on the physical function of older women with sarcopenic obesity. Method Twenty-eight women 65 to 80 years old, with a body mass index ≥30kg/m2 and handgrip strength ≤21kg were randomly allocated to two groups. The experimental group underwent a 10-week resistance exercise program designed to improve strength, power, and endurance of lower-limb muscles, with open chain and closed chain exercises. The control group had their health status monitored through telephone calls. The primary outcomes were lower limb muscle performance measured by knee extensor strength, power and fatigue by isokinetic dynamometry, and mobility measured by the Short Physical Performance Battery and by gait velocity. The secondary outcome was health-related quality of life assessed by the SF-36 Questionnaire. Results The average rate of adherence was 85%, with few mild adverse effects. There were no significant between-group differences for any of the outcomes. Conclusion In this study, a progressive resistance exercise program with high-speed component was not effective for improving the physical function of older women with sarcopenic obesity. PMID:27410162

Divergent systemic and local inflammatory response to hind limb demand ischemia in wild-type and ApoE-/- mice.

PubMed

Crawford, Robert S; Albadawi, Hassan; Robaldo, Alessandro; Peck, Michael A; Abularrage, Christopher J; Yoo, Hyung-Jin; Lamuraglia, Glenn M; Watkins, Michael T

2013-08-01

We designed studies to determine whether the ApoE-/- phenotype modulates the local skeletal muscle and systemic inflammatory (plasma) responses to lower extremity demand ischemia. The ApoE-/- phenotype is an experimental model for atherosclerosis in humans. Aged female ApoE-/- and C57BL6 mice underwent femoral artery ligation, then were divided into sedentary and demand ischemia (exercise) groups on day 14. We assessed baseline and postexercise limb perfusion and hind limb function. On day 14, animals in the demand ischemia group underwent daily treadmill exercise through day 28. Sedentary mice were not exercised. On day 28, we harvested plasma and skeletal muscle from ischemic limbs from sedentary and exercised mice. We assayed muscle for angiogenic and proinflammatory proteins, markers of skeletal muscle regeneration, and evidence of skeletal muscle fiber maturation. Hind limb ischemia was similar in ApoE-/- and C57 mice before the onset of exercise. Under sedentary conditions, plasma vascular endothelial cell growth factor and interleukin-6, but not keratinocyte chemoattractant factor (KC) or macrophage inflammatory protein-2 (MIP-2), were higher in ApoE (P < 0.0001). After exercise, plasma levels of vascular endothelial cell growth factor, KC, and MIP-2, but not IL-6, were lower in ApoE (P < 0.004). The cytokines KC and MIP-2 in muscle were greater in exercised ApoE-/- mice compared with C57BL6 mice (P = 0.01). Increased poly-ADP-ribose activity and mature muscle regeneration were associated with demand ischemia in the C57BL6 mice, compared with the ApoE-/- mice (P = 0.01). Demand limb ischemia in the ApoE-/- phenotype exacerbated the expression of select systemic cytokines in plasma and blunted indices of muscle regeneration. Copyright © 2013 Elsevier Inc. All rights reserved.

The Effect of Aerobic Exercise on Neuroplasticity within the Motor Cortex following Stroke

PubMed Central

Murdoch, Kate; Buckley, Jonathan D.; McDonnell, Michelle N.

2016-01-01

Background Aerobic exercise is associated with enhanced plasticity in the motor cortex of healthy individuals, but the effect of aerobic exercise on neuroplasticity following a stroke is unknown. Objective The aim of this study was to compare corticomotoneuronal excitability and neuroplasticity in the upper limb cortical representation following a single session of low intensity lower limb cycling, or a rest control condition. Methods We recruited chronic stroke survivors to take part in three experimental conditions in a randomised, cross-over design. Corticomotoneuronal excitability was examined using transcranial magnetic stimulation to elicit motor evoked potentials in the affected first dorsal interosseus muscle. Following baseline measures, participants either cycled on a stationary bike at a low exercise intensity for 30 minutes, or remained resting in a seated position for 30 minutes. Neuroplasticity within the motor cortex was then examined using an intermittent theta burst stimulation (iTBS) paradigm. During the third experimental condition, participants cycled for the 30 minutes but did not receive any iTBS. Results Twelve participants completed the study. We found no significant effect of aerobic exercise on corticomotoneuronal excitability when compared to the no exercise condition (P > 0.05 for all group and time comparisons). The use of iTBS did not induce a neuroplastic-like response in the motor cortex with or without the addition of aerobic exercise. Conclusions Our results suggest that following a stroke, the brain may be less responsive to non-invasive brain stimulation paradigms that aim to induce short-term reorganisation, and aerobic exercise was unable to induce or improve this response. PMID:27018862

Learning about Vertebrate Limb Development

ERIC Educational Resources Information Center

Liang, Jennifer O.; Noll, Matthew; Olsen, Shayna

2014-01-01

We have developed an upper-level undergraduate laboratory exercise that enables students to replicate a key experiment in developmental biology. In this exercise, students have the opportunity to observe live chick embryos and stain the apical ectodermal ridge, a key tissue required for development of the vertebrate limb. Impressively, every…

Patient-directed therapy during in-patient stroke rehabilitation: stroke survivors' views of feasibility and acceptability.

PubMed

Horne, Maria; Thomas, Nessa; McCabe, Candy; Selles, Rudd; Vail, Andy; Tyrrell, Pippa; Tyson, Sarah

2015-01-01

Patient-led therapy, in which patients work outside therapy sessions without direct supervision, is a possible way to increase the amount of therapy stroke patients' receive without increasing staff demands. Here, we report patients' views of patient-led mirror therapy and lower limb exercises. 94 stroke survivors with upper and lower limb limitations at least 1-week post-stroke undertook 4 weeks of daily patient-led mirror therapy or lower limb exercise, then completed questionnaires regarding their experience and satisfaction. A convenience random sample of 20 participants also completed a semi-structured telephone interview to consider their experience in more detail and to capture their longer term impressions. Participants were generally positive about patient-led therapy. About 71% found it useful; 68% enjoyed it; 59% felt it "worked" and 88% would recommend it to other patients. Exercise was viewed more positively than the mirror therapy. Difficulties included arranging the equipment and their position, particularly for more severe strokes, loss of motivation and concerns about working unsupervised. Patient-led mirror therapy and lower limb exercises during in-patient rehabilitation is generally feasible and acceptable to patients but "light touch" supervision to deal with any problems, and strategies to maintain focus and motivation are needed. Implications for Rehabilitation Most stroke patients receive insufficient therapy to maximize recovery during rehabilitation. As increases in staffing are unlikely there is an imperative to find ways for patients to increase the amount of exercise and practice of functional tasks they undertake without increasing demands on staff. Patient-led therapy (also known as patient-directed therapy or independent practice), in which patients undertake exercises or functional tasks practice prescribed by a professional outside formal therapy sessions is one way of achieving this. It is widely used in community-based rehabilitation but is uncommon in hospital-based stroke care. We explored the feasibility and acceptability of two types of patient-led therapy during hospital-based stroke care; mirror therapy for the upper limb and exercises (without a mirror) for the lower limb. Here, we report patients' experiences of undertaking patient-led therapy. Patient-led mirror therapy and lower limb exercises during in-patient stroke rehabilitation is generally feasible and acceptable to patients but "light touch" supervision to deal with any problems, and strategies to maintain focus and motivation are needed.

Pathogenesis of the limb manifestations and exercise limitations in peripheral artery disease.

PubMed

Hiatt, William R; Armstrong, Ehrin J; Larson, Christopher J; Brass, Eric P

2015-04-24

Patients with peripheral artery disease have a marked reduction in exercise performance and daily ambulatory activity irrespective of their limb symptoms of classic or atypical claudication. This review will evaluate the multiple pathophysiologic mechanisms underlying the exercise impairment in peripheral artery disease based on an evaluation of the current literature and research performed by the authors. Peripheral artery disease results in atherosclerotic obstructions in the major conduit arteries supplying the lower extremities. This arterial disease process impairs the supply of oxygen and metabolic substrates needed to match the metabolic demand generated by active skeletal muscle during walking exercise. However, the hemodynamic impairment associated with the occlusive disease process does not fully account for the reduced exercise impairment, indicating that additional pathophysiologic mechanisms contribute to the limb manifestations. These mechanisms include a cascade of pathophysiological responses during exercise-induced ischemia and reperfusion at rest that are associated with endothelial dysfunction, oxidant stress, inflammation, and muscle metabolic abnormalities that provide opportunities for targeted therapeutic interventions to address the complex pathophysiology of the exercise impairment in peripheral artery disease. © 2015 American Heart Association, Inc.

Effects of intensive repetition of a new facilitation technique on motor functional recovery of the hemiplegic upper limb and hand

PubMed Central

Kawahira, Kazumi; Shimodozono, Megumi; Etoh, Seiji; Kamada, Katsuya; Noma, Tomokazu; Tanaka, Nobuyuki

2010-01-01

Objective To study the effects on the hemiplegic upper limb of repetitive facilitation exercises (RFEs) using a novel facilitation technique, in which the patient's intention to move the hemiplegic upper limb or finger was followed by realization of the movement using multiple sensory stimulations. Methods Twenty-three stroke patients were enrolled in a cross-over study in which 2-week RFE sessions (100 repetitions each of five-to-eight types of facilitation exercise per day) were alternated with 2-week conventional rehabilitation (CR) sessions, for a total of four sessions. Treatments were begun with the 2-week RFE session in one group and the 2-week CR session in the second group. Results After the first 2-week RFE session, both groups showed improvements in the Brunnstrom stages of the upper limb and the hand, in contrast to the small improvements observed during the first CR session. The Simple Test for Evaluating Hand Function (STEF) score, which evaluates the ability of manipulating objects, in both groups improved during both sessions. After the second 2-week RFE and CR sessions, both groups showed little further improvement except in the STEF score. Conclusion The novel RFEs promoted the functional recovery of the hemiplegic upper limb and hand to a greater extent than the CR sessions. PMID:20715890

Gait changes after using a temporomandibular joint exerciser in patients who underwent lower limb joint surgery

PubMed Central

Chung, Gu-Young; Choi, Geun-Seok; Shin, Ki-Young; Park, Joon-Soo

2016-01-01

[Purpose] The improvements in gait of the patients with lower limb disease who used a temporomandibular joint (TMJ) exerciser were verified. [Subjects and Methods] Eleven subjects were included. Their mean age was 53.2 years. The lower limb joint angles before and after using the TMJ exerciser were measured using a gait analyzer. Before the gait experiment, the TMJ exerciser setting process and one-leg stance balance test (OLST) were repeated until the balance maintenance time improved. [Results] Because of the OLST, the mean change in the body center point after the subjects used the exerciser improved from 5.76 mm to 4.20 mm. When the TMJ exerciser was used, the joint angle range of the subjects approached that of the normal individuals. [Conclusion] According to the gait experiments, the angles of the subjects’ hips, knees, and ankle joints approached to those of the normal individuals after the subjects used the TMJ exerciser; however, the results did not completely match. The changes in the hip, knee, and ankle joint angles were statistically significant, which confirm the usefulness of the TMJ exerciser. PMID:27313377

AExaCTT - Aerobic Exercise and Consecutive Task-specific Training for the upper limb after stroke: Protocol for a randomised controlled pilot study.

PubMed

Valkenborghs, Sarah R; Visser, Milanka M; Dunn, Ashlee; Erickson, Kirk I; Nilsson, Michael; Callister, Robin; van Vliet, Paulette

2017-09-01

Motor function may be enhanced if aerobic exercise is paired with motor training. One potential mechanism is that aerobic exercise increases levels of brain-derived neurotrophic factor (BDNF), which is important in neuroplasticity and involved in motor learning and motor memory consolidation. This study will examine the feasibility of a parallel-group assessor-blinded randomised controlled trial investigating whether task-specific training preceded by aerobic exercise improves upper limb function more than task-specific training alone, and determine the effect size of changes in primary outcome measures. People with upper limb motor dysfunction after stroke will be allocated to either task-specific training or aerobic exercise and consecutive task-specific training. Both groups will perform 60 hours of task-specific training over 10 weeks, comprised of 3 × 1 hour sessions per week with a therapist and 3 × 1 hours of home-based self-practice per week. The combined intervention group will also perform 30 minutes of aerobic exercise (70-85%HR max ) immediately prior to the 1 hour of task-specific training with the therapist. Recruitment, adherence, retention, participant acceptability, and adverse events will be recorded. Clinical outcome measures will be performed pre-randomisation at baseline, at completion of the training program, and at 1 and 6 months follow-up. Primary clinical outcome measures will be the Action Research Arm Test (ARAT) and the Wolf Motor Function Test (WMFT). If aerobic exercise prior to task-specific training is acceptable, and a future phase 3 randomised controlled trial seems feasible, it should be pursued to determine the efficacy of this combined intervention for people after stroke.

Physical activity alters limb bone structure but not entheseal morphology.

PubMed

Wallace, Ian J; Winchester, Julia M; Su, Anne; Boyer, Doug M; Konow, Nicolai

2017-06-01

Studies of ancient human skeletal remains frequently proceed from the assumption that individuals with robust limb bones and/or rugose, hypertrophic entheses can be inferred to have been highly physically active during life. Here, we experimentally test this assumption by measuring the effects of exercise on limb bone structure and entheseal morphology in turkeys. Growing females were either treated with a treadmill-running regimen for 10 weeks or served as controls. After the experiment, femoral cortical and trabecular bone structure were quantified with μCT in the mid-diaphysis and distal epiphysis, respectively, and entheseal morphology was quantified in the lateral epicondyle. The results indicate that elevated levels of physical activity affect limb bone structure but not entheseal morphology. Specifically, animals subjected to exercise displayed enhanced diaphyseal and trabecular bone architecture relative to controls, but no significant difference was detected between experimental groups in entheseal surface topography. These findings suggest that diaphyseal and trabecular structure are more reliable proxies than entheseal morphology for inferring ancient human physical activity levels from skeletal remains. Copyright © 2017 Elsevier Ltd. All rights reserved.

Comparison of lower limb muscle activation with ballet movements (releve and demi-plie) and general movements (heel rise and squat) in healthy adults.

PubMed

Kim, Min-Ju; Kim, Joong-Hwi

2016-01-01

[Purpose] The aim of this study was to demonstrate therapeutic grounds for rehabilitation exercise approach by comparing and analyzing muscular activities of Ballet movements: the releve movement (RM) and the demi-plie movement (DM). [Methods] Four types of movements such as RM vs. heel rise (HM) and DM vs. squat movement (SM) were randomized and applied in 30 healthy male and female individuals while measuring 10-s lower limb muscular activities (gluteus maximus [GMa], gluteus medius [GMe], rectus femoris [RF], adductor longus [AL], medial gastrocnemius [MG], and lateral gastrocnemius [LG]) by using surface electromyography (EMG). [Results] Significant differences were found in GMa, GMe, AL and MG activities for DM and in all of the six muscles for RM, in particular when the two groups were compared (RM vs HM and DM vs SM). [Conclusion] The RM and DM have a greater effect on lower limb muscular force activities compared to HM and SM and could be recommended as clinical therapeutic exercises for lower limb muscle enhancement.

Comparison of lower limb muscle activation with ballet movements (releve and demi-plie) and general movements (heel rise and squat) in healthy adults

PubMed Central

Kim, Min-Ju; Kim, Joong-Hwi

2016-01-01

[Purpose] The aim of this study was to demonstrate therapeutic grounds for rehabilitation exercise approach by comparing and analyzing muscular activities of Ballet movements: the releve movement (RM) and the demi-plie movement (DM). [Methods] Four types of movements such as RM vs. heel rise (HM) and DM vs. squat movement (SM) were randomized and applied in 30 healthy male and female individuals while measuring 10-s lower limb muscular activities (gluteus maximus [GMa], gluteus medius [GMe], rectus femoris [RF], adductor longus [AL], medial gastrocnemius [MG], and lateral gastrocnemius [LG]) by using surface electromyography (EMG). [Results] Significant differences were found in GMa, GMe, AL and MG activities for DM and in all of the six muscles for RM, in particular when the two groups were compared (RM vs HM and DM vs SM). [Conclusion] The RM and DM have a greater effect on lower limb muscular force activities compared to HM and SM and could be recommended as clinical therapeutic exercises for lower limb muscle enhancement. PMID:26957762

[Cardiovascular resistance to orthostatic stress in athletes after aerobic exercise].

PubMed

Mel'nikov, A A; Popov, S G; Vikulov, A D

2014-01-01

In the paper cardiovascular resistance to orthostatic stress in the athletes in the two-hour recovery period after prolonged aerobic exercise was investigated. The reaction of the cardiac (stroke volume and cardiac output) and peripheral blood volumes in the lower and upper limbs, abdominal and neck regions in response to the tilt-test before and during two hours after exercise (30 min, heart rate = 156 +/- 8 beats/min) was determined by impedance method: It is found that: (1) at baseline distribution of blood flow in favor of the neck-region in response to the tilt-test, in spite of the decrease in cardiac output, was more efficient in athletes, that was due to a large decrease in blood flow to the lower extremities, and increased blood flow in the neck region; (2) after exercise it was established symptoms of potential orthostatic intolerance: postural hypotension and tachycardia, reduced peripheral pulse blood volume, expressed in a standing position, and reduced effectiveness of the distribution of blood flow in the direction of the neck region; (3) the abilityto effectively distribute blood flow in favor of the neck region in athletes after exercise remained elevated, which was due to a large decrease in blood flow in the abdominal region at the beginning, and in the lower limbs at the end of the recovery period.

Protocol for evaluating the effects of a therapeutic foot exercise program on injury incidence, foot functionality and biomechanics in long-distance runners: a randomized controlled trial.

PubMed

Matias, Alessandra B; Taddei, Ulisses T; Duarte, Marcos; Sacco, Isabel C N

2016-04-14

Overall performance, particularly in a very popular sports activity such as running, is typically influenced by the status of the musculoskeletal system and the level of training and conditioning of the biological structures. Any change in the musculoskeletal system's biomechanics, especially in the feet and ankles, will strongly influence the biomechanics of runners, possibly predisposing them to injuries. A thorough understanding of the effects of a therapeutic approach focused on feet biomechanics, on strength and functionality of lower limb muscles will contribute to the adoption of more effective therapeutic and preventive strategies for runners. A randomized, prospective controlled and parallel trial with blind assessment is designed to study the effects of a "ground-up" therapeutic approach focused on the foot-ankle complex as it relates to the incidence of running-related injuries in the lower limbs. One hundred and eleven (111) healthy long-distance runners will be randomly assigned to either a control (CG) or intervention (IG) group. IG runners will participate in a therapeutic exercise protocol for the foot-ankle for 8 weeks, with 1 directly supervised session and 3 remotely supervised sessions per week. After the 8-week period, IG runners will keep exercising for the remaining 10 months of the study, supervised only by web-enabled software three times a week. At baseline, 2 months, 4 months and 12 months, all runners will be assessed for running-related injuries (primary outcome), time for the occurrence of the first injury, foot health and functionality, muscle trophism, intrinsic foot muscle strength, dynamic foot arch strain and lower-limb biomechanics during walking and running (secondary outcomes). This is the first randomized clinical trial protocol to assess the effect of an exercise protocol that was designed specifically for the foot-and-ankle complex on running-related injuries to the lower limbs of long-distance runners. We intend to show that the proposed protocol is an innovative and effective approach to decreasing the incidence of injuries. We also expect a lengthening in the time of occurrence of the first injury, an improvement in foot function, an increase in foot muscle mass and strength and beneficial biomechanical changes while running and walking after a year of exercising. Clinicaltrials.gov Identifier NCT02306148 (November 28, 2014) under the name "Effects of Foot Strengthening on the Prevalence of Injuries in Long Distance Runners". Committee of Ethics in Research of the School of Medicine of the University of Sao Paulo (18/03/2015, Protocol # 031/15).

The effects of prism glasses and intensive upper limb exercise on hemineglect, upper limb function, and activities of daily living in stroke patients: a case series.

PubMed

Oh, Se-Il; Kim, Jin-Kyung; Park, So-Yeon

2015-12-01

[Purpose] This study aimed to examine the effects of visual field with prism glasses, and intensive upper limb functional training on reduction of hemineglect and improvement in upper limb function and activities of daily living in three stroke patients with hemineglect. [Subjects] This study included three stroke patients hospitalized in a sanatorium. [Methods] Intervention treatment involving prism glass use for 12 hours and 30 minutes and paretic side upper limb training was conducted 5 days a week for 15 weeks. Three upper limb training tasks (hitting a balloon, passing through a ring, and reading a newspaper) were performed for 10 minutes each session, for a total of 30 minutes. Line by Section, Motor-Free Visual Perception Test-3 (MVPT-3), Manual Function Test (MFT), Box & Block Test (BBT), and Assessment of Motor and Process Skills (AMPS) were conducted before and after intervention. [Results] Subjects' hemineglect decreased and upper limb function on the paretic side improved after intervention, which enhanced activities of daily living. [Conclusion] Prism glass use and paretic upper limb functional training effectively ameliorated stroke patients' hemineglect and improved upper limb function. Future research should focus on prism glasses that provide a wide visual field for use in patients with different conditions.

Home exercise programmes supported by video and automated reminders compared with standard paper-based home exercise programmes in patients with stroke: a randomized controlled trial.

PubMed

Emmerson, Kellie B; Harding, Katherine E; Taylor, Nicholas F

2017-08-01

To determine whether patients with stroke receiving rehabilitation for upper limb deficits using smart technology (video and reminder functions) demonstrate greater adherence to prescribed home exercise programmes and better functional outcomes when compared with traditional paper-based exercise prescription. Randomized controlled trial comparing upper limb home exercise programmes supported by video and automated reminders on smart technology, with standard paper-based home exercise programmes. A community rehabilitation programme within a large metropolitan health service. Patients with stroke with upper limb deficits, referred for outpatient rehabilitation. Participants were randomly assigned to the control (paper-based home exercise programme) or intervention group (home exercise programme filmed on an electronic tablet, with an automated reminder). Both groups completed their prescribed home exercise programme for four weeks. The primary outcome was adherence using a self-reported log book. Secondary outcomes were change in upper limb function and patient satisfaction. A total of 62 participants were allocated to the intervention ( n = 30) and control groups ( n = 32). There were no differences between the groups for measures of adherence (mean difference 2%, 95% CI -12 to 17) or change in the Wolf Motor Function Test log transformed time (mean difference 0.02 seconds, 95% CI -0.1 to 0.1). There were no between-group differences in how participants found instructions ( p = 0.452), whether they remembered to do their exercises ( p = 0.485), or whether they enjoyed doing their exercises ( p = 0.864). The use of smart technology was not superior to standard paper-based home exercise programmes for patients recovering from stroke. This trial design was registered prospectively with the Australian and New Zealand Clinical Trials Register, ID: ACTRN 12613000786796. http://www.anzctr.org.au/trialSearch.aspx.

The limb movement analysis of rehabilitation exercises using wearable inertial sensors.

PubMed

Bingquan Huang; Giggins, Oonagh; Kechadi, Tahar; Caulfield, Brian

2016-08-01

Due to no supervision of a therapist in home based exercise programs, inertial sensor based feedback systems which can accurately assess movement repetitions are urgently required. The synchronicity and the degrees of freedom both show that one movement might resemble another movement signal which is mixed in with another not precisely defined movement. Therefore, the data and feature selections are important for movement analysis. This paper explores the data and feature selection for the limb movement analysis of rehabilitation exercises. The results highlight that the classification accuracy is very sensitive to the mount location of the sensors. The results show that the use of 2 or 3 sensor units, the combination of acceleration and gyroscope data, and the feature sets combined by the statistical feature set with another type of feature, can significantly improve the classification accuracy rates. The results illustrate that acceleration data is more effective than gyroscope data for most of the movement analysis.

Self-Managed Exercises, Fitness and Strength Training, and Multifidus Muscle Size in Elite Footballers.

PubMed

Hides, Julie A; Walsh, Jazmin C; Smith, Melinda M Franettovich; Mendis, M Dilani

2017-07-01

  Low back pain (LBP) and lower limb injuries are common among Australian Football League (AFL) players. Smaller size of 1 key trunk muscle, the lumbar multifidus (MF), has been associated with LBP and injuries in footballers. The size of the MF muscle has been shown to be modifiable with supervised motor-control training programs. Among AFL players, supervised motor-control training has also been shown to reduce the incidence of lower limb injuries and was associated with increased player availability for games. However, the effectiveness of a self-managed MF exercise program is unknown.   To investigate the effect of self-managed exercises and fitness and strength training on MF muscle size in AFL players with or without current LBP.   Cross-sectional study.   Professional AFL context.   Complete data were available for 242 players from 6 elite AFL clubs.   Information related to the presence of LBP and history of injury was collected at the start of the preseason. At the end of the preseason, data were collected regarding performance of MF exercises as well as fitness and strength training. Ultrasound imaging of the MF muscle was conducted at the start and end of the preseason.   Size of the MF muscles.   An interaction effect was found between performance of MF exercises and time (F = 13.89, P ≤ .001). Retention of MF muscle size was greatest in players who practiced the MF exercises during the preseason (F = 4.77, P = .03). Increased adherence to fitness and strength training was associated with retained MF muscle size over the preseason (F = 5.35, P = .02).   Increased adherence to a self-administered MF exercise program and to fitness and strength training was effective in maintaining the size of the MF muscle in the preseason.

Optimum frequency of exercise for bone health: randomised controlled trial of a high-impact unilateral intervention.

PubMed

Bailey, Christine A; Brooke-Wavell, Katherine

2010-04-01

Exercise can increase bone strength, but to be effective in reducing fracture risk, exercise must be feasible enough to be adopted into daily life and influence potentially vulnerable skeletal sites such as the superolateral cortex of the femoral neck, where thinning is associated with increased fracture risk. Brief, high-impact exercise increases femoral neck bone density but the optimal frequency of such exercise and the location of bone accrual is unknown. This study thus examined (1) the effectiveness of different weekly frequencies of exercise on femoral neck BMD and (2) whether BMD change differed between hip sites using a high-impact, unilateral intervention. Healthy premenopausal women were randomly assigned to exercise 0, 2, 4, or 7 days/week for 6 months. The exercise intervention incorporated 50 multidirectional hops on one randomly selected leg. BMD was measured by DXA at baseline and after 6 months of exercise. Changes in the exercise leg were compared between groups using ANCOVA, with change in the control leg and baseline BMD as covariates. RM-MANOVA was conducted to determine whether bone changes from exercise differed between hip sites. 61 women (age 33.6+/-11.1 years) completed the intervention. Compliance amongst exercisers was 86.7+/-10.6%. Peak ground reaction forces during exercise increased from 2.5 to 2.8 times body weight. The change in femoral neck BMD in the exercise limb (adjusted for change in the control limb and baseline BMD) differed between groups (p=0.015), being -0.3% (-1.2 to 0.6), 0.0% (-1.0 to 1.0), 0.9% (-0.1 to 2.0) and 1.8% (0.8 to 2.8) in those exercising 0, 2, 4 and 7 days per week, respectively. When BMD changes at upper neck, lower neck and trochanter were compared using RM-MANOVA, a significant exercise effect was observed (p=0.048), but this did not differ significantly between sites (p=0.439) despite greatest mean increases at the upper femoral neck. Brief, daily hopping exercises increased femoral neck BMD in premenopausal women but less frequent exercise was not effective. Brief high-impact exercise may have a role in reducing hip fragility, but may need to be performed frequently for optimal response. Copyright 2009 Elsevier Inc. All rights reserved.

Workplace-Based Rehabilitation of Upper Limb Conditions: A Systematic Review.

PubMed

Hoosain, Munira; de Klerk, Susan; Burger, Marlette

2018-05-23

Purpose The objective of this systematic review was to identify, collate and analyse the current available evidence on the effectiveness of workplace-based rehabilitative interventions in workers with upper limb conditions on work performance, pain, absenteeism, productivity and other outcomes. Methods We searched Medline, Cochrane Library, Scopus, Web of Science, Academic Search Premier, Africa-Wide Information, CINAHL, OTSeeker and PEDro with search terms in four broad areas: upper limb, intervention, workplace and clinical trial (no date limits). Studies including neck pain only or musculoskeletal pain in other areas were not included. Results Initial search located 1071 articles, of which 80 were full text reviewed. Twenty-eight articles were included, reporting on various outcomes relating to a total of seventeen studies. Nine studies were of high methodological quality, seven of medium quality, and one of low quality. Studies were sorted into intervention categories: Ergonomic controls (n = 3), ergonomic training and workstation adjustments (n = 4), exercise and resistance training (n = 6), clinic-based versus workplace-based work hardening (n = 1), nurse case manager training (n = 1), physiotherapy versus Feldenkrais (n = 1), and ambulant myofeedback training (n = 1). The largest body of evidence supported workplace exercise programs, with positive effects for ergonomic training and workstation adjustments, and mixed effects for ergonomic controls. Ambulant myofeedback training had no effect. The remaining three categories had positive effects in the single study on each intervention. Conclusion While there is substantial evidence for workplace exercise programs, other workplace-based interventions require further high quality research. Systematic review registration PROSPERO CRD42017059708.

Limb symmetry during double-leg squats and single-leg squats on land and in water in adults with long-standing unilateral anterior knee pain; a cross sectional study.

PubMed

Severin, Anna C; Burkett, Brendan J; McKean, Mark R; Wiegand, Aaron N; Sayers, Mark G L

2017-01-01

The presence of pain during movement typically results in changes in technique. However, the physical properties of water, such as flotation, means that water-based exercise may not only reduce compensatory movement patterns but also allow pain sufferers to complete exercises that they are unable to perform on land. The purpose of this study was to assess bilateral kinematics during double-leg squats and single-leg squats on land and in water in individuals with unilateral anterior knee pain. A secondary aim was to quantify bilateral asymmetry in both environments in affected and unaffected individuals using a symmetry index. Twenty individuals with unilateral knee pain and twenty healthy, matched controls performed body weight double- and single-leg squats in both environments while inertial sensors (100 Hz) recorded trunk and lower body kinematics. Repeated-measures statistics tested for environmental effects on movement depths and peak angles within the anterior knee pain group. Differences in their inter-limb symmetry in each environments was compared to the control group using analysis of variance tests. Water immersion allowed for greater movement depths during both exercises (double-leg squat: +7 cm, p  = 0.032, single-leg squat: +9 cm, p  = 0.002) for the knee pain group. The double-leg squat was symmetrical on land but water immersion revealed asymmetries in the lower body frontal plane movements. The single-leg squat revealed decreased hip flexion and frontal plane shank motions on the affected limb in both environments. Water immersion also affected the degree of lower limb asymmetry in both groups, with differences also showing between groups. Individuals with anterior knee pain achieved increased squat depth during both exercises whilst in water. Kinematic differences between the affected and unaffected limbs were often increased in water. Individuals with unilateral anterior knee pain appear to utilise different kinematics in the affected and unaffected limb in both environments.

Exercise intensity and muscle hypertrophy in blood flow-restricted limbs and non-restricted muscles: a brief review.

PubMed

Abe, Takashi; Loenneke, Jeremy P; Fahs, Christopher A; Rossow, Lindy M; Thiebaud, Robert S; Bemben, Michael G

2012-07-01

Although evidence for high-intensity resistance training-induced muscle hypertrophy has accumulated over the last several decades, the basic concept of the training can be traced back to ancient Greece: Milo of Croton lifted a bull-calf daily until it was fully grown, which would be known today as progressive overload. Now, in the 21st century, different types of training are being tested and studied, such as low-intensity exercise combined with arterial as well as venous blood flow restriction (BFR) to/from the working muscles. Because BFR training requires the use of a cuff that is placed at the proximal ends of the arms and/or legs, the BFR is only applicable to limb muscles. Consequently, most previous BFR training studies have focused on the physiological adaptations of BFR limb muscles. Muscle adaptations in non-BFR muscles of the hip and trunk are lesser known. Recent studies that have reported both limb and trunk muscle adaptations following BFR exercise training suggest that low-intensity (20-30% of 1RM) resistance training combined with BFR elicits muscle hypertrophy in both BFR limb and non-BFR muscles. However, the combination of leg muscle BFR with walk training elicits muscle hypertrophy only in the BFR leg muscles. In contrast to resistance exercise with BFR, the exercise intensity may be too low during BFR walk training to cause muscle hypertrophy in the non-BFR gluteus maximus and other trunk muscles. Other mechanisms including hypoxia, local and systemic growth factors and muscle cell swelling may also potentially affect the hypertrophic response of non-BFR muscles to BFR resistance exercise. © 2012 The Authors Clinical Physiology and Functional Imaging © 2012 Scandinavian Society of Clinical Physiology and Nuclear Medicine.

Revascularization and Muscle Adaptation to Limb Demand Ischemia in Diet Induced Obese Mice

PubMed Central

Albadawi, Hassan; Tzika, Aria; Rask-Madsen, Christian; Crowley, Lindsey M.; Koulopoulos, Michael W.; Yoo, Hyung-Jin; Watkins, Michael T.

2016-01-01

Background Obesity and type 2 diabetes are major risk factors for peripheral arterial disease (PAD) in humans which can result in lower limb demand ischemia and exercise intolerance. Exercise triggers skeletal muscle adaptation including increased vasculogenesis. The goal of this study was to determine whether demand ischemia modulates revascularization, fiber size, and signaling pathways in the ischemic hind limb muscles of mice with diet-induced obesity (DIO). Materials and Methods DIO mice (n=7) underwent unilateral femoral artery ligation (FAL) and recovered for 2-weeks followed by 4-weeks with daily treadmill exercise to induce demand ischemia. A parallel sedentary ischemia group (n=7) had FAL without exercise. The contralateral limb muscles of sedentary ischemia served as control. Muscles were examined for capillary density, myofiber cross-sectional area (CSA), cytokine levels, and phosphorylation of STAT3 and ERK1/2. Results Exercise significantly enhanced capillary density (p<0.01) and markedly lowered CSA (p<0.001) in demand ischemia compared to sedentary ischemia. These findings coincided with a significant increase in G-CSF (p<0.001) and IL-7 (p<0.01) levels. In addition, phosphorylation of STAT3 and ERK1/2 (p<0.01) were increased while UCP-1 and MCP-1 protein levels were lower (p<0.05) without altering VEGF and TNFα protein levels. Demand ischemia increased the PGC1α mRNA (p<0.001) without augmenting PGC1α protein levels. Conclusions Exercise induced limb demands ischemia in the setting of DIO causes myofiber atrophy despite an increase in muscle capillary density. The combination of persistent increase in TNFα, lower VEGF and failure to increase PGC1α protein may reflect a deficient adaption to demand ischemia in DIO. PMID:27620999

Bridging the gap between content and context: establishing expert consensus on the content of an exercise training program to prevent lower-limb injuries.

PubMed

Donaldson, Alex; Cook, Jill; Gabbe, Belinda; Lloyd, David G; Young, Warren; Finch, Caroline F

2015-05-01

To achieve expert consensus on the content of an exercise training program (known as FootyFirst) to prevent lower-limb injuries. Three-round online Delphi consultation process. Community Australian Football (AF). Members of the Australian Football Leagues' Medical Officers (n = 94), physiotherapists (n = 50), and Sports Science (n = 19) Associations were invited to participate through e-mail. Five people with more general expertise in sports-related lower-limb injury prevention were also invited to participate. The primary outcome measure was the level of agreement on the appropriateness of the proposed exercises and progressions for inclusion in FootyFirst. Consensus was reached when ≥75% of experts who responded to each item agreed and strongly agreed, or disagreed and strongly disagreed, that an exercise or its progressions were appropriate to include in FootyFirst. Fifty-five experts participated in at least 1 Delphi round. In round 1, consensus was achieved that the proposed warm-up (run through and dynamic stretches) and the exercises and progressions for hamstring strength and for balance, landing, and changing direction were appropriate to include in FootyFirst. There was also consensus in round 1 that progressions for hip/core strength should be included in FootyFirst. Consensus was reached in round 2 that the revised groin strength and hip strength exercises should be included in FootyFirst. Consensus was reached for the progression of the groin strength exercises in round 3. The formal consensus development process has resulted in an evidence-informed, researcher-developed, exercise-based sports injury prevention program that is expert endorsed and specific to the context of AF. Lower-limb injuries are common in running, kicking, and contact sports like AF. These injuries are often costly to treat, and many have high rates of recurrence, making them challenging to treat clinically. Reducing these injuries is a high priority for players, teams, and medical staff. Exercise programs provide a method for primary prevention of lower-limb injuries, but they have to be evidence based, have currency with sports practitioners/clinicians, and utility for the context in which they are to be used. However, the comprehensive methods and clinical engagement processes used to develop injury prevention exercise programs have not previously been described in detail. This study describes the results of engaging clinicians and sport scientists in the development of a lower-limb sports injury prevention program for community AF, enabling the development of a program that is both evidence informed and considerate of expert clinical opinion.

Modest Amounts of Voluntary Exercise Reduce Pain- and Stress-Related Outcomes in a Rat Model of Persistent Hind Limb Inflammation.

PubMed

Pitcher, Mark H; Tarum, Farid; Rauf, Imran Z; Low, Lucie A; Bushnell, Catherine

2017-06-01

Aerobic exercise improves outcomes in a variety of chronic health conditions, yet the support for exercise-induced effects on chronic pain in humans is mixed. Although many rodent studies have examined the effects of exercise on persistent hypersensitivity, the most used forced exercise paradigms that are known to be highly stressful. Because stress can also produce analgesic effects, we studied how voluntary exercise, known to reduce stress in healthy subjects, alters hypersensitivity, stress, and swelling in a rat model of persistent hind paw inflammation. Our data indicate that voluntary exercise rapidly and effectively reduces hypersensitivity as well as stress-related outcomes without altering swelling. Moreover, the level of exercise is unrelated to the analgesic and stress-reducing effects, suggesting that even modest amounts of exercise may impart significant benefit in persistent inflammatory pain states. Modest levels of voluntary exercise reduce pain- and stress-related outcomes in a rat model of persistent inflammatory pain, independently of the amount of exercise. As such, consistent, self-regulated activity levels may be more relevant to health improvement in persistent pain states than standardized exercise goals. Published by Elsevier Inc.

Aquatic Therapy Improves Outcomes for Subacute Stroke Patients by Enhancing Muscular Strength of Paretic Lower Limbs Without Increasing Spasticity: A Randomized Controlled Trial.

PubMed

Zhang, Yue; Wang, Yi-Zhao; Huang, Li-Ping; Bai, Bei; Zhou, Shi; Yin, Miao-Miao; Zhao, Hua; Zhou, Xiao-Na; Wang, Hong-Tu

2016-11-01

The aim of this study was to evaluate the effects of an aquatic exercise program designed to enhance muscular strength in paretic lower limbs in subacute stroke patients. Thirty-six subacute stroke patients were randomly divided to a conventional or an aquatic group (n = 18 each). Outcome measures were assessed at baseline and after 8 wks of training. For the paretic lower limbs, maximum isometric voluntary contraction strength of the rectus femoris and biceps femoris caput longus and the tibialis anterior and lateral gastrocnemius was measured. Cocontraction ratios during knee extension and flexion and ankle dorsiflexion and plantarflexion were calculated respectively. In addition, Modified Ashworth Scale, Functional Ambulation Category, and Barthel Index were assessed. Compared with the conventional intervention, the aquatic intervention resulted in significantly higher knee extension (P = 0.002) and ankle plantarflexion torque (P = 0.002), accompanied with a significantly lower knee extension cocontraction ratio in the paretic limb (P = 0.000). Functional Ambulation Category (P = 0.009) and Barthel Index (P = 0.024) were greater in aquatic group than conventional group posttreatment. Modified Ashworth Scale scores did not show any differences between groups. Aquatic exercise enhanced muscle strength in paretic lower limbs and improved muscle cocontraction without increasing spasticity in subacute stroke patients.

[Women boxing athletes' EMG of upper limbs and lumbar muscles in the training of air striking of straight punch].

PubMed

Zhang, Ri-Hui; Kang, Zhi-Xin

2011-05-01

To study training effect of upper limbs and lumbar muscles in the proceed of air striking of straight punch by analyzing boxing athletes' changes of electromyogram (EMG). We measured EMG of ten women boxing athletes' upper arm biceps (contractor muscle), upper arm triceps (antagonistic muscle), forearm flexor muscle (contractor muscle), forearm extensor muscle (antagonistic muscle), and lumbar muscles by ME6000 (Mega Electronics Ltd.). The stipulated exercise was to do air striking of straight punch with loads of 2.5 kg of dumbbell in the hand until exhausted. In the proceed of exercise-induce exhausted, the descend magnitude and speed of median frequency (MF) in upper limb antagonistic muscle exceeded to contracting muscle, moreover, the work percentage showed that contractor have done a larger percentage of work than antagonistic muscle. Compared with world champion's EMG, the majority of ordinary athletes' lumbar muscles MF revealed non-drop tendency, and the work percentage showed that lumbar muscles had a very little percentage of work. After comparing the EMG test index in upper limb and lumbar muscle of average boxing athletes with that of the world champion, we find the testees lack of the training of upper limb antagonistic muscle and lumbar muscle, and more trainings aimed at these muscles need to be taken.

Kinematic analysis of the thoracic limb of healthy dogs during descending stair and ramp exercises.

PubMed

Kopec, Nadia L; Williams, Jane M; Tabor, Gillian F

2018-01-01

OBJECTIVE To compare the kinematics of the thoracic limb of healthy dogs during descent of stairs and a ramp with those during a trot across a flat surface (control). ANIMALS 8 privately owned dogs. PROCEDURES For each dog, the left thoracic limb was instrumented with 5 anatomic markers to facilitate collection of 2-D kinematic data during each of 3 exercises (descending stairs, descending a ramp, and trotting over a flat surface). The stair exercise consisted of 4 steps with a 35° slope. For the ramp exercise, a solid plank was placed over the steps to create a ramp with a 35° slope. For the flat exercise, dogs were trotted across a flat surface for 2 m. Mean peak extension, peak flexion, and range of movement (ROM) of the shoulder, elbow, and carpal joints were compared among the 3 exercises. RESULTS Mean ROM for the shoulder and elbow joints during the stair exercise were significantly greater than during the flat exercise. Mean peak extension of the elbow joint during the flat exercise was significantly greater than that during both the stair and ramp exercises. Mean peak flexion of the elbow joint during the stair exercise was significantly greater than that during the flat exercise. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that descending stairs may be beneficial for increasing the ROM of the shoulder and elbow joints of dogs. Descending stair exercises may increase elbow joint flexion, whereas flat exercises may be better for targeting elbow joint extension.

New perspectives concerning feedback influences on cardiorespiratory control during rhythmic exercise and on exercise performance.

PubMed

Dempsey, Jerome A

2012-09-01

The cardioaccelerator and ventilatory responses to rhythmic exercise in the human are commonly viewed as being mediated predominantly via feedforward 'central command' mechanisms, with contributions from locomotor muscle afferents to the sympathetically mediated pressor response. We have assessed the relative contributions of three types of feedback afferents on the cardiorespiratory response to voluntary, rhythmic exercise by inhibiting their normal 'tonic' activity in healthy animals and humans and in chronic heart failure. Transient inhibition of the carotid chemoreceptors during moderate intensity exercise reduced muscle sympathetic nerve activity (MSNA) and increased limb vascular conductance and blood flow; and reducing the normal level of respiratory muscle work during heavier intensity exercise increased limb vascular conductance and blood flow. These cardiorespiratory effects were prevented via ganglionic blockade and were enhanced in chronic heart failure and in hypoxia. Blockade of μ opioid sensitive locomotor muscle afferents, with preservation of central motor output via intrathecal fentanyl: (a) reduced the mean arterial blood pressure (MAP), heart rate and ventilatory responses to all steady state exercise intensities; and (b) during sustained high intensity exercise, reduced O(2) transport, increased central motor output and end-exercise muscle fatigue and reduced endurance performance. We propose that these three afferent reflexes - probably acting in concert with feedforward central command - contribute significantly to preserving O(2) transport to locomotor and to respiratory muscles during exercise. Locomotor muscle afferents also appear to provide feedback concerning the metabolic state of the muscle to influence central motor output, thereby limiting peripheral fatigue development.

Tai chi chuan exercise for patients with breast cancer: a systematic review and meta-analysis.

PubMed

Pan, Yuanqing; Yang, Kehu; Shi, Xiue; Liang, Haiqian; Zhang, Fengwa; Lv, Qingfang

2015-01-01

Objective. Tai Chi Chuan (TCC) is a form of aerobic exercise that may be an effective therapy for improving psychosomatic capacity among breast cancer survivors. This meta-analysis analyzed the available randomized controlled trials (RCTs) on the effects of TCC in relieving treatment-related side effects and quality of life in women with breast cancer. Methods. RCTs were searched in PubMed, Embase, Web of Science, and Cochrane Library through April 2014. Data were analyzed on pathology (pain, interleukin-6, and insulin-like growth factor 1), physical capacity (handgrip, limb physical fitness, and BMI), and well-being (physical, social, emotional, and general quality of life). Results. Nine RCTs, including a total of 322 breast cancer patients, were examined. Compared with control therapies, the pooled results suggested that TCC showed significant effects in improving handgrip dynamometer strength, limb elbow flexion (elbow extension, abduction, and horizontal adduction). No significant differences were observed in pain, interleukin-6, insulin-like growth factor, BMI, physical well-being, social or emotional well-being, or general health-related quality of life. Conclusion. The short-term effects of TCC may have potential benefits in upper limb functional mobility in patients with breast cancer. Additional randomized controlled trials with longer follow-up are needed to provide more reliable evidence.

Do dominant and non-dominant arms respond similarly to maximal eccentric exercise of the elbow flexors?

PubMed

Newton, Michael J; Sacco, Paul; Chapman, Dale; Nosaka, Kazunori

2013-03-01

Two common models to investigate the effect of interventions on muscle damage include using two groups in which one group receives an intervention while the other acts as control, and using contralateral limbs of one group. The latter model is based on the assumption that changes in markers of muscle damage are similar between limbs, but this has not been examined systematically. This study compared changes in muscle damage markers between dominant and non-dominant arms following maximal eccentric exercise of the elbow flexors. Eighteen men performed 60 maximal eccentric elbow flexions of each arm separated by 4 weeks with the order of testing between arms randomised. Maximal voluntary isometric torque, range of motion, upper arm circumference, plasma creatine kinase (CK) activity and muscle soreness before and for 7 days following exercise were compared between arms using two-way repeated measures ANOVA. No significant differences between arms were evident for any of the markers, but significant (P<0.05) differences between first and second bouts were evident for changes in strength, circumference and CK with smaller changes following the second bout. A poor correlation was found for the magnitude of changes in the markers between dominant and non-dominant arms, suggesting that responses to eccentric exercise were not necessarily the same between arms. These results show that the order affected the responses of dominant and non-dominant arms to the eccentric exercise; however, the contralateral limb design appears to be usable if bout order is counterbalanced and randomised among participants. Copyright © 2012. Published by Elsevier Ltd.

Effects of exercise on functional aerobic capacity in adults with fibromyalgia syndrome: A systematic review of randomized controlled trials.

PubMed

García-Hermoso, Antonio; Saavedra, Jose M; Escalante, Yolanda

2015-01-01

Patients with fibromyalgia present a reduced capacity of upper and lower limb physical performance and affect their independence in performing everyday activities. The purpose of the present systematic review was to summarize evidence for the effectiveness and structure of exercise programs on functional aerobic capacity in patients with fibromyalgia syndrome. Keyword searches were made of seven databases. The systematic review was limited to English language studies of people with FM that evaluated the effects of exercise programs on functional aerobic capacity (6-minute walk test). The criteria for inclusion were satisfied by 12 randomized controlled trial (RCT) studies. The main cumulative evidence indicates that the programs based on aerobic exercise alone and on aquatic exercises have large (effect size = 0.85) and moderate (effect size = 0.44) effects. Aerobic and aquatic exercises at the proper intensity favour the increased functional aerobic capacity of fibromyalgia patients; however, most works do not adequately detail the intensity of the exercises. Moderate intensity exercise (aerobic and aquatic exercise) performed at least two times per week and 30-60 minutes a day is effective for increasing functional aerobic capacity, favouring the daily activities of daily living in this population.

The effect of high intensity exercise and anticipation on trunk and lower limb biomechanics during a crossover cutting manoeuvre.

PubMed

Whyte, Enda F; Richter, Chris; O'connor, Siobhan; Moran, Kieran A

2018-04-01

We investigated the effects of high intensity, intermittent exercise (HIIP) and anticipation on trunk, pelvic and lower limb biomechanics during a crossover cutting manoeuvre. Twenty-eight male, varsity athletes performed crossover cutting manoeuvres in anticipated and unanticipated conditions pre- and post-HIIP. Kinematic and kinetic variables were captured using a motion analysis system. Statistical parametric mapping (repeated-measures ANOVA) was used to identify differences in biomechanical patterns. Results demonstrated that both unanticipation and fatigue (HIIP) altered the biomechanics of the crossover cutting manoeuvre, whereas no interactions effects were observed. Unanticipation resulted in less trunk and pelvic side flexion in the direction of cut (d = 0.70 - 0.79). This led to increased hip abductor and external rotator moments and increased knee extensor and valgus moments with small effects (d = 0.24-0.42), potentially increasing ACL strain. The HIIP resulted in trivial to small effects only with a decrease in internal knee rotator and extensor moment and decreased knee power absorption (d = 0.35), reducing potential ACL strain. The effect of trunk and hip control exercises in unanticipated conditions on the crossover cutting manoeuvre should be investigated with a view to refining ACL injury prevention programmes.

No impaired hemoglobin oxygenation in forearm muscles of patients with chronic CRPS-1.

PubMed

Brunnekreef, Jaap J J; Oosterhof, Jan; Wolff, André P; Crul, Ben J P; Wilder-Smith, Oliver H G; Oostendorp, Rob A B

2009-01-01

Physiotherapy is considered an important treatment option in patients with upper limb complex regional pain syndrome type-1 (CRPS-1). In case of chronic CRPS-1, exercise therapy of the affected limb forms an important part of the physiotherapeutic program. We investigated whether muscle loading in chronic CRPS-1 patients is associated with impairments in muscle circulation of the forearm of the affected limb. Thirty patients with chronic CRPS-1 unilaterally affecting their upper limbs, and 30 age-matched and sex-matched control participants were included in this study. Local muscle blood flow and hemoglobin oxygenation were measured by near infrared spectroscopy within the muscles of the forearm at rest, after 1-minute isometric handgrip exercises, and after arterial occlusion. Main outcome parameters were: local muscle blood flow, O2 consumption (mVO2), and postischemic reoxygenation (ReOx). We found no differences in baseline muscle blood flow, mVO2, and ReOx between the affected CRPS-1, unaffected CRPS-1, and control arms. After exercise, mVO2 of the affected CRPS-1 arms was not different from the clinically unaffected CRPS-1 arms. Furthermore, in comparison with the control arms, unaffected CRPS-1 arms showed no difference in mVO2 or ReOx. Muscle loading does not seems to be related to impairments in muscle oxygen uptake in forearm muscles of upper limbs affected by chronic CRPS-1. Our results suggest that exercise therapy can be safely used in physiotherapeutic training programs for chronic CRPS-1 of the upper limb.

The effects of electrical stimulation and exercise therapy in patients with limb girdle muscular dystrophy

PubMed Central

Kılınç, Muhammed; Yıldırım, Sibel A.; Tan, Ersin

2015-01-01

Objective: To evaluate and compare the effects of exercise therapy and electrical stimulation on muscle strength and functional activities in patients with limb-girdle muscular dystrophy (LGMD). Methods: This controlled clinical trial included 24 subjects who were diagnosed with LGMD by the Neurology Department of the Hacettepe University Hospital, Ankara, Turkey and were referred to the Physical Therapy Department between May 2013 and December 2014. Subjects were enrolled into an electrical stimulation (11 patients) group, or an exercise therapy (13 patients) group. Results: The mean age of patients was 31.62 years in the electrical stimulation group, and 30.14 years in the exercise therapy group. The most important results in this controlled clinical study were that the muscle strength in both groups was significantly decreased and post-treatment evaluation results indicated that muscle strength of the Deltoideus was higher in the electrical stimulation group, and the difference between the groups was maintained in the follow-up period (p<0.05). However, the muscle strength of quadriceps was similar in both groups, according to the post-treatment and follow-up evaluation results (p>0.05). Additionally, the electrical stimulation group presented more obvious overall improvements than the exercise therapy group according to muscle strength, endurance, and timed performance tests. Conclusions: Since no definitive treatments currently exist for patients with LGMD, these results provide important information on the role of exercise therapy and electrical stimulation for clinicians working in rehabilitation. PMID:26166595

Influence of shoes increasing dorsiflexion and decreasing metatarsus flexion on lower limb muscular activity during fitness exercises, walking, and running.

PubMed

Bourgit, David; Millet, Guillaume Y; Fuchslocher, Jörg

2008-05-01

The aim of the present study was to compare electromyographic activity during fitness exercises, walking, and running among 3 different dorsiflexion shoes (+2 degrees , +4 degrees , and +10 degrees ) and standard shoes (-4 degrees ). The 3 different dorsiflexion shoes tested in this study have a curvature placed in the middle of the sole. This design was specially projected to decrease the metatarsus flexion. Electromyographic activity of 9 lower limb muscles was measured on 12 healthy female subjects during 5 fitness exercises (unload squat, side and front step, submaximal ballistic plantar flexion, and lunge exercise), and during running (10 km x h(-1)) and walking (4.5 km x h(-1)) on a treadmill. EMG signal was analyzed with the root mean square (RMS) and integrated EMG. All RMS data measured during these exercises were expressed as percentages of maximum voluntary isometric contraction. The results show that dorsiflexion affects muscle recruitment and reorganizes the motor pattern. The general tendency was that the tibialis anterior activity increased with dorsiflexion. However, an optimal dorsiflexion existed for various exercises. It is concluded that shoes with moderate dorsiflexion can activate lower limb muscles differently compared with both standard shoes and shoes with large dorsiflexion during submaximal exercises and locomotion.

Comparison of reduction of edema after rest and after muscle exercises in treatment of chronic venous insufficiency

PubMed Central

Quilici, Belczak Cleusa Ema; Gildo, Cavalheri; de Godoy, Jose Maria Pereira; Quilici, Belczak Sergio; Augusto, Caffaro Roberto

2009-01-01

Aim The aim of this work was to compare the reduction in edema obtained in the conservative treatment of phlebopathies after resting and after performing a muscle exercise program in the Trendelenburg position. Methods Twenty-eight limbs of 24 patients with venous edema of distinct etiologies and classified as between C3 and C5 using CEAP classification. Volumetric evaluation by water displacement was carried out before and after resting in the Trendelenburg position and after performing programmed muscle exercises 24 hours later under identical conditions of time, position and temperature. For the statistical analysis the paired t-test was used with an alpha error of 5% being considered acceptable. Results The average total volume of the lower limbs was 3,967.46 mL. The mean reduction in edema obtained after resting was 92.9 mL, and after exercises it was 135.4 mL, giving a statistically significant difference (p-value = 0.0007). Conclusion In conclusion, exercises are more efficient to reduce the edema of lower limbs than resting in the Trendelenburg position. PMID:19602249

Cost-effectiveness of postural exercise therapy versus physiotherapy in computer screen-workers with early non-specific work-related upper limb disorders (WRULD); a randomized controlled trial.

PubMed

van Eijsden, Marjon D; Gerhards, Sylvia A; de Bie, Rob A; Severens, Johan L

2009-11-17

Exercise therapies generate substantial costs in computer workers with non-specific work-related upper limb disorders (WRULD). To study if postural exercise therapy is cost-effective compared to regular physiotherapy in screen-workers with early complaints, both from health care and societal perspective. Prospective randomized trial including cost-effectiveness analysis; one year follow-up. Eighty-eight screen-workers with early non-specific WRULD; six drop-outs. A ten week postural exercise program versus regular physiotherapy. Effectiveness measures: Pain: visual analogous scale (VAS), self-perceived WRULD (yes/no). Functional outcome: Disabilities of Arm, Shoulder and Hand- Dutch Language Version (DASH-DLV). Quality of life outcome: EQ-5D.Economic measures: health care costs including patient and family costs and productivity costs resulting in societal costs. Cost-effectiveness measures: health care costs and societal costs related to the effectiveness measures. OUTCOME MEASURES were assessed at baseline; three, six and twelve months after baseline. At baseline both groups were comparable for baseline characteristics except scores on the Pain Catastrophizing Scale and comparable for costs. No significant differences between the groups concerning effectiveness at one year follow-up were found. Effectiveness scores slightly improved over time. After one year 55% of participants were free of complaints. After one year the postural exercise group had higher mean total health care costs, but lower productivity costs compared to the physiotherapy group. Mean societal costs after one year (therefore) were in favor of postural exercise therapy [- euro622; 95% CI -2087; +590)]. After one year, only self- perceived WRULD seemed to result in acceptable cost-effectiveness of the postural exercise strategy over physiotherapy; however the probability of acceptable cost-effectiveness did not exceed 60%.Considering societal costs related to QALYs, postural exercise therapy had a probability of over 80% to be cost-effective over a wide range of cost-effectiveness ceiling ratios; however based on a marginal QALY-difference of 0.1 over a 12 month time frame. Although our trial failed to find significant differences in VAS, QALYs and ICERs based on VAS and QALYs at one-year follow-up, CEACs suggest that postural exercise therapy according to Mensendieck/Cesar has a higher probability of being cost-effective compared to regular physiotherapy; however further research is required. ISRCTN 15872455.

Changes in lower limb muscle function and muscle mass following exercise-based interventions in patients with chronic obstructive pulmonary disease: A review of the English-language literature.

PubMed

De Brandt, Jana; Spruit, Martijn A; Hansen, Dominique; Franssen, Frits Me; Derave, Wim; Sillen, Maurice Jh; Burtin, Chris

2018-05-01

Chronic obstructive pulmonary disease (COPD) patients often experience lower limb muscle dysfunction and wasting. Exercise-based training has potential to improve muscle function and mass, but literature on this topic is extensive and heterogeneous including numerous interventions and outcome measures. This review uses a detailed systematic approach to investigate the effect of this wide range of exercise-based interventions on muscle function and mass. PUBMED and PEDro databases were searched. In all, 70 studies ( n = 2504 COPD patients) that implemented an exercise-based intervention and reported muscle strength, endurance, or mass in clinically stable COPD patients were critically appraised. Aerobic and/or resistance training, high-intensity interval training, electrical or magnetic muscle stimulation, whole-body vibration, and water-based training were investigated. Muscle strength increased in 78%, muscle endurance in 92%, and muscle mass in 88% of the cases where that specific outcome was measured. Despite large heterogeneity in exercise-based interventions and outcome measures used, most exercise-based trials showed improvements in muscle strength, endurance, and mass in COPD patients. Which intervention(s) is (are) best for which subgroup of patients remains currently unknown. Furthermore, this literature review identifies gaps in the current knowledge and generates recommendations for future research to enhance our knowledge on exercise-based interventions in COPD patients.

Changes in lower limb muscle function and muscle mass following exercise-based interventions in patients with chronic obstructive pulmonary disease: A review of the English-language literature

PubMed Central

De Brandt, Jana; Spruit, Martijn A; Hansen, Dominique; Franssen, Frits ME; Derave, Wim; Sillen, Maurice JH; Burtin, Chris

2017-01-01

Chronic obstructive pulmonary disease (COPD) patients often experience lower limb muscle dysfunction and wasting. Exercise-based training has potential to improve muscle function and mass, but literature on this topic is extensive and heterogeneous including numerous interventions and outcome measures. This review uses a detailed systematic approach to investigate the effect of this wide range of exercise-based interventions on muscle function and mass. PUBMED and PEDro databases were searched. In all, 70 studies (n = 2504 COPD patients) that implemented an exercise-based intervention and reported muscle strength, endurance, or mass in clinically stable COPD patients were critically appraised. Aerobic and/or resistance training, high-intensity interval training, electrical or magnetic muscle stimulation, whole-body vibration, and water-based training were investigated. Muscle strength increased in 78%, muscle endurance in 92%, and muscle mass in 88% of the cases where that specific outcome was measured. Despite large heterogeneity in exercise-based interventions and outcome measures used, most exercise-based trials showed improvements in muscle strength, endurance, and mass in COPD patients. Which intervention(s) is (are) best for which subgroup of patients remains currently unknown. Furthermore, this literature review identifies gaps in the current knowledge and generates recommendations for future research to enhance our knowledge on exercise-based interventions in COPD patients. PMID:28580854

Intensity-level assessment of lower body plyometric exercises based on mechanical output of lower limb joints.

PubMed

Sugisaki, Norihide; Okada, Junichi; Kanehisa, Hiroaki

2013-01-01

The present study aimed to quantify the intensity of lower extremity plyometric exercises by determining joint mechanical output. Ten men (age, 27.3 ± 4.1 years; height, 173.6 ± 5.4 cm; weight, 69.4 ± 6.0 kg; 1-repetition maximum [1RM] load in back squat 118.5 ± 12.0 kg) performed the following seven plyometric exercises: two-foot ankle hop, repeated squat jump, double-leg hop, depth jumps from 30 and 60 cm, and single-leg and double-leg tuck jumps. Mechanical output variables (torque, angular impulse, power, and work) at the lower limb joints were determined using inverse-dynamics analysis. For all measured variables, ANOVA revealed significant main effects of exercise type for all joints (P < 0.05) along with significant interactions between joint and exercise (P < 0.01), indicating that the influence of exercise type on mechanical output varied among joints. Paired comparisons revealed that there were marked differences in mechanical output at the ankle and hip joints; most of the variables at the ankle joint were greatest for two-foot ankle hop and tuck jumps, while most hip joint variables were greatest for repeated squat jump or double-leg hop. The present results indicate the necessity for determining mechanical output for each joint when evaluating the intensity of plyometric exercises.

Fatigue-related firing of muscle nociceptors reduces voluntary activation of ipsilateral but not contralateral lower limb muscles.

PubMed

Kennedy, David S; Fitzpatrick, Siobhan C; Gandevia, Simon C; Taylor, Janet L

2015-02-15

During fatiguing upper limb exercise, maintained firing of group III/IV muscle afferents can limit voluntary drive to muscles within the same limb. It is not known if this effect occurs in the lower limb. We investigated the effects of group III/IV muscle afferent firing from fatigued ipsilateral and contralateral extensor muscles and ipsilateral flexor muscles of the knee on voluntary activation of the knee extensors. In three experiments, we examined voluntary activation of the knee extensors by measuring changes in superimposed twitches evoked by femoral nerve stimulation. Subjects attended on 2 days for each experiment. On one day a sphygmomanometer cuff occluded blood flow of the fatigued muscles to maintain firing of group III/IV muscle afferents. After a 2-min extensor contraction (experiment 1; n = 9), mean voluntary activation was lower with than without maintained ischemia (47 ± 19% vs. 87 ± 8%, respectively; P < 0.001). After a 2-min knee flexor maximal voluntary contraction (MVC) (experiment 2; n = 8), mean voluntary activation was also lower with than without ischemia (59 ± 21% vs. 79 ± 9%; P < 0.01). After the contralateral (left) MVC (experiment 3; n = 8), mean voluntary activation of the right leg was similar with or without ischemia (92 ± 6% vs. 93 ± 4%; P = 0.65). After fatiguing exercise, activity in group III/IV muscle afferents reduces voluntary activation of the fatigued muscle and nonfatigued antagonist muscles in the same leg. However, group III/IV muscle afferents from the fatigued left leg had no effect on the unfatigued right leg. This suggests that any "crossover" of central fatigue in the lower limbs is not mediated by group III/IV muscle afferents. Copyright © 2015 the American Physiological Society.

Management of priapism with a trial of exercise in the emergency department.

PubMed

Gravel, Jonathan; LeBlanc, Constance; Varner, Catherine

2018-03-16

Priapism is characterized by persistent penile erection in the absence of sexual arousal or desire that does not subside with orgasm. Although relatively uncommon, it is a genitourinary emergency that necessities prompt work-up and appropriate management, as there is a time-dependent relationship between total duration of erection and an increasing risk of permanent erectile dysfunction. Confirming the type of priapism is key to proper management, but the majority of cases presenting to the emergency department are ischemic in nature. Conservative management strategies for ischemic priapism are sparsely described in the literature but generally include ice pack application to the area, cold showers, masturbation and rarely, exercise. These strategies lack sound evidence, but the risks of attempting them are minimal as long as access to more definitive treatment is not delayed. Lower-limb exercise as a first-line treatment warrants further study in the undifferentiated emergency department priapism population. The case we present and discuss here illustrates the potential benefits of a trial of acute lower-limb exercise, specifically stair climbing, as a treatment for medication-induced priapism. If effective, this simple non-invasive management strategy may decrease the time to effective treatment, requires minimal resource utilization, and ultimately, avoids the need for more invasive treatment.

New perspectives concerning feedback influences on cardiorespiratory control during rhythmic exercise and on exercise performance

PubMed Central

Dempsey, Jerome A

2012-01-01

The cardioaccelerator and ventilatory responses to rhythmic exercise in the human are commonly viewed as being mediated predominantly via feedforward ‘central command’ mechanisms, with contributions from locomotor muscle afferents to the sympathetically mediated pressor response. We have assessed the relative contributions of three types of feedback afferents on the cardiorespiratory response to voluntary, rhythmic exercise by inhibiting their normal ‘tonic’ activity in healthy animals and humans and in chronic heart failure. Transient inhibition of the carotid chemoreceptors during moderate intensity exercise reduced muscle sympathetic nerve activity (MSNA) and increased limb vascular conductance and blood flow; and reducing the normal level of respiratory muscle work during heavier intensity exercise increased limb vascular conductance and blood flow. These cardiorespiratory effects were prevented via ganglionic blockade and were enhanced in chronic heart failure and in hypoxia. Blockade of μ opioid sensitive locomotor muscle afferents, with preservation of central motor output via intrathecal fentanyl: (a) reduced the mean arterial blood pressure (MAP), heart rate and ventilatory responses to all steady state exercise intensities; and (b) during sustained high intensity exercise, reduced O2 transport, increased central motor output and end-exercise muscle fatigue and reduced endurance performance. We propose that these three afferent reflexes – probably acting in concert with feedforward central command – contribute significantly to preserving O2 transport to locomotor and to respiratory muscles during exercise. Locomotor muscle afferents also appear to provide feedback concerning the metabolic state of the muscle to influence central motor output, thereby limiting peripheral fatigue development. PMID:22826128

The effects of performing a one-legged bridge with hip abduction and use of a sling on trunk and lower extremity muscle activation in healthy adults.

PubMed

Choi, Kyuju; Bak, Jongwoo; Cho, Minkwon; Chung, Yijung

2016-09-01

[Purpose] This study investigated the changes in the muscle activities of the trunk and lower limbs of healthy adults during a one-legged bridge exercise using a sling, and with the addition of hip abduction. [Subjects and Methods] Twenty-seven healthy individuals participated in this study (14 males and 13 females). The participants were instructed to perform the bridge exercises under five different conditions. Trunk and lower limb muscle activation of the erector spinae (ES), external oblique (EO), gluteus maximus (GM), and biceps femoris (BF) was measured using surface electromyography. Data analysis was performed using the mean scores of three trials performed under each condition. [Results] There was a significant increase in bilateral EO and contralateral GM with the one-legged bridge compared with the one-legged bridge with sling exercise. Muscle activation of the ipsilateral GM and BF was significantly less during the one-legged bridge exercise compared to the one-legged bridge with sling exercise, and was significantly greater during the one-legged bridge with hip abduction compared to the one-legged bridge exercise. The muscle activation of the contralateral GM and BF was significantly greater with the one-legged bridge with hip abduction compared to the general bridge exercise. [Conclusion] With the one-legged bridge with hip abduction, the ipsilateral EO, GM and BF muscle activities were significantly greater than those of the one-legged bridge exercise. The muscle activation of all trunk and contralateral lower extremity muscles increased with the bridge with sling exercises compared with general bridge exercises.

Randomised controlled trial of the cost-effectiveness of water-based therapy for lower limb osteoarthritis.

PubMed

Cochrane, T; Davey, R C; Matthes Edwards, S M

2005-08-01

To determine the efficacy of community water-based therapy for the management of lower limb osteoarthritis (OA) in older patients. A pre-experimental matched-control study was used to estimate efficacy of water-based exercise treatment, to check design assumptions and delivery processes. The main study was a randomised controlled trial of the effectiveness of water-based exercise (treatment) compared with usual care (control) in older patients with hip and/or knee OA. The latter was accompanied by an economic evaluation comparing societal costs and consequences of the two treatments. Water exercise was delivered in public swimming pools in the UK. Physical function assessments were carried out in established laboratory settings. 106 patients (93 women, 13 men) over the age of 60 years with confirmed hip and/or knee OA took part in the preliminary study. A similar, but larger, group of 312 patients (196 women, 116 men) took part in the main study, randomised into control (159) and water exercise (153) groups. Control group patients received usual care with quarterly semi-structured telephone interview follow-up only. The intervention in the main study lasted for 1 year, with a further follow-up period of 6 months. Pain score on the Western Ontario and McMaster Universities OA index (WOMAC). Additional outcome measures were included to evaluate effects on quality of life, cost-effectiveness and physical function measurements. Short-term efficacy of water exercise in the management of lower limb OA was confirmed, with effect sizes ranging from 0.44 [95% confidence interval (CI) 0.03 to 0.85] on WOMAC pain to 0.76 (95% CI 0.33 to 1.17) on WOMAC physical function. Of 153 patients randomised to treatment, 82 (53.5%) were estimated to have complied satisfactorily with their treatment at the 1-year point. This had declined to 28 (18%) by the end of the 6-month follow-up period, during which support for the intervention had been removed and those wishing to continue exercise had to pay their own costs for maintaining their exercise treatment. High levels of co-morbidity were recorded in both groups. Nearly two thirds of all patients had a significant other illness in addition to their OA. Fifty-four control and 53 exercise patients had hospital inpatient episodes during the study period. Water exercise remained effective in the main study but overall effect size was small, on WOMAC pain at 1 year, a reduction of about 10% in group mean pain score. This had declined, and was non-significant, at 18 months. Mean cost difference estimates showed a saving in the water exercise group of pound123--175 per patient per annum and incremental cost-effectiveness ratios ranged from pound3838 to pound5951 per quality-adjusted life-year (QALY). Net reduction in pain was achieved at a net saving of pound135--175 per patient per annum and the ceiling valuation of pound580--740 per unit of WOMAC pain reduction was favourably low. Group-based exercise in water over 1 year can produce significant reduction in pain and improvement in physical function in older adults with lower limb OA, and may be a useful adjunct in the management of hip and/or knee OA. The water-exercise programme produced a favourable cost--benefit outcome, using reduction in WOMAC pain as the measure of benefit. Further research is suggested into other similar public health interventions. Investigation is also needed into how general practice can best be supported to facilitate access to participants for research trials in healthcare, as well as an examination of the infrastructure and workforce capacities for physical activity delivery and the potential extent to which healthcare may be supported in this way. More detailed research is required to develop a better understanding of the types of exercise that will work for the different biomechanical subtypes of knee and hip OA and investigation is needed on access and environmental issues for physical activity programmes for older people, from both a provider and a participant perspective, the societal costs of the different approaches to the management of OA and longer term trends in outcome measures (costs and effects).

Crouch gait can be an effective form of forced-use/no constraint exercise for the paretic lower limb in stroke.

PubMed

Tesio, Luigi; Rota, Viviana; Malloggi, Chiara; Brugliera, Luigia; Catino, Luigi

2017-09-01

In hemiplegic gait the paretic lower limb provides less muscle power and shows a briefer stance compared with the unaffected limb. Yet, a longer stance and a higher power can be obtained from the paretic lower limb if gait speed is increased. This supports the existence of a 'learned non-use' phenomenon, similar to that underlying some asymmetric impairments of the motion of the eyes and of the upper limbs. Crouch gait (CG) (bent-hip bent-knee, about 30° minimum knee flexion) might be an effective form of 'forced-use' treatment of the paretic lower limb. It is not known whether it also stimulates a more symmetric muscle power output. Gait analysis on a force treadmill was carried out in 12 healthy adults and seven hemiplegic patients (1-127 months after stroke, median: 1.6). Speed was imposed at 0.3 m/s. Step length and single and double stance times, sagittal joint rotations, peak positive power, and work in extension of the hip, knee, and ankle (plantar flexion), and surface electromyography (sEMG) area from extensor muscles during the generation of power were measured on either side during both erect and crouch walking. Significance was set at P less than 0.05; corrections for multiplicity were applied. Patients, compared with healthy controls, adopted in both gait modalities and on both sides a shorter step length (61-84%) as well as a shorter stance (76-90%) and swing (63-83%) time. As a rule, they also provided a higher muscular work (median: 137%, range: 77-250%) paralleled by a greater sEMG area (median: 174%, range: 75-185%). In erect gait, the generation of peak extensor power across hip, knee, and ankle joints was in general lower (83-90%) from the paretic limb and higher (98-165%) from the unaffected limb compared with control values. In CG, peak power generation across the three lower limb joints was invariably higher in hemiparetic patients: 107-177% from the paretic limb and 114-231% from the unaffected limb. When gait shifted from erect to crouch, only for hemiplegic patients, at the hip, the paretic/unaffected ratio increased significantly. For peak power, work, sEMG area, and joint rotation, the paretic/unaffected ratio increased from 55 to 85%, 56 to 72%, 68 to 91%, and 67 to 93%, respectively. CG appears to be an effective form of forced-use exercise eliciting more power and work from the paretic lower limb muscles sustained by a greater neural drive. It also seems effective in forcing a more symmetric power and work from the hip extensor muscles, but neither from the knee nor the ankle.

Physiotherapy management of lower limb osteoarthritis.

PubMed

Walsh, Nicola E; Pearson, Jennifer; Healey, Emma L

2017-06-01

Osteoarthritis (OA) of the lower limb affects millions of people worldwide, and results in pain and reduced function. We reviewed guidelines and Cochrane reviews for physical therapy interventions to manage the condition. Evidence from meta-analyses and systematic reviews was included. We also identified the recommendations from guidelines relevant to practice in the UK. There is strongest evidence to support the use of exercise to improve pain, function and quality of life. There is limited evidence to support the use of some commonly utilized physiotherapy interventions. National Institute for Health and Clinical Excellence do not recommend the use of acupuncture. Programmes that include single exercise type may be more beneficial than combined strengthening and aerobic interventions. Further research is required to determine how to facilitate long-term engagement with exercise to sustain the beneficial effects on pain, function and quality of life. Studies that investigate packages of care, combining interventions require further investigation. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Protein synthesis rates in atrophied gastrocnemius muscles after limb immobilization

NASA Technical Reports Server (NTRS)

Tucker, K. R.; Seider, M. J.; Booth, F. W.

1981-01-01

Noting that protein synthesis declines in the gastrocnemius 6 hr after immobilization, the study sought to detect an increase of protein synthesis when the limb was freed, and to examine the effects of exercise on the rate of increase. Rats were used as subjects, with their hind legs in plaster of Paris in plantar flexion to eliminate strain on the gastrocnemius. Periods of immobilization were varied and samples of blood from the muscle were taken to track protein synthesis rates for different groups in immobilization and exercise regimens (running and weightlifting). Synthesis rates declined 3.6% during time in the cast, then increased 6.3%/day after the casts were removed. Both running and weightlifting were found to increase the fractional rate of protein formation in the gastrocnemius muscle when compared with contralateral muscles that were not exercised and were used as controls, suggesting that the mechanism controlling protein synthesis in skeletal muscles is rapidly responsive to changes in muscular contractile activity.

Proteinase-Activated Receptor-2 Sensitivity of Amplified TRPA1 Activity in Skeletal Muscle Afferent Nerves and Exercise Pressor Reflex in Rats with Femoral Artery Occlusion

PubMed Central

Xing, Jihong; Li, Jianhua

2017-01-01

Background/Aims Limb ischemia occurs in peripheral artery disease (PAD). Sympathetic nerve activity (SNA) that regulates blood flow directed to the ischemic limb is exaggerated during exercise in this disease, and transient receptor potential channel A1 (TRPA1) in thin-fiber muscle afferents contributes to the amplified sympathetic response. The purpose of the present study was to determine the role of proteinase-activated receptor-2 (PAR2) in regulating abnormal TRPA1 function and the TRPA1-mediated sympathetic component of the exercise pressor reflex. Methods A rat model of femoral artery ligation was employed to study PAD. Dorsal root ganglion (DRG) tissues were obtained to examine the protein levels of PAR2 using western blot analysis. Current responses induced by activation of TRPA1 in skeletal muscle DRG neurons were characterized using whole-cell patch clamp methods. The blood pressure response to static exercise (i.e., muscle contraction) and stimulation of TRPA1 was also examined after a blockade of PAR2. Results The expression of PAR2 was amplified in DRG neurons of the occluded limb, and PAR2 activation with SL-NH2 (a PAR2 agonist) increased the amplitude of TRPA1 currents to a greater degree in DRG neurons of the occluded limb. Moreover, FSLLRY-NH2 (a PAR antagonist) injected into the arterial blood supply of the hindlimb muscles significantly attenuated the pressor response to muscle contraction and TRPA1 stimulation in rats with occluded limbs. Conclusions The PAR2 signal in muscle sensory nerves contributes to the amplified exercise pressor reflex via TRPA1 mechanisms in rats with femoral artery ligation. These findings provide a pathophysiological basis for autonomic responses during exercise activity in PAD, which may potentially aid in the development of therapeutic approaches for improvement of blood flow in this disease. PMID:29131007

Revascularization and muscle adaptation to limb demand ischemia in diet-induced obese mice.

PubMed

Albadawi, Hassan; Tzika, A Aria; Rask-Madsen, Christian; Crowley, Lindsey M; Koulopoulos, Michael W; Yoo, Hyung-Jin; Watkins, Michael T

2016-09-01

Obesity and type 2 diabetes are major risk factors for peripheral arterial disease in humans, which can result in lower limb demand ischemia and exercise intolerance. Exercise triggers skeletal muscle adaptation including increased vasculogenesis. The goal of this study was to determine whether demand ischemia modulates revascularization, fiber size, and signaling pathways in the ischemic hind limb muscles of mice with diet-induced obesity (DIO). DIO mice (n = 7) underwent unilateral femoral artery ligation and recovered for 2 wks followed by 4 wks with daily treadmill exercise to induce demand ischemia. A parallel sedentary ischemia (SI) group (n = 7) had femoral artery ligation without exercise. The contralateral limb muscles of SI served as control. Muscles were examined for capillary density, myofiber cross-sectional area, cytokine levels, and phosphorylation of STAT3 and ERK1/2. Exercise significantly enhanced capillary density (P < 0.01) and markedly lowered cross-sectional area (P < 0.001) in demand ischemia compared with SI. These findings coincided with a significant increase in granulocyte colony-stimulating factor (P < 0.001) and interleukin-7 (P < 0.01) levels. In addition, phosphorylation levels of STAT3 and ERK1/2 (P < 0.01) were increased, whereas UCP1 and monocyte chemoattractant protein-1 protein levels were lower (P < 0.05) without altering vascular endothelial growth factor and tumor necrosis factor alpha protein levels. Demand ischemia increased the PGC1α messenger RNA (P < 0.001) without augmenting PGC1α protein levels. Exercise-induced limb demand ischemia in the setting of DIO causes myofiber atrophy despite an increase in muscle capillary density. The combination of persistent increase in tumor necrosis factor alpha, lower vascular endothelial growth factor, and failure to increase PGC1α protein may reflect a deficient adaption to demand ischemia in DIO. Copyright © 2016 Elsevier Inc. All rights reserved.

Importance of upper-limb inertia in calculating concentric bench press force.

PubMed

Rambaud, Olivier; Rahmani, Abderrahmane; Moyen, Bernard; Bourdin, Muriel

2008-03-01

The purpose of this study was to investigate the influence of upper-limb inertia on the force-velocity relationship and maximal power during concentric bench press exercise. Reference peak force values (Fpeakp) measured with a force plate positioned below the bench were compared to those measured simultaneously with a kinematic device fixed on the barbell by taking (Fpeakt) or not taking (Fpeakb) upper-limb inertia into account. Thirteen men (27.8 +/- 4.1 years, 184.6 +/- 5.5 cm, 99.5 +/- 18.6 kg) performed all-out concentric bench press exercise against 8 loads ranging between 7 and 74 kg. The results showed that for each load, Fpeakb was significantly less than Fpeakp (P < 0.0001), whereas no significant difference was found between Fpeakp and Fpeakt. The values of maximal force (F0), maximal velocity (V0), optimal velocity (Vopt), and maximal power (Pmax), extrapolated from the force- and power-velocity relationships determined with the kinematic device, were significantly underestimated when upper-limb inertia was ignored. The results underline the importance of taking account of the total inertia of the moving system to ensure precise evaluation of upper-limb muscular characteristics in all-out concentric bench press exercise with a kinematic device. A major application of this study would be to develop precise upper-limb muscular characteristic evaluation in laboratory and field conditions by using a simple and cheap kinematic device.

Implementing an exercise-training programme to prevent lower-limb injuries: considerations for the development of a randomised controlled trial intervention delivery plan.

PubMed

Finch, Caroline F; White, Peta; Twomey, Dara; Ullah, Shahid

2011-08-01

To identify important considerations for the delivery of an exercise training intervention in a randomised controlled trial to maximise subsequent participation in that randomised controlled trial and intervention uptake. A cross-sectional survey, with a theoretical basis derived from the Health Belief Model (HBM) and the Reach, Efficacy/Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) framework. 374 male senior Australian Football players, aged 17-38 years. Beliefs about lower-limb injury causation/prevention, and the relative value of exercise training for performance and injury prevention. The data are interpreted within HBM constructs and implications for subsequent intervention implementation considered within the RE-AIM framework. Ordinal logistic regression compared belief scores across player characteristics. 74.4% of players agreed that doing specific exercises during training would reduce their risk of lower-limb injury and would be willing to undertake them. However, 64.1% agreed that training should focus more on improving game performance than injury prevention. Younger players (both in terms of age and playing experience) generally had more positive views. Players were most supportive of kicking (98.9%) and ball-handling (97.0%) skills for performance and warm-up runs and cool-downs (both 91.5%) for injury prevention. Fewer than three-quarters of all players believed that balance (69.2%), landing (71.3%) or cutting/stepping (72.8) training had injury-prevention benefits. Delivery of future exercise training programmes for injury prevention aimed at these players should be implemented as part of routine football activities and integrated with those as standard practice, as a means of associating them with training benefits for this sport.

Engineering and Technology in Wheelchair Sport.

PubMed

Cooper, Rory A; Tuakli-Wosornu, Yetsa A; Henderson, Geoffrey V; Quinby, Eleanor; Dicianno, Brad E; Tsang, Kalai; Ding, Dan; Cooper, Rosemarie; Crytzer, Theresa M; Koontz, Alicia M; Rice, Ian; Bleakney, Adam W

2018-05-01

Technologies capable of projecting injury and performance metrics to athletes and coaches are being developed. Wheelchair athletes must be cognizant of their upper limb health; therefore, systems must be designed to promote efficient transfer of energy to the handrims and evaluated for simultaneous effects on the upper limbs. This article is brief review of resources that help wheelchair users increase physiologic response to exercise, develop ideas for adaptive workout routines, locate accessible facilities and outdoor areas, and develop wheelchair sports-specific skills. Published by Elsevier Inc.

Impact of virtual reality games on psychological well-being and upper limb performance in adults with physical disabilities: A pilot study.

PubMed

Singh, D K A; Rahman, N N A; Seffiyah, R; Chang, S Y; Zainura, A K; Aida, S R; Rajwinder, K H S

2017-04-01

There is limited information regarding the effects of interactive virtual reality (VR) games on psychological and physical well-being among adults with physical disabilities. We aimed to examine the impact of VR games on psychological well-being, upper limb motor function and reaction time in adults with physical disabilities. Fifteen participants completed the intervention using Wii VR games in this pilot study. Depressive, Anxiety and Stress Scales (DASS) and Capabilities of Upper Extremity (CUE) questionnaires were used to measure psychological well-being and upper limb motor function respectively. Upper limb reaction time was measured using reaction time test. Results showed that there was a significant difference (p<0.05) in DASS questionnaire and average reaction time score after intervention. There is a potential for using interactive VR games as an exercise tool to improve psychological wellbeing and upper limb reaction time among adults with disabilities.

Effect of 6-month community-based exercise interventions on gait and functional fitness of an older population: a quasi-experimental study.

PubMed

Ramalho, Fátima; Santos-Rocha, Rita; Branco, Marco; Moniz-Pereira, Vera; André, Helô-Isa; Veloso, António P; Carnide, Filomena

2018-01-01

Gait ability in older adults has been associated with independent living, increased survival rates, fall prevention, and quality of life. There are inconsistent findings regarding the effects of exercise interventions in the maintenance of gait parameters. The aim of the study was to analyze the effects of a community-based periodized exercise intervention on the improvement of gait parameters and functional fitness in an older adult group compared with a non-periodized program. A quasi-experimental study with follow-up was performed in a periodized exercise group (N=15) and in a non-periodized exercise group (N=13). The primary outcomes were plantar pressure gait parameters, and the secondary outcomes were physical activity, aerobic endurance, lower limb strength, agility, and balance. These variables were recorded at baseline and after 6 months of intervention. Both programs were tailored to older adults' functional fitness level and proved to be effective in reducing the age-related decline regarding functional fitness and gait parameters. Gait parameters were sensitive to both the exercise interventions. These exercise protocols can be used by exercise professionals in prescribing community exercise programs, as well as by health professionals in promoting active aging.

