Biomedical subjects

D L Roth

Publications and source records attributed to D L Roth.

At least 37 records · Page 2Linked to original sources

PubMed1995

The effects of strength conditioning on older women's ability to perform daily tasks.

OBJECTIVES: The objectives of this study were to determine the effects of a strength-training program on walking speed and relative muscular stress, as measured by normalized integrated electromyographic (nIEMG) activity, while carrying a box of groceries and standing from a chair. DESIGN: Prospective intervention study. SETTING: Volunteer subjects from the community of Birmingham, Alabama. PARTICIPANTS: Fourteen healthy women aged 60 to 77 years. INTERVENTION: Sixteen weeks of total body strength conditioning. MEASUREMENTS: Before and after 16 weeks of strength conditioning, the following variables were evaluated for all subjects: (1) strength, six isotonic tests and two isometric tests; (2) walking velocity; (3) nIEMG of the biceps while carrying a box of groceries; and (4) nIEMG of the rectus femoris while standing from a chair. MAIN RESULTS: After the strength training program, subjects' isotonic strength increased significantly, an average of 52% on the isotonic tests and 31% on the isometric tests. Walking velocity also increased significantly (18%). nIEMG of the biceps decreased 36% while carrying a box of groceries. Rectus femoris nIEMG decreased 40% while standing and 47% while sitting. CONCLUSIONS: After strength conditioning, healthy older women showed not only substantially increased strength but also improvements in walking velocity and the ability to carry out daily tasks such as rising from a chair and carrying a box of groceries.

Activities of Daily Living↗

PubMed1995

Battered woman syndrome: a conceptual analysis of its status vis-à-vis DSM IV mental disorders.

Literature on battered woman syndrome is examined with a view to validating the use of the word 'syndrome'. It is concluded that there is now sufficient information to justify its serious consideration as a form of post-traumatic stress disorder, as that diagnosis is defined in DSM IV: and that this has significance for the legal defence of battered women who react aggressively towards their abusers.

Battered Women↗

PubMed1995

Psychological, social, and health impact of caregiving: a comparison of black and white dementia family caregivers and noncaregivers.

Psychological, social, and health variables were compared in 175 Black and White family caregivers of patients with dementia and 175 Black and White noncaregivers. Caregivers and noncaregivers did not differ within race on demographic variables. Caregiving was associated with increased depression and decreased life satisfaction only in White families. However, caregiving appears to have similar social consequences for Black and White families, including restriction of social activity and increased visits and support by family from outside of the home. Race, but not caregiving, was associated with physical health variables. Methodological issues in comparing well-being in Black and White caregivers, in particular the importance of including noncaregiving comparison subjects are discussed.

Activities of Daily Living↗

PubMed1994

Reliability and validity of a newly developed test of physical work performance.

This study examined the interrater reliability and validity of a newly developed test of physical work abilities, the Physical Work Performance Evaluation. Eleven physical therapists were trained to administer and score this evaluation. From this group, two therapists at a time simultaneously and independently evaluated 50 patients with musculoskeletal disorders as they performed the tasks of the Physical Work Performance Evaluation. At the conclusion of the evaluation, each therapist determined the safe level of physical work for each patient. A comparison of the two independent evaluations was used to determine reliability. To determine validity, the predicted level of work was compared with the actual level of work. Kappa coefficient between the two therapists on the level of work was .83. Spearman rho correlations between the predicted and actual levels of work ranged from .41 to .55. Only 14 to 18% were working above the level predicted by the Physical Work Performance Evaluation. These results indicate high interrater reliability. Given the lack of a perfect standard for validity comparisons, these results also provide evidence in support of convergent validity. The test can be used in making decisions regarding return to work after injury, preemployment placement, and vocational exploration.

Adolescent↗

PubMed1992

Association between aerobic fitness and visuospatial performance in healthy older adults.

This study examined whether chronic physical exercise activity is associated with better neurocognitive performance in older adults. One hundred five men participated in 1 of 3 age groups (18-28, 35-45, and 60-73). For each age group, subjects were classified as high or low in fitness on the basis of self-reported activity levels and the results of a submaximal bicycle ergometer test. A comprehensive battery of neuropsychological tests was administered to each subject, and older subjects scored significantly lower than the younger groups on most tests. Significant differences between high- and low-fit subjects were found only on tasks with heavy visuospatial demands, and these differences were most notable in the older adult group. These findings suggest that participation in aerobic exercise activity selectively preserves some cognitive functions that normally decline with age. The benefits of activity appear to be most evident on tasks that require visuospatial processing.

Adolescent↗

PubMed1992

Rescue angioplasty during myocardial infarction has a beneficial effect on mortality: a tenable hypothesis.