Mobile-phone-based home exercise training program decreases systemic inflammation in COPD: a pilot study.

PubMed

Wang, Chun-Hua; Chou, Pai-Chien; Joa, Wen-Ching; Chen, Li-Fei; Sheng, Te-Fang; Ho, Shu-Chuan; Lin, Horng-Chyuan; Huang, Chien-Da; Chung, Fu-Tsai; Chung, Kian Fan; Kuo, Han-Pin

2014-08-30

Moderate-intensity exercise training improves skeletal muscle aerobic capacity and increased oxidative enzyme activity, as well as exercise tolerance in COPD patients. To investigate whether the home-based exercise training program can reduce inflammatory biomarkers in patients with COPD, twelve patients using mobile phone assistance and 14 with free walk were assessed by incremental shuttle walk test (ISWT), spirometry, strength of limb muscles, and serum C-reactive protein (CRP) and inflammatory cytokines. Patients in the mobile phone group improved their ISWT walking distance, with decrease in serum CRP after 2 months, and sustained at 6 months. Patients in the control group had no improvement. Serum IL-8 in the mobile phone group was significantly reduced at 2, 3 and 6 months after doing home exercise training compared to baseline. IL-6 and TNF-α were significantly elevated at 3 and 6 months in control group, while there were no changes in mobile phone group. The strength of limb muscles was significantly greater compared to baseline at 3 and 6 months in the mobile phone group. A mobile-phone-based system can provide an efficient home endurance exercise training program with improved exercise capacity, strength of limb muscles and a decrease in serum CRP and IL-8 in COPD patients. Decreased systemic inflammation may contribute to these clinical benefits. (Clinical trial registration No.: NCT01631019).

An official American Thoracic Society/European Respiratory Society statement: update on limb muscle dysfunction in chronic obstructive pulmonary disease.

PubMed

Maltais, François; Decramer, Marc; Casaburi, Richard; Barreiro, Esther; Burelle, Yan; Debigaré, Richard; Dekhuijzen, P N Richard; Franssen, Frits; Gayan-Ramirez, Ghislaine; Gea, Joaquim; Gosker, Harry R; Gosselink, Rik; Hayot, Maurice; Hussain, Sabah N A; Janssens, Wim; Polkey, Micheal I; Roca, Josep; Saey, Didier; Schols, Annemie M W J; Spruit, Martijn A; Steiner, Michael; Taivassalo, Tanja; Troosters, Thierry; Vogiatzis, Ioannis; Wagner, Peter D

2014-05-01

Limb muscle dysfunction is prevalent in chronic obstructive pulmonary disease (COPD) and it has important clinical implications, such as reduced exercise tolerance, quality of life, and even survival. Since the previous American Thoracic Society/European Respiratory Society (ATS/ERS) statement on limb muscle dysfunction, important progress has been made on the characterization of this problem and on our understanding of its pathophysiology and clinical implications. The purpose of this document is to update the 1999 ATS/ERS statement on limb muscle dysfunction in COPD. An interdisciplinary committee of experts from the ATS and ERS Pulmonary Rehabilitation and Clinical Problems assemblies determined that the scope of this document should be limited to limb muscles. Committee members conducted focused reviews of the literature on several topics. A librarian also performed a literature search. An ATS methodologist provided advice to the committee, ensuring that the methodological approach was consistent with ATS standards. We identified important advances in our understanding of the extent and nature of the structural alterations in limb muscles in patients with COPD. Since the last update, landmark studies were published on the mechanisms of development of limb muscle dysfunction in COPD and on the treatment of this condition. We now have a better understanding of the clinical implications of limb muscle dysfunction. Although exercise training is the most potent intervention to address this condition, other therapies, such as neuromuscular electrical stimulation, are emerging. Assessment of limb muscle function can identify patients who are at increased risk of poor clinical outcomes, such as exercise intolerance and premature mortality. Limb muscle dysfunction is a key systemic consequence of COPD. However, there are still important gaps in our knowledge about the mechanisms of development of this problem. Strategies for early detection and specific treatments for this condition are also needed.

An Official American Thoracic Society/European Respiratory Society Statement: Update on Limb Muscle Dysfunction in Chronic Obstructive Pulmonary Disease

PubMed Central

Maltais, François; Decramer, Marc; Casaburi, Richard; Barreiro, Esther; Burelle, Yan; Debigaré, Richard; Dekhuijzen, P. N. Richard; Franssen, Frits; Gayan-Ramirez, Ghislaine; Gea, Joaquim; Gosker, Harry R.; Gosselink, Rik; Hayot, Maurice; Hussain, Sabah N. A.; Janssens, Wim; Polkey, Micheal I.; Roca, Josep; Saey, Didier; Schols, Annemie M. W. J.; Spruit, Martijn A.; Steiner, Michael; Taivassalo, Tanja; Troosters, Thierry; Vogiatzis, Ioannis; Wagner, Peter D.

2014-01-01

Background: Limb muscle dysfunction is prevalent in chronic obstructive pulmonary disease (COPD) and it has important clinical implications, such as reduced exercise tolerance, quality of life, and even survival. Since the previous American Thoracic Society/European Respiratory Society (ATS/ERS) statement on limb muscle dysfunction, important progress has been made on the characterization of this problem and on our understanding of its pathophysiology and clinical implications. Purpose: The purpose of this document is to update the 1999 ATS/ERS statement on limb muscle dysfunction in COPD. Methods: An interdisciplinary committee of experts from the ATS and ERS Pulmonary Rehabilitation and Clinical Problems assemblies determined that the scope of this document should be limited to limb muscles. Committee members conducted focused reviews of the literature on several topics. A librarian also performed a literature search. An ATS methodologist provided advice to the committee, ensuring that the methodological approach was consistent with ATS standards. Results: We identified important advances in our understanding of the extent and nature of the structural alterations in limb muscles in patients with COPD. Since the last update, landmark studies were published on the mechanisms of development of limb muscle dysfunction in COPD and on the treatment of this condition. We now have a better understanding of the clinical implications of limb muscle dysfunction. Although exercise training is the most potent intervention to address this condition, other therapies, such as neuromuscular electrical stimulation, are emerging. Assessment of limb muscle function can identify patients who are at increased risk of poor clinical outcomes, such as exercise intolerance and premature mortality. Conclusions: Limb muscle dysfunction is a key systemic consequence of COPD. However, there are still important gaps in our knowledge about the mechanisms of development of this problem. Strategies for early detection and specific treatments for this condition are also needed. PMID:24787074

The influence of musical cadence into aquatic jumping jacks kinematics.

PubMed

Costa, Mário J; Oliveira, Cristiana; Teixeira, Genoveva; Marinho, Daniel A; Silva, António J; Barbosa, Tiago M

2011-01-01

The aim of this study was to analyze the relationships between the head-out aquatic exercise "Jumping jacks" kinematics and the musical cadence in healthy and fit subjects. Five young women, with at least one year of experience conducting head- out aquatic programs were videotaped in the frontal plane, with a pair of cameras providing a double projection (above and below the water surface). Subjects performed an incremental protocol of five bouts (120 b·min(-1), 135 b·min(-1), 150 b·min(-1), 165 b·min(-1) and 180 b·min(-1)) with 16 full cycles of the "Jumping jacks" exercise. Data processing and calculation of upper limbs' (i.e. hands), lower limbs' (i.e. feet) and center of mass' 2D linear velocity and displacement were computed with the software Ariel Performance Analysis System and applying the 2D-DLT algorithm. Subjects decreased the cycle period during the incremental protocol. Significant and negative relationships with the musical cadence were verified for the center of mass and upper limbs vertical displacement. On the other hand, for the lower limbs lateral velocity, a significant and positive relationship was observed. It is concluded that expert and fit subjects increase the lower limb's velocity to maintain the range of motion, while the upper limb's displacement is reduced to coupe the music cadence. Key pointsWhile performing the Jumping Jacks, expert and fit subjects increase their lower limbs segmental velocity to maintain the range of motion.The upper limbs displacement is reduced to maintain the music cadence.Expert and fit subjects present similar response for alternating or simultaneously head-out aquatic exercises when increasing the music cadence.

Creatine Supplementation and Upper Limb Strength Performance: A Systematic Review and Meta-Analysis.

PubMed

Lanhers, Charlotte; Pereira, Bruno; Naughton, Geraldine; Trousselard, Marion; Lesage, François-Xavier; Dutheil, Frédéric

2017-01-01

Creatine is the most widely used supplementation to increase performance in strength; however, the most recent meta-analysis focused specifically on supplementation responses in muscles of the lower limbs without regard to upper limbs. We aimed to systematically review the effect of creatine supplementation on upper limb strength performance. We conducted a systematic review and meta-analyses of all randomized controlled trials comparing creatine supplementation with a placebo, with strength performance measured in exercises shorter than 3 min in duration. The search strategy used the keywords 'creatine', 'supplementation', and 'performance'. Independent variables were age, sex and level of physical activity at baseline, while dependent variables were creatine loading, total dose, duration, time interval between baseline (T0) and the end of the supplementation (T1), and any training during supplementation. We conducted three meta-analyses: at T0 and T1, and on changes between T0 and T1. Each meta-analysis was stratified within upper limb muscle groups. We included 53 studies (563 individuals in the creatine supplementation group and 575 controls). Results did not differ at T0, while, at T1, the effect size (ES) for bench press and chest press were 0.265 (95 % CI 0.132-0.398; p < 0.001) and 0.677 (95 % CI 0.149-1.206; p = 0.012), respectively. Overall, pectoral ES was 0.289 (95 % CI 0.160-0.419; p = 0.000), and global upper limb ES was 0.317 (95 % CI 0.185-0.449; p < 0.001). Meta-analysis of changes between T0 and T1 gave similar results. The meta-regression showed no link with characteristics of population or supplementation, demonstrating the efficacy of creatine independently of all listed conditions. Creatine supplementation is effective in upper limb strength performance for exercise with a duration of less than 3  min, independent of population characteristics, training protocols, and supplementary doses or duration.

A novel upper limb rehabilitation system with self-driven virtual arm illusion.

PubMed

Aung, Yee Mon; Al-Jumaily, Adel; Anam, Khairul

2014-01-01

This paper proposes a novel upper extremity rehabilitation system with virtual arm illusion. It aims for fast recovery from lost functions of the upper limb as a result of stroke to provide a novel rehabilitation system for paralyzed patients. The system is integrated with a number of technologies that include Augmented Reality (AR) technology to develop game like exercise, computer vision technology to create the illusion scene, 3D modeling and model simulation, and signal processing to detect user intention via EMG signal. The effectiveness of the developed system has evaluated via usability study and questionnaires which is represented by graphical and analytical methods. The evaluation provides with positive results and this indicates the developed system has potential as an effective rehabilitation system for upper limb impairment.

Efficacy of a Virtual Reality Commercial Gaming Device in Upper Limb Recovery after Stroke: A Randomized, Controlled Study.

PubMed

Kong, Keng-He; Loh, Yong-Joo; Thia, Ernest; Chai, Audrey; Ng, Chwee-Yin; Soh, Yan-Ming; Toh, Shirlene; Tjan, Soon-Yin

2016-10-01

To compare the efficacy of a virtual reality commercial gaming device, Nintendo wii (NW) with conventional therapy and customary care in facilitating upper limb recovery after stroke. Randomized, controlled, single-blinded study. Tertiary rehabilitation center. 105 subjects admitted to in inpatient rehabilitation program within 6 weeks of stroke onset. Subjects were randomly assigned to one of three groups of upper limb exercises: (1) NW gaming; (2) conventional therapy; (3) control. NW gaming and conventional therapy were provided fourtimes a week for 3 weeks. The main outcome measure was Fugl-Meyer assessment (FMA) of upper limb function. Secondary outcome measures included Action Research Arm Test, Functional Independence Measure, and Stroke Impact Scale. These measures were assessed at baseline, completion of intervention (week 3) and at 4 weeks and 8 weeks after completion of intervention. The primary outcome measure was the change in FMA scores at completion of intervention. The mean age was 57.5±9.8 years, and subjects were enrolled at a mean of 13.7±8.9 days after stroke. The mean baseline FMA score was 16.4±14.2. There was no difference in FMA scores between all 3 groups at the end of intervention, and at 4 and 8 weeks after completion of intervention. Similar findings were also noted for the secondary outcome measures. Twelve sessions of augmented upper limb exercises via NW gaming or conventional therapy over a 3-week period was not effective in enhancing upper limb motor recovery compared to control.

Effect of breaking up sedentary time with callisthenics on endothelial function.

PubMed

Carter, Sophie E; Gladwell, Valerie F

2017-08-01

Periods of prolonged sitting impairs endothelial function in lower limb conduit arteries, which is attenuated with physical activity breaks. The effect of activity breaks on upper limb arteries has not been examined. This study assessed changes in brachial artery endothelial function following either a prolonged sitting period or breaking up this sedentary time by performing sets of callisthenics exercises. Ten healthy participants (6 men) completed 2 conditions in a counterbalanced order: (a) 1-h 26-min sitting, or (b) breaking up this period every 20 min by performing a set of 5 callisthenics exercises. Brachial artery endothelial function was assessed via ultrasound using the flow-mediated dilation (FMD) technique prior to and following each condition, while brachial shear rate (SR) was acquired after each set of callisthenics. There was no significant change in FMD over time (P = 0.09) or between conditions (P = 0.12). Compared to sitting, brachial SR increased following each set of callisthenics, with a significant difference after the third break (Sit: 33.94 ± 12.79 s -1 ; Callisthenics: 57.16 ± 30.48 s -1 , P = 0.02). Alterations in SR in the upper limbs suggest callisthenics may be an effective intervention to break up sedentary time and attenuate the potentially deleterious effects of prolonged sitting on cardiovascular health.

Investigating human skeletal muscle physiology with unilateral exercise models: when one limb is more powerful than two.

PubMed

MacInnis, Martin J; McGlory, Chris; Gibala, Martin J; Phillips, Stuart M

2017-06-01

Direct sampling of human skeletal muscle using the needle biopsy technique can facilitate insight into the biochemical and histological responses resulting from changes in exercise or feeding. However, the muscle biopsy procedure is invasive, and analyses are often expensive, which places pragmatic restraints on sample sizes. The unilateral exercise model can serve to increase statistical power and reduce the time and cost of a study. With this approach, 2 limbs of a participant are randomized to 1 of 2 treatments that can be applied almost concurrently or sequentially depending on the nature of the intervention. Similar to a typical repeated measures design, comparisons are made within participants, which increases statistical power by reducing the amount of between-person variability. A washout period is often unnecessary, reducing the time needed to complete the experiment and the influence of potential confounding variables such as habitual diet, activity, and sleep. Variations of the unilateral exercise model have been employed to investigate the influence of exercise, diet, and the interaction between the 2, on a wide range of variables including mitochondrial content, capillary density, and skeletal muscle hypertrophy. Like any model, unilateral exercise has some limitations: it cannot be used to study variables that potentially transfer across limbs, and it is generally limited to exercises that can be performed in pairs of treatments. Where appropriate, however, the unilateral exercise model can yield robust, well-controlled investigations of skeletal muscle responses to a wide range of interventions and conditions including exercise, dietary manipulation, and disuse or immobilization.

Strength and endurance training of an individual with left upper and lower limb amputations.

PubMed

Donachy, J E; Brannon, K D; Hughes, L S; Seahorn, J; Crutcher, T T; Christian, E L

2004-04-22

The purpose of this article is to describe the development of a strength and endurance training programme designed to prepare an individual with a left glenohumeral disarticulation and transtibial amputation for a bike trip across the USA. The subject was scheduled for training three times per week over a two-month period followed by two times per week for an additional two months. Training consisted of a resistance training circuit using variable resistance machines, cycling using a recumbent stationary bike, and core stability training using stability ball exercises. Changes in strength were assessed using 10 RM tests on the resistance machines and changes in peak VO(2) were monitored utilizing the Cosmed K4b pulmonary function tester. The subject demonstrated a 30.3% gain in peak VO(2). The subject's 10 RM for left single limb leg press increased 36.8% and gains of at least 7.7% were seen for all other muscle groups tested. The strength and endurance training programme adapted to compensate for this subject's limb losses was effective in increasing both strength and peak VO(2). Adapting exercise programmes to compensate for limb loss may allow individuals with amputations to participate in physically challenging activities that otherwise may not be available to them.

Evaluation of muscle injury using magnetic resonance imaging

NASA Technical Reports Server (NTRS)

LeBlanc, A. D.; Jaweed, M.; Evans, H.

1993-01-01

The objective of this study was to investigate spin echo T2 relaxation time changes in thigh muscles after intense eccentric exercise in healthy men. Spin echo and calculated T2 relaxation time images of the thighs were obtained on several occasions after exercise of one limb; the contralateral limb served as control. Muscle damage was verified by elevated levels of serum creatine kinase (CK). Thirty percent of the time no exercise effect was discernible on the magnetic resonance (MR) images. In all positive MR images (70%) the semitendinosus muscle was positive, while the biceps femoris, short head, and gracilis muscles were also positive in 50% and 25% of the total cases, respectively. The peak T2 relaxation time and serum CK were correlated (r = 0.94, p<0.01); temporal changes in muscle T2 relaxation time and serum CK were similar, although T2 relaxation time remained positive after serum CK returned to background levels. We conclude that magnetic resonance imaging can serve as a useful tool in the evaluation of eccentric exercise muscle damage by providing a quantitative indicator of damage and its resolution as well as the specific areas and muscles.

Vibration Platform Training in Women at Risk for Symptomatic Knee Osteoarthritis

PubMed Central

Segal, Neil A.; Glass, Natalie A.; Shakoor, Najia; Wallace, Robert

2013-01-01

Objective To determine whether a platform exercise program with vibration is more effective than the platform exercise alone for improving lower limb muscle strength and power in women age 45-60 with risk factors for knee osteoarthritis (OA). Design Randomized, controlled study Setting Academic center Participants 48 women age 45-60 years old with risk factors for knee OA (history of knee injury or surgery or BMI≥25kg/m2). Interventions Subjects were randomized to a twice weekly lower limb exercise program (quarter squat, posterolateral leg lifts, calf raises) on either a vertically vibrating (35Hz, 2mm), or a non-vibrating platform. Main Outcome Measurements The main outcome measures included change in isokinetic quadriceps strength, leg press power, and stair climb power by 12 weeks. Results 39 out of 48 enrolled participants completed the study (26 vibration and 13 control exercise). Nine participants discontinued the study after randomization mainly due to lack of time. There were no intergroup differences in age, BMI, or activity level. Isokinetic knee extensor strength did not significantly improve in either group. Leg press power improved by 92.0±69.7 W in the vibration group (p<.0001) and 58.2±96.2 W in the control group (p=0.0499), but did not differ between groups (p=0.2262). Stair climb power improved by 53.4±64.7 W in the vibration group (p=0.0004) and 55.7±83.3 W in the control group (p=0.0329), but did not differ between groups (p=0.9272). Conclusions Whole body vibration platforms have been marketed for increasing strength and power. In this group of asymptomatic middle-aged women with risk factors for knee OA, addition of vibration to a 12-week exercise program did not result in significantly greater improvement in lower limb strength or power than participation in the exercise program without vibration. PMID:22981005

Vibration platform training in women at risk for symptomatic knee osteoarthritis.

PubMed

Segal, Neil A; Glass, Natalie A; Shakoor, Najia; Wallace, Robert

2013-03-01

To determine whether a platform exercise program with vibration is more effective than platform exercise alone for improving lower limb muscle strength and power in women ages 45 to 60 with risk factors for knee osteoarthritis (OA). Randomized, controlled study. Academic center. A total of 48 women ages 45-60 years with risk factors for knee OA (a history of knee injury or surgery or body mass index ≥25 kg/m(2)). Subjects were randomly assigned to a twice-weekly lower limb exercise program (quarter squat, posterolateral leg lifts, calf raises, step-ups, and lunges) on either a vertically vibrating platform (35 Hz, 2 mm) or a nonvibrating platform. Change in isokinetic quadriceps strength, leg press power, and stair climb power by 12 weeks. A total of 39 of 48 enrolled participants completed the study (26 vibration and 13 control exercise). Nine participants discontinued the study after randomization mainly because of a lack of time. No intergroup differences in age, body mass index, or activity level existed. Isokinetic knee extensor strength did not significantly improve in either group. Leg press power improved by 92.0 ± 69.7 W in the vibration group (P < .0001) and 58.2 ± 96.2 W in the control group (P = .0499) but did not differ between groups (P = .2262). Stair climb power improved by 53.4 ± 64.7 W in the vibration group (P = .0004) and 55.7 ± 83.3 W in the control group (P = .0329) but did not differ between groups (P = .9272). Whole body vibration platforms have been marketed for increasing strength and power. In this group of asymptomatic middle-aged women with risk factors for knee OA, the addition of vibration to a 12-week exercise program did not result in significantly greater improvement in lower limb strength or power than did participation in the exercise program without vibration. Copyright © 2013 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

Case Series of a Knowledge Translation Intervention to Increase Upper Limb Exercise in Stroke Rehabilitation.

PubMed

Connell, Louise A; McMahon, Naoimh E; Tyson, Sarah F; Watkins, Caroline L; Eng, Janice J

2016-12-01

Current approaches to upper limb rehabilitation are not sufficient to drive neural reorganization and maximize recovery after stroke. To address this evidence-practice gap, a knowledge translation intervention using the Behaviour Change Wheel was developed. The intervention involves collaboratively working with stroke therapy teams to change their practice and increase therapy intensity by therapists prescribing supplementary self-directed arm exercise. The purposes of this case series are: (1) to provide an illustrative example of how a research-informed process changed clinical practice and (2) to report on staff members' and patients' perceptions of the utility of the developed intervention. A participatory action research approach was used in 3 stroke rehabilitation units in the United Kingdom. The intervention aimed to change 4 therapist-level behaviors: (1) screening patients for suitability for supplementary self-directed arm exercise, (2) provision of exercises, (3) involving family and caregivers in assisting with exercises, and (4) monitoring and progressing exercises. Data on changes in practice were collected by therapy teams using a bespoke audit tool. Utility of the intervention was explored in qualitative interviews with patients and staff. Components of the intervention were successfully embedded in 2 of the 3 stroke units. At these sites, almost all admitted patients were screened for suitability for supplementary self-directed exercise. Exercises were provided to 77%, 70%, and 88% of suitable patients across the 3 sites. Involving family and caregivers and monitoring and progressing exercises were not performed consistently. This case series is an example of how a rigorous research-informed knowledge translation process resulted in practice change. Research is needed to demonstrate that these changes can translate into increased intensity of upper limb exercise and affect patient outcomes. © 2016 American Physical Therapy Association.

Analysis of muscular activity and dynamic response of the lower limb adding vibration to cycling.

PubMed

Munera, Marcela; Bertucci, William; Duc, Sebastien; Chiementin, Xavier

2018-07-01

Vibration in cycling has been proved to have undesirable effects over health, comfort and performance of the rider. In this study, 15 participants performed eight 6-min sub-maximal pedalling exercises at a constant power output (150W) and pedalling cadence (80 RPM) being exposed to vibration at different frequencies (20, 30, 40, 50, 60, 70 Hz) or without vibration. Oxygen uptake (VO2), heart rate (HR), surface EMG activity of seven lower limb muscles (GMax, RF, BF, VM, GAS, SOL and TA) and 3-dimentional accelerations at ankle, knee and hip were measured during the exercises. To analyse the dynamic response, the influence of the pedalling movement was taken into account. The results show that there was not significant influence of vibrations on HR and VO2 during this pedalling exercise. However, muscular activity presents a significant increase with the presence of vibration that is influenced by the frequency, but this increase was very low (< 1%). Also, the dynamic response shows an influence of the frequency as well as an influence of the different parts of the pedalling cycle. Those results help to explain the effects of vibration on the human body and the influence of the rider/bike interaction in those effects.

Spatiotemporal, kinematic, force and muscle activation outcomes during gait and functional exercise in water compared to on land: A systematic review.

PubMed

Heywood, Sophie; McClelland, Jodie; Geigle, Paula; Rahmann, Ann; Clark, Ross

2016-07-01

Exercises replicating functional activities are commonly used in aquatic rehabilitation although it is not clear how the movement characteristics differ between the two environments. A systematic review was completed in order to compare the biomechanics of gait, closed kinetic chain and plyometric exercise when performed in water and on land. Databases including MEDLINE, CINAHL, SPORTDiscus, Embase and the Cochrane library were searched. Studies were included where a functional lower limb activity was performed in water and on land with the same instructions. Standardized mean differences (SMD) and 95% confidence intervals were calculated for spatiotemporal, kinematic, force and muscle activation outcomes. 28 studies included walking or running (19 studies), stationary running (three), closed kinetic chain exercise (two), plyometric exercise (three) and timed-up and go (one). Very large effect sizes showed self-selected speed of walking (SMD >4.66) and vertical ground reaction forces (VGRF) (SMD >1.91) in water were less than on land, however, lower limb range of movement and muscle activity were similar. VGRF in plyometric exercise was lower in water when landing but more similar between the two environments in propulsion. Maximal speed of movement for walking and stationary running was lower in water compared to on land (SMD>3.05), however was similar in propulsion in plyometric exercise. Drag forces may contribute to lower self-selected speed of walking. Monitoring speed of movement in water assists in determining the potential advantages or limitations of aquatic exercise and the task specificity to land-based function. Copyright © 2016 Elsevier B.V. All rights reserved.

Exercise Training Reverses Extrapulmonary Impairments in Smoke-exposed Mice.

PubMed

Bowen, T Scott; Aakerøy, Lars; Eisenkolb, Sophia; Kunth, Patricia; Bakkerud, Fredrik; Wohlwend, Martin; Ormbostad, Anne Marie; Fischer, Tina; Wisloff, Ulrik; Schuler, Gerhard; Steinshamn, Sigurd; Adams, Volker; Bronstad, Eivind

2017-05-01

Cigarette smoking is the main risk factor for chronic obstructive pulmonary disease and emphysema. However, evidence on the extrapulmonary effects of smoke exposure that precede lung impairments remains unclear at present, as are data on nonpharmacological treatments such as exercise training. Three groups of mice, including control (n = 10), smoking (n = 10), and smoking with 6 wk of high-intensity interval treadmill running (n = 11), were exposed to 20 wk of fresh air or whole-body cigarette smoke. Exercise capacity (peak oxygen uptake) and lung destruction (histology) were subsequently measured, whereas the heart, peripheral endothelium (aorta), and respiratory (diaphragm) and limb (extensor digitorum longus and soleus) skeletal muscles were assessed for in vivo and in vitro function, in situ mitochondrial respiration, and molecular alterations. Smoking reduced body weight by 26% (P < 0.05) without overt airway destruction (P > 0.05). Smoking impaired exercise capacity by 15% while inducing right ventricular dysfunction by ~20%, endothelial dysfunction by ~20%, and diaphragm muscle weakness by ~15% (all P < 0.05), but these were either attenuated or reversed by exercise training (P < 0.05). Compared with controls, smoking mice had normal limb muscle and mitochondrial function (cardiac and skeletal muscle fibers); however, diaphragm measures of oxidative stress and protein degradation were increased by 111% and 65%, respectively (P < 0.05), but these were attenuated by exercise training (P < 0.05). Prolonged cigarette smoking reduced exercise capacity concomitant with functional impairments to the heart, peripheral endothelium, and respiratory muscle that preceded the development of overt emphysema. However, high-intensity exercise training was able to reverse these smoke-induced extrapulmonary impairments.

Lower limb strength in sports-active transtibial amputees.

PubMed

Nolan, Lee

2009-09-01

The aim of this study was to compare hip strength in sports-active transtibial (TT) amputees, sedentary TT amputees and sports-active non-amputees. Three 'active' (exercising recreationally at least three times per week) TT amputees, four 'inactive' or sedentary TT amputees and nine 'active' able-bodied persons (AB) underwent concentric and eccentric hip flexion and extension strength testing on both limbs on an isokinetic dynamometer at 60 and 120 degrees /s. Little strength asymmetry was noted between the limbs of the active TT amputees (8% and 14% at 60 and 120 degrees /s, respectively), their residual limb being slightly stronger. Inactive TT amputees demonstrated up to 49% strength asymmetry, their intact limb being the stronger. Active TT amputees demonstrated greater peak hip torques (Nm/kg) for all conditions and speeds compared to inactive TT amputees. Peak hip torques (Nm/kg), were greater in the active TT amputees' residual limb compared to AB. While inactive TT amputees and AB had similar flexion/extension ratios, active TT amputees exhibited a lower ratio indicating overdeveloped hip extensors with respect to their hip flexors. It is not known whether this is due to the demands of sport or exercise with a prosthetic limb, or remaining residual thigh atrophy.

The Effects of Multiple Cold Water Immersions on Indices of Muscle Damage

PubMed Central

Goodall, Stuart; Howatson, Glyn

2008-01-01

The aim of this investigation was to elucidate the efficacy of repeated cold water immersions (CWI) in the recovery of exercise induced muscle damage. A randomised group consisting of eighteen males, mean ± s age, height and body mass were 24 ± 5 years, 1.82 ± 0.06 m and 85.7 ± 16.6 kg respectively, completed a bout of 100 drop jumps. Following the bout of damaging exercise, participants were randomly but equally assigned to either a 12 min CWI (15 ± 1 °C; n = 9) group who experienced immersions immediately post-exercise and every 24 h thereafter for the following 3 days, or a control group (no treatment; n = 9). Maximal voluntary contraction (MVC) of the knee extensors, creatine kinase activity (CK), muscle soreness (DOMS), range of motion (ROM) and limb girth were measured pre-exercise and then for the following 96 h at 24 h increments. In addition MVC was also recorded immediately post-exercise. Significant time effects were seen for MVC, CK, DOMS and limb girth (p < 0.05) indicating muscle damage was evident, however there was no group effect or interaction observed showing that CWI did not attenuate any of the dependent variables (p > 0.05). These results suggest that repeated CWI do not enhance recovery from a bout of damaging eccentric contractions. Key pointsCryotherapy, particularly cold water immersions are one of the most common interventions used in order to enhance recovery post-exercise.There is little empirical evidence demonstrating benefits from cold water immersions. Research evidence is equivocal, probably due to methodological inconsistencies.Our results show that the cryotherapy administered did not attenuate any markers of EIMD or enhance the recovery of function.We conclude that repeated cold water immersions are ineffective in the recovery from heavy plyometric exercise and suggest athletes and coaches should use caution before using this intervention as a recovery strategy PMID:24149455

Effects of whole-body vibration on muscle architecture, muscle strength, and balance in stroke patients: a randomized controlled trial.

PubMed

Marín, Pedro J; Ferrero, Cristina M; Menéndez, Héctor; Martín, Juan; Herrero, Azael J

2013-10-01

The aim of the present study was to analyze the effects of whole-body vibration on lower limb muscle architecture, muscle strength, and balance in stroke patients during a period of 3 mos. The inclusion criteria were having had ischemic or hemorrhagic stroke at least 6 mos before the study and a National Institutes of Health Stroke Scale score of greater than 1 and less than 20. The patients were randomly divided into two groups: an experimental group (n = 11, six men and five women; age, 62.4 ± 10.7 yrs; height, 1.64 ± 0.07 m; mass, 69.4 ± 12.9 kg) and a sham group (n = 9, five men and four women; age, 64.4 ± 7.6 yrs; height, 1.62 ± 0.07 m; mass, 75.0 ± 15.8 kg). The experimental group received a whole-body vibration treatment, with an increase in frequency, sets, and time per set during 17 sessions. The sham group performed the same exercises as that of the experimental group but was not exposed to vibration. Outcome variables included the muscle architecture (the rectus femoris, the vastus lateralis, and the medial gastrocnemius), the maximal isometric voluntary contraction of the knee extensors, and the Berg Balance Scale. There were no significant differences between the groups on the primary outcomes of lower limb muscle architecture, muscle strength, and balance. It seems that whole-body vibration exercise does not augment the increase in neuromuscular performance and lower limb muscle architecture induced by isometric exercise alone in stroke patients.

Exerciser for rehabilitation of the Arm (ERA): Development and unique features of a 3D end-effector robot.

PubMed

Milot, Marie-Helene; Hamel, Mathieu; Provost, Philippe-Olivier; Bernier-Ouellet, Julien; Dupuis, Maxime; Letourneau, Dominic; Briere, Simon; Michaud, Francois

2016-08-01

Stroke is one of the leading causes of disability worldwide. Consequently, many stroke survivors exhibit difficulties undergoing voluntary movement in their affected upper limb, compromising their functional performance and level of independence. To minimize the negative impact of stroke disabilities, exercises are recognized as a key element in post-stroke rehabilitation. In order to provide the practice of exercises in a uniform and controlled manner as well as increasing the efficiency of therapists' interventions, robotic training has been found, and continues to prove itself, as an innovative intervention for post-stroke rehabilitation. However, the complexity as well as the limited degrees of freedom and workspace of currently commercially available robots can limit their use in clinical settings. Up to now, user-friendly robots covering a sufficiently large workspace for training of the upper limb in its full range of motion are lacking. This paper presents the design and implementation of ERA, an upper-limb 3-DOF force-controlled exerciser robot, which presents a workspace covering the entire range of motion of the upper limb. The ERA robot provides 3D reaching movements in a haptic virtual environment. A description of the hardware and software components of the ERA robot is also presented along with a demonstration of its capabilities in one of the three operational modes that were developed.

Crouch gait can be an effective form of forced-use/no constraint exercise for the paretic lower limb in stroke

PubMed Central

Rota, Viviana; Malloggi, Chiara; Brugliera, Luigia; Catino, Luigi

2017-01-01

In hemiplegic gait the paretic lower limb provides less muscle power and shows a briefer stance compared with the unaffected limb. Yet, a longer stance and a higher power can be obtained from the paretic lower limb if gait speed is increased. This supports the existence of a ‘learned non-use’ phenomenon, similar to that underlying some asymmetric impairments of the motion of the eyes and of the upper limbs. Crouch gait (CG) (bent-hip bent-knee, about 30° minimum knee flexion) might be an effective form of ‘forced-use’ treatment of the paretic lower limb. It is not known whether it also stimulates a more symmetric muscle power output. Gait analysis on a force treadmill was carried out in 12 healthy adults and seven hemiplegic patients (1–127 months after stroke, median: 1.6). Speed was imposed at 0.3 m/s. Step length and single and double stance times, sagittal joint rotations, peak positive power, and work in extension of the hip, knee, and ankle (plantar flexion), and surface electromyography (sEMG) area from extensor muscles during the generation of power were measured on either side during both erect and crouch walking. Significance was set at P less than 0.05; corrections for multiplicity were applied. Patients, compared with healthy controls, adopted in both gait modalities and on both sides a shorter step length (61–84%) as well as a shorter stance (76–90%) and swing (63–83%) time. As a rule, they also provided a higher muscular work (median: 137%, range: 77–250%) paralleled by a greater sEMG area (median: 174%, range: 75–185%). In erect gait, the generation of peak extensor power across hip, knee, and ankle joints was in general lower (83–90%) from the paretic limb and higher (98–165%) from the unaffected limb compared with control values. In CG, peak power generation across the three lower limb joints was invariably higher in hemiparetic patients: 107–177% from the paretic limb and 114–231% from the unaffected limb. When gait shifted from erect to crouch, only for hemiplegic patients, at the hip, the paretic/unaffected ratio increased significantly. For peak power, work, sEMG area, and joint rotation, the paretic/unaffected ratio increased from 55 to 85%, 56 to 72%, 68 to 91%, and 67 to 93%, respectively. CG appears to be an effective form of forced-use exercise eliciting more power and work from the paretic lower limb muscles sustained by a greater neural drive. It also seems effective in forcing a more symmetric power and work from the hip extensor muscles, but neither from the knee nor the ankle. PMID:28574860

How Therapists Use Visualizations of Upper Limb Movement Information From Stroke Patients: A Qualitative Study With Simulated Information

PubMed Central

Fong, Justin; Klaic, Marlena; Nair, Siddharth; Vetere, Frank; Cofré Lizama, L. Eduardo; Galea, Mary Pauline

2016-01-01

Background Stroke is a leading cause of disability worldwide, with upper limb deficits affecting an estimated 30% to 60% of survivors. The effectiveness of upper limb rehabilitation relies on numerous factors, particularly patient compliance to home programs and exercises set by therapists. However, therapists lack objective information about their patients’ adherence to rehabilitation exercises as well as other uses of the affected arm and hand in everyday life outside the clinic. We developed a system that consists of wearable sensor technology to monitor a patient’s arm movement and a Web-based dashboard to visualize this information for therapists. Objective The aim of our study was to evaluate how therapists use upper limb movement information visualized on a dashboard to support the rehabilitation process. Methods An interactive dashboard prototype with simulated movement information was created and evaluated through a user-centered design process with therapists (N=8) at a rehabilitation clinic. Data were collected through observations of therapists interacting with an interactive dashboard prototype, think-aloud data, and interviews. Data were analyzed qualitatively through thematic analysis. Results Therapists use visualizations of upper limb information in the following ways: (1) to obtain objective data of patients’ activity levels, exercise, and neglect outside the clinic, (2) to engage patients in the rehabilitation process through education, motivation, and discussion of experiences with activities of daily living, and (3) to engage with other clinicians and researchers based on objective data. A major limitation is the lack of contextual data, which is needed by therapists to discern how movement data visualized on the dashboard relate to activities of daily living. Conclusions Upper limb information captured through wearable devices provides novel insights for therapists and helps to engage patients and other clinicians in therapy. Consideration needs to be given to the collection and visualization of contextual information to provide meaningful insights into patient engagement in activities of daily living. These findings open the door for further work to develop a fully functioning system and to trial it with patients and clinicians during therapy. PMID:28582257

Decreased muscle oxygenation and increased arterial blood flow in the non-exercising limb during leg exercise.

PubMed

Shiroishi, Kiyoshi; Kime, Ryotaro; Osada, Takuya; Murase, Norio; Shimomura, Kousuke; Katsumura, Toshihito

2010-01-01

We evaluated arterial blood flow, muscle tissue oxygenation and muscle metabolism in the non-exercising limb during leg cycling exercise. Ten healthy male volunteers performed a graded leg cycling exercise at 0, 40, 80, 120 and 160 watts (W) for 5 min each. Tissue oxygenation index (TOI) of the non-exercising left forearm muscle was measured using a near-infrared spatially resolved spectroscopy (NIR(SRS)), and non-exercising forearm blood flow ((NONEX)FBF) in the brachial artery was also evaluated by a Doppler ultrasound system. We also determined O(2) consumption of the non-exercising forearm muscle (NONEXV(O)(2mus)) by the rate of decrease in O(2)Hb during arterial occlusion at each work rate. TOI was significantly decreased at 160 W (p < 0.01) compared to the baseline. The (NONEX)V(O)(2mus) at each work rate was not significantly increased. In contrast, (NONEX)FBF was significantly increased at 120 W (p < 0.05) and 160 W (p < 0.01) compared to the baseline. These results suggest that the O(2) supply to the non-exercising muscle may be reduced, even though (NONEX)FBF increases at high work rates during leg cycling exercise.

Risk Factors Related to Lower Limb Edema, Compression, and Physical Activity During Pregnancy: A Retrospective Study.

PubMed

Ochalek, Katarzyna; Pacyga, Katarzyna; Curyło, Marta; Frydrych-Szymonik, Aleksandra; Szygula, Zbigniew

2017-06-01

The aim of the article was to assess risk factors and to analyze methods applied in the prevention and treatment of lower limb edema in pregnant women with a particular focus on compression therapy and exercise. Fifty-four women during the early 24-hour period following delivery were assigned to two groups-either to a group with swellings of lower limbs during pregnancy, located mostly in the region of feet and lower legs (Group A, n = 42), or to a group without edema (Group B, n = 12). Two subgroups, namely A1 and A2, were additionally distinguished in Group A. Compression therapy that consisted in wearing circular-knit compression garments, usually at compression level 1 (ccl1), with three cases of compression level 2 (ccl2) was applied only in Group A1 (n = 18 women). The analysis has led to a conclusion that there is a link between the occurrence of edema during pregnancy on the one hand and the pregravidity episodes of venous conditions (vascular insufficiency and thrombosis, p < 0.05) and the lack of physical exercise during pregnancy (p = 0.01) on the other hand. However, interdependence between the occurrence of edema and the number of times a female had been pregnant, physical activity before gravidity, or body mass index before gravidity has not been identified. Only 33% of the analyzed women applied compression therapy during pregnancy; a half of them continued to apply compression during the postpartum period. Compression therapy in combination with proper physical exercises appears to be an effective means to prevent and treat venous thrombosis and lower limb edema in pregnant women, yet further research in line with the principles of evidence-based medicine is required.

Effect of acute inspiratory muscle exercise on blood flow of resting and exercising limbs and glucose levels in type 2 diabetes.

PubMed

Corrêa, Ana Paula dos Santos; Antunes, Cristiano Fetter; Figueira, Franciele Ramos; de Castro, Marina Axmann; Ribeiro, Jorge Pinto; Schaan, Beatriz D'Agord

2015-01-01

To evaluate the effects of inspiratory loading on blood flow of resting and exercising limbs in patients with diabetic autonomic neuropathy. Ten diabetic patients without cardiovascular autonomic neuropathy (DM), 10 patients with cardiovascular autonomic neuropathy (DM-CAN) and 10 healthy controls (C) were randomly assigned to inspiratory muscle load of 60% or 2% of maximal inspiratory pressure (PImax) for approximately 5 min, while resting calf blood flow (CBF) and exercising forearm blood flow (FBF) were measured. Reactive hyperemia was also evaluated. From the 20 diabetic patients initially allocated, 6 wore a continuous glucose monitoring system to evaluate the glucose levels during these two sessions (2%, placebo or 60%, inspiratory muscle metaboreflex). Mean age was 58 ± 8 years, and mean HbA1c, 7.8% (62 mmol/mol) (DM and DM-CAN). A PImax of 60% caused reduction of CBF in DM-CAN and DM (P<0.001), but not in C, whereas calf vascular resistance (CVR) increased in DM-CAN and DM (P<0.001), but not in C. The increase in FBF during forearm exercise was blunted during 60% of PImax in DM-CAN and DM, and augmented in C (P<0.001). Glucose levels decreased by 40 ± 18.8% (P<0.001) at 60%, but not at 2%, of PImax. A negative correlation was observed between reactive hyperemia and changes in CVR (Beta coefficient = -0.44, P = 0.034). Inspiratory muscle loading caused an exacerbation of the inspiratory muscle metaboreflex in patients with diabetes, regardless of the presence of neuropathy, but influenced by endothelial dysfunction. High-intensity exercise that recruits the diaphragm can abruptly reduce glucose levels.

Exercise training causes differential changes in gene expression in diaphragm arteries and 2A arterioles of obese rats.

PubMed

Laughlin, M Harold; Padilla, Jaume; Jenkins, Nathan T; Thorne, Pamela K; Martin, Jeffrey S; Rector, R Scott; Akter, Sadia; Davis, J Wade

2015-09-15

We employed next-generation, transcriptome-wide RNA sequencing (RNA-Seq) technology to assess the effects of two different exercise training protocols on transcriptional profiles in diaphragm second-order arterioles (D2a) and in the diaphragm feed artery (DFA) from Otsuka Long Evans Tokushima Fatty (OLETF) rats. Arterioles were isolated from the diaphragm of OLETF rats that underwent an endurance exercise training program (EX; n = 13), interval sprint training program (SPRINT; n = 14), or remained sedentary (Sed; n = 12). Our hypothesis was that exercise training would have similar effects on gene expression in the diaphragm and soleus muscle arterioles because diaphragm blood flow increases during exercise to a similar extent as in soleus. Results reveal that several canonical pathways that were significantly altered by exercise in limb skeletal muscles were not among the pathways significantly changed in the diaphragm arterioles including actin cytoskeleton signaling, role of NFAT in regulation of immune response, protein kinase A signaling, and protein ubiquitination pathway. EX training altered the expression of a smaller number of genes than did SPRINT in the DFA but induced a larger number of genes with altered expression in the D2a than did SPRINT. In fact, FDR differential expression analysis (FDR, 10%) indicated that only two genes exhibited altered expression in D2a of SPRINT rats. Very few of the genes that exhibited altered expression in the DFA or D2a were also altered in limb muscle arterioles. Finally, results indicate that the 2a arterioles of soleus muscle (S2a) from endurance-trained animals and the DFA of SPRINT animals exhibited the largest number of genes with altered expression.

The Effects of a Motorized Aquatic Treadmill Exercise Program on Muscle Strength, Cardiorespiratory Fitness, and clinical function in Subacute Stroke Patients -- a Randomized Controlled Pilot Trial.

PubMed

Lee, So Young; Han, Eun Young; Kim, Bo Ryun; Im, Sang Hee

2018-03-12

The aim of this study was to assess the effects of a motorized aquatic treadmill exercise program improve the isometric strength of the knee muscles, cardiorespiratory fitness, arterial stiffness, motor function, balance, functional outcomes and quality of life in subacute stroke patients. Thirty-two patients were randomly assigned to 4-week training sessions of either aquatic therapy(n=19) or land-based aerobic exercise(n=18). Isometric strength was measured using an isokinetic dynamometer. Cardiopulmonary fitness was evaluated using a symptom-limited exercise tolerance test and by measuring brachial ankle pulse wave velocity. Moreover, motor function(Fugl-Meyer Assessment[FMA] and FMA-lower limb[FMA-LL]), balance(Berg Balance Scale[BBS]), Activities of daily living(Korean version of the Modified Barthel Index [K-MBI]), and Quality of life(EQ-5D index) were examined. There were no inter-group differences between demographic and clinical characteristics at baseline(p>0.05). The results shows significant improvements in peak oxygen consumption (p=0.02), maximal isometric strength of the bilateral knee extensors (p<0.01) and paretic knee flexors (p=0.01), FMA (p=0.03), FMA-LL (p=0.01), BBS (p=0.01), K-MBI (p<0.01), and EQ-5D index (p=0.04) after treatment in the aquatic therapy group. However, only significant improvements in maximal isometric strength in the knee extensors (p=0.03) and flexors (p=0.04) were found within the aquatic therapy group and control group. Water-based aerobic exercise performed on a motorized aquatic treadmill had beneficial effect on isometric muscle strength in the lower limb.

Health Promotion Outcomes of a Newly Developed Elastic Band Exercise Program for Older Adults in the Community: A Pilot Test.

PubMed

Chan, Shu-Ya; Kuo, Chang-Chih; Chen, Kuei-Min; Tseng, Wei-Shyuan; Huang, Hsin-Ting; Li, Chun-Huw

2016-06-01

Studies indicate that the incidence of disease, the mortality rate, and medical costs are significantly higher in people aged 65 years and over who do not engage in physical activities than in their peers who do engage in these activities. Therefore, promoting appropriate physical activity among older adults in the community is essential to delaying the health implications of aging. This pilot test was developed to assess the effectiveness of a newly developed Senior Elastic Band (SEB) exercise program on the health of older adults in community care stations. A quasiexperimental design was used. A convenience sample of 20 participants from a community care station was recruited. The SEB intervention included three phases (warm-up, aerobic motion, and static stretching) and was conducted three times per week, 40 minutes per session for 1 month. Twelve health indicators in three categories (functional fitness, self-perceived health status, and sleep quality) were examined before and immediately after 1 month of SEB exercises. Participants showed improved performance at the end of the 1-month study for the following indicators: lung capacity, cardiopulmonary fitness, upper and lower body flexibilities, upper limb muscle power, lower limb muscle endurance, and self-perceived physical health status (all ps < .05). No significant differences were identified for the other indicators. The SEB exercise program shows preliminary and promising effects on improving the health of older adults in a community care station. Healthcare professionals who work with older adults living in the community may consider the SEB exercise program as a health promotion modality to recommend and implement with this population. However, we recommend further testing the long-term effects of this program on a larger population.

Effects of High Intensity Interval Training on Increasing Explosive Power, Speed, and Agility

NASA Astrophysics Data System (ADS)

Fajrin, F.; Kusnanik, N. W.; Wijono

2018-01-01

High Intensity Interval Training (HIIT) is a type of exercise that combines high-intensity exercise and low intensity exercise in a certain time interval. This type of training is very effective and efficient to improve the physical components. The process of improving athletes achievement related to how the process of improving the physical components, so the selection of a good practice method will be very helpful. This study aims to analyze how is the effects of HIIT on increasing explosive power, speed, and agility. This type of research is quantitative with quasi-experimental methods. The design of this study used the Matching-Only Design, with data analysis using the t-test (paired sample t-test). After being given the treatment for six weeks, the results showed there are significant increasing in explosive power, speed, and agility. HIIT in this study used a form of exercise plyometric as high-intensity exercise and jogging as mild or moderate intensity exercise. Increase was due to the improvement of neuromuscular characteristics that affect the increase in muscle strength and performance. From the data analysis, researchers concluded that, Exercises of High Intensity Interval Training significantly effect on the increase in Power Limbs, speed, and agility.

Bruxism: Is There an Indication for Muscle-Stretching Exercises?

PubMed

Gouw, Simone; de Wijer, Anton; Creugers, Nico Hj; Kalaykova, Stanimira I

Bruxism is a common phenomenon involving repetitive activation of the masticatory muscles. Muscle-stretching exercises are a recommended part of several international guidelines for musculoskeletal disorders and may be effective in management of the jaw muscle activity that gives rise to bruxism. However, most studies of muscle-stretching exercises have mainly focused on their influence on performance (eg, range of motion, coordination, and muscle strength) of the limb or trunk muscles of healthy individuals or individuals with sports-related injuries. Very few have investigated stretching of the human masticatory muscles and none muscle-stretching exercises in the management of (sleep) bruxism. This article reviews the literature on muscle-stretching exercises and their potential role in the management of sleep bruxism or its consequences in the musculoskeletal system.

Balance and gait performance after maximal and submaximal endurance exercise in seniors: is there a higher fall-risk?

PubMed

Donath, Lars; Zahner, Lukas; Roth, Ralf; Fricker, Livia; Cordes, Mareike; Hanssen, Henner; Schmidt-Trucksäss, Arno; Faude, Oliver

2013-03-01

Impaired balance and gait performance increase fall-risk in seniors. Acute effects of different exercise bouts on gait and balance were not yet addressed. Therefore, 19 healthy seniors (10 women, 9 men, age: 64.6 ± 3.2 years) were examined on 3 days. After exhaustive treadmill testing, participants randomly completed a 2-km treadmill walking test (76 ± 8 % VO(2max)) and a resting control condition. Standing balance performance (SBALP) was assessed by single limb-eyes opened (SLEO) and double limb-eyes closed (DLEC) stance. Gait parameters were collected at comfortable walking velocity. A condition × time interaction of center of pressure path length (COP(path)) was observed for both balance tasks (p < 0.001). Small (Cohen's d = 0.42, p = 0.05) and large (d = 1.04, p < 0.001) COP(path) increases were found after 2-km and maximal exercise during DLEC. Regarding SLEO, slightly increased COP(path) occurred after 2-km walking (d = 0.29, p = 0.65) and large increases after exhaustive exercise (d = 1.24, p < 0.001). No significant differences were found for gait parameters. Alterations of SBALP after exhaustive exercise might lead to higher fall-risk in seniors. Balance changes upon 2-km testing might be of minor relevance. Gait is not affected during single task walking at given velocities.

Effects of regular exercise training on skeletal muscle contractile function

NASA Technical Reports Server (NTRS)

Fitts, Robert H.

2003-01-01

Skeletal muscle function is critical to movement and one's ability to perform daily tasks, such as eating and walking. One objective of this article is to review the contractile properties of fast and slow skeletal muscle and single fibers, with particular emphasis on the cellular events that control or rate limit the important mechanical properties. Another important goal of this article is to present the current understanding of how the contractile properties of limb skeletal muscle adapt to programs of regular exercise.

Molecular effects of exercise training in patients with cardiovascular disease: focus on skeletal muscle, endothelium, and myocardium.

PubMed

Adams, Volker; Reich, Bernhard; Uhlemann, Madlen; Niebauer, Josef

2017-07-01

For decades, we have known that exercise training exerts beneficial effects on the human body, and clear evidence is available that a higher fitness level is associated with a lower incidence of suffering premature cardiovascular death. Despite this knowledge, it took some time to also incorporate physical exercise training into the treatment plan for patients with cardiovascular disease (CVD). In recent years, in addition to continuous exercise training, further training modalities such as high-intensity interval training and pyramid training have been introduced for coronary artery disease patients. The beneficial effect for patients with CVD is clearly documented, and during the last years, we have also started to understand the molecular mechanisms occurring in the skeletal muscle (limb muscle and diaphragm) and endothelium, two systems contributing to exercise intolerance in these patients. In the present review, we describe the effects of the different training modalities in CVD and summarize the molecular effects mainly in the skeletal muscle and cardiovascular system. Copyright © 2017 the American Physiological Society.

The effect of combined resistance exercise training and vitamin D3 supplementation on musculoskeletal health and function in older adults: a systematic review and meta-analysis.

PubMed

Antoniak, Anneka Elizabeth; Greig, Carolyn A

2017-07-20

In older adults, there is a blunted responsiveness to resistance training and reduced muscle hypertrophy compared with younger adults. There is evidence that both exercise training and vitamin D supplementation may benefit musculoskeletal health in older adults, and it is plausible that in combination their effects may be additive. The aim of this systematic review was to evaluate the effectiveness of combined resistance exercise training and vitamin D 3 supplementation on musculoskeletal health in older adults. A comprehensive search of electronic databases, including Science Direct, Medline, PubMed, Google Scholar and Cochrane Central Register of Controlled Trials (Cochrane CENTRAL accessed by Wiley Science) was conducted. Eligible studies were randomised controlled trials including men and women (aged ≥65 years or mean age ≥65 years); enlisting resistance exercise training and vitamin D 3 supplementation; including outcomes of muscle strength, function, muscle power, body composition, serum vitamin D/calcium status or quality of life comparing results with a control group. The review was informed by a preregistered protocol (http://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42015020157). Seven studies including a total of 792 participants were identified. Studies were categorised into two groups; group 1 compared vitamin D 3 supplementation and exercise training versus exercise alone (describing the additive effect of vitamin D 3 supplementation when combined with resistance exercise training) and group 2 compared vitamin D 3 supplementation and exercise training versus vitamin D 3 supplementation alone (describing the additive effect of resistance exercise training when combined with vitamin D 3 supplementation).Meta-analyses for group 1 found muscle strength of the lower limb to be significantly improved within the intervention group (0.98, 95% CI 0.73 to 1.24, p<0.001); all other outcomes showed small but non-significant positive effects for the intervention group. The short physical performance battery (SPPB), timed up and go (TUG), muscle strength of the lower limb and femoral neck bone mineral density showed significantly greater improvements in the intervention group for group 2 comparisons. This review provides tentative support for the additive effect of resistance exercise and vitamin D 3 supplementation for the improvement of muscle strength in older adults. For other functional variables, such as SPPB and TUG, no additional benefit beyond exercise was shown. Further evidence is required to draw firm conclusions or make explicit recommendations regarding combined exercise and vitamin D 3 supplementation. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Testing the effectiveness of a self-efficacy based exercise intervention for adults with venous leg ulcers: protocol of a randomised controlled trial

PubMed Central

2014-01-01

Background Exercise and adequate self-management capacity may be important strategies in the management of venous leg ulcers. However, it remains unclear if exercise improves the healing rates of venous leg ulcers and if a self-management exercise program based on self-efficacy theory is well adhered to. Method/design This is a randomised controlled in adults with venous leg ulcers to determine the effectiveness of a self-efficacy based exercise intervention. Participants with venous leg ulcers are recruited from 3 clinical sites in Australia. After collection of baseline data, participants are randomised to either an intervention group or control group. The control group receive usual care, as recommended by evidence based guidelines. The intervention group receive an individualised program of calf muscle exercises and walking. The twelve week exercise program integrates multiple elements, including up to six telephone delivered behavioural coaching and goal setting sessions, supported by written materials, a pedometer and two follow-up booster calls if required. Participants are encouraged to seek social support among their friends, self-monitor their weekly steps and lower limb exercises. The control group are supported by a generic information sheet that the intervention group also receive encouraging lower limb exercises, a pedometer for self-management and phone calls at the same time points as the intervention group. The primary outcome is the healing rates of venous leg ulcers which are assessed at fortnightly clinic appointments. Secondary outcomes, assessed at baseline and 12 weeks: functional ability (range of ankle motion and Tinetti gait and balance score), quality of life and self-management scores. Discussion This study seeks to address a significant gap in current wound management practice by providing evidence for the effectiveness of a home-based exercise program for adults with venous leg ulcers. Theory-driven, evidence-based strategies that can improve an individual’s exercise self-efficacy and self-management capacity could have a significant impact in improving the management of people with venous leg ulcers. Information gained from this study will provide much needed information on management of this chronic disease to promote health and independence in this population. Trial registration Australian New Zealand Clinical Trials Registry ACTRN12612000475842. PMID:25277416

Effect of acute augmented feedback on between limb asymmetries and eccentric knee flexor strength during the Nordic hamstring exercise.

PubMed

Chalker, Wade J; Shield, Anthony J; Opar, David A; Rathbone, Evelyne N; Keogh, Justin W L

2018-01-01

Hamstring strain injuries (HSI) are one of the most prevalent and serious injuries affecting athletes, particularly those in team ball sports or track and field. Recent evidence demonstrates that eccentric knee flexor weakness and between limb asymmetries are possible risk factors for HSIs. While eccentric hamstring resistance training, e.g. the Nordic hamstring exercise (NHE) significantly increases eccentric hamstring strength and reduces HSI risk, little research has examined whether between limb asymmetries can be reduced with training. As augmented feedback (AF) can produce significant acute and chronic increases in muscular strength and reduce injury risk, one way to address the limitation in the eccentric hamstring training literature may be to provide athletes real-time visual AF of their NHE force outputs with the goal to minimise the between limb asymmetry. Using a cross over study design, 44 injury free, male cricket players from two skill levels performed two NHE sessions on a testing device. The two NHE sessions were identical with the exception of AF, with the two groups randomised to perform the sessions with and without visual feedback of each limb's force production in real-time. When performing the NHE with visual AF, the participants were provided with the following instructions to 'reduce limb asymmetries as much as possible using the real-time visual force outputs displayed in front them'. Between limb asymmetries and mean peak force outputs were compared between the two feedback conditions (FB1 and FB2) using independent t -tests to ensure there was no carryover effect, and to determine any period and treatment effects. The magnitude of the differences in the force outputs were also examined using Cohen d effect size. There was a significant increase in mean peak force production when feedback was provided (mean difference, 21.7 N; 95% CI [0.2-42.3 N]; P = 0.048; d = 0.61) and no significant difference in between limb asymmetry for feedback or no feedback (mean difference, 5.7%; 95% CI [-2.8% to 14.3%]; P = 0.184; d = 0.41). Increases in force production under feedback were a result of increased weak limb (mean difference, 15.0 N; 95% CI [1.6-28.5 N]; P = 0.029; d = 0.22) force contribution compared to the strong limb. The results of this study further support the potential utility of AF in improving force production and reducing risk in athletic populations. While there are currently some financial limitations to the application of this training approach, even in high-performance sport, such an approach may improve outcomes for HSI prevention programs. Further research with more homogenous populations over greater periods of time that assess the chronic effect of such training practices on injury risk factors and injury rates are also recommended.

Influence of complementing a robotic upper limb rehabilitation system with video games on the engagement of the participants: a study focusing on muscle activities.

PubMed

Li, Chong; Rusák, Zoltán; Horváth, Imre; Ji, Linhong

2014-12-01

Efficacious stroke rehabilitation depends not only on patients' medical treatment but also on their motivation and engagement during rehabilitation exercises. Although traditional rehabilitation exercises are often mundane, technology-assisted upper-limb robotic training can provide engaging and task-oriented training in a natural environment. The factors that influence engagement, however, are not fully understood. This paper therefore studies the relationship between engagement and muscle activities as well as the influencing factors of engagement. To this end, an experiment was conducted using a robotic upper limb rehabilitation system with healthy individuals in three training exercises: (a) a traditional exercise, which is typically used for training the grasping function, (b) a tracking exercise, currently used in robot-assisted stroke patient rehabilitation for fine motor movement, and (c) a video game exercise, which is a proliferating approach of robot-assisted rehabilitation enabling high-level active engagement of stroke patients. These exercises differ not only in the characteristics of the motion that they use but also in their method of triggering engagement. To measure the level of engagement, we used facial expressions, motion analysis of the arm movements, and electromyography. The results show that (a) the video game exercise could engage the participants for a longer period than the other two exercises, (b) the engagement level decreased when the participants became too familiar with the exercises, and (c) analysis of normalized root mean square in electromyographic data indicated that muscle activities were more intense when the participants are engaged. This study shows that several sub-factors on engagement, such as versatility of feedback, cognitive tasks, and competitiveness, may influence engagement more than the others. To maintain a high level of engagement, the rehabilitation system needs to be adaptive, providing different exercises to engage the participants.

Creatine kinase response to high-intensity aerobic exercise in adult-onset muscular dystrophy.

PubMed

Andersen, Søren P; Sveen, Marie-Louise; Hansen, Regitze S; Madsen, Karen L; Hansen, Jonas B; Madsen, Mads; Vissing, John

2013-12-01

We investigated the effect of high-intensity exercise on plasma creatine kinase (CK) in patients with muscular dystrophies. Fourteen patients with Becker (BMD), facioscapulohumeral (FSHD), or limb-girdle type 2 (LGMD2) muscular dystrophy, and 8 healthy subjects performed 5 cycling tests: an incremental max test, and tests at 65%, 75%, 85%, and 95% of maximal oxygen uptake (VO2max ). Heart rate and oxygen consumption were measured during the tests, and plasma CK was measured before, immediately after, and 24 hours after exercise. All subjects were able to perform high-intensity exercise at the different levels. In patients with LGMD2 and FSHD, CK normalized 24 hours after exercise compared with the pre-exercise value, whereas those with BMD and healthy controls had elevated CK values 24 hours after exercise. The findings suggest that high-intensity exercise is generally well tolerated in patients with LGMD2 and FSHD, whereas those with BMD may be more prone to exercise-induced damage. Copyright © 2013 Wiley Periodicals, Inc.

Declining Skeletal Muscle Function in Diabetic Peripheral Neuropathy.

PubMed

Parasoglou, Prodromos; Rao, Smita; Slade, Jill M

2017-06-01

The present review highlights current concepts regarding the effects of diabetic peripheral neuropathy (DPN) in skeletal muscle. It discusses the lack of effective pharmacologic treatments and the role of physical exercise intervention in limb protection and symptom reversal. It also highlights the importance of magnetic resonance imaging (MRI) techniques in providing a mechanistic understanding of the disease and helping develop targeted treatments. This review provides a comprehensive reporting on the effects of DPN in the skeletal muscle of patients with diabetes. It also provides an update on the most recent trials of exercise intervention targeting DPN pathology. Lastly, we report on emerging MRI techniques that have shown promise in providing a mechanistic understanding of DPN and can help improve the design and implementation of clinical trials in the future. Impairments in lower limb muscles reduce functional capacity and contribute to altered gait, increased fall risk, and impaired balance in patients with DPN. This finding is an important concern for patients with DPN because their falls are likely to be injurious and lead to bone fractures, poorly healing wounds, and chronic infections that may require amputation. Preliminary studies have shown that moderate-intensity exercise programs are well tolerated by patients with DPN. They can improve their cardiorespiratory function and partially reverse some of the symptoms of DPN. MRI has the potential to bring new mechanistic insights into the effects of DPN as well as to objectively measure small changes in DPN pathology as a result of intervention. Noninvasive exercise intervention is particularly valuable in DPN because of its safety, low cost, and potential to augment pharmacologic interventions. As we gain a better mechanistic understanding of the disease, more targeted and effective interventions can be designed. Copyright © 2017 Elsevier HS Journals, Inc. All rights reserved.

The effect of exercise hypertrophy and disuse atrophy on muscle contractile properties: a mechanomyographic analysis.

PubMed

Than, Christian; Tosovic, Danijel; Seidl, Laura; Mark Brown, J

2016-12-01

To determine whether mechanomyographic (MMG) determined contractile properties of the biceps brachii change during exercise-induced hypertrophy and subsequent disuse atrophy. Healthy subjects (mean ± SD, 23.7 ± 2.6 years, BMI 21.8 ± 2.4, n = 19) performed unilateral biceps curls (9 sets × 12 repetitions, 5 sessions per week) for 8 weeks (hypertrophic phase) before ceasing exercise (atrophic phase) for the following 8 weeks (non-dominant limb; treatment, dominant limb; control). MMG measures of muscle contractile properties (contraction time; T c , maximum displacement; D max , contraction velocity; V c ), electromyographic (EMG) measures of muscle fatigue (median power frequency; MPF), strength measures (maximum voluntary contraction; MVC) and measures of muscle thickness (ultrasound) were obtained. Two-way repeated measures ANOVA showed significant differences (P < 0.05) between treatment and control limbs. During the hypertrophic phase treatment MVC initially declined (weeks 1-3), due to fatigue (decline in MPF), followed by improvement against control during weeks 6-8. Between weeks 5 and 8 treatment, muscle thickness was greater than control, reflecting gross hypertrophy. MMG variables Dmax (weeks 2, 7) and Vc (weeks 7, 8) declined. During the atrophic phase, MVC (weeks 9-12) and muscle thickness (weeks 9, 10) initially remained high before declining to control levels, reflecting gross atrophy. MMG variables D max (weeks 9, 14) and V c (weeks 9, 14, 15) also declined during the atrophic phase. No change in T c was found throughout the hypertrophic or atrophic phases. MMG detects changes in contractile properties during stages of exercise-induced hypertrophy and disuse atrophy suggesting its applicability as a clinical tool in musculoskeletal rehabilitation.

Military exercises, knee and ankle joint position sense, and injury in male conscripts: a pilot study.

PubMed

Mohammadi, Farshid; Azma, Kamran; Naseh, Iman; Emadifard, Reza; Etemadi, Yasaman

2013-01-01

The high incidence of lower limb injuries associated with physical exercises in military conscripts suggests that fatigue may be a risk factor for injuries. Researchers have hypothesized that lower limb injuries may be related to altered ankle and knee joint position sense (JPS) due to fatigue. To evaluate if military exercises could alter JPS and to examine the possible relation of JPS to future lower extremity injuries in military service. Cohort study. Laboratory. A total of 50 male conscripts (age = 21.4 ± 2.3 years, height = 174.5 ± 6.4 cm, mass = 73.1 ± 6.3 kg) from a unique military base were recruited randomly. main outcome measure(s): Participants performed 8 weeks of physical activities at the beginning of a military course. In the first part of the study, we instructed participants to recognize predetermined positions before and after military exercises so we could examine the effects of military exercise on JPS. The averages of the absolute error and the variable error of 3 trials were recorded. We collected data on the frequency of lower extremity injuries over 8 weeks. Next, the participants were divided into 2 groups: injured and uninjured. Separate 2 × 2 × 2 (group-by-time-by-joint) mixed-model analyses of variance were used to determine main effects and interactions of these factors for each JPS measure. In the second part of the study, we examined whether the effects of fatigue on JPS were related to the development of injury during an 8-week training program. We calculated Hedges effect sizes for JPS changes postexercise in each group and compared change scores between groups. We found group-by-time interactions for all JPS variables (F range = 2.86-4.05, P < .01). All participants showed increases in JPS errors postexercise (P < .01), but the injured group had greater changes for all the variables (P < .01). Military conscripts who sustained lower extremity injuries during an 8-week military exercise program had greater loss of JPS acuity than conscripts who did not sustain injuries. The changes in JPS found after 1 bout of exercise may have predictive ability for future musculoskeletal injuries.

Land-based versus aquatic resistance therapeutic exercises for older women with sarcopenic obesity: study protocol for a randomised controlled trial

PubMed Central

2013-01-01

Background Sarcopenic obesity is a health condition that combines excess adipose tissue and loss of muscle mass and strength. Sarcopenic obesity predisposes to more functional disabilities than obesity or sarcopenia alone. Progressive resistance exercises are recommended for older people as a potential treatment for sarcopenia and also for obesity. However, there is a lack of evidence indicating which programmes are best applied to older people, and no studies have investigated their effects on sarcopenic obese people. The aims of this protocol study are to investigate and compare the efficacy of land-based and aquatic resistance exercise programmes on improving muscle performance, functional capacity and quality of life of older women with sarcopenic obesity. Methods/Design This is a protocol study for a parallel randomised controlled clinical trial. Eligible participants are older women (≥65 years) with a body mass index ≥30 kg/m 2 and hand grip strength ≤21 kg force. A total sample of 36 participants will be randomly allocated to one of the intervention groups in blocks of three: land-based, aquatic or control. Each intervention group will undergo 2-week sessions of a 10-week therapeutic exercise programme for strength, power and endurance training of the lower-limb muscles. Participants in the control group will not participate in any strengthening activity for lower limbs and will receive telephone calls once a week. Baseline and final evaluation of outcomes will encompass muscle performance of the lower limbs assessed by an isokinetic dynamometer; functional tests of usual walking speed, maximal walking speed (shuttle walking test), stair speed and the Short Physical Performance Battery; and health-related quality of life (Medical Outcomes Study Short Form Questionnaire – SF-36). Data collectors will be blinded to randomisation and will not be in touch with participants during the interventions. Discussion This study is the first randomised controlled trial designed to evaluate resistance exercises in older patients with sarcopenic obesity. If our hypothesis proves correct, both intervention programmes will be effective, with the land-based exercises conferring better results in muscle performance. Trial registration Registro Brasileiro de Ensaios Clínicos: RBR-9p5q67 PMID:24041219

The effects of therapeutic hip exercise with abdominal core activation on recruitment of the hip muscles.

PubMed

Chan, Mandy Ky; Chow, Ka Wai; Lai, Alfred Ys; Mak, Noble Kc; Sze, Jason Ch; Tsang, Sharon Mh

2017-07-21

Core stabilization has been utilized for rehabilitation and prevention of lower limb musculoskeletal injuries. Previous studies showed that activation of the abdominal core muscles enhanced the hip muscle activity in hip extension and abduction exercises. However, the lack of the direct measurement and quantification of the activation level of the abdominal core muscles during the execution of the hip exercises affect the level of evidence to substantiate the proposed application of core exercises to promote training and rehabilitation outcome of the hip region. The aim of the present study was to examine the effects of abdominal core activation, which is monitored directly by surface electromyography (EMG), on hip muscle activation while performing different hip exercises, and to explore whether participant characteristics such as gender, physical activity level and contractile properties of muscles, which is assessed by tensiomyography (TMG), have confounding effect to the activation of hip muscles in enhanced core condition. Surface EMG of bilateral internal obliques (IO), upper gluteus maximus (UGMax), lower gluteus maximus (LGMax), gluteus medius (GMed) and biceps femoris (BF) of dominant leg was recorded in 20 young healthy subjects while performing 3 hip exercises: Clam, side-lying hip abduction (HABD), and prone hip extension (PHE) in 2 conditions: natural core activation (NC) and enhanced core activation (CO). EMG signals normalized to percentage of maximal voluntary isometric contraction (%MVIC) were compared between two core conditions with the threshold of the enhanced abdominal core condition defined as >20%MVIC of IO. Enhanced abdominal core activation has significantly promoted the activation level of GMed in all phases of clam exercise (P < 0.05), and UGMax in all phases of PHE exercise (P < 0.05), LGMax in eccentric phases of all 3 exercises (P < 0.05), and BF in all phases of all 3 exercises except the eccentric phase of PHE exercise (P < 0.05). The %MVIC of UGMax was significantly higher than that of LGMax in all phases of clam and HABD exercises under both CO and NC conditions (P < 0.001) while the %MVIC of LGMax was significantly higher than UGMax in concentric phase of PHE exercise under NC condition (P = 0.003). Gender, physical activity level and TMG parameters were not major covariates to activation of hip muscles under enhanced core condition. Abdominal core activation enhances the hip muscles recruitment in Clam, HABD and PHE exercises, and this enhancement is correlated with higher physical activity and stiffer hip muscle. Our results suggest the potential application of abdominal core activation for lower limb rehabilitation since the increased activation of target hip muscles may enhance the therapeutic effects of hip strengthening exercises.

Efficacy of a movement control injury prevention programme in adult men’s community rugby union: a cluster randomised controlled trial

PubMed Central

Attwood, Matthew J; Roberts, Simon P; Trewartha, Grant; England, Mike E; Stokes, Keith A

2018-01-01

Background Exercise programmes aimed at reducing injury have been shown to be efficacious for some non-collision sports, but evidence in adult men’s collision sports such as rugby union is lacking. Objective To evaluate the efficacy of a movement control injury prevention exercise programme for reducing match injuries in adult men’s community rugby union players. Methods 856 clubs were invited to participate in this prospective cluster randomised (single-blind) controlled trial where clubs were the unit of randomisation. 81 volunteered and were randomly assigned (intervention/control). A 42-week exercise programme was followed throughout the season. The control programme reflected ‘normal practice’ exercises, whereas the intervention focused on proprioception, balance, cutting, landing and resistance exercises. Outcome measures were match injury incidence and burden for: (1) all ≥8 days time-loss injuries and (2) targeted (lower limb, shoulder, head and neck, excluding fractures and lacerations) ≥8 days time-loss injuries. Results Poisson regression identified no clear effects on overall injury outcomes. A likely beneficial difference in targeted injury incidence (rate ratio (RR), 90% CI=0.6, 0.4 to 1.0) was identified, with a 40% reduction in lower-limb incidence (RR, 90% CI=0.6, 0.4 to 1.0) and a 60% reduction in concussion incidence (RR, 90% CI=0.4, 0.2 to 0.7) in the intervention group. Comparison between arms for clubs with highest compliance (≥median compliance) demonstrated very likely beneficial 60% reductions in targeted injury incidence (RR, 90% CI=0.4, 0.2 to 0.8) and targeted injury burden (RR, 90% CI=0.4, 0.2 to 0.7). Conclusions The movement control injury prevention programme resulted in likely beneficial reductions in lower-limb injuries and concussion. Higher intervention compliance was associated with reduced targeted injury incidence and burden. PMID:29055883

Efficacy of a movement control injury prevention programme in adult men's community rugby union: a cluster randomised controlled trial.

PubMed

Attwood, Matthew J; Roberts, Simon P; Trewartha, Grant; England, Mike E; Stokes, Keith A

2018-03-01

Exercise programmes aimed at reducing injury have been shown to be efficacious for some non-collision sports, but evidence in adult men's collision sports such as rugby union is lacking. To evaluate the efficacy of a movement control injury prevention exercise programme for reducing match injuries in adult men's community rugby union players. 856 clubs were invited to participate in this prospective cluster randomised (single-blind) controlled trial where clubs were the unit of randomisation. 81 volunteered and were randomly assigned (intervention/control). A 42-week exercise programme was followed throughout the season. The control programme reflected 'normal practice' exercises, whereas the intervention focused on proprioception, balance, cutting, landing and resistance exercises.Outcome measures were match injury incidence and burden for: (1) all ≥8 days time-loss injuries and (2) targeted (lower limb, shoulder, head and neck, excluding fractures and lacerations) ≥8 days time-loss injuries. Poisson regression identified no clear effects on overall injury outcomes. A likely beneficial difference in targeted injury incidence (rate ratio (RR), 90% CI=0.6, 0.4 to 1.0) was identified, with a 40% reduction in lower-limb incidence (RR, 90% CI=0.6, 0.4 to 1.0) and a 60% reduction in concussion incidence (RR, 90% CI=0.4, 0.2 to 0.7) in the intervention group. Comparison between arms for clubs with highest compliance (≥median compliance) demonstrated very likely beneficial 60% reductions in targeted injury incidence (RR, 90% CI=0.4, 0.2 to 0.8) and targeted injury burden (RR, 90% CI=0.4, 0.2 to 0.7). The movement control injury prevention programme resulted in likely beneficial reductions in lower-limb injuries and concussion. Higher intervention compliance was associated with reduced targeted injury incidence and burden. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

[Selective cervical dorsal root cutting off part of the vertebral lateral mass fixation combined with exercise therapy for treating spastic cerebral paralysis of the upper limbs caused by cerebral palsy].

PubMed

Zhang, Peng; Hu, Wei; Cao, Xu; Xu, Shi-gang; Li, De-kui; Xu, Lin

2009-10-01

To explore the feasibility and the result for the surgical treatment of spastic cerebral paralysis of the upper limbs in patients who underwent the selective cervical dorsal root cutting off part of the vertebral lateral mass fixation combined with exercise therapy. From March 2004 to April 2008, 27 patients included 19 boys and 8 girls, aging 13-21 years with an average of 15 years underwent selective cervical dorsal root cutting off part of the vertebral lateral mass fixation with exercise therapy. The AXIS 8 holes titanium plate was inserted into the lateral mass of spinous process through guidance of the nerve stimulator, choosed fasciculus of low-threshold nerve dorsal root and cut off its 1.5 cm. After two weeks, training exercise therapy was done in patients. Training will include lying position, turning body, sitting position, crawling, kneeling and standing position, walking and so on. Spastic Bobath inhibiting abnormal pattern was done in the whole process of training. The muscular tension, motor function (GMFM), functional independence (WeeFIM) were observed after treatment. All patients were followed up from 4 to 16 months with an average of 6 months. Muscular tension score were respectively 3.30 +/- 0.47 and 1.25 +/- 0.44 before and after treatment;GMFM score were respectively 107.82 +/- 55.17 and 131.28 +/- 46.45; WeeFIM score were respectively 57.61 +/- 25.51 and 87.91 +/- 22.39. There was significant improvement before and after treatment (P < 0.01). Selective cervical dorsal root cutting off part of the vertebral lateral mass fixation combined with exercise therapy was used to treat spastic cerebral paralysis of the upper limbs is safe and effective method, which can decrease muscular tension and improve motor function, which deserves more wide use.

A Randomized Pilot Trial of Remote Ischemic Preconditioning in Heart Failure with Reduced Ejection Fraction

PubMed Central

McDonald, Michael A.; Braga, Juarez R.; Li, Jing; Manlhiot, Cedric; Ross, Heather J.; Redington, Andrew N.

2014-01-01

Background Remote ischemic preconditioning (RIPC) induced by transient limb ischemia confers multi-organ protection and improves exercise performance in the setting of tissue hypoxia. We aimed to evaluate the effect of RIPC on exercise capacity in heart failure patients. Methods We performed a randomized crossover trial of RIPC (4×5-minutes limb ischemia) compared to sham control in heart failure patients undergoing exercise testing. Patients were randomly allocated to either RIPC or sham prior to exercise, then crossed over and completed the alternate intervention with repeat testing. The primary outcome was peak VO2, RIPC versus sham. A mechanistic substudy was performed using dialysate from study patient blood samples obtained after sham and RIPC. This dialysate was used to test for a protective effect of RIPC in a mouse heart Langendorff model of infarction. Mouse heart infarct size with RIPC or sham dialysate exposure was also compared with historical control data. Results Twenty patients completed the study. RIPC was not associated with improvements in peak VO2 (15.6+/−4.2 vs 15.3+/−4.6 mL/kg/min; p = 0.53, sham and RIPC, respectively). In our Langendorff sub-study, infarct size was similar between RIPC and sham dialysate groups from our study patients, but was smaller than expected compared to healthy controls (29.0%, 27.9% [sham, RIPC] vs 51.2% [controls]. We observed less preconditioning among the subgroup of patients with increased exercise performance following RIPC (p<0.04). Conclusion In this pilot study of RIPC in heart failure patients, RIPC was not associated with improvements in exercise capacity overall. However, the degree of effect of RIPC may be inversely related to the degree of baseline preconditioning. These data provide the basis for a larger randomized trial to test the potential benefits of RIPC in patients with heart failure. Trial Registration ClinicalTrials.gov +++++NCT01128790 PMID:25181050

Study of the effects of multimodal exercise program on physical fitness and health perception in community-living Hungarian older adults.

PubMed

Virág, Anikó; Harkányi, Izabella; Karóczi, Csilla K; Vass, Zsolt; Kovács, Éva

2018-05-01

The aim of this study was to investigate the effects on fitness indicators and subjective health-perception of a multimodal exercise program provided by a district in Budapest among community-living seniors. Sixty community-living older adults aged over 60 years formed beginner group (who were at the beginning of the exercise program), advanced group (who had been in the programme for 3-6 months), active group (who had been participating in the exercise program for at least 6 months, in addition to Nordic walking program) and a physically inactive control group. Balance, functional mobility, lower and upper limb strength, lower and upper body flexibility, aerobic endurance and self-reported health perception were measured at baseline, and after a 12-week follow-up period. The beginner group and the advanced group improved in upper body flexibility (beginner Δ=1.2; d=0.83; advanced: Δ=1.7; d=1.39), lower body flexibility (beginner: Δ=1.7, d=0.484; advanced: Δ=1.9; d=1.55), lower limb strength (beginner: Δ=1.47; d=0.84; advanced: Δ=1.57; d=0.72), and functional mobility (beginner: Δ=-0.6; d=0.54; advanced: Δ=-0.4; d=0.90). There were also improvements in aerobic endurance (Δ=11.06; d=0.96) and balance (Δ=1.6; d=0.62) of beginner group. These indicators declined in the control group. Indicators of the active group did not change. The self-perceived health status declined (Δ=-13.9; d=0.73) in the control group but did not change in any exercising groups. This multimodal exercise program can be effective among community-living older adults, even in Hungary, a country where geriatric physical activity is not widespread. Therefore, it would be useful to extend this model program to other settlements as well.

A putative low-carbohydrate ketogenic diet elicits mild nutritional ketosis but does not impair the acute or chronic hypertrophic responses to resistance exercise in rodents.

PubMed

Roberts, Michael D; Holland, A Maleah; Kephart, Wesley C; Mobley, C Brooks; Mumford, Petey W; Lowery, Ryan P; Fox, Carlton D; McCloskey, Anna E; Shake, Joshua J; Mesquita, Paulo; Patel, Romil K; Martin, Jeffrey S; Young, Kaelin C; Kavazis, Andreas N; Wilson, Jacob M

2016-05-15

We examined whether acute and/or chronic skeletal muscle anabolism is impaired with a low-carbohydrate diet formulated to elicit ketosis (LCKD) vs. a mixed macronutrient Western diet (WD). Male Sprague-Dawley rats (9-10 wk of age, 300-325 g) were provided isoenergetic amounts of a LCKD or a WD for 6 wk. In AIM 1, basal serum and gastrocnemius assessments were performed. In AIM 2, rats were resistance exercised for one bout and were euthanized 90-270 min following exercise for gastrocnemius analyses. In AIM 3, rats voluntarily exercised daily with resistance-loaded running wheels, and hind limb muscles were analyzed for hypertrophy markers at the end of the 6-wk protocol. In AIM 1, basal levels of gastrocnemius phosphorylated (p)-rps6, p-4EBP1, and p-AMPKα were similar between diets, although serum insulin (P < 0.01), serum glucose (P < 0.001), and several essential amino acid levels (P < 0.05) were lower in LCKD-fed rats. In AIM 2, LCKD- and WD-fed rats exhibited increased postexercise muscle protein synthesis levels (P < 0.0125), but no diet effect was observed (P = 0.59). In AIM 3, chronically exercise-trained LCKD- and WD-fed rats presented similar increases in relative hind limb muscle masses compared with their sedentary counterparts (12-24%, P < 0.05), but there was no between-diet effects. Importantly, the LCKD induced "mild" nutritional ketosis, as the LCKD-fed rats in AIM 2 exhibited ∼1.5-fold greater serum β-hydroxybutyrate levels relative to WD-fed rats (diet effect P = 0.003). This study demonstrates that the tested LCKD in rodents, while only eliciting mild nutritional ketosis, does not impair the acute or chronic skeletal muscle hypertrophic responses to resistance exercise. Copyright © 2016 the American Physiological Society.

Effects of exercise and heat stress on regional blood flow in pregnant sheep.

PubMed

Bell, A W; Hales, J R; Fawcett, A A; King, R B

1986-05-01

Radioactive microspheres were used to measure cardiac output and blood flow to most major tissues, including those in the pregnant uterus, in late-pregnant ewes at rest and during treadmill exercise (approximately 3-fold increase in metabolic rate for 30 min) in thermoneutral (TN) (dry bulb temperature (Tdb) = 13 degrees C, wet bulb temperature (Twb) = 10 degrees C) and mildly hot (MH) (Tdb = 40 degrees C, Twb = 27 degrees C) environments. Exercise caused major increases in blood flow to respiratory muscles, nonrespiratory limb muscles, and adipose tissue, and flow was decreased to some gastrointestinal tissues, spleen, pancreas, and to placental and nonplacental tissues in the pregnant uterus. Heat exposure had relatively little effect on these exercise-induced changes, except that flow was further increased in the respiratory muscles. Results are compared with those of a similar study on nonpregnant sheep in which changes in muscle, skin, and visceral flows during exercise were attenuated by heat exposure. It is suggested that redistribution of blood flow from the pregnant uterus, which in resting ewes took 22% of cardiac output, is a significant buffer against the potentially deleterious effects of combined exercise and heat stress on blood flow to exercising muscles and thermoregulatory tissues.

Proprioceptive Rehabilitation of Upper Limb Dysfunction in Movement Disorders: A Clinical Perspective

PubMed Central

Abbruzzese, Giovanni; Trompetto, Carlo; Mori, Laura; Pelosin, Elisa

2014-01-01

Movement disorders (MDs) are frequently associated with sensory abnormalities. In particular, proprioceptive deficits have been largely documented in both hypokinetic (Parkinson’s disease) and hyperkinetic conditions (dystonia), suggesting a possible role in their pathophysiology. Proprioceptive feedback is a fundamental component of sensorimotor integration allowing effective planning and execution of voluntary movements. Rehabilitation has become an essential element in the management of patients with MDs, and there is a strong rationale to include proprioceptive training in rehabilitation protocols focused on mobility problems of the upper limbs. Proprioceptive training is aimed at improving the integration of proprioceptive signals using “task-intrinsic” or “augmented feedback.” This perspective article reviews the available evidence on the effects of proprioceptive stimulation in improving upper limb mobility in patients with MDs and highlights the emerging innovative approaches targeted to maximizing the benefits of exercise by means of enhanced proprioception. PMID:25505402

Effectiveness of muscle strengthening and description of protocols for preventing falls in the elderly: a systematic review

PubMed Central

Ishigaki, Erika Y.; Ramos, Lidiane G.; Carvalho, Elisa S.; Lunardi, Adriana C.

2014-01-01

Background Falls are a geriatric syndrome that is considered a significant public health problem in terms of morbidity and mortality because they lead to a decline in functional capacity and an impaired quality of life in the elderly. Lower limb muscle strengthening seems to be an effective intervention for preventing falls; however, there is no consensus regarding the best method for increasing lower limb muscle strength. Objectives To analyze the effectiveness of lower limb muscle strengthening and to investigate and describe the protocols used for preventing falls in elderly subjects. Method We performed a systematic review of randomized and controlled clinical trials published between 2002 and 2012 in the databases PubMed, EMBASE, Scopus, Web of Science, and PEDro that cited some type of lower limb muscle strengthening protocol and that evaluated the incidence of falls as the primary outcome exclusively in elderly subjects. Twelve studies met the inclusion criteria. Qualitative analysis was performed by independent reviewers applying the PEDro scale. Results The data obtained from the selected studies showed lower fall rates in the intervention groups compared to controls. Six studies described the lower limb muscle strengthening protocol in detail. High methodological quality was found in 6 studies (PEDro score ≥7/10 points). Conclusions The methodological quality of the studies in this area appears to leave little doubt regarding the effectiveness of lower limb strengthening exercises for preventing falls in elderly subjects, however the interventions in these studies were poorly reported. PMID:24760166

A haptic-robotic platform for upper-limb reaching stroke therapy: Preliminary design and evaluation results

PubMed Central

Lam, Paul; Hebert, Debbie; Boger, Jennifer; Lacheray, Hervé; Gardner, Don; Apkarian, Jacob; Mihailidis, Alex

2008-01-01

Background It has been shown that intense training can significantly improve post-stroke upper-limb functionality. However, opportunities for stroke survivors to practice rehabilitation exercises can be limited because of the finite availability of therapists and equipment. This paper presents a haptic-enabled exercise platform intended to assist therapists and moderate-level stroke survivors perform upper-limb reaching motion therapy. This work extends on existing knowledge by presenting: 1) an anthropometrically-inspired design that maximizes elbow and shoulder range of motions during exercise; 2) an unobtrusive upper body postural sensing system; and 3) a vibratory elbow stimulation device to encourage muscle movement. Methods A multi-disciplinary team of professionals were involved in identifying the rehabilitation needs of stroke survivors incorporating these into a prototype device. The prototype system consisted of an exercise device, postural sensors, and a elbow stimulation to encourage the reaching movement. Eight experienced physical and occupational therapists participated in a pilot study exploring the usability of the prototype. Each therapist attended two sessions of one hour each to test and evaluate the proposed system. Feedback about the device was obtained through an administered questionnaire and combined with quantitative data. Results Seven of the nine questions regarding the haptic exercise device scored higher than 3.0 (somewhat good) out of 4.0 (good). The postural sensors detected 93 of 96 (97%) therapist-simulated abnormal postures and correctly ignored 90 of 96 (94%) of normal postures. The elbow stimulation device had a score lower than 2.5 (neutral) for all aspects that were surveyed, however the therapists felt the rehabilitation system was sufficient for use without the elbow stimulation device. Conclusion All eight therapists felt the exercise platform could be a good tool to use in upper-limb rehabilitation as the prototype was considered to be generally well designed and capable of delivering reaching task therapy. The next stage of this project is to proceed to clinical trials with stroke patients. PMID:18498641

Running wheel exercise enhances recovery from nigrostriatal dopamine injury without inducing neuroprotection.

PubMed

O'Dell, S J; Gross, N B; Fricks, A N; Casiano, B D; Nguyen, T B; Marshall, J F

2007-02-09

Forced use of the forelimb contralateral to a unilateral injection of the dopaminergic neurotoxin 6-hydroxydopamine can promote recovery of motor function in that limb and can significantly decrease damage to dopamine terminals. The present study was conducted to determine (1) whether a form of voluntary exercise, wheel running, would improve motor performance in rats with such lesions, and (2) whether any beneficial effects of wheel running are attributable to ameliorating the dopaminergic damage. In experiment 1, rats were allowed to run in exercise wheels or kept in home cages for 2 1/2 weeks, then given stereotaxic infusions of 6-hydroxydopamine into the left striatum. The rats were replaced into their original environments (wheels or home cages) for four additional weeks, and asymmetries in forelimb use were quantified at 3, 10, 17, and 24 days postoperatively. After killing, dopaminergic damage was assessed by both quantifying 3 beta-(4-iodophenyl)tropan-2 beta-carboxylic acid methyl ester ([(125)I]RTI-55) binding to striatal dopamine transporters and counting tyrosine hydroxylase-positive cells in the substantia nigra. Exercised 6-hydroxydopamine-infused rats showed improved motor outcomes relative to sedentary lesioned controls, effects that were most apparent at postoperative days 17 and 24. Despite this behavioral improvement, 6-hydroxydopamine-induced loss of striatal dopamine transporters and tyrosine hydroxylase-positive nigral cells in exercised and sedentary groups did not differ. Since prior studies suggested that forced limb use improves motor performance by sparing nigrostriatal dopaminergic neurons from 6-hydroxydopamine damage, experiment 2 used a combined regimen of forced plus voluntary wheel running. Again, we found that the motor performance of exercised rats improved more rapidly than that of sedentary controls, but that there were no differences between these groups in the damage produced by 6-hydroxydopamine. It appears that voluntary exercise can facilitate recovery from partial nigrostriatal injury, but it does so without evident sparing of dopamine nerve terminals.

Effects of the belt electrode skeletal muscle electrical stimulation system on lower extremity skeletal muscle activity: Evaluation using positron emission tomography.

PubMed

Numata, Hitoaki; Nakase, Junsuke; Inaki, Anri; Mochizuki, Takafumi; Oshima, Takeshi; Takata, Yasushi; Kinuya, Seigo; Tsuchiya, Hiroyuki

2016-01-01

Lower-extremity muscle weakness in athletes after lower limb trauma or surgery can hinder their return to sports, and the associated muscle atrophy may lead to deterioration in performance after returning to sports. Recently, belt electrode skeletal muscle electrical stimulation (B-SES) which can contract all the lower limb skeletal muscles simultaneously was developed. However, no study has evaluated skeletal muscle activity with B-SES. Since only superficial muscles as well as a limited number of muscles can be investigated using electromyography, we investigated whether positron emission tomography (PET) can evaluate the activity of all the skeletal muscles in the body simultaneously. The purpose of this study was to evaluate the effectiveness of the B-SES system using PET. Twelve healthy males (mean age, 24.3 years) were divided into two groups. The subjects in the control group remained in a sitting position for 10 min, and [(18)F] fluorodeoxyglucose (FDG) was intravenously injected. In the exercise group, subjects exercised using the B-SES system for 20 min daily for three consecutive days as a pre-test exercise. On the measurement day, they exercised for 10 min, received an injection of FDG, and exercised for another 10 min. PET-computed tomography images were obtained in each group 60 min after the FDG injection. Regions of interest were drawn in each lower-extremity muscle. We compared each skeletal muscle metabolism using the standardized uptake value. In the exercise group, FDG accumulation in the gluteus maximus, gluteus medius, gluteus minimus, quadriceps femoris, sartorius, and hamstrings was significantly higher than the muscles in the control (P < 0.05). Exercise with B-SES increased the skeletal muscle activity of the gluteal muscles as well as the most lower-extremity muscles simultaneously. Copyright © 2015 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.

Limb Lengthening Surgery: Internal Lengthening Device (For Parents)

MedlinePlus

... and bathing. Your child will need help doing stretching and strengthening exercises. These are a very important ... therapy in a pool). Help your child with stretching and strengthening exercises. Give your child medicine for ...

Six-Month Lower Limb Aerobic Exercise Improves Physical Function in Young-Old, Old-Old, and Oldest-Old Adults.

PubMed

Cho, Chaeyoon; Han, Changwan; Sung, Misun; Lee, Chaewon; Kim, Minji; Ogawa, Yoshiko; Kohzuki, Masahiro

2017-08-01

The effect of aerobic exercise on physical function and mental health in various adult age groups (young-old, 65-74; old-old, 75-84; oldest-old, ≥ 85 years) is unclear. The aim of this study was to investigate the effects of the Kohzuki Exercise Program (KEP) on physical function and mental health in these age groups. The KEP consisted of 40-min supervised sessions 3 times per week for 6 months as follows: 5 min of warm-up, 30 min of lower limb aerobic exercise, and 5 min of cool-down. A total of 50 participants (22 young-old, 20 old-old, and 8 oldest-old) who participated in the KEP completed at least 88% of the sessions. In statistical analysis, 3 (group: oldest-old, old-old, young-old) × 2 (time: baseline and after 6 months) analyses of variance were used to determine if there were significant main and interaction effects. Significant interactions were probed using the post-hoc paired t test. The Short Physical Performance Battery (SPPB) score showed significant group × time interactions after 6 months (p = 0.031). In the post-hoc test, oldest-old (p < 0.001), old-old (p < 0.001), and young-old (p < 0.01) groups had significantly better physical function after 6 months. However, none of the mental health measures showed group × time interactions at 6-month. Our results suggest that a 6-month KEP led to improved physical function in oldest-old, old-old, and young-old adults. The KEP was effective for oldest-old adults in particular. The KEP exhibits good adherence, making it suitable for a wide age range in society.

Stretch-Induced Reductions in Throwing Performance Are Attenuated by Warm-up Before Exercise.

PubMed

Mascarin, Naryana C; Vancini, Rodrigo L; Lira, Claudio A B; Andrade, Marilia S

2015-05-01

Recent investigations have suggested that static stretching (SS) performed before exercise reduces muscular performance. However, it is yet unknown whether dynamic warm-up exercises performed together with SS may actually minimize the detrimental acute effects of stretching on muscular performance. This study aimed to assess the effects of static shoulder stretching exercises, dynamic warm-up exercises, or both together, on muscular performance evaluated by ball throwing. Twenty-one female handball players (age: 16.2 ± 1.0 years [range: 14-18 years], height: 167.0 ± 10.0 cm [range: 158-179 cm], and body mass: 63.3 ± 7.6 kg [range: 50.4-77.4 kg]) performed SS, dynamic warm-up exercises or both, targeting the muscles of the upper limbs. Thereafter, medicine ball throwing distance and handball ball throwing speed tests were performed. Static stretching performed before the medicine ball throwing test reduced performance when compared with the warm-up exercises (95% confidence interval [CI] = 0.02-0.17, p ≤ 0.05, effect size [ES] = 0.34). When a warm-up exercise routine was added to SS, the detrimental effects of SS were abolished (95% CI = -0.01 to 0.18, p > 0.05, ES = 0.31). The throwing speed was the same over the 3 conditions. In conclusion, warm-up exercises performed together with SS abolished the impairment in medicine ball throwing distance. We recommend that athletes perform warm-up exercises together with SS before activity to avoid detrimental effects on muscle strength.

Exercise interventions for the improvement of falls-related outcomes among older adults with diabetes mellitus: A systematic review and meta-analyses.

PubMed

Chapman, Anna; Meyer, Claudia; Renehan, Emma; Hill, Keith D; Browning, Colette J

2017-03-01

Falls as a complication of diabetes mellitus (DM) can have a major impact on the health of older adults. Previous reviews have demonstrated that certain exercise interventions are effective at reducing falls in older people; however, no studies have quantified the effectiveness of exercise interventions on falls-related outcomes among older adults with DM. A systematic search for all years to September 2015 identified available literature. Eligibility criteria included: appropriate exercise intervention/s; assessed falls-related outcomes; older adults with DM. Effect sizes were pooled using a random effects model. Positive effect sizes favoured the intervention. Ten RCTs were eligible for the meta-analyses. Exercise interventions were more effective than the control condition for static balance (0.53, 95% CI: 0.13 to 0.93), lower-limb strength (0.63, 95% CI: 0.09 to 1.18), and gait (0.59, 95% CI: 0.22 to 0.96). No RCTs assessed falls-risk; one RCT reported 12month falls-rate, with no differential treatment effect observed. Exercise interventions can improve certain falls-related outcomes among older adults with DM. Substantial heterogeneity and limited numbers of studies should be considered when interpreting results. Among older adults, where DM burden is increasing, exercise interventions may provide promising approaches to assist the improvement of falls-related outcomes. Copyright © 2016 Elsevier Inc. All rights reserved.

Ground Reaction Forces During Locomotion in Simulated Microgravity

NASA Technical Reports Server (NTRS)

Davis, B. L.; Cavanagh, Peter R.; Sommer, H. J., III; Wu, G.

1996-01-01

Significant losses in bone density and mineral, primarily in the lower extremities have been reported following exposure to weightlessness. Recent investigations suggest that mechanical influences such as bone deformation and strain rate may be critically important in stimulating new bone formation. It was hypothesized that velocity, cadence and harness design would significantly affect lower limb impact forces during treadmill exercise in simulated zero gravity (0G). A ground-based hypogravity simulator was used to investigate which factors affect limb loading during tethered treadmill exercise. A fractional factorial design was used and 12 subjects were studied. The results showed that running on active and passive treadmills in the simulator with a tethering force close to the maximum comfortable level produced similar magnitudes for the peak ground reaction force. It was also found that these maximum forces were significantly lower than those obtained during overground trials, even when the speeds of locomotion in the simulator were 66 % greater than those in 1 G. Cadence had no effect on any of the response variables. The maximum rate of force application (DFDT-Max) was similar for overground running and exercise in simulated 0G, provided that the "weightless subjects ran on a motorized treadmill. These findings have implications for the use of treadmill exercise as a countermeasure for hypokinetic osteoporosis. As the relationship between mechanical factors and osteogenesis becomes better understood, results from human experiments in 0G simulators will help to design in-flight exercise programs that are more closely targeted to generate appropriate mechanical stimuli.

Heterogeneity of muscle recruitment pattern during pedaling in professional road cyclists: a magnetic resonance imaging and electromyography study.

PubMed

Hug, François; Bendahan, David; Le Fur, Yann; Cozzone, Patrick J; Grélot, Laurent

2004-07-01

Although a number of studies have been devoted to the analysis of the activity pattern of the muscles involved in pedaling in sedentary subjects and/or amateur cyclists, data on professional cyclists are scarce and the issue of inter-individual differences has never been addressed in detail. In the present series of experiments, we performed a non-invasive investigation using functional magnetic resonance imaging and surface electromyography to determine the pattern of activity of lower limb muscles during two different exhausting pedaling exercises in eight French professional cyclists. Each subject performed an incremental exercise during which electromyographic activity of eight lower limb muscles and respiratory variables were recorded. After a 3-h recovery period, transverse relaxation times (T2) were measured before and just after a standardized constant-load maximal exercise in order to quantify exercise-related T2 changes. The global EMG activity illustrated by the root mean square clearly showed a large inter-individual difference during the incremental exercise regardless of the investigated muscle (variation coefficient up to 81%). In addition, for most of the muscles investigated, the constant-load exercise induced T2 increases, which varied noticeably among the subjects. This high level of variation in the recruitment of lower limb muscles in professional cyclists during both incremental and constant-load exercises is surprising given the homogeneity related to maximal oxygen consumption and training volume. The high degree of expertise of these professional cyclists was not linked to the production of a common pattern of pedaling and our results provide an additional evidence that the nervous system has multiple ways of accomplishing a given motor task, as has been suggested previously by neural control theorists and experimentalists.

Effects of virtual reality-based bilateral upper-extremity training on brain activity in post-stroke patients.

PubMed

Lee, Su-Hyun; Kim, Yu-Mi; Lee, Byoung-Hee

2015-07-01

[Purpose] This study investigated the therapeutic effects of virtual reality-based bilateral upper-extremity training on brain activity in patients with stroke. [Subjects and Methods] Eighteen chronic stroke patients were divided into two groups: the virtual reality-based bilateral upper-extremity training group (n = 10) and the bilateral upper-limb training group (n = 8). The virtual reality-based bilateral upper-extremity training group performed bilateral upper-extremity exercises in a virtual reality environment, while the bilateral upper-limb training group performed only bilateral upper-extremity exercise. All training was conducted 30 minutes per day, three times per week for six weeks, followed by brain activity evaluation. [Results] Electroencephalography showed significant increases in concentration in the frontopolar 2 and frontal 4 areas, and significant increases in brain activity in the frontopolar 1 and frontal 3 areas in the virtual reality-based bilateral upper-extremity training group. [Conclusion] Virtual reality-based bilateral upper-extremity training can improve the brain activity of stroke patients. Thus, virtual reality-based bilateral upper-extremity training is feasible and beneficial for improving brain activation in stroke patients.

Effects of a Home-Based Upper Limb Training Program in Patients With Multiple Sclerosis: A Randomized Controlled Trial.

PubMed

Ortiz-Rubio, Araceli; Cabrera-Martos, Irene; Rodríguez-Torres, Janet; Fajardo-Contreras, Waldo; Díaz-Pelegrina, Ana; Valenza, Marie Carmen

2016-12-01

To evaluate the effects of a home-based upper limb training program on arm function in patients with multiple sclerosis (MS). Additionally, the effects of this program on manual dexterity, handgrip strength, and finger prehension force were analyzed. Randomized, single-blind controlled trial. Home based. Patients with a clinical diagnosis of MS acknowledging impaired manual ability (N=37) were randomized into 2 groups. Patients in the experimental group were included in a supervised home-based upper limb training program for 8 weeks twice a week. Patients in the control group received information in the form of a leaflet with a schedule of upper limb exercise training. The primary outcome measure was arm function (motor functioning assessed using the finger tapping test and a functional measure, the Action Research Arm Test). The secondary outcome measures were manual dexterity assessed with the Purdue Pegboard Test and handgrip strength and finger prehension force evaluated with a handgrip and a pinch dynamometer, respectively. After 8 weeks, a significant between-group improvement (P<.05) was found on the Action Research Arm Test bilaterally and the finger tapping test in the most affected upper limb. The secondary outcomes also improved in the most affected limb in the experimental group. An 8-week home-based intervention program focused on upper limbs twice a week improved arm function and physiologic variables with a primary focus on the more affected extremity in patients with MS compared with the control group. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Effect of unilateral knee extensor fatigue on force and balance of the contralateral limb.

PubMed

Arora, Shruti; Budden, Shawn; Byrne, Jeannette M; Behm, David G

2015-10-01

Fatigue in one limb can decrease force production in the homologous muscle as well as other muscles of the non-fatigued limb affecting balance. The objective of the study was to examine the effect of unilateral knee extensor fatigue on the non-fatigued limb's standing balance, muscle force and activation. Sixteen healthy male subjects performed pre-fatigue balance trials, warm-up exercises, maximum voluntary isometric contractions, a knee extensors fatigue protocol, and post-fatigue balance trials. The fatigue protocol consisted of sets of 15 consecutive isometric contractions of 16 s each with 4 s recovery between repetitions, which were performed at 30% peak force for the dominant knee extensor muscles. Additional sets of contractions continued until a 50% decrease in MVIC knee extensor force was observed. Pre- and post-fatigue balance assessment consisted of transition from double to single leg standing and also single leg standing trials, which were performed bilaterally and in randomized order. The peak force and F100 were significantly decreased by 44.8% (ES = 2.54) and 39.9% (ES = 0.59), respectively, for the fatigued limb post-fatigue. There were no significant changes in the non-fatigued limb's muscle force, activation, muscle onset timing or postural stability parameters. While the lack of change in non-fatigued limb force production is in agreement with some of the previous literature in this area, the lack of effect on postural measures directly contradicts earlier work. It is hypothesized that discrepancies in the duration and the intensity of the fatigue protocol may have accounted for this discrepancy.

Nordic Walking and the Isa Method for Breast Cancer Survivors: Effects on Upper Limb Circumferences and Total Body Extracellular Water - a Pilot Study.

PubMed

Di Blasio, Andrea; Morano, Teresa; Napolitano, Giorgio; Bucci, Ines; Di Santo, Serena; Gallina, Sabina; Cugusi, Lucia; Di Donato, Francesco; D'Arielli, Alberto; Cianchetti, Ettore

2016-12-01

The negative side effects of breast cancer treatments can include upper limb lymphoedema. The growing literature indicates that Nordic walking is an effective discipline against several disease symptoms. The aim of this study was to determine whether introduction to Nordic walking alone is effective against total body extracellular water and upper limb circumferences in breast cancer survivors compared to its combination with a series of specifically created exercises (i.e. the Isa method). 16 breast cancer survivors (49.09 ± 2.24 years) were recruited and randomly assigned to 1 of 2 different training groups. 10 lessons on Nordic walking technique plus the Isa method significantly reduced both extracellular body water and the extracellular-to-total body water ratio (p = 0.01 for both), and also the circumference of the upper limb, (both relaxed arm and forearm circumferences) (p = 0.01 for all), whereas Nordic walking alone did not. Introduction to Nordic walking does not seem to affect lymphoedema in breast cancer survivors. This might be because novice Nordic Walkers do not adequately generate an effective muscular pump through coordination of the alternated bimanual open-close cycle. The Isa method appears to close this gap.

Nordic Walking and the Isa Method for Breast Cancer Survivors: Effects on Upper Limb Circumferences and Total Body Extracellular Water - a Pilot Study

PubMed Central

Di Blasio, Andrea; Morano, Teresa; Napolitano, Giorgio; Bucci, Ines; Di Santo, Serena; Gallina, Sabina; Cugusi, Lucia; Di Donato, Francesco; D'Arielli, Alberto; Cianchetti, Ettore

2016-01-01

Background The negative side effects of breast cancer treatments can include upper limb lymphoedema. The growing literature indicates that Nordic walking is an effective discipline against several disease symptoms. The aim of this study was to determine whether introduction to Nordic walking alone is effective against total body extracellular water and upper limb circumferences in breast cancer survivors compared to its combination with a series of specifically created exercises (i.e. the Isa method). Methods 16 breast cancer survivors (49.09 ± 2.24 years) were recruited and randomly assigned to 1 of 2 different training groups. Results 10 lessons on Nordic walking technique plus the Isa method significantly reduced both extracellular body water and the extracellular-to-total body water ratio (p = 0.01 for both), and also the circumference of the upper limb, (both relaxed arm and forearm circumferences) (p = 0.01 for all), whereas Nordic walking alone did not. Conclusions Introduction to Nordic walking does not seem to affect lymphoedema in breast cancer survivors. This might be because novice Nordic Walkers do not adequately generate an effective muscular pump through coordination of the alternated bimanual open-close cycle. The Isa method appears to close this gap. PMID:28228712

Differential effects of water-based exercise on the cognitive function in independent elderly adults.

PubMed

Sato, Daisuke; Seko, Chihiro; Hashitomi, Tatsuya; Sengoku, Yasuo; Nomura, Takeo

2015-04-01

Physical exercise has been reported to be the most effective method to improve cognitive function and brain health, but there is as yet no research on the effect of water-based exercise. The aim of the present study was to compare the effects of water-based exercise with and without cognitive stimuli on cognitive and physical functions. The design is a single-blind randomized controlled study. Twenty-one participants were randomly assigned to a normal water-based exercise (Nor-WE) group or a cognitive water-based exercise (Cog-WE) group. The exercise sessions were divided into two exercise series: a 10-min series of land-based warm-up, consisting of flexibility exercises, and a 50-min series of exercises in water. The Nor-WE consisted of 10 min of walking, 30 min of strength and stepping exercise, including stride over, and 10 min of stretching and relaxation in water. The Cog-WE consisted of 10 min of walking, 30 min of water-cognitive exercises, and 10 min of stretching and relaxation in water. Cognitive function, physical function, and ADL were measured before the exercise intervention (pre-intervention) and 10 weeks after the intervention (post-intervention). Participation in the Cog-WE performed significantly better on the pegboard test and the choice stepping reaction test and showed a significantly improved attention, memory, and learning, and in the general cognitive function (measured as the total score in the 5-Cog test). Participation in the Nor-WE dramatically improved walking ability and lower limb muscle strength. Our results reveal that the benefits elderly adults may obtain from water-based exercise depend on the characteristics of each specific exercise program. These findings highlight the importance of prescription for personalized water-based exercises to elderly adults to improve cognitive function.

Working towards More Effective Implementation, Dissemination and Scale-Up of Lower-Limb Injury-Prevention Programs: Insights from Community Australian Football Coaches

PubMed Central

2018-01-01

Disseminating lower-limb injury-prevention exercise programs (LL-IPEPs) with strategies that effectively reach coaches across sporting environments is a way of preventing lower-limb injuries (LLIs) and ensuring safe and sustainable sport participation. The aim of this study was to explore community-Australian Football (community-AF) coaches’ perspectives on the strategies they believed would enhance the dissemination and scale-up of LL-IPEPs. Using a qualitative multiple case study design, semi-structured interviews with community-AF coaches in Victoria, Australia, were conducted. Overall, coaches believed a range of strategies were important including: coach education, policy drivers, overcoming potential problem areas, a ‘try before you buy approach’, presenting empirical evidence and guidelines for injury-prevention exercise programs (IPEPs), forming strategic collaboration and working in partnership, communication and social marketing, public meetings, development of a coach hotline, and targeted multi-focused approaches. A shift to a culture whereby evidence-based IPEP practices in community-AF will take time, and persistent commitment by all involved in the sport is important. This will support the creation of strategies that will enhance the dissemination and scale-up of LL-IPEPs across community sport environments. The focus of research needs to continue to identify effective, holistic and multi-level interventions to support coaches in preventing LLIs. This could lead to the determination of successful strategies such as behavioural regulation strategies and emotional coping resources to implement LL-IPEPs into didactic curricula and practice. Producing changes in practice will require attention to which strategies are a priority and the most effective. PMID:29462913

Influence of cold water immersion on limb and cutaneous blood flow at rest.

PubMed

Gregson, Warren; Black, Mark A; Jones, Helen; Milson, Jordon; Morton, James; Dawson, Brian; Atkinson, Greg; Green, Daniel J

2011-06-01

Cold water immersion reduces exercise-induced muscle damage. Benefits may partly arise from a decline in limb blood flow; however, no study has comprehensively investigated the influence of different degrees of cooling undertaken via cold water immersion on limb blood flow responses. To determine the influence of cold (8°C) and cool (22°C) water immersion on lower limb and cutaneous blood flow. Controlled laboratory study. Nine men were placed in a semireclined position and lowered into 8°C or 22°C water to the iliac crest for two 5-minute periods interspersed with 2 minutes of nonimmersion. Rectal and thigh skin temperature, deep and superficial muscle temperature, heart rate, mean arterial pressure, thigh cutaneous blood velocity (laser Doppler), and superficial femoral artery blood flow (duplex ultrasound) were measured during immersion and for 30 minutes after immersion. Indices of vascular conductance were calculated (flux and blood flow/mean arterial pressure). Reductions in rectal temperature (8°C, 0.2° ± 0.1°C; 22°C, 0.1° ± 0.1°C) and thigh skin temperature (8°C, 6.2° ± 0.5°C; 22°C, 3.2° ± 0.2°C) were greater in 8°C water than in 22°C (P < .01). Femoral artery conductance was reduced to a similar extent immediately after immersion (~30%) and 30 minutes after immersion (~40%) under both conditions (P < .01). In contrast, there was less thigh cutaneous vasoconstriction during and after immersion in 8°C water compared with 22°C (P = .01). These data suggest that immersion at both temperatures resulted in similar whole limb blood flow but, paradoxically, more blood was distributed to the skin in the colder water. This suggests that colder temperatures may be associated with reduced muscle blood flow, which could provide an explanation for the benefits of cold water immersion in alleviating exercise-induced muscle damage in sports and athletic contexts. Colder water temperatures may be more effective in the treatment of exercise-induced muscle damage and injury rehabilitation because of greater reductions in muscle blood flow.

Efficacy of blood flow restriction exercise during dialysis for end stage kidney disease patients: protocol of a randomised controlled trial.

PubMed

Clarkson, Matthew J; Fraser, Steve F; Bennett, Paul N; McMahon, Lawrence P; Brumby, Catherine; Warmington, Stuart A

2017-09-11

Exercise during haemodialysis improves strength and physical function. However, both patients and clinicians are time poor, and current exercise recommendations add an excessive time burden making exercise a rare addition to standard care. Hypothetically, blood flow restriction exercise performed during haemodialysis can provide greater value for time spent exercising, reducing this time burden while producing similar or greater outcomes. This study will explore the efficacy of blood flow restriction exercise for enhancing strength and physical function among haemodialysis patients. This is a randomised controlled trial design. A total of 75 participants will be recruited from haemodialysis clinics. Participants will be allocated to a blood flow restriction cycling group, traditional cycling group or usual care control group. Both exercising groups will complete 3 months of cycling exercise, performed intradialytically, three times per week. The blood flow restriction cycling group will complete two 10-min cycling bouts separated by a 20-min rest at a subjective effort of 15 on a 6 to 20 rating scale. This will be done with pressurised cuffs fitted proximally on the active limbs during exercise at 50% of a pre-determined limb occlusion pressure. The traditional cycling group will perform a continuous 20-min bout of exercise at a subjective effort of 12 on the same subjective effort scale. These workloads and volumes are equivalent and allow for comparison of a common blood flow restriction aerobic exercise prescription and a traditional aerobic exercise prescription. The primary outcome measures are lower limb strength, assessed by a three repetition maximum leg extension test, as well as objective measures of physical function: six-minute walk test, 30-s sit to stand, and timed up and go. Secondary outcome measures include thigh muscle cross sectional area, body composition, routine pathology, quality of life, and physical activity engagement. This study will determine the efficacy of blood flow restriction exercise among dialysis patients for improving key physiological outcomes that impact independence and quality of life, with reduced burden on patients. This may have broader implications for other clinical populations with similarly declining muscle health and physical function, and those contraindicated to higher intensities of exercise. Australian and New Zealand Clinical Trial Register: ACTRN12616000121460.

The effects of an exercise program on several abilities associated with driving performance in older adults.

PubMed

Marmeleira, José F; Godinho, Mário B; Fernandes, Orlando M

2009-01-01

The purpose of this study was to investigate the effects of participation in an exercise program on several abilities associated with driving performance in older adults. Thirty-two subjects were randomly assigned to either an exercise group (60-81 years, n=16) or a control group (60-82 years, n=16). The exercise program was planned to stress perceptive, cognitive, and physical abilities. It lasted 12 weeks with a periodicity of three sessions of 60 min per week. Assessments were conducted before and after the intervention on behavioral speed (in single- and dual-task conditions), visual attention, psychomotor performance, speed perception (time-to-contact), and executive functioning. Significant positive effects were found at 12-week follow-up resulting from participation in the exercise program. Behavioral speed improvements were found in reaction time, movement time, and response time (both in single- and dual-task conditions); visual attention improvements took place in speed processing and divided attention; psychomotor performance improvements occurred in lower limb mobility. These results showed that exercise is capable of enhancing several abilities relevant for driving performance and safety in older adults and, therefore, should be promoted.

Effects of a Strength Training Session After an Exercise Inducing Muscle Damage on Recovery Kinetics.

PubMed

Abaïdia, Abd-Elbasset; Delecroix, Barthélémy; Leduc, Cédric; Lamblin, Julien; McCall, Alan; Baquet, Georges; Dupont, Grégory

2017-01-01

Abaïdia, A-E, Delecroix, B, Leduc, C, Lamblin, J, McCall, A, Baquet, G, and Dupont, G. Effects of a strength training session after an exercise inducing muscle damage on recovery kinetics. J Strength Cond Res 31(1): 115-125, 2017-The purpose of this study was to investigate the effects of an upper-limb strength training session the day after an exercise inducing muscle damage on recovery of performance. In a randomized crossover design, subjects performed the day after the exercise, on 2 separate occasions (passive vs. active recovery conditions) a single-leg exercise (dominant in one condition and nondominant in the other condition) consisting of 5 sets of 15 eccentric contractions of the knee flexors. Active recovery consisted of performing an upper-body strength training session the day after the exercise. Creatine kinase, hamstring strength, and muscle soreness were assessed immediately and 20, 24, and 48 hours after exercise-induced muscle damage. The upper-body strength session, after muscle-damaging exercise accelerated the recovery of slow concentric force (effect size = 0.65; 90% confidence interval = -0.06 to 1.32), but did not affect the recovery kinetics for the other outcomes. The addition of an upper-body strength training session the day after muscle-damaging activity does not negatively affect the recovery kinetics. Upper-body strength training may be programmed the day after a competition.

The impact of exercise and vitamin D supplementation on physical function in community-dwelling elderly individuals: A randomized trial.

PubMed

Aoki, Kana; Sakuma, Mayumi; Endo, Naoto

2018-04-25

We investigated the impact of exercise and vitamin D supplementation on physical function and locomotor dysfunction in community-dwelling elderly individuals. In total, 148 community-dwelling elderly individuals (aged ≥60 years) who were not taking osteoporosis medications participated in a 24-week intervention. The participants were randomly divided into an exercise group, vitamin D group, and exercise and vitamin D group. The participants and outcome-assessing staff were not blinded to group assignment. Exercise comprised three daily sets each of single-leg standing (1 min/leg/set) and squatting (5-6 repetitions/set); vitamin D supplementation was 1000 IU/day. Participants were contacted every 2 weeks to check on their condition and encourage continued participation. The primary outcome was lower limb muscle strength and mass; secondary outcomes were several physical function measurements, serum 25-hydroxyvitamin D levels, and results of a self-assessment questionnaire completed pre- and post-intervention. We analyzed data from 45, 42, and 43 participants in the exercise, vitamin D, and exercise and vitamin D groups, respectively, who completed the intervention. Locomotive syndrome, which involves reduced mobility due to locomotive organ impairment, was diagnosed in 99 participants (76.2%). Many physical function measurements improved in all groups. Lower limb muscle mass increased significantly in all three groups, with no significant differences between the groups in the degree of change. The average serum 25-hydroxyvitamin D of all vitamin D-supplemented participants increased from 28.1 ng/ml to 47.3 ng/ml after vitamin D supplementation. Both exercise and vitamin D supplementation independently improved physical function and increased muscle mass in community-dwelling elderly individuals. Moreover, the combination of exercise and vitamin D supplementation might further enhance these positive effects. UMIN Clinical Trial, UMIN000028229. Copyright © 2018. Published by Elsevier B.V.

A functional murine model of hindlimb demand ischemia.

PubMed

Peck, Michael A; Crawford, Robert S; Abularrage, Christopher J; Patel, Virendra I; Conrad, Mark F; Yoo, Jin Hyung; Watkins, Michael T; Albadawi, Hassan

2010-05-01

To date, murine models of treadmill exercise have been used to study general exercise physiology and angiogenesis in ischemic hindlimbs. The purpose of these experiments was to develop a murine model of demand ischemia in an ischemic limb to mimic claudication in humans. The primary goal was to determine whether treadmill exercise reflected a hemodynamic picture which might be consistent with the hyperemic response observed in humans. Aged hypercholesterolemic ApoE null mice (ApoE(-/-), n = 13) were subjected to femoral artery ligation (FAL) and allowed to recover from the acute ischemic response. Peripheral perfusion of the hindlimbs at rest was determined by serial evaluation using laser Doppler imaging (LDI) on days 0, 7, and 14 following FAL. During the experiments, mice were also assessed on an established five-point clinical ischemic score, which assessed the degree of digital amputation, necrosis, and cyanosis compared to the nonischemic contralateral limb. After stabilization of the LDI ratio (ischemic limb flux/contralateral nonischemic limb flux) and clinical ischemic score, mice underwent 2 days of treadmill training (10 min at 10 m/min, incline of 10 degrees ) followed by 60 min of daily treadmill exercise (13 m/min, incline of 10 degrees ) through day 25. An evaluation of preexercise and postexercise perfusion using LDI was performed on two separate occasions following the onset of daily exercise. During the immediate 15 min postexercise evaluation, LDI scanning was obtained in quadruplicate, to allow identification of peak flux ratios. Statistical analysis included unpaired t-tests and analysis of variance. After FAL, the LDI flux ratio reached a nadir between days 1 and 2, then stabilized by day 14 and remained stable through day 25. The clinical ischemic score stabilized at day 7 and remained stable throughout the rest of the experiment. Based on stabilization of both the clinical ischemic score and LDI ratio, exercise training began on day 15. The peak 15 min postexercise LDI ratio increased significantly compared to the preexercise ratio on day 17 (0.48 +/- 0.04 vs. 0.34 +/- 0.04, p < 0.05) and day 25 (0.37 +/- 0.03 vs. 0.27 +/- 0.03, p < 0.01). Within 2 hr of exercise, the LDI ratio returned to preexercise levels on both days 17 and 25. Clinical and hemodynamic stabilization of limb perfusion is evident by 14 days after FAL. FAL followed by demand ischemia results in a reversible relative hyperemic response similar to that observed in exercising human claudicants. A murine model of FAL associated with demand ischemia may be useful to evaluate the metabolic, inflammatory, and flow-related changes associated with claudication in humans. Copyright 2010 Annals of Vascular Surgery Inc. All rights reserved.

The effects of water-based exercise in combination with blood flow restriction on strength and functional capacity in post-menopausal women.

PubMed

Araújo, Joamira P; Neto, Gabriel R; Loenneke, Jeremy P; Bemben, Michael G; Laurentino, Gilberto C; Batista, Gilmário; Silva, Júlio C G; Freitas, Eduardo D S; Sousa, Maria S C

2015-12-01

Water-based exercise and low-intensity exercise in combination with blood flow restriction (BFR) are two methods that have independently been shown to improve muscle strength in those of advancing age. The objective of this study was to assess the long-term effect of water-based exercise in combination with BFR on maximum dynamic strength and functional capacity in post-menopausal women. Twenty-eight women underwent an 8-week water-based exercise program. The participants were randomly allocated to one of the three groups: (a) water exercise only, (b) water exercise + BFR, or (c) a non-exercise control group. Functional capacity (chair stand test, timed up and go test, gait speed, and dynamic balance) and strength testing were tested before and after the 8-week aquatic exercise program. The main findings were as follows: (1) water-based exercise in combination with BFR significantly increased the lower limb maximum strength which was not observed with water-based exercise alone and (2) water-based exercise, regardless of the application of BFR, increased functional performance measured by the timed up and go test over a control group. Although we used a healthy population in the current study, these findings may have important implications for those who may be contraindicated to using traditional resistance exercise. Future research should explore this promising modality in these clinical populations.

Moderate-intensity treadmill running promotes expansion of the satellite cell pool in young and old mice.

PubMed

Shefer, Gabi; Rauner, Gat; Stuelsatz, Pascal; Benayahu, Dafna; Yablonka-Reuveni, Zipora

2013-09-01

Satellite cells, the myogenic progenitors located at the myofibre surface, are essential for the repair of adult skeletal muscle. There is ample evidence for an age-linked decline in the number of satellite cells and performance in limb muscles. Hence, an effective means of activating and expanding the satellite cell pool may enhance muscle maintenance and reduce the impact of age-associated muscle deterioration (sarcopaenia). Accordingly, in the present study, we explored the beneficial effects of endurance exercise on satellite cells in young and old mice. Animals were subjected to an 8-week moderate-intensity treadmill-running approach that does not inflict apparent muscle damage (0° inclination, 11.5 m·min(-1) for 30 min·day(-1) , 6 days·week(-1) ). Myofibres of extensor digitorum longus muscles were then isolated from exercised and sedentary mice and used for monitoring the number of satellite cells, as well as for harvesting individual satellite cells for clonal growth assays. We specifically focused on satellite cell pools of single myofibres, with the view that daily wear of muscles probably affects individual myofibres rather than causing overall muscle damage. We found an expansion of the satellite cell pool in the exercised groups compared to the sedentary groups, with the same increase (~ 1.6-fold) in both ages. The results of the present study are in agreement with our findings obtained using rat gastrocnemius, indicating the consistent effect of exercise on satellite cell expansion in limb muscles. The experimental paradigm established in the present study is useful for investigating satellite cell dynamics at the myofibre niche, as well as for broader investigations of the impact of physiologically and pathologically relevant factors on adult myogenesis. © 2013 The Authors Journal compilation © 2013 FEBS.

Effects of treadmill training on functional recovery following peripheral nerve injury in rats

PubMed Central

Boeltz, Tiffany; Ireland, Meredith; Mathis, Kristin; Nicolini, Jennifer; Poplavski, Karen; Rose, Samuel J.; Wilson, Erin

2013-01-01

Exercise, in the form of moderate daily treadmill training following nerve transection and repair leads to enhanced axon regeneration, but its effect on functional recovery is less well known. Female rats were exercised by walking continuously, at a slow speed (10 m/min), for 1 h/day on a level treadmill, beginning 3 days after unilateral transection and surgical repair of the sciatic nerve, and conducted 5 days/wk for 2 wk. In Trained rats, both direct muscle responses to tibial nerve stimulation and H reflexes in soleus reappeared earlier and increased in amplitude more rapidly over time than in Untrained rats. The efficacy of the restored H reflex was greater in Trained rats than in Untrained controls. The reinnervated tibialis anterior and soleus were coactivated during treadmill locomotion in Untrained rats. In Trained animals, the pattern of activation of soleus, but not tibialis anterior, was not significantly different from that found in Intact rats. The overall length of the hindlimb during level and up- and downslope locomotion was conserved after nerve injury in both groups. This conservation was achieved by changes in limb orientation. Limb length was conserved effectively in all rats during downslope walking but only in Trained rats during level and upslope walking. Moderate daily exercise applied immediately after sciatic nerve transection is sufficient to promote axon regeneration, to restore muscle reflexes, and to improve the ability of rats to cope with different biomechanical demands of slope walking. PMID:23468390

The Effect of Two Different Hand Exercises on Grip Strength, Forearm Circumference, and Vascular Maturation in Patients Who Underwent Arteriovenous Fistula Surgery

PubMed Central

Kong, Sangwon; Lee, Kyung Soo; Kim, Junho

2014-01-01

Objective To compare the effect of two different hand exercises on hand strength and vascular maturation in patients who underwent arteriovenous fistula surgery. Methods We recruited 18 patients who had chronic kidney disease and had undergone arteriovenous fistula surgery for hemodialysis. After the surgery, 10 subjects performed hand-squeezing exercise with GD Grip, and other 8 subjects used Soft Ball. The subjects continued the exercises for 4 weeks. The hand grip strength, pinch strength (tip, palmar and lateral pinch), and forearm circumference of the subjects were assessed before and after the hand-squeezing exercise. The cephalic vein size, blood flow velocity and volume were also measured by ultrasonography in the operated limb. Results All of the 3 types of pinch strengths, grip strength, and forearm circumference were significantly increased in the group using GD Grip. Cephalic vein size and blood flow volume were also significantly increased. However, blood flow velocity showed no difference after the exercise. The group using Soft Ball showed a significant increase in the tip and lateral pinch strength and forearm circumference. The cephalic vein size and blood flow volume were also significantly increased. On comparing the effect of the two different hand exercises, hand-squeezing exercise with GD Grip had a significantly better effect on the tip and palmar pinch strength than hand-squeezing exercise with Soft Ball. The effect on cephalic vein size was not significantly different between the two groups. Conclusion The results showed that hand squeezing exercise with GD Grip was more effective in increasing the tip and palmar pinch strength compared to hand squeezing exercise with soft ball. PMID:25379494

Effects of calisthenics and Pilates exercises on coordination and proprioception in adult women: a randomized controlled trial.

PubMed

Ozer Kaya, Derya; Duzgun, Irem; Baltaci, Gul; Karacan, Selma; Colakoglu, Filiz

2012-08-01

To assess and compare the effects of 6 mo of Pilates and calisthenics on multijoint coordination and proprioception of the lower limbs at the 3rd and 6th mo of training. Randomized, controlled, assessor-blinded, repeated-measures. University research laboratory. Healthy, sedentary, female participants age 25-50 y were recruited and randomly divided into 3 groups: a calisthenic exercise group (n = 34, mean age ± SD 40 ± 8 y, body-mass index [BMI] 31.04 ± 4.83 kg/m2), a Pilates exercise group (n = 32, mean age ± SD 37 ± 8 y, BMI 31.04 ± 4.83 kg/m2), and a control group (n = 41, mean age ± SD 41 ± 7 y, BMI 27.09 ± 4.77 kg/m2). The calisthenics and Pilates groups underwent related training programs for 6 mo, while the controls had no specific training. Coordination and proprioception of the lower extremities with concentric and eccentric performances in the closed kinetic chain assessed with the monitored rehab functional squat system at baseline and at the 3rd and 6th mo of training. For the within-group comparison, coordinative concentric and eccentric deviation values were significantly decreased for both dominant and nondominant lower limbs at pretraining and at the 3rd and 6th mo posttraining in the calisthenics group (P < .05). In contrast, there was no improvement in the Pilates group throughout the training. However, for comparisons between groups, the baseline values of coordinative concentric and eccentric deviations were different in the calisthenics group than in Pilates and the controls (P < .05). There were no differences in the proprioception values of either visible or nonvisible movement in any group throughout the training (P > .05). It seems that calisthenic exercises are more likely to improve coordination of the lower extremity after 3 and 6 mo of training than Pilates exercises. Calisthenic exercises may be useful for individuals who require improved coordination.

Pilates improves lower limbs strength and postural control during quite standing in a child with hemiparetic cerebral palsy: A case report study.

PubMed

Dos Santos, Adriana Neves; Serikawa, Simoni Sayuri; Rocha, Nelci Adriana Cicuto Ferreira

2016-08-01

To verify the effect of Pilates exercises in a child with cerebral palsy (CP) with mild functional impairment. We evaluated average peak torque of ankle and knee extensors/flexors using a Biodex System, using concentric active-assisted test. We also evaluated amplitude of anterior-posterior and of medial-lateral displacement of the CoP and area of oscillation during quite standing with a BERTEC platform. We applied Pilates exercises for eight weeks. Peak torque/body weight of ankle and knee extensors/flexors of both affected and unaffected limbs increased after Pilates. Also, all kinetic variables decreased after Pilates' intervention. After one-month follow-up, isokinetic variable values were higher while kinetic variable values were lower than baseline values. Pilates may be an important rehabilitation technique for children with CP that present mild deficits in motor structures and high functional level, especially when the aims are to improve muscle strength and postural control during quite standing.

Assessing the efficacy of different upper limb hemiparesis interventions on improving health-related quality of life in stroke patients: a systematic review.

PubMed

Pulman, Jennifer; Buckley, Emily

2013-01-01

This review aims to assess the efficacy of upper limb interventions on stroke survivors' health-related quality of life (QOL). Published studies were identified following a systematic search of the literature from 10 electronic databases, 3 subject-relevant journals, a Web search via a popular search engine, and reference lists of the included articles. In total, 22 articles met the inclusion criteria and were subjected to data extraction to establish the effectiveness of the intervention on QOL scores. Interventions varied according to their content, including acupuncture treatment, botulinum toxin type A (BTX-A) injections, constraint-induced movement therapy (CIMT), task training, and therapeutic exercise. Studies were required to have at least 1 quantitative outcome QOL measure. Of the 22 studies, 12 reported significant findings within groups and between control groups. Interventions including BTX-A injections, CIMT, exercise programs, baclofen pump, robotic-assisted therapy, electrical stimulation, and acupuncture were reported to significantly improve either overall health-related QOL or certain individual QOL domains, such as strength, hand function, memory, mood, activities of daily living, mobility, social participation, communication, energy, pain, and sleep. The review demonstrates the need for upper limb intervention studies to focus on QOL as a primary outcome measure in addition to the functional outcomes currently used.

Lower limb explosive strength capacity in elderly women: effects of resistance training and healthy diet.

PubMed

Edholm, Peter; Strandberg, Emelie; Kadi, Fawzi

2017-07-01

The effects of 24 wk of resistance training combined with a healthy diet on lower limb explosive strength capacity were investigated in a population of healthy elderly women. Participants ( n = 63; 67.5 ± 0.4 yr) were randomized into three groups; resistance training (RT), resistance training and healthy diet (RT-HD), and control (CON). Progressive resistance training was performed at a load of 75-85% one-repetition maximum. A major adjustment in the healthy dietary approach was an n-6/n-3 polyunsaturated fatty acid (PUFA) ratio below 2. Lower limb maximal strength, explosive force capacity during dynamic and isometric movements, whole body lean mass, and physical function were assessed. Whole body lean mass significantly increased by 1.5 ± 0.5% in RT-HD only. Isometric strength performance during knee extension as well as the performance in the five sit-to-stand and single-leg-stance tests increased similarly in RT and RT-HD. Improvements in dynamic peak power and time to reach peak power (i.e shorter time) during knee extension occurred in both RT (+15.7 ± 2.6 and -11.0 ± 3.8%, respectively) and RT-HD (+24.6 ± 2.6 and -20.3 ± 2.7%, respectively); however, changes were significantly larger in RT-HD. Similarly, changes in peak force and rate of force development during squat jump were higher in RT-HD (+58.5 ± 8.4 and +185.4 ± 32.9%, respectively) compared with RT (+35.7 ± 6.9 and +105.4 ± 22.4%, respectively). In conclusion, a healthy diet rich in n-3 PUFA can optimize the effects of resistance training on dynamic explosive strength capacity during isolated lower limb movements and multijoint exercises in healthy elderly women. NEW & NOTEWORTHY Age-related decline in lower limb explosive strength leads to impaired ability to perform daily living tasks. The present randomized controlled trial demonstrates that a healthy diet rich in n-3 polyunsaturated fatty acid (n-3 PUFA) enhances resistance training-induced gains in dynamic explosive strength capacity during isolated lower limb movements and multijoint exercises in healthy elderly women. This supports the use of strategies combining resistance training and dietary changes to mitigate the decline in explosive strength capacity in older adults. Copyright © 2017 the American Physiological Society.

Effect of Exercise on Motor and Nonmotor Symptoms of Parkinson's Disease

PubMed Central

Dashtipour, Khashayar; Johnson, Eric; Kani, Camellia; Kani, Kayvan; Hadi, Ehsan; Ghamsary, Mark; Pezeshkian, Shant; Chen, Jack J.

2015-01-01

Background. Novel rehabilitation strategies have demonstrated potential benefits for motor and non-motor symptoms of Parkinson's disease (PD). Objective. To compare the effects of Lee Silverman Voice Therapy BIG (LSVT BIG therapy) versus a general exercise program (combined treadmill plus seated trunk and limb exercises) on motor and non-motor symptoms of PD. Methods. Eleven patients with early-mid stage PD participated in the prospective, double-blinded, randomized clinical trial. Both groups received 16 one-hour supervised training sessions over 4 weeks. Outcome measures included the Unified Parkinson's Disease Rating Scale (UPDRS), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI) and Modified Fatigue Impact Scale (MFIS). Five patients performed general exercise and six patients performed LSVT BIG therapy. Post-intervention evaluations were conducted at weeks 4, 12 and 24. Results. The combined cohort made improvements at all follow-up evaluations with statistical significance for UPDRS total and motor, BDI, and MFIS (P < 0.05). Conclusion. This study demonstrated positive effects of general exercise and LSVT BIG therapy on motor and non-motor symptoms of patients with PD. Our results suggest that general exercise may be as effective as LSVT BIG therapy on symptoms of PD for patients not able to readily access outpatient LSVT BIG therapy. PMID:25722915

The 'sensory tolerance limit': A hypothetical construct determining exercise performance?

PubMed

Hureau, Thomas J; Romer, Lee M; Amann, Markus

2018-02-01

Neuromuscular fatigue compromises exercise performance and is determined by central and peripheral mechanisms. Interactions between the two components of fatigue can occur via neural pathways, including feedback and feedforward processes. This brief review discusses the influence of feedback and feedforward mechanisms on exercise limitation. In terms of feedback mechanisms, particular attention is given to group III/IV sensory neurons which link limb muscle with the central nervous system. Central corollary discharge, a copy of the neural drive from the brain to the working muscles, provides a signal from the motor system to sensory systems and is considered a feedforward mechanism that might influence fatigue and consequently exercise performance. We highlight findings from studies supporting the existence of a 'critical threshold of peripheral fatigue', a previously proposed hypothesis based on the idea that a negative feedback loop operates to protect the exercising limb muscle from severe threats to homeostasis during whole-body exercise. While the threshold theory remains to be disproven within a given task, it is not generalisable across different exercise modalities. The 'sensory tolerance limit', a more theoretical concept, may address this issue and explain exercise tolerance in more global terms and across exercise modalities. The 'sensory tolerance limit' can be viewed as a negative feedback loop which accounts for the sum of all feedback (locomotor muscles, respiratory muscles, organs, and muscles not directly involved in exercise) and feedforward signals processed within the central nervous system with the purpose of regulating the intensity of exercise to ensure that voluntary activity remains tolerable.

The effects of arm crank ergometry, cycle ergometry and treadmill walking on postural sway in healthy older females.

PubMed

Hill, M W; Oxford, S W; Duncan, M J; Price, M J

2015-01-01

Older adults are increasingly being encouraged to exercise but this may lead to muscle fatigue, which can adversely affect postural stability. Few studies have investigated the effects of upper body exercise on postural sway in groups at risk of falling, such as the elderly. The purpose of this study was to compare the effects arm crank ergometry (ACE), cycle ergometry (CE) and treadmill walking (TM) on postural sway in healthy older females. In addition, this study sought to determine the time necessary to recover postural control after exercise. A total of nine healthy older females participated in this study. Participants stood on a force platform to assess postural sway which was measured by displacement of the centre of pressure before and after six separate exercise trials. Each participant completed three incremental exercise tests to 85% of individual's theoretical maximal heart rate (HRMAX) for ACE, CE and TM. Subsequent tests involved 20-min of ACE, CE and TM exercise at a relative workload corresponding to 50% of each individual's predetermined heart rate reserve (HRE). Post fatigue effects and postural control recovery were measured at different times after exercise (1, 3, 5, 10, 15 and 30-min). None of the participants exhibited impaired postural stability after ACE. In contrast, CE and TM elicited significant post exercise balance impairments, which lasted for ∼ 10 min post exercise. We provide evidence of an exercise mode which does not elicit post exercise balance impairments. Older adults should exercise caution immediately following exercise engaging the lower limbs to avoid fall risk. Copyright © 2014 Elsevier B.V. All rights reserved.

Oral nutritional support with or without exercise in the management of malnutrition in nutritionally vulnerable older people: A systematic review and meta-analysis.

PubMed

Wright, Jessie; Baldwin, Christine

2017-09-09

Physical functioning declines with advancing age and compounds malnutrition, common in elderly populations. A dual-intervention combining oral nutritional support and exercise may delay these changes. Our aims were to assess whether exercise combined with oral nutritional support (ONS) has greater improvements on physical functioning, quality of life and nutritional status than nutrition intervention alone in nutritionally vulnerable older adults. Three electronic databases were searched for randomised controlled trials of older adults judged to be: sarcopenic, cachexic, frail, malnourished, and/or at risk of malnutrition, receiving ONS and exercise compared to nutrition intervention alone. Meta-analyses were performed using a fixed-effect model to calculate standardised mean difference (SMD) (hand-grip strength, limb strength, gait speed, timed up-and-go test (TUG), physical activity level and fat-free mass) or relative risk (hospitalisation) with 95% confidence intervals (CIs). Eleven studies (n = 1459 participants) were included. ONS and exercise interventions varied considerably between studies. There was very low quality evidence that exercise combined with ONS compared to nutrition intervention alone resulted in significant improvements in limb strength (SMD = 0.33; 95% CI 0.13-0.53; P = 0.001) but low quality evidence of no effect on fat-free mass (SMD = -0.05; 95% CI -0.27 to 0.18; P = 0.70), physical activity level (SMD = 0.04; 95% CI -0.26 to 0.33; P = 0.81) and TUG (mean difference = -0.80; 95% CI -2.06 to 0.47; P = 0.22). Moderate quality evidence from a small number of studies found no effect on handgrip strength and QOL. Low quality evidence of faster gait speeds were found in participants receiving ONS alone compared to combined intervention (SMD = 0.38; 95% CI 0.19 to 0.56; P < 0.0001). Combining exercise with ONS may provide additional improvements to muscle strength but had no effect on other measures of physical functioning, nutritional status or morbidity in nutritionally vulnerable older adults. This trial was registered at http://www.crd.york.ac.uk/PROSPERO/ as CRD42015027323. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

Evaluation of carbon dioxide rebreathing during exercise assisted by noninvasive ventilation with plateau exhalation valve

PubMed Central

Ou, Yong-er; Lin, Zhi-min; Hua, Dong-ming; Jiang, Ying; Huo, Ya-ting; Luo, Qun; Chen, Rong-Chang

2017-01-01

Noninvasive ventilation with a plateau exhalation valve (PEV) is often used as an adjunct to exercise to achieve a physiologic training effect in severe chronic obstructive pulmonary disease (COPD) patients. However, during exercise, with the increase of exhalation flow and respiratory rate and limited capability of PEV to exhale gases out of the circuit, it is still unknown whether CO2 rebreathing occurs in COPD patients ventilated during exercise assisted by single-limb circuit with a PEV. A maximal symptom-limited cycle exercise test was performed while ventilated on pressure support (inspiratory:expiratory pressure 14:4 cmH2O) in 18 male patients with stable severe COPD (mean ± standard deviation, forced expiratory volume in 1 s: 29.5%±6.9% predicted). At rest and during exercise, breathing pattern, mean expiratory flow, mean expiratory flow of PEV, and the mean inspiratory fraction of CO2 (tidal fractional concentration of inspired CO2 [FiCO2]) reinsufflated from the circuit was measured for each breath. In comparison with rest, with the significant increase of mean expiratory flow (0.39±0.15 vs 0.82±0.27 L/s), fractional concentration of end-tidal CO2 (2.6%±0.7% vs 5.5%±0.6%), and the significant decrease of mean expiratory flow of PEV (0.41±0.02 vs 0.39±0.03 L/s), tidal FiCO2 significantly increased at peak exercise (0.48%±0.19% vs 1.8%±0.6%) in patients with stable severe COPD. The inflection point of obvious CO2 rebreathing was 0.67±0.09 L/s (95% confidence interval 0.60–0.73 L/s). Ventilated by a single-limb tubing with PEV caused CO2 rebreathing to COPD patients during exercise. Patients with mean expiratory flow >0.60–0.73 L/s may be predisposed to a higher risk of CO2 rebreathing. PMID:28144134

Biomechanics of front and back squat exercises

NASA Astrophysics Data System (ADS)

Braidot, A. A.; Brusa, M. H.; Lestussi, F. E.; Parera, G. P.

2007-11-01

Squat constitutes one of the most popular exercises to strengthen the muscles of the lower limbs. It is considered one of the most widely spread exercises for muscle sport training and is part of the competition movements comprised within olympic weight-lifting. In physical rehabilitation, squats are used for muscular recovery after different injuries of the lower limbs, especially the knee. In previous anterior cruciate ligament injuries, the mini-squats are generally used, in a knee flexion motion range from 0° to 50° because in this range the shear forces, the tibiofemoral and patellofemoral compression forces decrease related to greater flexion angles. The aim of this work is to make a comparative bidimensional study of the kinematic and dynamic variables of the excecution of the parallel squat exercise with the front and back bar. It is observed in the knee a better development of energy with the front bar, allowing a better muscular exercise with the same load. The mean power absorbed by the hip with the back bar is considerably greater, associated to the speed of the gesture.

Is There a Role for Exercise in the Management of Bulbar Dysfunction in Amyotrophic Lateral Sclerosis?

ERIC Educational Resources Information Center

Plowman, Emily K.

2015-01-01

Purpose: The role of exercise in the management of people with amyotrophic lateral sclerosis (PALS) is controversial and currently unclear. The purpose of this review article is to review literature examining the impact of limb, respiratory, and oral motor exercise on function, disease progression, and survival in PALS and the transgenic ALS…

[Deep venous thrombosis of the upper limb in a violin player: The "bow syndrome"].

PubMed

Sanson, H; Gautier, V; Stansal, A; Sfeir, D; Franceschi, C; Priollet, P

2016-12-01

Exercise-induced thrombosis is a rare cause of deep venous thrombosis (DVT) of the upper limb and usually affects young subjects without comorbid conditions. The diagnosis may be challenging. A 23-year-old female right-handed French teacher and amateur violin player presented with edema of the root of the right arm associated with erythrocyanosis of the extremity and collateral circulation of the shoulder. History taking revealed oral contraception and recent change in violin playing habits. D-dimers were negative. A second duplex-Doppler was required before visualization of a DVT in the right subclavian vein. The patient was given low-molecular-weight heparin alone, followed by rivaroxaban. The outcome was very favorable at 48h. The patient was seen at 4 months and had not had a recurrent episode. The diagnosis of DVT of the upper limb is basically clinical. There is a clinical probability score for the introduction of anticoagulation even if the duplex-Doppler fails to visualize DVT, a situation that can occur due to the clavicular superposition in this region. Exercise-induced DVT should be suspected in patients with minimally intense but repeated exercise (hyper-abduction), e.g. as here playing the violin. Anticoagulation is the treatment of choice. The role for surgery and pharmacomechanical strategies remains to be defined. Exercise-induced thrombosis (Paget-Schroetter syndrome) should be suspected in young patients free of any comorbidity who develop a thrombosis of the upper limb. Studies comparing different therapeutic options would be useful to achieve more homogeneous management practices despite the heterogeneous clinical presentations. Copyright © 2016. Published by Elsevier Masson SAS.

Ankle brachial index is equally predictive of exercise-induced limb ischemia in diabetic and non-diabetic patients with walking limitation.

PubMed

Henni, Samir; Ammi, Myriam; Gourdier, Anne-Sophie; Besnier, Louis; Signolet, Isabelle; Colas-Ribas, Christophe; Picquet, Jean; Abraham, Pierre

2018-03-29

In diabetic patients, arterial stiffness may impair compressibility of vessels and result in higher ankle to brachial index (ABI) than in non-diabetic subjects. We studied 1972 non-diabetic and 601 diabetic patients, with suspected peripheral artery disease, Exercise transcutaneous oxygen pressure (Ex-tcpO2), expressed in DROP index (limb tcpO2 change minus chest tcpO2 change), is insensitive to arterial stiffness and can estimate exercise-induced regional blood flow impairment (RBFI). A minimal DROP <-15 mm Hg indicates the presence of RBFI (positive test). ABI was simplified to a category variable (ABIc) by rounding ABI to the closest first decimal. In the ABIc range 0.4 to 1.1 linear regression for mean DROP values were: y = 34 x - 53; (R 2  = 0.211) and y = 33 x - 52; (R 2  = 0.186) in diabetic and Non-diabetic patients, respectively. Both Db and non-D patients showed a high proportion of positive Ex-tcpO2 tests for ABIc in the normal range (ABIc: 1.0 and over) from 27.1 to up to 58%. More than half of patients with borderline ABI (ABIc = 0.9) had RBFI during exercise. it was 65.6% in diabetic and 58.5% non-diabetic patients. Resting ABI was not a better predictor of exercise-induced RBFI in non-Db than in Diabetic patients. Our results highlights the interest of still measuring resting-ABI in diabetic patients to argue for the vascular origin of exertional limb pain, but also of performing exercise tests in patients with walking impairment. Copyright © 2018 Elsevier Inc. All rights reserved.

[The mirror neuron system in motor and sensory rehabilitation].

PubMed

Oouchida, Yutaka; Izumi, Shinichi

2014-06-01

The discovery of the mirror neuron system has dramatically changed the study of motor control in neuroscience. The mirror neuron system provides a conceptual framework covering the aspects of motor as well as sensory functions in motor control. Previous studies of motor control can be classified as studies of motor or sensory functions, and these two classes of studies appear to have advanced independently. In rehabilitation requiring motor learning, such as relearning movement after limb paresis, however, sensory information of feedback for motor output as well as motor command are essential. During rehabilitation from chronic pain, motor exercise is one of the most effective treatments for pain caused by dysfunction in the sensory system. In rehabilitation where total intervention unifying the motor and sensory aspects of motor control is important, learning through imitation, which is associated with the mirror neuron system can be effective and suitable. In this paper, we introduce the clinical applications of imitated movement in rehabilitation from motor impairment after brain damage and phantom limb pain after limb amputation.

Functional electrical stimulation: cardiorespiratory adaptations and applications for training in paraplegia.

PubMed

Deley, Gaëlle; Denuziller, Jérémy; Babault, Nicolas

2015-01-01

Regular exercise can be broadly beneficial to health and quality of life in humans with spinal cord injury (SCI). However, exercises must meet certain criteria, such as the intensity and muscle mass involved, to induce significant benefits. SCI patients can have difficulty achieving these exercise requirements since the paralysed muscles cannot contribute to overall oxygen consumption. One solution is functional electrical stimulation (FES) and, more importantly, hybrid training that combines volitional arm and electrically controlled contractions of the lower limb muscles. However, it might be rather complicated for therapists to use FES because of the wide variety of protocols that can be employed, such as stimulation parameters or movements induced. Moreover, although the short-term physiological and psychological responses during different types of FES exercises have been extensively reported, there are fewer data regarding the long-term effects of FES. Therefore, the purpose of this brief review is to provide a critical appraisal and synthesis of the literature on the use of FES for exercise in paraplegic individuals. After a short introduction underlying the importance of exercise for SCI patients, the main applications and effects of FES are reviewed and discussed. Major findings reveal an increased physiological demand during FES hybrid exercises as compared with arms only exercises. In addition, when repeated within a training period, FES exercises showed beneficial effects on muscle characteristics, force output, exercise capacity, bone mineral density and cardiovascular parameters. In conclusion, there appears to be promising evidence of beneficial effects of FES training, and particularly FES hybrid training, for paraplegic individuals.

Pediatric endurance and limb strengthening for children with cerebral palsy (PEDALS) – a randomized controlled trial protocol for a stationary cycling intervention

PubMed Central

Fowler, Eileen G; Knutson, Loretta M; DeMuth, Sharon K; Sugi, Mia; Siebert, Kara; Simms, Victoria; Azen, Stanley P; Winstein, Carolee J

2007-01-01

Background In the past, effortful exercises were considered inappropriate for children with spastic cerebral palsy (CP) due to concern that they would escalate abnormalities including spasticity and abnormal movement patterns. Current scientific evidence indicates that these concerns were unfounded and that therapeutic interventions focused on muscle strengthening can lead to improved functional ability. However, few studies have examined the potential benefits of cardiorespiratory fitness exercises in this patient population. Methods/design The rationale and design of a randomized controlled trial examining the effects of a stationary cycling intervention for children with CP are outlined here. Sixty children with spastic diplegic CP between the ages of 7 and 18 years and Gross Motor Function Classification System (GMFCS) levels of I, II, or III will be recruited for this study. Participants will be randomly assigned to either an intervention (cycling) or a control (no cycling) group. The cycling intervention will be divided into strengthening and cardiorespiratory endurance exercise phases. During the strengthening phase, the resistance to lower extremity cycling will be progressively increased using a uniquely designed limb-loaded mechanism. The cardiorespiratory endurance phase will focus on increasing the intensity and duration of cycling. Children will be encouraged to exercise within a target heart rate (HR) range (70 – 80% maximum HR). Thirty sessions will take place over a 10–12 week period. All children will be evaluated before (baseline) and after (follow-up) the intervention period. Primary outcome measures are: knee joint extensor and flexor moments, or torque; the Gross Motor Function Measure (GMFM); the 600 Yard Walk-Run test and the Thirty-Second Walk test (30 sec WT). Discussion This paper presents the rationale, design and protocol for Pediatric Endurance and Limb Strengthening (PEDALS); a Phase I randomized controlled trial evaluating the efficacy of a stationary cycling intervention for children with spastic diplegic cerebral palsy. PMID:17374171

Exercise effects on the size and metabolic properties of soleus fibers in hindlimb-suspended rats

NASA Technical Reports Server (NTRS)

Graham, Scot C.; Roy, Roland R.; West, Steve P.; Thomason, Don; Baldwin, Kenneth M.

1989-01-01

The effects of four-week-long hind-limb suspension (HS) of rats on the size the soleus muscle fibers and the activity of succinate dehydrogenase (SDH) in dark and light ATPase fibers were investigated together with the efficacy of an endurance exercise (EX) program (daily treadmill exercise for 1.5 h/day at 20 m/min and a 30-percent grade) in ameliorating HS-induced changes. It was found that, in comparison to age-matched controls, the soleus wet weight decreased by 69 and 30 percent in HS and HS-EX rats, respectively, and the percent of dark ATPase fibers increased from 10 percent in controls to 19 and 17 percent, respectively. The values of the integrated fiber activity (activity/min times muscle area) showed a net loss of SDH in both the light and dark ATPase fibers of HS rats, but only in the light ATPase fibers of the HS-EX rats, indicating that exercise ameliorated but did not prevent the muscle fiber atrophy induced by HS.

Muscle activation patterns in the Nordic hamstring exercise: Impact of prior strain injury.

PubMed

Bourne, M N; Opar, D A; Williams, M D; Al Najjar, A; Shield, A J

2016-06-01

This study aimed to determine: (a) the spatial patterns of hamstring activation during the Nordic hamstring exercise (NHE); (b) whether previously injured hamstrings display activation deficits during the NHE; and (c) whether previously injured hamstrings exhibit altered cross-sectional area (CSA). Ten healthy, recreationally active men with a history of unilateral hamstring strain injury underwent functional magnetic resonance imaging of their thighs before and after six sets of 10 repetitions of the NHE. Transverse (T2) relaxation times of all hamstring muscles [biceps femoris long head (BFlh); biceps femoris short head (BFsh); semitendinosus (ST); semimembranosus (SM)] were measured at rest and immediately after the NHE and CSA was measured at rest. For the uninjured limb, the ST's percentage increase in T2 with exercise was 16.8%, 15.8%, and 20.2% greater than the increases exhibited by the BFlh, BFsh, and SM, respectively (P < 0.002 for all). Previously injured hamstring muscles (n = 10) displayed significantly smaller increases in T2 post-exercise than the homonymous muscles in the uninjured contralateral limb (mean difference -7.2%, P = 0.001). No muscles displayed significant between-limb differences in CSA. During the NHE, the ST is preferentially activated and previously injured hamstring muscles display chronic activation deficits compared with uninjured contralateral muscles. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Wearable Sensing of Cardiac Timing Intervals from Cardiogenic Limb Vibration Signals

PubMed Central

Wiens, Andrew D.; Johnson, Ann; Inan, Omer T.

2017-01-01

In this paper we describe a new method to measure aortic valve opening (AVO) and closing (AVC) from cardiogenic limb vibrations (i.e., wearable ballistocardiogram [BCG] signals). AVO and AVC were detected for each heartbeat with accelerometers on the upper arm (A), wrist (W), and knee (K) of 22 subjects following isometric exercise. Exercise-induced changes were recorded with impedance cardiography. The method, Filter BCG, detects peaks in distal vibrations after filtering with individually-tuned bandpass filters. In agreement with recent studies, we did not find peaks at AVO and AVC in limb vibrations directly. Interestingly, distal vibrations filtered with FilterBCG yielded reliable peaks at AVO (r2 = 0.95 A, 0.94 W, 0.77 K) and AVC (r2= 0.92 A, 0.89 W, 0.68 K). FilterBCG measures AVO and AVC accurately from arm, wrist, and knee vibrations, and it outperforms the standard R-J interval method. PMID:29123459

Randomized controlled comparative study on effect of training to improve lower limb motor paralysis in convalescent patients with post-stroke hemiplegia

PubMed Central

Kawakami, Kenji; Miyasaka, Hiroyuki; Nonoyama, Sayaka; Hayashi, Kazuya; Tonogai, Yusuke; Tanino, Genichi; Wada, Yosuke; Narukawa, Akihisa; Okuyama, Yuko; Tomita, Yutaka; Sonoda, Shigeru

2015-01-01

[Purpose] The motor paralysis-improving effect on the hemiplegic lower limb was compared among mirror therapy, integrated volitional-control electrical stimulation, therapeutic electrical stimulation, repetitive facilitative exercises, and the standard training method in post-stroke hemiplegia patients. [Subjects and Methods] Eighty one stroke patients admitted to a convalescent rehabilitation ward were randomly allocated to the above 5 treatment groups. Each patient performed functional training of the paralytic lower limb for 20 minutes a day for 4 weeks, and changes in the lower limb function were investigated using the Stroke Impairment Assessment Set. [Results] The hip and knee joint functions did not significantly improve in the standard training control group, but significant improvements were observed after 4 weeks in the other intervention groups. Significant improvement was noted in the ankle joint function in all groups. [Conclusion] Although the results were influenced by spontaneous recovery and the standard training in the control group, the hip and knee joints were more markedly improved by the interventions in the other 4 groups of patients with moderate paralysis, compared to the control group. PMID:26504331

Short-term effects of hip abductors and lateral rotators strengthening in females with patellofemoral pain syndrome: a randomized controlled clinical trial.

PubMed

Fukuda, Thiago Yukio; Rossetto, Flavio Marcondes; Magalhães, Eduardo; Bryk, Flavio Fernandes; Lucareli, Paulo Roberto Garcia; de Almeida Aparecida Carvalho, Nilza

2010-11-01

Randomized clinical trial. To investigate the influence of strengthening the hip abductor and lateral rotator musculature on pain and function of females with patellofemoral pain syndrome (PFPS). Hip muscle weakness in women athletes has been the focus of many recent studies and is suggested as an important impairment to address in the conservative treatment of women with PFPS. However, it is still not well established if strengthening these muscles is associated with clinical improvement in pain and function in sedentary females with PFPS. Seventy females (average±SD age, 25±07 years), with a diagnosis of unilateral PFPS, were distributed randomly into 3 groups: 22 females in the knee exercise group, who received a conventional treatment that emphasized stretching and strengthening of the knee musculature; 23 females in the knee and hip exercise group, who performed exercises to strengthen the hip abductors and external rotators in addition to the same exercises performed by those in the knee exercise group; and of the 25 females who did not receive any treatment. The females of the nontreatment group (control) were instructed to maintain their normal daily activities. An 11-point numerical pain rating scale (NPRS) was used to assess pain during stair ascent and descent. The lower extremity functional scale (LEFS) and the anterior knee pain scale (AKPS) were used to assess function. The single-limb single hop test was also used as a functional outcome to measure preintervention and 4-week postintervention function. The 3 groups were homogeneous prior to treatment in respect to demographic, pain, and functional scales data. Both the knee exercise and the knee and hip exercise groups showed significant improvement in the LEFS, the AKPS, and the NPRS, when compared to the control group (P<.05 and P<.001, respectively). But, when we considered minimal clinically important differences, only the knee and hip exercise group demonstrated mean improvements in AKPS and pain scores that were large enough to be clinically meaningful. For the single-limb single hop test, both groups receiving an intervention showed greater improvement than the control group, but there was no difference between the 2 interventions (P>.05). Rehabilitation programs focusing on knee strengthening exercises and knee strengthening exercises supplemented by hip strengthening exercises were both effective in improving function and reducing pain in sedentary women with PFPS. Improvements of pain and function were greater for the group that performed the hip strengthening exercises, but the difference was significant only for pain rating while descending stairs. Therapy, level 1b-.

Heat exchanges in wet suits.

PubMed

Wolff, A H; Coleshaw, S R; Newstead, C G; Keatinge, W R

1985-03-01

Flow of water under foam neoprene wet suits could halve insulation that the suits provided, even at rest in cold water. On the trunk conductance of this flow was approximately 6.6 at rest and 11.4 W . m-2 . C-1 exercising; on the limbs, it was only 3.4 at rest and 5.8 W . m-2 . degrees C-1 exercising; but during vasoconstriction in the cold, skin temperatures on distal parts of limbs were lower than were those of the trunk, allowing adequate metabolic responses. In warm water, minor postural changes and movement made flow under suits much higher, approximately 60 on trunk and 30 W . m-2 . degrees C-1 on limbs, both at rest and at work. These changes in flow allowed for a wide range of water temperatures at which people could stabilize body temperature in any given suit, neither overheating when exercising nor cooling below 35 degrees C when still. Even thin people with 4- or 7- mm suits covering the whole body could stabilize their body temperatures in water near 10 degrees C in spite of cold vasodilatation. Equations to predict limits of water temperature for stability with various suits and fat thicknesses are given.

Bilateral upper limb trainer with virtual reality for post-stroke rehabilitation: case series report.

PubMed

Sampson, Michael; Shau, Yio-Wha; King, Marcus James

2012-01-01

Stroke is a leading cause of disability with many survivors having upper limb (UL) hemiparesis. UL rehabilitation using bilateral exercise enhances outcomes and the Bilateral Upper Limb Trainer (BUiLT) was developed to provide symmetrical, bilateral arm exercise in a 'forced' and self-assistive manner, incorporating virtual reality (VR) to provide direction and task specificity to users as well as action observation-execution and greater motivation to exercise. The BUiLT + VR system was trialled on five post-stroke participants with UL hemiparesis: one sub-acute and four chronic. The intervention was supplied for 45 min, 4 days/week for 6 weeks. The Fugl-Meyer Upper Extremity score (FMA-UE) was used as the primary outcome measure. Secondary outcome measures used were UL isometric strength and the Intrinsic Motivation Inventory (IMI) questionnaire. The BUiLT + VR therapy increased FMA-UE scores from 1 to 5 and overall strength in the shoulder and elbow. Motivation at the end of intervention was positive. Therapy using the BUiLT + VR system is reliable, can be administered safely and has a positive trend of benefit as measured by the FMA-UE, isometric strength testing and IMI questionnaire.

High-speed resistance training and balance training for people with knee osteoarthritis to reduce falls risk: study protocol for a pilot randomized controlled trial.

PubMed

Levinger, Pazit; Dunn, Jeremy; Bifera, Nancy; Butson, Michael; Elias, George; Hill, Keith D

2017-08-18

The number of falls experienced by people with knee osteoarthritis (OA) is almost double the number experienced by people with no OA. The neuromuscular elements required to arrest a fall are more impaired in people with knee OA compared to their asymptomatic counterparts. Therefore, these elements may need to be incorporated into an exercise intervention to reduce the risk of falling. The aim of this study will be to examine the feasibility, safety and patient satisfaction of a high-speed resistance-training program, with and without balance exercises, in people with knee OA compared to a control group. The effect of these exercise programs on lower-limb muscle strength and physiological and functional risk factors for falls will also be examined. This study will be a pilot randomized controlled trial with a pre- and post-intervention design (outcome assessments at baseline and 8 weeks after participation commencement) comparing three groups: a control group (no intervention), a high-speed resistance-training group and a high-speed resistance-training plus balance exercises group. Thirty people with knee osteoarthritis aged 60-90 years will be recruited and randomized to one of the three groups. Feasibility and safety will be assessed by examining adherence to the exercise program, dropout rate, pain level during and following exercise, number of exercises stopped due to pain, and any adverse event or any incident that prevents the participant from completing the prescribed exercise. Secondary measures of lower-limb strength, physical function, self-reported pain and function, fear of falls, and executive function and quality of life will also be assessed. To determine statistical trends of effectiveness and hence to inform sample size for a fully powered study, analyses of the secondary outcomes will be performed to assess the changes within and between groups over time (pre-post) using repeated measure ANOVA. The results of this study will improve understanding of what type of exercise is safe and beneficial for people with knee OA to reduce their risk of falling, and hence will inform the development of a future large research trial. Australian New Zealand Clinical Trials Registry, ID: ACTRN12616001382460 . Registered on 6 October 2016.

Towards evidence based strength training: a comparison of muscle forces during deadlifts, goodmornings and split squats.

PubMed

Schellenberg, Florian; Taylor, William R; Lorenzetti, Silvio

2017-01-01

To ensure an efficient and targeted adaptation with low injury risk during strength exercises, knowledge of the participant specific internal loading conditions is essential. The goal of this study was to calculate the lower limb muscles forces during the strength exercises deadlifts, goodmornings and splits squats by means of musculoskeletal simulation. 11 participants were assessed performing 10 different variations of split squats by varying the step length as well as the maximal frontal tibia angle, and 13 participants were measured performing deadlift and goodmorning exercises. Using individualised musculoskeletal models, forces of the Quadriceps ( four parts), Hamstrings (four parts) and m. gluteus maximus (three parts) were computed. Deadlifts resulted highest loading for the Quadriceps, especially for the vasti (18-34 N/kg), but not for the rectus femoris (8-10 N/kg), which exhibited its greatest loading during split squats (13-27 N/kg) in the rear limb. Hamstrings were loaded isometrically during goodmornings but dynamically during deadlifts. For the m. gluteus maximus , the highest loading was observed during split squats in the front limb (up to 25 N/kg), while deadlifts produced increasingly, large loading over large ranges of motion in hip and knee. Acting muscle forces vary between exercises, execution form and joint angle. For all examined muscles, deadlifts produced considerable loading over large ranges of motion, while split squats seem to be highly dependent upon exercise variation. This study provides key information to design strength-training programs with respect to loading conditions and ranges of motion of lower extremity muscles.

Effects of Clinical Pilates Exercises on Patients Developing Lymphedema after Breast Cancer Treatment: A Randomized Clinical Trial.

PubMed

Şener, Hülya Özlem; Malkoç, Mehtap; Ergin, Gülbin; Karadibak, Didem; Yavuzşen, Tuğba

2017-01-01

The aim of the present study was to compare the effects of clinical Pilates exercises with those of the standard lymphedema exercises on lymphedema developing after breast cancer treatment. The study comprised 60 female patients with a mean age of 53.2±7.7 years who developed lymphedema after having breast cancer treatment. The patients were randomized into two groups: the clinical Pilates exercise group (n=30), and the control group (n=30). Before, and at the 8th week of treatment, the following parameters were measured: the severity of lymphedema, limb circumferences, body image using the Social Appearance Anxiety Scale, quality of life with the European Organization for Research and Treatment of Cancer (EORTC) quality of life questionnaire (QLQ-BR23), and upper extremity function using the Disabilities of the Arm, Shoulder and Hand (DASH) outcome measure. Both groups performed one-hour exercises three days a week for 8 weeks. After treatment, the symptoms recovered significantly in both groups. Reductions in the severity of lymphedema, improvements in the social appearance anxiety scale scores, quality of life scores, and upper extremity functions scores in the clinical Pilates exercise group were greater than those in the control group. Clinical Pilates exercises were determined to be more effective on the symptoms of patients with lymphedema than were standard lymphedema exercises. Clinical Pilates exercises could be considered a safe model and would contribute to treatment programs.

Effects of Clinical Pilates Exercises on Patients Developing Lymphedema after Breast Cancer Treatment: A Randomized Clinical Trial

PubMed Central

Şener, Hülya Özlem; Malkoç, Mehtap; Ergin, Gülbin; Karadibak, Didem; Yavuzşen, Tuğba

2017-01-01

Objective The aim of the present study was to compare the effects of clinical Pilates exercises with those of the standard lymphedema exercises on lymphedema developing after breast cancer treatment. Materials and Methods The study comprised 60 female patients with a mean age of 53.2±7.7 years who developed lymphedema after having breast cancer treatment. The patients were randomized into two groups: the clinical Pilates exercise group (n=30), and the control group (n=30). Before, and at the 8th week of treatment, the following parameters were measured: the severity of lymphedema, limb circumferences, body image using the Social Appearance Anxiety Scale, quality of life with the European Organization for Research and Treatment of Cancer (EORTC) quality of life questionnaire (QLQ-BR23), and upper extremity function using the Disabilities of the Arm, Shoulder and Hand (DASH) outcome measure. Both groups performed one-hour exercises three days a week for 8 weeks. Results After treatment, the symptoms recovered significantly in both groups. Reductions in the severity of lymphedema, improvements in the social appearance anxiety scale scores, quality of life scores, and upper extremity functions scores in the clinical Pilates exercise group were greater than those in the control group. Clinical Pilates exercises were determined to be more effective on the symptoms of patients with lymphedema than were standard lymphedema exercises. Conclusions Clinical Pilates exercises could be considered a safe model and would contribute to treatment programs. PMID:28331763

Recovery From Exercise-Induced Muscle Damage: Cold-Water Immersion Versus Whole-Body Cryotherapy.

PubMed

Abaïdia, Abd-Elbasset; Lamblin, Julien; Delecroix, Barthélémy; Leduc, Cédric; McCall, Alan; Nédélec, Mathieu; Dawson, Brian; Baquet, Georges; Dupont, Grégory

2017-03-01

To compare the effects of cold-water immersion (CWI) and whole-body cryotherapy (WBC) on recovery kinetics after exercise-induced muscle damage. Ten physically active men performed single-leg hamstring eccentric exercise comprising 5 sets of 15 repetitions. Immediately postexercise, subjects were exposed in a randomized crossover design to CWI (10 min at 10°C) or WBC (3 min at -110°C) recovery. Creatine kinase concentrations, knee-flexor eccentric (60°/s) and posterior lower-limb isometric (60°) strength, single-leg and 2-leg countermovement jumps, muscle soreness, and perception of recovery were measured. The tests were performed before and immediately, 24, 48, and 72 h after exercise. Results showed a very likely moderate effect in favor of CWI for single-leg (effect size [ES] = 0.63; 90% confidence interval [CI] = -0.13 to 1.38) and 2-leg countermovement jump (ES = 0.68; 90% CI = -0.08 to 1.43) 72 h after exercise. Soreness was moderately lower 48 h after exercise after CWI (ES = -0.68; 90% CI = -1.44 to 0.07). Perception of recovery was moderately enhanced 24 h after exercise for CWI (ES = -0.62; 90% CI = -1.38 to 0.13). Trivial and small effects of condition were found for the other outcomes. CWI was more effective than WBC in accelerating recovery kinetics for countermovement-jump performance at 72 h postexercise. CWI also demonstrated lower soreness and higher perceived recovery levels across 24-48 h postexercise.