HYPOTHESIS: Rescue percutaneous transluminal coronary angioplasty (PTCA) reduces mortality during myocardial infarction. OBJECTIVE: To determine if PTCA after failed thrombolytic therapy results in reduced mortality. DESIGN: Twenty-eight patients with a persistently occluded infarct artery following thrombolytic therapy more than 3 h after symptom onset were randomized to rescue PTCA (n = 16) or conservative treatment (n = 12) as part of a prospective randomized trial of reperfusion therapy during myocardial infarction in 184 patients. Hospital mortality was assessed in these groups as well as in the 177 patients with known infarct artery status after initial attempts at reperfusion. MAIN RESULTS: There was one death among the 16 patients in the rescue PTCA group versus four deaths in the 12 patients treated conservatively (P = 0.13). Moreover, the death in the rescue PTCA group occurred in one of three patients in whom the procedure failed. Mortality in the entire study group was 10.3% (19 of 184); 4.2% (six of 142) in patients in whom patency was achieved after thrombolysis and/or PTCA and 34.3% (12 of 35) in those in whom reperfusion was not achieved (P less than 0.001). In patients with anterior myocardial infarction, mortality was 6.7% (four of 60) in those with reperfusion and 47.1% (eight of 17) in those with a persistently occluded artery (P less than 0.001). In patients with inferior myocardial infarction, 2.4% (two of 82) with reperfusion and 22.2% (four of 18) with a persistently occluded artery died (P less than 0.01). CONCLUSIONS: Although the number of patients in the randomized groups was small, the trend toward a lower mortality after rescue PTCA supports the hypothesis that rescue PTCA may be beneficial. The mortality results in relation to presence or absence of reperfusion from the entire study population underscores the importance of achieving patency during myocardial infarction.

Aged↗

PubMed1991

Relation between flow grade after thrombolytic therapy and the effect of angioplasty on left ventricular function: a prospective randomized trial.

Recent intervention trials during myocardial infarction demonstrated no benefit from emergency angioplasty after thrombolytic therapy when compared with either delayed percutaneous transluminal coronary angioplasty (PTCA) or a conservative strategy. However, it is possible that subgroups of patients may benefit from early intervention with angioplasty. We performed a prospective randomized trial in patients with a patent infarct-related artery after thrombolytic therapy to determine whether initial flow grade is related to infarct-zone function and whether patients with ineffective reperfusion (greater than 90% stenosis or Thrombolysis in Myocardial Infarction [TIMI] flow less than or equal to 2) might benefit from immediate PTCA. Thrombolytic therapy was administered to 170 patients at a mean of 2.1 +/- 0.5 hours after onset of myocardial infarction. A patent infarct-related artery that was suitable for angioplasty was present in 89 patients who comprised the study group; after randomization, 47 of 50 patients with a patent infarct-related artery had successful emergency PTCA 3.8 +/- 1.5 hours after onset of symptoms, and 39 were scheduled for delayed (18 to 48-hour) PTCA. Reocclusion occurred before the scheduled (delayed) procedure in eight patients (20.5%), and was symptomatic in six. Infarct-region function (by the centerline method) measured initially, before discharge, and at 4 months was similar in both groups; improvement was significant (p less than 0.001) at discharge when compared with initial values with no further change at 4 months. However, patients with ineffective reperfusion had greater hypokinesia initially (p less than 0.05) compared with those with effective reperfusion (less than or equal to 90% stenosis plus TIMI flow 3). Moreover, independent of the timing of PTCA, improvement was greater before discharge in patients with ineffective reperfusion (p less than 0.05) with a trend also evident at 4 months. Importantly, 42 of 51 patients (82%) with a residual lumen less than 0.4 mm after thrombolysis had some improvement in function at discharge; this compared with a previous study in which patients with a similar degree of stenosis (without PTCA) had no improvement. Moreover, reocclusion occurred before scheduled (delayed) PTCA in 37% of patients with greater than 90% stenosis compared with only 5% in those with less than or equal to 90% stenosis (p = 0.02). Thus flow grade is an important determinant of myocardial function in patients with a patent artery after thrombolytic therapy and is predictive both of improvement in wall motion after PTCA and early reocclusion.(ABSTRACT TRUNCATED AT 400 WORDS)

Angioplasty, Balloon, Coronary↗

PubMed1990

Effect of short-term prostacyclin administration on restenosis after percutaneous transluminal coronary angioplasty.