The effectiveness of home hand exercise programmes in rheumatoid arthritis: a systematic review.

PubMed

Hammond, Alison; Prior, Yeliz

2016-09-01

Rheumatoid arthritis (RA) commonly reduces hand function. We systematically reviewed trials to investigate effects of home hand exercise programmes on hand symptoms and function in RA. We searched: Medline (1946-), AMED, CINAHL, Physiotherapy Evidence Database, OT Seeker, the Cochrane Library, ISI Web of Science from inception to January 2016. Nineteen trials were evaluated. Only three were randomized controlled trials with a low risk of bias (n = 665). Significant short-term improvements occurred in hand function, pain and grip strength, with long-term improvements in hand and upper limb function and pinch strength. Heterogeneity of outcome measures meant meta-analysis was not possible. Evaluation of low and moderate risk of bias trials indicated high-intensity home hand exercise programmes led to better short-term outcomes than low-intensity programmes. Such programmes are cost-effective. Further research is required to evaluate methods of helping people with RA maintain long-term home hand exercise. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Effects on muscle strength, maximal jump height, flexibility and postural sway after soccer and Zumba exercise among female hospital employees: a 9-month randomised controlled trial.

PubMed

Barene, Svein; Holtermann, Andreas; Oseland, Harald; Brekke, Ole-Lars; Krustrup, Peter

2016-10-01

This 9-month randomised controlled workplace physical activity trial investigated the effects of soccer and Zumba exercise, respectively, on muscle strength, maximal jump height, sit-and-reach flexibility and postural sway among female workers. A total of 107 female hospital employees aged 25-63 were cluster-randomised to a soccer group, a Zumba group or a control group. Training was conducted outside working hours as two to three 1-h weekly sessions the first 3 months and once a week the last 6 months. Tests were conducted at baseline, after 3 and 9 months. The soccer group improved maximal neck extension strength both after 3 (1.2 kg; P < 0.05) and 9 months (1.7 kg; P < 0.01) compared to the control group. The Zumba group improved maximal trunk extension strength (3.1 kg; P = 0.04) after 3 months, with improvements in postural sway velocity moment (-9.2 mm(2)/s; P < 0.05) and lower limb lean mass (0.4 kg; P < 0.05) after 9 months. No significant intervention effects were revealed in vertical jump height or sit-and-reach flexibility. The present study indicates that workplace-initiated soccer and Zumba exercise may be beneficial for improvement of the neck and trunk strength, which may have preventive effects with regard to future perceived muscle pain in the respective body regions. Furthermore, the Zumba group revealed positive effects on lower limb lean mass and postural sway compared to the control group.

Comparison of two techniques of robot-aided upper limb exercise training after stroke.

PubMed

Stein, Joel; Krebs, Hermano Igo; Frontera, Walter R; Fasoli, Susan E; Hughes, Richard; Hogan, Neville

2004-09-01

This study examined whether incorporating progressive resistive training into robot-aided exercise training provides incremental benefits over active-assisted robot-aided exercise for the upper limb after stroke. A total of 47 individuals at least 1 yr poststroke were enrolled in this 6-wk training protocol. Paretic upper limb motor abilities were evaluated using clinical measures and a robot-based assessment to determine eligibility for robot-aided progressive resistive training at study entry. Subjects capable of participating in resistance training were randomized to receive either active-assisted robot-aided exercises or robot-aided progressive resistance training. Subjects who were incapable of participating in resistance training underwent active-assisted robotic therapy and were again screened for eligibility after 3 wks of robotic therapy. Those subjects capable of participating in resistance training at 3 wks were then randomized to receive either robot-aided resistance training or to continue with robot-aided active-assisted training. One subject withdrew due to unrelated medical issues, and data for the remaining 46 subjects were analyzed. Subjects in all groups showed improvement in measures of motor control (mean increase in Fugl-Meyer of 3.3; 95% confidence interval, 2.2-4.4) and maximal force (mean increase in maximal force of 3.5 N, P = 0.027) over the course of robot-aided exercise training. No differences in outcome measures were observed between the resistance training groups and the matched active-assisted training groups. Subjects' ability to perform the robotic task at the time of group assignment predicted the magnitude of the gain in motor control. The incorporation of robot-aided progressive resistance exercises into a program of robot-aided exercise did not favorably or negatively affect the gains in motor control or strength associated with this training, though interpretation of these results is limited by sample size. Individuals with better motor control at baseline experienced greater increases in motor control with robotic training.

Bench press exercise: the key points.

PubMed

Padulo, J; Laffaye, G; Chaouachi, A; Chamari, K

2015-06-01

The bench press exercise (BPE) is receiving increasing interest as a field testing, training/therapeutic modality to improve neuromuscular performance or to increase bone mass density. Several studies have been performed using BPE as a standard for increasing upper-limb strength. For this purpose, the position of the bar, the loads, the sets, the number of repetitions, the recovery time in-between sets, the movement speed, the muscular work and the use of the determination of the one repetition maximum (1-RM) are the classical tools investigated in the literature that have been shown to affect the BPE effect on neuromuscular. The goal of the present short review is to make a picture of the current knowledge on the bench press exercise, which could be very helpful for a better understanding of this standard movement and its effects. Based on the related literature, several recommendations on these key points are presented here.

Long-term wheel running compromises diaphragm function but improves cardiac and plantarflexor function in the mdx mouse

PubMed Central

Acosta, Pedro; Sleeper, Meg M.; Barton, Elisabeth R.; Sweeney, H. Lee

2013-01-01

Dystrophin-deficient muscles suffer from free radical injury, mitochondrial dysfunction, apoptosis, and inflammation, among other pathologies that contribute to muscle fiber injury and loss, leading to wheelchair confinement and death in the patient. For some time, it has been appreciated that endurance training has the potential to counter many of these contributing factors. Correspondingly, numerous investigations have shown improvements in limb muscle function following endurance training in mdx mice. However, the effect of long-term volitional wheel running on diaphragm and cardiac function is largely unknown. Our purpose was to determine the extent to which long-term endurance exercise affected dystrophic limb, diaphragm, and cardiac function. Diaphragm specific tension was reduced by 60% (P < 0.05) in mice that performed 1 yr of volitional wheel running compared with sedentary mdx mice. Dorsiflexor mass (extensor digitorum longus and tibialis anterior) and function (extensor digitorum longus) were not altered by endurance training. In mice that performed 1 yr of volitional wheel running, plantarflexor mass (soleus and gastrocnemius) was increased and soleus tetanic force was increased 36%, while specific tension was similar in wheel-running and sedentary groups. Cardiac mass was increased 15%, left ventricle chamber size was increased 20% (diastole) and 18% (systole), and stroke volume was increased twofold in wheel-running compared with sedentary mdx mice. These data suggest that the dystrophic heart may undergo positive exercise-induced remodeling and that limb muscle function is largely unaffected. Most importantly, however, as the diaphragm most closely recapitulates the human disease, these data raise the possibility of exercise-mediated injury in dystrophic skeletal muscle. PMID:23823150

Soreness-related changes in three-dimensional running biomechanics following eccentric knee extensor exercise.

PubMed

Paquette, Max R; Peel, Shelby A; Schilling, Brian K; Melcher, Dan A; Bloomer, Richard J

2017-06-01

Runners often experience delayed onset muscle soreness (DOMS), especially of the knee extensors, following prolonged running. Sagittal knee joint biomechanics are altered in the presence of knee extensor DOMS but it is unclear how muscle soreness affects lower limb biomechanics in other planes of motion. The purpose of this study was to assess the effects of knee extensor DOMS on three-dimensional (3D) lower limb biomechanics during running. Thirty-three healthy men (25.8 ± 6.8 years; 84.1 ± 9.2 kg; 1.77 ± 0.07 m) completed an isolated eccentric knee extensor damaging protocol to elicit DOMS. Biomechanics of over-ground running at a set speed of 3.35 m s -1 ±5% were measured before eccentric exercise (baseline) and, 24 h and 48 h following exercise in the presence of knee extensor DOMS. Knee flexion ROM was reduced at 48 h (P = 0.01; d = 0.26), and peak knee extensor moment was reduced at 24 h (P = 0.001; d = 0.49) and 48 h (P < 0.001; d = 0.68) compared to baseline. Frontal and transverse plane biomechanics were unaffected by the presence of DOMS (P > 0.05). Peak positive ankle and knee joint powers and, peak negative knee joint power were all reduced from baseline to 24 h and 48 h (P < 0.05). These findings suggest that knee extensor DOMS greatly influences sagittal knee joint angular kinetics and, reduces sagittal power production at the ankle joint. However, knee extensor DOMS does not affect frontal and transverse plane lower limb joint biomechanics during running.

Evaluation Results of an Ontology-based Design Model of Virtual Environments for Upper Limb Motor Rehabilitation of Stroke Patients.

PubMed

Ramírez-Fernández, Cristina; Morán, Alberto L; García-Canseco, Eloísa; Gómez-Montalvo, Jorge R

2017-03-23

1) To enhance the content of an ontology for designing virtual environments (VEs) for upper limb motor rehabilitation of stroke patients according to the suggestions and comments of rehabilitation specialists and software developers, 2) to characterize the perceived importance level of the ontology, 3) to determine the perceived usefulness of the ontology, and 4) to identify the safety characteristics of the ontology for VEs design according to the rehabilitation specialists. Using two semi-structured Web questionnaires, we asked six rehabilitation specialists and six software developers to provide us with their perception regarding the level of importance and the usability of the ontology. From their responses we have identified themes related to perceived and required safety characteristics of the ontology. Significant differences in the importance level were obtained for the Stroke Disability, VE Configuration, Outcome Measures, and Safety Calibration classes, which were perceived as highly important by rehabilitation specialists. Regarding usability, the ontology was perceived by both groups with high usefulness, ease of use, learnability and intention of use. Concerning the thematic analysis of recommendations, eight topics for safety characteristics of the ontology were identified: adjustment of therapy strategies; selection and delimitation of movements; selection and proper calibration of the interaction device; proper selection of measuring instruments; gradual modification of the difficulty of the exercise; adaptability and variability of therapy exercises; feedback according to the capabilities of the patient; and real-time support for exercise training. The rehabilitation specialists and software developers confirmed the importance of the information contained in the ontology regarding motor rehabilitation of the upper limb. Their recommendations highlight the safety features and the advantages of the ontology as a guide for the effective design of VEs.

Anterior cruciate ligament- specialized post-operative return-to-sports (ACL-SPORTS) training: a randomized control trial

PubMed Central

2013-01-01

Background Anterior cruciate ligament reconstruction (ACLR) is standard practice for athletes that wish to return to high-level activities; however functional outcomes after ACLR are poor. Quadriceps strength weakness, abnormal movement patterns and below normal knee function is reported in the months and years after ACLR. Second ACL injuries are common with even worse outcomes than primary ACLR. Modifiable limb-to-limb asymmetries have been identified in individuals who re-injure after primary ACLR, suggesting a neuromuscular training program is needed to improve post-operative outcomes. Pre-operative perturbation training, a neuromuscular training program, has been successful at improving limb symmetry prior to surgery, though benefits are not lasting after surgery. Implementing perturbation training after surgery may be successful in addressing post-operative deficits that contribute to poor functional outcomes and second ACL injury risk. Methods/Design 80 athletes that have undergone a unilateral ACLR and wish to return to level 1 or 2 activities will be recruited for this study and randomized to one of two treatment groups. A standard care group will receive prevention exercises, quadriceps strengthening and agility exercises, while the perturbation group will receive the same exercise program with the addition of perturbation training. The primary outcomes measures will include gait biomechanics, clinical and functional measures, and knee joint loading. Return to sport rates, return to pre-injury level of activity rates, and second injury rates will be secondary measures. Discussion The results of this ACL-Specialized Post-Operative Return To Sports (ACL-SPORTS) Training program will help clinicians to better determine an effective post-operative treatment program that will improve modifiable impairments that influence outcomes after ACLR. Trial registration Randomized Control Trial NIH 5R01AR048212-07. ClinicalTrials.gov: NCT01773317 PMID:23522373

Exercise starts and ends in the brain.

PubMed

Kayser, Bengt

2003-10-01

Classically the limit to endurance of exercise is explained in terms of metabolic capacity. Cardio-respiratory capacity and muscle fatigue are thought to set the limit and the majority of studies on factors limiting endurance exercise discuss issues such as maximal oxygen uptake (VO2max), aerobic enzyme capacity, cardiac output, glycogen stores, etc. However, this paradigm does not explain the limitation to endurance exercise with large muscle groups at altitude, when at exhaustion exercise is ended without limb locomotor muscle fatigue and with sub-maximal cardiac output. A simple fact provides a basis for an explanation. Voluntary exercise starts and ends in the brain. It starts with spatial and temporal recruitment of motor units and ends with their de-recruitment. A conscious decision precedes a voluntary effort. The end of effort is again volitional and a forced conscious decision to stop precedes it, but it is unknown what forces the off-switch of recruitment at exhaustion although sensation of exertion certainly plays a role. An alternative model explaining the limitation of exercise endurance thus proposes that the central nervous system integrates input from various sources all related to the exercise and limits the intensity and duration of recruitment of limb skeletal muscle to prevent jeopardizing the integrity of the organism. This model acknowledges the cardio-respiratory and muscle metabolic capacities as prime actors on the performance scene, while crediting the central nervous system for its pivotal role as the ultimate site where exercise starts and ends.

Acute Effect of Static Stretching on Lower Limb Movement Performance by Using STABL Virtual Reality System.

PubMed

Ameer, Mariam A; Muaidi, Qassim I

2017-07-17

The effect of acute static stretch (ASS) on the lower limb RT has been recently questioned to decrease the risk of falling and injuries in situations requiring a rapid reaction, as in the cases of balance disturbance. The main purpose of this study was to detect the effect of ASS on the lower limb RT by using virtual reality device. Two Group Control Group design. Research laboratory. The control and experimental groups were formed randomly from sixty female university students. Each participant in the experimental group was tested before and after ASS for the quadriceps, hamstrings and planter flexor muscles, and compared with the control group with warming-up exercise only. The stretching program involved warming-up in the form of circular running inside the lab for 5 minutes followed by stretching of each muscle group thrice, to the limit of discomfort of 45 s, with resting period of 15s between stretches. The measurements included the RT of the dominant lower extremity by using the dynamic stability program, STABL Virtual Reality System (Model No. DIZ 2709, Motek Medical and Force Link Merged Co., Amsterdam). There was statistically significant reduction (F = 162, P= .00) in post-test RT between the two groups, and significant decrease in RT after stretching, in the experimental group (7.5%) (P= .00). ASS of the lower limb muscles tends to decrease the lower limb RT and improve movement performance.

Exercise and Sports Science Australia position statement on exercise and falls prevention in older people.

PubMed

Tiedemann, Anne; Sherrington, Catherine; Close, Jacqueline C T; Lord, Stephen R

2011-11-01

Falls affect a significant number of older Australians and present a major challenge to health care providers and health systems. The purpose of this statement is to inform and guide exercise practitioners and health professionals in the safe and effective prescription of exercise for older community-dwelling people with the goal of preventing falls. Falls in older people are not random events but can be predicted by assessing a number of risk factors. Of particular importance are lower limb muscle strength, gait and balance, all of which can be improved with appropriate exercise. There is now extensive evidence to demonstrate that many falls are preventable, with exercise playing a crucial role in prevention. Research evidence has identified that programs which include exercises that challenge balance are more effective in preventing falls than those which do not challenge balance. It is important for exercise to be progressively challenging, ongoing and of sufficient dose to maximise its benefits in reducing falls. Other (non-exercise) interventions are necessary for certain people with complex medical conditions or recent hospitalisation and risk factors relating to vision and the use of psychotropic medications. Qualified exercise professionals are well placed to implement the research evidence and to prescribe and supervise specific exercise aimed at preventing falls in both healthy older community-dwelling people and those with co-morbidities. Copyright © 2011 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Effects of compression garments on recovery following intermittent exercise.

PubMed

Pruscino, Cathryn L; Halson, Shona; Hargreaves, Mark

2013-06-01

The objective of the study was to examine the effects of wearing compression garments for 24 h post-exercise on the biochemical, physical and perceived recovery of highly trained athletes. Eight field hockey players completed a match simulation exercise protocol on two occasions separated by 4 weeks after which lower-limb compression garments (CG) or loose pants (CON) were worn for 24 h. Blood was collected pre-exercise and 1, 24 and 48 h post-exercise for IL-6, IL-1β, TNF-α, CRP and CK. Blood lactate was monitored throughout exercise and for 30 min after. A 5 counter-movement jump (5CMJ) and squat jump were performed and perceived soreness rated at pre-exercise and 1, 24 and 48 h post-exercise. Perceived recovery was assessed post-exercise using a questionnaire related to exercise readiness. Repeated measures ANOVA was used to assess changes in blood, perceptual and physical responses to recovery. CK and CRP were significantly elevated 24 h post-exercise in both conditions (p < 0.05). No significant differences were observed for TNF-α, IL1-β, IL-6 between treatments (p > 0.05). Power and force production in the 5CMJ was reduced and perceived soreness was highest at 1 h post-exercise (p < 0.05). Perceived recovery was lowest at 1 h post-exercise in both conditions (p < 0.01), whilst overall, perceived recovery was greater when CG were worn (p < 0.005). None of the blood or physical markers of recovery indicates any benefit of wearing compression garments post-exercise. However, muscle soreness and perceived recovery indicators suggest a psychological benefit may exist.

Electromyographic analysis of a modified maneuver for quadriceps femoris muscle setting with co-contraction of the hamstrings.

PubMed

Nakajima, Masaaki; Kawamura, Kenji; Takeda, Isao

2003-05-01

A "quadriceps femoris muscle setting" is isometric quadriceps femoris exercise which can be widely used in early knee rehabilitation. However this exercise cannot obtain enough co-contraction of the hamstrings. Isolated quadriceps femoris contraction in knee extension imposes severe strain to anterior cruciate ligament. We succeeded in developing a simple training maneuver that is effective in obtaining co-contraction of the hamstrings--a modified maneuver for the quadriceps femoris muscle setting with the contralateral lower limb raised (MQS). In this study, we analyzed the effect of this maneuver by EMG quantification. Twenty-eight healthy young adult men performed sequential trials consisting of normal quadriceps femoris muscle setting (NQS) and MQS. Electromyographic activity was recorded from surface electrodes on the gluteus maximus, vastus medialis, rectus femoris, vastus lateralis, semitendinosus and biceps femoris (long head), and normalized to values derived from maximal isometric trials. The % maximal voluntary isometric contraction (%MVIC) of the vastus medialis, vastus lateralis and rectus femoris did not vary in the each maneuver. However, the %MVIC of the hamstrings varied significantly in the MQS. This study suggests that effective co-contraction of the hamstrings can be obtained in MQS by adjusting the load to the raised lower limb.

Recovery of upper limb muscle function in chronic fatigue syndrome with and without fibromyalgia.

PubMed

Ickmans, Kelly; Meeus, Mira; De Kooning, Margot; Lambrecht, Luc; Nijs, Jo

2014-02-01

Chronic fatigue syndrome (CFS) patients frequently complain of muscle fatigue and abnormally slow recovery, especially of the upper limb muscles during and after activities of daily living. Furthermore, disease heterogeneity has not yet been studied in relation to recovery of muscle function in CFS. Here, we examine recovery of upper limb muscle function from a fatiguing exercise in CFS patients with (CFS+FM) and without (CFS-only) comorbid fibromyalgia and compare their results with a matched inactive control group. In this case-control study, 18 CFS-only patients, 30 CFS+FM patients and 30 healthy inactive controls performed a fatiguing upper limb exercise test with subsequent recovery measures. There was no significant difference among the three groups for maximal handgrip strength of the non-dominant hand. A significant worse recovery of upper limb muscle function was found in the CFS+FM, but not in de CFS-only group compared with the controls (P < 0·05). This study reveals, for the first time, delayed recovery of upper limb muscle function in CFS+FM, but not in CFS-only patients. The results underline that CFS is a heterogeneous disorder suggesting that reducing the heterogeneity of the disorder in future research is important to make progress towards a better understanding and uncovering of mechanisms regarding the nature of divers impairments in these patients. © 2013 Stichting European Society for Clinical Investigation Journal Foundation. Published by John Wiley & Sons Ltd.

Influence of fatigue on upper limb muscle activity and performance in tennis.

PubMed

Rota, Samuel; Morel, Baptiste; Saboul, Damien; Rogowski, Isabelle; Hautier, Christophe

2014-02-01

The study examined the fatigue effect on tennis performance and upper limb muscle activity. Ten players were tested before and after a strenuous tennis exercise. Velocity and accuracy of serve and forehand drives, as well as corresponding surface electromyographic (EMG) activity of eight upper limb muscles were measured. EMG and force were also evaluated during isometric maximal voluntary contractions (IMVC). Significant decreases were observed after exercise in serve accuracy (-11.7%) and velocity (-4.5%), forehand accuracy (-25.6%) and consistency (-15.6%), as well as pectoralis major (PM) and flexor carpi radialis (FCR) IMVC strength (-13.0% and -8.2%, respectively). EMG amplitude decreased for PM and FCR in serve, forehand and IMVC, and for extensor carpi radialis in forehand. No modification was observed in EMG activation timing during strokes or in EMG frequency content during IMVC. Several hypotheses can be put forward to explain these results. First, muscle fatigue may induce a reduction in activation level of PM and forearm muscles, which could decrease performance. Second, conscious or subconscious strategies could lead to a redistribution of muscle activity to non-fatigued muscles in order to protect the organism and/or limit performance losses. Otherwise, the modifications of EMG activity could also illustrate the strategies adopted to manage the speed-accuracy trade-off in such a complex task. Copyright © 2013 Elsevier Ltd. All rights reserved.

Training transfer: scientific background and insights for practical application.

PubMed

Issurin, Vladimir B

2013-08-01

Training transfer as an enduring, multilateral, and practically important problem encompasses a large body of research findings and experience, which characterize the process by which improving performance in certain exercises/tasks can affect the performance in alternative exercises or motor tasks. This problem is of paramount importance for the theory of training and for all aspects of its application in practice. Ultimately, training transfer determines how useful or useless each given exercise is for the targeted athletic performance. The methodological background of training transfer encompasses basic concepts related to transfer modality, i.e., positive, neutral, and negative; the generalization of training responses and their persistence over time; factors affecting training transfer such as personality, motivation, social environment, etc. Training transfer in sport is clearly differentiated with regard to the enhancement of motor skills and the development of motor abilities. The studies of bilateral skill transfer have shown cross-transfer effects following one-limb training associated with neural adaptations at cortical, subcortical, spinal, and segmental levels. Implementation of advanced sport technologies such as motor imagery, biofeedback, and exercising in artificial environments can facilitate and reinforce training transfer from appropriate motor tasks to targeted athletic performance. Training transfer of motor abilities has been studied with regard to contralateral effects following one limb training, cross-transfer induced by arm or leg training, the impact of strength/power training on the preparedness of endurance athletes, and the impact of endurance workloads on strength/power performance. The extensive research findings characterizing the interactions of these workloads have shown positive transfer, or its absence, depending on whether the combinations conform to sport-specific demands and physiological adaptations. Finally, cross-training as a form of concurrent exercising in different athletic disciplines has been examined in reference to the enhancement of general fitness, the preparation of recreational athletes, and the preparation of athletes for multi-sport activities such as triathlon, duathlon, etc.

[Benefits of Decumanum Phlebodium intake on the muscle damage in the response to intense physical exercise in sedentary subjects].

PubMed

Vargas Corzo, M C; Aguilar Cordero, M J; de Teresa Galván, C; Segura Millán, D; Miranda Leon, M T; Castillo Rueda, G; Guisado Barrilao, R

2014-06-01

Intense physical exercise provoke muscle damage, that in sedentary people can increase cardiovascular risk. Phlebodium decumanum (PD) has shown to have immunomodulator effects in models of moderate intense physical activities in well conditioned groups. To evaluate the PD effects during eccentric exercise, as a model of muscle inflammation protocol, on a sedentary population with cardiovascular risk. This is an experimental, double-blind, multigroup randomized study. Experimental Group 1 (n = 17)received PD, 9 doses of 400 mg (total amount 3.6 g) every 8 hours during 3 days, and Control Group 2 (n = 16)received a placebo. All the subjects performed two treadmill ergoespirometry tests: first, a modified Bruce protocol to discard ischemic responses during exercise and to evaluate VO2max before the experimental phase;and second, with an eccentric protocol (14% descending ramp test) during 10 minutes in stable state at 70-80%VO2max, as experimental inflammatory protocol.We compared intra and inter groups to evaluate differences in the pre and post-test differences results on blood muscle damage variables. The study shown statistically significant differences in all pre-post intra-groups results in muscle damage variables (CK, LDH and Myoglobin, but not in Cardiac Troponin), and in functional lower-limb test (SJand CMJ). The comparison of inter-group results shown less muscle damage and less functional lower-limb deterioration in Group 1 compared with Control group, with statistical significance in both cases. Differences in handgrip dynamometry were no statistically significant. The eccentric exercise protocol in that study has proven to be a good model to induce muscle and functional damage in sedentary people. Short PD treatment has shown to reduce muscle and functional acute damages compared with placebo control group in this specific population. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

Exergaming and Static Postural Control in Individuals With a History of Lower Limb Injury

PubMed Central

Sims, Jennifer; Cosby, Nicole; Saliba, Ethan N.; Hertel, Jay; Saliba, Susan A.

2013-01-01

Context: Therapeutic exercise programs that incorporate real-time feedback have been reported to enhance outcomes in patients with lower extremity joint injuries. The Wii Fit has been purported to improve balance, strength, flexibility, and fitness. Objective: To determine the effects of Wii Fit rehabilitation on postural control and self-reported function in patients with a history of lower limb injury. Design: Single-blinded, randomized controlled trial. Setting: Laboratory. Patients or Other Participants: Twenty-eight physically active participants with a history of lower limb injuries were randomly assigned to 1 of 3 groups (9 Wii Fit, 10 traditional, 9 control). Intervention(s): Intervention groups performed supervised rehabilitation 3 d/wk for a total of 12 sessions. Main Outcome Measure(s): Time to boundary (TTB) and the Star Excursion Balance Test (SEBT) were conducted at baseline, 2 weeks, and 4 weeks. Self-reported function was measured at baseline and 4-week follow-up. Between-groups differences were compared using repeated-measures multivariate analysis of variance. Results: With the eyes open, both intervention groups improved (P < .05) in the mean and the SD of the TTB anterior-posterior minima. In the eyes-closed condition, a time main effect (P < .05) for absolute TTB medial-lateral minima was observed. A time main effect was also noted in the posteromedial and posterolateral reach directions of the SEBT. When the scores for each group were pooled, improvement (P < .05) in self-reported function was demonstrated at 4-week follow-up. Conclusions: Rehabilitation using the Wii Fit and traditional exercises improved static postural control in patients with a history of lower extremity injury. PMID:23675790

Effects of combined aerobic and resistance exercise on central arterial stiffness and gait velocity in patients with chronic poststroke hemiparesis.

PubMed

Lee, Yong Hee; Park, Soo Hyun; Yoon, Eun Sun; Lee, Chong-Do; Wee, Sang Ouk; Fernhall, Bo; Jae, Sae Young

2015-09-01

The effects of combined aerobic and resistance exercise training on central arterial stiffness and gait velocity in patients with chronic poststroke hemiparesis were investigated. Twenty-six patients with chronic poststroke hemiparesis were randomly assigned to either the combined aerobic and resistance exercise group (n = 14) or the control group (n = 12). The exercise intervention group received a combined aerobic and resistance exercise training (1 hr/day, three times/week for 16 wks), whereas the control group received usual care. Central arterial stiffness was determined by pulse wave velocity and augmentation index. Gait velocity was assessed using the 6-min walk test, 10-m walk test, and the Timed Up-and-Go test. Patients in the exercise intervention group had greater improvement of mean pulse wave velocity (P < 0.001), augmentation index (P = 0.048), and gait velocity (6-min walk test, P < 0.001; 10-m walk test, P < 0.001) than did patients in the control group. Patients in the exercise intervention group also had greater improvements in physical fitness component (grip strength, P < 0.001; muscular strength of upper and lower limbs, P < 0.027; flexibility, P < 0.001) when compared with control patients. The combined aerobic and resistance exercise program significantly reduced central arterial stiffness and increased gait velocity in patients with chronic poststroke hemiparesis.

Kinematic Differences Between Motorized and Nonmotorized Treadmill Locomotion

NASA Technical Reports Server (NTRS)

DeWitt, John K.; Bentley, Jason R.; Lee, Stuart M. C.; Norcross, Jason; Smith, Cassie; Hagan, R. Donald

2006-01-01

There are few scientific publications comparing human locomotion between motorized and nonmotorized treadmills. Lakomy (1987) and Gamble et al (1988) reported that forward lean is greater on a nonmotorized treadmill to aid in the generation of horizontal force necessary for belt propulsion, but there are no data concerning lower limb kinematics. During long-term spaceflight, astronauts use locomotive exercise to mitigate the physiological effects caused by long-term exposure to microgravity. A critical decision for mission planners concerns the requirements for a treadmill to be used during potential trips to the Moon and Mars. Treadmill operation in an un-powered configuration could reduce mission resource demands, but also may impact the efficacy of treadmill exercise countermeasures. To ascertain the most appropriate type of treadmill to be used, it is important to understand biomechanical differences between motorized (M) and nonmotorized (NM) locomotion. The purpose of this evaluation was to test for differences in lower limb kinematics that occur during M and NM treadmill locomotion at two speeds. It was hypothesized that hip and knee joint angle trajectories would differ between the conditions.

Low-Load Resistance Training with Blood Flow Occlusion as a Countermeasure to Disuse Atrophy

NASA Technical Reports Server (NTRS)

Ploutz-Snyder, L. L.; Cook, S. B.

2009-01-01

Decreases in strength and neuromuscular function are observed following prolonged disuse. Exercise countermeasures to prevent muscle dysfunction during disuse typically involve high intensity resistance training. The purpose of the study is to evaluate the effectiveness of low-load resistance training with a blood flow occlusion to mitigate muscle loss and dysfunction during 30 days of unilateral lower limb suspension (ULLS).

The Use of Motion Tracking Technologies in Serious Games to Enhance Rehabilitation in Stroke Patients

ERIC Educational Resources Information Center

Burton, Andrew M.; Liu, Hao; Battersby, Steven; Brown, David; Sherkat, Nasser; Standen, Penny; Walker, Marion

2011-01-01

Stroke is the main cause of long term disability worldwide. Of those surviving, more than half will fail to regain functional usage of their impaired upper limb. Typically stroke upper limb rehabilitation exercises consist of repeated movements, which when tracked can form the basis of inputs to games. This paper discusses two systems utilizing…

Interseason variability in isokinetic strength and poor correlation with Nordic hamstring eccentric strength in football players.

PubMed

van Dyk, N; Witvrouw, E; Bahr, R

2018-04-25

In elite sport, the use of strength testing to establish muscle function and performance is common. Traditionally, isokinetic strength tests have been used, measuring torque during concentric and eccentric muscle action. A device that measures eccentric hamstring muscle strength while performing the Nordic hamstring exercise is now also frequently used. The study aimed to investigate the variability of isokinetic muscle strength over time, for example, between seasons, and the relationship between isokinetic testing and the new Nordic hamstring exercise device. All teams (n = 18) eligible to compete in the premier football league in Qatar underwent a comprehensive strength assessment during their periodic health evaluation at Aspetar Orthopaedic and Sports Medicine Hospital in Qatar. Isokinetic strength was investigated for measurement error, and correlated to Nordic hamstring exercise strength. Of the 529 players included, 288 players had repeated tests with 1/2 seasons between test occasions. Variability (measurement error) between test occasions was substantial, as demonstrated by the measurement error (approximately 25 Nm, 15%), whether separated by 1 or 2 seasons. Considering hamstring injuries, the same pattern was observed among injured (n = 60) and uninjured (n = 228) players. A poor correlation (r = .35) was observed between peak isokinetic hamstring eccentric torque and Nordic hamstring exercise peak force. The strength imbalance between limbs calculated for both test modes was not correlated (r = .037). There is substantial intraindividual variability in all isokinetic test measures, whether separated by 1 or 2 seasons, irrespective of injury. Also, eccentric hamstring strength and limb-to-limb imbalance were poorly correlated between the isokinetic and Nordic hamstring exercise tests. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Nutrition Coupled with High-Load Traditional or Low-Load Blood Flow Restricted Exercise During Human Limb Suspension

NASA Technical Reports Server (NTRS)

Hackney, K. J.; Everett, M.; Ploutz-Snyder, L. L.

2011-01-01

High-load resistance exercise (HRE) and low-load blood flow restricted (BFR) exercise have demonstrated efficacy for attenuating unloading related muscle atrophy and dysfunction. In recreational exercisers, protein consumption immediately before and/or after exercise has been shown to increase the skeletal muscle anabolic response to resistance training. PURPOSE: To compare the skeletal muscle adaptations when chocolate milk intake was coupled with HRE or low-load BFR exercise [3 d/wk] during simulated lower limb weightlessness. METHODS: Eleven subjects were counterbalanced [based on age and gender] to HRE (31 +/- 14 yr, 170 +/- 13 cm, 71 +/- 18 kg, 2M/3W) or low-load BFR exercise (31 +/- 12 yr, 169 +/- 13 cm, 66 +/- 14 kg, 2M/4W) during 30 days of unilateral lower limb suspension (ULLS). Both HRE and BFR completed 3 sets of single leg press and calf raise exercise during ULLS. BFR exercise intensity was 20% of repetition maximum (1RM) with a cuff inflation pressure of 1.3 systolic blood pressure (143 4 mmHg). Cuff pressure was maintained during all 3 sets including rest intervals (90s). HRE intensity was 75% 1RM and was performed without cuff inflation. Immediately (<10 min) before and after exercise 8 fl oz of chocolate milk (150 kcal, 2.5g total fat, 22g total carbohydrate, 8g protein) was consumed to optimize acute exercise responses in favor of muscle anabolism. ULLS analog compliance was assessed from leg skin temperature recordings and plantar accelerometry. Muscle cross-sectional area (CSA) for knee extensor and plantar flexor muscle groups were determined from analysis of magnetic resonance images using ImageJ software. 1RM strength for leg press and calf raise was assessed on the Agaton exercise system. Muscular endurance during leg press and calf raise was evaluated from the maximal number of repetitions performed to volitional fatigue using 40% of pre-ULLS 1RM. RESULTS: Steps detected by plantar acceleometry declined by 98.9% during ULLS relative to an ambulatory control period. Average skin temperature of the unloaded calf declined from 27.4 C to 26.8 C (-2.1%), while there was a slight increase (+1.1%) in skin temperature in the loaded calf (27.6 C to 27.9 C). Collectively, these measures indicate strong subject compliance with the ULLS analog. Unloaded limb work performed during leg press (1514 +/- 334 vs. 576 +/- 103) and calf raise (2886 +/- 508 vs. 1233 +/- 153) exercises sessions was greater in HRE vs. BFR, respectively. Leg press training loads were 44 +/- 7 kg in HRE compared to 11 +/- 1 kg in BFR. Similarly, calf raise training loads were 81 +/- 11 kg in HRE and 16 +/- 1 kg in BFR. Pre to post-ULLS training adaptations in the unloaded leg are shown in the table. CONCLUSION: The preliminary results of this investigation suggest when HRE is optimized for muscle anabolism during unloading muscle size and strength are preserved (or enhanced) at the expense of muscle endurance. In contrast, when BFR exercise is optimized for muscle anabolism during unloading muscle endurance is preserved (or enhanced) at the expense of muscle size and strength

Older adults show higher increases in lower-limb muscle activity during whole-body vibration exercise.

PubMed

Lienhard, Karin; Vienneau, Jordyn; Nigg, Sandro; Friesenbichler, Bernd; Nigg, Benno M

2017-02-08

The purpose of this study was to compare lower limb muscle activity during whole-body vibration (WBV) exercise between a young and an older study population. Thirty young (25.9±4.3yrs) and thirty older (64.2±5.3yrs) individuals stood on a side-alternating WBV platform while surface electromyography (sEMG) was measured for the tibialis anterior (TA), gastrocnemius medialis (GM), soleus (SOL), vastus lateralis (VL), vastus medialis (VM), and biceps femoris (BF). The WBV protocol included nine vibration settings consisting of three frequencies (6, 11, 16Hz) x three amplitudes (0.9, 2.5, 4.0mm), and three control trials without vibration (narrow, medium, wide stance). The vertical platform acceleration (peak values of maximal displacement from equilibrium) was quantified during each vibration exercise using an accelerometer. The outcomes of this study showed that WBV significantly increased muscle activity in both groups for most vibration conditions in the TA (averaged absolute increase: young: +3.9%, older: +18.4%), GM (young: +4.1%, older: +9.5%), VL (young: +6.3%, older: +12.6%) and VM (young: +5.4%, older: +8.0%), and for the high frequency-amplitude combinations in the SOL (young: +7.5%, older: +12.6%) and BF (young: +1.9%, older: +7.5%). The increases in sEMG activity were significantly higher in the older than the young adults for all muscles, i.e., TA (absolute difference: 13.8%, P<0.001), GM (4.6%, P=0.034), VL (7.6%, P=0.001), VM (6.7%, P=0.042), BF (6.4%, P<0.001), except for the SOL (0.3%, P=0.248). Finally, the vertical platform acceleration was a significant predictor of the averaged lower limb muscle activity in the young (r=0.917, P<0.001) and older adults (r=0.931, P<0.001). In conclusion, the older population showed greater increases in lower limb muscle activity during WBV exercise than their young counterparts, meaning that they might benefit more from WBV exercises. Additionally, training intensity can be increased by increasing the vertical acceleration load. Copyright © 2016 Elsevier Ltd. All rights reserved.

Effects of Extremity Armor on Metabolic Cost and Gait Biomechanics

DTIC Science & Technology

2010-05-26

of prosthetics , orthotics, and exercise equipment could benefit from knowing the tipping point at which a mass on the limb begins to effect metabolic...measured. For this, you wear a nose clip and 4 breathe through a rubber mouthpiece and valve , similar to those found in scuba diving 5 equipment. The...32 33 Stress fractures , or breaks of bones in the foot and leg, have been associated with road 34 marching while carrying loads, especially

Impact of traditional Greek dancing on jumping ability, muscular strength and lower limb endurance in cardiac rehabilitation programmes.

PubMed

Vordos, Zacharias; Kouidi, Evangelia; Mavrovouniotis, Fotios; Metaxas, Thomas; Dimitros, Eleftherios; Kaltsatou, Antonia; Deligiannis, Asterios

2017-02-01

The objective of this study was to evaluate the effect of a training programme based on traditional Greek dance on the jumping ability, muscle strength and lower limb endurance in patients with chronic heart failure (CHF). Forty Greek patients with CHF graded as NYHA ⩽ II and aged 73.2±4.7 years were randomly divided into two groups. Group A ( n=20) participated in a three-month physical rehabilitation programme based on Greek traditional dances, whereas group B ( n=20) remained untrained and served as the control group. All patients were studied before and after the 12-week exercise training programme. At baseline and follow-up the exercise capacity of the patients was evaluated by the six-minute walking test, their lower extremity muscle strength was evaluated by an isokinetic dynamometer and their jumping ability by the Myotest-Pro test, which includes three types of jumps (plyometric, countermovement and squat jumps). No significant difference was observed between the two groups at the baseline evaluation. At follow-up, group A showed significant improvements in walking distance calculated from the six-minute walking test (10.0% improvement; p<0.05), in lower limb strength (10.32% improvement; p<0.05), and in countermovement jump speed (6.9%; p<0.05) and squat jump speed (5.8%; p<0.05). Group A also increased their jump plyometry height by 13.86% ( p<0.05), their counter jump height by 10.68% ( p<0.05) and their squat jump height by 10.45% ( p<0.05). Group A had a 6.85% ( p<0.05) increased force of counter jump compared with group B. The design and implementation of cardiac rehabilitation programmes using Greek traditional dances in patients with CHF are both safe and effective in improving lower limb function.

Aquatic versus land-based exercises as early functional rehabilitation for elite athletes with acute lower extremity ligament injury: a pilot study.

PubMed

Kim, Eunkuk; Kim, Taegyu; Kang, Hyunyong; Lee, Jongha; Childers, Martin K

2010-08-01

To compare outcomes between aquatic and land-based exercises during early-phase recovery from acute lower extremity ligament injuries in elite athletes. A single-blinded, covariate adaptive randomized, controlled study. National training center for elite athletes. Twenty-two athletes with isolated grade I or II ligament injury in ankles or knees were randomized into either an aquatic or land-based exercise group. Early functional rehabilitation program (ranging, strengthening, proprioceptive training, and functional exercises) was performed in both groups. All exercises were identical except for the training environment. Data were collected at baseline and at 2 and 4 weeks using a visual analog scale (VAS) for pain; static stability (overall stability index [OSI] level 5 and 3); dynamic stability (TCT), and percentage single-limb support time (%SLST). Both groups showed decreases in VAS, OSI 5 and 3, and TCT, with a concomitant increase in %SLST at 2 and 4 weeks (P < .05). No significant differences were detected between the 2 groups in any of the outcome measures. However, the line graphs for VAS, OSI 3, TCT, and %SLST in the aquatic exercise group were steeper than those in the land-based exercise group indicating significant group by time interactions (P < .05). These data indicate that the aquatic exercise group improved more rapidly than the land-based exercise group. For elite athletes with acute ligament sprains in the lower limb, aquatic exercises may provide advantages over standard land-based therapy for rapid return to athletic activities. Consequently, aquatic exercise could be recommended for the initial phase of a rehabilitation program. Copyright © 2010 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

Effects of a High-Intensity Functional Exercise Program on Dependence in Activities of Daily Living and Balance in Older Adults with Dementia

PubMed Central

Toots, Annika; Littbrand, Håkan; Lindelöf, Nina; Wiklund, Robert; Holmberg, Henrik; Nordström, Peter; Lundin-Olsson, Lillemor; Gustafson, Yngve; Rosendahl, Erik

2016-01-01

Objectives To investigate the effects of a high-intensity functional exercise program on independence in activities of  daily living (ADLs) and balance in older people with dementia and whether exercise effects differed between dementia types. Design Cluster-randomized controlled trial: Umeå Dementia and Exercise (UMDEX) study. Setting Residential care facilities, Umeå, Sweden. Participants Individuals aged 65 and older with a dementia diagnosis, a Mini-Mental State Examination score of 10 or greater, and dependence in ADLs (N = 186). Intervention Ninety-three participants each were allocated to the high-intensity functional exercise program, comprising lower limb strength and balance exercises, and 93 to a seated control activity. Measurements Blinded assessors measured ADL independence using the Functional Independence Measure (FIM) and Barthel Index (BI) and balance using the Berg Balance Scale (BBS) at baseline and 4 (directly after intervention completion) and 7 months. Results Linear mixed models showed no between-group effect on ADL independence at 4 (FIM=1.3, 95% confidence interval (CI)=−1.6–4.3; BI=0.6, 95% CI=−0.2–1.4) or 7 (FIM=0.8, 95% CI=−2.2–3.8; BI=0.6, 95% CI=−0.3–1.4) months. A significant between-group effect on balance favoring exercise was observed at 4 months (BBS=4.2, 95% CI=1.8–6.6). In interaction analyses, exercise effects differed significantly between dementia types. Positive between-group exercise effects were found in participants with non-Alzheimer's dementia according to the FIM at 7 months and BI and BBS at 4 and 7 months. Conclusion In older people with mild to moderate dementia living in residential care facilities, a 4-month high-intensity functional exercise program appears to slow decline in ADL independence and improve balance, albeit only in participants with non-Alzheimer's dementia. PMID:26782852

Effects of a High-Intensity Functional Exercise Program on Dependence in Activities of Daily Living and Balance in Older Adults with Dementia.

PubMed

Toots, Annika; Littbrand, Håkan; Lindelöf, Nina; Wiklund, Robert; Holmberg, Henrik; Nordström, Peter; Lundin-Olsson, Lillemor; Gustafson, Yngve; Rosendahl, Erik

2016-01-01

To investigate the effects of a high-intensity functional exercise program on independence in activities of daily living (ADLs) and balance in older people with dementia and whether exercise effects differed between dementia types. Cluster-randomized controlled trial: Umeå Dementia and Exercise (UMDEX) study. Residential care facilities, Umeå, Sweden. Individuals aged 65 and older with a dementia diagnosis, a Mini-Mental State Examination score of 10 or greater, and dependence in ADLs (N=186). Ninety-three participants each were allocated to the high-intensity functional exercise program, comprising lower limb strength and balance exercises, and 93 to a seated control activity. Blinded assessors measured ADL independence using the Functional Independence Measure (FIM) and Barthel Index (BI) and balance using the Berg Balance Scale (BBS) at baseline and 4 (directly after intervention completion) and 7 months. Linear mixed models showed no between-group effect on ADL independence at 4 (FIM=1.3, 95% confidence interval (CI)=-1.6-4.3; BI=0.6, 95% CI=-0.2-1.4) or 7 (FIM=0.8, 95% CI=-2.2-3.8; BI=0.6, 95% CI=-0.3-1.4) months. A significant between-group effect on balance favoring exercise was observed at 4 months (BBS=4.2, 95% CI=1.8-6.6). In interaction analyses, exercise effects differed significantly between dementia types. Positive between-group exercise effects were found in participants with non-Alzheimer's dementia according to the FIM at 7 months and BI and BBS at 4 and 7 months. In older people with mild to moderate dementia living in residential care facilities, a 4-month high-intensity functional exercise program appears to slow decline in ADL independence and improve balance, albeit only in participants with non-Alzheimer's dementia. © 2016 The Authors. The Journal of the American Geriatrics Society published by Wiley Periodicals, Inc. on behalf of The American Geriatrics Society.

Regular Exercise Reduces Endothelial Cortical Stiffness in Western Diet-Fed Female Mice.

PubMed

Padilla, Jaume; Ramirez-Perez, Francisco I; Habibi, Javad; Bostick, Brian; Aroor, Annayya R; Hayden, Melvin R; Jia, Guanghong; Garro, Mona; DeMarco, Vincent G; Manrique, Camila; Booth, Frank W; Martinez-Lemus, Luis A; Sowers, James R

2016-11-01

We recently showed that Western diet-induced obesity and insulin resistance promotes endothelial cortical stiffness in young female mice. Herein, we tested the hypothesis that regular aerobic exercise would attenuate the development of endothelial and whole artery stiffness in female Western diet-fed mice. Four-week-old C57BL/6 mice were randomized into sedentary (ie, caged confined, n=6) or regular exercise (ie, access to running wheels, n=7) conditions for 16 weeks. Exercise training improved glucose tolerance in the absence of changes in body weight and body composition. Compared with sedentary mice, exercise-trained mice exhibited reduced endothelial cortical stiffness in aortic explants (sedentary 11.9±1.7 kPa versus exercise 5.5±1.0 kPa; P<0.05), as assessed by atomic force microscopy. This effect of exercise was not accompanied by changes in aortic pulse wave velocity (P>0.05), an in vivo measure of aortic stiffness. In comparison, exercise reduced femoral artery stiffness in isolated pressurized arteries and led to an increase in femoral internal artery diameter and wall cross-sectional area (P<0.05), indicative of outward hypertrophic remodeling. These effects of exercise were associated with an increase in femoral artery elastin content and increased number of fenestrae in the internal elastic lamina (P<0.05). Collectively, these data demonstrate for the first time that the aortic endothelium is highly plastic and, thus, amenable to reductions in stiffness with regular aerobic exercise in the absence of changes in in vivo whole aortic stiffness. Comparatively, the same level of exercise caused destiffening effects in peripheral muscular arteries, such as the femoral artery, that perfuse the working limbs. © 2016 American Heart Association, Inc.

Effects of hip and trunk muscle strengthening on hip function and lower limb kinematics during step-down task.

PubMed

Araújo, Vanessa Lara; Souza, Thales Rezende; Carvalhais, Viviane Otoni do Carmo; Cruz, Aline Castro; Fonseca, Sérgio Teixeira

2017-05-01

Strengthening of the hip and trunk muscles has the potential to change lower limb kinematic patterns, such as excessive hip medial rotation and adduction during weight-bearing tasks. This study aimed to investigate the effect of hip and trunk muscles strengthening on hip muscle performance, hip passive properties, and lower limb kinematics during step-down task in women. Thirty-four young women who demonstrated dynamic knee valgus during step-down were divided into two groups. The experimental group underwent three weekly sessions of strengthening exercises for eight weeks, and the control group continued their usual activities. The following evaluations were carried out: (a) isokinetic maximum concentric and eccentric work of hip lateral rotators, (b) isokinetic hip passive torque of lateral rotation and resting transverse plane position, and (c) three-dimensional kinematics of the lower limb during step-down. The strengthening program increased concentric (P<0.001) and eccentric (P<0.001) work of hip lateral rotators, and changed hip resting position toward lateral rotation (P<0.001). The intervention did not significantly change hip passive torque (P=0.089, main effect). The program reduced hip (P=0.002), thigh (P=0.024) and shank (P=0.005) adduction during step-down task. Hip, thigh and knee kinematics in transverse plane and foot kinematics in frontal plane did not significantly modify after intervention (P≥0.069, main effect). Hip and trunk strengthening reduced lower limb adduction during step-down. The changes in hip maximum work and resting position may have contributed to the observed kinematic effects. Copyright © 2017 Elsevier Ltd. All rights reserved.

Effects of training programs based on ipsilateral voluntary and stimulated contractions on muscle strength and monopedal postural control of the contralateral limb.

PubMed

Kadri, Mohamed Abdelhafid; Noé, Frederic; Nouar, Merbouha Boulahbel; Paillard, Thierry

2017-09-01

To compare the effects of unilateral strength training by stimulated and voluntary contractions on muscle strength and monopedal postural control of the contralateral limb. 36 non-active healthy male subjects were recruited and split randomly into three groups. Two groups of 12 subjects took part in a strength-training program (3 sessions a week over 8 weeks) comprising 43 contractions of the quadriceps femoris of the ipsilateral limb (at 20% of the MVC). One group carried out voluntary contractions exclusively (VOL group), while the other group benefited exclusively from electro-induced contractions (NMES group). The other 12 subjects formed the control (CON) group. Assessments of MVC and monopedal postural control in static and dynamic postural tasks were performed with the ipsilateral (ISPI) and contralateral (CONTRA) limbs before (PRE) and after (POST) completion of the training program. After the training program, the MVC of the IPSI and CONTRA limbs increased similarly for both experimental groups (VOL and NMES). There were no significant improvements of monopedal postural control for the IPSI or CONTRA limbs in either the VOL or NMES experimental group. No change was observed for the CON group over the protocol period. The purposed training program with NMES vs VOL contractions induced strength gains but did not permit any improvement of contralateral monopedal postural control in healthy young subjects. This has potential for therapeutic application and allows clinicians to focus their training programs on dynamic and poly-articular exercises to improve the postural control in young subjects.

Analysis of injuries' prevalence in surfers from Paraná seacoast

PubMed Central

de Moraes, Gabriela Chueiri; Guimarães, Ana Tereza Bittencourt; Gomes, Anna Raquel Silveira

2013-01-01

OBJECTIVE: to analyze the prevalence of musculoskeletal injuries of surfers from the Paraná's seacoast. METHODS: Sixty men (27 ± 6 years) completed a surf semi structured questionnaire (category, time of daily practice, frequency and exercises performed before and/or after surfing) and characteristics of injuries induced by this sport. A descriptive analysis of the data on distribution of the relative frequency was performed. RESULTS: It was found that 70% of the respondents practiced surfing as a relaxing activity, 28% were amateurs and 2% were professionals, who were surfing for 10 years or more. Most of them surfed between 2 to 4 times a week during 2 to 4 hours a day. The most common exercise performed before surfing was upper and lower limbs stretching and no exercises at all was done after practice. The most common injury was contusion (29%), lower limb was the most affected segment (46%) and the most common cause of injury was due to contact with the board (52%). The interruption period mostly reported was 1-3 months and the most frequent treatment was taking medicines. CONCLUSIONS: Recreational was the predominant category of surfers with lower limb's contusion as the most common musculoskeletal injury, resulting from contact with the board, being treated with medication and rest. Level of Evidence II, Retrospective Study. PMID:24453671

Preamputation evaluation of lower-limb skeletal muscle perfusion with H(2) (15)O positron emission tomography.

PubMed

Scremin, Oscar U; Figoni, Stephen F; Norman, Keith; Scremin, A M Erika; Kunkel, Charles F; Opava-Rutter, Dorene; Schmitter, Eric D; Bert, Alberto; Mandelkern, Mark

2010-06-01

To establish whether muscle blood flow (MBF) measurements with O-water positron emission tomography could reliably identify patients with critical limb ischemia and detect and quantify a distal deficit in skeletal MBF in these cases. O-water positron emission tomography scans were performed at rest or during unloaded ankle plantar and dorsiflexion exercise of the diseased leg in 17 subjects with leg ischemia or on a randomly selected leg of 18 age-matched healthy control subjects. TcPO2 was evaluated with Novametrix monitors and perfusion of skin topically heated to 44 degrees C and adjacent nonheated areas with a Moor Instruments laser Doppler imaging scanner. The enhancement of MBF induced by exercise was significantly lower in ischemic than in normal legs, and the sensitivity and specificity of this phenomenon were similar to those of laser Doppler imaging or TcPO2 in identifying ischemia subjects. In addition, the exercise MBF deficit was predominant at the distal-leg levels, indicating the ability of the technique to help determine the correct level of amputation. Skeletal MBF of legs with severe ischemia can be detected accurately with O-water positron emission tomography and could add valuable information about viability of skeletal muscle in the residual limb when deciding the level of an amputation.

Are falls prevention programs effective at reducing the risk factors for falls in people with type-2 diabetes mellitus and peripheral neuropathy: A systematic review with narrative synthesis.

PubMed

Gu, Yu; Dennis, Sarah M

2017-02-01

Diabetic peripheral neuropathy (DPN) is a common complication of type-2 diabetes mellitus (T2DM) that predisposes the elderly to a higher falls risk. Falls prevention programs with a component of weight-bearing exercises are effective in decreasing future falls in the elderly. However, weight-bearing exercise was only recently recommended in guidelines for exercise for people with T2DM and DPN. Since then, there have been an increasing number of studies to evaluate the effectiveness of falls prevention programs on this targeted population. A systematic literature review was undertaken to determine the effectiveness of falls prevention programs for people with T2DM and DPN. Nine published studies that investigated the effect of exercise training on falls risk among people with T2DM and DPN were included in the review. Interventions included lower limb strengthening, balance practice, aerobic exercise, walking programs, and Tai Chi. The preliminary evidence presented in this review suggests that people with T2DM and DPN can improve their balance and walking after a targeted multicomponent program without risk of serious adverse events. There is insufficient long-term follow-up data to determine whether the improvements in balance or strength resulted in a decrease falls risk in the community setting. Copyright © 2016 Elsevier Inc. All rights reserved.

Hemodynamic responses to small muscle mass exercise in heart failure patients with reduced ejection fraction

PubMed Central

Barrett-O'Keefe, Zachary; Lee, Joshua F.; Berbert, Amanda; Witman, Melissa A. H.; Nativi-Nicolau, Jose; Stehlik, Josef; Richardson, Russell S.

2014-01-01

To better understand the mechanisms responsible for exercise intolerance in heart failure with reduced ejection fraction (HFrEF), the present study sought to evaluate the hemodynamic responses to small muscle mass exercise in this cohort. In 25 HFrEF patients (64 ± 2 yr) and 17 healthy, age-matched control subjects (64 ± 2 yr), mean arterial pressure (MAP), cardiac output (CO), and limb blood flow were examined during graded static-intermittent handgrip (HG) and dynamic single-leg knee-extensor (KE) exercise. During HG exercise, MAP increased similarly between groups. CO increased significantly (+1.3 ± 0.3 l/min) in the control group, but it remained unchanged across workloads in HFrEF patients. At 15% maximum voluntary contraction (MVC), forearm blood flow was similar between groups, while HFrEF patients exhibited an attenuated increase at the two highest intensities compared with controls, with the greatest difference at the highest workload (352 ± 22 vs. 492 ± 48 ml/min, HFrEF vs. control, 45% MVC). During KE exercise, MAP and CO increased similarly across work rates between groups. However, HFrEF patients exhibited a diminished leg hyperemic response across all work rates, with the most substantial decrement at the highest intensity (1,842 ± 64 vs. 2,675 ± 81 ml/min; HFrEF vs. control, 15 W). Together, these findings indicate a marked attenuation in exercising limb perfusion attributable to impairments in peripheral vasodilatory capacity during both arm and leg exercise in patients with HFrEF, which likely plays a role in limiting exercise capacity in this patient population. PMID:25260608

Feasibility of Pilates exercise to decrease falls risk: a pilot randomized controlled trial in community-dwelling older people.

PubMed

Barker, Anna L; Talevski, Jason; Bohensky, Megan A; Brand, Caroline A; Cameron, Peter A; Morello, Renata T

2016-10-01

To evaluate the feasibility of Pilates exercise in older people to decrease falls risk and inform a larger trial. Pilot Randomized controlled trial. Community physiotherapy clinic. A total of 53 community-dwelling people aged ⩾60 years (mean age, 69.3 years; age range, 61-84). A 60-minute Pilates class incorporating best practice guidelines for exercise to prevent falls, performed twice weekly for 12 weeks. All participants received a letter to their general practitioner with falls risk information, fall and fracture prevention education and home exercises. Indicators of feasibility included: acceptability (recruitment, retention, intervention adherence and participant experience survey); safety (adverse events); and potential effectiveness (fall, fall injury and injurious fall rates; standing balance; lower limb strength; and flexibility) measured at 12 and 24 weeks. Recruitment was achievable but control group drop-outs were high (23%). Of the 20 participants who completed the intervention, 19 (95%) attended ⩾75% of the classes and reported classes were enjoyable and would recommend them to others. The rate of fall injuries at 24 weeks was 42% lower and injurious fall rates 64% lower in the Pilates group, however, was not statistically significant (P = 0.347 and P = 0.136). Standing balance, lower-limb strength and flexibility improved in the Pilates group relative to the control group (P < 0.05). Estimates suggest a future definitive study would require 804 participants to detect a difference in fall injury rates. A definitive randomized controlled trial analysing the effect of Pilates in older people would be feasible and is warranted given the acceptability and potential positive effects of Pilates on fall injuries and fall risk factors. The protocol for this study is registered with the Australian and New Zealand Clinical Trials Registry (ACTRN1262000224820). © The Author(s) 2015.

Effect of Fatigue Protocols on Lower Limb Neuromuscular Function and Implications for Anterior Cruciate Ligament Injury Prevention Training: A Systematic Review.

PubMed

Barber-Westin, Sue D; Noyes, Frank R

2017-12-01

Approximately two-thirds of anterior cruciate ligament (ACL) tears are sustained during noncontact situations when an athlete is cutting, pivoting, decelerating, or landing from a jump. Some investigators have postulated that fatigue may result in deleterious alterations in lower limb biomechanics during these activities that could increase the risk of noncontact ACL injuries. However, prior studies have noted a wide variation in fatigue protocols, athletic tasks studied, and effects of fatigue on lower limb kinetics and kinematics. First, to determine if fatigue uniformly alters lower limb biomechanics during athletic tasks that are associated with noncontact ACL injuries. Second, to determine if changes should be made in ACL injury prevention training programs to alter the deleterious effects of fatigue on lower limb kinetics and kinematics. Systematic review; Level of evidence, 4. A systematic review of the literature using MEDLINE was performed. Key terms were fatigue, neuromuscular, exercise, hop test, and single-legged function tests. Inclusion criteria were original research studies involving healthy participants, use of a fatigue protocol, study of at least 1 lower limb task that involved landing from a hop or jump or cutting, and analysis of at least 1 biomechanical variable. Thirty-seven studies involving 806 athletes (485 female, 321 male; mean age, 22.7 years) met the inclusion criteria. General fatigue protocols were used in 20 investigations, peripheral protocols were used in 17 studies, and 21 different athletic tasks were studied (13 single-legged, 8 double-legged). There was no consistency among investigations regarding the effects of fatigue on hip, knee, or ankle joint angles and moments or surface electromyography muscle activation patterns. The fatigue protocols typically did not produce statistically significant changes in ground-reaction forces. Published fatigue protocols did not uniformly produce alterations in lower limb neuromuscular factors that heighten the risk of noncontact ACL injuries. Therefore, justification does not currently exist for major changes in ACL injury prevention training programs to account for potential fatigue effects. However, the effect of fatigue related to ACL injuries is worthy of further investigation, including the refinement of protocols and methods of analysis.

A study on the effect of self bedside exercise program on resilience and activities of daily living for patients with hemiplegia

PubMed Central

Lee, Yang-Chool; Yi, Eun-Surk; Choi, Won-Ho; Lee, Byung-Mun; Cho, Sung-Bo; Kim, Ji-Youn

2015-01-01

The purpose of this study was to design a repeatable universal rehabilitation program in which patients with hemiplegia can participate voluntarily, complementing physical and occupational therapies to increase voluntary exercise practice rate. Also, this study attempted to identify the relationship between psychological resilience due to the implementation of self-bedside exercise and functional recovery of activity of daily living (ADL). 12 patients with hemiplegia voluntarily participated in 8 weeks of self-bedside exercise 5 times a day and more than 5 days a week. Their program implementation, resilience, activities of daily living (MBI), upper limb motor functions (MFT), and balance ability (BBS) were analyzed and compared before and after the program. Compared to before implementing the program, significant increases were found in resilience, MBI, BBS, and MFT in the affected side after the implementation, and the resilience scores showed statistically positive correlation in MBI and MFT. Also, the change in resilience before and after the program implementation showed a statistically positive correlation. Therefore, it can be concluded that the self-bedside exercise developed in this study had a positive effect on voluntary participation in exercise as well as resilience and ADL. However, many studies which complement the psychological aspects of hemiparetic patients with stroke are still needed. PMID:25830141

Comparison between dopaminergic agents and physical exercise as treatment for periodic limb movements in patients with spinal cord injury.

PubMed

De Mello, M T; Esteves, A M; Tufik, S

2004-04-01

Randomized controlled trial of physical exercise and dopaminergic agonist in persons with spinal cord injury and periodic leg movement (PLM). The objective of the present study was to compare the effectiveness of physical exercise and of a dopaminergic agonist in reducing the frequency of PLM. Centro de Estudos em Psicobiologia e Exercício. Universidade Federal de São Paulo, Brazil. A total of 13 volunteers (mean age: 31.6+/-8.3 years) received L-DOPA (200 mg) and benserazide (50 mg) 1 h before sleeping time for 30 days and were then submitted to a physical exercise program on a manual bicycle ergometer for 45 days (3 times a week). Both L-DOPA administration (35.11-19.87 PLM/h, P<0.03) and physical exercise (35.11-18.53 PLM/h, P<0.012) significantly reduced PLM; however, no significant difference was observed between the two types of treatment. The two types of treatment were found to be effective in the reduction of PLM; however, physical exercise is indicated as the first treatment approach, while dopaminergic agonists or other drugs should only be recommended for patients who do not respond to this type of treatment.

Effect of Exercise and Cognitive Training on Falls and Fall-Related Factors in Older Adults With Mild Cognitive Impairment: A Systematic Review.

PubMed

Lipardo, Donald S; Aseron, Anne Marie C; Kwan, Marcella M; Tsang, William W

2017-10-01

To evaluate the effect of exercise and cognitive training on falls reduction and on factors known to be associated with falls among community-dwelling older adults with mild cognitive impairment (MCI). Seven databases (PubMed, CINAHL, Cochrane Library, Web of Science, ProQuest, ProQuest Dissertations and Theses, Digital Dissertation Consortium) and reference lists of pertinent articles were searched. Randomized controlled trials (RCTs) on the effect of exercise, cognitive training, or a combination of both on falls and factors associated with falls such as balance, lower limb muscle strength, gait, and cognitive function among community-dwelling older adults with MCI were included. Data were extracted using the modified Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) tool. Study quality was assessed using the JBI-MAStARI appraisal instrument. Seventeen RCTs (1679 participants; mean age ± SD, 74.4±2.4y) were included. Exercise improved gait speed and global cognitive function in MCI; both are known factors associated with falls. Cognitive training alone had no significant effect on cognitive function, while combined exercise and cognitive training improved balance in MCI. Neither fall rate nor the number of fallers was reported in any of the studies included. This review suggests that exercise, and combined exercise and cognitive training improve specific factors associated with falls such as gait speed, cognitive function, and balance in MCI. Further research on the direct effect of exercise and cognitive training on the fall rate and incidence in older adults with MCI with larger sample sizes is highly recommended. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

The nature of arm movement in children with cerebral palsy when using computer-generated exercise games.

PubMed

Weightman, Andrew; Preston, Nick; Levesley, Martin; Bhakta, Bipin; Holt, Raymond; Mon-Williams, Mark

2014-05-01

To compare upper limb kinematics of children with spastic cerebral palsy (CP) using a passive rehabilitation joystick with those of adults and able-bodied children, to better understand the design requirements of computer-based rehabilitation devices. A blocked comparative study involving seven children with spastic CP, nine able-bodied adults and nine able-bodied children, using a joystick system to play a computer game whilst the kinematics of their upper limb were recorded. The translational kinematics of the joystick's end point and the participant's shoulder movement (protraction/retraction) and elbow rotational kinematics (flexion/extension) were analysed for each group. Children with spastic CP matched their able-bodied peers in the time taken to complete the computer task, but this was due to a failure to adhere to the task instructions of travelling along a prescribed straight line when moving between targets. The spastic CP group took longer to initiate the first movement, which showed jerkier trajectories and demonstrated qualitatively different movement patterns when using the joystick, with shoulder movements that were significantly of greater magnitude than the able-bodied participants. Children with spastic CP generate large shoulder and hence trunk movements when using a joystick to undertake computer-generated arm exercises. This finding has implications for the development and use of assistive technologies to encourage exercise and the instructions given to users of such systems. A kinematic analysis of upper limb function of children with CP when using joystick devices is presented. Children with CP may use upper body movements to compensate for limitations in voluntary shoulder and elbow movements when undertaking computer games designed to encourage the practice of arm movement. The design of rehabilitative computer exercise systems should consider movement of the torso/shoulder as it may have implications for the quality of therapy in the rehabilitation of the upper limb in children with CP.

Aerobic Exercise Intervention Alters Executive Function and White Matter Integrity in Deaf Children: A Randomized Controlled Study

PubMed Central

Xiong, Xuan; Zhu, Li-Na; Dong, Xiao-xiao; Wang, Wei; Yan, Jun

2018-01-01

This study examined the effects of an 11-week aerobic exercise intervention on executive function (EF) and white matter integrity (WMI). In total, 28 deaf children (aged 9–13 years) were randomly assigned to either an 11-week exercise intervention or the control group. All the children had behavioral assessment and diffusion tensor imaging prior to and following the exercise intervention. The behavioral performance results demonstrated that EF was enhanced by exercise. Relative to the control group, WMI of the exercise intervention group showed (1) lower fractional anisotropy (FA) in the pontine crossing tract (PCT) and right cingulum (hippocampus) (CH), genu of the corpus callosum (gCC), right inferior cerebellar peduncle (ICP), left superior corona radiata (SCR), and left superior frontooccipital fasciculus (SFOF); (2) higher mean diffusivity (MD) in the gCC, right CH, right inferior frontooccipital fasciculus (IFOF), and left anterior limb of the internal capsule (ALIC); and (3) lower MD in the left ICP and left tapetum (TAP). Furthermore, the lower FA in gCC showed a significant negative correlation with improvement in behavioral performance, but the correlation was not significant after FDR correction. These results suggest that exercise can effectively improve deaf children's EF and reshape the WMI in deaf children. The improved EF by exercise is not related to a reshaping of WMI, but more studies on the relationship between EF and WMI by exercise may be needed. PMID:29853843

Colostrum supplementation protects against exercise - induced oxidative stress in skeletal muscle in mice

PubMed Central

2012-01-01

Background This study examined the effects of bovine colostrum on exercise –induced modulation of antioxidant parameters in skeletal muscle in mice. Adult male BALB/c mice were randomly divided into four groups (control, colostrum alone, exercise and exercise with colostrum) and each group had three subgroups (day 0, 21 and 42). Colostrum groups of mice were given a daily oral supplement of 50 mg/kg body weight of bovine colostrum and the exercise group of mice were made to exercise on the treadmill for 30 minutes per day. Total antioxidants, lipid hydroperoxides, xanthine oxidase and super oxide dismutase level was assayed from the homogenate of hind limb skeletal muscle. Results Exercise—induced a significant oxidative stress in skeletal muscles as evidenced by the elevated lipid hydroperoxides and xanthine oxidase levels. There was a significant decrease in skeletal muscle total antioxidants and superoxide dismutase levels. Daily colostrum supplement significantly reduced the lipid hydroperoxides and xanthine oxidase enzyme level and increased the total antioxidant levels in the leg muscle. Conclusion Thus, the findings of this study showed that daily bovine colostrum supplementation was beneficial to skeletal muscle to reduce the oxidant-induced damage during muscular exercise. PMID:23173926

The Effect of Inspiratory Muscle Training on Respiratory and Limb Locomotor Muscle Deoxygenation During Exercise with Resistive Inspiratory Loading.

PubMed

Turner, L A; Tecklenburg-Lund, S L; Chapman, R; Shei, R-J; Wilhite, D P; Mickleborough, T

2016-07-01

We investigated how inspiratory muscle training impacted respiratory and locomotor muscle deoxygenation during submaximal exercise with resistive inspiratory loading. 16 male cyclists completed 6 weeks of either true (n=8) or sham (n=8) inspiratory muscle training. Pre- and post-training, subjects completed 3, 6-min experimental trials performed at ~80%  ˙VO2peak with interventions of either moderate inspiratory loading, heavy inspiratory loading, or maximal exercise imposed in the final 3 min. Locomotor and respiratory muscle oxy-, deoxy-, and total-haemoglobin and myoglobin concentration was continuously monitored using near-infrared spectroscopy. Locomotor muscle deoxygenation changes from 80%  ˙VO2peak to heavy inspiratory loading were significantly reduced pre- to post-training from 4.3±5.6 µM to 2.7±4.7 µM. Respiratory muscle deoxygenation was also significantly reduced during the heavy inspiratory loading trial (4.6±3.5 µM to 1.9±1.5 µM) post-training. There was no significant difference in oxy-, deoxy-, or total-haemoglobin and myoglobin during any of the other loading trials, from pre- to post-training, in either group. After inspiratory muscle training, highly-trained cyclists exhibited decreased locomotor and respiratory muscle deoxygenation during exercise with heavy inspiratory loading. These data suggest that inspiratory muscle training reduces oxygen extraction by the active respiratory and limb muscles, which may reflect changes in respiratory and locomotor muscle oxygen delivery. © Georg Thieme Verlag KG Stuttgart · New York.

Effectiveness of tai chi as a community-based falls prevention intervention: a randomized controlled trial.

PubMed

Taylor, Denise; Hale, Leigh; Schluter, Philip; Waters, Debra L; Binns, Elizabeth E; McCracken, Hamish; McPherson, Kathryn; Wolf, Steven L

2012-05-01

To compare the effectiveness of tai chi and low-level exercise in reducing falls in older adults; to determine whether mobility, balance, and lower limb strength improved and whether higher doses of tai chi resulted in greater effect. Randomized controlled trial. Eleven sites throughout New Zealand. Six hundred eighty-four community-residing older adults (mean age 74.5; 73% female) with at least one falls risk factor. Tai chi once a week (TC1) (n = 233); tai chi twice a week (TC2) (n = 220), or a low-level exercise program control group (LLE) (n = 231) for 20 wks. Number of falls was ascertained according to monthly falls calendars. Mobility (Timed-Up-and-Go Test), balance (step test), and lower limb strength (chair stand test) were assessed. The adjusted incident rate ratio (IRR) for falls was not significantly different between the TC1 and LLE groups (IRR = 1.05, 95% confidence interval (CI) = 0.83-1.33, P = .70) or between the TC2 and LLE groups (IRR = 0.88, 95% CI = 0.68-1.16, P = .37). Adjusted multilevel mixed-effects Poisson regression showed a significant reduction in logarithmic mean fall rate of -0.050 (95% CI = -0.064 to -0.037, P < .001) per month for all groups. Multilevel fixed-effects analyses indicated improvements in balance (P < .001 right and left leg) and lower limb strength (P < .001) but not mobility (P = .54) in all groups over time, with no differences between the groups (P = .37 (right leg), P = .66 (left leg), P = .21, and P = .44, respectively). There was no difference in falls rates between the groups, with falls reducing similarly (mean falls rate reduction of 58%) over the 17-month follow-up period. Strength and balance improved similarly in all groups over time. © 2012, Copyright the Authors Journal compilation © 2012, The American Geriatrics Society.

Gravity-supported exercise with computer gaming improves arm function in chronic stroke.

PubMed

Jordan, Kimberlee; Sampson, Michael; King, Marcus

2014-08-01

To investigate the effect of 4 to 6 weeks of exergaming with a computer mouse embedded within an arm skate on upper limb function in survivors of chronic stroke. Intervention study with a 4-week postintervention follow-up. In home. Survivors (N=13) of chronic (≥6 mo) stroke with hemiparesis of the upper limb with stable baseline Fugl-Meyer assessment scores received the intervention. One participant withdrew, and 2 participants were not reassessed at the 4-week follow-up. No participants withdrew as a result of adverse effects. Four to 6 weeks of exergaming using the arm skate where participants received either 9 (n=5) or 16 (n=7) hours of game play. Upper limb component of the Fugl-Meyer assessment. There was an average increase in the Fugl-Meyer upper limb assessment score from the beginning to end of the intervention of 4.9 points. At the end of the 4-week period after the intervention, the increase was 4.4 points. A 4- to 6-week intervention using the arm skate significantly improved arm function in survivors of chronic stroke by an average of 4.9 Fugl-Meyer upper limb assessment points. This research shows that a larger-scale randomized trial of this device is warranted and highlights the potential value of using virtual reality technology (eg, computer games) in a rehabilitation setting. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Exercise enhanced functional recovery and expression of GDNF after photochemically induced cerebral infarction in the rat.

PubMed

Ohwatashi, Akihiko; Ikeda, Satoshi; Harada, Katsuhiro; Kamikawa, Yurie; Yoshida, Akira

2013-01-01

Exercise has been considered to affect the functional recovery from central nervous damage. Neurotrophic factors have various effects on brain damage. However, the effects of exercise for expression of GDNF on functional recovery with brain damage are not well known. We investigated the difference in functional recovery between non-exercise and beam-walking exercise groups, and the expression of GDNF in both groups after photochemical infarction. Adult male Wistar rats (N = 64) were used. Animals were divided into two groups: non-exercise (N = 35), and beam-walking exercise (N = 29). All rats underwent surgical photochemical infarction. The rats of the beam-walking group were trained every day to walk on a narrow beam after a one-day recovery period and those of the non-exercise group were left to follow a natural course. Animals were evaluated for hind limb function every day using a beam-walking task with an elevated narrow beam. The number of GDNF-like immunoreactive cells in the temporal cortex surrounding the lesion was counted 1, 3, 5, and 7 days after the infarction. Functional recovery of the beam-walking exercise group was significantly earlier than that of the non-exercise group. At 3 days after infarction, the number of GDNF-positive cells in the temporal cortex surrounding the infarction was significantly increased in the beam-walking exercise group compared with that in the non-exercise group. In the exercise group, motor function was remarkably recovered with the increased expression of GDNF-like immunoreactive cells. Our results suggested that a rehabilitative approach increased the expression of GDNF and facilitated functional recovery from cerebral infarction.

Exercise and sports science Australia (ESSA) position statement on exercise and spinal cord injury.

PubMed

Tweedy, Sean M; Beckman, Emma M; Geraghty, Timothy J; Theisen, Daniel; Perret, Claudio; Harvey, Lisa A; Vanlandewijck, Yves C

2017-02-01

Traumatic spinal cord injury (SCI) may result in tetraplegia (motor and/or sensory nervous system impairment of the arms, trunk and legs) or paraplegia (motor and/or sensory impairment of the trunk and/or legs only). The adverse effects of SCI on health, fitness and functioning are frequently compounded by profoundly sedentary behaviour. People with paraplegia (PP) and tetraplegia (TP) have reduced exercise capacity due to paralysis/paresis and reduced exercising stroke volume. TP often further reduces exercise capacity due to lower maximum heart-rate and respiratory function. There is strong, consistent evidence that exercise can improve cardiorespiratory fitness and muscular strength in people with SCI. There is emerging evidence for a range of other exercise benefits, including reduced risk of cardio-metabolic disease, depression and shoulder pain, as well as improved respiratory function, quality-of-life and functional independence. Exercise recommendations for people with SCI are: ≥30min of moderate aerobic exercise on ≥5d/week or ≥20min of vigorous aerobic ≥3d/week; strength training on ≥2d/week, including scapula stabilisers and posterior shoulder girdle; and ≥2d/week flexibility training, including shoulder internal and external rotators. These recommendations may be aspirational for profoundly inactive clients and stratification into "beginning", "intermediate" and "advanced" will assist application of the recommendations in clinical practice. Flexibility exercise is recommended to preserve upper limb function but may not prevent contracture. For people with TP, Rating of Perceived Exertion may provide a more valid indication of exercise intensity than heart rate. The safety and effectiveness of exercise interventions can be enhanced by initial screening for autonomic dysreflexia, orthostatic hypotension, exercise-induced hypotension, thermoregulatory dysfunction, pressure sores, spasticity and pain. Copyright © 2016 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

An affordable, computerised, table-based exercise system for stroke survivors.

PubMed

King, Marcus; Hale, Leigh; Pekkari, Anna; Persson, Martin; Gregorsson, Malin; Nilsson, Mikaela

2010-07-01

Loss of hand function as a result of upper limb paresis after a stroke leads to reduced independence. Robotic-assisted therapy with virtual reality leads to improvements in motor function, but there is a need to improve the cost-benefit ratio of these therapies. This case series study investigated augmented reality computer games which provided a rewarded, goal-directed task to upper limb rehabilitation via a gravity supported reaching task. A computer game was developed to motivate chronic stroke survivors to undertake gravity supported reaching tasks performed on a table, and a focus group study investigated the application of this device for rehabilitation. From the focus group, a simple device was developed to improve the quality of the exercise and a further focus group study investigated a variety of computer games to determine motivations for undertaking rehabilitation exercises. Of the four participants in the case study, two showed improvement in ability to play the game and in arm function. Participants enjoyed playing a range of computer games and felt that the system provided a worthwhile exercise. Motivation for undertaking exercise with the system included: intellectual stimulation during game play, feedback such as game score, gaining physical benefits from the exercise, the system tolerating varying levels of disability, ability to relate to the game and ability to use the system in social groups. A low-cost device has been developed which increases the exercise of gravity supported reaching movements, provides goal-directed tasks with rewards and motivates the user to undertake extended rehabilitation.

Comparison of neuromuscular and quadriceps strengthening exercise in the treatment of varus malaligned knees with medial knee osteoarthritis: a randomised controlled trial protocol.

PubMed

Bennell, Kim L; Egerton, Thorlene; Wrigley, Tim V; Hodges, Paul W; Hunt, Michael; Roos, Ewa M; Kyriakides, Mary; Metcalf, Ben; Forbes, Andrew; Ageberg, Eva; Hinman, Rana S

2011-12-05

Osteoarthritis of the knee involving predominantly the medial tibiofemoral compartment is common in older people, giving rise to pain and loss of function. Many people experience progressive worsening of the disease over time, particularly those with varus malalignment and increased medial knee joint load. Therefore, interventions that can reduce excessive medial knee loading may be beneficial in reducing the risk of structural progression. Traditional quadriceps strengthening can improve pain and function in people with knee osteoarthritis but does not appear to reduce medial knee load. A neuromuscular exercise program, emphasising optimal alignment of the trunk and lower limb joints relative to one another, as well as quality of movement performance, while dynamically and functionally strengthening the lower limb muscles, may be able to reduce medial knee load. Such a program may also be superior to traditional quadriceps strengthening with respect to improved pain and physical function because of the functional and dynamic nature. This randomised controlled trial will investigate the effect of a neuromuscular exercise program on medial knee joint loading, pain and function in individuals with medial knee joint osteoarthritis. We hypothesise that the neuromuscular program will reduce medial knee load as well as pain and functional limitations to a greater extent than a traditional quadriceps strengthening program. 100 people with medial knee pain, radiographic medial compartment osteoarthritis and varus malalignment will be recruited and randomly allocated to one of two 12-week exercise programs: quadriceps strengthening or neuromuscular exercise. Each program will involve 14 supervised exercise sessions with a physiotherapist plus four unsupervised sessions per week at home. The primary outcomes are medial knee load during walking (the peak external knee adduction moment from 3D gait analysis), pain, and self-reported physical function measured at baseline and immediately following the program. Secondary outcomes include the external knee adduction moment angular impulse, electromyographic muscle activation patterns, knee and hip muscle strength, balance, functional ability, and quality-of-life. The findings will help determine whether neuromuscular exercise is superior to traditional quadriceps strengthening regarding effects on knee load, pain and physical function in people with medial knee osteoarthritis and varus malalignment. Australian New Zealand Clinical Trials Registry reference: ACTRN12610000660088.

Comparison of neuromuscular and quadriceps strengthening exercise in the treatment of varus malaligned knees with medial knee osteoarthritis: a randomised controlled trial protocol

PubMed Central

2011-01-01

Background Osteoarthritis of the knee involving predominantly the medial tibiofemoral compartment is common in older people, giving rise to pain and loss of function. Many people experience progressive worsening of the disease over time, particularly those with varus malalignment and increased medial knee joint load. Therefore, interventions that can reduce excessive medial knee loading may be beneficial in reducing the risk of structural progression. Traditional quadriceps strengthening can improve pain and function in people with knee osteoarthritis but does not appear to reduce medial knee load. A neuromuscular exercise program, emphasising optimal alignment of the trunk and lower limb joints relative to one another, as well as quality of movement performance, while dynamically and functionally strengthening the lower limb muscles, may be able to reduce medial knee load. Such a program may also be superior to traditional quadriceps strengthening with respect to improved pain and physical function because of the functional and dynamic nature. This randomised controlled trial will investigate the effect of a neuromuscular exercise program on medial knee joint loading, pain and function in individuals with medial knee joint osteoarthritis. We hypothesise that the neuromuscular program will reduce medial knee load as well as pain and functional limitations to a greater extent than a traditional quadriceps strengthening program. Methods/Design 100 people with medial knee pain, radiographic medial compartment osteoarthritis and varus malalignment will be recruited and randomly allocated to one of two 12-week exercise programs: quadriceps strengthening or neuromuscular exercise. Each program will involve 14 supervised exercise sessions with a physiotherapist plus four unsupervised sessions per week at home. The primary outcomes are medial knee load during walking (the peak external knee adduction moment from 3D gait analysis), pain, and self-reported physical function measured at baseline and immediately following the program. Secondary outcomes include the external knee adduction moment angular impulse, electromyographic muscle activation patterns, knee and hip muscle strength, balance, functional ability, and quality-of-life. Discussion The findings will help determine whether neuromuscular exercise is superior to traditional quadriceps strengthening regarding effects on knee load, pain and physical function in people with medial knee osteoarthritis and varus malalignment. Trial Registration Australian New Zealand Clinical Trials Registry reference: ACTRN12610000660088 PMID:22141334

Effect of traditional resistance and power training using rated perceived exertion for enhancement of muscle strength, power, and functional performance.

PubMed

Tiggemann, Carlos Leandro; Dias, Caroline Pieta; Radaelli, Regis; Massa, Jéssica Cassales; Bortoluzzi, Rafael; Schoenell, Maira Cristina Wolf; Noll, Matias; Alberton, Cristine Lima; Kruel, Luiz Fernando Martins

2016-04-01

The present study compared the effects of 12 weeks of traditional resistance training and power training using rated perceived exertion (RPE) to determine training intensity on improvements in strength, muscle power, and ability to perform functional task in older women. Thirty healthy elderly women (60-75 years) were randomly assigned to traditional resistance training group (TRT; n = 15) or power training group (PT; n = 15). Participants trained twice a week for 12 weeks using six exercises. The training protocol was designed to ascertain that participants exercised at an RPE of 13-18 (on a 6-20 scale). Maximal dynamic strength, muscle power, and functional performance of lower limb muscles were assessed. Maximal dynamic strength muscle strength leg press (≈58 %) and knee extension (≈20 %) increased significantly (p < 0.001) and similarly in both groups after training. Muscle power also increased with training (≈27 %; p < 0.05), with no difference between groups. Both groups also improved their functional performance after training period (≈13 %; p < 0.001), with no difference between groups. The present study showed that TRT and PT using RPE scale to control intensity were significantly and similarly effective in improving maximal strength, muscle power, and functional performance of lower limbs in elderly women.

Physical medicine after limb transplantation. Therapeutic effects of physical procedures in the treatment of limb transplantation after cut-off by a threshing machine - Case report.

PubMed

Pasek, Jarosław; Pasek, Tomasz; Cieślar, Grzegorz; Sieroń, Aleksander

2018-06-20

Introduction. The number of accidents in agriculture involving children as the victims continues to increase year-by-year. Parents often allow children to perform certain tasks, or even entrust them to perform such tasks as a duty. The paper presents results of treatment using a 3D magnetic field in a 31-year- old patient after transplantation of the upper extremity of the arm. Amputation of the extremity had been caused by an accident (hand cut-off by a threshing machine). The therapeutic cycle for the patient constituted of 3 series of 15 daily procedures, performed for 15 minutes. There was a break of 4 weeks between sessions. Additionally, the patient performed kinesitherapy exercises in the outpatient clinic. The results obtained regarding improvement of the functional condition of the limb showed that in the complex planning of treatment, the taking into account of the physical medicine procedures should be indispensable.

Effect of Fontan geometry on exercise haemodynamics and its potential implications.

PubMed

Tang, Elaine; Wei, Zhenglun Alan; Whitehead, Kevin K; Khiabani, Reza H; Restrepo, Maria; Mirabella, Lucia; Bethel, James; Paridon, Stephen M; Marino, Bradley S; Fogel, Mark A; Yoganathan, Ajit P

2017-11-01

Exercise intolerance afflicts Fontan patients with total cavopulmonary connections (TCPCs) causing a reduction in quality of life. Optimising TCPC design is hypothesised to have a beneficial effect on exercise capacity. This study investigates relationships between TCPC geometries and exercise haemodynamics and performance. This study included 47 patients who completed metabolic exercise stress test with cardiac magnetic resonance (CMR). Phase-contrast CMR images were acquired immediately following supine lower limb exercise. Both anatomies and exercise vessel flow rates at ventilatory anaerobic threshold (VAT) were extracted. The vascular modelling toolkits were used to analyse TCPC geometries. Computational simulations were performed to quantify TCPC indexed power loss (iPL) at VAT. A highly significant inverse correlation was found between the TCPC diameter index, which factors in the narrowing of TCPC vessels, with iPL at VAT (r=-0.723, p<0.001) but positive correlations with exercise performance variables, including minute oxygen consumption (VO 2 ) at VAT (r=0.373, p=0.01), VO 2 at peak exercise (r=0.485, p=0.001) and work at VAT/weight (r=0.368, p=0.01). iPL at VAT was negatively correlated with VO 2 at VAT (r=-0.337, p=0.02), VO 2 at peak exercise (r=-0.394, p=0.007) and work at VAT/weight (r=-0.208, p=0.17). Eliminating vessel narrowing in TCPCs and reducing elevated iPL at VAT could enhance exercise tolerance for patients with TCPCs. These findings could help plan surgical or catheter-based strategies to improve patients' exercise capacity. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Acute effects of intradialytic aerobic exercise on solute removal, blood gases and oxidative stress in patients with chronic kidney disease.

PubMed

Böhm, Joseane; Monteiro, Mariane Borba; Andrade, Francini Porcher; Veronese, Francisco Veríssimo; Thomé, Fernando Saldanha

2017-01-01

Hemodialysis contributes to increased oxidative stress and induces transitory hypoxemia. Compartmentalization decreases the supply of solutes to the dialyzer during treatment. The aim of this study was to investigate the acute effects of intradialytic aerobic exercise on solute removal, blood gases and oxidative stress in patients with chronic kidney disease during a single hemodialysis session. Thirty patients were randomized to perform aerobic exercise with cycle ergometer for lower limbs during 30 minutes with intensity between 60-70% of maximal heart rate, or control group (CG). Blood samples were collected prior to and immediately after exercise or the equivalent time in CG. Analysis of blood and dialysate biochemistry as well as blood gases were performed. Mass removal and solute clearance were calculated. Oxidative stress was determined by lipid peroxidation and by the total antioxidant capacity. Serum concentrations of solutes increased with exercise, but only phosphorus showed a significant elevation (p = 0.035). There were no significant changes in solute removal and in the acid-base balance. Both oxygen partial pressure and saturation increased with exercise (p = 0.035 and p = 0.024, respectivelly), which did not occur in the CG. The total antioxidant capacity decreased significantly (p = 0.027). The acute intradialytic aerobic exercise increased phosphorus serum concentration and decreased total antioxidant capacity, reversing hypoxemia resulting from hemodialysis. The intradialytic exercise did not change the blood acid-base balance and the removal of solutes.

Effect of exercise on hemodynamic conditions in the abdominal aorta.

PubMed

Taylor, C A; Hughes, T J; Zarins, C K

1999-06-01

The beneficial effect of exercise in the retardation of the progression of cardiovascular disease is hypothesized to be caused, at least in part, by the elimination of adverse hemodynamic conditions, including flow recirculation and low wall shear stress. In vitro and in vivo investigations have provided qualitative and limited quantitative information on flow patterns in the abdominal aorta and on the effect of exercise on the elimination of adverse hemodynamic conditions. We used computational fluid mechanics methods to examine the effects of simulated exercise on hemodynamic conditions in an idealized model of the human abdominal aorta. A three-dimensional computer model of a healthy human abdominal aorta was created to simulate pulsatile aortic blood flow under conditions of rest and graded exercise. Flow velocity patterns and wall shear stress were computed in the lesion-prone infrarenal aorta, and the effects of exercise were determined. A recirculation zone was observed to form along the posterior wall of the aorta immediately distal to the renal vessels under resting conditions. Low time-averaged wall shear stress was present in this location, along the posterior wall opposite the superior mesenteric artery and along the anterior wall between the superior and inferior mesenteric arteries. Shear stress temporal oscillations, as measured with an oscillatory shear index, were elevated in these regions. Under simulated light exercise conditions, a region of low wall shear stress and high oscillatory shear index remained along the posterior wall immediately distal to the renal arteries. Under simulated moderate exercise conditions, all the regions of low wall shear stress and high oscillatory shear index were eliminated. This numeric investigation provided detailed quantitative data on the effect of exercise on hemodynamic conditions in the abdominal aorta. Our results indicated that moderate levels of lower limb exercise are necessary to eliminate the flow reversal and regions of low wall shear stress in the abdominal aorta that exist under resting conditions. The lack of flow reversal and increased wall shear stress during exercise suggest a mechanism by which exercise may promote arterial health, namely with the elimination of adverse hemodynamic conditions.

Arm mechanical efficiency and arm exercise capacity are relatively preserved in chronic obstructive pulmonary disease.

PubMed

Franssen, Frits M E; Wouters, Emiel F M; Baarends, Erica M; Akkermans, Marco A; Schols, Annemie M W J

2002-10-01

Previous studies indicate that energy expenditure related to physical activity is enhanced and that mechanical efficiency of leg exercise is reduced in patients with chronic obstructive pulmonary disease (COPD). However, it is yet unclear whether an inefficient energy expenditure is also present during other activities in COPD. This study was carried out to examine arm efficiency and peak arm exercise performance relative to leg exercise in 33 (23 male) patients with COPD ((mean +/- SEM) age: 61 +/- 2 yr; FEV : 40 +/- 2% of predicted) and 20 sex- and age-matched healthy controls. Body composition, pulmonary function, resting energy expenditure (REE), and peak leg and arm exercise performance were determined. To calculate mechanical efficiency, subjects performed submaximal leg and arm ergometry at 50% of achieved peak loads. During exercise testing, metabolic and ventilatory parameters were measured. In contrast to a reduced leg mechanical efficiency in patients compared with controls (15.6 +/- 0.6% and 22.5 +/- 0.6%, respectively; < 0.001), arm mechanical efficiency was comparable in both groups (COPD: 18.3 +/- 0.9%, controls: 21.0 +/- 1.2%; NS). Arm efficiency was not related to leg efficiency, pulmonary function, work of breathing, or REE. Also, arm exercise capacity was relatively preserved in patients with COPD (ratio arm peak work rate/leg peak work rate in patients: 89% vs 53% in controls; < 0.001). Mechanical efficiency and exercise capacity of the upper and lower limbs are not homogeneously affected in COPD, with a relative preservation of the upper limbs. This may have implications for screening of exercise tolerance and prescription of training interventions in patients with COPD. Future studies need to elucidate the mechanism behind this observation.

Limb Stress-Rest Perfusion Imaging With Contrast Ultrasound For The Assessment Of Peripheral Arterial Disease Severity

PubMed Central

Lindner, Jonathan R.; Womack, Lisa; Barrett, Eugene J.; Feltman, Judy; Price, Wendy; Harthun, Nancy L.; Kaul, Sanjiv; Patrie, James T.

2009-01-01

Objectives We hypothesized that lower extremity stress-rest perfusion imaging with contrast-enhanced ultrasound (CEU) could evaluate the severity of peripheral arterial disease (PAD). Background Perfusion imaging may provide valuable quantitative information on PAD, particularly in patients with diabetes in whom microvascular functional abnormalities are common. Methods Twenty-six control subjects and 39 patients with symptomatic PAD, 19 with type-2 diabetes mellitus, were studied. Claudication threshold was determined by a modified treadmill exercise test. Bilateral pulse-volume recordings, ankle-brachial index (ABI), and post-exercise ABI were performed. CEU perfusion imaging of the gastrocnemius and soleus was performed at rest and after 2 min of plantar-flexion exercise. Results During exercise, claudication occurred earlier in PAD patients with diabetes than without. Muscle blood flow during plantar-flexion exercise was lower (p<0.05) in patients with PAD (10.4±6.7) and PAD with diabetes (7.9±5.9) compared to control subjects (20.0±9.5). After adjusting for diabetes, the only diagnostic tests that predicted severity of disease defined by claudication threshold were CEU exercise blood flow (odds ratios: 0.67 [95% CI (0.51 to 0.88); p=0.003], and flow reserve (odds ratio: 0.64 [95% CI (0.46 to 0.89), p=0.008]). A multivariate model incorporating all non-invasive diagnostic tests indicated that the best models for predicting severity of disease were the combination of presence of diabetes and either exercise blood flow or flow reserve. Conclusions Limb microvascular perfusion imaging during exercise can be evaluated by CEU. Skeletal muscle blood flow during exercise and flow reserve are impaired in patients with PAD and correlate with the severity of symptoms. PMID:19356447

A novel device using the Nordic hamstring exercise to assess eccentric knee flexor strength: a reliability and retrospective injury study.

PubMed

Opar, David A; Piatkowski, Timothy; Williams, Morgan D; Shield, Anthony J

2013-09-01

Reliability and case-control injury study. To determine if a novel device designed to measure eccentric knee flexor strength via the Nordic hamstring exercise displays acceptable test-retest reliability; to determine normative values for eccentric knee flexor strength derived from the device in individuals without a history of hamstring strain injury (HSI); and to determine if the device can detect weakness in elite athletes with a previous history of unilateral HSI. HSI and reinjury are the most common cause of lost playing time in a number of sports. Eccentric knee flexor weakness is a major modifiable risk factor for future HSI. However, at present, there is a lack of easily accessible equipment to assess eccentric knee flexor strength. Thirty recreationally active males without a history of HSI completed the Nordic hamstring exercise on the device on 2 separate occasions. Intraclass correlation coefficients, typical error, typical error as a coefficient of variation, and minimal detectable change at a 95% confidence level were calculated. Normative strength data were determined using the most reliable measurement. An additional 20 elite athletes with a unilateral history of HSI within the previous 12 months performed the Nordic hamstring exercise on the device to determine if residual eccentric muscle weakness existed in the previously injured limb. The device displayed high to moderate reliability (intraclass correlation coefficient = 0.83-0.90; typical error, 21.7-27.5 N; typical error as a coefficient of variation, 5.8%-8.5%; minimal detectable change at a 95% confidence level, 60.1-76.2 N). Mean ± SD normative eccentric flexor strength in the uninjured group was 344.7 ± 61.1 N for the left and 361.2 ± 65.1 N for the right side. The previously injured limb was 15% weaker than the contralateral uninjured limb (mean difference, 50.3 N; 95% confidence interval: 25.7, 74.9; P<.01), 15% weaker than the normative left limb (mean difference, 50.0 N; 95% confidence interval: 1.4, 98.5; P = .04), and 18% weaker than the normative right limb (mean difference, 66.5 N; 95% confidence interval: 18.0, 115.1; P<.01). The experimental device offers a reliable method to measure eccentric knee flexor strength and strength asymmetry and to detect residual weakness in previously injured elite athletes.

The differential diagnosis of the short-limbed dwarfs presenting at birth.

PubMed

Mukherji, R N; Moss, P D

1977-04-01

Attention is drawn to the fact that in a number of types of short-limbed dwarfism a precise diagnosis can be made in the neonatal period. Examples are given and the prognostic and genetic implications are discussed. It is important to be able to advise parents of the likely outlook for the infant and of the genetic implication. Early diagnosis is therefore not merely an academic exercise.

Limb length inequality: clinical implications for assessment and intervention.

PubMed

Brady, Rebecca J; Dean, John B; Skinner, T Marc; Gross, Michael T

2003-05-01

The purpose of this paper is to review relevant literature concerning limb length inequalities in adults and to make recommendations for assessment and intervention based on the literature and our own clinical experience. Literature searches were conducted in the MEDLINE, PubMed, and CINAHL databases. Limb length inequality and common classification criteria are defined and etiological factors are presented. Common methods of detecting limb length inequality include direct (tape measure methods), indirect (pelvic leveling), and radiological techniques. Interventions include shoe inserts or external shoe lift therapy for mild cases. Surgery may be appropriate in severe cases. Little agreement exists regarding the prevalence of limb length inequality, the degree of limb length inequality that is considered clinically significant, and the reliability and validity of assessment methods. Based on correlational studies, the relationship between limb length inequality and orthopaedic pathologies is questionable. Stronger support for the link between low back pain (LBP) and limb length inequality is provided by intervention studies. Methods involving palpation of pelvic landmarks with block correction have the most support for clinical assessment of limb length inequality. Standing radiographs are suggested when clinical assessment methods are unsatisfactory. Clinicians should exercise caution when undertaking intervention strategies for limb length inequality of less than 5 mm when limb length inequality has been identified with clinical techniques. Recommendations are provided regarding intervention strategies.

Electromyographic analysis of trunk and hip muscles during resisted lateral band walking.

PubMed

Youdas, James W; Foley, Brooke M; Kruger, BreAnna L; Mangus, Jessica M; Tortorelli, Alis M; Madson, Timothy J; Hollman, John H

2013-02-01

The purpose of this study was to simultaneously quantify bilateral activation/recruitment levels (% maximum voluntary isometric contraction [MVIC]) for trunk and hip musculature on both moving and stance lower limbs during resisted lateral band walking. Differential electromyographic (EMG) activity was recorded in neutral, internal, and external hip rotation in 21 healthy participants. EMG signals were collected with DE-3.1 double-differential surface electrodes at a sampling frequency of 1,000 Hz during three consecutive lateral steps. Gluteus medius average EMG activation was greater (p = 0.001) for the stance limb (52 SD 18% MVIC) than moving limb (35 SD 16% MVIC). Gluteus maximus EMG activation was greater (p = 0.002) for the stance limb (19 SD 13% MVIC) than moving limb (13 SD 9% MVIC). Erector spinae activation was greater (p = 0.007) in hip internal rotation (30 SD 13% MVIC) than neutral rotation (26 SD 10% MVIC) and the moving limb (31 SD 15% MVIC) was greater (p = 0.039) than the stance limb (23 SD 11% MVIC). Gluteus medius and maximus muscle activation were greater on the stance limb than moving limb during resisted lateral band walking. Therefore, clinicians may wish to consider using the involved limb as the stance limb during resisted lateral band walking exercise.

Local and systemic effects of leg cycling training on arterial wall thickness in healthy humans.

PubMed

Thijssen, Dick H J; Dawson, Ellen A; van den Munckhof, Inge C L; Birk, Gurpreet K; Timothy Cable, N; Green, Daniel J

2013-08-01

Exercise training is associated with direct effects on conduit artery function and structure. Cross-sectional studies suggest the presence of systemic changes in wall thickness as a result of exercise in healthy subjects, but no previous study has examined this question in humans undertaking exercise training. To examine the change in superficial femoral (SFA, i.e. local effect) and carotid (CA, i.e. systemic effect) artery wall thickness across 8 weeks of lower limb cycle training in healthy young men. Fourteen healthy young male subjects were assigned to an 8-week training study of cycling exercise (n = 9) or a control period (n = 5). Before, during (2, 4 and 6 weeks) and after training, SFA and CA wall thickness was examined using automated edge-detection of high resolution ultrasound images. We also measured resting diameter and calculated the wall:lumen(W:L)-ratio. Exercise training did not alter CA or SFA baseline diameter (P = 0.14), but was associated with gradual, consistent and significant decreases in wall thickness and W:L-ratio in both the CA and SFA (P < 0.001 and 0.002, respectively). Two-way ANOVA revealed a comparable magnitude of decrease in wall thickness and W:L-ratio in both arteries across the 8-week period (interaction-effect; P = 0.29 and 0.12, respectively). No changes in artery diameter, wall thickness or W:L-ratio were apparent in controls (0.82, 0.38 and 0.52, respectively). We found that cycle exercise training in healthy young individuals is associated with modest, but significant, decreases in wall thickness in the superficial femoral and carotid arteries. These findings suggest that exercise training causes systemic adaptation of the arterial wall in healthy young subjects. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Applications of Shape Memory Alloys for Neurology and Neuromuscular Rehabilitation

PubMed Central

Pittaccio, Simone; Garavaglia, Lorenzo; Ceriotti, Carlo; Passaretti, Francesca

2015-01-01

Shape memory alloys (SMAs) are a very promising class of metallic materials that display interesting nonlinear properties, such as pseudoelasticity (PE), shape memory effect (SME) and damping capacity, due to high mechanical hysteresis and internal friction. Our group has applied SMA in the field of neuromuscular rehabilitation, designing some new devices based on the mentioned SMA properties: in particular, a new type of orthosis for spastic limb repositioning, which allows residual voluntary movement of the impaired limb and has no predetermined final target position, but follows and supports muscular elongation in a dynamic and compliant way. Considering patients in the sub-acute phase after a neurological lesion, and possibly bedridden, the paper presents a mobiliser for the ankle joint, which is designed exploiting the SME to provide passive exercise to the paretic lower limb. Two different SMA-based applications in the field of neuroscience are then presented, a guide and a limb mobiliser specially designed to be compatible with diagnostic instrumentations that impose rigid constraints in terms of electromagnetic compatibility and noise distortion. Finally, the paper discusses possible uses of these materials in the treatment of movement disorders, such as dystonia or hyperkinesia, where their dynamic characteristics can be advantageous. PMID:26023790

Cross-education of muscular strength following unilateral resistance training: a meta-analysis.

PubMed

Manca, A; Dragone, D; Dvir, Z; Deriu, Franca

2017-11-01

Cross-education (CE) of strength is a well-known phenomenon whereby exercise of one limb can induce strength gains in the contralateral untrained limb. The only available meta-analyses on CE, which date back to a decade ago, estimated a modest 7.8% increase in contralateral strength following unilateral training. However, in recent years new evidences have outlined larger contralateral gains, which deserve to be systematically evaluated. Therefore, the aim of this meta-analysis was to appraise current data on CE and determine its overall magnitude of effect. Five databases were searched from inception to December 2016. All randomized controlled trials focusing on unilateral resistance training were carefully checked by two reviewers who also assessed the eligibility of the identified trials and extracted data independently. The risk of bias was assessed using the Cochrane Risk-of-Bias tool. Thirty-one studies entered the meta-analysis. Data from 785 subjects were pooled and subgroup analyses by body region (upper/lower limb) and type of training (isometric/concentric/eccentric/isotonic-dynamic) were performed. The pooled estimate of CE was a significant 11.9% contralateral increase (95% CI 9.1-14.8; p < 0.00001; upper limb: + 9.4%, p < 0.00001; lower limb: + 16.4%, p < 0.00001). Significant CE effects were induced by isometric (8.2%; p = 0.0003), concentric (11.3%; p < 0.00001), eccentric (17.7%; p = 0.003) and isotonic-dynamic training (15.9%; p < 0.00001), although a high risk of bias was detected across the studies. Unilateral resistance training induces significant contraction type-dependent gains in the contralateral untrained limb. Methodological issues in the included studies are outlined to provide guidance for a reliable quantification of CE in future studies.

Erythrocyte volume in acidified venous blood from exercising limbs.

NASA Technical Reports Server (NTRS)

Van Beaumont, W.; Rochelle, R. H.

1973-01-01

Five male volunteers performed arm exercises in the sitting position by cranking the pedals of a bicycle ergometer at 50 revolutions per min. The initial mechanical work load of 0 kgm/min was increased every minute by 75 kgm/min until exhaustion occurred. The data obtained show a significant acidification of the venous blood from the working arms and a substantial increase in venous pCO2 during this type of muscular activity. However, the erythrocyte volume remained unaltered during the exercise.

Study protocol for a randomized controlled trial: tongue strengthening exercises in head and neck cancer patients, does exercise load matter?

PubMed

Van Nuffelen, Gwen; Van den Steen, Leen; Vanderveken, Olivier; Specenier, Pol; Van Laer, Carl; Van Rompaey, Diane; Guns, Cindy; Mariën, Steven; Peeters, Marc; Van de Heyning, Paul; Vanderwegen, Jan; De Bodt, Marc

2015-09-04

Reduced tongue strength is an important factor contributing to early and late dysphagia in head and neck cancer patients previously treated with chemoradiotherapy. The evidence is growing that tongue strengthening exercises can improve tongue strength and swallowing function in both healthy and dysphagic subjects. However, little is known about the impact of specific features of an exercise protocol for tongue strength on the actual outcome (strength or swallowing function). Previous research originating in the fields of sports medicine and physical rehabilitation shows that the degree of exercise load is an influential factor for increasing muscle strength in the limb skeletal muscles. Since the tongue is considered a muscular hydrostat, it remains to be proven whether the same concepts will apply. This ongoing randomized controlled trial in chemoradiotherapy-treated patients with head and neck cancer investigates the effect of three tongue strengthening exercise protocols, with different degrees of exercise load, on tongue strength and swallowing. At enrollment, 51 patients whose dysphagia is primarily related to reduced tongue strength are randomly assigned to a training schedule of 60, 80, or 100% of their maximal tongue strength. Patients are treated three times a week for 8 weeks, executing 120 repetitions of the assigned exercise once per training day. Exercise load is progressively adjusted every 2 weeks. Patients are evaluated before, during and after treatment by means of tongue strength measurements, fiber-optic endoscopic evaluation of swallowing and quality-of-life questionnaires. This randomized controlled trial is the first to systematically investigate the effect of different exercise loads in tongue strengthening exercise protocols. The results will allow the development of more efficacious protocols. Current Controlled Trials ISRCTN14447678.

Effectiveness of Hip External Rotator Strengthening Exercise in Korean Postural Bowleg Women.

PubMed

Park, Seong Hoon; Lee, Jun Won; Kim, Joo Hyun; Tak, Kyoung Seok; Lee, Byeong Ho; Suh, In Suck

2017-08-01

Postural bowleg is a subclinical entity with both aesthetic and functional outcomes and appears to be common in East Asian countries. Internal rotation of the hip joint is associated with varus alignment at the knee joint of the bowleg. Strengthening exercise for the hip external rotator muscles seems to be effective in improving varus alignment of bowleg, but no standardized exercise program exists. A standardized active resistance strengthening exercise for hip external rotator muscles could improve varus alignment of the lower limb in bowlegged Korean women. In this article, a case series study was conducted to observe changes following a standardized 3-month program using equipment designed for strengthening of the hip external rotator muscles. Photogrammetric and radiographic data were used to compare the gap between knees and tibiofemoral (TF) angles before and after the exercise program. As a result, on average, the knee gap decreased by 1.6 cm. The TF angle decreased by 1.5°. Regression analysis revealed a statistically significant association between changes in knee gap and TF angle. The standardized 3-month active resistance strengthening exercise program of hip external rotator muscles was effective in improving postural deviation and cosmetic outcomes in bowlegged Korean women. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Effects of mirror therapy combined with motor tasks on upper extremity function and activities daily living of stroke patients.

PubMed

Kim, Kyunghoon; Lee, Sukmin; Kim, Donghoon; Lee, Kyoungbo; Kim, Youlim

2016-01-01

[Purpose] The objective of this study was to investigate the effects of mirror therapy combined with exercise tasks on the function of the upper limbs and activities of daily living. [Subjects and Methods] Twenty-five stroke patients who were receiving physical therapy at K Hospital in Gyeonggi-do, South Korea, were classified into a mirror therapy group (n=12) and a conventional therapy group (n=13). The therapies were applied for 30 minutes per day, five times per week, for a total of four weeks. Upper limb function was measured with the Action Research Arm test, the Fugl-Meyer Assessment, and the Box and Block test, and activities of daily living were measured with the Functional Independence Measure. A paired test was performed to compare the intragroup differences between before training and after four weeks of therapy, and an independent t-test was performed to compare the differences between the two groups before and after four weeks of therapy. [Results] In the intragroup comparison, both groups showed significant differences between measurements taken before and after four weeks of therapy. In the intergroup comparison, the mirror therapy group showed significant improvements compared with the conventional therapy group, both in upper limb function and activities of daily living. [Conclusion] The findings of this study demonstrated that mirror therapy is more effective than conventional therapy for the training of stroke patients to improve their upper limb function and activities of daily living.

An Acute Bout of Barefoot Running Alters Lower-limb Muscle Activation for Minimalist Shoe Users.

PubMed

Snow, N J; Basset, F A; Byrne, J

2016-05-01

Despite the abundance of barefoot running-related research, there have been no electromyography studies evaluating the effects of this mode of exercise on habitual users of minimalist footwear. The present study investigated differences in muscle activation during acute bouts of barefoot and shod running, in minimalist shoe users. 8 male participants ran on a motorized treadmill for 10 min under both conditions, at 70% maximal aerobic speed. Electromyographic data were sampled from the biceps femoris, gluteus maximus, gastrocnemius medialis, tibialis anterior, and vastus lateralis during both swing and stance. Root-mean-square analysis of electromyographic data was conducted to compare muscle activation between conditions. During stance, barefoot running resulted in greater muscle activity in gastrocnemius medialis and gluteus maximus, and lower muscle activity in tibialis anterior. During swing, barefoot running resulted in increased muscle activity in vastus lateralis and gastrocnemius medialus. These results indicate that, for minimalist shoe users, an acute bout of barefoot running results in significantly different lower-limb muscle activity. Increased activation in the above muscles presents a possible mechanism for injury, which should be considered during exercise prescription. © Georg Thieme Verlag KG Stuttgart · New York.

Effect of plyometric training on lower limb biomechanics in females.

PubMed

Baldon, Rodrigo de Marche; Moreira Lobato, Daniel F; Yoshimatsu, Andre P; dos Santos, Ana Flávia; Francisco, Andrea L; Pereira Santiago, Paulo R; Serrão, Fábio V

2014-01-01

To verify the effects of plyometric training on lower limb kinematics, eccentric hip and knee torques, and functional performance. Cohort study. Research laboratory. Thirty-six females were divided into a training group (TG; n = 18) that carried out the plyometric training for 8 weeks, and a control group (CG; n = 18) that carried out no physical training. Twenty-four plyometric training sessions during approximately 8 weeks with 3 sessions per week on alternate days. Lower limb kinematics (maximum excursion of hip adduction, hip medial rotation, and knee abduction during the single leg squat), eccentric hip (abductor, adductor, medial, and lateral rotator) isokinetic peak torques and knee (flexor and extensor) isokinetic peak torques, and functional performance (triple hop test and the 6-m timed hop test). After 8 weeks, only the TG significantly reduced the values for the maximum excursion of knee abduction (P = 0.01) and hip adduction (P < 0.001). Similarly, only the TG significantly increased the eccentric hip abductor (P < 0.001) and adductor (P = 0.01) torques. Finally, only the TG significantly increased the values in the triple hop test (P < 0.001) and significantly decreased the values in the 6-m timed hop test (P < 0.001) after intervention. Plyometric training alters lower limb kinematics and increases eccentric hip torque and functional performance, suggesting the incorporation of these exercises in preventive programs for ACL injuries.

The effect of isolating the paretic limb on weight-bearing distribution and EMG activity during squats in hemiplegic and healthy individuals.

PubMed

Lee, Dong-Kyu; An, Duk-Hyun; Yoo, Won-Gyu; Hwang, Byong-Yong; Kim, Tae-Ho; Oh, Jae-Seop

2017-05-01

Neural reorganization for movement therapy after a stroke is thought to be an important mechanism that facilitates motor recovery. However, there is a lack of evidence for the effectiveness of exercise programs in improving the lower limbs. We investigated the immediate effect of isolating the paretic limb using different foot positions ((i) foot parallel; both feet parallel, (ii) foot asymmetry; paretic foot backward by 10 cm, and (iii) foot lifting; nonparetic foot lifting by normalization to 25% of knee height) on weight-bearing distribution and electromyography (EMG) of the thigh muscle during squats. In total, 20 patients with hemiplegia and 16 healthy subjects randomly performed three squat conditions in which the knee joint was flexed to 30°. Weight distribution was measured using the BioRescue system. Muscle activity was measured using a surface EMG system. Patients with hemiplegia exhibited significantly decreased weight bearing on the paretic foot at 0° and 30° knee flexion compared with the nondominant foot of a healthy subject. The muscle activity of the quadriceps was significantly lower in patients with hemiplegia compared to healthy subjects. Weight bearing and EMG activity of the quadriceps femoris on the paretic or nondominant side significantly increased during a knee flexion of 30° with under the foot asymmetry and foot lifting positions compared with the parallel foot position. Isolating the paretic limb using the asymmetric foot positions and lifting of the foot during squats might help patients with hemiplegia to improve weight-bearing and achieve greater activation of the quadriceps muscle in the paretic limb.

Intervention for the maintenance and improvement of physical function and quality of life among elderly disaster victims of the Great East Japan Earthquake and Tsunami.

PubMed

Greiner, Chieko; Ono, Kana; Otoguro, Chizuru; Chiba, Kyoko; Ota, Noriko

2016-08-01

The purpose of this study was to examine the effectiveness of an exercise class implemented in an area affected by the Great East Japan Earthquake and Tsunami for maintaining and improving physical function and quality of life (QOL) among elderly victims. Participants were 45 elderly disaster victims. To measure the effectiveness of the exercise classes, results on the Functional Reach Test (FRT), Timed Up and Go Test (TUG), One-leg Standing Balance (OSB), and Chair Stand Test (CST) were measured at the beginning of the exercise classes, and after 3 and 6months. In order to assess health-related QOL, the 8-item Short-Form Health Survey (SF-8) was carried out at the beginning of the exercise classes, and after 1, 3, and 6months. Of the 45 people who consented to participate, 27 continued the program for 6months and were used for analysis. Analysis of the results for FRT, OSB, and CST showed significant improvements (respectively, p=.000, .007, and .000). SF-8 showed significant increases for the subscales of bodily pain (p=.004), general health perception (p=.001), and mental health (p=.035). By continuing an exercise program for 6months, improvements were seen in lower limb muscle strength and balance functions. Effectiveness for HRQOL was also observed. Copyright © 2016 Elsevier Inc. All rights reserved.

Robotic upper limb rehabilitation after acute stroke by NeReBot: evaluation of treatment costs.

PubMed

Stefano, Masiero; Patrizia, Poli; Mario, Armani; Ferlini, Gregorio; Rizzello, Roberto; Rosati, Giulio

2014-01-01

Stroke is the first cause of disability. Several robotic devices have been developed for stroke rehabilitation. Robot therapy by NeReBot is demonstrated to be an effective tool for the treatment of poststroke paretic upper limbs, able to improve the activities of daily living of stroke survivors when used both as additional treatment and in partial substitution of conventional rehabilitation therapy in the acute and subacute phases poststroke. This study presents the evaluation of the costs related to delivering such therapy, in comparison with conventional rehabilitation treatment. By comparing several NeReBot treatment protocols, made of different combinations of robotic and nonrobotic exercises, we show that robotic technology can be a valuable and economically sustainable aid in the management of poststroke patient rehabilitation.

One minute sit-to-stand test is an alternative to 6MWT to measure functional exercise performance in COPD patients.

PubMed

Reychler, Gregory; Boucard, Eliott; Peran, Loïc; Pichon, Romain; Le Ber-Moy, Catherine; Ouksel, Hakima; Liistro, Giuseppe; Chambellan, Arnaud; Beaumont, Marc

2018-03-01

Chronic obstructive pulmonary disease (COPD) is frequently associated with a reduced functional exercise performance. Even if this parameter is routinely evaluated using 6-minute walking test (6MWT), new field tests are regularly investigated as alternative tests. The aim of this study was to compare functional exercise performance evaluation by sit-to-stand test (STST) and 6MWT and to evaluate reliability and repeatability of the STST in COPD patients. Forty-two COPD patients performed randomly two tests: 6MWT and STST. Each test was repeated two times. Distance (6MWD) and number of repetitions were measured. Cardiorespiratory parameters, dyspnea and lower limb fatigue (Borg) were recorded before and after the tests. Sit-to-stand repetitions (19 ± 6) and 6MWD (441 ± 104 m) were correlated (r = .716; P < .001). Good repeatability was found for STST and 6MWT. Good reliability was observed for STST (ICC = 0.902). Variations of heart rate and pulsed oxygen saturation were significantly different between these two tests (23% ± 17% vs 13% ± 11%; P = .022 and -7.6% ± 4.6% vs -0.7% ± 2.7%; P < .001 for 6MWT and STST, respectively). Variations of dyspnea and lower limb fatigue were similar between both tests (P = .827 and P = .467). The one minute sit-to-stand test is a valuable alternative to 6MWT to estimate functional exercise performance in COPD patients. The cardiorespiratory demand is different between both tests although the variation of dypsnea is similar. No learning effect was observed for STST. © 2017 John Wiley & Sons Ltd.

Brachial artery vasodilatation during prolonged lower limb exercise: role of shear rate

PubMed Central

Padilla, Jaume; Simmons, Grant H.; Vianna, Lauro C.; Davis, Michael J.; Laughlin, M. Harold; Fadel, Paul J.

2012-01-01

We recently observed a marked increase in brachial artery (BA) diameter during prolonged leg cycling exercise. The purpose of the present study was to test the hypothesis that this increase in BA diameter during lower limb exercise is shear stress mediated. Accordingly, we determined whether recapitulation of cycling-induced BA shear rate with forearm heating, a known stimulus evoking shear-induced conduit artery dilatation, would elicit comparable profiles and magnitudes of BA vasodilatation to those observed during cycling. In 12 healthy men, BA diameter and blood velocity were measured simultaneously using Doppler ultrasonography at baseline and every 5 min during 60 min of either steady-state semi-recumbent leg cycling (120 W) or forearm heating. At the onset of cycling, the BA diameter was reduced (−3.9 ± 1.2% at 5 min; P < 0.05), but it subsequently increased throughout the remainder of the exercise bout (+15.1 ± 1.6% at 60 min; P < 0.05). The increase in BA diameter during exercise was accompanied by an approximately 2.5-fold rise in BA mean shear rate (P < 0.05). Similar increases in BA mean shear with forearm heating elicited an equivalent magnitude of BA vasodilatation to that observed during cycling (P > 0.05). Herein, we found that in the absence of exercise the extent of the BA vasodilator response was reproduced when the BA was exposed to comparable magnitudes of shear rate via forearm heating. These results are consistent with the hypothesis that shear stress plays a key role in signalling brachial artery vasodilatation during dynamic leg exercise. PMID:21784788

Energy expenditure and physiological responses during walking on a treadmill and moving on the Torqway vehicle.

PubMed

Maciejczyk, Marcin; Wiecek, Magdalena; Szymura, Jadwiga; Szygula, Zbigniew

2016-01-01

One of the new products which can be used to increase physical activity and energy expenditure is the Torqway vehicle, powered by the upper limbs. The aim of this study was to (1) assess the usefulness and repeatability of the Torqway vehicle for physical exercise, (2) compare energy expenditure and physiological responses during walking on a treadmill and during physical effort while moving on the Torqway at a constant speed. The participants (11 men, aged 20.2 ± 1.3) performed the incremental test and submaximal exercises (walking on the treadmill and moving on the Torqway vehicle at the same speed). Energy expenditure during the exercise on the Torqway was significantly higher (p = 0.001) than during the walking performed at the same speed. The intensity of the exercise performed on the Torqway expressed as %VO2max and %HRmax was significantly ( p < 0.001) higher than during walking (respectively: 35.0 ± 6.0 vs. 29.4 ± 7.4 %VO2max and 65.1 ± 7.3 vs. 47.2 ± 7.4 %HRmax). Exercise on the Torqway vehicle allows for the intensification of the exercise at a low movement speed, comparable to walking. Moving on the Torqway vehicle could be an effective alternative activity for physical fitness and exercise rehabilitation programs.

Effects of Swiss-ball core strength training on strength, endurance, flexibility, and balance in sedentary women.

PubMed

Sekendiz, Betül; Cuğ, Mutlu; Korkusuz, Feza

2010-11-01

The purpose of this study was to investigate the effects of Swiss-ball core strength training on trunk extensor (abdominal)/flexor (lower back) and lower limb extensor (quadriceps)/flexor (hamstring) muscular strength, abdominal, lower back and leg endurance, flexibility and dynamic balance in sedentary women (n = 21; age = 34 ± 8.09; height = 1.63 ± 6.91 cm; weight = 64 ± 8.69 kg) trained for 45 minutes, 3 d·wk-1 for 12 weeks. Results of multivariate analysis revealed significant difference (p ≤ 0.05) between pre and postmeasures of 60 and 90° s trunk flexion/extension, 60 and 240° s-1 lower limb flexion/extension (Biodex Isokinetic Dynamometer), abdominal endurance (curl-up test), lower back muscular endurance (modified Sorensen test), lower limb endurance (repetitive squat test), lower back flexibility (sit and reach test), and dynamic balance (functional reach test). The results support the fact that Swiss-ball core strength training exercises can be used to provide improvement in the aforementioned measures in sedentary women. In conclusion, this study provides practical implications for sedentary individuals, physiotherapists, strength and conditioning specialists who can benefit from core strength training with Swiss balls.

Effects of aerobic training combined with respiratory muscle stretching on the functional exercise capacity and thoracoabdominal kinematics in patients with COPD: a randomized and controlled trial.

PubMed

Wada, Juliano T; Borges-Santos, Erickson; Porras, Desiderio Cano; Paisani, Denise M; Cukier, Alberto; Lunardi, Adriana C; Carvalho, Celso Rf

2016-01-01

Patients with COPD present a major recruitment of the inspiratory muscles, predisposing to chest incoordination, increasing the degree of dyspnea and impairing their exercise capacity. Stretching techniques could decrease the respiratory muscle activity and improve their contractile capacity; however, the systemic effects of stretching remain unknown. The aim of this study was to evaluate the effects of aerobic training combined with respiratory muscle stretching on functional exercise capacity and thoracoabdominal kinematics in patients with COPD. This study was a randomized and controlled trial. A total of 30 patients were allocated to a treatment group (TG) or a control group (CG; n=15, each group). The TG was engaged in respiratory muscle stretching and the CG in upper and lower limb muscle stretching. Both groups performed 24 sessions (twice a week, 12 weeks) of aerobic training. Functional exercise capacity (6-minute walk test), thoracoabdominal kinematics (optoelectronic plethysmography), and respiratory muscle activity (surface electromyography) were evaluated during exercise. Analysis of covariance was used to compare the groups at a significance level of 5%. After the intervention, the TG showed improved abdominal (ABD) contribution, compartmental volume, mobility, and functional exercise capacity with decreased dyspnea when compared with the CG ( P <0.01). The TG also showed a decreased respiratory muscle effort required to obtain the same pulmonary volume compared to the CG ( P <0.001). Our results suggest that aerobic training combined with respiratory muscle stretching increases the functional exercise capacity with decreased dyspnea in patients with COPD. These effects are associated with an increased efficacy of the respiratory muscles and participation of the ABD compartment.

Effects of aerobic training combined with respiratory muscle stretching on the functional exercise capacity and thoracoabdominal kinematics in patients with COPD: a randomized and controlled trial

PubMed Central

Wada, Juliano T; Borges-Santos, Erickson; Porras, Desiderio Cano; Paisani, Denise M; Cukier, Alberto; Lunardi, Adriana C; Carvalho, Celso RF

2016-01-01

Background Patients with COPD present a major recruitment of the inspiratory muscles, predisposing to chest incoordination, increasing the degree of dyspnea and impairing their exercise capacity. Stretching techniques could decrease the respiratory muscle activity and improve their contractile capacity; however, the systemic effects of stretching remain unknown. Objective The aim of this study was to evaluate the effects of aerobic training combined with respiratory muscle stretching on functional exercise capacity and thoracoabdominal kinematics in patients with COPD. Design This study was a randomized and controlled trial. Participants A total of 30 patients were allocated to a treatment group (TG) or a control group (CG; n=15, each group). Intervention The TG was engaged in respiratory muscle stretching and the CG in upper and lower limb muscle stretching. Both groups performed 24 sessions (twice a week, 12 weeks) of aerobic training. Evaluations Functional exercise capacity (6-minute walk test), thoracoabdominal kinematics (optoelectronic plethysmography), and respiratory muscle activity (surface electromyography) were evaluated during exercise. Analysis of covariance was used to compare the groups at a significance level of 5%. Results After the intervention, the TG showed improved abdominal (ABD) contribution, compartmental volume, mobility, and functional exercise capacity with decreased dyspnea when compared with the CG (P<0.01). The TG also showed a decreased respiratory muscle effort required to obtain the same pulmonary volume compared to the CG (P<0.001). Conclusion Our results suggest that aerobic training combined with respiratory muscle stretching increases the functional exercise capacity with decreased dyspnea in patients with COPD. These effects are associated with an increased efficacy of the respiratory muscles and participation of the ABD compartment. PMID:27822031

The Effect of Exercise on Breast Cancer-Related Lymphedema: What the Lymphatic Surgeon Needs to Know.

PubMed

Panchik, Daniel; Masco, Sarah; Zinnikas, Patrice; Hillriegel, Brooke; Lauder, Tori; Suttmann, Erica; Chinchilli, Vernon; McBeth, Maureen; Hermann, William

2018-06-23

 Breast cancer-related lymphedema (BCRL) affects many areas of daily living. Individuals with lymphedema may experience chronic and progressive swelling, recurrent skin infections, and decreased self-image and quality of life. For many years, it was considered best practice for this population to avoid exercise; however, in recent years, research has begun to challenge this belief. This systematic review and meta-analyses examined the recent literature on the effects of exercise for patients with, or at risk for, BCRL to inform best practice.  A total of 807 articles were retrieved from CINAHL, Academic Search Complete, Medline, and PubMed. Results were systematically filtered to 26 articles through inclusion criteria, exclusion criteria, and the Effective Public Health Practice Project quality assessment tool for quantitative studies. Data were pooled from studies containing relative and absolute volume measurements of limb volume, as well as upper extremity function measured by the Disabilities of Arm, Shoulder, and Hand (DASH) questionnaire; meta-analyses were conducted using SAS software.  The literature was reviewed and statistically analyzed. Results have indicated aerobic exercise, resistance exercise, stretching, yoga, qigong, and pilates can be safe and effective in the management of symptoms for those with, or at risk for, BCRL.  Several forms of exercise appear to be safe interventions for clinicians to use when treating this population and offer benefits such as improved quality of life, strength, body mass index, and mental health and decreased pain and lymphatic swelling. Additional research should be conducted to further examine the efficacy and safety of nontraditional forms of exercise in the treatment of BCRL. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

A model for nonexercising hindlimb muscles in exercising animals.

PubMed

Bonen, A; Blewett, C; McDermott, J C; Elder, G C

1990-07-01

Nonexercising muscles appear to be metabolically active during exercise. Animal models for this purpose have not been established. However, we have been able to teach animals to run on their forelimbs while their hindlimbs are suspended above the treadmill with no visible limb movement. To document that indeed this mode of exercise does not provoke additional muscle activity, we have compared the levels of neural activation of the soleus and plantaris muscles using a computer analysis of the electromyographic interference pattern, recorded from bipolar fine wire electrodes implanted across each muscle. Via computer analyses of the electromyographic interference patterns the frequencies and amplitudes of motor unit action potentials were obtained. The data were sampled during 20 s of every minute of observation. Comparisons were made in four conditions: (i) resting on the treadmill while bearing weight on the hindlimbs (normal rest), (ii) running on the treadmill (15 m/min, 8% grade) on all four limbs (normal exercise), (iii) resting while the hindlimbs were suspended in a harness above the treadmill (suspended rest), and (iv) exercising with the forelimbs (15 m/min, 8% grade) while the hindlimbs were suspended above the treadmill (suspended exercise). All four experimental conditions were carried out for 90 min each and were performed by each animal. The results clearly show that muscle activities (frequencies and amplitudes), when the hindlimbs are suspended above the treadmill, at rest or during exercise, are lower than the activities in these same muscles when the animals are at rest, supporting only their body weight. Activities in the same muscles during exercise were from 300 to 2000% greater than during hindlimb suspension.(ABSTRACT TRUNCATED AT 250 WORDS)

Effects of step length and step frequency on lower-limb muscle function in human gait.

PubMed

Lim, Yoong Ping; Lin, Yi-Chung; Pandy, Marcus G

2017-05-24

The aim of this study was to quantify the effects of step length and step frequency on lower-limb muscle function in walking. Three-dimensional gait data were used in conjunction with musculoskeletal modeling techniques to evaluate muscle function over a range of walking speeds using prescribed combinations of step length and step frequency. The body was modeled as a 10-segment, 21-degree-of-freedom skeleton actuated by 54 muscle-tendon units. Lower-limb muscle forces were calculated using inverse dynamics and static optimization. We found that five muscles - GMAX, GMED, VAS, GAS, and SOL - dominated vertical support and forward progression independent of changes made to either step length or step frequency, and that, overall, changes in step length had a greater influence on lower-limb joint motion, net joint moments and muscle function than step frequency. Peak forces developed by the uniarticular hip and knee extensors, as well as the normalized fiber lengths at which these muscles developed their peak forces, correlated more closely with changes in step length than step frequency. Increasing step length resulted in larger contributions from the hip and knee extensors and smaller contributions from gravitational forces (limb posture) to vertical support. These results provide insight into why older people with weak hip and knee extensors walk more slowly by reducing step length rather than step frequency and also help to identify the key muscle groups that ought to be targeted in exercise programs designed to improve gait biomechanics in older adults. Copyright © 2017 Elsevier Ltd. All rights reserved.

Effectiveness of a balance training home exercise programme for adults with haemophilia: a pilot study.

PubMed

Hill, K; Fearn, M; Williams, S; Mudge, L; Walsh, C; McCarthy, P; Walsh, M; Street, A

2010-01-01

Adults with haemophilia and other bleeding disorders often develop lower limb musculoskeletal problems associated with bleeds into joints and muscles, which may affect balance performance and increase likelihood of falling. The aim of this study was to evaluate the effectiveness of an individualized balance and strength home exercise programme on improving balance and related outcomes for adults with haemophilia and other bleeding disorders. Twenty male adults with haemophilia and other bleeding disorders (mean age 39.4 years, 95% CI = 33.7-45.1) were recruited to participate. They underwent a comprehensive clinical and force platform assessment of balance and related measures. Based on assessment findings, the assessing physiotherapist provided an individualized home exercise programme of balance, strengthening and walking exercises. Re-assessment occurred after the 4-month exercise programme. Twelve participants (60%) completed the programme and were re-assessed. There were no safety problems or dropouts associated with the exercise programme aggravating joint status. Although there were no statistically significant changes in any of the measures (adjusted for multiple comparisons), there were improvements of between 5% and 22% on 10 of the 16 measures, with the Neurocom modified Clinical Test of Sensory Interaction on Balance (P = 0.036) and Timed Sit to Stand (P = 0.064) approaching significance. A tailored home exercise programme targeting balance, strengthening and walking is feasible for adults with haemophilia and other bleeding disorders. These results suggest that positive physical outcomes including improved balance and mobility may be achieved with this type of programme.

Effects of Partial Vibration on Morphological Changes in Bone and Surrounding Muscle of Rats Under Microgravity Condition: Comparative Study by Gender

NASA Astrophysics Data System (ADS)

Park, Ji Hyung; Seo, Dong-Hyun; Cho, Seungkwan; Kim, Seo-Hyun; Eom, Sinae; Kim, Han Sung

2015-09-01

Musculoskeletal disorders during and after spaceflight are considered as a serious health issue. In space, weight-bearing exercise recognized as the main countermeasure to bone loss, since many anti-resorptive medications have not yet been approved for spaceflight or have been unsuccessful in their limited application. We need to investigate a complementary or alternative way to prevent bone loss and muscle atrophy resulting from microgravity condition. Partial vibration was chosen because it is one of the most feasible ways to adopt safely and effectively. Moreover, although the influence of hind-limb suspension has been studied in both male and female rodents, only rarely are both genders evaluated in the same study. Thus, to further extend our knowledge, the present study performed comparative analysis between genders. A total of 36 12-week-old male and female Sprague-Dawley rats were used and were randomly assigned to control (CON), hind-limb suspension without vibration stimulus (HS), and hind-limb suspension with vibration stimulus (HV) groups. Hind-limb suspension has led to increasing the rate of bone loss and muscle atrophy regardless of gender. The rates of bone loss in male group obviously increased than that of female group. All structural parameters were showed significant difference between HS and HV ( p < 0.05) in male group whereas there are no significant differences in female group. In female, the muscle volume with treatment of partial vibration stimulus significantly increased which compared with that of hind-limb suspension ( p < 0.05) whereas there are no significant differences in male group. Thus partial vibration could prevent bone loss of tibia in males and muscle atrophy in females induced by hind-limb suspension. In other words, partial vibration has positive effects on damaged musculoskeletal tissues that differ based on gender.

The effects of Tai-Chi in conjunction with thera-band resistance exercise on functional fitness and muscle strength among community-based older people.

PubMed

Lin, Shu-Fen; Sung, Huei-Chuan; Li, Tzai-Li; Hsieh, Tsung-Cheng; Lan, Hsiao-Chin; Perng, Shoa-Jen; Smith, Graeme D

2015-05-01

The aim of this study was to investigate the effects of Tai-Chi in conjunction with thera-band resistance exercise on functional fitness and muscle strength in community-based older people. Tai-Chi is known to improve functional fitness in older people. Tai-Chi is usually performed with free hands without resistance training and usually focuses on training lower limbs. To date, no study has examined the use of Tai-Chi in conjunction with thera-band resistance exercise in this population. Cluster randomised trial design. Older people at six senior day care centres in Taiwan were assigned to thera-band resistance exercise or control group using a cluster randomisation. The thera-band resistance exercise group (n = 48) received sixty minute thera-band resistance exercise twice weekly for a period of 16 weeks. The control group (n = 47) underwent routine activities in the day care centre, receiving no Tai-Chi or resistance exercise. After receiving the thera-band resistance exercise, intervention participants displayed a significant increase in muscle strength of upper and lower extremities. Significant improvements were recorded on most measures of the Senior Fitness Test, with the exception of the chair-stand and back-scratch test. Thera-band resistance exercise has the potential to improve functional fitness and muscle strength in community-based older people. Thera-band resistance exercise potentially offers a safe and appropriate form of physical activity that nursing staff can easily incorporate into the daily routine of older people in day care centres, potentially improving functional performance and muscle strength. © 2015 John Wiley & Sons Ltd.

Upper limb motor rehabilitation impacts white matter microstructure in multiple sclerosis.

PubMed

Bonzano, Laura; Tacchino, Andrea; Brichetto, Giampaolo; Roccatagliata, Luca; Dessypris, Adriano; Feraco, Paola; Lopes De Carvalho, Maria L; Battaglia, Mario A; Mancardi, Giovanni L; Bove, Marco

2014-04-15

Upper limb impairments can occur in patients with multiple sclerosis, affecting daily living activities; however there is at present no definite agreement on the best rehabilitation treatment strategy to pursue. Moreover, motor training has been shown to induce changes in white matter architecture in healthy subjects. This study aimed at evaluating the motor behavioral and white matter microstructural changes following a 2-month upper limb motor rehabilitation treatment based on task-oriented exercises in patients with multiple sclerosis. Thirty patients (18 females and 12 males; age=43.3 ± 8.7 years) in a stable phase of the disease presenting with mild or moderate upper limb sensorimotor deficits were randomized into two groups of 15 patients each. Both groups underwent twenty 1-hour treatment sessions, three times a week. The "treatment group" received an active motor rehabilitation treatment, based on voluntary exercises including task-oriented exercises, while the "control group" underwent passive mobilization of the shoulder, elbow, wrist and fingers. Before and after the rehabilitation protocols, motor performance was evaluated in all patients with standard tests. Additionally, finger motor performance accuracy was assessed by an engineered glove. In the same sessions, every patient underwent diffusion tensor imaging to obtain parametric maps of fractional anisotropy, mean diffusivity, axial diffusivity, and radial diffusivity. The mean value of each parameter was separately calculated within regions of interest including the fiber bundles connecting brain areas involved in voluntary movement control: the corpus callosum, the corticospinal tracts and the superior longitudinal fasciculi. The two rehabilitation protocols induced similar effects on unimanual motor performance, but the bimanual coordination task revealed that the residual coordination abilities were maintained in the treated patients while they significantly worsened in the control group (p=0.002). Further, in the treatment group white matter integrity in the corpus callosum and corticospinal tracts was preserved while a microstructural integrity worsening was found in the control group (fractional anisotropy of the corpus callosum and corticospinal tracts: p=0.033 and p=0.022; radial diffusivity of the corpus callosum and corticospinal tracts: p=0.004 and p=0.008). Conversely, a significant increase of radial diffusivity was observed in the superior longitudinal fasciculi in both groups (p=0.02), indicating lack of treatment effects on this structure, showing damage progression likely due to a demyelination process. All these findings indicate the importance of administering, when possible, a rehabilitation treatment consisting of voluntary movements. We also demonstrated that the beneficial effects of a rehabilitation treatment are task-dependent and selective in their target; this becomes crucial towards the implementation of tailored rehabilitative approaches. Copyright © 2013 The Authors. Published by Elsevier Inc. All rights reserved.

A progressive 5-week exercise therapy program leads to significant improvement in knee function early after anterior cruciate ligament injury.

PubMed

Eitzen, Ingrid; Moksnes, Håvard; Snyder-Mackler, Lynn; Risberg, May Arna

2010-11-01

Prospective cohort study without a control group. Firstly, to present our 5-week progressive exercise therapy program in the early stage after anterior cruciate ligament (ACL) injury. Secondly, to evaluate changes in knee function after completion of the program for patients with ACL injury in general and also when classified as potential copers or noncopers, and, finally, to examine potential adverse events. Few studies concerning early-stage ACL rehabilitation protocols exist. Consequently, little is known about the tolerance for, and outcomes from, short-term exercise therapy programs in the early stage after injury. One-hundred patients were included in a 5-week progressive exercise therapy program, within 3 months after injury. Knee function before and after completion of the program was evaluated from isokinetic quadriceps and hamstrings muscle strength tests, 4 single-leg hop tests, 2 different self-assessment questionnaires, and a global rating of knee function. A 2-way mixed-model analysis of variance was conducted to evaluate changes from pretest to posttest for the limb symmetry index for muscle strength and single-leg hop tests, and the change in scores for the patient-reported questionnaires. In addition, absolute values and the standardized response mean for muscle strength and single-leg hop tests were calculated at pretest and posttest for the injured and uninjured limb. Adverse events during the 5-week period were recorded. The progressive 5-week exercise therapy program led to significant improvements (P<.05) in knee function from pretest to posttest both for patients classified as potential copers and noncopers. Standardized response mean values for changes in muscle strength and single-leg hop performance from pretest to posttest for the injured limb were moderate to strong (0.49-0.84), indicating the observed improvements to be clinically relevant. Adverse events occurred in 3.9% of the patients. Short-term progressive exercise therapy programs are well tolerated and should be incorporated in early-stage ACL rehabilitation, either to improve knee function before ACL reconstruction or as a first step in further nonoperative management. Therapy, level 2b.

Effect of aqua exercise on recovery of lower limb muscles after downhill running.

PubMed

Takahashi, Junichiro; Ishihara, Keiji; Aoki, Junichiro

2006-08-01

The aim of the present study was to examine how the recovery of physiological functioning of the leg muscles after high-intensity eccentric exercise such as downhill running could be promoted by aqua exercise for a period until the damaged muscle had recovered almost completely. Ten male long-distance runners were divided equally into an aqua exercise group and a control group. From the first day (Day 0) to the fourth day (Day 3), the participants completed a questionnaire on muscle soreness, and serum creatine kinase activity, muscle power, flexibility, whole-body reaction time and muscle stiffness were measured. After measurements on Day 0, the participants performed downhill running (three 5 min runs with a 5 min rest interval at -10%, 335.7 +/- 6.1 m . min-1). The aqua exercise group performed walking, jogging and jumping in water on three successive days following the downhill running on Day 0 for 30 min each day. Muscle power was reduced on Day 1 in the control group (P < 0.05). Muscle soreness in the calf on Day 3 was greater in the control group than that in the aqua exercise group (P < 0.05). In the aqua exercise group, muscle stiffness in the calf was less than that in the control group over 4 days (time main effect: P < 0.05; group x time interaction: P < 0.05). We conclude that aqua exercise promoted physiological functioning of the muscles in the legs after high-intensity downhill running for a period until the damaged muscles had recovered almost completely.

Exercise-induced muscle damage and the repeated bout effect: evidence for cross transfer.

PubMed

Starbuck, Chelsea; Eston, Roger G

2012-03-01

We examined whether a prior bout of eccentric exercise in the elbow flexors provided protection against exercise-induced muscle damage in the contralateral arm. Fifteen males (age 22.7 ± 2.1 years; height 178.6 ± 6.8 cm, mass 75.8 ± 9.3 kg) were randomly assigned to two groups who performed two bouts of 60 eccentric contractions (30°/s) separated by 2 weeks: ipsilateral (n = 7, both bouts performed in the same arm), contralateral (n = 8, one bout performed in each arm). Strength, muscle soreness and resting arm angle (RAA) were measured at baseline and at 1, 24 and 48 h post exercise. Surface electromyography was recorded during both bouts of exercise. The degree of strength loss was attenuated (p < 0.05) in the ipsilateral group after the second bout of eccentric exercise (-22 cf. -3% for bout 1 and 2 at 24 h, respectively). Strength loss following eccentric exercise was also attenuated (p < 0.05) at 24 h in the contralateral group (-30 cf. 13% for bout 1 and 2, respectively). Muscle soreness (≈34 cf 19 mm) and change in RAA (≈5 cf. 3%) were also lower following the second bout of eccentric exercise (p < 0.05), although there was no difference in the overall change in these values between groups. Median frequency (MF) was decreased by 31% between bouts, with no difference between groups. Data support observations that the repeated bout effect transfers to the opposite (untrained) limb. The similar reduction in MF between bouts for the two groups provides evidence for a centrally mediated, neural adaptation.

Skill transfer from symmetric and asymmetric bimanual training using a robotic system to single limb performance

PubMed Central

2012-01-01

Background Humans are capable of fast adaptation to new unknown dynamics that affect their movements. Such motor learning is also believed to be an important part of motor rehabilitation. Bimanual training can improve post-stroke rehabilitation outcome and is associated with interlimb coordination between both limbs. Some studies indicate partial transfer of skills among limbs of healthy individuals. Another aspect of bimanual training is the (a)symmetry of bimanual movements and how these affect motor learning and possibly post-stroke rehabilitation. Methods A novel bimanual 2-DOF robotic system was used for both bimanual and unimanual reaching movements. 35 young healthy adults participated in the study. They were divided into 5 test groups that performed movements under different conditions (bimanual or unimanual movements and symmetric or asymmetric bimanual arm loads). The subjects performed a simple tracking exercise with the bimanual system. The exercise was developed to stimulate motor learning by applying a velocity-dependent disturbance torque to the handlebar. Each subject performed 255 trials divided into three phases: baseline without disturbance torque, training phase with disturbance torque and evaluation phase with disturbance torque. Results Performance was assessed with the maximal values of rotation errors of the handlebar. After exposure to disturbance torque, the errors decreased for both unimanual and bimanual training. Errors in unimanual evaluation following the bimanual training phase were not significantly different from errors in unimanual evaluation following unimanual training. There was no difference in performance following symmetric or asymmetric training. Changing the arm force symmetry during bimanual movements from asymmetric to symmetric had little influence on performance. Conclusions Subjects could adapt to an unknown disturbance torque that was changing the dynamics of the movements. The learning effect was present during both unimanual and bimanual training. Transfer of learned skills from bimanual training to unimanual movements was also observed, as bimanual training also improved single limb performance with the dominant arm. Changes of force symmetry did not have an effect on motor learning. As motor learning is believed to be an important mechanism of rehabilitation, our findings could be tested for future post-stroke rehabilitation systems. PMID:22805223

Neuromuscular dysfunction in type 2 diabetes: underlying mechanisms and effect of resistance training.

PubMed

Orlando, Giorgio; Balducci, Stefano; Bazzucchi, Ilenia; Pugliese, Giuseppe; Sacchetti, Massimo

2016-01-01

Diabetic patients are at higher risk of developing physical disabilities than non-diabetic subjects. Physical disability appears to be related, at least in part, to muscle dysfunction. Several studies have reported reduced muscle strength and power under dynamic and static conditions in both the upper and lower limbs of patients with type 2 diabetes. Additional effects of diabetes include a reduction in muscle mass, quality, endurance and an alteration in muscle fibre composition, though the available data on these parameters are conflicting. The impact of diabetes on neuromuscular function has been related to the co-existence of long-term complications. Peripheral neuropathy has been shown to affect muscle by impairing motor nerve conduction. Also, vascular complications may contribute to the decline in muscle strength. However, muscle dysfunction occurs early in the course of diabetes and affects also the upper limbs, thus suggesting that it may develop independently of micro and macrovascular disease. A growing body of evidence indicates that hyperglycaemia may cause an alteration of the intrinsic properties of the muscle to generate force, via several mechanisms. Recently, resistance exercise has been shown to be an effective strategy to counteract the deterioration of muscular performance. High-intensity exercise seems to provide greater benefits than moderate-intensity training, whereas the effect of a power training is yet unknown. This article reviews the available literature on the impairment of muscle function induced by diabetes, the underlying mechanisms, and the effect of resistance training on this defect. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

Dynamic Foot Pressure as a Countermeasure to Muscle Atrophy

NASA Astrophysics Data System (ADS)

Kyparos, A.; Layne, C. S.; Martinez, D. A.; Clarke, M. S. F.; Feeback, D. L.

2002-01-01

Mechanical unloading of skeletal muscle (SKM) as a consequence of space flight or ground-based analogues, such as human bedrest and rodent hindlimb suspension (HLS) models, induces SKM atrophy particularly affecting the anti-gravity musculature of the lower limbs. In the context of manned space flight, the subsequent loss of muscle strength and functionality will pose operational implications jeopardizing mission success. Exercise, currently the primary muscle degradation countermeasure, has not proven completely effective in preventing muscle atrophy. It is therefore imperative that some other forms of in- flight countermeasure be also developed to supplement the prescribed exercise regimen the astronauts follow during spaceflight. Previous work in both humans and rats has shown that mechanical stimulation of the soles of the feet increases neuromuscular activation in the lower limb musculature and that such stimulation results in the limited prevention of atrophy in the soleus muscle of unloaded rats. This study was designed to investigate the effect of cutaneous mechanoreceptor stimulation on hindlimb unloading- induced SKM atrophy in rats. It was hypothesized that mechanical stimulation of the plantar surface of the rat foot during hindlimb suspension (HLS), utilizing a novel stimulation paradigm known as Dynamic Foot Pressure (DFP), would attenuate unloading-induced SKM atrophy. Mature adult male Wistar rats were randomly assigned to four groups of 10 rats each as follows: sedentary controls (Ctrl), hindlimb suspended only (HLS), hindlimb suspended wearing an inflatable boot (HLS-IFL) and hindlimb suspended rats wearing a non-inflatable boot (HLS-NIFL). The stimulation of mechanoreceptors was achieved by applying pressure to the plantar surface of the foot during the 10-day period of HLS using a custom-built boot. The anti-atrophic effects of DFP application was quantified directly by morphological (muscle wet weight, myofiber cross-sectional area, neuromuscular junction size/density), histochemical (myofiber type distribution) and biochemical (myosin heavy chain-MHC isoform content, muscle collagen concentration and maturation) analysis techniques in the soleus, medial gastrocnemius, and tibialis anterior muscles. The results indicated that the application of DFP ameliorated hindlimb-induced SKM atrophy. It is postulated that this effect was achieved via proprioceptive pathways as a consequence of DFT mimicking the neuromuscular activity/contraction patterns normally induced by load bearing in specific anti-gravity muscles of the lower limbs in a terrestrial environment. The underlined concept promises to serve as the basis for developing a novel supplemental to exercise during space flight countermeasure as well as an effective rehabilitation technique for bed-ridden patients.

Profile of isokinetic eccentric-to-concentric strength ratios of shoulder rotator muscles in elite female team handball players.

PubMed

Andrade, Marilia Dos Santos; Fleury, Anna Maria; de Lira, Claudio Andre Barbosia; Dubas, Joao Paulo; da Silva, Antonio Carlos

2010-05-01

The purpose of this study was to establish the isokinetic profile of shoulder rotator muscles strength in female handball players. Twenty-seven handball players performed concentric and eccentric strength tests of both dominant and non-dominant upper limbs on an isokinetic dynamometer. Internal and external rotator muscles peak torque was assessed at 1.05, 3.14, and 5.23 rad . s(-1) in concentric mode and at 3.14 and 5.23 rad . s(-1) in eccentric mode. Concentric balance ratio and functional ratio were obtained. Bi-lateral deficiency was compared. Concentric strength for internal and external rotation was significantly greater for the dominant than for the non-dominant limb for all speeds (P < or = 0.0001). For eccentric actions, internal rotator muscles were stronger in the dominant than the non-dominant limb (P < or = 0.0001) at both speeds. Concentric balance and functional balance ratios did not differ between sides at 3.14 rad . s(-1) (P = 0.1631), but at 5.23 rad . s(-1) the functional balance ratio in the dominant limb was lower than for the non-dominant limb (P = 0.0500). Although the dominant side was stronger than the non-dominant side, balance concentric ratios remained the same, with only the functional strength ratio different at 5.23 rad . s(-1). Our results suggest that concentric strength exercises be used for internal and external rotators on the non-dominant side, and functional exercise that improves eccentric rotation strength for prevention programmes.

[Exercise in haemodyalisis patients: a literature systematic review].

PubMed

Segura-Ortí, Eva

2010-01-01

Exercise as a therapeutic tool used in End-stage renal disease patients (ESRD) in hemodialysis (HD) is not routinately applied, as it occurs with cardiac or respiratory patients. Lack of awareness of research in this field may contribute to the current situation. Thus, the aims of this review are: 1) to systematically review the literature of exercise training on adult HD patients or patients at a pre-HD stage; 2) to show the evidence on the benefits of exercise for counteracting physiological, functional and psychological impairments found even in older ESRD patients; 3) to recommend requirements of future research in order to include exercise prescription in the HD patients treatment. The Data bases reviewed from 2005 to 2009 were: MEDLINE (Ovid), CINAHL (EBSCOHost), SportDicus (EBSCOHost), Academic Search Complete (EBSCOHost), Fuente Académica (EBSCOHost), MedicLatina (EBSCOHost), PEDro y PubMed. Additionally, references from identified articles, several reviews on ESRD and abstracts to Nephrology Congresses were also reviewed. Randomized Controlled Trials on aerobic, strength and combined programs for HD patients were selected. Data from the studies was compiled and Van Tulder criteria were used for methodological quality assessment. Metanalysis included 6 studies on aerobic exercise, 2 on strength exercise and 5 on combined exercise programs. 640 patients were included in 16 included studies. Effects on physical function, health related quality of life and other secondary measurements were summarized by the Standardized Mean Difference (SMD) Moderate evidence exists on positive effects of aerobic training on peak oxygen consumption at the graded exercise test (SMD 6.55; CI 95%: 4.31-8.78). There is high evidence on positive effects of strength training on health related quality of life (SMD 11.03; CI 95%: 5.63-16.43). Finally, moderate evidence exists on positive effects of combined exercise on peak oxygen consumption at the graded exercise test (SMD 5.57; CI 95%: 2.52-8.61). Summarizing, moderate evidence exists on the improvement on exercise capacity of aerobic training, isolated or combined with strength training. Strength training improves health related quality of life, functional capacity and lower limbs strength. Future studies should clarify which out of the three modalities results in higher benefits for HD patients.

Treadmill walking with load carriage increases aortic pressure wave reflection.

PubMed

Ribeiro, Fernando; Oliveira, Nórton L; Pires, Joana; Alves, Alberto J; Oliveira, José

2014-01-01

The study examined the effects of treadmill walking with load carriage on derived measures of central pressure and augmentation index in young healthy subjects. Fourteen male subjects (age 31.0 ± 1.0 years) volunteered in this study. Subjects walked 10 minutes on a treadmill at a speed of 5 km/h carrying no load during one session and a load of 10% of their body weight on both upper limbs in two water carboys with handle during the other session. Pulse wave analysis was performed at rest and immediately after exercise in the radial artery of the right upper limb by applanation tonometry. The main result indicates that walking with load carriage sharply increased augmentation index at 75 bpm (-5.5 ± 2.2 to -1.4 ± 2.2% vs. -5.2 ± 2.8 to -5.5 ± 2.1%, p<0.05), and also induced twice as high increments in central pulse pressure (7.4 ± 1.5 vs. 3.1 ± 1.4 mmHg, p<0.05) and peripheral (20.5 ± 2.7 vs. 10.3 ± 2.5 mmHg, p<0.05) and central systolic pressure (14.7 ± 2.1 vs. 7.4 ± 2.0 mmHg, p<0.05). Walking with additional load of 10% of their body weight (aerobic exercise accompanied by upper limb isometric contraction) increases derived measures of central pressure and augmentation index, an index of wave reflection and arterial stiffness. Copyright © 2013 Sociedade Portuguesa de Cardiologia. Published by Elsevier España. All rights reserved.

Typical balance exercises or exergames for balance improvement?

PubMed

Gioftsidou, Asimenia; Vernadakis, Nikolaos; Malliou, Paraskevi; Batzios, Stavros; Sofokleous, Polina; Antoniou, Panagiotis; Kouli, Olga; Tsapralis, Kyriakos; Godolias, George

2013-01-01

Balance training is an effective intervention to improve static postural sway and balance. The purpose of the present study was to investigate the effectiveness of the Nintendo Wii Fit Plus exercises for improving balance ability in healthy collegiate students in comparison with a typical balance training program. Forty students were randomly divided into two groups, a traditional (T group) and a Nintendo Wii group (W group) performed an 8 week balance program. The "W group" used the interactive games as a training method, while the "T group" used an exercise program with mini trampoline and inflatable discs (BOSU). Pre and Post-training participants completed balance assessments. Two-way repeated measures analyses of variance (ANOVAs) were conducted to determine the effect of training program. Analysis of the data illustrated that both training program groups demonstrated an improvement in Total, Anterior-posterior and Medial Lateral Stability Index scores for both limbs. Only at the test performed in the balance board with anterior-posterior motion, the improvement in balance ability was greater in the "T group" than the "W group", when the assessment was performed post-training (p=0.023). Findings support the effectiveness of using the Nintendo Wii gaming console as a balance training intervention tool.

Effects of functional stabilization training on pain, function, and lower extremity biomechanics in women with patellofemoral pain: a randomized clinical trial.

PubMed

Baldon, Rodrigo de Marche; Serrão, Fábio Viadanna; Scattone Silva, Rodrigo; Piva, Sara Regina

2014-04-01

Randomized clinical trial. To compare the effects of functional stabilization training (FST) versus standard training on knee pain and function, lower-limb and trunk kinematics, trunk muscle endurance, and eccentric hip and knee muscle strength in women with patellofemoral pain. A combination of hip- and knee-strengthening exercise may be more beneficial than quadriceps strengthening alone to improve pain and function in individuals with patellofemoral pain. However, there is limited evidence of the effectiveness of these exercise programs on the biomechanics of the lower extremity. Thirty-one women were randomized to either the FST group or standard-training group. Patients attended a baseline assessment session, followed by an 8-week intervention, and were reassessed at the end of the intervention and at 3 months after the intervention. Assessment measures were a 10-cm visual analog scale for pain, the Lower Extremity Functional Scale, and the single-leg triple-hop test. A global rating of change scale was used to measure perceived improvement. Kinematics were assessed during the single-leg squat. Outcome measures also included trunk endurance and eccentric hip and knee muscle strength assessment. The patients in the FST group had less pain at the 3-month follow-up and greater global improvement and physical function at the end of the intervention compared to those in the standard-training group. Lesser ipsilateral trunk inclination, pelvis contralateral depression, hip adduction, and knee abduction, along with greater pelvis anteversion and hip flexion movement excursions during the single-leg squat, were only observed in the FST group after the intervention. Only those in the FST group had greater eccentric hip abductor and knee flexor strength, as well as greater endurance of the anterior, posterior, and lateral trunk muscles, after training. An intervention program consisting of hip muscle strengthening and lower-limb and trunk movement control exercises was more beneficial in improving pain, physical function, kinematics, and muscle strength compared to a program of quadriceps-strengthening exercises alone.

Manual Lymphatic Drainage and Active Exercise Effects on Lymphatic Function Do Not Translate Into Morbidities in Women Who Underwent Breast Cancer Surgery.

PubMed

Freire de Oliveira, Mariana Maia; Costa Gurgel, Maria Salete; Pace do Amaral, Maria Teresa; Amorim, Bárbara Juarez; Ramos, Celso Darío; Almeida Filho, José Geraldo; de Rezende, Laura Ferreira; Zanatta Sarian, Luís Otávio

2017-02-01

To evaluate manual lymphatic drainage (MLD) and active exercise effects on lymphatic alterations of the upper limb (UL), range of motion (ROM) of shoulder, and scar complications after breast cancer surgery. Clinical trial. Health care center. Women (N=105) undergoing radical breast cancer surgery who were matched for staging, age, and body mass index. Women (n=52) were submitted to MLD and 53 to active exercises for UL for 1 month and followed up. Shoulder ROM, surgical wound inspection and palpation, UL circumference measurements, and lymphoscintigraphy were performed in preoperative and postoperative periods. There was no significant difference between groups with regard to wound healing complications, ROM, and UL circumferences. After surgery, 25 (48.1%) of the MLD group and 19 (35.8%) of the active exercise group showed worsening in radiopharmaceutical uptake velocity, whereas 9 (17.3%) of the MLD group and 11 (20.8%) of the active exercise group showed improved velocity (P=.445). With regard to uptake intensity, 27 (51.9%) of the MLD group and 21 (39.6%) of the active exercise group showed worsening whereas 7 (13.5%) of the MLD group and 7 (13.2%) of the active exercise group showed some improvement (P=.391). The presence of collateral circulation was similar in both groups at both time points evaluated. The active exercise group had a significant increase in postoperative liver absorption (P=.005), and the MLD group had a significant increase in postoperative dermal backflow (P=.024). MLD and active exercise effects are equivalent with regard to morbidity. Minor changes in lymphatic function associated with either MLD or active exercises were not related to patients' symptoms or signs. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Acute achilles tendon repair: strength outcomes after an acute bout of exercise in recreational athletes.

PubMed

Porter, David A; Barnes, Adam F; Rund, Angela M; Kaz, Ari J; Tyndall, James A; Millis, Andrew A

2014-02-01

This is the first study to evaluate the effect of an acute bout of exercise on strength evaluation after Achilles tendon (AT) rupture and repair. Forty patients sustained an acute AT injury and met inclusion criteria for this study. At a minimum of 12 months after operative repair, patients were measured for (1) calf circumference, (2) bilateral isokinetic strength on a Cybex dynamometer before and after 30 minutes of walking at 70% maximal exertion, and (3) subjective evaluation by AAOS lower limb core and foot and ankle modules. Follow-up occurred at a mean of 32.4 ± 20.7 (range, 12-80) months after surgery, and patients were on average 44.4 ± 8.6 (range, 20-62) years old. One-tailed Student's paired t tests analyzed significance for strength and fatigue between the involved and uninvolved ankle (P < .05). The calf circumference of the involved ankle was significantly smaller than the uninvolved ankle by 1.9 cm, or 4.7%. Plantarflexion deficits of the involved ankle ranged from 12% to 18% for peak torque (P < .0001) and from 17% to 25% for work per repetition (P < .0001), but both ankles fatigued at equal proportions as measured after exercise. Dorsiflexion strength of the involved ankle increased 6% to 11% for peak torque (P = .070) and 1% to 25% for peak work (P = .386). Reported AAOS lower limb core and foot and ankle scores averaged 99.8 and 96.0, respectively. After an AT rupture with repair, patients had less plantarflexion strength, and equal dorsiflexion strength in the operative leg compared to the uninvolved, normal leg. However, subjective results indicated near normal pain and function despite mild plantarflexion strength deficits. Dorsiflexion strength was normal after repair and remained normal even after an acute bout of exercise. Plantarflexion strength ratios postexercise remained similar to pre-exercise after acute exercise bouts. Athletes reported a "flat tire" feeling while running, which suggests a probable gait adjustment as cause for long-term plantarflexion strength deficits. Level III, cohort study.

Hybrid diffuse optical techniques for continuous hemodynamic measurement in gastrocnemius during plantar flexion exercise

NASA Astrophysics Data System (ADS)

Henry, Brad; Zhao, Mingjun; Shang, Yu; Uhl, Timothy; Thomas, D. Travis; Xenos, Eleftherios S.; Saha, Sibu P.; Yu, Guoqiang

2015-12-01

Occlusion calibrations and gating techniques have been recently applied by our laboratory for continuous and absolute diffuse optical measurements of forearm muscle hemodynamics during handgrip exercises. The translation of these techniques from the forearm to the lower limb is the goal of this study as various diseases preferentially affect muscles in the lower extremity. This study adapted a hybrid near-infrared spectroscopy and diffuse correlation spectroscopy system with a gating algorithm to continuously quantify hemodynamic responses of medial gastrocnemius during plantar flexion exercises in 10 healthy subjects. The outcomes from optical measurement include oxy-, deoxy-, and total hemoglobin concentrations, blood oxygen saturation, and relative changes in blood flow (rBF) and oxygen consumption rate (rV˙O2). We calibrated rBF and rV˙O2 profiles with absolute baseline values of BF and V˙O2 obtained by venous and arterial occlusions, respectively. Results from this investigation were comparable to values from similar studies. Additionally, significant correlation was observed between resting local muscle BF measured by the optical technique and whole limb BF measured concurrently by a strain gauge venous plethysmography. The extensive hemodynamic and metabolic profiles during exercise will allow for future comparison studies to investigate the diagnostic value of hybrid technologies in muscles affected by disease.

The impact of clinical, psychological, behavioral, social, and environmental factors on self-perceived symptom severity in a male cohort with intermittent claudication.

PubMed

Sharath, Sherene E; Kougias, Panos; Pisimisis, George; Barshes, Neal R

2016-05-01

To understand the relationship between self-perceived severity of intermittent claudication and various associated nonclinical factors, we examined how correlates in domains of physical activity (ie, clinical, psychological, behavioral, social, and environmental factors) relate to exertional limb symptoms. A survey was administered to individuals with intermittent claudication during their initial outpatient assessment. The subjects' self-reported exertional limb symptom severity and classic-versus-atypical claudication classification was based on the Walking Impairment Questionnaire (WIQ) and San Diego Claudication Questionnaire (SDCQ), respectively. We evaluated psychosocial and environmental factors, osteoarthritis symptoms, health, behaviors, and beliefs. Logistic and linear regressions identified factors with a strong independent association with total WIQ scores and the SDCQs. A cohort of 102 subjects (99.0% male) was enrolled in the study. The median age was 65 years with a median ankle-brachial index of 0.69. Forty-three subjects (43%) had "typical" claudication per SDCQs. Individuals with atypical claudication were more likely to report higher Aberdeen Clinical Back Pain Questionnaire scores (odds ratio, 1.04; P = .04) and no depressive symptoms (odds ratio, 8.30; P = .03). Exertional limb symptom severity among the entire cohort was significantly associated with increasing osteoarthritis symptoms (P <.001), age (P = .02), a reserved personality (P = .008), and the belief that an exercise regimen would not improve symptoms (P = .005), self-perceived levels of boredom (P = .002), and the belief that exercise (P = .002) was the best way to improve symptoms were associated with decreased symptom severity. When restricted to those with atypical pain, significant factors associated with increasing exertional symptom severity included age greater than 60 years (P = .005), osteoarthritis (P = .02), alcohol use (P = .01), belief that exercise would not improve walking (P = .03), and difficulty walking around the neighborhood (P = .02). When restricted to those with classic claudication, significant factors associated with increasing exertional limb symptom severity included frequent pain or aching in the calves while walking or sitting (P = .03 [walking]; P = .01 [sitting]) and occasional morning joint stiffness (P = .007). Exertional limb symptom severity was also associated with high limitations at home (P = .003) and a belief that exercise would not improve walking (P = .005) among those with classic claudication. Symptom severity and type of pain are associated with a number of nonclinical factors. A multidomain approach, as indicated by the models above, would benefit the continuum of care for intermittent claudication, where management is integrated and coordinated among multiple lines of care. Published by Elsevier Inc.

The effect of military load carriage on 3-D lower limb kinematics and spatiotemporal parameters.

PubMed

Birrell, Stewart A; Haslam, Roger A

2009-10-01

The 3-D gait analysis of military load carriage is not well represented, if at all, within the available literature. This study collected 3-D lower limb kinematics and spatiotemporal parameters in order to assess the subsequent impact of carrying loads in a backpack of up to 32 kg. Results showed the addition of load significantly decreased the range of motion of flexion/extension of the knee and pelvic rotation. Also seen were increases in adduction/abduction and rotation of the hip and pelvis tilt. No changes to ankle kinematics were observed. Alterations to the spatiotemporal parameters of gait were also of considerable interest, namely, an increase in double support and a decrease in preferred stride length as carried load increased. Analysing kinematics during military or recreational load carriage broadens the knowledge regarding the development of exercise-related injuries, while helping to inform the human-centred design process for future load carrying systems. The importance of this study is that limited available research has investigated 3-D lower limb joint kinematics when carrying loads.

Strength training improves the tri-digit finger-pinch force control of older adults.

PubMed

Keogh, Justin W; Morrison, Steve; Barrett, Rod

2007-08-01

To investigate the effect of unilateral upper-limb strength training on the finger-pinch force control of older men. Pretest and post-test 6-week intervention study. Exercise science research laboratory. Eleven neurologically fit older men (age range, 70-80y). The strength training group (n=7) trained twice a week for 6 weeks, performing dumbbell bicep curls, wrist flexions, and wrists extensions, while the control group subjects (n=4) maintained their normal activities. Changes in force variability, targeting error, peak power frequency, proportional power, sample entropy, digit force sharing, and coupling relations were assessed during a series of finger-pinch tasks. These tasks involved maintaining a constant or sinusoidal force output at 20% and 40% of each subject's maximum voluntary contraction. All participants performed the finger-pinch tasks with both the preferred and nonpreferred limbs. Analysis of covariance for between-group change scores indicated that the strength training group (trained limb) experienced significantly greater reductions in finger-pinch force variability and targeting error, as well as significantly greater increases in finger-pinch force, sample entropy, bicep curl, and wrist flexion strength than did the control group. A nonspecific upper-limb strength-training program may improve the finger-pinch force control of older men.

Advances in upper limb stroke rehabilitation: a technology push.

PubMed

Loureiro, Rui C V; Harwin, William S; Nagai, Kiyoshi; Johnson, Michelle

2011-10-01

Strokes affect thousands of people worldwide leaving sufferers with severe disabilities affecting their daily activities. In recent years, new rehabilitation techniques have emerged such as constraint-induced therapy, biofeedback therapy and robot-aided therapy. In particular, robotic techniques allow precise recording of movements and application of forces to the affected limb, making it a valuable tool for motor rehabilitation. In addition, robot-aided therapy can utilise visual cues conveyed on a computer screen to convert repetitive movement practice into an engaging task such as a game. Visual cues can also be used to control the information sent to the patient about exercise performance and to potentially address psychosomatic variables influencing therapy. This paper overviews the current state-of-the-art on upper limb robot-mediated therapy with a focal point on the technical requirements of robotic therapy devices leading to the development of upper limb rehabilitation techniques that facilitate reach-to-touch, fine motor control, whole-arm movements and promote rehabilitation beyond hospital stay. The reviewed literature suggest that while there is evidence supporting the use of this technology to reduce functional impairment, besides the technological push, the challenge ahead lies on provision of effective assessment of outcome and modalities that have a stronger impact transferring functional gains into functional independence.

A multicentre, pragmatic, parallel group, randomised controlled trial to compare the clinical and cost-effectiveness of three physiotherapy-led exercise interventions for knee osteoarthritis in older adults: the BEEP trial protocol (ISRCTN: 93634563)

PubMed Central

2014-01-01

Background Exercise is consistently recommended for older adults with knee pain related to osteoarthritis. However, the effects from exercise are typically small and short-term, likely linked to insufficient individualisation of the exercise programme and limited attention to supporting exercise adherence over time. The BEEP randomised trial aims to improve patients’ short and long-term outcomes from exercise. It will test the overall effectiveness and cost-effectiveness of two physiotherapy-led exercise interventions (Individually Tailored Exercise and Targeted Exercise Adherence) to improve the individual tailoring of, and adherence to exercise, compared with usual physiotherapy care. Methods/design Based on the learning from a pilot study (ISRCTN 23294263), the BEEP trial is a multi-centre, pragmatic, parallel group, individually randomised controlled trial, with embedded longitudinal qualitative interviews. 500 adults in primary care, aged 45 years and over with knee pain will be randomised to 1 of 3 treatment groups delivered by fully trained physiotherapists in up to 6 NHS services. These are: Usual Physiotherapy Care (control group consisting of up to 4 treatment sessions of advice and exercise), Individually Tailored Exercise (an individualised, supervised and progressed lower-limb exercise programme) or Targeted Exercise Adherence (supporting patients to adhere to exercise and to engage in general physical activity over the longer-term). The primary outcomes are pain and function as measured by the Western Ontario and McMaster Osteoarthritis index. A comprehensive range of secondary outcomes are also included. Outcomes are measured at 3, 6 (primary outcome time-point), 9, 18 and 36 months. Data on adverse events will also be collected. Semi-structured, qualitative interviews with a subsample of 30 participants (10 from each treatment group) will be undertaken at two time-points (end of treatment and 12 to 18 months later) and analysed thematically. Discussion This trial will contribute to the evidence base for management of older adults with knee pain attributable to osteoarthritis in primary care. The findings will have important implications for healthcare commissioners, general practitioners and physiotherapy service providers and it will inform future education of healthcare practitioners. It may also serve to delay or prevent some individuals from becoming surgical candidates. Trial registration ISRCTN: ISRCTN93634563. PMID:25064573

A multicentre, pragmatic, parallel group, randomised controlled trial to compare the clinical and cost-effectiveness of three physiotherapy-led exercise interventions for knee osteoarthritis in older adults: the BEEP trial protocol (ISRCTN: 93634563).

PubMed

Foster, Nadine E; Healey, Emma L; Holden, Melanie A; Nicholls, Elaine; Whitehurst, David Gt; Jowett, Susan; Jinks, Clare; Roddy, Edward; Hay, Elaine M

2014-07-27

Exercise is consistently recommended for older adults with knee pain related to osteoarthritis. However, the effects from exercise are typically small and short-term, likely linked to insufficient individualisation of the exercise programme and limited attention to supporting exercise adherence over time. The BEEP randomised trial aims to improve patients' short and long-term outcomes from exercise. It will test the overall effectiveness and cost-effectiveness of two physiotherapy-led exercise interventions (Individually Tailored Exercise and Targeted Exercise Adherence) to improve the individual tailoring of, and adherence to exercise, compared with usual physiotherapy care. Based on the learning from a pilot study (ISRCTN 23294263), the BEEP trial is a multi-centre, pragmatic, parallel group, individually randomised controlled trial, with embedded longitudinal qualitative interviews. 500 adults in primary care, aged 45 years and over with knee pain will be randomised to 1 of 3 treatment groups delivered by fully trained physiotherapists in up to 6 NHS services. These are: Usual Physiotherapy Care (control group consisting of up to 4 treatment sessions of advice and exercise), Individually Tailored Exercise (an individualised, supervised and progressed lower-limb exercise programme) or Targeted Exercise Adherence (supporting patients to adhere to exercise and to engage in general physical activity over the longer-term). The primary outcomes are pain and function as measured by the Western Ontario and McMaster Osteoarthritis index. A comprehensive range of secondary outcomes are also included. Outcomes are measured at 3, 6 (primary outcome time-point), 9, 18 and 36 months. Data on adverse events will also be collected. Semi-structured, qualitative interviews with a subsample of 30 participants (10 from each treatment group) will be undertaken at two time-points (end of treatment and 12 to 18 months later) and analysed thematically. This trial will contribute to the evidence base for management of older adults with knee pain attributable to osteoarthritis in primary care. The findings will have important implications for healthcare commissioners, general practitioners and physiotherapy service providers and it will inform future education of healthcare practitioners. It may also serve to delay or prevent some individuals from becoming surgical candidates. ISRCTN93634563.

Electromyography-controlled exoskeletal upper-limb-powered orthosis for exercise training after stroke.

PubMed

Stein, Joel; Narendran, Kailas; McBean, John; Krebs, Kathryn; Hughes, Richard

2007-04-01

Robot-assisted exercise shows promise as a means of providing exercise therapy for weakness that results from stroke or other neurological conditions. Exoskeletal or "wearable" robots can, in principle, provide therapeutic exercise and/or function as powered orthoses to help compensate for chronic weakness. We describe a novel electromyography (EMG)-controlled exoskeletal robotic brace for the elbow (the active joint brace) and the results of a pilot study conducted using this brace for exercise training in individuals with chronic hemiparesis after stroke. Eight stroke survivors with severe chronic hemiparesis were enrolled in this pilot study. One subject withdrew from the study because of scheduling conflicts. A second subject was unable to participate in the training protocol because of insufficient surface EMG activity to control the active joint brace. The six remaining subjects each underwent 18 hrs of exercise training using the device for a period of 6 wks. Outcome measures included the upper-extremity component of the Fugl-Meyer scale and the modified Ashworth scale of muscle hypertonicity. Analysis revealed that the mean upper-extremity component of the Fugl-Meyer scale increased from 15.5 (SD 3.88) to 19 (SD 3.95) (P = 0.04) at the conclusion of training for the six subjects who completed training. Combined (summated) modified Ashworth scale for the elbow flexors and extensors improved from 4.67 (+/-1.2 SD) to 2.33 (+/-0.653 SD) (P = 0.009) and improved for the entire upper limb as well. All subjects tolerated the device, and no complications occurred. EMG-controlled powered elbow orthoses can be successfully controlled by severely impaired hemiparetic stroke survivors. This technique shows promise as a new modality for assisted exercise training after stroke.

Skeletal Structural Consequences of Reduced Gravity Environments

NASA Technical Reports Server (NTRS)

Ruff, Christropher B.

1999-01-01

The overall goal of this project is to provide structurally meaningful data on bone loss after exposure to reduced gravity environments so that more precise estimates of fracture risk and the effectiveness of countermeasures in reducing fracture risk can be developed. The project has three major components: (1) measure structural changes in the limb bones of rats subjected to complete and partial nonweightbearing, with and without treatment with ibandronate and periodic full weightbearing; (2) measure structural changes in the limb bones of human bedrest subjects, with and without treatment with alendronate and resistive exercise, and Russian cosmonauts flying on the Mir Space Station; and (3) validate and extend the 2-dimensional structural analyses currently possible in the second project component (bedrest and Mir subjects) using 3-dimensional finite element modeling techniques, and determine actual fracture-producing loads on earth and in space.

Effects of 14 days of head-down tilt bed rest on cutaneous vasoconstrictor responses in humans

NASA Technical Reports Server (NTRS)

Wilson, Thad E.; Shibasaki, Manabu; Cui, Jian; Levine, Benjamin D.; Crandall, Craig G.

2003-01-01

This study tested the hypothesis that head-down tilt bed rest (HDBR) reduces adrenergic and nonadrenergic cutaneous vasoconstrictor responsiveness. Additionally, an exercise countermeasure group was included to identify whether exercise during bed rest might counteract any vasoconstrictor deficits that arose during HDBR. Twenty-two subjects underwent 14 days of strict 6 degrees HDBR. Eight of these 22 subjects did not exercise during HDBR, while 14 of these subjects exercised on a supine cycle ergometer for 90 min a day at 75% of pre-bed rest heart rate maximum. To assess alpha-adrenergic vasoconstrictor responsiveness, intradermal microdialysis was used to locally administer norepinephrine (NE), while forearm skin blood flow (SkBF; laser-Doppler flowmetry) was monitored over microdialysis membranes. Nonlinear regression modeling was used to identify the effective drug concentration that caused 50% of the cutaneous vasoconstrictor response (EC(50)) and minimum values from the SkBF-NE dose-response curves. In addition, the effects of HDBR on nonadrenergic cutaneous vasoconstriction were assessed via the venoarteriolar response of the forearm and leg. HDBR did not alter EC(50) or the magnitude of cutaneous vasoconstriction to exogenous NE administration regardless of whether the subjects exercised during HDBR. Moreover, HDBR did not alter the forearm venoarteriolar response in either the control or exercise groups during HDBR. However, HDBR significantly reduced the magnitude of cutaneous vasoconstriction due to the venoarteriolar response in the leg, and this response was similarly reduced in the exercise group. These data suggest that HDBR does not alter cutaneous vasoconstrictor responses to exogenous NE administration, whereas cutaneous vasoconstriction of the leg due to the venoarteriolar response is reduced after HDBR. It remains unclear whether attenuated venoarteriolar responses in the lower limbs contribute to reduced orthostatic tolerance after bed rest and spaceflight.

The Effect of Water Temperature during Cold-Water Immersion on Recovery from Exercise-Induced Muscle Damage.

PubMed

Vieira, A; Siqueira, A F; Ferreira-Junior, J B; do Carmo, J; Durigan, J L Q; Blazevich, A; Bottaro, M

2016-11-01

This study investigated the effects of 5 and 15°C cold-water immersion on recovery from exercise resulting in exercise-induced muscle damage. 42 college-aged men performed 5×20 drop-jumps and were randomly allocated into one of 3 groups: (1) 5°C; (2) 15°C; or (3) control. After exercise, individuals from the cold-water immersion groups had their lower limbs immerged in iced water for 20 min. Isometric knee extensor torque, countermovement jump, muscle soreness, and creatine kinase were measured before, immediately after, 24, 48, 72, 96 and 168 h post-exercise. There was no between-group difference in isometric strength recovery (p=0.73). However, countermovement jump recovered quicker in cold-water immersion groups compared to control group (p<0.05). Countermovement jump returned to baseline after 72 h in 15°C, 5°C group recovered after 96 h and control did not recovered at any time point measured. Also, creatine kinase returned to baseline at 72 h and remained stable for all remaining measurements for 15°C group, whereas remained elevated past 168 h in both 5°C and control groups. There was a trend toward lower muscle soreness (p=0.06) in 15°C group compared to control at 24 h post-exercise. The result suggests that cold-water immersion promote recovery of stretch-shortening cycle performance, but not influence the recovery of maximal contractile force. Immersion at warmer temperature may be more effective than colder temperatures promoting recovery from strenuous exercise. © Georg Thieme Verlag KG Stuttgart · New York.

Efficacy of isokinetic exercise on functional capacity and pain in patellofemoral pain syndrome.

PubMed

Alaca, Ridvan; Yilmaz, Bilge; Goktepe, A Salim; Mohur, Haydar; Kalyon, Tunc Alp

2002-11-01

To assess the effect of an isokinetic exercise program on symptoms and functions of patients with patellofemoral pain syndrome. A total of 22 consecutive patients with the complaint of anterior knee pain who met the inclusion criteria were recruited to assess the efficacy of isokinetic exercise on functional capacity, isokinetic parameters, and pain scores in patients with patellofemoral pain syndrome. A total of 37 knees were examined. Six-meter hopping, three-step hopping, and single-limb hopping course tests were performed for each patient with the measurements of the Lysholm scale and visual analog scale. Tested parameters were peak torque, total work, average power, and endurance ratios. Statistical analyses revealed that at the end of the 6-wk treatment period, functional and isokinetic parameters improved significantly, as did pain scores. There was not statistically significant correlation between different groups of parameters. The isokinetic exercise treatment program used in this study prevented the extensor power loss due to patellofemoral pain syndrome, but the improvement in the functional capacity was not correlated with the gained power.

Strength of knee flexors of the paretic limb as an important determinant of functional status in post-stroke rehabilitation.

PubMed

Kostka, Joanna; Czernicki, Jan; Pruszyńska, Magdalena; Miller, Elżbieta

The purpose of the study was to assess the effectiveness of the multi-modal exercise program (MMEP) in patients after stroke, and to identify muscles that are the best predictors of functional performance and changes in functional status in a 3-week rehabilitation program. Thirty-one post-stroke patients (60.6±12.7 years) participating in a 3-week MMEP took part in the study. Measurements of extensor and flexor strength of the knee (F ext , F flex ) were done. Functional performance was measured using Timed Up & Go test (TUG), 6-Minute Walk Test (6-MWT) and Tinetti Test. The rehabilitation program improved all the results of functional tests, as well as the values of strength in the patients. Both baseline and post-rehabilitation functional status was associated with knee flexor and extensor muscle strength of paretic but not of non-paretic limbs. At baseline examination muscle strength difference between both F flex kg -1 and F ext kg -1 had an influence on functional status. After rehabilitation the effect of muscle strength difference on functional status was not evident for F ext kg -1 and, interestingly, even more prominent for F flex kg -1 . MMEP can effectively increase muscle strength and functional capacity in post-stroke patients. Knee flexor muscle strength of the paretic limb and the knee flexor difference between the limbs is the best predictor of functional performance in stroke survivors. Copyright © 2017 Polish Neurological Society. Published by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

Robot-supported upper limb training in a virtual learning environment : a pilot randomized controlled trial in persons with MS.

PubMed

Feys, Peter; Coninx, Karin; Kerkhofs, Lore; De Weyer, Tom; Truyens, Veronik; Maris, Anneleen; Lamers, Ilse

2015-07-23

Despite the functional impact of upper limb dysfunction in multiple sclerosis (MS), effects of intensive exercise programs and specifically robot-supported training have been rarely investigated in persons with advanced MS. To investigate the effects of additional robot-supported upper limb training in persons with MS compared to conventional treatment only. Seventeen persons with MS (pwMS) (median Expanded Disability Status Scale of 8, range 3.5-8.5) were included in a pilot RCT comparing the effects of additional robot-supported training to conventional treatment only. Additional training consisted of 3 weekly sessions of 30 min interacting with the HapticMaster robot within an individualised virtual learning environment (I-TRAVLE). Clinical measures at body function (Hand grip strength, Motricity Index, Fugl-Meyer) and activity (Action Research Arm test, Motor Activity Log) level were administered before and after an intervention period of 8 weeks. The intervention group were also evaluated on robot-mediated movement tasks in three dimensions, providing active range of motion, movement duration and speed and hand-path ratio as indication of movement efficiency in the spatial domain. Non-parametric statistics were applied. PwMS commented favourably on the robot-supported virtual learning environment and reported functional training effects in daily life. Movement tasks in three dimensions, measured with the robot, were performed in less time and for the transporting and reaching movement tasks more efficiently. There were however no significant changes for any clinical measure in neither intervention nor control group although observational analyses of the included cases indicated large improvements on the Fugl-Meyer in persons with more marked upper limb dysfunction. Robot-supported training lead to more efficient movement execution which was however, on group level, not reflected by significant changes on standard clinical tests. Persons with more marked upper limb dysfunction may benefit most from additional robot-supported training, but larger studies are needed. This trial is registered within the registry Clinical Trials GOV ( NCT02257606 ).

Muscular activities during sling- and ground-based push-up exercise.

PubMed

Maeo, Sumiaki; Chou, Tatsuya; Yamamoto, Masayoshi; Kanehisa, Hiroaki

2014-03-28

This study aimed to clarify the characteristics of muscle activities during push-up exercises performed under sling condition by comparison with those performed under ground condition. We hypothesized that sling-based push-ups induce higher muscle activities than the ground-based push-ups, and its effects are more prominent in dynamic compared to static exercise owing to increased demands of stabilization. Twenty young males performed sling- and ground-based push-ups in each of static (maintaining the posture with the elbow joint angle at 90 deg) and dynamic (repeating push-ups at a rate of 45 per minute) exercises. Surface electromyograms (EMGs) of the pectoralis major, latissimus dorsi, triceps brachii, biceps brachii, rectus abdominis, external oblique, internal oblique, and erector spinae muscles were recorded during the exercises. The EMG data were normalized to those obtained during maximal voluntary contraction of each muscle (% EMGmax). In the static exercise, sling condition showed significantly higher % EMGmax values than the ground condition in the triceps brachii (+27%: relative to ground condition) and biceps brachii (+128%) as well as the three abdominal muscles (+15% to +27%). In the dynamic exercise, such condition-related differences were more prominent and those in the pectoralis major (+29%) in addition to the aforementioned five muscles (+19% to +144%) were significant. These results supported the hypothesis and indicate that sling-based push-up exercise can provide greater activation in upper limb and anterior trunk muscles than the ground-based push-up exercise.

Muscular activities during sling- and ground-based push-up exercise

PubMed Central

2014-01-01

Background This study aimed to clarify the characteristics of muscle activities during push-up exercises performed under sling condition by comparison with those performed under ground condition. We hypothesized that sling-based push-ups induce higher muscle activities than the ground-based push-ups, and its effects are more prominent in dynamic compared to static exercise owing to increased demands of stabilization. Findings Twenty young males performed sling- and ground-based push-ups in each of static (maintaining the posture with the elbow joint angle at 90 deg) and dynamic (repeating push-ups at a rate of 45 per minute) exercises. Surface electromyograms (EMGs) of the pectoralis major, latissimus dorsi, triceps brachii, biceps brachii, rectus abdominis, external oblique, internal oblique, and erector spinae muscles were recorded during the exercises. The EMG data were normalized to those obtained during maximal voluntary contraction of each muscle (% EMGmax). In the static exercise, sling condition showed significantly higher % EMGmax values than the ground condition in the triceps brachii (+27%: relative to ground condition) and biceps brachii (+128%) as well as the three abdominal muscles (+15% to +27%). In the dynamic exercise, such condition-related differences were more prominent and those in the pectoralis major (+29%) in addition to the aforementioned five muscles (+19% to +144%) were significant. Conclusion These results supported the hypothesis and indicate that sling-based push-up exercise can provide greater activation in upper limb and anterior trunk muscles than the ground-based push-up exercise. PMID:24678968

Design and preliminary evaluation of an exoskeleton for upper limb resistance training

NASA Astrophysics Data System (ADS)

Wu, Tzong-Ming; Chen, Dar-Zen

2012-06-01

Resistance training is a popular form of exercise recommended by national health organizations, such as the American College of Sports Medicine (ACSM) and the American Heart Association (AHA). This form of training is available for most populations. A compact design of upper limb exoskeleton mechanism for homebased resistance training using a spring-loaded upper limb exoskeleton with a three degree-of-freedom shoulder joint and a one degree-of-freedom elbow joint allows a patient or a healthy individual to move the upper limb with multiple joints in different planes. It can continuously increase the resistance by adjusting the spring length to train additional muscle groups and reduce the number of potential injuries to upper limb joints caused by the mass moment of inertia of the training equipment. The aim of this research is to perform a preliminary evaluation of the designed function by adopting an appropriate motion analysis system and experimental design to verify our prototype of the exoskeleton and determine the optimal configuration of the spring-loaded upper limb exoskeleton.

Psychosocial effects of workplace physical exercise among workers with chronic pain

PubMed Central

Andersen, Lars L.; Persson, Roger; Jakobsen, Markus D.; Sundstrup, Emil

2017-01-01

Abstract While workplace physical exercise can help manage musculoskeletal disorders, less is known about psychosocial effects of such interventions. This aim of this study was to investigate the effect of workplace physical exercise on psychosocial factors among workers with chronic musculoskeletal pain. The trial design was a 2-armed parallel-group randomized controlled trial with allocation concealment. A total of 66 slaughterhouse workers (51 men and 15 women, mean age 45 years [standard deviation (SD) 10]) with upper limb chronic musculoskeletal pain were randomly allocated to group-based strength training (physical exercise group) or individual ergonomic training and education (reference group) for 10 weeks. Social climate was assessed with the General Nordic Questionnaire for Psychological and Social Factors at Work, and vitality and mental health were assessed with the 36-item Short Form Health Survey. All scales were converted to 0 to 100 (higher scores are better). Between-group differences from baseline to follow-up were determined using linear mixed models adjusted for workplace, age, gender, and baseline values of the outcome. Mean baseline scores of social climate, mental health, and vitality were 52.2 (SD 14.9), 79.5 (SD 13.7), and 53.9 (SD 19.7), respectively. Complete baseline and follow-up data were obtained from 30 and 31 from the physical exercise and reference groups, respectively. The between-group differences from baseline to follow-up between physical exercise and reference were 7.6 (95% CI 0.3 to 14.9), −2.3 (95% CI -10.3 to 5.8), and 10.1 (95% CI 0.6 to 19.5) for social climate, mental health, and vitality, respectively. For social climate and vitality, this corresponded to moderate effect sizes (Cohen d = 0.51 for both) in favor of physical exercise. There were no reported adverse events. In conclusion, workplace physical exercise performed together with colleagues improves social climate and vitality among workers with chronic musculoskeletal pain. Mental health remained unchanged. PMID:28072707

Psychosocial effects of workplace physical exercise among workers with chronic pain: Randomized controlled trial.

PubMed

Andersen, Lars L; Persson, Roger; Jakobsen, Markus D; Sundstrup, Emil

2017-01-01

While workplace physical exercise can help manage musculoskeletal disorders, less is known about psychosocial effects of such interventions. This aim of this study was to investigate the effect of workplace physical exercise on psychosocial factors among workers with chronic musculoskeletal pain.The trial design was a 2-armed parallel-group randomized controlled trial with allocation concealment. A total of 66 slaughterhouse workers (51 men and 15 women, mean age 45 years [standard deviation (SD) 10]) with upper limb chronic musculoskeletal pain were randomly allocated to group-based strength training (physical exercise group) or individual ergonomic training and education (reference group) for 10 weeks. Social climate was assessed with the General Nordic Questionnaire for Psychological and Social Factors at Work, and vitality and mental health were assessed with the 36-item Short Form Health Survey. All scales were converted to 0 to 100 (higher scores are better). Between-group differences from baseline to follow-up were determined using linear mixed models adjusted for workplace, age, gender, and baseline values of the outcome.Mean baseline scores of social climate, mental health, and vitality were 52.2 (SD 14.9), 79.5 (SD 13.7), and 53.9 (SD 19.7), respectively. Complete baseline and follow-up data were obtained from 30 and 31 from the physical exercise and reference groups, respectively. The between-group differences from baseline to follow-up between physical exercise and reference were 7.6 (95% CI 0.3 to 14.9), -2.3 (95% CI -10.3 to 5.8), and 10.1 (95% CI 0.6 to 19.5) for social climate, mental health, and vitality, respectively. For social climate and vitality, this corresponded to moderate effect sizes (Cohen d = 0.51 for both) in favor of physical exercise. There were no reported adverse events.In conclusion, workplace physical exercise performed together with colleagues improves social climate and vitality among workers with chronic musculoskeletal pain. Mental health remained unchanged.

The effect of vertical whole-body vibration on lower limb muscle activation in elderly adults: Influence of vibration frequency, amplitude and exercise.

PubMed

Lam, Freddy M H; Liao, L R; Kwok, Timothy C Y; Pang, Marco Y C

2016-06-01

This study aimed to investigate how whole-body vibration (WBV) and exercise and their interactions influenced leg muscle activity in elderly adults. An experimental study with repeated measures design that involved a group of ambulatory, community-dwelling elderly adults (n=30; 23 women; mean age=61.4±5.3years). Muscle activity of the vastus lateralis (VL), biceps femoris (BF), tibialis anterior (TA), and gastrocnemius (GS) was measured by surface electromyography (EMG), while participants were performing seven different exercises during 4 WBV conditions (condition 1: frequency=30Hz, amplitude=0.6mm, intensity=2.25 units of Earth's gravity (g); condition 2: 30Hz, 0.9mm, 3.40g; condition 3: 40Hz, 0.6mm, 3.65g; condition 4: 40Hz, 0.9mm, 5.50g) and a no-WBV condition in a single experimental session. Significantly greater muscle activity was recorded in VL (3%-148%), BF (16%-202%), and GS (19% -164%) when WBV was added to the exercises, compared with the same exercises without WBV (p≤0.015). The effect of vibration intensity on EMG amplitude was exercise-dependent in VL (p=0.002), and this effect was marginally significant in GS (p=0.052). The EMG activity induced by the four WBV intensities was largely similar, and was the most pronounced during static erect standing and static single-leg standing. The EMG amplitude of majority of leg muscles tested was significantly greater during WBV exposure compared with the no-WBV condition. Low-intensity WBV can induce muscle activity as effectively as higher-intensity protocols, and may be the preferred choice for frail elderly adults. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Is hip strengthening the best treatment option for females with patellofemoral pain? A randomized controlled trial of three different types of exercises.

PubMed

Saad, Marcelo Camargo; Vasconcelos, Rodrigo Antunes de; Mancinelli, Letícia Villani de Oliveira; Munno, Matheus Soares de Barros; Liporaci, Rogério Ferreira; Grossi, Débora Bevilaqua

2018-04-04

To evaluate the effect of three types of exercise intervention in patients with patellofemoral pain and to verify the contributions of each intervention to pain control, function, and lower extremity kinematics. A randomized controlled, single-blinded trial was conducted. Forty women with patellofemoral pain were randomly allocated into four groups: hip exercises, quadriceps exercises, stretching exercises and a control group (no intervention). Pain (using a visual analog scale), function (using the Anterior Knee Pain Scale), hip and quadriceps strength (using a handheld isometric dynamometer) and measuring lower limb kinematics during step up and down activities were evaluated at baseline and 8 weeks post intervention. All treatment groups showed significant improvements on pain and Anterior Knee Pain Scale after intervention with no statistically significant differences between groups except when compared to the control group. Only hip and quadriceps groups demonstrated improvements in muscle strength and knee valgus angle during the step activities. Hip strengthening exercises were not more effective for pain relief and function compared to quadriceps or stretching exercises in females with patellofemoral pain. Only hip and quadriceps groups were able to decrease the incidence of dynamic valgus during step-down activity. This study was approved by Brazilian Clinical Trials Registry registration number: RBR-6tc7mj (http://www.ensaiosclinicos.gov.br/rg/RBR-6tc7mj/). Copyright © 2018 Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia. Publicado por Elsevier Editora Ltda. All rights reserved.

Considerations for designing robotic upper limb rehabilitation devices

NASA Astrophysics Data System (ADS)

Nadas, I.; Vaida, C.; Gherman, B.; Pisla, D.; Carbone, G.

2017-12-01

The present study highlights the advantages of robotic systems for post-stroke rehabilitation of the upper limb. The latest demographic studies illustrate a continuous increase of the average life span, which leads to a continuous increase of stroke incidents and patients requiring rehabilitation. Some studies estimate that by 2030 the number of physical therapists will be insufficient for the patients requiring physical rehabilitation, imposing a shift in the current methodologies. A viable option is the implementation of robotic systems that assist the patient in performing rehabilitation exercises, the physical therapist role being to establish the therapeutic program for each patient and monitor their individual progress. Using a set of clinical measurements for the upper limb motions, the analysis of rehabilitation robotic systems provides a comparative study between the motions required by clinicians and the ones that robotic systems perform for different therapeutic exercises. A critical analysis of existing robots is performed using several classifications: mechanical design, assistance type, actuation and power transmission, control systems and human robot interaction (HRI) strategies. This classification will determine a set of pre-requirements for the definition of new concepts and efficient solutions for robotic assisted rehabilitation therapy.

Golf and upper limb injuries: a summary and review of the literature

PubMed Central

McHardy, Andrew J; Pollard, Henry P

2005-01-01

Background Golf is a popular past time that provides exercise with social interaction. However, as with all sports and activities, injury may occur. Many golf-related injuries occur in the upper limb, yet little research on the potential mechanisms of these injuries has been conducted. Objective To review the current literature on golf-related upper limb injuries and report on potential causes of injury as it relates to the golf swing. Discussion An overview of the golf swing is described in terms of its potential to cause the frequently noted injuries. Most injuries occur at impact when the golf club hits the ball. This paper concludes that more research into golf-related upper limb injuries is required to develop a thorough understanding of how injuries occur. Types of research include epidemiology studies, kinematic swing analysis and electromyographic studies of the upper limb during golf. By conducting such research, preventative measures maybe developed to reduce golf related injury. PMID:15967021

The Effect of High-Intensity Interval Cycling Sprints Subsequent to Arm-Curl Exercise on Upper-Body Muscle Strength and Hypertrophy.

PubMed

Kikuchi, Naoki; Yoshida, Shou; Okuyama, Mizuki; Nakazato, Koichi

2016-08-01

Kikuchi, N, Yoshida, S, Okuyama, M, and Nakazato, K. The effect of high-intensity interval cycling sprints subsequent to arm-curl exercise on upper-body muscle strength and hypertrophy. J Strength Cond Res 30(8): 2318-2323, 2016-The purpose of this study was to examine whether lower limb sprint interval training (SIT) after arm resistance training (RT) influences training response of arm muscle strength and hypertrophy. Twenty men participated in this study. We divided subjects into RT group (n = 6) and concurrent training group (CT, n = 6). The RT program was designed to induce muscular hypertrophy (3 sets × 10 repetitions [reps] at 80% 1 repetition maximum [1RM] of arm-curl exercise) and was performed in an 8-week training schedule performed 3 times per week on nonconsecutive days. Subjects assigned to the CT group performed identical protocols as strength training and modified SIT (4 sets of 30-s maximal effort, separated in 4 m 30-s rest intervals) on the same day. Pretest and posttest maximal oxygen consumption (V[Combining Dot Above]O2max), muscle cross-sectional area (CSA), and 1RM were measured. Significant increase in V[Combining Dot Above]O2max from pretest to posttest was observed in the CT group (p = 0.010, effect size [ES] = 1.84) but not in the RT group (p = 0.559, ES = 0.35). Significant increase in CSA from pretest to posttest was observed in the RT group (p = 0.030, ES = 1.49) but not in the CT group (p = 0.110, ES = 1.01). Significant increase in 1RM from pretest to posttest was observed in the RT group (p = 0.021, ES = 1.57) but not in the CT group (p = 0.065, ES = 1.19). In conclusion, our data indicate that concurrent lower limb SIT interferes with arm muscle hypertrophy and strength.

Effects of loaded voluntary wheel exercise on performance and muscle hypertrophy in young and old male C57Bl/6J mice.

PubMed

Soffe, Z; Radley-Crabb, H G; McMahon, C; Grounds, M D; Shavlakadze, T

2016-02-01

This study compared the capacity of young and old male C57Bl/6J mice to exercise with increasing resistance over 10 weeks, and its impact on muscle mass. Young mice (aged 15-25 weeks) were subjected to low (LR) and high (HR) resistance exercise, whereas only LR was used for old mice (107-117 weeks). Weekly patterns of voluntary wheel activity, food consumption and body weights were measured. Running patterns changed over time and with age, with two peaks of activity detected for young, but only one for old mice: speed and distance run was also less for old mice. The mass for six limb muscles was measured at the end of the experiment. The most pronounced increase in mass in response to exercise was for the soleus in young and old mice, and also quadriceps and gastrocnemius in young mice. Soleus and quadriceps muscles were analyzed histologically for myofiber number and size. A striking feature was the many small myofibers in response to exercise in young (but not old) soleus, whereas these were not present after exercise in young or old quadriceps. Overall, there was a striking difference in response to exercise between muscles and this was influenced by age. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Track and Field Practice and Bone Outcomes among Adolescents: A Pilot Study (ABCD-Growth Study).

PubMed

Faustino-da-Silva, Yuri da Silva Ventura; Agostinete, Ricardo Ribeiro; Werneck, André Oliveira; Maillane-Vanegas, Santiago; Lynch, Kyle Robinson; Exupério, Isabella Neto; Ito, Igor Hideki; Fernandes, Romulo Araújo

2018-02-01

Osteoporosis is considered a public health problem with high worldwide prevalence. One approach to prevention is through the promotion of physical activity, especially exercise, during adolescence. This study compared bone variables in different body segments in adolescents according to participation in track and field. The study included 34 adolescents (22 boys), of whom 17 were track and field athletes and 17 were control subjects. Bone mineral density (BMD, g/cm 2 ) and bone mineral content (BMC, g) were analyzed using dual energy X-ray absorptiometry (total body stratified by body segments). Peak height velocity was used to estimate somatic maturation. Athletes had higher BMD ( P =0.003) and BMC ( P =0.011) values in the lower limbs and higher whole body BMD ( P =0.025) than the control group. However, when adjusted for confounding factors, the difference was not maintained. The groups had similar lean soft tissue values ( P =0.094). Training overload was positively correlated with BMD in the upper limbs (r=0.504; 95% confidence interval, 0.031-0.793). Although track and field athletes had higher BMD and BMC values in the lower limbs, these differences were not significant when adjusted for confounding factors. Track and field participation in adolescence appears to influence BMD and BMC in lower limbs, and fat-free mass seems to mediate this effect. Also, higher training loads were found to be positive for bone health in upper limbs.

Track and Field Practice and Bone Outcomes among Adolescents: A Pilot Study (ABCD-Growth Study)

PubMed Central

Faustino-da-Silva, Yuri da Silva Ventura; Werneck, André Oliveira; Maillane-Vanegas, Santiago; Lynch, Kyle Robinson; Exupério, Isabella Neto; Ito, Igor Hideki; Fernandes, Romulo Araújo

2018-01-01

Background Osteoporosis is considered a public health problem with high worldwide prevalence. One approach to prevention is through the promotion of physical activity, especially exercise, during adolescence. Methods This study compared bone variables in different body segments in adolescents according to participation in track and field. The study included 34 adolescents (22 boys), of whom 17 were track and field athletes and 17 were control subjects. Bone mineral density (BMD, g/cm2) and bone mineral content (BMC, g) were analyzed using dual energy X-ray absorptiometry (total body stratified by body segments). Peak height velocity was used to estimate somatic maturation. Results Athletes had higher BMD (P=0.003) and BMC (P=0.011) values in the lower limbs and higher whole body BMD (P=0.025) than the control group. However, when adjusted for confounding factors, the difference was not maintained. The groups had similar lean soft tissue values (P=0.094). Training overload was positively correlated with BMD in the upper limbs (r=0.504; 95% confidence interval, 0.031-0.793). Although track and field athletes had higher BMD and BMC values in the lower limbs, these differences were not significant when adjusted for confounding factors. Conclusions Track and field participation in adolescence appears to influence BMD and BMC in lower limbs, and fat-free mass seems to mediate this effect. Also, higher training loads were found to be positive for bone health in upper limbs. PMID:29564304

Enhanced maximal exercise capacity, vasodilation to electrical muscle contraction, and hind limb vascular density in ASIC1a null mice.

PubMed

Drummond, Heather A; Xiang, Lusha; Chade, Alejandro R; Hester, Robert

2017-08-01

Acid-sensing ion channel (ASIC) proteins form extracellular proton-gated, cation-selective channels in neurons and vascular smooth muscle cells and are proposed to act as extracellular proton sensors. However, their importance to vascular responses under conditions associated with extracellular acidosis, such as strenuous exercise, is unclear. Therefore, the purpose of this study was to determine if one ASIC protein, ASIC1a, contributes to extracellular proton-gated vascular responses and exercise tolerance. To determine if ASIC1a contributes to exercise tolerance, we determined peak oxygen (O 2 ) uptake in conscious ASIC1a -/- mice during exhaustive treadmill running. Loss of ASIC1a was associated with a greater peak running speed (60 ± 2 vs. 53 ± 3 m·min -1 , P  = 0.049) and peak oxygen (O 2 ) uptake during exhaustive treadmill running (9563 ± 120 vs. 8836 ± 276 mL·kg -1 ·h -1 , n  = 6-7, P  = 0.0082). There were no differences in absolute or relative lean body mass, as determined by EchoMRI. To determine if ASIC1a contributes to vascular responses during muscle contraction, we measured femoral vascular conductance (FVC) during a stepwise electrical stimulation (0.5-5.0 Hz at 3 V for 60 sec) of the left major hind limb muscles. FVC increased to a greater extent in ASIC1a -/- versus ASIC1a +/+ mice (0.44 ± 0.03 vs. 0.30 ± 0.04 mL·min -1 ·100 g hind limb mass -1 · mmHg -1 , n  = 5 each, P  = 0.0009). Vasodilation following local application of external protons in the spinotrapezius muscle increased the duration, but not the magnitude, of the vasodilatory response in ASIC1a -/- mice. Finally, we examined hind limb vascular density using micro-CT and found increased density of 0-80  μ m vessels ( P  <   0.05). Our findings suggest an increased vascular density and an enhanced vasodilatory response to local protons, to a lesser degree, may contribute to the enhanced vascular conductance and increased peak exercise capacity in ASIC1a -/- mice. © 2017 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on behalf of The Physiological Society and the American Physiological Society.

Passive exercise of the lower limbs and trunk alleviates decreased intestinal motility in patients in the intensive care unit after cardiovascular surgery.

PubMed

Morisawa, Tomoyuki; Takahashi, Tetsuya; Sasanuma, Naoki; Mabuchi, Satoshi; Takeda, Kenta; Hori, Naoto; Ohashi, Naotsugu; Ide, Takeshi; Domen, Kazuhisa; Nishi, Shinichi

2017-02-01

[Purpose] The purpose of this study was to clarify the effects of passive exercise of the lower limbs and trunk (PELT) in ICU patients after cardiovascular surgery with decreased bowel motility. [Subjects and Methods] Ten ICU patients with clinically-apparent decreased bowel motility during the period of April to July 2016 were enrolled this study. Bowel sounds (BS) for 5 minutes at rest and 5 minutes after PELT were recorded through an electronic stethoscope. A frequency analysis was performed and the BS before and after PELT were compared. In addition, the percent change in BS before and after PELT was determined, and the relationship between the percent change in BS and individual parameters (invasiveness of surgery, inflammation, nutrition, renal function) was examined. [Results] Average BS (integral value) for 5 minutes before and after PELT were 63.1 ± 41.3 mVsec and 115.0 ± 57.8 mVsec, respectively; therefore, BS was significantly increased by PELT. When compared to patients at rest, a significant increase was found 0-4 minutes after PELT. None of the individual parameters was significantly correlated with the percent change. [Conclusion] PELT can increase the bowel motility of ICU patients with decreased bowel motility.

Does aquatic exercise reduce hip and knee joint loading? In vivo load measurements with instrumented implants

PubMed Central

Kutzner, Ines; Dymke, Jörn; Damm, Philipp; Duda, Georg N.; Günzl, Reiner; Bergmann, Georg

2017-01-01

Aquatic exercises are widely used for rehabilitation or preventive therapies in order to enable mobilization and muscle strengthening while minimizing joint loading of the lower limb. The load reducing effect of water due to buoyancy is a main advantage compared to exercises on land. However, also drag forces have to be considered that act opposite to the relative motion of the body segments and require higher muscle activity. Due to these opposing effects on joint loading, the load-reducing effect during aquatic exercises remains unknown. The aim of this study was to quantify the joint loads during various aquatic exercises and to determine the load reducing effect of water. Instrumented knee and hip implants with telemetric data transfer were used to measure the resultant joint contact forces in 12 elderly subjects (6x hip, 6x knee) in vivo. Different dynamic, weight-bearing and non-weight-bearing activities were performed by the subjects on land and in chest-high water. Non-weight-bearing hip and knee flexion/extension was performed at different velocities and with additional Aquafins. Joint forces during aquatic exercises ranged between 32 and 396% body weight (BW). Highest forces occurred during dynamic activities, followed by weight-bearing and slow non-weight-bearing activities. Compared to the same activities on land, joint forces were reduced by 36–55% in water with absolute reductions being greater than 100%BW during weight-bearing and dynamic activities. During non-weight-bearing activities, high movement velocities and additional Aquafins increased the joint forces by up to 59% and resulted in joint forces of up to 301%BW. This study confirms the load reducing effect of water during weight-bearing and dynamic exercises. Nevertheless, high drag forces result in increased joint contact forces and indicate greater muscle activity. By the choice of activity, movement velocity and additional resistive devices joint forces can be modulated individually in the course of rehabilitation or preventive therapies. PMID:28319145

Does aquatic exercise reduce hip and knee joint loading? In vivo load measurements with instrumented implants.

PubMed

Kutzner, Ines; Richter, Anja; Gordt, Katharina; Dymke, Jörn; Damm, Philipp; Duda, Georg N; Günzl, Reiner; Bergmann, Georg

2017-01-01

Aquatic exercises are widely used for rehabilitation or preventive therapies in order to enable mobilization and muscle strengthening while minimizing joint loading of the lower limb. The load reducing effect of water due to buoyancy is a main advantage compared to exercises on land. However, also drag forces have to be considered that act opposite to the relative motion of the body segments and require higher muscle activity. Due to these opposing effects on joint loading, the load-reducing effect during aquatic exercises remains unknown. The aim of this study was to quantify the joint loads during various aquatic exercises and to determine the load reducing effect of water. Instrumented knee and hip implants with telemetric data transfer were used to measure the resultant joint contact forces in 12 elderly subjects (6x hip, 6x knee) in vivo. Different dynamic, weight-bearing and non-weight-bearing activities were performed by the subjects on land and in chest-high water. Non-weight-bearing hip and knee flexion/extension was performed at different velocities and with additional Aquafins. Joint forces during aquatic exercises ranged between 32 and 396% body weight (BW). Highest forces occurred during dynamic activities, followed by weight-bearing and slow non-weight-bearing activities. Compared to the same activities on land, joint forces were reduced by 36-55% in water with absolute reductions being greater than 100%BW during weight-bearing and dynamic activities. During non-weight-bearing activities, high movement velocities and additional Aquafins increased the joint forces by up to 59% and resulted in joint forces of up to 301%BW. This study confirms the load reducing effect of water during weight-bearing and dynamic exercises. Nevertheless, high drag forces result in increased joint contact forces and indicate greater muscle activity. By the choice of activity, movement velocity and additional resistive devices joint forces can be modulated individually in the course of rehabilitation or preventive therapies.

Effects of exercise improves muscle strength and fat mass in patients with high fracture risk: A randomized control trial.

PubMed

Chan, Ding-Cheng; Chang, Chirn-Bin; Han, Der-Sheng; Hong, Cian-Hui; Hwang, Jawl-Shan; Tsai, Keh-Sung; Yang, Rong-Sen

2017-10-26

The deterioration of the musculoskeletal system imposes significant impact on physical activity. Exercise is an important strategy which minimizes these changes. It is not clear which type of exercise provides better improvement on low physical performance, low muscle mass and low strength of sarcopenia. We aim to develop an integrated care (IC) model and compare its relative efficacy in limb fat free mass, muscle strength, and physical performance with low extremities exercise (LEE) in community dwelling older adults with high risk of fractures (Fracture Risk Assessment Tool (FRAX ® )) ≧3% for hip fracture, ≧20% for major osteoporotic fracture or 1-min osteoporosis risk test (≧1 point) or fall (≧2 falls in previous year). Patients were assigned randomized to participate in either IC or LEE group (n = 55 each) for 3 months. All participants received education including home-based exercise. The IC group consisted of different modalities of exercise while the LEE group performed machine-based low extremities exercise. Fat free mass, muscle strength, and physical performance were measured at their baseline and 3-months follow-up. Mean age was 73.8 ± 7 years with 69.1% women. Entire cohort demonstrated significant increment in fat free mass, muscle strength (4 indicators) and physical performance (3 indicators). However, between group differences were not significant. With regular supervise exercise; both groups are equally effective in decreasing fat mass and increasing physical performance, muscle mass and strength. However, the IC group required fewer resources and thus more financially feasible in a community setting. Copyright © 2017. Published by Elsevier B.V.

Low-level laser therapy (LLLT) in human progressive-intensity running: effects on exercise performance, skeletal muscle status, and oxidative stress.

PubMed

De Marchi, Thiago; Leal Junior, Ernesto Cesar Pinto; Bortoli, Celiana; Tomazoni, Shaiane Silva; Lopes-Martins, Rodrigo Alvaro Brandão; Salvador, Mirian

2012-01-01

The aim of this work was to evaluate the effects of low-level laser therapy (LLLT) on exercise performance, oxidative stress, and muscle status in humans. A randomized double-blind placebo-controlled crossover trial was performed with 22 untrained male volunteers. LLLT (810 nm, 200 mW, 30 J in each site, 30 s of irradiation in each site) using a multi-diode cluster (with five spots - 6 J from each spot) at 12 sites of each lower limb (six in quadriceps, four in hamstrings, and two in gastrocnemius) was performed 5 min before a standardized progressive-intensity running protocol on a motor-drive treadmill until exhaustion. We analyzed exercise performance (VO(2 max), time to exhaustion, aerobic threshold and anaerobic threshold), levels of oxidative damage to lipids and proteins, the activities of the antioxidant enzymes superoxide dismutase (SOD) and catalase (CAT), and the markers of muscle damage creatine kinase (CK) and lactate dehydrogenase (LDH). Compared to placebo, active LLLT significantly increased exercise performance (VO(2 max) p = 0.01; time to exhaustion, p = 0.04) without changing the aerobic and anaerobic thresholds. LLLT also decreased post-exercise lipid (p = 0.0001) and protein (p = 0.0230) damages, as well as the activities of SOD (p = 0.0034), CK (p = 0.0001) and LDH (p = 0.0001) enzymes. LLLT application was not able to modulate CAT activity. The use of LLLT before progressive-intensity running exercise increases exercise performance, decreases exercise-induced oxidative stress and muscle damage, suggesting that the modulation of the redox system by LLLT could be related to the delay in skeletal muscle fatigue observed after the use of LLLT.

Effects of Wii balance board exercises on balance after posterior cruciate ligament reconstruction.

PubMed

Puh, Urška; Majcen, Nia; Hlebš, Sonja; Rugelj, Darja

2014-05-01

To establish the effects of training on Wii balance board (WBB) after posterior cruciate ligament (PCL) reconstruction on balance. Included patient injured her posterior cruciate ligament 22 months prior to the study. Training on WBB was performed 4 weeks, 6 times per week, 30-45 min per day. Center of pressure (CoP) sway during parallel and one-leg stance, and body weight distribution in parallel stance were measured. Additionally, measurements of joint range of motion and limb circumferences were taken before and after training. After training, the body weight was almost equally distributed on both legs. Decrease in CoP sway was most significant for one-leg stance with each leg on compliant surface with eyes open and closed. The knee joint range of motion increased and limb circumferences decreased. According to the results of this single case report, we might recommend the use of WBB for balance training after PCL reconstruction. Case series with no comparison group, Level IV.

Home-based neurologic music therapy for upper limb rehabilitation with stroke patients at community rehabilitation stage—a feasibility study protocol

PubMed Central

Street, Alexander J.; Magee, Wendy L.; Odell-Miller, Helen; Bateman, Andrew; Fachner, Jorg C.

2015-01-01

Background: Impairment of upper limb function following stroke is more common than lower limb impairment and is also more resistant to treatment. Several lab-based studies with stroke patients have produced statistically significant gains in upper limb function when using musical instrument playing and techniques where rhythm acts as an external time-keeper for the priming and timing of upper limb movements. Methods: For this feasibility study a small sample size of 14 participants (3–60 months post stroke) has been determined through clinical discussion between the researcher and study host in order to test for management, feasibility and effects, before planning a larger trial determined through power analysis. A cross-over design with five repeated measures will be used, whereby participants will be randomized into either a treatment (n = 7) or wait list control (n = 7) group. Intervention will take place twice weekly over 6 weeks. The ARAT and 9HPT will be used to measure for quantitative gains in arm function and finger dexterity, pre/post treatment interviews will serve to investigate treatment compliance and tolerance. A lab based EEG case comparison study will be undertaken to explore audio-motor coupling, brain connectivity and neural reorganization with this intervention, as evidenced in similar studies. Discussion: Before evaluating the effectiveness of a home-based intervention in a larger scale study, it is important to assess whether implementation of the trial methodology is feasible. This study investigates the feasibility, efficacy and patient experience of a music therapy treatment protocol comprising a chart of 12 different instrumental exercises and variations, which aims at promoting measurable changes in upper limb function in hemiparetic stroke patients. The study proposes to examine several new aspects including home-based treatment and dosage, and will provide data on recruitment, adherence and variability of outcomes. PMID:26441586

Home-based neurologic music therapy for upper limb rehabilitation with stroke patients at community rehabilitation stage-a feasibility study protocol.

PubMed

Street, Alexander J; Magee, Wendy L; Odell-Miller, Helen; Bateman, Andrew; Fachner, Jorg C

2015-01-01

Impairment of upper limb function following stroke is more common than lower limb impairment and is also more resistant to treatment. Several lab-based studies with stroke patients have produced statistically significant gains in upper limb function when using musical instrument playing and techniques where rhythm acts as an external time-keeper for the priming and timing of upper limb movements. For this feasibility study a small sample size of 14 participants (3-60 months post stroke) has been determined through clinical discussion between the researcher and study host in order to test for management, feasibility and effects, before planning a larger trial determined through power analysis. A cross-over design with five repeated measures will be used, whereby participants will be randomized into either a treatment (n = 7) or wait list control (n = 7) group. Intervention will take place twice weekly over 6 weeks. The ARAT and 9HPT will be used to measure for quantitative gains in arm function and finger dexterity, pre/post treatment interviews will serve to investigate treatment compliance and tolerance. A lab based EEG case comparison study will be undertaken to explore audio-motor coupling, brain connectivity and neural reorganization with this intervention, as evidenced in similar studies. Before evaluating the effectiveness of a home-based intervention in a larger scale study, it is important to assess whether implementation of the trial methodology is feasible. This study investigates the feasibility, efficacy and patient experience of a music therapy treatment protocol comprising a chart of 12 different instrumental exercises and variations, which aims at promoting measurable changes in upper limb function in hemiparetic stroke patients. The study proposes to examine several new aspects including home-based treatment and dosage, and will provide data on recruitment, adherence and variability of outcomes.

Lower-limb and trunk muscle activation with back squats and weighted sled apparatus.

PubMed

Maddigan, Meaghan E; Button, Duane C; Behm, David G

2014-12-01

The back squat is a traditional resistance training exercise, whereas the resisted sled exercise is a relatively new resistance exercise. However, as there are no studies comparing muscle activation between the exercises, the objective of this study was to examine activity of leg and trunk muscles for both exercises. Ten healthy resistance-trained men participated in a randomized crossover design study consisting of 2 preparation sessions and 2 testing sessions. Electromyographic (EMG) activity of the rectus femoris, biceps femoris, gastrocnemius, lower erector spinae, and the transversus abdominis/internal obliques (TrA/IO) were monitored during a 20-step maximum push with the weighted sled apparatus and a 10 repetition maximum with a bilateral back squat. There were nonsignificant trends for the rectus femoris (p = 0.092: 8.6-16.7%) and biceps femoris (p = 0.09: 10.5-32.8%) to demonstrate higher activity with the sled and squat exercises, respectively. There were main effects for condition with 61.2% greater gastrocnemius EMG with the sled exercise (p = 0.01) and 74.5% greater erector spinae EMG activity with the squat (p = 0.002). There were no significant differences between the exercises for the TrA/IO. In summary, the sled and squat exercises provided similar EMG activity for the quadriceps, hamstrings, and TrA/IO. The squat provided higher lower erector spinae activation, whereas the sled had superior gastrocnemius activation. Depending on the movement-training specificity of the sport, either exercise may be used in a training program while acknowledging the differences in gastrocnemius and erector spinae activity.

The use of near-infrared spectroscopy in understanding skeletal muscle physiology: recent developments.

PubMed

Ferrari, Marco; Muthalib, Makii; Quaresima, Valentina

2011-11-28

This article provides a snapshot of muscle near-infrared spectroscopy (NIRS) at the end of 2010 summarizing the recent literature, offering the present status and perspectives of the NIRS instrumentation and methods, describing the main NIRS studies on skeletal muscle physiology, posing open questions and outlining future directions. So far, different NIRS techniques (e.g. continuous-wave (CW) and spatially, time- and frequency-resolved spectroscopy) have been used for measuring muscle oxygenation during exercise. In the last four years, approximately 160 muscle NIRS articles have been published on different physiological aspects (primarily muscle oxygenation and haemodynamics) of several upper- and lower-limb muscle groups investigated by using mainly two-channel CW and spatially resolved spectroscopy commercial instruments. Unfortunately, in only 15 of these studies were the advantages of using multi-channel instruments exploited. There are still several open questions in the application of NIRS in muscle studies: (i) whether NIRS can be used in subjects with a large fat layer; (ii) the contribution of myoglobin desaturation to the NIRS signal during exercise; (iii) the effect of scattering changes during exercise; and (iv) the effect of changes in skin perfusion, particularly during prolonged exercise. Recommendations for instrumentation advancements and future muscle NIRS studies are provided.

Effect of Compression Garments on the Development of Delayed-Onset Muscle Soreness: A Multimodal Approach Using Contrast-Enhanced Ultrasound and Acoustic Radiation Force Impulse Elastography.

PubMed

Heiss, Rafael; Kellermann, Marion; Swoboda, Bernd; Grim, Casper; Lutter, Christoph; May, Matthias S; Wuest, Wolfgang; Uder, Michael; Nagel, Armin M; Hotfiel, Thilo

2018-06-12

Study Design Controlled laboratory study with repeated measures. Background Delayed-onset muscle soreness (DOMS) is one of the most common reasons for impaired muscle performance in sports. However, little consensus exists regarding which treatments may be most effective and the underlying mechanisms are poorly understood. Objectives To investigate the influence of compression garments on the development of DOMS, focusing on changes in muscle perfusion and muscle stiffness. Methods Muscle perfusion and stiffness, calf circumference, muscle soreness, passive ankle dorsiflexion, and creatine kinase levels were assessed on participants before (baseline) a DOMS-inducing eccentric calf exercise intervention and 60 h later (follow-up). After DOMS induction, a sports compression garment (18-21 mmHg) was worn on one randomized calf until follow-up. The contralateral calf served as an internal control. Muscle perfusion was assessed using contrast-enhanced ultrasound (peak enhancement [PE] and wash-in area under the curve [WiAUC]), while muscle stiffness was assessed using acoustic radiation force impulse (shear wave velocities [SWV]). An MRI scan of both lower legs was also performed during the follow-up testing session to characterize the extent of exercise-induced muscle damage. Comparisons were made between limbs and over time. Results SWV values of the medial gastrocnemius showed a significant interaction between time and limb (p=0.006) with the non-compressed muscle demonstrating lower muscle stiffness values at follow-up compared to baseline or the compressed muscle. No significant differences in soleus muscle stiffness were noted between limb or over time, as was the case for muscle perfusion metrics (PE and WiAUC) for the medial gastrocnemius and soleus muscles. Further, compression had no significant effect on passive ankle dorsiflexion, muscle soreness, calf circumference, or injury severity per MRI. Conclusion Continuous wearing of compression garments during the inflammation phase of DOMS may play an important role in regulating muscle stiffness; however, they have no significant effects on intramuscular perfusion or other common clinical assessments. J Orthop Sports Phys Ther, Epub 12 Jun 2018. doi:10.2519/jospt.2018.8038.

Musculoskeletal strength, balance performance, and self-efficacy in elderly ving tsun chinese martial art practitioners: implications for fall prevention.

PubMed

Fong, Shirley S M; Ng, Shamay S M; Liu, Karen P Y; Pang, Marco Y C; Lee, H W; Chung, Joanne W Y; Lam, Priscillia L; Guo, X

2014-01-01

Objectives. To (1) compare the bone strength, lower limb muscular strength, functional balance performance, and balance self-efficacy between Ving Tsun (VT) martial art practitioners and nonpractitioners and (2) identify the associations between lower limb muscular strength, functional balance performance, and balance self-efficacy among the VT-trained participants. Methods. Thirty-five VT practitioners (mean age ± SD = 62.7 ± 13.3 years) and 49 nonpractitioners (mean age ± SD = 65.9 ± 10.5 years) participated in the study. The bone strength of the distal radius, lower limb muscular strength, functional balance performance, and balance self-efficacy were assessed using an ultrasound bone sonometer, the five times sit-to-stand test (FTSTS), the Berg balance scale (BBS), and the Chinese version of the activities-specific balance confidence scale, respectively. A multivariate analysis of covariance was performed to compare all the outcome variables between the two groups. Results. Elderly VT practitioners had higher radial bone strength on the dominant side (P < 0.05), greater lower limb muscular strength (P = 0.001), better functional balance performance (P = 0.003), and greater balance confidence (P < 0.001) than the nonpractitioners. Additionally, only the FTSTS time revealed a significant association with the BBS score (r = -0.575,  P = 0.013). Conclusions. VT may be a suitable health-maintenance exercise for the elderly. Our findings may inspire the development of VT fall-prevention exercises for the community-dwelling healthy elderly.

Musculoskeletal Strength, Balance Performance, and Self-Efficacy in Elderly Ving Tsun Chinese Martial Art Practitioners: Implications for Fall Prevention

PubMed Central

Fong, Shirley S. M.; Ng, Shamay S. M.; Liu, Karen P. Y.; Pang, Marco Y. C.; Lee, H. W.; Chung, Joanne W. Y.; Lam, Priscillia L.; Guo, X.

2014-01-01

Objectives. To (1) compare the bone strength, lower limb muscular strength, functional balance performance, and balance self-efficacy between Ving Tsun (VT) martial art practitioners and nonpractitioners and (2) identify the associations between lower limb muscular strength, functional balance performance, and balance self-efficacy among the VT-trained participants. Methods. Thirty-five VT practitioners (mean age ± SD = 62.7 ± 13.3 years) and 49 nonpractitioners (mean age ± SD = 65.9 ± 10.5 years) participated in the study. The bone strength of the distal radius, lower limb muscular strength, functional balance performance, and balance self-efficacy were assessed using an ultrasound bone sonometer, the five times sit-to-stand test (FTSTS), the Berg balance scale (BBS), and the Chinese version of the activities-specific balance confidence scale, respectively. A multivariate analysis of covariance was performed to compare all the outcome variables between the two groups. Results. Elderly VT practitioners had higher radial bone strength on the dominant side (P < 0.05), greater lower limb muscular strength (P = 0.001), better functional balance performance (P = 0.003), and greater balance confidence (P < 0.001) than the nonpractitioners. Additionally, only the FTSTS time revealed a significant association with the BBS score (r = −0.575,  P = 0.013). Conclusions. VT may be a suitable health-maintenance exercise for the elderly. Our findings may inspire the development of VT fall-prevention exercises for the community-dwelling healthy elderly. PMID:25530782

Activity of Lower Limb Muscles During Squat With and Without Abdominal Drawing-in and Pilates Breathing.

PubMed

Barbosa, Alexandre C; Martins, Fábio M; Silva, Angélica F; Coelho, Ana C; Intelangelo, Leonardo; Vieira, Edgar R

2017-11-01

Barbosa, AC, Martins, FM, Silva, AF, Coelho, AC, Intelangelo, L, and Vieira, ER. Activity of lower limb muscles during squat with and without abdominal drawing-in and Pilates breathing. J Strength Cond Res 31(11): 3018-3023, 2017-The purpose of this study was to assess the effects of abdominal drawing-in and Pilates breathing on the activity of lower limb muscles during squats. Adults (n = 13, 22 ± 3 years old) with some Pilates experience performed three 60° squats under each of the following conditions in a random order: (I) normal breathing, (II) drawing-in maneuver with normal breathing, and (III) drawing-in maneuver with Pilates breathing. Peak-normalized surface electromyography of the rectus femoris, biceps femoris, gastrocnemius medialis, and tibialis anterior during the knee flexion and extension phases of squat exercises was analyzed. There were significant differences among the conditions during the knee flexion phase for the rectus femoris (p = 0.001), biceps femoris (p = 0.038), and tibialis anterior (p = 0.001), with increasing activation from conditions I to III. For the gastrocnemius medialis, there were significant differences among the conditions during the knee extension phase (p = 0.023), with increased activity under condition I. The rectus and biceps femoris activity was higher during the extension vs. flexion phase under conditions I and II. The tibialis anterior activity was higher during the flexion compared with the extension phase under all conditions, and the medial gastrocnemius activity was higher during the extension phase under condition I. Doing squats with abdominal drawing-in and Pilates breathing resulted in increased rectus, biceps femoris, and tibialis anterior activity during the flexion phase, increasing movement stability during squat exercises.

A pilot study examining the impact of exercise training on skeletal muscle genes related to the TLR signaling pathway in older adults following hip fracture recovery.

PubMed

McKenzie, Alec I; Briggs, Robert A; Barrows, Katherine M; Nelson, Daniel S; Kwon, Oh Sung; Hopkins, Paul N; Higgins, Thomas F; Marcus, Robin L; Drummond, Micah J

2017-01-01

Older adults after hip fracture surgery experience progressive muscle atrophy and weakness, limiting full recovery. Further understanding of the molecular mechanisms in muscle with adaptation to exercise training in this vulnerable population is necessary. Therefore, we conducted a pilot study to investigate the skeletal muscle inflammatory and ceramide biosynthesis gene expression levels associated with the toll-like receptor (TLR) pathway before (Pre) and following a 3-mo multicomponent exercise training program in older adults (3M, 4F; 78.4 ± 13.3 yr; 25.5 ± 2.3 kg/m 2 ) ~4 mo after repair from hip fracture (HipFx). Vastus lateralis biopsies from the surgical limb were obtained before (Pre) and after training. Molecular end points and muscle function data were also compared with matched nonexercise healthy controls (CON). As a follow-up analysis, we evaluated specific sphingolipid pools in HipFx and CON muscle. Following training, quadriceps cross-sectional area, strength, and 6-min walk (6MW) increased in the surgical limb (P < 0.05). Additionally, MYD88, TAK1, NFKB1, IL6, SPT2, and CERS1 gene expression decreased after training (P ≤ 0.05), but some remained elevated above CON levels. Interestingly, MYD88 mRNA was inversely correlated to quadriceps CSA, strength, and 6MW. Finally, muscle dihydroceramides and phosphoceramides in HipFx were lower than CON at Pre (P ≤ 0.05), but after training differences from CON were removed. Together, our pilot data support that exercise training alters skeletal muscle inflammation and ceramide metabolism associated with TLR signaling in older adults recovering from hip fracture surgery and may be related to improvements in muscle function recovery. These pilot data demonstrate that 3 mo of exercise training in older adults recovering from hip fracture surgery was able to mitigate skeletal muscle gene expression related to inflammation and ceramide metabolism while also improving surgical limb lean tissue, strength, and physical function. Copyright © 2017 the American Physiological Society.

Changes in body surface temperature during speed endurance work-out in highly-trained male sprinters

NASA Astrophysics Data System (ADS)

Korman, Paweł; Straburzyńska-Lupa, Anna; Kusy, Krzysztof; Kantanista, Adam; Zieliński, Jacek

2016-09-01

The mechanism of thermoregulatory adaptation to exercise cannot yet be fully explained, however, infrared thermography (IRT) seems to have potential for monitoring physiological changes during exercise and training. It is a non-contact and easy to use technology to measure heat radiation from the body surface. The objective of the study was to examine the temperature changes over time on lower limbs in sprinters during speed endurance training session. Eight sprinters, specialized in distances 100 m and 200 m, aged 21-29 years, members of the Polish national team, were evaluated during an outdoor speed endurance work-out. Their track session comprised of warm-up, specific drills for sprinting technique, and speed endurance exercise. The surface temperature of lower limbs was measured and thermal images were taken using infrared camera after each part of the session. The speed endurance training session brought about specific time course of body surface (legs) temperature. The warm-up induced a significant decline in surface temperature by ∼2.5 °C, measured both on the front and back of lower limbs (p < 0.001), followed by a temperature stabilization until the end of the session. No significant asymmetry between the front and back sides of legs was observed. Body surface temperature may help identify an individual optimal time to terminate warm up and start the main part of the training session. It may also be useful for the assessment of muscle activity symmetry in cyclical activities, such as sprint running. This is of particular relevance when a training session is performed outdoors in changeable weather conditions.

Effect of recovery mode following hind-limb suspension on soleus muscle composition in the rat

NASA Technical Reports Server (NTRS)

McNulty, A. L.; Otto, A. J.; Kasper, C. E.; Thomas, D. P.

1992-01-01

The purpose of this study was to compare the effects of two different recovery modes from hind-limb suspension-induced hypodynamia on whole body and muscle (soleus) growth as well as soleus composition and size changes of different fiber types within this same muscle. Following 28 days of tail-suspension, rats were returned to their cages and sedentarily recovered (HS), or were exercised by running on a treadmill 5 days/wk, at progressively increasing workloads (HR) for one month. Sedentary and running control groups of animals (CS, CR) were also evaluated for comparative purposes. The exercise program, which was identical for CR and HR groups, had no effect on body wt., soleus wt., soleus muscle composition or fiber size in CR rats. Atrophied soleus muscle and reduced soleus wt./body wt. ratio (both 60% of control) had returned to control values by day 7 of recovery in both suspended groups despite the fact that whole body wt. gain was significantly reduced (p less than 0.05) in HR as compared to HS rats. Atrophied soleus Type I fiber mean cross-sectional area in both HR and HS groups demonstrated similar and significant (p less than 0.01) increases during recovery. Increases in Type IIa and IIc fiber area during this same period were significant only in the HR group. While the percentage area of muscle composed of Type I fibers increased in both hypodynamic groups during recovery, the reduction in area percentage of muscle made up of Type IIa fibers was again only significant in the HR group.(ABSTRACT TRUNCATED AT 250 WORDS).

The effects of two out-wintering pad systems compared with free-stalls on dairy cow hoof and limb health.

PubMed

O'Driscoll, Keelin Km; Hanlon, Alison; French, Padraig; Boyle, Laura A

2009-02-01

Lameness is one of the most serious health and welfare problems for dairy cows. This study compared hoof health, limb health and locomotion of dairy cows in three over-winter management systems. Treatments were: (1) an indoor free-stall system (FS), (2) outdoors on an uncovered woodchip pad (UP) and (3) outdoors on a covered woodchip pad (CP). Animals were assigned to treatments at drying off, remained on treatment until parturition, then turned out to pasture. Sole lesions were scored on assignment to treatment, at calving, and 6 weeks and 12 weeks post partum. Locomotion and skin lesions were scored on assignment to treatment, and every 2 weeks until parturition. Post-partum locomotion was scored weekly for 13 weeks. More FS cows were affected by limb lesions than CP cows, and these animals had the worst locomotion scores post calving. There was an effect of inspection, and interactive effect of inspection and treatment on sole lesion scores. UP cows had the highest sole lesion scores 12 weeks post partum probably due to softening of the hooves arising from exposure to moisture while on the woodchip pad. However, post partum, UP cows had better locomotion scores, and CP cows tended to have better scores than cows in FS. Both of these treatments were less likely to have a high tracking-up score than cows in FS. It is possible that cows in this treatment were able to exercise more, owing to the secure underfoot surface and lack of barriers, and this promoted limb flexibility. Although woodchip pads provided benefits for limb health and locomotion, the wood chip surface in both outdoor systems did not offer protective benefits to the hooves relative to housing on concrete. However, the provision of shelter on the pad somewhat overcame the problem of high sole lesion scores in the post-partum period.

Effects of Exergames on Quality of Life, Pain, and Disease Effect in Women With Fibromyalgia: A Randomized Controlled Trial.

PubMed

Collado-Mateo, Daniel; Dominguez-Muñoz, Francisco Javier; Adsuar, Jose Carmelo; Garcia-Gordillo, Miguel Angel; Gusi, Narcis

2017-09-01

To evaluate the effects of an exergame-based intervention on a population sample of women with fibromyalgia. Single-blinded, randomized controlled trial with 8-week intervention. Fibromyalgia center. Participants (all women) (N=83) were divided into 2 groups: an exercise group (n=42; mean age ± SD, 52.52±9.73y) and a nonexercise group (n=41; mean age ± SD, 52.47±8.75y). Women in the exercise group completed an 8-week exergame-based training program, which was focused on postural control and coordination of the upper and lower limbs, aerobic conditioning, strength, and mobility. Women (groups of 3) were encouraged to exercise for 120 minutes (over 2 sessions) per week. Main outcome measures included pain and disease effect, which were assessed with the Fibromyalgia Impact Questionnaire (FIQ), a specific measure for fibromyalgia. Secondary outcome measure included quality of life, which was assessed with the EuroQoL-5 Dimensions-5 Levels (EQ-5D-5L) generic instrument. The results showed that 97.62% of participants in the exercise group completed the 8-week intervention. The exercise group showed a significant improvement (P<.05) in the EQ-5D-5L utility index, and in 3 of 5 dimensions. For the FIQ, significant improvements were observed in the dimensions of pain, stiffness, anxiety, and feel good. The FIQ score was also reduced. The mean between-group improvement was 8.25 (95% confidence interval, 2.85-13.65). The results and levels of compliance/adherence suggest this exergame-based training program is an effective intervention for reducing pain and increasing health-related quality of life in women with fibromyalgia. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Audio-Visual Stimulation in Conjunction with Functional Electrical Stimulation to Address Upper Limb and Lower Limb Movement Disorder.

PubMed

Kumar, Deepesh; Verma, Sunny; Bhattacharya, Sutapa; Lahiri, Uttama

2016-06-13

Neurological disorders often manifest themselves in the form of movement deficit on the part of the patient. Conventional rehabilitation often used to address these deficits, though powerful are often monotonous in nature. Adequate audio-visual stimulation can prove to be motivational. In the research presented here we indicate the applicability of audio-visual stimulation to rehabilitation exercises to address at least some of the movement deficits for upper and lower limbs. Added to the audio-visual stimulation, we also use Functional Electrical Stimulation (FES). In our presented research we also show the applicability of FES in conjunction with audio-visual stimulation delivered through VR-based platform for grasping skills of patients with movement disorder.

Loading, electromyograph, and motion during exercise

NASA Technical Reports Server (NTRS)

Figueroa, Fernando

1993-01-01

A system is being developed to gather kineto-dynamic data for a study to determine the load vectors applied to bone during exercise on equipment similar to that used in space. This information will quantify bone loading for exercise countermeasures development. Decreased muscle loading and external loading of bone during weightlessness results in cancellous bone loss of 1 percent per month in the lower extremities and 2 percent per month in the calcaneous. It is hypothesized that loading bone appropriately during exercise may prevent the bone loss. The system consists of an ergometer instrumented to provide position of the pedal (foot), pedaling forces on the foot (on the sagittal plane), and force on the seat. Accelerometers attached to the limbs will provide acceleration. These data will be used as input to an analytical model of the limb to determine forces on the bones and on groups of muscles. EMG signals from activity in the muscles will also be used in conjunction with the equations of mechanics of motion to be able to discern forces exerted by specific muscles. The tasks to be carried out include: design of various mechanical components to mount transducers, specification of mechanical components, specification of position transducers, development of a scheme to control the data acquisition instruments (TEAC recorder and optical encoder board), development of a dynamic model of the limbs in motion, and development of an overall scheme for data collection analysis and presentation. At the present time, all the hardware components of the system are operational, except for a computer board to gather position data from the pedals and crank. This board, however, may be put to use by anyone with background in computer based instrumentation. The software components are not all done. Software to transfer data recorded from the EMG measurements is operational, software to drive the optical encoder card is mostly done. The equations to model the kinematics and dynamics of motion of the limbs have been developed, but they have not yet been implemented in software. Aside from the development of the hardware and software components of the system, the methodology to use accelerometers and encoders and the formulation of the appropriate equations are an important contribution to the area of biomechanics, particularly in space applications.

Exercise in waist-high warm water decreases pain and improves health-related quality of life and strength in the lower extremities in women with fibromyalgia.

PubMed

Gusi, N; Tomas-Carus, P; Häkkinen, A; Häkkinen, K; Ortega-Alonso, A

2006-02-15

To evaluate the short- and long-term efficacy of exercise therapy in a warm, waist-high pool in women with fibromyalgia. Thirty-four women (mean +/- SD tender points 17 +/- 1) were randomly assigned to either an exercise group (n = 17) to perform 3 weekly sessions of training including aerobic, proprioceptive, and strengthening exercises during 12 weeks, or to a control group (n = 17). Maximal unilateral isokinetic strength was measured in the knee extensors and flexors in concentric and eccentric actions at 60 degrees /second and 210 degrees /second, and in the shoulder abductors and adductors in concentric contractions. Health-related quality of life (HRQOL) was assessed using the EQ-5D questionnaire; pain was assessed on a visual analog scale. All were measured at baseline, posttreatment, and after 6 months. The strength of the knee extensors in concentric actions increased by 20% in both limbs after the training period, and these improvements were maintained after the de-training period in the exercise group. The strength of other muscle actions measured did not change. HRQOL improved by 93% (P = 0.007) and pain was reduced by 29% (P = 0.012) in the exercise group during the training, but pain returned close to the pretraining level during the subsequent de-training. However, there were no changes in the control group during the entire period. The therapy relieved pain and improved HRQOL and muscle strength in the lower limbs at low velocity in patients with initial low muscle strength and high number of tender points. Most of these improvements were maintained long term.

THE EFFECT OF DOUBLE VERSUS SINGLE OSCILLATING EXERCISE DEVICES ON TRUNK AND LIMB MUSCLE ACTIVATION

PubMed Central

Arora, Shruti; Button, Duane C.; Basset, Fabien A.

2013-01-01

Purpose/Background: Proper strengthening of the core and upper extremities is important for muscular health, performance, and rehabilitation. Exercise devices have been developed that attempt to disrupt the center of gravity in order to activate the trunk stabilizing muscles. The objective of this study was to analyze the trunk and shoulder girdle muscle activation with double and single oscillating exercise devices (DOD and SOD respectively) in various planes. Methods: Twelve male subjects performed three interventions using both devices under randomized conditions: single-handed vertical orientation of DOD and SOD to produce 1) medio-lateral oscillation in the frontal plane 2) dorso-ventral oscillation in the sagittal plane and 3) single-handed horizontal orientation for superior and inferior oscillation in the transverse plane. Electromyographic (EMG) activity during the interventions of the anterior deltoid, triceps brachii, biceps brachii, forearm flexors as well as lower abdominal and back stabilizer muscles was collected, and were normalized to maximal voluntary contractions. A two way repeated measures ANOVA (2x3) was conducted to assess the influence of the devices and movement planes on muscle activation. Results: The DOD provided 35.9%, 40.8%, and 52.3% greater anterior deltoid, transverse abdominus (TA)/internal oblique (IO) and lumbo-sacral erector spinae (LSES) activation than did the SOD respectively. Effect size calculations revealed that these differences were of moderate to large magnitude (0.86, 0.48, and 0.61 respectively). There were no significant differences in muscular activation achieved between devices for the triceps brachii, biceps brachii and forearm flexor muscles. Exercise in the transverse plane resulted in 30.5%, 29.5%, and 19.5% greater activation than the sagittal and 21.8%, 17.2%, and 26.3% greater activation than the frontal plane for the anterior deltoid, TA/IO and LSES respectively. Conclusions: A DOD demonstrated greater muscular activity for trunk and shoulder muscle activation but does not provide an advantage for limb activation. Overall, oscillating the devices in the transverse plane provided greater muscular activation of the anterior deltoid, TA/IO and LSES than use of the devices during frontal or sagittal plane movements. Level of evidence: 2c: Outcomes research. PMID:24175124

Influence of cold-water immersion on limb blood flow after resistance exercise.

PubMed

Mawhinney, Chris; Jones, Helen; Low, David A; Green, Daniel J; Howatson, Glyn; Gregson, Warren

2017-06-01

This study determined the influence of cold (8°C) and cool (22°C) water immersion on lower limb and cutaneous blood flow following resistance exercise. Twelve males completed 4 sets of 10-repetition maximum squat exercise and were then immersed, semi-reclined, into 8°C or 22°C water for 10-min, or rested in a seated position (control) in a randomized order on different days. Rectal and thigh skin temperature, muscle temperature, thigh and calf skin blood flow and superficial femoral artery blood flow were measured before and after immersion. Indices of vascular conductance were calculated (flux and blood flow/mean arterial pressure). The colder water reduced thigh skin temperature and deep muscle temperature to the greatest extent (P < .001). Reductions in rectal temperature were similar (0.2-0.4°C) in all three trials (P = .69). Femoral artery conductance was similar after immersion in both cooling conditions, with both conditions significantly lower (55%) than the control post-immersion (P < .01). Similarly, there was greater thigh and calf cutaneous vasoconstriction (40-50%) after immersion in both cooling conditions, relative to the control (P < .01), with no difference between cooling conditions. These findings suggest that cold and cool water similarly reduce femoral artery and cutaneous blood flow responses but not muscle temperature following resistance exercise.

Aerobic Exercise Alters Analgesia and Neurotrophin-3 Synthesis in an Animal Model of Chronic Widespread Pain

PubMed Central

Ryals, Janelle M.; Gajewski, Byron J.; Wright, Douglas E.

2010-01-01

Background Present literature and clinical practice provide strong support for the use of aerobic exercise in reducing pain and improving function for individuals with chronic musculoskeletal pain syndromes. However, the molecular basis for the positive actions of exercise remains poorly understood. Recent studies suggest that neurotrophin-3 (NT-3) may act in an analgesic fashion in various pain states. Objective The purpose of the present study was to examine the effects of moderate-intensity aerobic exercise on pain-like behavior and NT-3 in an animal model of widespread pain. Design This was a repeated-measures, observational cross-sectional study. Methods Forty female mice were injected with either normal (pH 7.2; n=20) or acidic (pH 4.0; n=20) saline in the gastrocnemius muscle to induce widespread hyperalgesia and exercised for 3 weeks. Cutaneous (von Frey monofilament) and muscular (forceps compression) mechanical sensitivity were assessed. Neurotrophin-3 was quantified in 2 hind-limb skeletal muscles for both messenger RNA (mRNA) and protein levels after exercise training. Data were analyzed with 2-factor analysis of variance for repeated measures (group × time). Results Moderate-intensity aerobic exercise reduced cutaneous and deep tissue hyperalgesia induced by acidic saline and stimulated NT-3 synthesis in skeletal muscle. The increase in NT-3 was more pronounced at the protein level compared with mRNA expression. In addition, the increase in NT-3 protein was significant in the gastrocnemius muscle but not in the soleus muscle, suggesting that exercise can preferentially target NT-3 synthesis in specific muscle types. Limitations Results are limited to animal models and cannot be generalized to chronic pain syndromes in humans. Conclusions This is the first study demonstrating the effect of exercise on deep tissue mechanical hyperalgesia in a rodent model of pain and providing a possible molecular basis for exercise training in reducing muscular pain. PMID:20338916

[Improvement in quality of life and exercise capacity without muscular biology changes after general training in patients with severe chronic obstructive pulmonary disease].

PubMed

Pascual-Guardia, Sergio; Wodja, Emil; Gorostiza, Amaya; López de Santamaría, Elena; Gea, Joaquim; Gáldiz, Juan B; Sliwinski, Pawel; Barreiro, Esther

2013-03-02

Despite the beneficial effects of exercise training in chronic obstructive pulmonary disease (COPD) patients, several studies have revealed functional and biological abnormalities in their peripheral muscles. The objective was to determine whether exercise training of high intensity and long duration modifies oxidative stress levels and structure of respiratory and peripheral muscles of severe COPD patients, while also improving their exercise capacity and quality of life. Multicenter study (Warsaw and Barakaldo) in which 25 severe COPD out-patients were recruited from the COPD clinics. In all patients, lung and muscle functions, exercise capacity (walking test and cycloergometer) and quality of life (QoL) were assessed, and open muscle biopsies from the vastus lateralis and external intercostals (n=14) were obtained before and after an exercise training program of high intensity (respiratory rehabilitation area, 70% maximal tolerated load in a cycloergometer) and long duration (10 weeks). Oxidative stress and muscle structural modifications were evaluated in all muscle biopsies using immunoblotting and immunohistochemistry. In all patients, after the training program, without any drop-outs, exercise capacity and QoL improved significantly, whereas oxidative stress, muscle damage and structure were not modified in their respiratory or limb muscles compared to baseline. In patients with severe COPD, exercise training of high intensity and long duration significantly improves their exercise capacity and QoL, without inducing significant modifications on oxidative stress levels or muscle structure in their respiratory or peripheral muscles. These results may have future clinical therapeutic implications. Copyright © 2011 Elsevier España, S.L. All rights reserved.

High-intensity Aerobic Exercise Blocks the Facilitation of iTBS-induced Plasticity in the Human Motor Cortex.

PubMed

Smith, Ashleigh E; Goldsworthy, Mitchell R; Wood, Fiona M; Olds, Timothy S; Garside, Tessa; Ridding, Michael C

2018-03-01

Acute exercise studies using transcranial magnetic stimulation (TMS) can provide important insights into the mechanisms underpinning the positive relationship between regular engagement in physical activity and cortical neuroplasticity. Emerging evidence indicates that a single session of aerobic exercise can promote the response to an experimentally induced suppressive neuroplasticity paradigm; however, little is known about the neuroplasticity response to facilitatory paradigms, including intermittent theta burst stimulation (iTBS). To more fully characterize the effects of exercise on brain plasticity we investigated if a single 30 min bout of high-intensity cycling (80% predicted heart rate reserve) modulated the response to an iTBS paradigm compared to rest. In 18 participants (9 females; 25.5 ± 5.0 years, range: 18-35 years) iTBS was applied using standard repetitive transcranial magnetic stimulation techniques immediately following exercise or 30 min of rest. Motor evoked potentials (MEPs) were recorded from the right first dorsal interosseous muscle at baseline, after the exercise/rest period but before iTBS, and at 5 time points following iTBS (0, 5, 10, 20 and 30 min). Contrary to our hypothesis, MEPs were suppressed following iTBS after a single 30 min bout of lower limb aerobic exercise compared to rest. These results indicate that acute aerobic exercise may not always enhance the response to an experimentally induced neuroplasticity paradigm. Further investigation of the factors that influence the relationship between exercise and neuroplasticity is warranted. Copyright © 2018 IBRO. Published by Elsevier Ltd. All rights reserved.

Does neuromuscular electrical stimulation training of the lower limb have functional effects on the elderly?: A systematic review.

PubMed

Langeard, Antoine; Bigot, Lucile; Chastan, Nathalie; Gauthier, Antoine

2017-05-01

The lower limb muscle functions of the elderly are known to be preferentially altered by ageing. Traditional training effectively counteracts some of these functional declines but is not always accessible due to its cost and to the accessibility of the training centers and to the incapacities of some seniors to practice some exercises. Neuromuscular electrical stimulation (NMES) could provide an interesting alternative muscle training technique because it is inexpensive and transportable. The aim of this systematic review was to summarize the current evidence on the effect of the use of lower limb NMES as a training technique for healthy elderly rehabilitation. Electronic databases were searched for trials occurring between 1971 (first occurrence of NMES training) and November 2016. Ten published articles were retrieved. Training programs either used NMES alone, or NMES associated with voluntary muscle contraction (NMES+). They either targeted calves or thigh muscles and their training length and intensity were heterogeneous but all studies noted positive effects of NMES on the elderly's functional status. Indeed, NMES efficiently improved functional and molecular muscle physiology, and, depending on the studies, could lead to better gait and balance performances especially among less active elderly. Given the association between gait, balance and the risk of falls among the elderly, future research should focus on the efficiency of NMES to reduce the high fall rate among this population. Copyright © 2017 Elsevier Inc. All rights reserved.

The Effect of Chinese Yuanji-Dance on Dynamic Balance and the Associated Attentional Demands in Elderly Adults

PubMed Central

Wu, Wen-Lan; Wei, Ta-Sen; Chen, Shen-Kai; Chang, Jyh-Jong; Guo, Lan-Yuen; Lin, Hwai-Ting

2010-01-01

Walking performance changes with age. This has implications for the problem of falls in older adults. The aim of this study was to investigate the effects of Yuanji-Dance practice on walking balance and the associated attention demand in healthy elderly. Fifteen community-dwelling elderly (comparison group, no regular exercise habit) and fifteen Yuanji- Dance elderly (exercise group, dancing experience: 5.40 ± 1.95 years), aged 60-70 years, were included in this study. The subjects in exercise group participated in a 90-minute Yuanji-Dance practice at least three times per week and the comparison group continued their normal daily physical activity. Walking balance measures (including walking velocity, step length, step width, and percentage of time spent in double limb support, COM velocity and COM-COP inclination angles) and attentional demand tests (button reaction time and accuracy) were conducted under different conditions. Our results showed that stride lengths, walking velocities, peak A/P velocities (AP V) of the COM, medial COM-COP inclination (M angle) angles, reaction time, and accuracy decrease significantly as the dual-task (walking plus hand button pressing tasks) applied for either the comparison or exercise groups. These results demonstrated that walking performance is attenuated in our elderly participants as the cognitive tasks applied. Analysis also identified a significantly faster RT for our exercise group both in standing and walking conditions. This may indicate that physical exercise (Yuanji-Dance) may have facilitating effects on general cognitive and perceptual- motor functions. This implies that Chinese Yuanji-Dance practice for elderly adults may improve their personal safety when walking especially under the condition of multiple task demand. Key points The purpose of this study was to investigate the training effects of a Chinese traditional exercise, Yuanji-Dance, on walking balance and the associated attention demand in the healthy elderly. Walking performance is attenuated in elderly participants as the cognitive tasks applied. A significantly faster reaction time for our exercise group both in standing and walking conditions. Yuanji-Dance exercise training can improve the information processing speed of elderly people and has no influence of the dynamic walking balance. PMID:24149395

Effects of rest interval on isokinetic strength and functional performance after short-term high intensity training.

PubMed

Pincivero, D M; Lephart, S M; Karunakara, R G

1997-09-01

The ability to maximally generate active muscle tension during resistance training has been established to be a primary determinant for strength development. The influence of intrasession rest intervals may have a profound effect on strength gains subsequent to short-term high intensity training. The purpose of this study was to examine the effects of rest interval on strength and functional performance after four weeks of isokinetic training. Fifteen healthy college aged individuals were randomly assigned to either a short rest interval group (group 1, n = 8) or a long rest interval group (group 2, n = 7). Subjects were evaluated for quadriceps and hamstring isokinetic strength at 60 (five repetitions) and 180 (30 repetitions) degrees/second and functional performance with the single leg hop for distance test. One leg of each subject was randomly assigned to a four week, three days/week isokinetic strength training programme for concentric knee extension and flexion performed at 90 degrees/second. Subjects in group 1 received a 40 second rest interval in between exercise sets, whereas subjects in group 2 received a 160 second rest period. A two factor analysis of variance for the pre-test--post-test gain scores (%) showed significantly greater improvements for isokinetic hamstring total work and average power at 180 degrees/second for the trained limb of subjects in group 2 than their contralateral non-trained limb and the subjects in group 1. Significantly greater improvements for the single leg hop for distance were also found for the trained limbs of subjects in both groups as compared with the non-trained limbs. The findings indicate that a relatively longer intrasession rest period resulted in a greater improvement in hamstring muscle strength during short term high intensity training.

The differential diagnosis of the short-limbed dwarfs presenting at birth.

PubMed Central

Mukherji, R. N.; Moss, P. D.

1977-01-01

Attention is drawn to the fact that in a number of types of short-limbed dwarfism a precise diagnosis can be made in the neonatal period. Examples are given and the prognostic and genetic implications are discussed. It is important to be able to advise parents of the likely outlook for the infant and of the genetic implication. Early diagnosis is therefore not merely an academic exercise. Images Fig. 6 Fig. 7 Fig. 8 Fig. 9 Fig. 1 Fig. 2 Fig. 3 Fig. 4 Fig. 5 Fig. 10 Fig. 11 PMID:859790

Effects of whole body vibration exercise on neuromuscular function for individuals with knee osteoarthritis: study protocol for a randomized controlled trial.

PubMed

Lai, Zhangqi; Wang, Xueqiang; Lee, Seullee; Hou, Xihe; Wang, Lin

2017-09-20

Knee osteoarthritis (KOA) is a leading cause of public disability. Neuromuscular function contributes to the development and/or progression of KOA. Whole body vibration (WBV) exercise improve the neuromuscular function of patients with neurological disorders and even that of older patients with limited exercise options. Therefore, WBV exercise may offer an efficient and alternative treatment for individuals with KOA. However, the effects of WBV training on the neuromuscular function of individuals with KOA remain unclear. Therefore, this study attempts to investigate the effect of a 12-week WBV exercise on the neuromuscular function of individuals with KOA. We will conduct a prospective, single-blind randomized controlled trial on 180 KOA patients. Participants will be randomly assigned to the WBV exercise, lower extremity resistance training, and health education groups. The WBV exercise group will participate in a 12-week WBV training. The lower extremity resistance training group will undergo a 12-week lower extremity resistance training of both lower limbs. The control group will receive health education for 12 weeks. After the intervention, the participants will be followed up for 3 months with no active intervention. Primary outcome measures will include anthropometric measurements, gait analysis during walking and stair climbing, muscle strength test of the knee and ankle, proprioception test of the knee and ankle, and neuromuscular response of the leg muscles. Secondary outcome measures will include self-reported pain and physical functional capacity, and physical performance measures. Furthermore, adverse events will be recorded and analyzed. If any participant withdraws from the trial, intention-to-treat analysis will be performed. Important features of this trial mainly include intervention setting, outcome measure selection, and study duration. This study is intended for estimating the effect of WBV intervention on neuromuscular control outcomes. Study results may provide evidence to support the beneficial effects of WBV exercise on the physical performance and neuromuscular control of individuals with KOA to fill the research gap on the efficacy of WBV. Chinese Clinical Trial Registry, ID: ChiCTR-IOR-16009234 . Registered on 21 September 2016.

Error amplification to promote motor learning and motivation in therapy robotics.

PubMed

Shirzad, Navid; Van der Loos, H F Machiel

2012-01-01

To study the effects of different feedback error amplification methods on a subject's upper-limb motor learning and affect during a point-to-point reaching exercise, we developed a real-time controller for a robotic manipulandum. The reaching environment was visually distorted by implementing a thirty degrees rotation between the coordinate systems of the robot's end-effector and the visual display. Feedback error amplification was provided to subjects as they trained to learn reaching within the visually rotated environment. Error amplification was provided either visually or through both haptic and visual means, each method with two different amplification gains. Subjects' performance (i.e., trajectory error) and self-reports to a questionnaire were used to study the speed and amount of adaptation promoted by each error amplification method and subjects' emotional changes. We found that providing haptic and visual feedback promotes faster adaptation to the distortion and increases subjects' satisfaction with the task, leading to a higher level of attentiveness during the exercise. This finding can be used to design a novel exercise regimen, where alternating between error amplification methods is used to both increase a subject's motor learning and maintain a minimum level of motivational engagement in the exercise. In future experiments, we will test whether such exercise methods will lead to a faster learning time and greater motivation to pursue a therapy exercise regimen.

Voluntary Exercise Improves Estrous Cyclicity in Prenatally Androgenized Female Mice Despite Programming Decreased Voluntary Exercise: Implications for Polycystic Ovary Syndrome (PCOS).

PubMed

Homa, Lori D; Burger, Laura L; Cuttitta, Ashley J; Michele, Daniel E; Moenter, Suzanne M

2015-12-01

Prenatal androgen (PNA) exposure in mice produces a phenotype resembling lean polycystic ovary syndrome. We studied effects of voluntary exercise on metabolic and reproductive parameters in PNA vs vehicle (VEH)-treated mice. Mice (8 wk of age) were housed individually and estrous cycles monitored. At 10 weeks of age, mice were divided into groups (PNA, PNA-run, VEH, VEH-run, n = 8-9/group); those in the running groups received wheels allowing voluntary running. Unexpectedly, PNA mice ran less distance than VEH mice; ovariectomy eliminated this difference. In ovary-intact mice, there was no difference in glucose tolerance, lower limb muscle fiber types, weight, or body composition among groups after 16 weeks of running, although some mitochondrial proteins were mildly up-regulated by exercise in PNA mice. Before running, estrous cycles in PNA mice were disrupted with most days in diestrus. There was no change in cycles during weeks 1-6 of running (10-15 wk of age). In contrast, from weeks 11 to 16 of running, cycles in PNA mice improved with more days in proestrus and estrus and fewer in diestrus. PNA programs reduced voluntary exercise, perhaps mediated in part by ovarian secretions. Exercise without weight loss improved estrous cycles, which if translated could be important for fertility in and counseling of lean women with polycystic ovary syndrome.

Effects of different heel-raise-lower exercise interventions on the strength of plantarflexion, balance, and gait parameters in stroke survivors.

PubMed

Lee, Seung-Mi; Cynn, Heon-Seock; Yoon, Tae-Lim; Lee, Ji-Hyun

2017-09-01

The objective of this study was to investigate the effects of Heel-Raise-Lower Exercise (HRLE) interventions on the strength of plantarflexion, balance, and gait parameters in people with stroke. Specifically, this study compared the two different HRLEs to identify whether heels raise-lower with forefoot on a block (HRB) is more effective or ineffective to enhance strength and functional capacities than heels raise-lower on a level floor (HRL) exercise in people with stroke. Repetitive heel raise-lower is a common exercise for improving the strength and power of ankle plantarflexors. It is a simple movement, requires no equipment, and can be performed at home. Each group of 10 people with stroke was given either HRB training or HRL training. The subjects performed the exercise 100 times per day, 5 days per week for 6 weeks. The strength of plantarflexors, static/dynamic balance, and gait parameters were measured using the manual muscle test (MMT), a Biodex Balance System (BBS) SD, and the GAITRite system. After 6 weeks of treatment, there were significant increases in the plantarflexors strength in both groups: by 34% in the HRB group and by 21% in the HRL group. Static and dynamic balance and gait speed also increased significantly in both groups. However, cadence, the paretic side single limb support period (SLSP), paretic side step length, and paretic side stride length significantly increased only in the HRB group. The HRB improved significantly the plantar flexor strength of the paretic side, gait speed, and cadence compared to the HRL.

Increased Interstitial Concentrations of Glutamate and Pyruvate in Vastus Lateralis of Women with Fibromyalgia Syndrome Are Normalized after an Exercise Intervention – A Case-Control Study

PubMed Central

Gerdle, Björn; Ernberg, Malin; Mannerkorpi, Kaisa; Larsson, Britt; Kosek, Eva; Christidis, Nikolaos; Ghafouri, Bijar

2016-01-01

Background Fibromyalgia syndrome (FMS) is associated with central alterations, but controversies exist regarding the presence and role of peripheral factors. Microdialysis (MD) can be used in vivo to study muscle alterations in FMS. Furthermore for chronic pain conditions such as FMS, the mechanisms for the positive effects of exercise are unclear. This study investigates the interstitial concentrations of algesics and metabolites in the vastus lateralis muscle of 29 women with FMS and 28 healthy women before and after an exercise intervention. Methods All the participants went through a clinical examination and completed a questionnaire. In addition, their pressure pain thresholds (PPTs) in their upper and lower extremities were determined. For both groups, MD was conducted in the vastus lateralis muscle before and after a 15-week exercise intervention of mainly resistance training of the lower limbs. Muscle blood flow and interstitial muscle concentrations of lactate, pyruvate, glutamate, glucose, and glycerol were determined. Results FMS was associated with significantly increased interstitial concentrations of glutamate, pyruvate, and lactate. After the exercise intervention, the FMS group exhibited significant decreases in pain intensity and in mean interstitial concentrations of glutamate, pyruvate, and glucose. The decrease in pain intensity in FMS correlated significantly with the decreases in pyruvate and glucose. In addition, the FMS group increased their strength and endurance. Conclusion This study supports the suggestion that peripheral metabolic and algesic muscle alterations are present in FMS patients and that these alterations contribute to pain. After an exercise intervention, alterations normalized, pain intensity decreased (but not abolished), and strength and endurance improved, all findings that suggest the effects of exercise are partially peripheral. PMID:27695113

Cycling exercise and fetal spinal cord transplantation act synergistically on atrophied muscle following chronic spinal cord injury in rats.

PubMed

Peterson, C A; Murphy, R J; Dupont-Versteegden, E E; Houlé, J D

2000-01-01

The potential of two interventions, alone or in combination, to restore chronic spinal cord transection-induced changes in skeletal muscles of adult Sprague-Dawley rats was studied. Hind limb skeletal muscles were examined in the following groups of animals: rats with a complete spinal cord transection (Tx) for 8 weeks; Tx with a 4-week delay before initiation of a 4-week motor-assisted cycling exercise (Ex) program; Tx with a 4-week delay before transplantation (Tp) of fetal spinal cord tissue into the lesion cavity; Tx with a 4-week delay before Tp and Ex; and uninjured control animals. Muscle mass, muscle to body mass ratios, and mean myofiber cross-sectional areas were significantly reduced 8 weeks after transection. Whereas transplantation of fetal spinal cord tissue did not reverse this atrophy and exercise alone had only a modest effect in restoring lost muscle mass, the combination of exercise and transplantation significantly increased muscle mass, muscle to body mass ratios, and mean myofiber cross-sectional areas in both soleus and plantaris muscles. Spinal cord injury (SCI) also caused changes in myosin heavy chain (MyHC) expression toward faster isoforms in both soleus and plantaris and increased soleus myofiber succinate dehydrogenase (SDH) activity. Combined exercise and transplantation led to a change in the expression of the fastest MyHC isoform in soleus but had no effect in the plantaris. Exercise alone and in combination with transplantation reduced SDH activity to control levels in the soleus. These results suggest a synergistic action of exercise and transplantation of fetal spinal cord tissue on skeletal muscle properties following SCI, even after an extended post-injury period before intervention.

Effect of Virtual Reality-based Bilateral Upper Extremity Training on Upper Extremity Function after Stroke: A Randomized Controlled Clinical Trial.

PubMed

Lee, Suhyun; Kim, Yumi; Lee, Byoung-Hee

2016-12-01

In the present study, we aimed to investigate the effect of virtual reality-based bilateral upper extremity training (VRBT) on paretic upper limb function and muscle strength in patients with stroke. Eighteen stroke survivors were assigned to either the VRBT group (n = 10) or the bilateral upper limb training group (BT, n = 8). Patients in the VRBT group performed bilateral upper extremity exercises in a virtual reality environment, whereas those in the BT group performed conventional bilateral upper extremity exercises. All training was conducted for 30 minutes day -1 , 3 days a week, for a period of 6 weeks. Patients were assessed for upper extremity function and hand strength. Compared with the BT group, the VRBT group exhibited significant improvements in upper extremity function and muscle strength (p < 0.05) after the 6-week training programme. The Box and Block test results revealed that upper extremity function and elbow flexion in hand strength were significantly improved in terms of group, time and interaction effect of group by time. Furthermore, the VRBT group demonstrated significant improvements in upper extremity function, as measured by the Jebsen Hand Function Test and Grooved Pegboard test, and in the hand strength test, as measured by elbow extension, grip, palmar pinch, lateral pinch and tip pinch, in both time and the interaction effect of group by time. These results suggest that VRBT is a feasible and beneficial means of improving upper extremity function and muscle strength in individuals following stroke. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Psychophysiological effects of synchronous versus asynchronous music during cycling.

PubMed

Lim, Harry B T; Karageorghis, Costas I; Romer, Lee M; Bishop, Daniel T

2014-02-01

Synchronizing movement to a musical beat may reduce the metabolic cost of exercise, but findings to date have been equivocal. Our aim was to examine the degree to which the synchronous application of music moderates the metabolic demands of a cycle ergometer task. Twenty-three recreationally active men made two laboratory visits. During the first visit, participants completed a maximal incremental ramp test on a cycle ergometer. At the second visit, they completed four randomized 6-min cycling bouts at 90% of ventilatory threshold (control, metronome, synchronous music, and asynchronous music). Main outcome variables were oxygen uptake, HR, ratings of dyspnea and limb discomfort, affective valence, and arousal. No significant differences were evident for oxygen uptake. HR was lower under the metronome condition (122 ± 15 bpm) compared to asynchronous music (124 ± 17 bpm) and control (125 ± 16 bpm). Limb discomfort was lower while listening to the metronome (2.5 ± 1.2) and synchronous music (2.3 ± 1.1) compared to control (3.0 ± 1.5). Both music conditions, synchronous (1.9 ± 1.2) and asynchronous (2.1 ± 1.3), elicited more positive affective valence compared to metronome (1.2 ± 1.4) and control (1.2 ± 1.2), while arousal was higher with synchronous music (3.4 ± 0.9) compared to metronome (2.8 ± 1.0) and control (2.8 ± 0.9). Synchronizing movement to a rhythmic stimulus does not reduce metabolic cost but may lower limb discomfort. Moreover, synchronous music has a stronger effect on limb discomfort and arousal when compared to asynchronous music.

Effectiveness of acute in-hospital physiotherapy with knee-extension strength training in reducing strength deficits in patients with a hip fracture: A randomised controlled trial

PubMed Central

2017-01-01

Question Is acute in-hospital physiotherapy with additional progressive knee-extension strength training (ST) of the fractured limb more effective in reducing knee-extension strength deficit at follow-up compared to physiotherapy without strength training in patients with a hip fracture? Design Assessor blinded, randomised controlled trial with intention-to-treat analysis. Participants 90 patients with a hip fracture admitted to an acute orthopaedic Hip Fracture Unit at a university hospital between October 2013 and May 2015. Intervention Daily physiotherapy with or without progressive knee-extension strength training (10RM), 3 x 10 repetitions, of the fractured limb using ankle weight cuffs conducted by ward physical therapists during hospital stay. Outcome measures Primary outcome was the change in maximal isometric knee-extension strength in the fractured limb in percentage of the non-fractured limb from inclusion to postoperative day 10 or discharge (follow-up). Secondary outcome was Timed Up and Go test measured early after surgery and at follow-up. Results In the intention-to-treat analysis of between-group differences, the primary outcome improved 8.1% (95% CI -2.3; 18.4) by additional strength training from baseline to follow-up. In the per-protocol analysis of non-missing data, significant between-group improvements by 10.5% (95% CI 0.3; 20.7) were found in favour of additional ST. No significant between-group differences were found in any secondary outcome. Conclusion Physiotherapy with addition of 5 sessions of ST yielded no additional improvements compared to physiotherapy without strength training in reducing the knee-extension strength deficit at follow-up in patients with a hip fracture. It is debatable whether larger improvements than the observed 8–10% can be expected given that only five exercise sessions, on average, were completed. In fragile patients with a hip fracture in the acute phase, where the ability to participate in functional exercise is compromised, we still consider early strength training a possibility to improve outcomes of clinical importance, given the results of the per-protocol analysis. The present data provides an important basis and call for future investigations including longer term interventions. Trial registration Clinicaltrials.gov NCT00848913 PMID:28662153

Movement amplitude on the Functional Re-adaptive Exercise Device: deep spinal muscle activity and movement control.

PubMed

Winnard, A; Debuse, D; Wilkinson, M; Samson, L; Weber, T; Caplan, Nick

2017-08-01

Lumbar multifidus (LM) and transversus abdominis (TrA) show altered motor control, and LM is atrophied, in people with low-back pain (LBP). The Functional Re-adaptive Exercise Device (FRED) involves cyclical lower-limb movement against minimal resistance in an upright posture. It has been shown to recruit LM and TrA automatically, and may have potential as an intervention for non-specific LBP. However, no studies have yet investigated the effects of changes in FRED movement amplitude on the activity of these muscles. This study aimed to assess the effects of different FRED movement amplitudes on LM and TrA muscle thickness and movement variability, to inform an evidence-based exercise prescription. Lumbar multifidus and TrA thickness of eight healthy male volunteers were examined using ultrasound imaging during FRED exercise, normalised to rest at four different movement amplitudes. Movement variability was also measured. Magnitude-based inferences were used to compare each amplitude. Exercise at all amplitudes recruited LM and TrA more than rest, with thickness increases of approximately 5 and 1 mm, respectively. Larger amplitudes also caused increased TrA thickness, LM and TrA muscle thickness variability and movement variability. The data suggests that all amplitudes are useful for recruiting LM and TrA. A progressive training protocol should start in the smallest amplitude, increasing the setting once participants can maintain a consistent movement speed, to continue to challenge the motor control system.

Effect of stretching with and without muscle strengthening exercises for the foot and hip in patients with plantar fasciitis: A randomized controlled single-blind clinical trial.

PubMed

Kamonseki, Danilo H; Gonçalves, Geiseane A; Yi, Liu C; Júnior, Império Lombardi

2016-06-01

To compare the effect of stretching with and without muscle strengthening of the foot alone or foot and hip on pain and function in patients with plantar fasciitis. Single blind randomized controlled trial. Eighty-three patients with plantar fasciitis were allocated to one of three treatment options for an eight-week period: Foot Exercise Group (FEG - extrinsic and intrinsic foot muscles), Foot and Hip Exercise Group (FHEG - abductor and lateral rotator muscles) and Stretching Alone Exercise Group (SAEG). A visual analog scale for pain, the Foot and Ankle Outcome Score and the Star Excursion Balance Test. All evaluations were performed before treatment and after the last treatment session. Improvements were found in all groups regarding the visual analog scale, the pain, activities of daily living, sports and recreation, quality of life (p < 0.001) and other symptoms (p < 0.01) subscales of the Foot and Ankle Outcome Score as well as posterolateral movement, posteromedial movement and composite score (p < 0.001) on the Star Excursion Balance Test. No time-group interactions were found for any of the variables (p > 0.05). All three exercise protocols analyzed led to improvements at eight-week follow-up in pain, function and dynamic lower limb stability in patients with plantar fasciitis. Copyright © 2015 Elsevier Ltd. All rights reserved.

A novel dynamic exercise initiative for older people to improve health and well-being: study protocol for a randomised controlled trial.

PubMed

Sales, Myrla Patricia Reis; Polman, Remco; Hill, Keith D; Karaharju-Huisman, Tuire; Levinger, Pazit

2015-06-24

Exercise is an important and effective approach to preventing falls in older people, but adherence to exercise participation remains a persistent problem. A unique purpose-built exercise park was designed to provide a fun but physically challenging environment to support exercise in a community setting. This project is a randomised controlled trial designed to evaluate the effectiveness of an exercise intervention using an exercise park specifically designed for older people in reducing the risk of falls. This study will be a parallel randomised control trial with pre and post intervention design. One hundred and twenty people aged between 60 and 90 years old will be recruited from Melbourne suburbs and will be randomly allocated to either an exercise park intervention group (EPIG) or a control group (CG). The CG will receive social activities and an educational booklet on falls prevention. The BOOMER balance test will be used as the primary outcome measure. Secondary outcome measures will include hand grip strength, two minute walk test, lower limb strength test, spatio-temporal walking parameters, health related quality of life, feasibility, adherence, safety, and a number of other psychosocial measures. Outcome assessment will be conducted at baseline and at 18 and 26 weeks after intervention commencement. Participants will inform their falls and physical activity history for a 12-month period via monthly calendars. Mixed linear modelling incorporating intervention and control groups at the baseline and two follow up time points (18 weeks and 26 weeks after intervention commencement) will be used to assess outcomes. This planned trial will be the first to provide evidence if the exercise park can improve functional and physiological health, psychological and well-being. In addition, this study will provide empirical evidence for effectiveness and explore the barriers to participation and the acceptability of the senior exercise park in the Australian older community. This trial is registered with the Australian New Zealand Clinical Trials Registry-Registry No. ACTRN12614000700639 registered on Jul 3rd 2014.

GH/IGF-I Transgene Expression on Muscle Homeostasis

NASA Technical Reports Server (NTRS)

Schwartz, Robert J.

1999-01-01

We propose to test the hypothesis that the growth hormone/ insulin like growth factor-I axis through autocrine/paracrine mechanisms may provide long term muscle homeostasis under conditions of prolonged weightlessness. As a key alternative to hormone replacement therapy, ectopic production of hGH, growth hormone releasing hormone (GHRH), and IGF-I will be studied for its potential on muscle mass impact in transgenic mice under simulated microgravity. Expression of either hGH or IGF-I would provide a chronic source of a growth-promoting protein whose biosynthesis or secretion is shut down in space. Muscle expression of the IGF-I transgene has demonstrated about a 20% increase in hind limb muscle mass over control nontransgenic litter mates. These recent experiments, also establish the utility of hind-limb suspension in mice as a workable model to study atrophy in weight bearing muscles. Thus, transgenic mice will be used in hind-limb suspension models to determine the role of GH/IGF-I on maintenance of muscle mass and whether concentric exercises might act in synergy with hormone treatment. As a means to engineer and ensure long-term protein production that would be workable in humans, gene therapy technology will be used by to monitor muscle mass preservation during hind-limb suspension, after direct intramuscular injection of a genetically engineered muscle-specific vector expressing GHRH. Effects of this gene-based therapy will be assessed in both fast twitch (medial gastrocnemius) and slow twitch muscle (soleus). End-points include muscle size, ultrastructure, fiber type, and contractile function, in normal animals, hind limb suspension, and reambutation.

Retrieval of stratospheric ozone and nitrogen dioxide profiles from Odin Optical Spectrograph and Infrared Imager System (OSIRIS) limb-scattered sunlight measurements

NASA Astrophysics Data System (ADS)

Haley, Craig Stuart

2009-12-01

Key to understanding and predicting the effects of global environmental problems such as ozone depletion and global warming is a detailed understanding of the atmospheric processes, both dynamical and chemical. Essential to this understanding are accurate global data sets of atmospheric constituents with adequate temporal and spatial (vertical and horizontal) resolutions. For this purpose the Canadian satellite instrument OSIRIS (Optical Spectrograph and Infrared Imager System) was launched on the Odin satellite in 2001. OSIRIS is primarily designed to measure minor stratospheric constituents, including ozone (O3) and nitrogen dioxide (NO2), employing the novel limb-scattered sunlight technique, which can provide both good vertical resolution and near global coverage. This dissertation presents a method to retrieve stratospheric O 3 and NO2 from the OSIRIS limb-scatter observations. The retrieval method incorporates an a posteriori optimal estimator combined with an intermediate spectral analysis, specifically differential optical absorption spectroscopy (DOAS). A detailed description of the retrieval method is presented along with the results of a thorough error analysis and a geophysical validation exercise. It is shown that OSIRIS limb-scatter observations successfully produce accurate stratospheric O3 and NO2 number density profiles throughout the stratosphere, clearly demonstrating the strength of the limb-scatter technique. The OSIRIS observations provide an extremely useful data set that is of particular importance for studies of the chemistry of the middle atmosphere. The long OSIRIS record of stratospheric ozone and nitrogen dioxide may also prove useful for investigating variability and trends.

Exercise order affects the total training volume and the ratings of perceived exertion in response to a super-set resistance training session

PubMed Central

Balsamo, Sandor; Tibana, Ramires Alsamir; Nascimento, Dahan da Cunha; de Farias, Gleyverton Landim; Petruccelli, Zeno; de Santana, Frederico dos Santos; Martins, Otávio Vanni; de Aguiar, Fernando; Pereira, Guilherme Borges; de Souza, Jéssica Cardoso; Prestes, Jonato

2012-01-01

The super-set is a widely used resistance training method consisting of exercises for agonist and antagonist muscles with limited or no rest interval between them – for example, bench press followed by bent-over rows. In this sense, the aim of the present study was to compare the effects of different super-set exercise sequences on the total training volume. A secondary aim was to evaluate the ratings of perceived exertion and fatigue index in response to different exercise order. On separate testing days, twelve resistance-trained men, aged 23.0 ± 4.3 years, height 174.8 ± 6.75 cm, body mass 77.8 ± 13.27 kg, body fat 12.0% ± 4.7%, were submitted to a super-set method by using two different exercise orders: quadriceps (leg extension) + hamstrings (leg curl) (QH) or hamstrings (leg curl) + quadriceps (leg extension) (HQ). Sessions consisted of three sets with a ten-repetition maximum load with 90 seconds rest between sets. Results revealed that the total training volume was higher for the HQ exercise order (P = 0.02) with lower perceived exertion than the inverse order (P = 0.04). These results suggest that HQ exercise order involving lower limbs may benefit practitioners interested in reaching a higher total training volume with lower ratings of perceived exertion compared with the leg extension plus leg curl order. PMID:22371654

Technology-assisted training of arm-hand skills in stroke: concepts on reacquisition of motor control and therapist guidelines for rehabilitation technology design

PubMed Central

Timmermans, Annick AA; Seelen, Henk AM; Willmann, Richard D; Kingma, Herman

2009-01-01

Background It is the purpose of this article to identify and review criteria that rehabilitation technology should meet in order to offer arm-hand training to stroke patients, based on recent principles of motor learning. Methods A literature search was conducted in PubMed, MEDLINE, CINAHL, and EMBASE (1997–2007). Results One hundred and eighty seven scientific papers/book references were identified as being relevant. Rehabilitation approaches for upper limb training after stroke show to have shifted in the last decade from being analytical towards being focussed on environmentally contextual skill training (task-oriented training). Training programmes for enhancing motor skills use patient and goal-tailored exercise schedules and individual feedback on exercise performance. Therapist criteria for upper limb rehabilitation technology are suggested which are used to evaluate the strengths and weaknesses of a number of current technological systems. Conclusion This review shows that technology for supporting upper limb training after stroke needs to align with the evolution in rehabilitation training approaches of the last decade. A major challenge for related technological developments is to provide engaging patient-tailored task oriented arm-hand training in natural environments with patient-tailored feedback to support (re) learning of motor skills. PMID:19154570

A short overview of upper limb rehabilitation devices

NASA Astrophysics Data System (ADS)

Macovei, S.; Doroftei, I.

2016-08-01

As some studies show, the number of people over 65 years old increases constantly, leading to the need of solution to provide services regarding patient mobility. Diseases, accidents and neurologic problems affect hundreds of people every day, causing pain and lost of motor functions. The ability of using the upper limb is indispensable for a human being in everyday activities, making easy tasks like drinking a glass of water a real challenge. We can agree that physiotherapy promotes recovery, but not at an optimal level, due to limited financial and human resources. Hence, the need of robot-assisted rehabilitation emerges. A robot for upper-limb exercises should have a design that can accurately control interaction forces and progressively adapt assistance to the patients’ abilities and also to record the patient's motion and evolution. In this paper a short overview of upper limb rehabilitation devices is presented. Our goal is to find the shortcomings of the current developed devices in terms of utility, ease of use and costs, for future development of a mechatronic system for upper limb rehabilitation.

Resveratrol enhances exercise training responses in rats selectively bred for high running performance.

PubMed

Hart, Nikolett; Sarga, Linda; Csende, Zsolt; Koltai, Erika; Koch, Lauren G; Britton, Steven L; Davies, Kelvin J A; Kouretas, Dimitris; Wessner, Barbara; Radak, Zsolt

2013-11-01

High Capacity Runner (HCR) rats have been developed by divergent artificial selection for treadmill endurance running capacity to explore an aerobic biology-disease connection. The beneficial effects of resveratrol supplementation have been demonstrated in endurance running and the antioxidant capacity of resveratrol is also demonstrated. In this study we examine whether 12 weeks of treadmill exercise training and/or resveratrol can enhance performance in HCR. Indeed, resveratrol increased aerobic performance and strength of upper limbs of these rats. Moreover, we have found that resveratrol activated the AMP-activated protein kinase, SIRT1, and mitochondrial transcription factor A (p<0.05). The changes in mitochondrial fission/fusion and Lon protease/HSP78 levels suggest that exercise training does not significantly induce damage of proteins. Moreover, neither exercise training nor resveratrol supplementation altered the content of protein carbonyls. Changes in the levels of forkhead transcription factor 1 and SIRT4 could suggest increased fat utilization and improved insulin sensitivity. These data indicate, that resveratrol supplementation enhances aerobic performance due to the activation of the AMPK-SIRT1-PGC-1α pathway. Copyright © 2013 Elsevier Ltd. All rights reserved.

Effect of duration of upper- and lower-extremity rehabilitation sessions and walking speed on recovery of interlimb coordination in hemiplegic gait.

PubMed

Kwakkel, Gert; Wagenaar, Robert C

2002-05-01

The effects of different durations of rehabilitation sessions for the upper extremities (UEs) and lower extremities (LEs) on the recovery of interlimb coordination in hemiplegic gait in patients who have had a stroke were investigated. Fifty-three subjects who had strokes involving their middle cerebral arteries were assigned to rehabilitation programs with (1) an emphasis on the LEs, (2) an emphasis on the paretic UE, or (3) a condition in which the paretic arm (UE) and leg (LE) were immobilized with an inflatable pressure splint (control treatment). The 3 treatment regimens were applied for 30 minutes, 5 days a week, during the first 20 weeks after onset of stroke. All subjects also participated in a rehabilitation program 5 days a week that consisted of 15 minutes of UE exercises and 15 minutes of LE exercises in addition to a weekly 11/2-hour session of training in activities of daily living. A repeated-measures design was used. Differences among the 3 treatment regimens were evaluated in terms of comfortable and maximal walking speeds. In addition, mean continuous relative phase (CRP) between paretic arm and leg (PAL) movements and nonparetic arm and leg (NAL) movements and standard deviations of CRP of both limb pairs as a measurement of stability (variability) were evaluated. Comfortable walking speed improved in the group that received interventions involving the LEs compared with the group that received interventions involving the UEs and the group that received the control treatment. No differences among the 3 treatment conditions were found for the mean CRP of NAL and PAL as well as the standard deviation of CRP of both limb pairs. With the exception of an improved comfortable walking speed as a result of a longer duration of rehabilitation sessions, no differential effects of duration of rehabilitation sessions for the LEs and UEs on the variable we measured related to hemiplegic gait were found. Increasing walking speed, however, resulted in a larger mean CRP for both limb pairs, with increased stability and asymmetry of walking, indicating that walking speed influences interlimb coordination in hemiplegic gait.

Effect of shoulder girdle strengthening on trunk alignment in patients with stroke.

PubMed

Awad, Amina; Shaker, Hussien; Shendy, Wael; Fahmy, Manal

2015-07-01

[Purpose] This study investigated the effect of shoulder girdle strengthening, particularly the scapular muscles, on poststroke trunk alignment. [Subjects and Methods] The study involved 30 patients with residual hemiparesis following cerebrovascular stroke. Patient assessment included measuring shoulder muscle peak torque, scapular muscles peak force, spinal lateral deviation angle, and motor functional performance. Patients were randomly allocated either to the control group or the study group and received an 18-session strengthening program including active resisted exercises for shoulder abductors and external rotators in addition to trunk control exercises. The study group received additional strengthening exercises for the scapular muscles. [Results] The two groups showed significant improvement in strength of all shoulder and scapular muscles, with higher improvement in the study group. Similarly, the lateral spinal deviation angles significantly improved in both groups, with significantly higher improvement in the study group. Transfer activity, sitting balance, upper limb functions, and hand movements significantly improved in the two groups, with higher improvement in the latter two functions in the study group. [Conclusion] Strengthening of shoulder girdle muscles, particularly scapular muscles, can significantly contribute to improving the postural alignment of the trunk in patients with poststroke hemiparesis.

Prevention of bedrest-induced physical deconditioning by daily dobutamine infusions. Implications for drug-induced physical conditioning.

PubMed Central

Sullivan, M J; Binkley, P F; Unverferth, D V; Ren, J H; Boudoulas, H; Bashore, T M; Merola, A J; Leier, C V

1985-01-01

The effects of intermittent infusions of dobutamine were studied in young normal male subjects during a period of bedrest deconditioning to determine whether this synthetic catechol affects physical conditioning processes in humans. 24 volunteers were placed at bedrest and randomized to daily 2-h treatments of saline infusions (control), dobutamine infusions, or maintenance exercise (control). Exercise, hemodynamic, and metabolic studies were performed at base line and at the termination of the 3-wk treatment period. Maximal exercise (duration, oxygen consumption, and workload) fell for the saline group and remained unchanged for the dobutamine and exercise groups. Hemodynamics during exercise were maintained the same as pretreatment base line for the dobutamine and exercise groups, whereas stroke volume and cardiac output dropped and heart rate rose for the saline group. The metabolic profile showed an increased blood lactate response at rest and during submaximal exercise after 3 wk of bedrest for the saline group, and essentially no change for the exercise and the dobutamine groups. Extraction of oxygen across the exercising lower limb rose for the dobutamine group, as did the activity of the skeletal muscle oxidative enzymes, citrate synthetase, and succinate dehydrogenase. In contrast to the exercise control group, the saline and dobutamine groups developed orthostatic hypotension, tachycardia, and accentuation of the renin-aldosterone response over the 3-wk treatment period; for the saline group, this is best explained by the observed fall in blood volume and for the dobutamine group, by the blunting of vascular vasoconstrictive responses. During a period of bedrest deconditioning in humans, infusions of dobutamine maintain many of the physiologic expressions of physical conditioning. PMID:3932470

Desensitization of the cough reflex by exercise and voluntary isocapnic hyperpnea.

PubMed

Lavorini, Federico; Fontana, Giovanni A; Chellini, Elisa; Magni, Chiara; Duranti, Roberto; Widdicombe, John

2010-05-01

Little is known about the effects of exercise on the sensory and cognitive aspects of coughing evoked by inhalation of tussigenic agents. The threshold for the cough reflex induced by inhalation of increasing nebulizer outputs of ultrasonically nebulized distilled water (fog), an index of cough reflex sensitivity, was assessed in twelve healthy humans in control conditions, during exercise and during voluntary isocapnic hyperpnea (VIH) at the same ventilatory level as the exercise. The intensity of the urge to cough (UTC), a cognitive component of coughing, was recorded throughout the trials on a linear scale. The relationships between inhaled fog nebulizer outputs and the correspondingly evoked UTC values, an index of the perceptual magnitude of the UTC sensitivity, were also calculated. Cough appearance was always assessed audiovisually. At an exercise level of 80% of anaerobic threshold, the median cough threshold was increased from a control value of 0.73 to 2.22 ml/min (P<0.01), i.e., cough sensitivity was downregulated. With VIH, the threshold increased from 0.73 to 2.22 ml/min (P<0.01), a similar downregulation. With exercise and VIH compared with control, mean UTC values at cough threshold were unchanged, i.e., control, 3.83 cm; exercise, 3.12 cm; VIH, 4.08 cm. The relationship of the fog nebulizer output/UTC value was linear in control conditions and logarithmic during both exercise and VIH. The perception of the magnitude of the UTC seems to be influenced by signals or sensations arising from exercising limb and thoracic muscles and/or by higher nervous (cortical) mechanisms. The results indicate that the adjustments brought into action by exercise-induced or voluntary hyperpnea exert inhibitory influences on the sensory and cognitive components of fog-induced cough.

Investigation of the Effects of High-Intensity, Intermittent Exercise and Unanticipation on Trunk and Lower Limb Biomechanics During a Side-Cutting Maneuver Using Statistical Parametric Mapping.

PubMed

Whyte, Enda F; Richter, Chris; OʼConnor, Siobhan; Moran, Kieran A

2018-06-01

Whyte, EF, Richter, C, O'Connor, S, and Moran, KA. Investigation of the effects of high-intensity, intermittent exercise and unanticipation on trunk and lower limb biomechanics during a side-cutting maneuver using statistical parametric mapping. J Strength Cond Res 32(6): 1583-1593, 2018-Anterior cruciate ligament (ACL) injuries frequently occur during side-cutting maneuvers when fatigued or reacting to the sporting environment. Trunk and hip biomechanics are proposed to influence ACL loading during these activities. However, the effects of fatigue and unanticipation on the biomechanics of the kinetic chain may be limited by traditional discrete point analysis. We recruited 28 male, varsity, Gaelic footballers (21.7 ± 2.2 years; 178.7 ± 14.6 m; 81.8 ± 11.4 kg) to perform anticipated and unanticipated side-cutting maneuvers before and after a high-intensity, intermittent exercise protocol (HIIP). Statistical parametric mapping (repeated-measures analysis of varience) identified differences in phases of trunk and stance leg biomechanics during weight acceptance. Unanticipation resulted in less trunk flexion (p < 0.001) and greater side flexion away from the direction of cut (p < 0.001). This led to smaller (internal) knee flexor and greater (internal) knee extensor (p = 0.002-0.007), hip adductor (p = 0.005), and hip external rotator (p = 0.007) moments. The HIIP resulted in increased trunk flexion (p < 0.001) and side flexion away from the direction of cut (p = 0.038), resulting in smaller (internal) knee extensor moments (p = 0.006). One interaction effect was noted demonstrating greater hip extensor moments in the unanticipated condition post-HIIP (p = 0.025). Results demonstrate that unanticipation resulted in trunk kinematics considered an ACL injury risk factor. A subsequent increase in frontal and transverse plane hip loading and sagittal plane knee loading was observed, which may increase ACL strain. Conversely, HIIP-induced trunk kinematic alterations resulted in reduced sagittal plane knee and subsequent ACL loading. Therefore, adequate hip and knee control is important during unanticipated side-cutting maneuvers.

Sweating response to passive stretch of the calf muscle during activation of forearm muscle metaboreceptors in heated humans.

PubMed

Amano, Tatsuro; Ichinose, Masashi; Nishiyasu, Takeshi; Inoue, Yoshimitsu; Koga, Shunsaku; Miwa, Mikio; Kondo, Narihiko

2014-05-15

Activation of muscle metaboreceptors and mechanoreceptors has been shown to independently influence the sweating response, while their integrative control effects remain unclear. We examined the sweating response when the two muscle receptors are concurrently activated in different limbs, as well as the blood pressure response. In total, 27 young males performed passive calf muscle stretches (muscle mechanoreceptor activation) for 30 s in a semisupine position with and without postisometric handgrip exercise muscle ischemia (PEMI, muscle metaboreceptor activation) at exercise intensities of 35 and 50% of maximum voluntary contraction (MVC) under hot conditions (ambient temperature, 35°C, relative humidity, 50%). Passive calf muscle stretching alone increased the mean sweating rate significantly on the forehead, chest, and thigh (SRmean) and mean arterial blood pressure (MAP), but not the heart rate (HR), from prestretching levels by 0.04 ± 0.01 mg·cm(2)·min(-1), 4.0 ± 1.3 mmHg (P < 0.05), and -1.0 ± 0.5 beats/min (P > 0.05), respectively. The SRmean and MAP during PEMI were significantly higher than those at rest. The passive calf muscle stretch during PEMI increased MAP significantly by 3.4 ± 1.0 and 2.0 ± 0.7 mmHg for 35 and 50% of MVC, respectively (P < 0.05), but not that of SRmean or HR at either exercise intensity. These results suggest that sweating and blood pressure responses to concurrent activation of the two muscle receptors in different limbs differ and that the influence of calf muscle mechanoreceptor activation alone on the sweating response disappears during forearm muscle metaboreceptor activation. Copyright © 2014 the American Physiological Society.

Manual therapy intervention for a patient with a total hip arthroplasty revision.

PubMed

Howard, Paul D; Levitsky, Beth

2007-12-01

Case report. A 73-year-old active woman with a total hip arthroplasty, who later had revision surgery, developed left hip and buttock pain 2 years after the revision surgery, subsequent to lifting her foot while seated. This movement was performed so that her spouse could assist her in putting on her sock and shoe. During the first physical therapy session, the patient exhibited a forward-flexed trunk posture and difficulty weight bearing on the involved lower limb. The patient was successfully treated with manual therapy techniques and a home exercise program. The manual therapy techniques included long-axis hip distraction, lateral hip distraction, posterior-to-anterior hip joint mobilization, and a contract-relax proprioceptive neuromuscular facilitation technique. The patient's home program consisted of long-axis hip distraction, performed by her spouse, and standing lower limb pendular movements into flexion and extension. Pain scale ratings, posture and gait observations, strength, range of motion, and return to functional activities served as outcome measures. After 1 physical therapy visit, in which manual therapy techniques were utilized, the patient had a significant decrease in hip symptoms. The patient and spouse were compliant with the home exercise program and continued with physical therapy for 3 more visits, and the patient ultimately became symptom free. The patient returned to all previous activities, including household chores, cooking, and a walking program. The patient was contacted at 6 months, 1 year, and 4 years, and reported no recurrences of hip or buttock symptoms. Manual therapy techniques and home exercises described in this case report were apparently effective in eliminating symptoms and returning this patient, who had total hip arthroplasty and revision surgery 2 years earlier, to all previous functional activities after a dressing incident produced hip and buttock symptoms.

Early exercise in critically ill patients enhances short-term functional recovery.

PubMed

Burtin, Chris; Clerckx, Beatrix; Robbeets, Christophe; Ferdinande, Patrick; Langer, Daniel; Troosters, Thierry; Hermans, Greet; Decramer, Marc; Gosselink, Rik

2009-09-01

: To investigate whether a daily exercise session, using a bedside cycle ergometer, is a safe and effective intervention in preventing or attenuating the decrease in functional exercise capacity, functional status, and quadriceps force that is associated with prolonged intensive care unit stay. A prolonged stay in the intensive care unit is associated with muscle dysfunction, which may contribute to an impaired functional status up to 1 yr after hospital discharge. No evidence is available concerning the effectiveness of an early exercise training intervention to prevent these detrimental complications. : Randomized controlled trial. : Medical and surgical intensive care unit at University Hospital Gasthuisberg. : Ninety critically ill patients were included as soon as their cardiorespiratory condition allowed bedside cycling exercise (starting from day 5), given they still had an expected prolonged intensive care unit stay of at least 7 more days. : Both groups received respiratory physiotherapy and a daily standardized passive or active motion session of upper and lower limbs. In addition, the treatment group performed a passive or active exercise training session for 20 mins/day, using a bedside ergometer. : All outcome data are reflective for survivors. Quadriceps force and functional status were assessed at intensive care unit discharge and hospital discharge. Six-minute walking distance was measured at hospital discharge. No adverse events were identified during and immediately after the exercise training. At intensive care unit discharge, quadriceps force and functional status were not different between groups. At hospital discharge, 6-min walking distance, isometric quadriceps force, and the subjective feeling of functional well-being (as measured with "Physical Functioning" item of the Short Form 36 Health Survey questionnaire) were significantly higher in the treatment group (p < .05). : Early exercise training in critically ill intensive care unit survivors enhanced recovery of functional exercise capacity, self-perceived functional status, and muscle force at hospital discharge.

Movement velocity as a measure of exercise intensity in three lower limb exercises.

PubMed

Conceição, Filipe; Fernandes, Juvenal; Lewis, Martin; Gonzaléz-Badillo, Juan José; Jimenéz-Reyes, Pedro

2016-01-01

The purpose of this study was to investigate the relationship between movement velocity and relative load in three lower limbs exercises commonly used to develop strength: leg press, full squat and half squat. The percentage of one repetition maximum (%1RM) has typically been used as the main parameter to control resistance training; however, more recent research has proposed movement velocity as an alternative. Fifteen participants performed a load progression with a range of loads until they reached their 1RM. Maximum instantaneous velocity (Vmax) and mean propulsive velocity (MPV) of the knee extension phase of each exercise were assessed. For all exercises, a strong relationship between Vmax and the %1RM was found: leg press (r(2)adj = 0.96; 95% CI for slope is [-0.0244, -0.0258], P < 0.0001), full squat (r(2)adj = 0.94; 95% CI for slope is [-0.0144, -0.0139], P < 0.0001) and half squat (r(2)adj = 0.97; 95% CI for slope is [-0.0135, -0.00143], P < 0.0001); for MPV, leg press (r(2)adj = 0.96; 95% CI for slope is [-0.0169, -0.0175], P < 0.0001, full squat (r(2)adj = 0.95; 95% CI for slope is [-0.0136, -0.0128], P < 0.0001) and half squat (r(2)adj = 0.96; 95% CI for slope is [-0.0116, 0.0124], P < 0.0001). The 1RM was attained with a MPV and Vmax of 0.21 ± 0.06 m s(-1) and 0.63 ± 0.15 m s(-1), 0.29 ± 0.05 m s(-1) and 0.89 ± 0.17 m s(-1), 0.33 ± 0.05 m s(-1) and 0.95 ± 0.13 m s(-1) for leg press, full squat and half squat, respectively. Results indicate that it is possible to determine an exercise-specific %1RM by measuring movement velocity for that exercise.

The Effects of Fortetropin Supplementation on Body Composition, Strength, and Power in Humans and Mechanism of Action in a Rodent Model.

PubMed

Sharp, Matthew H; Lowery, Ryan P; Mobley, C Brooks; Fox, Carlton D; de Souza, Eduardo O; Shields, Kevin A; Healy, James C; Arick, Ned Q; Thompson, Richard M; Roberts, Michael D; Wilson, Jacob M

2016-01-01

The purpose of this study was to investigate the effects of Fortetropin on skeletal muscle growth and strength in resistance-trained individuals and to investigate the anabolic and catabolic signaling effects using human and rodent models. In the rodent model, male Wistar rats (250 g) were gavage fed with either 1.2 ml of tap water control (CTL) or 0.26 g Fortetropin for 8 days. Then rats participated in a unilateral plantarflexion exercise bout. Nonexercised and exercised limbs were harvested at 180 minutes following and analyzed for gene and protein expression relative to mammalian target of rapamycin (mTOR) and ubiquitin signaling. For the human model, 45 (of whom 37 completed the study), resistance-trained college-aged males were divided equally into 3 groups receiving a placebo macronutrient matched control, 6.6 or 19.8 g of Fortetropin supplementation during 12 weeks of resistance training. Lean mass, muscle thickness, and lower and upper body strength were measured before and after 12 weeks of training. The human study results indicated a Group × Time effect (p ≤ 0.05) for lean mass in which the 6.6 g (+1.7 kg) and 19.8 g (+1.68 kg) but not placebo (+0.6 kg) groups increased lean mass. Similarly, there was a Group × Time effect for muscle thickness (p ≤ 0.05), which increased in the experimental groups only. All groups increased equally in bench press and leg press strength. In the rodent model, a main effect for exercise (p ≤ 0.05) in which the control plus exercise but not Fortetropin plus exercise increased both ubiquitin monomer protein expression and polyubiquitination. mTOR signaling was elevated to a greater extent in the Fortetropin exercising conditions as indicated by greater phosphorylation status of 4EBP1, rp6, and p70S6K for both exercising conditions. Fortetropin supplementation increases lean body mass (LBM) and decreases markers of protein breakdown while simultaneously increasing mTOR signaling.

Intra-session repeatability of lower limb muscles activation pattern during pedaling.

PubMed

Dorel, Sylvain; Couturier, Antoine; Hug, François

2008-10-01

Assessment of intra-session repeatability of muscle activation pattern is of considerable relevance for research settings, especially when used to determine changes over time. However, the repeatability of lower limb muscles activation pattern during pedaling is not fully established. Thus, we tested the intra-session repeatability of the activation pattern of 10 lower limb muscles during a sub-maximal cycling exercise. Eleven triathletes participated to this study. The experimental session consisted in a reference sub-maximal cycling exercise (i.e. 150 W) performed before and after a 53-min simulated training session (mean power output=200+/-12 W). Repeatability of EMG patterns was assessed in terms of muscle activity level (i.e. RMS of the mean pedaling cycle and burst) and muscle activation timing (i.e. onset and offset of the EMG burst) for the 10 following lower limb muscles: gluteus maximus (GMax), semimembranosus (SM), Biceps femoris (BF), vastus medialis (VM), rectus femoris (RF), vastus lateralis (VL), gastrocnemius medianus (GM) and lateralis (GL), soleus (SOL) and tibialis anterior (TA). No significant differences concerning the muscle activation level were found between test and retest for all the muscles investigated. Only VM, SOL and TA showed significant differences in muscle activation timing parameters. Whereas ICC and SEM values confirmed this weak repeatability, cross-correlation coefficients suggest a good repeatability of the activation timing parameters for all the studied muscles. Overall, the main finding of this work is the good repeatability of the EMG pattern during pedaling both in term of muscle activity level and muscle activation timing.

Strength deficit of knee flexors is dependent on hip position in adults with chronic hemiparesis.

PubMed

Michaelsen, Stella M; Ovando, Angélica C; Bortolotti, Adriano; Bandini, Bruno

2013-01-01

The extent to which muscle length affects force production in paretic lower limb muscles after stroke in comparison to controls has not been established. To investigate knee flexor strength deficits dependent on hip joint position in adults with hemiparesis and compare with healthy controls. a cross-sectional study with ten subjects with chronic (63±40 months) hemiparesis with mild to moderate lower limb paresis (Fugl-Meyer score 26±3) and 10 neurologically healthy controls. Isometric knee flexion strength with the hip positioned at 90° and 0° of flexion was assessed randomly on the paretic and non-paretic side of hemiparetic subjects and healthy controls. Subjects were asked to perform a maximal isometric contraction sustained for four seconds and measured by a dynamometer. The ratio of knee flexor strength between these two hip positions was calculated: Hip 0°/Hip 90°. Also, locomotor capacity was evaluated by the timed up and go test and by walking velocity over 10 meters. In subjects with hemiparesis, absolute knee flexion torque decreased (p<0.001) with the hip in extension (at 0°). The ratio of knee flexor torque Hip 0°/Hip 90° on the paretic side in hemiparetics was lower than in controls (p=0.02). Weakness dependent on joint position is more significant in the paretic lower limb of adults with hemiparesis when compared to controls. More attention should be given to lower limb muscle strengthening exercises in individuals with stroke, with emphasis on the strengthening exercises in positions in which the muscle is shortened.

Neuromuscular electrical stimulation via the peroneal nerve is superior to graduated compression socks in reducing perceived muscle soreness following intense intermittent endurance exercise.

PubMed

Ferguson, Richard A; Dodd, Matthew J; Paley, Victoria R

2014-10-01

A novel technique of neuromuscular electrical stimulation (NMES) via the peroneal nerve has been shown to augment limb blood flow which could enhance recovery following exercise. The present study examined the effects of NMES, compared to graduated compression socks on muscle soreness, strength, and markers of muscle damage and inflammation following intense intermittent exercise. Twenty-one (age 21 ± 1 years, height 179 ± 7 cm, body mass 76 ± 9 kg,) healthy males performed a 90-min intermittent shuttle running test on three occasions. Following exercise, the following interventions were applied: passive recovery (CON), graduated compression socks (GCS) or NMES. Perceived muscle soreness (PMS) and muscle strength (isometric maximal voluntary contraction of knee extensors and flexors) were measured and a venous blood sample taken pre-exercise and 0, 1, 24, 48 and 72 h following exercise for measurement of creatine kinase (CK) and Lactate dehydrogenase (LDH) activity and IL-6 and CRP concentrations. PMS increased in all conditions immediately, 1 and 24 h post-exercise. At 24 h PMS was lower in NMES compared to GCS and CON (2.0 ± 1.6, 3.2 ± 2.1, 4.6 ± 2.0, respectively). At 48 h PMS was lower in NMES compared to CON (1.3 ± 1.5 and 3.1 ± 1.8, respectively). There were no differences between treatments for muscle strength, CK and LDH activity, IL-6 and CRP concentrations. The novel NMES technique is superior to GCS in reducing PMS following intense intermittent endurance exercise.

The effect of arm support combined with rehabilitation games on upper-extremity function in subacute stroke: a randomized controlled trial.

PubMed

Prange, Gerdienke B; Kottink, Anke I R; Buurke, Jaap H; Eckhardt, Martine M E M; van Keulen-Rouweler, Bianca J; Ribbers, Gerard M; Rietman, Johan S

2015-02-01

Use of rehabilitation technology, such as (electro)mechanical devices or robotics, could partly relieve the increasing strain on stroke rehabilitation caused by an increasing prevalence of stroke. Arm support (AS) training showed improvement of unsupported arm function in chronic stroke. To examine the effect of weight-supported arm training combined with computerized exercises on arm function and capacity, compared with dose-matched conventional reach training in subacute stroke patients. In a single-blind, multicenter, randomized controlled trial, 70 subacute stroke patients received 6 weeks of training with either an AS device combined with computerized exercises or dose-matched conventional training (CON). Arm function was evaluated pretraining and posttraining by Fugl-Meyer assessment (FM), maximal reach distance, Stroke Upper Limb Capacity Scale (SULCS), and arm pain via Visual Analogue Scale, in addition to perceived motivation by Intrinsic Motivation Inventory posttraining. FM and SULCS scores and reach distance improved significantly within both groups. These improvements and experienced pain did not differ between groups. The AS group reported higher interest/enjoyment during training than the CON group. AS training with computerized exercises is as effective as conventional therapy dedicated to the arm to improve arm function and activity in subacute stroke rehabilitation, when applied at the same dose. © The Author(s) 2014.

Design and Development of a Telerehabilitation Platform for Patients With Phantom Limb Pain: A User-Centered Approach

PubMed Central

2017-01-01

Background Phantom limb pain is a frequent and persistent problem following amputation. Achieving sustainable favorable effects on phantom limb pain requires therapeutic interventions such as mirror therapy that target maladaptive neuroplastic changes in the central nervous system. Unfortunately, patients’ adherence to unsupervised exercises is generally poor and there is a need for effective strategies such as telerehabilitation to support long-term self-management of patients with phantom limb pain. Objective The main aim of this study was to describe the user-centered approach that guided the design and development of a telerehabilitation platform for patients with phantom limb pain. We addressed 3 research questions: (1) Which requirements are defined by patients and therapists for the content and functions of a telerehabilitation platform and how can these requirements be prioritized to develop a first prototype of the platform? (2) How can the user interface of the telerehabilitation platform be designed so as to match the predefined critical user requirements and how can this interface be translated into a medium-fidelity prototype of the platform? (3) How do patients with phantom limb pain and their treating therapists judge the usability of the medium-fidelity prototype of the telerehabilitation platform in routine care and how can the platform be redesigned based on their feedback to achieve a high-fidelity prototype? Methods The telerehabilitation platform was developed using an iterative user-centered design process. In the first phase, a questionnaire followed by a semistructured interview was used to identify the user requirements of both the patients and their physical and occupational therapists, which were then prioritized using a decision matrix. The second phase involved designing the interface of the telerehabilitation platform using design sketches, wireframes, and interface mock-ups to develop a low-fidelity prototype. Heuristic evaluation resulted in a medium-fidelity prototype whose usability was tested in routine care in the final phase, leading to the development of a high-fidelity prototype. Results A total of 7 categories of patient requirements were identified: monitoring, exercise programs, communication, settings, background information, log-in, and general requirements. One additional category emerged for therapists: patient management. Based on these requirements, patient and therapist interfaces for the telerehabilitation platform were developed and redesigned by the software development team in an iterative process, addressing the usability problems that were reported by the users during 4 weeks of field testing in routine care. Conclusions Our findings underline the importance of involving the users and other stakeholders early and continuously in an iterative design process, as well as the need for clear criteria to identify critical user requirements. A decision matrix is presented that incorporates the views of various stakeholders in systematically rating and prioritizing user requirements. The findings and lessons learned might help health care providers, researchers, software designers, and other stakeholders in designing and evaluating new teletreatments, and hopefully increase the likelihood of user acceptance. PMID:28582249

The Lichfield bone study: the skeletal response to exercise in healthy young men

PubMed Central

Eleftheriou, Kyriacos I.; Kehoe, Anthony; James, Laurence E.; Payne, John R.; Skipworth, James R.; Puthucheary, Zudin A.; Drenos, Fotios; Pennell, Dudley J.; Loosemore, Mike; World, Michael; Humphries, Steve E.; Haddad, Fares S.; Montgomery, Hugh E.

2012-01-01

The skeletal response to short-term exercise training remains poorly described. We thus studied the lower limb skeletal response of 723 Caucasian male army recruits to a 12-wk training regime. Femoral bone volume was assessed using magnetic resonance imaging, bone ultrastructure by quantitative ultrasound (QUS), and bone mineral density (BMD) using dual-energy X-ray absorptiometry (DXA) of the hip. Left hip BMD increased with training (mean ± SD: 0.85 ± 3.24, 2.93 ± 4.85, and 1.89 ± 2.85% for femoral neck, Ward's area, and total hip, respectively; all P < 0.001). Left calcaneal broadband ultrasound attenuation rose 3.57 ± 0.5% (P < 0.001), and left and right femoral cortical volume by 1.09 ± 4.05 and 0.71 ± 4.05%, respectively (P = 0.0001 and 0.003), largely through the rise in periosteal volume (0.78 ± 3.14 and 0.59 ± 2.58% for right and left, respectively, P < 0.001) with endosteal volumes unchanged. Before training, DXA and QUS measures were independent of limb dominance. However, the dominant femur had higher periosteal (25,991.49 vs. 2,5572 mm3, P < 0.001), endosteal (6,063.33 vs. 5,983.12 mm3, P = 0.001), and cortical volumes (19,928 vs. 19,589.56 mm3, P = 0.001). Changes in DXA, QUS, and magnetic resonance imaging measures were independent of limb dominance. We show, for the first time, that short-term exercise training in young men is associated not only with a rise in human femoral BMD, but also in femoral bone volume, the latter largely through a periosteal response. PMID:22114178

Exercise Increases the Cardiovascular Stimulus Provided by Artificial Gravity

NASA Technical Reports Server (NTRS)

Howarth, M. S.; Moore, F. B.; Hinghofer-Szalkay, H.; Jezova, D.; Diedrich, A.; Ferris, M. B.; Schlegel, T. T.; Pathwardhan, A. R.; Knapp, C. F.; Evans, J. M.

2008-01-01

We investigated fluid shifts and regulatory responses to variations of posture, exercise, Gz level and radius of rotation in subjects riding NASA Ames 20G centrifuge. Results are from 4 protocols that address radius and exercise effects only. Protocol A: After 10 min supine control, 12 healthy men (35 plus or minus 9 yr, 82.8 plus or minus 7.9 kg) were exposed to rotational 1 Gz (2.5 m radius) for 2 min followed by 20 min alternating between 1 and 1.25 Gz. Blood samples were taken pre and post spin. Protocol B: Same as A, but lower limb exercise (70% V02max) preceded ramps to 1.25 Gz. Protocol C: Same as A but radius of rotation 8.3 m. Protocol D: Same as B but at 8.3 m. The 8 subjects who completed all protocols, increased heart rate (HR) from control, on average, by: A: 5, B: 39, C: 11, D: 44 bpm. For thoracic fluid volume, (bioimpedance), the 8 subjects changed from control, on average: A: -394, B: -548, C: -537, D: -708 mL. For thigh fluid volume, changes from control, on average, were: A: -137, B: 129, C: -75, D: 159 mL. Hematocrit changes from control were: A: 2.3, B: 3.5, C: 2.3, D: 4.3 %. Radius effects were mild and included greater loss of fluid from the thorax, less fluid loss from the thigh and increased heart rate at the longer radius. Pre-acceleration exercise effects were more dramatic and included additional loss of fluid from the chest, increased fluid volume of the thigh, increased hematocrit and greater heart rate increases. We propose that short bouts of intense exercise can be used to magnify the cardiovascular stress delivered by artificial gravity (AG) training and the combination of AG with exercise training can be fine-tuned to preserve orthostatic tolerance of astronauts during spaceflight.

Core stability training on lower limb balance strength.

PubMed

Dello Iacono, Antonio; Padulo, Johnny; Ayalon, Moshe

2016-01-01

This study aimed to assess the effects of core stability training on lower limbs' muscular asymmetries and imbalances in team sport. Twenty footballers were divided into two groups, either core stability or control group. Before each daily practice, core stability group (n = 10) performed a core stability training programme, while control group (n = 10) did a standard warm-up. The effects of the core stability training programme were assessed by performing isokinetic tests and single-leg countermovement jumps. Significant improvement was found for knee extensors peak torque at 3.14 rad · s(-1) (14%; P < 0.05), knee flexors peak torque at 1.05 and 3.14 rad · s(-1) (19% and 22% with P < 0.01 and P < 0.01, respectively) and peak torque flexors/extensors ratios at 1.05 and 3.14 rad · s(-1) (7.7% and 8.5% with P < 0.05 and P < 0.05, respectively) only in the core stability group. The jump tests showed a significant reduction in the strength asymmetries in core stability group (-71.4%; P = 0.02) while a concurrent increase was seen in the control group (33.3%; P < 0.05). This study provides practical evidence in combining core exercises for optimal lower limbs strength balance development in young soccer players.

OBESITY: CHALLENGES TO VENTILATORY CONTROL DURING EXERCISE A BRIEF REVIEW

PubMed Central

Babb, Tony G.

2013-01-01

Obesity is a national health issue in the US. Among the many physiological changes induced by obesity, it also presents a unique challenge to ventilatory control during exercise due to increased metabolic demand of moving larger limbs, increased work of breathing due to extra weight on the chest wall, and changes in breathing mechanics. These challenges to ventilatory control in obesity can be inconspicuous or overt among obese adults but for the most part adaptation of ventilatory control during exercise in obesity appears remarkably unnoticed in the majority of obese people. In this brief review, the changes to ventilatory control required for maintaining normal ventilation during exercise will be examined, especially the interaction between respiratory neural drive and ventilation. Also, gaps in our current knowledge will be discussed. PMID:23707540

Gait characteristics of individuals with multiple sclerosis before and after a 6-month aerobic training program.

PubMed

Rodgers, M M; Mulcare, J A; King, D L; Mathews, T; Gupta, S C; Glaser, R M

1999-07-01

Individuals who have multiple sclerosis (MS) typically experience problems with physical activities such as walking, resulting from the combined effects of skeletal muscle weakness, sensory disturbances, spasticity, gait ataxia, and reduction in aerobic capacity. The aim of this study was to determine whether a 6-mo exercise program designed for aerobic conditioning might also affect gait abnormalities in individuals with MS. Subjects included 18 individuals with MS who presented a range of disability. Passive range of motion (PROM) in the lower limbs was measured and gait analyzed before and after exercise conditioning. Three-dimensional kinematics, ground reaction forces (GRF), and electromyographic information were acquired as subjects walked at self-selected velocities. Hip PROM increased following conditioning. Mean walking velocity, cadence, and posterior shear GRF (push-off force) decreased. During walking, maximum ankle dorsiflexion decreased and ankle plantarflexion increased. Total knee flexion/extension range during the walking cycle decreased slightly as did maximum hip extension. Results suggest this 6-mo training program had minimal effect on gait abnormalities.

Acute Effects of Two Different Warm-Up Protocols on Flexibility and Lower Limb Explosive Performance in Male and Female High Level Athletes

PubMed Central

Tsolakis, Charilaos; Bogdanis, Gregory C.

2012-01-01

This study examined the effects of two different warm-up protocols on lower limb power and flexibility in high level athletes. Twenty international level fencers (10 males and 10 females) performed two warm-up protocols that included 5-min light jogging and either short (15s) or long (45s) static stretching exercises for each of the main leg muscle groups (quadriceps, hamstrings and triceps surae), followed by either 3 sets of 3 (short stretching treatment), or 3 sets of 5 tuck jumps (long stretching treatment), in a randomized crossover design with one week between treatments. Hip joint flexion was measured with a Lafayette goniometer before and after the 5-min warm-up, after stretching and 8 min after the tuck jumps, while counter movement jump (CMJ) performance was evaluated by an Ergojump contact platform, before and after the stretching treatment, as well as immediately after and 8 minutes after the tuck jumps. Three way ANOVA (condition, time, gender) revealed significant time (p < 0.001) and gender (p < 0.001) main effects for hip joint flexion, with no interaction between factors. Flexibility increased by 6. 8 ± 1.1% (p < 0.01) after warm-up and by another 5.8 ± 1.6% (p < 0.01) after stretching, while it remained increased 8 min after the tuck jumps. Women had greater ROM compared with men at all time points (125 ± 8° vs. 94 ± 4° p<0.01 at baseline), but the pattern of change in hip flexibility was not different between genders. CMJ performance was greater in men compared with women at all time points (38.2 ± 1.9 cm vs. 29.8 ± 1.2 cm p < 0.01 at baseline), but the percentage of change CMJ performance was not different between genders. CMJ performance remained unchanged throughout the short stretching protocol, while it decreased by 5.5 ± 0.9% (p < 0.01) after stretching in the long stretching protocol However, 8 min after the tuck jumps, CMJ performance was not different from the baseline value (p = 0.075). In conclusion, lower limb power may be decreased after long periods of stretching, but performance of explosive exercises may reverse this phenomenon. Key points Stretching of the main leg muscle groups for 45 s results in a relatively large decrease (by 5.5%) in subsequent jumping performance Stretching of the main leg muscle groups for only 15 s results in an increase in flexibility similar to that of the longer duration stretching (by 12.6%), with no change in subsequent jumping performance Performance of a PAP exercise such as tuck jumps may reverse the negative effects of long duration stretching on leg muscle power. However, jumping performance is not increased above baseline Speed/power athletes should be advised against using long duration stretching. The number of repetitions of a PAP exercise such as the tuck jumps, should be further examined in order to induce an increase in explosive performance during competition PMID:24150077

Muscle, functional and cognitive adaptations after flywheel resistance training in stroke patients: a pilot randomized controlled trial.

PubMed

Fernandez-Gonzalo, Rodrigo; Fernandez-Gonzalo, Sol; Turon, Marc; Prieto, Cristina; Tesch, Per A; García-Carreira, Maria del Carmen

2016-04-06

Resistance exercise (RE) improves neuromuscular function and physical performance after stroke. Yet, the effects of RE emphasizing eccentric (ECC; lengthening) actions on muscle hypertrophy and cognitive function in stroke patients are currently unknown. Thus, this study explored the effects of ECC-overload RE training on skeletal muscle size and function, and cognitive performance in individuals with stroke. Thirty-two individuals with chronic stroke (≥6 months post-stroke) were randomly assigned into a training group (TG; n = 16) performing ECC-overload flywheel RE of the more-affected lower limb (12 weeks, 2 times/week; 4 sets of 7 maximal closed-chain knee extensions; <2 min of contractile activity per session) or a control group (CG; n = 16), maintaining daily routines. Before and after the intervention, quadriceps femoris volume, maximal force and power for each leg were assessed, and functional and dual task performance, and cognitive functions were measured. Quadriceps femoris volume of the more-affected leg increased by 9.4 % in TG. Muscle power of the more-affected, trained (48.2 %), and the less-affected, untrained limb (28.1 %) increased after training. TG showed enhanced balance (8.9 %), gait performance (10.6 %), dual-task performance, executive functions (working memory, verbal fluency tasks), attention, and speed of information processing. CG showed no changes. ECC-overload flywheel resistance exercise comprising 4 min of contractile activity per week offers a powerful aid to regain muscle mass and function, and functional performance in individuals with stroke. While the current intervention improved cognitive functions, the cause-effect relationship, if any, with the concomitant neuromuscular adaptations remains to be explored. Clinical Trials NCT02120846.

Interventions for preventing lower limb soft-tissue running injuries.

PubMed

Yeung, Simon S; Yeung, Ella W; Gillespie, Lesley D

2011-07-06

Overuse soft-tissue injuries occur frequently in runners. Stretching exercises, modification of training schedules, and the use of protective devices such as braces and insoles are often advocated for prevention. This is an update of a review first published in 2001. To assess the effects of interventions for preventing lower limb soft-tissue running injuries. We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register (March 2011); The Cochrane Library 2010, Issue 4; MEDLINE (1966 to January 2011); EMBASE (1980 to January 2011); and international trial registries (17 January 2011). Randomised or quasi-randomised trials evaluating interventions to prevent lower limb soft-tissue running injuries. Two authors independently assessed risk of bias (relating to sequence generation, allocation concealment, blinding, incomplete outcome data) and extracted data. Data were adjusted for clustering if necessary and pooled using the fixed-effect model when appropriate. We included 25 trials (30,252 participants). Participants were military recruits (19 trials), runners from the general population (three trials), soccer referees (one trial), and prisoners (two trials). The interventions tested in the included trials fell into four main preventive strategies: exercises, modification of training schedules, use of orthoses, and footwear and socks. All 25 included trials were judged as 'unclear' or 'high' risk of bias for at least one of the four domains listed above.We found no evidence that stretching reduces lower limb soft-tissue injuries (6 trials; 5130 participants; risk ratio [RR] 0.85, 95% confidence interval [95% CI] 0.65 to 1.12). As with all non-significant results, this is compatible with either a reduction or an increase in soft-tissue injuries. We found no evidence to support a training regimen of conditioning exercises to improve strength, flexibility and coordination (one trial; 1020 participants; RR 1.20, 95% CI 0.77 to 1.87).We found no evidence that a longer, more gradual increase in training reduces injuries in novice runners (one trial; 486 participants; RR 1.02, 95% CI 0.72 to 1.45). There was some evidence from a poor quality trial that additional training resulted in a significant increase in the number of naval recruits with shin splints (one trial; 1670 participants; RR 2.02, 95% CI 1.11 to 3.70). There was limited evidence that injuries were less frequent in prisoners when running duration (one trial; 69 participants; RR 0.41, 95% CI 0.21 to 0.79) or frequency (one trial; 58 participants; RR 0.19, 95% CI 0.06 to 0.66) were reduced.Patellofemoral braces appear to be effective for preventing anterior knee pain (two trials; 227 participants; RR 0.41, 95% CI 0.24 to 0.67).Custom-made biomechanical insoles may be more effective than no insoles for reducing shin splints (medial tibial stress syndrome) in military recruits (one trial; 146 participants; RR 0.24, 95% CI 0.08 to 0.69).We found no evidence in military recruits that wearing running shoes based on foot shape, rather than standard running shoes, significantly reduced rate of running injuries (2 trials; 5795 participants; Rate Ratio 1.03, 95% CI 0.93 to 1.14). Overall, the evidence base for the effectiveness of interventions to reduce soft-tissue injury after intensive running is very weak, with few trials at low risk of bias. More well-designed and reported RCTs are needed that test interventions in recreational and competitive runners.

Effectiveness of a home-based strengthening program for elderly males in Italy. A preliminary study.

PubMed

Capodaglio, P; Facioli, M; Burroni, E; Giordano, A; Ferri, A; Scaglioni, G

2002-02-01

The practice of regular physical exercise has been shown to be effective in slowing the age-related progressive functional deterioration. Most exercise trials have been conducted with supervised training programs. The purpose of this study was to investigate the effectiveness of a 4-month home-based strength training on strength, function and personal satisfaction. Ten elderly men (mean age 68.5 years) were enrolled for home-based training one month after completing a 4-month supervised program; 12 age-matched men served as the control group. Subjects were asked to perform 3 sessions a week consisting of six resistance exercises with elastic bands involving the major muscle groups of the upper and lower limbs. We had calculated the correlation between the elongation and resistance of the elastic bands. The subjects were instructed to keep a diary reporting the execution of the session. We measured dynamic concentric strength of the muscle groups involved in the resistance exercises and maximal isometric strength of the knee extensors and elbow flexors before and after the 4-month home training. The Satisfaction Profile (SAT-P) questionnaire was administered before and one month after the completion of the training program for assessing personal satisfaction. The final to baseline comparison showed a non-significant decrease in mean isometric maximal strength values for knee extensors and elbow flexors in the control group, while the exercise group significantly (p=0.001) improved the average baseline values. Maximal dynamic concentric strength values decreased significantly in the control group, while significant improvements were observed in the exercising subjects. The SAT-P questionnaire did not show any difference in either group from baseline. The adherence-to-protocol rate based on self-report was 78%. Home training with elastic bands appears to be an effective low-cost modality of maintaining strength and function in an elderly population.

Interaction between cytokine gene polymorphisms and the effect of physical exercise on clinical and inflammatory parameters in older women: study protocol for a randomized controlled trial.

PubMed

Pereira, Daniele S; Queiroz, Bárbara Z; Mateo, Elvis C C; Assumpção, Alexandra M; Felício, Diogo C; Miranda, Aline S; Anjos, Daniela M C; Jesus-Moraleida, Fabianna; Dias, Rosângela C; Pereira, Danielle A G; Teixeira, Antônio L; Pereira, Leani S M

2012-08-08

Aging is associated with chronic low-grade inflammatory activity with an elevation of cytokine levels. An association between regular physical activity and reduction of blood levels of anti-inflammatory cytokines is demonstrated in the literature pointing to an anti-inflammatory effect related to exercise. However, there is no consensus regarding which type of exercise and which parameters are the most appropriate to influence inflammatory markers. Evidence indicates that the single nucleotide polymorphism (SNP) can influence the synthesis of those cytokines affecting their production. The design of this study is a randomized controlled trial. The aim of this study is to investigate the interaction between the cytokine genes SNP and the effect of physical activity on older women. The main outcomes are: serum levels of sTNFR-1, sTNFR-2, interleukin (IL)-6, IL-10, measured by the ELISA method; genotyping of tumor necrosis factor- (TNF)-alpha (rs1800629), IL6 (rs1800795), IL10 (rs1800896) by the TaqMan Method (Applied Biosystems, Foster City, CA, USA); and physical performance assessed by Timed Up and Go and 10-Meter Walk Tests. Secondary outcomes include: Geriatric Depression Scale, Perceived Stress Scaleand aerobic capacity, assessed by the six-minute walk; and lower limb muscle strength, using an isokinetic dinamometer (Biodex Medical Systems, Inc., Shirley, NY,USA). Both exercise protocols will be performed three times a week for 10 weeks, 30 sessions in total. Investigating the interaction between genetic factors and exercise effects of both protocols of exercise on the levels of inflammatory cytokine levels can contribute to guide clinical practice related to treatment and prevention of functional changes due to chronic inflammatory activity in older adults. This approach could develop new perspectives on preventive and treatment proposals in physical therapy and in the management of the older patient. (ReBEC) RBR9v9cwf.

Rest-Stress Limb Perfusion Imaging in Humans with Contrast Ultrasound Using Intermediate-Power Imaging and Microbubbles Resistant to Inertial Cavitation.

PubMed

Davidson, Brian P; Hodovan, James; Belcik, J Todd; Moccetti, Federico; Xie, Aris; Ammi, Azzdine Y; Lindner, Jonathan R

2017-05-01

Contrast-enhanced ultrasound (CEU) limb perfusion imaging is a promising approach for evaluating peripheral artery disease (PAD). However, low signal enhancement in skeletal muscle has necessitated high-power intermittent imaging algorithms, which are not clinically feasible. We hypothesized that CEU using a combination of intermediate power and a contrast agent resistant to inertial cavitation would allow real-time limb stress perfusion imaging. In normal volunteers, CEU of the calf skeletal muscle was performed on separate days with Sonazoid, Optison, or Definity. Progressive reduction in the ultrasound pulsing interval was used to assess the balance between signal enhancement and agent destruction at escalating mechanical indices (MI, 0.1-0.4). Real-time perfusion imaging at MI 0.1-0.4 using postdestructive replenishment kinetics was performed at rest and during 25 W plantar flexion contractile exercise. For Optison, limb perfusion imaging was unreliable at rest due to very low signal enhancement generated at all MIs and was possible during exercise-induced hyperemia only at MI 0.1 due to agent destruction at higher MIs. For Definity, signal intensity progressively increased with MI but was offset by microbubble destruction, which resulted in modest signal enhancement during CEU perfusion imaging and distortion of replenishment curves at MI ≥ 0.2. For Sonazoid, there strong signal enhancement at MI ≥ 0.2, with little destruction detected only at MI 0.4. Accordingly, high signal intensity and nondistorted perfusion imaging was possible at MI 0.2-0.3 and detected an 8.0- ± 5.7-fold flow reserve. Rest-stress limb perfusion imaging in humans with real-time CEU, which requires only seconds to perform, is possible using microbubbles with viscoelastic properties that produce strong nonlinear signal generation without destruction at intermediate acoustic pressures. Copyright © 2016 American Society of Echocardiography. All rights reserved.

Hemodynamic Functions of Fenestrated Stent Graft under Resting, Hypertension, and Exercise Conditions

PubMed Central

Kandail, Harkamaljot Singh; Hamady, Mohamad; Xu, Xiao Yun

2016-01-01

The aim of this study was to assess the hemodynamic performance of a patient-specific fenestrated stent graft (FSG) under different physiological conditions, including normal resting, hypertension, and hypertension with moderate lower limb exercise. A patient-specific FSG model was constructed from computed tomography images and was discretized into a fine unstructured mesh comprising tetrahedral and prism elements. Blood flow was simulated using Navier–Stokes equations, and physiologically realistic boundary conditions were utilized to yield clinically relevant results. For a given cycle-averaged inflow of 2.08 L/min at normal resting and hypertension conditions, approximately 25% of flow was channeled into each renal artery. When hypertension was combined with exercise, the cycle-averaged inflow increased to 6.39 L/min but only 6.29% of this was channeled into each renal artery, which led to a 438.46% increase in the iliac flow. For all the simulated scenarios and throughout the cardiac cycle, the instantaneous flow streamlines in the FSG were well organized without any notable flow recirculation. This well-organized flow led to low values of endothelial cell activation potential, which is a hemodynamic metric used to identify regions at risk of thrombosis. The displacement forces acting on the FSG varied with the physiological conditions, and the cycle-averaged displacement force at normal rest, hypertension, and hypertension with exercise was 6.46, 8.77, and 8.99 N, respectively. The numerical results from this study suggest that the analyzed FSG can maintain sufficient blood perfusion to the end organs at all the simulated conditions. Even though the FSG was found to have a low risk of thrombosis at rest and hypertension, this risk can be reduced even further with moderate lower limb exercise. PMID:27379242

Effectiveness of Home-Based Exercises Without Supervision by Physical Therapists for Patients With Early-Stage Amyotrophic Lateral Sclerosis: A Pilot Study.

PubMed

Kitano, Kosuke; Asakawa, Takashi; Kamide, Naoto; Yorimoto, Keisuke; Yoneda, Masaki; Kikuchi, Yutaka; Sawada, Makoto; Komori, Tetsuo

2018-03-31

To verify the effects of structured home-based exercises without supervision by a physical therapist in patients with early-stage amyotrophic lateral sclerosis (ALS). A historical controlled study that is part of a multicenter collaborative study. Rehabilitation departments at general hospitals and outpatient clinics with a neurology department. Patients (N=21) with ALS were enrolled and designated as the home-based exercise (Home-EX) group, and they performed unsupervised home-based exercises. As a control group, 84 patients with ALS who underwent supervised exercise with a physical therapist for 6 months were extracted from a database of patients with ALS and matched with the Home-EX group in terms of their basic attributes and clinical features. The Home-EX group was instructed to perform structured home-based exercises without supervision by a physical therapist that consisted of muscle stretching, muscle training, and functional training for 6 months. The primary outcome was the score on the ALS Functional Rating Scale-Revised (ALSFRS-R), which is composed of 3 domains: bulbar function, limb function, and respiratory function. The score ranges from 0 to 48 points, with a higher score indicating better function. In the Home-EX group, 15 patients completed the home-based exercises for 6 months, and 6 patients dropped out because of medical reasons or disease progression. No adverse events were reported. The Home-EX group was found to have a significantly higher respiratory function subscore and total score on the ALSFRS-R than the control group at follow-up (P<.001 and P<.05, respectively). Structured home-based exercises without supervision by a physical therapist could be used to alleviate functional deterioration in patients with early-stage ALS. Copyright © 2018 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

The effect of an intensive exercise programme on leg function in chronic stroke patients: a pilot study with one-year follow-up.

PubMed

Stock, Roland; Mork, Paul Jarle

2009-09-01

To investigate the effect of two weeks of intensive exercise on leg function in chronic stroke patients and to evaluate the feasibility of an intensive exercise programme in a group setting. Pilot study with one-group pre-test post-test design with two pre-tests and one-year follow-up. Inpatient rehabilitation hospital. Twelve hemiparetic patients completed the intervention. Ten patients participated at one-year follow-up. Six hours of daily intensive exercise for two weeks with focus on weight-shifting towards the affected side and increased use of the affected extremity during functional activities. An insole with nubs in the shoe of the non-paretic limb was used to reinforce weight-shift toward the affected side. Timed Up and Go, Four Square Step Test, gait velocity, gait symmetry and muscle strength in knee and ankle muscles. Maximal gait velocity (P = 0.002) and performance time (seconds) on Timed Up and Go (mean, SD; 12.2, 3.8 vs. 9.4, 3.2) and Four Square Step Test improved from pre- to post-test (P = 0.005). Improvements remained significant at follow-up. Preferred gait velocity and gait symmetry remained unchanged. Knee extensor (P<50.009) and flexor (P<50.001) strength increased bilaterally from pre- to post-test but only knee flexor strength remained significant at follow-up. Ankle dorsi flexor (P = 0.02) and plantar flexor (P<0.001) strength increased on paretic side only (not tested at follow-up). Intensive exercise for lower extremity is feasible in a group setting and was effective in improving ambulatory function, maximal gait velocity and muscle strength in chronic stroke patients. Most improvements persisted at the one-year follow-up.

Injury Prevention Exercise Programs for Professional Soccer: Understanding the Perceptions of the End-Users.

PubMed

OʼBrien, James; Finch, Caroline F

2017-01-01

To evaluate the perceptions of professional soccer players and staff members toward injury prevention exercise programs (IPEPs). Self-report survey. Four professional soccer teams in 4 different countries. 126 players, coaches, physiotherapists, and fitness coaches were invited to participate, with 72 respondents. Web-based survey detailing perceptions of lower limb (LL) injury susceptibility and seriousness, the value of IPEPs in general, and more specifically the International Federation of Association Football (FIFA) 11+. The vast majority of the respondents believed that professional soccer players are at high risk of LL injuries (93%) and that players should perform evidence-based injury prevention exercises (98%). They also agreed that LL injuries can shorten a player's career (85%), cause physical problems later in life (82%), and negatively impact on team performance (77%). However, perceptions varied across teams regarding which types of injury prevention exercises are effective, who holds responsibility for injury prevention, and when IPEPs should be performed. Specific knowledge of the FIFA 11+ was very low and 47% of respondents believed the program would need modification for use in their team. Players and staff members in professional soccer teams strongly support the use of evidence-based IPEPs. However, perceptions vary considerably between teams regarding which exercises can prevent injuries, who holds the responsibility for injury prevention, and when preventive exercises should be performed. Enhancing the ultimate impact of IPEPs in professional soccer requires a detailed understanding of each team's specific implementation context.

Neuromuscular Adaptations to Reduced Use

NASA Technical Reports Server (NTRS)

Ploutz-Snyder, Lori

2009-01-01

This viewgraph presentation reviews the studies done to reduce neuromuscular strength loss during unilateral lower limb suspension (ULLS). Since there are animals that undergo fairly long periods of muscular disuse without any or minimal muscular atrophy, there is an answer to that might be applicable to human in situations that require no muscular use to diminish the effects of muscular atrophy. Three sets of ULLS studies were reviewed indicated that muscle strength decreased more than the muscle mass. The study reviewed exercise countermeasures to combat the atrophy, including: ischemia maintained during Compound muscle action potential (CMAP), ischemia and low load exercise, Japanese kaatsu, and the potential for rehabilitation or situations where heavy loading is undesirable. Two forms of countermeasures to unloading have been successful, (1) high-load resistance training has maintained muscle mass and strength, and low load resistance training with blood flow restriction (LL(sub BFR)). The LL(sub BFR) has been shown to increase muscle mass and strength. There has been significant interest in Tourniquet training. An increase in Growth Hormone(GH) has been noted for LL(sub BFR) exercise. An experimental study with 16 subjects 8 of whom performed ULLS, and 8 of whom performed ULLS and LL(sub BFR) exercise three times per week during the ULLS. Charts show the results of the two groups, showing that performing LL(sub BFR) exercise during 30 days of ULLS can maintain muscle size and strength and even improve muscular endurance.

Effects of an 8-Week Body-Weight Neuromuscular Training on Dynamic Balance and Vertical Jump Performances in Elite Junior Skiing Athletes: A Randomized Controlled Trial.

PubMed

Vitale, Jacopo A; La Torre, Antonio; Banfi, Giuseppe; Bonato, Matteo

2018-04-01

Vitale, JA, La Torre, A, Banfi, G, and Bonato, M. Effects of an 8-week body-weight neuromuscular training on dynamic balance and vertical jump performances in elite junior skiing athletes: a randomized controlled trial. J Strength Cond Res 32(4): 911-920, 2018-The aim of the present randomized controlled trial was to evaluate the effects of an 8-week neuromuscular training program focused on core stability, plyometric, and body-weight strengthening exercises on dynamic postural control and vertical jump performance in elite junior skiers. Twenty-four Italian elite junior male skiers were recruited and randomized to either an experimental group (EG), performing neuromuscular warm-up exercises, (EG; n = 12; age 18 ± 1 years; body mass 66 ± 21 kg; height 1.70 ± 0.1 m) or a control group (CG) involved in a standard warm-up (CG; n = 12; age 18 ± 1 years; body mass 62 ± 14 kg; height 1.73 ± 0.1 m). lower quarter Y-Balance Test (YBT), countermovement jump (CMJ), and drop jump (DJ) at baseline (PRE) and at the end (POST) of the experimental procedures were performed. No significant differences between EG and CG were observed at baseline. Results showed that EG achieved positive effects from PRE to POST measures in the anterior, posteromedial, posterolateral directions, and composite score of YBT for both lower limbs, whereas no significant differences were detected for CG. Furthermore, 2-way analysis of variance with Bonferroni's multiple comparisons test did not reveal any significant differences in CMJ and DJ for both EG and CG. The inclusion of an 8-week neuromuscular warm-up program led to positive effects in dynamic balance ability but not in vertical jump performance in elite junior skiers. Neuromuscular training may be an effective intervention to specifically increase lower limb joint awareness and postural control.

Effects of Water-Based Training on Static and Dynamic Balance of Older Women.

PubMed

Bento, Paulo Cesar Barauce; Lopes, Maria de Fátima A; Cebolla, Elaine Cristine; Wolf, Renata; Rodacki, André L F

2015-08-01

The aim of this study was to evaluate the effects of a water-based exercise program on static and dynamic balance. Thirty-six older women were randomly assigned to a water-based training (3 days/week for 12 weeks) or control group. Water level was kept at the level of the xiphoid process and temperature at ∼28-30°C. Each session included aerobic activities and lower limb strength exercises. The medial-lateral, the anterior-posterior amplitude, and displacement of the center of pressure (CP-D) were measured in a quiet standing position (60 sec eyes opened and closed). The dynamic balance and 8-Foot Up-and-Go tests were also applied. Group comparisons were made using two-way analysis of variance (ANOVA) with repeated measures. No differences were found in the center of pressure variables; however, the WBT group showed better performance in the 8 Foot Up-and-Go Test after training (5.61±0.76 vs. 5.18±0.42; p<0.01). The water-based training was effective in improving dynamic balance, but not static balance.

Time to adapt exercise training regimens in pulmonary rehabilitation – a review of the literature

PubMed Central

Lee, Annemarie L; Holland, Anne E

2014-01-01

Exercise intolerance, exertional dyspnea, reduced health-related quality of life, and acute exacerbations are features characteristic of chronic obstructive pulmonary disease (COPD). Patients with a primary diagnosis of COPD often report comorbidities and other secondary manifestations, which diversifies the clinical presentation. Pulmonary rehabilitation that includes whole body exercise training is a critical part of management, and core programs involve endurance and resistance training for the upper and lower limbs. Improvement in maximal and submaximal exercise capacity, dyspnea, fatigue, health-related quality of life, and psychological symptoms are outcomes associated with exercise training in pulmonary rehabilitation, irrespective of the clinical state in which it is commenced. There may be benefits for the health care system as well as the individual patient, with fewer exacerbations and subsequent hospitalization reported with exercise training. The varying clinical profile of COPD may direct the need for modification to traditional training strategies for some patients. Interval training, one-legged cycling (partitioning) and non-linear periodized training appear to be equally or more effective than continuous training. Inspiratory muscle training may have a role as an adjunct to whole body training in selected patients. The benefits of balance training are also emerging. Strategies to ensure that health enhancing behaviors are adopted and maintained are essential. These may include training for an extended duration, alternative environments to undertake the initial program, maintenance programs following initial exercise training, program repetition, and incorporation of approaches to address behavioral change. This may be complemented by methods designed to maximize uptake and completion of a pulmonary rehabilitation program. PMID:25419125

Time to adapt exercise training regimens in pulmonary rehabilitation--a review of the literature.

PubMed

Lee, Annemarie L; Holland, Anne E

2014-01-01

Exercise intolerance, exertional dyspnea, reduced health-related quality of life, and acute exacerbations are features characteristic of chronic obstructive pulmonary disease (COPD). Patients with a primary diagnosis of COPD often report comorbidities and other secondary manifestations, which diversifies the clinical presentation. Pulmonary rehabilitation that includes whole body exercise training is a critical part of management, and core programs involve endurance and resistance training for the upper and lower limbs. Improvement in maximal and submaximal exercise capacity, dyspnea, fatigue, health-related quality of life, and psychological symptoms are outcomes associated with exercise training in pulmonary rehabilitation, irrespective of the clinical state in which it is commenced. There may be benefits for the health care system as well as the individual patient, with fewer exacerbations and subsequent hospitalization reported with exercise training. The varying clinical profile of COPD may direct the need for modification to traditional training strategies for some patients. Interval training, one-legged cycling (partitioning) and non-linear periodized training appear to be equally or more effective than continuous training. Inspiratory muscle training may have a role as an adjunct to whole body training in selected patients. The benefits of balance training are also emerging. Strategies to ensure that health enhancing behaviors are adopted and maintained are essential. These may include training for an extended duration, alternative environments to undertake the initial program, maintenance programs following initial exercise training, program repetition, and incorporation of approaches to address behavioral change. This may be complemented by methods designed to maximize uptake and completion of a pulmonary rehabilitation program.

The susceptibility of the knee extensors to eccentric exercise-induced muscle damage is not affected by leg dominance but by exercise order.

PubMed

Hody, S; Rogister, B; Leprince, P; Laglaine, T; Croisier, J-L

2013-09-01

The aims of this study were first to compare the response of dominant and non-dominant legs to eccentric exercise and second, to examine whether there is an effect of exercise order on the magnitude of symptoms associated with intense eccentric protocols. Eighteen young men performed three sets of 30 maximal eccentric isokinetic (60° s(-1)) contractions of the knee extensors (range of motion, ROM: 0°-100°, 0 = full extension) using either dominant or non-dominant leg. They repeated a similar eccentric bout using the contralateral leg 6 weeks later. The sequence of leg's use was allocated to create equally balanced groups. Four indirect markers of muscle damage including subjective pain intensity, maximal isometric strength, muscle stiffness and plasma creatine kinase (CK) activity were measured before and 24 h after exercise. All markers changed significantly following the eccentric bout performed either by dominant or non-dominant legs, but no significant difference was observed between legs. Interestingly, the comparison between the first and second eccentric bouts revealed that muscle soreness (-42%, P<0.001), CK activity (-62%, P<0.05) and strength loss (-54%, P<0.01) were significantly lower after the second bout. This study suggests that leg dominance does not influence the magnitude of exercise-induced muscle damage and supports for the first time the existence of a contralateral protection against exercise-induced muscle damage in the lower limbs. © 2013 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.

Exercise training, vascular function, and functional capacity in middle-aged subjects.

PubMed

Maiorana, A; O'Driscoll, G; Dembo, L; Goodman, C; Taylor, R; Green, D

2001-12-01

The aim of this study was to investigate the effect of 8 wk of exercise training on functional capacity, muscular strength, body composition, and vascular function in sedentary but healthy subjects by using a randomized, crossover protocol. After familiarization sessions, 19 subjects aged 47 +/- 2 yr (mean +/- SE) undertook a randomized, crossover design study of the effect of 8 wk of supervised circuit training consisting of combined aerobic and resistance exercise. Peak oxygen uptake (.VO(2peak)), sum of 7 maximal voluntary contractions and the sum of 8 skinfolds and 5 segment girths were determined at entry, crossover, and 16 wk. Endothelium-dependent and -independent vascular function were determined by forearm strain-gauge plethysmography and intrabrachial infusions of acetylcholine (ACh) and sodium nitroprusside (SNP) in 16 subjects. Training did not alter ACh or SNP responses. .VO(2peak), (28.6 +/- 1.1 to 32.6 +/- 1.3 mL.kg(-1).min(-1), P < 0.001), exercise test duration (17.4 +/- 1.1 to 22.1 +/- 1.2 min, P < 0.001), and muscular strength (465 +/- 27 to 535 +/- 27 kg, P < 0.001) significantly increased after the exercise program, whereas skinfolds decreased (144 +/- 10 vs 134 +/- 9 mm, P < 0.001). These results suggest that moderate intensity circuit training designed to minimize the involvement of the arms improves functional capacity, body composition, and strength in healthy, middle-aged subjects without significantly influencing upper limb vascular function. This finding contrasts with previous studies in subjects with type 2 diabetes and heart failure that employed an identical training program.

Effect of vibration frequency on agonist and antagonist arm muscle activity.

PubMed

Rodríguez Jiménez, Sergio; Benítez, Adolfo; García González, Miguel A; Moras Feliu, Gerard; Maffiuletti, Nicola A

2015-06-01

This study aimed to assess the effect of vibration frequency (f out) on the electromyographic (EMG) activity of the biceps brachii (BB) and triceps brachii (TB) muscles when acting as agonist and antagonist during static exercises with different loads. Fourteen healthy men were asked to hold a vibratory bar as steadily as possible for 10 s during lying row (pulling) and bench press (pushing) exercise at f out of 0 (non-vibration condition), 18, 31 and 42 Hz with loads of 20, 50, and 80 % of the maximum sustainable load (MSL). The root mean square of the EMG activity (EMGRMS) of the BB and TB muscles was expressed as a function of the maximal EMGRMS for respective muscles to characterize agonist activation and antagonist coactivation. We found that (1) agonist activation was greater during vibration (42 Hz) compared to non-vibration exercise for the TB but not for the BB muscle (p < 0.05); (2) antagonist activation was greater during vibration compared to non-vibration exercise for both BB (p < 0.01) and TB (p < 0.05) muscles; (3) the vibration-induced increase in antagonist coactivation was proportional to vibration f out in the range 18-42 Hz and (4) the vibration-induced increase in TB agonist activation and antagonist coactivation occurred at all loading conditions in the range 20-80 % MSL. The use of high vibration frequencies within the range of 18-42 Hz can maximize TB agonist activation and antagonist activation of both BB and TB muscles during upper limb vibration exercise.

Shoulder-elbow exoskeleton as rehabilitation exerciser

NASA Astrophysics Data System (ADS)

Ianoşi, A.; Dimitrova, A.; Noveanu, S.; Tătar, O. M.; Mândru, D. S.

2016-08-01

This paper presents a 2 degree of freedom exoskeleton designed for the rehabilitation of the shoulder and elbow movement in the sagittal plane; a semi-portable design strategy was chosen, which enables an easy attachment to a standard medical chair as well as the patient upper limb. A dedicated driver enables the control from a graphical user interface, which also provides the option of customized rehabilitation exercises. The potential of future improvements is assessed, and recommendations of research direction are made in order to broaden the usability of the proposed device.

Peripheral arterial disease decreases muscle torque and functional walking capacity in elderly.

PubMed

Dziubek, Wioletta; Bulińska, Katarzyna; Stefańska, Małgorzata; Woźniewski, Marek; Kropielnicka, Katarzyna; Jasiński, Tomasz; Jasiński, Ryszard; Pilch, Urszula; Dąbrowska, Grażyna; Skórkowska-Telichowska, Katarzyna; Wojcieszczyk-Latos, Joanna; Kałka, Dariusz; Janus, Agnieszka; Zywar, Katarzyna; Paszkowski, Rafał; Szuba, Andrzej

2015-08-01

The aim of this study is to compare values of force-velocity and functional walking capacity in elderly patients with intermittent claudication with respect to the control group. The study involved 135 individuals: 85-peripheral arterial disease (PAD) group diagnosed with stage II chronic lower limb ischemia, according to Fontaine's classification, and 50-control group. The studies included an assessment of walking capacity using a six-minute walk test (6MWT) and measurement of force-velocity parameters (peak torque-PTQ, total work-TW, average power-AVGP) of the lower limbs obtained by means of a functional dynamometry under isokinetic conditions. The peripheral arterial disease group is characterized by significantly lower values of force-velocity parameters compared to the control group (p<0.005). Walking capacity in this group is significantly reduced due to significant differences in the distance covered (p<0.0001), walking speed (p<0.01), and its intensity (p<0.01). Further, a positive correlation was found between the maximum distance specified in the six-minute walk test and lower limb muscle strength in the isokinetic test. Mean values of all force-velocity parameters and walk distance were significantly higher in the control group than in the peripheral arterial disease group. In the PAD group, in both men and women, the value of the agonist/antagonist ratio of both lower limbs are lower in men and women comparing to the control group. A rehabilitation program for patients with intermittent claudication must consider exercises improving strength, exercise capacity, and endurance in patients with PAD. Copyright © 2015 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

Obesity: challenges to ventilatory control during exercise--a brief review.

PubMed

Babb, Tony G

2013-11-01

Obesity is a national health issue in the US. Among the many physiological changes induced by obesity, it also presents a unique challenge to ventilatory control during exercise due to increased metabolic demand of moving larger limbs, increased work of breathing due to extra weight on the chest wall, and changes in breathing mechanics. These challenges to ventilatory control in obesity can be inconspicuous or overt among obese adults but for the most part adaptation of ventilatory control during exercise in obesity appears remarkably unnoticed in the majority of obese people. In this brief review, the changes to ventilatory control required for maintaining normal ventilation during exercise will be examined, especially the interaction between respiratory neural drive and ventilation. Also, gaps in our current knowledge will be discussed. Copyright © 2013 Elsevier B.V. All rights reserved.

The Kinematics of Treadmill Locomotion in Space

NASA Technical Reports Server (NTRS)

Thornton, W. E.; Cavanagh, P. R.; Buczek, F. L.; Burgess-Milliron, M. J.; Davis, B. L.

1997-01-01

Locomotion on a treadmill in 0 G will probably remain a centerpiece of NASA's exercise countermeasures programme. This form of physical activity has the potential to cause large bone and muscle forces as well as loading during a period of continuous treadmill exercise. A critical concern is the provision of a treadmill which can approximate 1 G performance in space. At this point, no adequate objective measurements of in-flight treadmill kinetics or of the human response to this activity have been made. Interpretation of the results obtained in the present study is limited by the following: (1) bungee tensions were not measured; (2) ground reaction forces were not measured in parallel with the kinematic measurements; and (3) the instrumentation used to film the astronauts could itself have been affected by microgravity. Despite these shortcomings, what is apparent is that exercise during NASA missions STS 7 and STS 8 resulted in leg motions that were similar to those found during 1 G locomotion on an inclined passive treadmill and on an active treadmill at an even steeper grade. In addition, it was apparent that the majority of the loads were transmitted through the forefoot, and one can surmise that this style of running would result in physiologically significant tensions in the calf musculature and resultant ankle compressive loading. Further speculation regarding limb loading is complicated by the fact that varying amounts of force are transmitted through (1) the treadmill handle and (2) bungee cords that act as a tether. New generations of treadmills are being manufactured that could provide I important information for planners of long-duration space missions. If these types of treadmill are flown on future missions, it will be possible to control bungee tensions more precisely, control for grade and speed, and, most importantly, provide data on the rates and magnitudes of limb loading. These data could then be incorporated into biomechanical models of the lower limb to more fully understand mechanisms of load transmission from distal to proximal structures and to optimize in-flight exercise protocols in such a way that muscle and bone loss could be reduced.

Roles of subcutaneous fat and thermoregulatory reflexes in determining ability to stabilize body temperature in water.

PubMed Central

Hayward, M G; Keatinge, W R

1981-01-01

1. The lowest water temperature in which different young adults could stabilize body temperature was found to vary from 32 degrees C to less than 12 degrees C, because of large differences in both total body insulation and metabolic heat production. 2. Total body insulation per unit surface area, in the coldest water allowing stability, was quite closely determined by mean subcutaneous fat thickness measured ultrasonically (r = 0.92), regardless of differences in distribution of this fat between men and women. 3. Reactive individuals developed high metabolic rates, and often rather high insulations in relation to fat thickness, which enabled them to stabilize their body temperatures in water more than 10 degrees C colder than was possible for less reactive individuals of similar fat thickness. 4. Measurements of heat flux, after stabilization in the coldest water possible, showed that the trunk was the main site of heat loss and that over half of the internal insulation there could be accounted for by subcutaneous fat; by contrast, fat could account for less than a third of higher insulations found in muscular parts of the limbs, and for less than 3% of very high insulations in the hands and feet. 5. After stabilization of body temperature at rest in the coldest possible water, exercise reduced internal insulation only in muscular parts of the limbs. Exercise also increased heat loss elsewhere by exposing skin of protected regions such as flexural surfaces of joints. During exercise total heat production increased rather more than heat loss in unreactive subjects, but less than loss in subjects whose heat production had already risen to a high level when they were at rest in cold water. 6. In warm (37 degrees C) water, tissue insulations were lower and much more uniform between subjects and between different body regions than in the cold. Even in the warm, however, insulations remained rather higher in fat than thin subjects, higher at rest than during exercise, and usually higher in the limbs than the upper trunk. PMID:7320937

Effect of cadence on locomotor-respiratory coupling during upper-body exercise.

PubMed

Tiller, Nicholas B; Price, Mike J; Campbell, Ian G; Romer, Lee M

2017-02-01

Asynchronous arm-cranking performed at high cadences elicits greater cardiorespiratory responses compared to low cadences. This has been attributed to increased postural demand and locomotor-respiratory coupling (LRC), and yet, this has not been empirically tested. This study aimed to assess the effects of cadence on cardiorespiratory responses and LRC during upper-body exercise. Eight recreationally-active men performed arm-cranking exercise at moderate and severe intensities that were separated by 10 min of rest. At each intensity, participants exercised for 4 min at each of three cadences (50, 70, and 90 rev min -1 ) in a random order, with 4 min rest-periods applied in-between cadences. Exercise measures included LRC via whole- and half-integer ratios, cardiorespiratory function, perceptions of effort (RPE and dyspnoea), and diaphragm EMG using an oesophageal catheter. The prevalence of LRC during moderate exercise was highest at 70 vs. 50 rev min -1 (27 ± 10 vs. 13 ± 9%, p = 0.000) and during severe exercise at 90 vs. 50 rev min -1 (24 ± 7 vs. 18 ± 5%, p = 0.034), with a shorter inspiratory time and higher mean inspiratory flow (p < 0.05) at higher cadences. During moderate exercise, [Formula: see text] and f C were higher at 90 rev min -1 (p < 0.05) relative to 70 and 50 rev min -1 ([Formula: see text] 1.19 ± 0.25 vs. 1.05 ± 0.21 vs. 0.97 ± 0.24 L min -1 ; f C 116 ± 11 vs. 101 ± 13 vs. 101 ± 12 b min -1 ), with concomitantly elevated dyspnoea. There were no discernible cadence-mediated effects on diaphragm EMG. Participants engage in LRC to a greater extent at moderate-high cadences which, in turn, increase respiratory airflow. Cadence rate should be carefully considered when designing aerobic training programmes involving the upper-limbs.

The Unsupported Upper Limb Exercise Test in People Without Disabilities: Assessing the Within-Day Test-Retest Reliability and the Effects of Age and Gender.

PubMed

Oliveira, Ana; Cruz, Joana; Jácome, Cristina; Marques, Alda

2018-01-01

Purpose: To estimate the within-day test-retest reliability and standard error of measurement (SEM) of the unsupported upper limb exercise test (UULEX) in adults without disabilities and to determine the effects of age and gender on performance of the UULEX. Method: A cross-sectional study was conducted with 100 adults without disabilities (44 men, mean age 44.2 [SD 26] y; 56 women, mean age 38.1 [SD 24.1] y). Participants performed three UULEX tests to establish within-day reliability, measured using an intra-class correlation coefficient (ICC) model 2 (two-way random effects) with a single rater (ICC[2,1]) and SEM. The effects of age and gender were examined using two-factor mixed-design analysis of variance (ANOVA) and one-way repeated-measures ANOVA. For analysis purposes, four sub-groups were created: younger adults, older adults, men, and women. Results: Excellent within-day reliability and a small SEM were found in the four sub-groups (younger adults: ICC[2,1]=0.88; 95% CI: 0.82, 0.92; SEM∼40 s; older adults: ICC[2,1]=0.82; 95% CI: 0.72, 0.90; SEM∼50 s; men: ICC[2,1]=0.93; 95% CI: 0.88, 0.96; SEM∼30 s; women: ICC[2,1]=0.85; 95% CI: 0.78, 0.91; SEM∼45 s). Younger adults took, on average, 308.24 seconds longer than older adults to perform the test; older adults performed significantly better on the third test ( p <0.0001; η 2 =0.096). Gender effects were not found ( p >0.05). Conclusion: The within-day test-retest reliability and SEM values of the UULEX may be used to define the magnitude of the error obtained with repeated measures. One UULEX test seems to be adequate for younger adults to achieve reliable results, whereas three tests seem to be needed for older adults.

Effects of Self Stretching on Pain and Musculoskeletal Symptom of Bus Drivers

PubMed Central

Lee, Jung-Ho; Gak, Hwang Bo

2014-01-01

[Purpose] The aim of this study was to evaluate the musculoskeletal symptoms, pain and risk of postures as well as the effects of stretching exercise on the work-related symptoms and pain of bus drivers. [Subjects and Methods] Eighty-one drivers were randomly recruited from a bus corporation for this study. Information about pain levels, painful regions, and general characteristics of subjects was obtained using the symptom research form (KOSHA Code H-30-2003). The level of pain was assessed on a scale of numeric rating scale (NRS) which is divided by 10. Ergonomic posture assessment was conducted using the rapid upper limb assessment (RULA). Self-stretching exercise was performed for 4 weeks by the bus drivers who suffered from neck and shoulder pain. [Results] Musculoskeletal symptoms were present in the order of shoulder, neck, lower back and lower extremities. Compared with other jobs, the final score, and the action level of bus drivers were very high, showing 57.6% of action levels 3 and 4. A statistically significant decrease of pain was shown after the self-stretching intervention. There was also a significant decrease of musculoskeletal symptoms in the neck and shoulders after the self-stretching exercise. [Conclusion] Performing stretching for musculoskeletal symptoms had a positive influence on the symptoms and reduced pain. PMID:25540496

Quantitative evaluation of the stretch reflex before and after hydro kinesy therapy in patients affected by spastic paresis.

PubMed

Pagliaro, P; Zamparo, P

1999-04-01

The aim of this study was the quantitative evaluation of the myotatic reflex in a group of 26 patients affected by stationary spastic paresis (6: hemiparesis; 5: paraparesis; 8: tetraparesis; 7: multiple sclerosis) before and after a treatment of hydro-kinesy therapy. The treatment was carried out in an indoor pool containing warm (32 degrees C) sea water and consisted of active and passive motion exercises, coordination exercises and immersion walking. The measured parameters were: (i) the peak input force (FpH) measured by means of an instrumented hammer with which the patellar tendon was hit; and (ii) the peak value of the corresponding reflex force of the quadriceps femoris (FpQ) measured by means of a load cell connected to the subject's ankle. The peak values of the reflex response (FpQ) were found to increase as a function of the intensity of the imposed stimulus and to reach a plateau between 15 and 30 N of FpH. A Student's t test applied to the paired values of FpQ (as measured at plateau conditions) on both the lower limbs, before and after therapy, showed no significant changes due to the treatment in the four groups of subjects. However, if all subjects were grouped regardless the type of illness: 1) the average reflex response of the affected limb (the one characterized before therapy by the higher FpQ values) was found to decrease following the treatment (75.1+/-26.7 N pre therapy and 69.1+/-29.3 N post therapy, p = 0.07, n = 26); and 2) the effect of the treatment was found to be significantly larger (p = 0.04, n = 26) on the affected limb (delta FpQ = 6.07+/-16.5 N) as respect with the contra lateral one (delta FpQ = -0.16+/-12.1 N).

Resistance Training using Low Cost Elastic Tubing is Equally Effective to Conventional Weight Machines in Middle-Aged to Older Healthy Adults: A Quasi-Randomized Controlled Clinical Trial.

PubMed

Lima, Fabiano F; Camillo, Carlos A; Gobbo, Luis A; Trevisan, Iara B; Nascimento, Wesley B B M; Silva, Bruna S A; Lima, Manoel C S; Ramos, Dionei; Ramos, Ercy M C

2018-03-01

The objectives of the study were to compare the effects of resistance training using either a low cost and portable elastic tubing or conventional weight machines on muscle force, functional exercise capacity, and health-related quality of life (HRQOL) in middle-aged to older healthy adults. In this clinical trial twenty-nine middle-aged to older healthy adults were randomly assigned to one of the three groups a priori defined: resistance training with elastic tubing (ETG; n = 10), conventional resistance training (weight machines) (CTG; n = 9) and control group (CG, n = 10). Both ETG and CTG followed a 12-week resistance training (3x/week - upper and lower limbs). Muscle force, functional exercise capacity and HRQOL were evaluated at baseline, 6 and 12 weeks. CG underwent the three evaluations with no formal intervention or activity counseling provided. ETG and CTG increased similarly and significantly muscle force (Δ16-44% in ETG and Δ25-46% in CTG, p < 0.05 for both), functional exercise capacity (ETG Δ4 ± 4% and CTG Δ6±8%; p < 0.05 for both). Improvement on "pain" domain of HRQOL could only be observed in the CTG (Δ21 ± 26% p = 0.037). CG showed no statistical improvement in any of the variables investigated. Resistance training using elastic tubing (a low cost and portable tool) and conventional resistance training using weight machines promoted similar positive effects on peripheral muscle force and functional exercise capacity in middle-aged to older healthy adults.

The Effect of Aerobic or Aerobic-Strength Exercise on Body Composition and Functional Capacity in Patients with BMI ≥35 after Bariatric Surgery: a Randomized Control Trial.

PubMed

Hassannejad, Alireza; Khalaj, Alireza; Mansournia, Mohammad Ali; Rajabian Tabesh, Mastaneh; Alizadeh, Zahra

2017-11-01

Although previous studies suggested that bariatric surgery is the most effective and sustainable treatment method for morbid obesity in long term, but without changing in lifestyle, maintaining optimal weight loss is almost impossible. Sixty morbid obese patients (BMI ≥ 35) were evaluated before and after 12 weeks of bariatric surgery in order to compare the impact of two different exercise programs on body composition and functional capacity outcomes. Participants were divided into three groups: aerobic (A), aerobic-strength (AS), and control (C) group. Aerobic capacity was assessed with 12-min walk-run test (12MWRT). One-repetition maximum (1RM) test was performed to evaluation upper limb muscle strength. Lower extremity functional capacity was assessed by sit-to-stand test. Weight, percent body fat (PBF), and fat mass (FM) reduced greater in the trial groups in comparison to the C group (P < 0.05). In the AS group, the reduction of fat-free mass (FFM) was significantly lower than that in the other groups. Mean changes in 12MWRT increased significantly in the intervention groups. The mean change in the sit-to-stand scores was not statistically significant between the three groups. Comparing the intervention groups showed that mean changes in 1RM variables increased in AS group (P = 0.03). The data suggests a positive effect of exercise on weight and PBF decrease after surgery, and it leads to significant improvement on aerobic capacity. Moreover, doing resisted exercise caused greater preserving of lean mass.

Effects of photobiomodulation therapy (pulsed LASER 904 nm) on muscle oxygenation and performance in exercise-induced skeletal muscle fatigue in young women: a pilot study

NASA Astrophysics Data System (ADS)

Oliveira, Murilo X.; Toma, Renata L.; Jones, Brett J. L.; Cyprien, Thomas P.; Tier, Matthew R.; Wallace, Cameron A.; Renno, Ana C. M.; Sabapathy, Surendran; Laakso, E.-Liisa

2017-02-01

Photobiomodulation therapy (PBMt) has been used to increase muscle performance and improve recovery when applied before exercise. We aimed to evaluate the effects of PBMt using LASER on muscle oxygenation and performance. The study was a randomized, participant and assessor-blinded, within-subject crossover trial with placebo control to test the viability of the methods. Five physically active young women were randomly assigned to either placebo, or active PBMt (12 diode cluster probe; 904 nm; 60 mW; 250 Hz; 43.2 J per site, 129.6 J total) in contact over rectus femoris (RF) muscle of the dominant limb immediately before an isokinetic fatigue protocol. A one-week wash-out period preceded cross-over. Electromyography and isokinetic performance measures were evaluated. Absolute concentrations of deoxygenated haemoglobin and myoglobin (deoxy[Hb + Mb]) of the RF, an index of local microvascular fractional O2 extraction, was monitored continuously by near-infrared spectroscopy (NIRS). Total haemoglobin concentration as an indicator of microvascular haematocrit was calculated as the sum of the deoxy[Hb + Mb] and oxy[Hb + Mb] signals. PBMt pre-conditioning reduced time to peak torque when compared to placebo (P<0.05). PBMt resulted in a noticeably reduced trend in deoxy[Hb + Mb] during exercise compared to placebo (P>0.05). PBMt before exercise improves indicators of muscle performance, potentially by increasing local matching of bulk and microvascular O2 delivery relative to skeletal muscle O2 utilisation. Further work is required to understand the effect of PBMt on haemodynamic and metabolic characteristics of muscle.

Jump Rope Training: Balance and Motor Coordination in Preadolescent Soccer Players

PubMed Central

Trecroci, Athos; Cavaggioni, Luca; Caccia, Riccardo; Alberti, Giampietro

2015-01-01

General physical practice and multidimensional exercises are essential elements that allow young athletes to enhance their coordinative traits, balance, and strength and power levels, which are linked to the learning soccer-specific skills. Jumping rope is a widely-used and non-specific practical method for the development of athletic conditioning, balance and coordination in several disciplines. Thus, the aim of this study was to investigate the effects of a short-term training protocol including jumping rope (JR) exercises on motor abilities and body balance in young soccer players. Twenty-four preadolescent soccer players were recruited and placed in two different groups. In the Experimental group (EG), children performed JR training at the beginning of the training session. The control group (CG), executed soccer specific drills. Harre circuit test (HCT) and Lower Quarter Y balance test (YBT-LQ) were selected to evaluate participant’s motor ability (e.g. ability to perform rapidly a course with different physical tasks such as somersault and passages above/below obstacles ) and to assess unilateral dynamic lower limb balance after 8 weeks of training. Statistical analysis consisted of paired t-test and mixed analysis of variance scores to determine any significant interactions. Children who performed jumping rope exercises showed a significant decrease of 9% (p < 0.01, ES = 0.50-0.80) in the performance time of HCT. With regard to the CG, no differences were highlighted (p > 0.05, ES = 0.05-0.2) from pre- to post-training. A training-by-group interaction was found for the composite score in both legs (p < 0.05, Part η2 > 0.14). Our findings demonstrated that JR practice within regular soccer training enhanced general motor coordination and balance in preadolescent soccer players. Therefore, the inclusion of JR practice within regular soccer training session should encouraged to improve children’s motor skills. Key points Performing jumping rope exercises within a regular soccer program can be an additional method to improve balance and motor coordination. The performance improvement in the Harre Circuit Test associated with jump rope training can potentially be attributed to an enhancement of the inter-limb coordination and SSC ability. Results from the present study indicate that young soccer players should be encouraged to practice general physical activities together with sport-specific exercise during their training sessions. PMID:26664276

Jump Rope Training: Balance and Motor Coordination in Preadolescent Soccer Players.

PubMed

Trecroci, Athos; Cavaggioni, Luca; Caccia, Riccardo; Alberti, Giampietro

2015-12-01

General physical practice and multidimensional exercises are essential elements that allow young athletes to enhance their coordinative traits, balance, and strength and power levels, which are linked to the learning soccer-specific skills. Jumping rope is a widely-used and non-specific practical method for the development of athletic conditioning, balance and coordination in several disciplines. Thus, the aim of this study was to investigate the effects of a short-term training protocol including jumping rope (JR) exercises on motor abilities and body balance in young soccer players. Twenty-four preadolescent soccer players were recruited and placed in two different groups. In the Experimental group (EG), children performed JR training at the beginning of the training session. The control group (CG), executed soccer specific drills. Harre circuit test (HCT) and Lower Quarter Y balance test (YBT-LQ) were selected to evaluate participant's motor ability (e.g. ability to perform rapidly a course with different physical tasks such as somersault and passages above/below obstacles ) and to assess unilateral dynamic lower limb balance after 8 weeks of training. Statistical analysis consisted of paired t-test and mixed analysis of variance scores to determine any significant interactions. Children who performed jumping rope exercises showed a significant decrease of 9% (p < 0.01, ES = 0.50-0.80) in the performance time of HCT. With regard to the CG, no differences were highlighted (p > 0.05, ES = 0.05-0.2) from pre- to post-training. A training-by-group interaction was found for the composite score in both legs (p < 0.05, Part η(2) > 0.14). Our findings demonstrated that JR practice within regular soccer training enhanced general motor coordination and balance in preadolescent soccer players. Therefore, the inclusion of JR practice within regular soccer training session should encouraged to improve children's motor skills. Key pointsPerforming jumping rope exercises within a regular soccer program can be an additional method to improve balance and motor coordination.The performance improvement in the Harre Circuit Test associated with jump rope training can potentially be attributed to an enhancement of the inter-limb coordination and SSC ability.Results from the present study indicate that young soccer players should be encouraged to practice general physical activities together with sport-specific exercise during their training sessions.

Results of a Pilates exercise program in patients with chronic non-specific low back pain: a randomized controlled trial.

PubMed

Valenza, M C; Rodríguez-Torres, J; Cabrera-Martos, I; Díaz-Pelegrina, A; Aguilar-Ferrándiz, M E; Castellote-Caballero, Y

2017-06-01

To investigate the effects of a Pilates exercise program on disability, pain, lumbar mobility, flexibility and balance in patients with chronic non-specific low back pain. Randomized controlled trial. University laboratory. A total of 54 patients with chronic non-specific low back pain. Patients were randomly allocated to an experimental group ( n=27) included in a Pilates exercise program or to a control group ( n=27) receiving information in a form of a leaflet. Disability (Roland-Morris Disability Questionnaire and Oswestry Disability Index), current, average and pain at it least and at its worst (Visual Analogue Scales), lumbar mobility (modified Shober test), flexibility (finger-to-floor test) and balance (single limb stance test) were measured at baseline and after the intervention. A between-group analysis showed significant differences in the intervention group compared to the control group for both disability scores, the Rolland-Morris questionnaire (mean change±standard deviation of 5.31±3.37 and 2.40±6.78 respectively and between-groups mean difference of 3.2 ± 4.12, p=0.003) and the Oswestry Disability Index ( p<0.001), current pain ( p=0.002) and pain at it least ( p=0.033), flexibility (0.032) and balance (0.043). An 8-week Pilates exercise program is effective in improving disability, pain, flexibility and balance in patients with chronic non-specific low back pain.

Changes of pedaling technique and muscle coordination during an exhaustive exercise.

PubMed

Dorel, Sylvain; Drouet, Jean-Marc; Couturier, Antoine; Champoux, Yvan; Hug, François

2009-06-01

Alterations of the mechanical patterns during an exhaustive pedaling exercise have been previously shown. We designed the present study to test the hypothesis that these alterations in the biomechanics of pedaling, which occur during exhaustive exercise, are linked to changes in the activity patterns of lower limb muscles. Ten well-trained cyclists were tested during a limited time to exhaustion, performing 80% of maximal power tolerated. Pedal force components were measured continuously using instrumented pedals and were synchronized with surface EMG signals measured in 10 lower limb muscles. The results confirmed most of the alterations of the mechanical patterns previously described in the literature. The magnitude of the root mean squared of the EMG during the complete cycle (RMScycle) for tibialis anterior and gastrocnemius medialis decreased significantly (P < 0.05) from 85% and 75% of Tlim, respectively. A higher RMScycle was obtained for gluteus maximus (P < 0.01) and biceps femoris (P < 0.05) from 75% of Tlim. The k values that resulted from the cross-correlation technique indicated that the activities of six muscles (gastrocnemius medialis, gastrocnemius lateralis, tibialis anterior, vastus lateralis, vastus medialis, and rectus femoris) were shifted forward in the cycle at the end of the exercise. The large increases in activity for gluteus maximus and biceps femoris, which are in accordance with the increase in force production during the propulsive phase, could be considered as instinctive coordination strategies that compensate for potential fatigue and loss of force of the knee extensors (i.e., vastus lateralis and vastus medialis) by a higher moment of the hip extensors.

Development of an Equine Groove Model to Induce Metacarpophalangeal Osteoarthritis: A Pilot Study on 6 Horses

PubMed Central

Maninchedda, Ugo; Lepage, Olivier M.; Gangl, Monika; Hilairet, Sandrine; Remandet, Bernard; Meot, Francoise; Penarier, Geraldine; Segard, Emilie; Cortez, Pierre; Jorgensen, Christian; Steinberg, Régis

2015-01-01

The aim of this work was to develop an equine metacarpophalangeal joint model that induces osteoarthritis that is not primarily mediated by instability or inflammation. The study involved six Standardbred horses. Standardized cartilage surface damage or “grooves” were created arthroscopically on the distal dorsal aspect of the lateral and medial metacarpal condyles of a randomly chosen limb. The contralateral limb was sham operated. After 2 weeks of stall rest, horses were trotted 30 minutes every other day for 8 weeks, then evaluated for lameness and radiographed. Synovial fluid was analyzed for cytology and biomarkers. At 10 weeks post-surgery, horses were euthanized for macroscopic and histologic joint evaluation. Arthroscopic grooving allowed precise and identical damage to the cartilage of all animals. Under the controlled exercise regime, this osteoarthritis groove model displayed significant radiographic, macroscopic, and microscopic degenerative and reactive changes. Histology demonstrated consistent surgically induced grooves limited to non-calcified cartilage and accompanied by secondary adjacent cartilage lesions, chondrocyte necrosis, chondrocyte clusters, cartilage matrix softening, fissuring, mild subchondral bone inflammation, edema, and osteoblastic margination. Synovial fluid biochemistry and cytology demonstrated significantly elevated total protein without an increase in prostaglandin E2, neutrophils, or chondrocytes. This equine metacarpophalangeal groove model demonstrated that standardized non-calcified cartilage damage accompanied by exercise triggered altered osteochondral morphology and cartilage degeneration with minimal or inefficient repair and little inflammatory response. This model, if validated, would allow for assessment of disease processes and the effects of therapy. PMID:25680102

Development of an equine groove model to induce metacarpophalangeal osteoarthritis: a pilot study on 6 horses.

PubMed

Maninchedda, Ugo; Lepage, Olivier M; Gangl, Monika; Hilairet, Sandrine; Remandet, Bernard; Meot, Francoise; Penarier, Geraldine; Segard, Emilie; Cortez, Pierre; Jorgensen, Christian; Steinberg, Régis

2015-01-01

The aim of this work was to develop an equine metacarpophalangeal joint model that induces osteoarthritis that is not primarily mediated by instability or inflammation. The study involved six Standardbred horses. Standardized cartilage surface damage or "grooves" were created arthroscopically on the distal dorsal aspect of the lateral and medial metacarpal condyles of a randomly chosen limb. The contralateral limb was sham operated. After 2 weeks of stall rest, horses were trotted 30 minutes every other day for 8 weeks, then evaluated for lameness and radiographed. Synovial fluid was analyzed for cytology and biomarkers. At 10 weeks post-surgery, horses were euthanized for macroscopic and histologic joint evaluation. Arthroscopic grooving allowed precise and identical damage to the cartilage of all animals. Under the controlled exercise regime, this osteoarthritis groove model displayed significant radiographic, macroscopic, and microscopic degenerative and reactive changes. Histology demonstrated consistent surgically induced grooves limited to non-calcified cartilage and accompanied by secondary adjacent cartilage lesions, chondrocyte necrosis, chondrocyte clusters, cartilage matrix softening, fissuring, mild subchondral bone inflammation, edema, and osteoblastic margination. Synovial fluid biochemistry and cytology demonstrated significantly elevated total protein without an increase in prostaglandin E2, neutrophils, or chondrocytes. This equine metacarpophalangeal groove model demonstrated that standardized non-calcified cartilage damage accompanied by exercise triggered altered osteochondral morphology and cartilage degeneration with minimal or inefficient repair and little inflammatory response. This model, if validated, would allow for assessment of disease processes and the effects of therapy.

Circuit weight training and cardiac morphology: a trial with magnetic resonance imaging.

PubMed

Camargo, M D; Stein, R; Ribeiro, J P; Schvartzman, P R; Rizzatti, M O; Schaan, B D

2008-02-01

Aerobic training (AT) and circuit weight training (CWT) improve peak oxygen uptake (VO(2)peak). During CWT the circulatory system is exposed to higher pressure, which could induce left ventricle morphological adaptations, possibly distinct from those derived from aerobic training. To compare the effects of aerobic training and CWT upon morphological and functional cardiac adaptations detected by magnetic resonance imaging. Twenty healthy sedentary individuals were randomly assigned to participate in a 12-week programme of aerobic training (n = 6), CWR (n = 7) or no intervention (n = 7, controls). Training programmes consisted of 36 sessions, 35 min each, 3 times per week, at 70% of maximal heart rate, and CWT included series of resistance exercises performed at 60% of 1 maximal repetition. Cardiopulmonary exercise testing and cardiac magnetic resonance imaging were performed before and after the intervention. There was a similar improvement in VO(2)peak following aerobic training (mean (SD) increment: 12 (4)%) and CWT (12 (4)%), while there was no change in the control group. Aerobic training (12 (6)%) and CWT (16 (5)%) improved strength in the lower limbs, and only CWT resulted in improvement of 13 (4)% in the strength of the upper limbs. However, there were no detectable changes in left ventricular mass, end-diastolic volume, stroke volume or ejection fraction. In previously sedentary individuals, short-term CWT and aerobic training induce similar improvement in functional capacity without any adaptation in cardiac morphology detectable by cardiac magnetic resonance imaging.

Design and Development of a Telerehabilitation Platform for Patients With Phantom Limb Pain: A User-Centered Approach.

PubMed

Rothgangel, Andreas; Braun, Susy; Smeets, Rob; Beurskens, Anna

2017-02-15

Phantom limb pain is a frequent and persistent problem following amputation. Achieving sustainable favorable effects on phantom limb pain requires therapeutic interventions such as mirror therapy that target maladaptive neuroplastic changes in the central nervous system. Unfortunately, patients' adherence to unsupervised exercises is generally poor and there is a need for effective strategies such as telerehabilitation to support long-term self-management of patients with phantom limb pain. The main aim of this study was to describe the user-centered approach that guided the design and development of a telerehabilitation platform for patients with phantom limb pain. We addressed 3 research questions: (1) Which requirements are defined by patients and therapists for the content and functions of a telerehabilitation platform and how can these requirements be prioritized to develop a first prototype of the platform? (2) How can the user interface of the telerehabilitation platform be designed so as to match the predefined critical user requirements and how can this interface be translated into a medium-fidelity prototype of the platform? (3) How do patients with phantom limb pain and their treating therapists judge the usability of the medium-fidelity prototype of the telerehabilitation platform in routine care and how can the platform be redesigned based on their feedback to achieve a high-fidelity prototype? The telerehabilitation platform was developed using an iterative user-centered design process. In the first phase, a questionnaire followed by a semistructured interview was used to identify the user requirements of both the patients and their physical and occupational therapists, which were then prioritized using a decision matrix. The second phase involved designing the interface of the telerehabilitation platform using design sketches, wireframes, and interface mock-ups to develop a low-fidelity prototype. Heuristic evaluation resulted in a medium-fidelity prototype whose usability was tested in routine care in the final phase, leading to the development of a high-fidelity prototype. A total of 7 categories of patient requirements were identified: monitoring, exercise programs, communication, settings, background information, log-in, and general requirements. One additional category emerged for therapists: patient management. Based on these requirements, patient and therapist interfaces for the telerehabilitation platform were developed and redesigned by the software development team in an iterative process, addressing the usability problems that were reported by the users during 4 weeks of field testing in routine care. Our findings underline the importance of involving the users and other stakeholders early and continuously in an iterative design process, as well as the need for clear criteria to identify critical user requirements. A decision matrix is presented that incorporates the views of various stakeholders in systematically rating and prioritizing user requirements. The findings and lessons learned might help health care providers, researchers, software designers, and other stakeholders in designing and evaluating new teletreatments, and hopefully increase the likelihood of user acceptance. ©Andreas Rothgangel, Susy Braun, Rob Smeets, Anna Beurskens. Originally published in JMIR Rehabilitation and Assistive Technology (http://rehab.jmir.org), 15.02.2017.

Effects of balance-specific exercises on balance, physical activity and quality of life in adults with multiple sclerosis: a pilot investigation.

PubMed

Kasser, Susan L; Jacobs, Jesse V; Ford, Marley; Tourville, Timothy W

2015-01-01

To evaluate the efficacy of functional balance exercises on balance impairment, physical activity and quality of life (QOL) in adults with multiple sclerosis (MS). A multiple-baseline time-series design with an uncontrolled intervention. Ten subjects with MS completed assessments twice before and once after a 10-week balance intervention. ANOVA were used to evaluate the effects of testing session on the Brief-BESTest, instrumented stance and gait recordings by inertial motion sensors, lower-limb strength recorded by force transducers, accelerometry-based activity, the 12-item MS Walking Scale (MSWS-12), the Multiple Sclerosis Quality of Life-54 (MSQOL-54) questionnaire, the Modified Fatigue Impact scale (MFIS) and the Activity-specific Balance Confidence (ABC) scale. The intervention associated with significantly improved scores on the MSQOL-54 mental component, MFIS, MSWS-12 and Brief-BESTest. Sway amplitude significantly decreased and jerk significantly increased during instrumented standing on foam with eyes closed. Instrumented gait recordings of sagittal trunk range of motion also significantly decreased. ABC scores, strength measures and activity measures were not significantly changed. Ten weeks of functional balance exercises provided a feasible intervention for individuals with MS that improved components of balance, mental well-being and perceived fatigue impact and ambulation disability. A future randomized, controlled clinical trial should confirm these preliminary findings. Implications for Rehabilitation A balance-specific exercise program is both safe and feasible for individuals with mild-to-moderate MS. Comprehensive exercise interventions that are conceptually driven and employ well-designed progressive exercise across multiple contexts of balance control can facilitate improvements in balance impairments associated with MS. Functional balance exercises can positively impact clinical and objective measures of balance control and favorably influence perceptions of ambulation disability and fatigue as well as perceived quality of life in people with MS.

Randomised controlled trial of exercise to prevent shoulder problems in women undergoing breast cancer treatment: study protocol for the prevention of shoulder problems trial (UK PROSPER)

PubMed Central

Williamson, Esther; Lait, Clare; Richmond, Helen; Betteley, Lauren; Lall, Ranjit; Petrou, Stavros; Rees, Sophie; Withers, Emma J; Lamb, Sarah E; Thompson, Alastair M

2018-01-01

Musculoskeletal shoulder problems are common after breast cancer treatment. Early postoperative exercises targeting the upper limb may improve shoulder function. This protocol describes a National Institute for Health Research-funded randomised controlled trial (RCT) to evaluate the clinical and cost-effectiveness of an early supervised structured exercise programme compared with usual care, for women at high risk of developing shoulder problems after breast cancer surgery. Methods This pragmatic two-armed, multicentre RCT is underway within secondary care in the UK. PRevention Of Shoulder ProblEms tRial (PROSPER) aims to recruit 350 women from approximately 15 UK centres with follow-up at 6 weeks, 6 and 12 months after randomisation. Recruitment processes and intervention development were optimised through qualitative research during a 6-month internal pilot phase. Participants are randomised to the PROSPER intervention or best practice usual care only. The PROSPER intervention is delivered by physiotherapists and incorporates three main components: shoulder-specific exercises targeting range of movement and strength; general physical activity and behavioural strategies to encourage adherence and support exercise behaviour. The primary outcome is upper arm function assessed using the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire at 12 months postrandomisation. Secondary outcomes include DASH subscales, acute and chronic pain, complications, health-related quality of life and healthcare resource use. We will interview a subsample of 20 participants to explore their experiences of the trial interventions. Discussion The PROSPER study is the first multicentre UK clinical trial to investigate the clinical and cost-effectiveness of supported exercise in the prevention of shoulder problems in high-risk women undergoing breast cancer surgery. The findings will inform future clinical practice and provide valuable insight into the role of physiotherapy-supported exercise in breast cancer rehabilitation. Protocol version Version 2.1; dated 11 January 2017 Trial registration number ISRCTN35358984; Pre-results. PMID:29574439

Cold Water Mediates Greater Reductions in Limb Blood Flow than Whole Body Cryotherapy.

PubMed

Mawhinney, Chris; Low, David A; Jones, Helen; Green, Daniel J; Costello, Joseph T; Gregson, Warren

2017-06-01

Cold-water immersion (CWI) and whole body cryotherapy (WBC) are widely used recovery methods in an attempt to limit exercise-induced muscle damage, soreness, and functional deficits after strenuous exercise. The aim of this study was to compare the effects of ecologically valid CWI and WBC protocols on postexercise lower limb thermoregulatory, femoral artery, and cutaneous blood flow responses. Ten males completed a continuous cycle exercise protocol at 70% maximal oxygen uptake until a rectal temperature of 38°C was attained. Participants were then exposed to lower-body CWI (8°C) for 10 min, or WBC (-110°C) for 2 min, in a randomized crossover design. Rectal and thigh skin, deep, and superficial muscle temperatures, thigh, and calf skin blood flow (laser Doppler flowmetry), superficial femoral artery blood flow (duplex ultrasound), and arterial blood pressure were measured before, and for 40 min post, cooling interventions. Greater reductions in thigh skin (CWI, -5.9°C ± 1.8°C; WBC, 0.2°C ± 0.5°C; P < 0.001) and superficial (CWI, -4.4°C ± 1.3°C; WBC, -1.8°C ± 1.1°C; P < 0.001) and deep (CWI, -2.9°C ± 0.8°C; WBC, -1.3°C ± 0.6°C; P < 0.001) muscle temperatures occurred immediately after CWI. Decreases in femoral artery conductance were greater after CWI (CWI, -84% ± 11%; WBC, -59% ± 21%, P < 0.02) and thigh (CWI, -80% ± 5%; WBC, -59% ± 14%, P < 0.001), and calf (CWI, -73% ± 13%; WBC, -45% ± 17%, P < 0.001) cutaneous vasoconstriction was greater after CWI. Reductions in rectal temperature were similar between conditions after cooling (CWI, -0.6°C ± 0.4°C; WBC, -0.6°C ± 0.3°C; P = 0.98). Greater reductions in blood flow and tissue temperature were observed after CWI in comparison with WBC. These novel findings have practical and clinical implications for the use of cooling in the recovery from exercise and injury.

Does a single session of high-intensity interval training provoke a transient elevated risk of falling in seniors and adults?

PubMed

Donath, Lars; Kurz, Eduard; Roth, Ralf; Hanssen, Henner; Schmidt-Trucksäss, Arno; Zahner, Lukas; Faude, Oliver

2015-01-01

Balance and strength training can reduce seniors' fall risk up to 50%. Available evidence suggests that acute bouts of neuromuscular and endurance exercise deteriorate postural control. High-intensity endurance training has been successfully applied in different populations. Thus, it seemed valuable to examine the acute effects of high-intensity interval training (HIIT) on neuromuscular performance in seniors and young adults. The acute impact of a HIIT session on balance performance and muscle activity after exercise cessation and during post-exercise recovery was examined in young and old adults. We intended to investigate whether a transient exercise-induced fall-risk may occur in both groups. 20 healthy seniors (age 70 (SD 4) years) and young adults (age 27 (SD 3) years) were examined on 3 days. After exhaustive ramp-like treadmill testing in order to determine maximal heart rate (HRmax) on the first day, either a 4 × 4 min HIIT at 90% of HRmax or a control condition (CON) was randomly performed on the second and third day, respectively. Balance performance (postural sway) was assessed during single limb stance with open eyes (SLEO) and double limb stance with closed eyes (DLEC). EMG was recorded for the soleus (SOL), anterior tibialis (TIB), gastrocnemius (GM) and peroneus longus (PL) muscles at the dominant leg. All measures were collected before, immediately as well as 10, 30 and 45 min after HIIT and CON, respectively. Compared to CON, HIIT induced significant increases of postural sway immediately after exercise cessation during SLEO in both groups (adults: p < 0.001, Δ = +25% sway; seniors: p = 0.007, Δ = +15% sway). Increased sway during DLEC was only found for seniors immediately and 10 min after HIIT (post: p = 0.003, Δ = +14% sway, 10 min post: p = 0.004, Δ = +18% sway). Muscle activity was increased during SLEO for TIB until 10 min post in seniors (0.008 < p < 0.03) and immediately after HIIT in adults (p < 0.001). HIIT training may cause an acute 'open-fall-window' with a transient impairment of balance performance for at least 10 min after exercise cessation in both groups. Occluded vision in seniors seems to prolong this period up to 30 min. Thus, the advantage of HIIT with regard to time efficiency seems debatable when considering transient HIIT-induced impairments of neuromuscular function. © 2014 S. Karger AG, Basel.

[Basic mechanisms of QRS voltage changes on ECG of healthy subjects during the exercise test].

PubMed

Saltykova, M M

2015-01-01

Electrocardiography is the most commonly used technique for detection stress-induced myocardial ischemia. However, the sensitivity of ECG-criteria is not high. One of the major problem is the difficulty in differentiating ECG changes caused by various factors. The aim of this study was to evaluate the dependence of the QRS voltage changes during exercise on parameters of central hemodynamics, gender particularities and to reveal mechanisms causing these changes. To eliminate the effect of changes in cardiomyocytes transmembrane potentials under the influence of the neurotransmitters of the autonomic nervous system during stepwise increasing exercises and/or due to a lack of ATP results from inadequate myocardial blood flow only healthy subjects not older than 35 years were included in the study (7 men and 7 women) and only periods of ventricular depolarization (QRS complex on the ECG) were included in the analysis. We compared the changes of QRS waves during exercise sessions with two upper and one lower limbs in both men and women. The exercise load was twice bigger in exercise with one leg relative to exercise with two arms. Responses of heart rate and systolic arterial pressure were similar. Amplitude of S-wave in left chest leads significantly increased in both sessions without significant difference between augmentations in the sessions and in groups of men and women. Significant relationship between the S wave augmentation and the peak systolic arterial pressure were revealed. Furthermore, the QRS changes during the exercise with vertical and a horizontal torso position were compared to assess the impact of diastolic arterial pressure and displacement of the diaphragm and heart rotation due to increase of abdominal pressure during the last steps of exercise. The obtained results allow us to exclude the impact of the heart position and size changes, as well as the exercise load on S-wave changes and make a conclusion about the dependence of this parameter on the value of systolic blood pressure.

Effects of load-bearing exercise on skeletal structure and mechanics differ between outbred populations of mice.

PubMed

Wallace, Ian J; Judex, Stefan; Demes, Brigitte

2015-03-01

Effects of load-bearing exercise on skeletal structure and mechanical properties can vary between inbred strains of mice. Here, we examine whether such variation also exists at the population level. An experiment was performed with two outbred mouse stocks that have been reproductively isolated for >120 generations (Hsd:ICR, Crl:CD1). Growing females from each stock were either treated with a treadmill-running regimen for 1 month or served as controls. Limb forces were recorded with a force plate and cage activity monitored to verify that they were similar between stocks. After the experiment, femoral cortical and trabecular bone structure were quantified with micro-CT in the mid-diaphysis and distal metaphysis, respectively, and diaphyseal structural strength was determined with mechanical testing. Among Hsd:ICR mice, running led to significant improvements in diaphyseal bone quantity, structural geometry, and mechanical properties, as well as enhanced trabecular morphology. In contrast, among Crl:CD1 mice, the same running regimen had little effect on cortical and trabecular structure and significantly reduced diaphyseal resistance to fracture. In neither stock was body mass, muscle mass, or cage activity level different between runners and controls. Given that most environmental variables were controlled in this study, the differential effects of exercise on Hsd:ICR and Crl:CD1 bones were likely due to genetic differences between stocks. These results suggest that the benefits of loading for bone may vary between human populations (e.g., ethnic groups), in which case exercise programs and technologies designed to promote bone health with mechanical signals may be more advantageous to certain populations than others. Copyright © 2014 Elsevier Inc. All rights reserved.

Protection from Muscle Damage in the Absence of Changes in Muscle Mechanical Behavior.

PubMed

Hoffman, Ben W; Cresswell, Andrew G; Carroll, Timothy J; Lichtwark, Glen A

2016-08-01

The repeated bout effect characterizes the protective adaptation after a single bout of unaccustomed eccentric exercise that induces muscle damage. Sarcomerogenesis and increased tendon compliance have been suggested as potential mechanisms for the repeated bout effect by preventing muscle fascicles from being stretched onto the descending limb of the length-tension curve (the region where sarcomere damage is thought to occur). In this study, evidence was sought for three possible mechanical changes that would support either the sarcomerogenesis or the increased tendon compliance hypotheses: a sustained rightward shift in the fascicle length-tension relationship, reduced fascicle strain amplitude, and reduced starting fascicle length. Subjects (n = 10) walked backward downhill (5 km·h, 20% incline) on a treadmill for 30 min on two occasions separated by 7 d. Kinematic data and medial gastrocnemius fascicle lengths (ultrasonography) were recorded at 10-min intervals to compare fascicle strains between bouts. Fascicle length-torque curves from supramaximal tibial nerve stimulation were constructed before, 2 h after, and 2 d after each exercise bout. Maximum torque decrement and elevated muscle soreness were present after the first, but not the second, backward downhill walking bout signifying a protective repeated bout effect. There was no sustained rightward shift in the length-torque relationship between exercise bouts, nor decreases in fascicle strain amplitude or shortening of the starting fascicle length. Protection from a repeated bout of eccentric exercise was conferred without changes in muscle fascicle strain behavior, indicating that sarcomerogenesis and increased tendon compliance were unlikely to be responsible. As fascicle strains are relatively small in humans, we suggest that changes to connective tissue structures, such as extracellular matrix remodeling, are better able to explain the repeated bout effect observed here.

Whole-body vibration and the prevention and treatment of delayed-onset muscle soreness.

PubMed

Aminian-Far, Atefeh; Hadian, Mohammad-Reza; Olyaei, Gholamreza; Talebian, Saeed; Bakhtiary, Amir Hoshang

2011-01-01

Numerous recovery strategies have been used in an attempt to minimize the symptoms of delayed-onset muscle soreness (DOMS). Whole-body vibration (WBV) has been suggested as a viable warm-up for athletes. However, scientific evidence to support the protective effects of WBV training (WBVT) on muscle damage is lacking. To investigate the acute effect of WBVT applied before eccentric exercise in the prevention of DOMS. Randomized controlled trial. University laboratory. A total of 32 healthy, untrained volunteers were randomly assigned to either the WBVT (n  =  15) or control (n  =  17) group. Volunteers performed 6 sets of 10 maximal isokinetic (60°/s) eccentric contractions of the dominant-limb knee extensors on a dynamometer. In the WBVT group, the training was applied using a vibratory platform (35 Hz, 5 mm peak to peak) with 100° of knee flexion for 60 seconds before eccentric exercise. No vibration was applied in the control group. Muscle soreness, thigh circumference, and pressure pain threshold were recorded at baseline and at 1, 2, 3, 4, 7, and 14 days postexercise. Maximal voluntary isometric and isokinetic knee extensor strength were assessed at baseline, immediately after exercise, and at 1, 2, 7, and 14 days postexercise. Serum creatine kinase was measured at baseline and at 1, 2, and 7 days postexercise. The WBVT group showed a reduction in DOMS symptoms in the form of less maximal isometric and isokinetic voluntary strength loss, lower creatine kinase levels, and less pressure pain threshold and muscle soreness (P < .05) compared with the control group. However, no effect on thigh circumference was evident (P < .05). Administered before eccentric exercise, WBVT may reduce DOMS via muscle function improvement. Further investigation should be undertaken to ascertain the effectiveness of WBVT in attenuating DOMS in athletes.

Exercise reverses pain-related weight asymmetry and differentially modulates trabecular bone microarchitecture in a rat model of osteoarthritis.

PubMed

Cormier, Jim; Cone, Katherine; Lanpher, Janell; Kinens, Abigail; Henderson, Terry; Liaw, Lucy; Bilsky, Edward J; King, Tamara; Rosen, Clifford J; Stevenson, Glenn W

2017-07-01

There is great interest in developing and utilizing non-pharmacological/non-invasive forms of therapy for osteoarthritis (OA) pain including exercise and other physical fitness regimens. The present experiments determined the effects of prior wheel running on OA-induced weight asymmetry and trabecular bone microarchitecture. Wheel running included 7 or 21days of prior voluntary access to wheels followed by OA induction, followed by 21days post-OA access to wheels. OA was induced with monosodium iodoacetate (MIA), and weight asymmetry was measured using a hind limb weight bearing apparatus. Bone microarchitecture was characterized using ex vivo μCT. Relative to saline controls, MIA (3.2mg/25μl) produced significant weight asymmetry measured on post-days (PDs) 3, 7, 14, 21 in sedentary rats. Seven days of prior running failed to alter MIA-induced weight asymmetry. In contrast, 21days of prior running resulted in complete reversal of MIA-induced weight asymmetry on all days tested. As a comparator, the opioid agonist morphine (3.2-10mg/kg) dose-dependently reversed weight asymmetry on PDs 3, 7, 14, but was ineffective in later-stage (PD 21) OA. In runners, Cohen's d (effect sizes) for OA vs. controls indicated large increases in bone volume fraction, trabecular number, trabecular thickness, and connective density in lateral compartment, and large decreases in the same parameters in medial compartment. In contrast, effect sizes were small to moderate for sedentary OA vs. Results indicate that voluntary exercise may protect against OA pain, the effect varies as a function of prior exercise duration, and is associated with distinct trabecular bone modifications. Copyright © 2017 Elsevier Inc. All rights reserved.

Parallel Robot for Lower Limb Rehabilitation Exercises.

PubMed

Rastegarpanah, Alireza; Saadat, Mozafar; Borboni, Alberto

2016-01-01

The aim of this study is to investigate the capability of a 6-DoF parallel robot to perform various rehabilitation exercises. The foot trajectories of twenty healthy participants have been measured by a Vicon system during the performing of four different exercises. Based on the kinematics and dynamics of a parallel robot, a MATLAB program was developed in order to calculate the length of the actuators, the actuators' forces, workspace, and singularity locus of the robot during the performing of the exercises. The calculated length of the actuators and the actuators' forces were used by motion analysis in SolidWorks in order to simulate different foot trajectories by the CAD model of the robot. A physical parallel robot prototype was built in order to simulate and execute the foot trajectories of the participants. Kinect camera was used to track the motion of the leg's model placed on the robot. The results demonstrate the robot's capability to perform a full range of various rehabilitation exercises.

Parallel Robot for Lower Limb Rehabilitation Exercises

PubMed Central

Saadat, Mozafar; Borboni, Alberto

2016-01-01

The aim of this study is to investigate the capability of a 6-DoF parallel robot to perform various rehabilitation exercises. The foot trajectories of twenty healthy participants have been measured by a Vicon system during the performing of four different exercises. Based on the kinematics and dynamics of a parallel robot, a MATLAB program was developed in order to calculate the length of the actuators, the actuators' forces, workspace, and singularity locus of the robot during the performing of the exercises. The calculated length of the actuators and the actuators' forces were used by motion analysis in SolidWorks in order to simulate different foot trajectories by the CAD model of the robot. A physical parallel robot prototype was built in order to simulate and execute the foot trajectories of the participants. Kinect camera was used to track the motion of the leg's model placed on the robot. The results demonstrate the robot's capability to perform a full range of various rehabilitation exercises. PMID:27799727

An Orthopedic Perspective. Does Running Cause Osteoarthritis?

ERIC Educational Resources Information Center

Pascale, Mark; Grana, William A.

1989-01-01

Discusses the development of osteoarthritis and whether running and other impact loading sports promote it. Although these sports do not cause arthritis in normal weight bearing limbs, they can accelerate it in damaged joints. It is important to identify people with preeexisting joint disease so they can choose nonimpact-loading aerobic exercise.…

Upper-Limb Exercises for Stroke Patients through the Direct Engagement of an Embodied Agent

DTIC Science & Technology

2011-03-01

hemiparesis . To alleviate impairments, pa- tients pursue therapy services at the acute, sub-acute, and chronic phases as necessary. Patients need...year-old male who suffered from a stroke 15 years ago. He has right hemiparesis and ambu- lates with a quad cane. He has limited scapula and minimal

Task-Specific and Functional Effects of Speed-Focused Elliptical or Motor-Assisted Cycle Training in Children With Bilateral Cerebral Palsy: Randomized Clinical Trial.

PubMed

Damiano, Diane L; Stanley, Christopher J; Ohlrich, Laurie; Alter, Katharine E

2017-08-01

Locomotor training using treadmills or robotic devices is commonly utilized to improve gait in cerebral palsy (CP); however, effects are inconsistent and fail to exceed those of equally intense alternatives. Possible limitations of existing devices include fixed nonvariable rhythm and too much limb or body weight assistance. To quantify and compare effectiveness of a motor-assisted cycle and a novel alternative, an elliptical, in CP to improve interlimb reciprocal coordination through intensive speed-focused leg training. A total of 27 children with bilateral CP, 5 to 17 years old, were randomized to 12 weeks of 20 minutes, 5 days per week home-based training (elliptical = 14; cycle = 13) at a minimum of 40 revolutions per minute, with resistance added when speed target was achieved. Primary outcomes were self-selected and fastest voluntary cadence on the devices and gait speed. Secondary outcomes included knee muscle strength, and selective control and functional mobility measures. Cadence on trained but not nontrained devices increased, demonstrating task specificity of training and increased exercise capability. Mean gait speed did not increase in either group, nor did parent-reported functional mobility. Knee extensor strength increased in both. An interaction between group and time was seen in selective control with scores slightly increasing for the elliptical and decreasing for the cycle, possibly related to tighter limb coupling with cycling. Task-specific effects were similarly positive across groups, but no transfer was seen to gait or function. Training dose was low (≤20 hours) compared with intensive upper-limb training recommendations and may be insufficient to produce appreciable clinical change.

What do community football players think about different exercise-training programmes? Implications for the delivery of lower limb injury prevention programmes

PubMed Central

Finch, Caroline F; Doyle, Tim LA; Dempsey, Alasdair R; Elliott, Bruce C; Twomey, Dara M; White, Peta E; Diamantopoulou, Kathy; Young, Warren; Lloyd, David G

2014-01-01

Background Players are the targeted end-users and beneficiaries of exercise-training programmes implemented during coach-led training sessions, and the success of programmes depends upon their active participation. Two variants of an exercise-training programme were incorporated into the regular training schedules of 40 community Australian Football teams, over two seasons. One variant replicated common training practices, while the second was an evidence-based programme to alter biomechanical and neuromuscular factors related to risk of knee injuries. This paper describes the structure of the implemented programmes and compares players’ end-of-season views about the programme variants. Methods This study was nested within a larger group-clustered randomised controlled trial of the effectiveness of two exercise-training programmes (control and neuromuscular control (NMC)) for preventing knee injuries. A post-season self-report survey, derived from Health Belief Model constructs, included questions to obtain players’ views about the benefits and physical challenges of the programme in which they participated. Results Compared with control players, those who participated in the NMC programme found it to be less physically challenging but more enjoyable and potentially of more benefit. Suggestions from players about potential improvements to the training programme and its future implementation included reducing duration, increasing range of drills/exercises and promoting its injury prevention and other benefits to players. Conclusions Players provide valuable feedback about the content and focus of implemented exercise-training programmes, that will directly inform the delivery of similar, or more successful, programmes in the future. PMID:24047571

The effectiveness of extracorporeal shock wave therapy in lower limb tendinopathy: a systematic review.

PubMed

Mani-Babu, Sethu; Morrissey, Dylan; Waugh, Charlotte; Screen, Hazel; Barton, Christian

2015-03-01

There is accumulating evidence for the effectiveness of extracorporeal shock wave therapy (ESWT) when treating lower limb tendinopathies including greater trochanteric pain syndrome (GTPS), patellar tendinopathy (PT), and Achilles tendinopathy (AT). To evaluate the effectiveness of ESWT for lower limb tendinopathies. Systematic review and meta-analysis. PubMed (Medline), Embase, Web of Knowledge, Cochrane, and CINAHL were searched from inception to February 2013 for studies of any design investigating the effectiveness of ESWT in GTPS, PT, and AT. Citation tracking was performed using PubMed and Google Scholar. Animal and non-English language studies were excluded. A quality assessment was performed by 2 independent reviewers, and effect size calculations were computed when sufficient data were provided. A total of 20 studies were identified, with 13 providing sufficient data to compute effect size calculations. The energy level, number of impulses, number of sessions, and use of a local anesthetic varied between studies. Additionally, current evidence is limited by low participant numbers and a number of methodological weaknesses including inadequate randomization. Moderate evidence indicates that ESWT is more effective than home training and corticosteroid injection in the short (<12 months) and long (>12 months) term for GTPS. Limited evidence indicates that ESWT is more effective than alternative nonoperative treatments including nonsteroidal anti-inflammatory drugs, physical therapy, and an exercise program and equal to patellar tenotomy surgery in the long term for PT. Moderate evidence indicates that ESWT is more effective than eccentric loading for insertional AT and equal to eccentric loading for midportion AT in the short term. Additionally, there is moderate evidence that combining ESWT and eccentric loading in midportion AT may produce superior outcomes to eccentric loading alone. Extracorporeal shock wave therapy is an effective intervention and should be considered for GTPS, PT, and AT particularly when other nonoperative treatments have failed. © 2014 The Author(s).

Using Non-Traditional Interfaces to Support Physical Therapy for Knee Strengthening.

PubMed

Torres, Andrea; López, Gustavo; Guerrero, Luis A

2016-09-01

Physical therapy consists mainly in the execution of rehabilitation processes that aim to help overcome injuries, as well as develop, maintain, or restore maximum body movement. Knee rehabilitation is one kind of physical therapy that requires daily exercises which could be considered monotonous and boring by the patients, discouraging their improvement. This is coupled with the fact that most physical therapists assess exercise performance through verbal and visual means with mostly manual measurements, making it difficult to constantly verify and validate if patients perform the exercises correctly. This article describes a physical therapy monitoring system that uses wearable technology to assess exercise performance and patient progress. This wearable device is able to measure and transfer the movement's data from the patient's limb to a mobile device. Moreover, the user interface is a game, which provides an entertaining approach to therapy exercising. In this article, it is shown that the developed system significantly increases daily user engagement in rehabilitation exercises, through a gameplay that matches physical therapy requirements for knee rehabilitation, as well as offering useful quantitative information to therapists.

Effects of short-term step aerobics exercise on bone metabolism and functional fitness in postmenopausal women with low bone mass.

PubMed

Wen, H J; Huang, T H; Li, T L; Chong, P N; Ang, B S

2017-02-01

Measurement of bone turnover markers is an alternative way to determine the effects of exercise on bone health. A 10-week group-based step aerobics exercise significantly improved functional fitness in postmenopausal women with low bone mass, and showed a positive trend in reducing resorption activity via bone turnover markers. The major goal of this study was to determine the effects of short-term group-based step aerobics (GBSA) exercise on the bone metabolism, bone mineral density (BMD), and functional fitness of postmenopausal women (PMW) with low bone mass. Forty-eight PMW (aged 58.2 ± 3.5 years) with low bone mass (lumbar spine BMD T-score of -2.00 ± 0.67) were recruited and randomly assigned to an exercise group (EG) or to a control group (CG). Participants from the EG attended a progressive 10-week GBSA exercise at an intensity of 75-85 % of heart rate reserve, 90 min per session, and three sessions per week. Serum bone metabolic markers (C-terminal telopeptide of type 1 collagen [CTX] and osteocalcin), BMD, and functional fitness components were measured before and after the training program. Mixed-models repeated measures method was used to compare differences between the groups (α = 0.05). After the 10-week intervention period, there was no significant exercise program by time interaction for CTX; however, the percent change for CTX was significantly different between the groups (EG = -13.1 ± 24.4 % vs. CG = 11.0 ± 51.5 %, P < 0.05). While there was no significant change of osteocalcin in both groups. As expected, there was no significant change of BMD in both groups. In addition, the functional fitness components in the EG were significantly improved, as demonstrated by substantial enhancement in both lower- and upper-limb muscular strength and cardiovascular endurance (P < 0.05). The current short-term GBSA exercise benefited to bone metabolism and general health by significantly reduced bone resorption activity and improved functional fitness in PMW with low bone mass. This suggested GBSA could be adopted as a form of group-based exercise for senior community.

Comparisons of eccentric knee flexor strength and asymmetries across elite, sub-elite and school level cricket players

PubMed Central

Chalker, Wade J.; Shield, Anthony J.; Opar, David A.

2016-01-01

Background. There has been a continual increase in injury rates in cricket, with hamstring strain injuries (HSIs) being the most prominent. Eccentric knee flexor weakness and bilateral asymmetries are major modifiable risk factors for future HSIs. However, there is a lack of data relating to eccentric hamstring strength in cricket at any skill level. The objective of this study was to compare eccentric knee flexor strength and bilateral asymmetries in elite, sub-elite and school level cricket players; and to determine if playing position and limb role influenced these eccentric knee flexor strength indices. Methods. Seventy four male cricket players of three distinct skill levels performed three repetitions of the Nordic hamstring exercise on the experimental device. Strength was assessed as the absolute and relative mean peak force output for both limbs, with bilateral asymmetries. Differences in mean peak force outputs between skill level and playing positions were measured. Results. There were no significant differences between elite, sub-elite and school level athletes for mean peak force and bilateral asymmetries of the knee flexors. There were no significant differences observed between bowler’s and batter’s mean peak force and bilateral asymmetries. There were no significant differences between front and back limb mean peak force outputs. Discussion. Skill level, playing position and limb role appeared to have no significant effect on eccentric knee flexor strength and bilateral asymmetries. Future research should seek to determine whether eccentric knee flexor strength thresholds are predictive of HSIs in cricket and if specific eccentric knee flexor strengthening can reduce these injuries. PMID:26925310

Comparisons of eccentric knee flexor strength and asymmetries across elite, sub-elite and school level cricket players.

PubMed

Chalker, Wade J; Shield, Anthony J; Opar, David A; Keogh, Justin W L

2016-01-01

Background. There has been a continual increase in injury rates in cricket, with hamstring strain injuries (HSIs) being the most prominent. Eccentric knee flexor weakness and bilateral asymmetries are major modifiable risk factors for future HSIs. However, there is a lack of data relating to eccentric hamstring strength in cricket at any skill level. The objective of this study was to compare eccentric knee flexor strength and bilateral asymmetries in elite, sub-elite and school level cricket players; and to determine if playing position and limb role influenced these eccentric knee flexor strength indices. Methods. Seventy four male cricket players of three distinct skill levels performed three repetitions of the Nordic hamstring exercise on the experimental device. Strength was assessed as the absolute and relative mean peak force output for both limbs, with bilateral asymmetries. Differences in mean peak force outputs between skill level and playing positions were measured. Results. There were no significant differences between elite, sub-elite and school level athletes for mean peak force and bilateral asymmetries of the knee flexors. There were no significant differences observed between bowler's and batter's mean peak force and bilateral asymmetries. There were no significant differences between front and back limb mean peak force outputs. Discussion. Skill level, playing position and limb role appeared to have no significant effect on eccentric knee flexor strength and bilateral asymmetries. Future research should seek to determine whether eccentric knee flexor strength thresholds are predictive of HSIs in cricket and if specific eccentric knee flexor strengthening can reduce these injuries.

Esmolol acutely alters oxygen supply-demand balance in exercising muscles of healthy humans.

PubMed

Proctor, David N; Luck, J Carter; Maman, Stephan R; Leuenberger, Urs A; Muller, Matthew D

2018-04-01

Beta-adrenoreceptor antagonists (β blockers) reduce systemic O 2 delivery and blood pressure (BP) during exercise, but the subsequent effects on O 2 extraction within the active limb muscles are unknown. In this study, we examined the effects of the fast-acting, β 1 selective blocker esmolol on systemic hemodynamics and leg muscle O 2 saturation (near infrared spectroscopy, NIRS) during submaximal leg ergometry. Our main hypothesis was that esmolol would augment exercise-induced reductions in leg muscle O 2 saturation. Eight healthy adults (6 men, 2 women; 23-67 year) performed light and moderate intensity bouts of recumbent leg cycling before (PRE), during (β 1 -blocked), and 45 min following (POST) intravenous infusion of esmolol. Oxygen uptake, heart rate (HR), BP, and O 2 saturation (SmO 2 ) of the vastus lateralis (VL) and medial gastrocnemius (MG) muscles were measured continuously. Esmolol attenuated the increases in HR and systolic BP during light (-12 ± 9 bpm and -26 ± 12 mmHg vs. PRE) and moderate intensity (-20 ± 10 bpm and -40 ± 18 mmHg vs. PRE) cycling (all P < 0.01). Exercise-induced reductions in SmO 2 occurred to a greater extent during the β 1 -blockade trial in both the VL (P = 0.001 vs. PRE) and MG muscles (P = 0.022 vs. PRE). HR, SBP and SmO 2 were restored during POST (all P < 0.01 vs. β 1 -blocked). In conclusion, esmolol rapidly and reversibly increases O 2 extraction within exercising muscles of healthy humans. © 2018 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on behalf of The Physiological Society and the American Physiological Society.

Dry needling in a manual physiotherapy and therapeutic exercise protocol for patients with chronic mechanical shoulder pain of unspecific origin: a protocol for a randomized control trial.

PubMed

Tejera-Falcón, Emma; Toledo-Martel, Nuria Del Carmen; Sosa-Medina, Francisco Manuel; Santana-González, Fátima; Quintana-de la Fe, Miriam Del Pino; Gallego-Izquierdo, Tomás; Pecos-Martín, Daniel

2017-09-18

Shoulder pain of musculoskeletal origin is the main cause of upper limb pain of non-traumatic origin. Despite being one of the most common reasons for consultation, there is no established protocol for treatment due to the complexity of its etiology. However, it has been shown that the presence of myofascial trigger points on the shoulder muscles is a common condition associated with patients suffering from shoulder pain. This protocol has been created which describes the design of a randomized controlled trial to evaluate the effectiveness of the inclusion of dry needling (DN) within a protocol of manual physiotherapy and therapeutic exercise in the treatment of chronic shoulder pain of unspecific origin. Thirty-six participants aged 18-65 years will be recruited having mechanical chronic shoulder pain on unspecific origin and meeting the inclusion criteria. These will be randomized to one of two interventions, (i) DN, manual physiotherapy and therapeutic exercise or (ii) sham DN, manual physiotherapy and therapeutic exercise. The protocol will cover 6 weeks of treatment, with a 6-month follow-up. Our main outcome measure will be the Visual Analogue Scale for pain. This is the first study to combine the use of DN, manual physiotherapy and an exercise program with a 6-month follow-up, thus becoming a new contribution to the treatment of chronic shoulder pain, while new lines of research may be established to help determine the effects of DN on chronic shoulder pain and the frequency and proper dosage. International Standard Randomized Controlled Trial Number Register: ISRCTN30604244 ( http://www.controlled-trials.com ) 29 June 2016.

A program of 3 physical therapy modalities improves peripheral arterial disease in diabetes type 2 patients: a randomized controlled trial.

PubMed

Castro-Sánchez, Adelaida María; Matarán-Peñarrocha, Guillermo A; Feriche-Fernández-Castanys, Belen; Fernández-Sola, Cayetano; Sánchez-Labraca, Nuria; Moreno-Lorenzo, Carmen

2013-01-01

Type 2 diabetes is one of the main causes of peripheral vascular disease. The beneficial effects of exercise on glucose homeostasis include a marked stimulation of blood glucose utilization during and after its performance. The objective of this study was to determine the effects of a program of 3 physical therapy modalities on blood circulation in patients with type 2 diabetes with peripheral arterial disease. A randomized controlled trial was undertaken. Sixty-eight patients with type 2 diabetes with Leriche-Fontaine stage I or IIa peripheral arterial disease were randomly assigned to an exercise or placebo group. For 20 weeks, the exercise group underwent treatment comprising 3 exercises at proximal, medium, and distal segments of the lower limbs, and the placebo group received sham treatment with disconnected ultrasound equipment. Peripheral arterial disease was determined by evaluating the ankle/brachial index (ABI), Doppler flow velocity, blood parameters, cardiovascular risk score, and heart rate during exercise test. After 20 weeks of treatment, significant differences between groups were found in the following: right (P < .039) and left (P < .023) ABI; Doppler flow velocity (cm/s) in the right (P < .010) and left (P < .026) posterior tibial artery and in the right (P < .012) and left (P < .022) dorsalis pedis artery; and fibrinogen (P < .045), hemoglobin (P < .021), cholesterol (P < .012), high-density lipoprotein cholesterol (P < .031), and HbA1c (P < .034) values. There was no significant difference in low-density lipoprotein cholesterol values (P < .110) between the groups. A program of these physical therapy modalities improves ABI, Doppler flow velocity, and blood parameters in patients with type 2 diabetes.

The effects of strength training on cognitive performance in elderly women.

PubMed

Smolarek, André de Camargo; Ferreira, Luis Henrique Boiko; Mascarenhas, Luis Paulo Gomes; McAnulty, Steven R; Varela, Karla Daniele; Dangui, Mônica C; de Barros, Marcelo Paes; Utter, Alan C; Souza-Junior, Tácito P

2016-01-01

Aging is a degenerative process marked by recognized functional, physiological, and metabolic impairments, such as dynapenia and diminished cognitive capacity. Therefore, the search for innovative strategies to prevent/delay these physiological and cognitive disorders is essential to guarantee the independence and life quality of an elderly population. The aim of this work is to verify the effect of a 12-week resistance exercise program on the general physical aptitude and cognitive capacities of elderly and sedentary women. Twenty-nine women (65.87±5.69 years) were divided into two groups. The control group was composed of eight elderly women who met the same inclusion criteria of the study and the strength training group was composed of 29 elderly women who were subjected to a resistance exercise program defined by 12 upper and lower limb exercises combined in 3×10 repetitions with 1-minute interval between repetitions and two resting minutes between exercises (three times/week). Weight loads were fixed between 60% and 75% of the apparent 1 repetition maximum, which was estimated by the test of 10 maximum repetitions. The direct curl was performed for upper body strength evaluation with 2.3 kg dumbbells for 30 seconds, whereas the chair test was used for lower body evaluation (total sit-stand movements in 30 seconds). The cognitive capacities of subjects were evaluated by "The Montreal Cognitive Assessment" questionnaire. After 12 weeks, the elderly group showed significant increases in the average upper body strength (58%), lower body strength (68%), and cognitive capacity (19%). The present study demonstrated that regular resistance exercises could provide significant gains on the upper and lower body strength concomitant to positive improvements on cognitive capacities of elderly women, bringing enhanced life quality.

Physiological and Functional Alterations after Spaceflight and Bed Rest.

PubMed

Mulavara, Ajitkumar P; Peters, Brian T; Miller, Chris A; Kofman, Igor S; Reschke, Millard F; Taylor, Laura C; Lawrence, Emily L; Wood, Scott J; Laurie, Steven S; Lee, Stuart M C; Buxton, Roxanne E; May-Phillips, Tiffany R; Stenger, Michael B; Ploutz-Snyder, Lori L; Ryder, Jeffrey W; Feiveson, Alan H; Bloomberg, Jacob J

2018-04-03

Exposure to microgravity causes alterations in multiple physiological systems, potentially impacting the ability of astronauts to perform critical mission tasks. The goal of this study was to determine the effects of spaceflight on functional task performance and to identify the key physiological factors contributing to their deficits. A test battery comprised of 7 functional tests and 15 physiological measures was used to investigate the sensorimotor, cardiovascular and neuromuscular adaptations to spaceflight. Astronauts were tested before and after 6-month spaceflights. Subjects were also tested before and after 70 days of 6° head-down bed rest, a spaceflight analog, to examine the role of axial body unloading on the spaceflight results. These subjects included Control and Exercise groups to examine the effects of exercise during bed rest. Spaceflight subjects showed the greatest decrement in performance during functional tasks that required the greatest demand for dynamic control of postural equilibrium which was paralleled by similar decrements in sensorimotor tests that assessed postural and dynamic gait control. Other changes included reduced lower limb muscle performance and increased heart rate to maintain blood pressure. Exercise performed during bed rest prevented detrimental change in neuromuscular and cardiovascular function, however, both bed rest groups experienced functional and balance deficits similar to spaceflight subjects. Bed rest data indicates that body support unloading experienced during spaceflight contributes to postflight postural control dysfunction. Further, the bed rest results in the Exercise group of subjects confirm that resistance and aerobic exercises performed during spaceflight can play an integral role in maintaining neuromuscular and cardiovascular function, which can help in reducing decrements in functional performance. These results indicate that a countermeasure to mitigate postflight postural control dysfunction is required to maintain functional performance.