The effect of short-term prostacyclin (PGI2) administration on the incidence of restenosis after coronary angioplasty was studied in a prospective single-blind randomized trial of 286 patients. Of the 270 patients in whom dilation was successful, 134 received prostacyclin and 136 received placebo. Intracoronary prostacyclin was administered before and after dilation and then intravenously for 48 h. The control group received intracoronary placebo infusions before and after dilation. All patients received aspirin and dipyridamole before and after angioplasty, at least until follow-up angiography. Follow-up angiograms were obtained in 93% of patients in whom angioplasty was successful. Restenosis of one or more lesions was present in 34 patients (27%) who were given prostacyclin compared with 40 patients (32%) in the control group (p = NS). Acute vessel closure and ventricular tachyarrhythmias were more common in the control group than in the patients who received prostacyclin (acute vessel closure occurred in 14 [10.3%] of 136 versus 4 [3.0%] of 134, respectively, p less than 0.01; ventricular tachyarrhythmias occurred in 5 [3.4%] of 147 versus 0 of 139 respectively, p less than 0.05). Short-term administration of prostacyclin did not significantly lower the risk of restenosis after coronary angioplasty.

Aged↗

PubMed1990

Confirmatory factor analysis of the Wechsler Memory Scale-Revised in a sample of head-injured patients.

As part of a standard evaluation of neuropsychological sequelae, the Wechsler Memory Scale-Revised (WMS-R) was administered to 107 patients with a history of traumatic brain injury. Confirmatory factor analyses were conducted on the 12 subtests of the WMS-R to examine the fit of various hypothesized factor patterns, including patterns identified in previous exploratory factor analytic studies. Because part of the correlation between immediate and delayed recall trials of the same material is attributable to a common measurement procedure, this correlation due to measurement commonality was partialled out of the conceptual factor structure. The results suggested the presence of 3 distinct but highly correlated factors: attention/concentration, immediate memory, and delayed recall. Models that posited separate verbal and nonverbal memory processes failed to improve fit over more parsimonious models. Comparisons with previous factor analytic studies and implications for clinical assessment are discussed.

Adolescent↗

PubMed1990

Acute emotional and cardiovascular effects of stressful mental work during aerobic exercise.

The acute effects of engaging in challenging mental work during a single session of aerobic exercise were examined on measures of subjective mood and cardiovascular function. Fifty-seven female subjects were randomly assigned to participate in either a 10-min aerobic exercise condition or a no-exercise control condition. Half of the subjects in each group performed digits backward problems during this time period, and no mental stressors were presented to the other subjects. The results indicated that the exercise and mental stress conditions had additive effects on subjective anxiety levels and on cardiovascular responses during exercise. Both exercise and mental stress increased heart rate. In addition, exercise had anti-anxiety and vasodilative effects, but both of these influences were attenuated by opposing main effects for mental stress exposure. No effects were found for exercise on measures of cardiovascular reactivity to a later digits backward stressor. The results are consistent with previous research in suggesting that exposure to mental stressors during aerobic exercise provides no acute psychological benefits but attenuates some of the mood improvements and vasodilative effects of the exercise activity.

Adolescent↗

PubMed1989

Cardiovascular reactivity and silent ischemia in response to mental stress in symptomatic and asymptomatic coronary artery disease patients: results of a pilot study.

The current study was designed to examine cardiovascular reactivity to psychological tasks and its relationship to provocation of ischemia in asymptomatic coronary artery disease (CAD) patients with documented silent ischemia and those with painful ischemia. ECG, heart rate, and blood pressure responses to mental stress were collected for 13 patients with coronary artery disease (CAD) and for 6 healthy control subjects. Six of the CAD patients were asymptomatic (documented silent ischemia and no history of angina), while the remaining 7 were symptomatic (history of angina). Three types of mental stress were employed: white noise (a passive stressor), digits repeated backwards (an active stressor), and a math task plus white noise (active + passive stressor). Results indicate that significant increases in heart rate and blood pressure, but not silent ischemic episodes, were induced by the mental stress tasks. In addition, patients with documented exercise-induced and ambulant silent ischemia showed trends of blunted autonomic responsiveness to the stressors. On the digits backwards task, the CAD patients with silent ischemia showed significantly lower diastolic blood pressure responses compared with controls or angina patients. Findings suggest that ischemic episodes are not easily induced by brief mental stress. However, results indicate that asymptomatic CAD patients with silent ischemia may be lacking in autonomic responsiveness, particularly in terms of peripheral resistance, to mental stress in comparison with health controls and symptomatic ischemic patients. Further investigation is needed to explore how patients with silent ischemia typically respond autonomically to mental stress and how blunted reactivity may relate to the provocation of unrecognized ischemic episodes.

Adaptation, Psychological↗

PubMed1989

The effects of distraction on the perception of exercise-induced symptoms.

The purpose of this study was to investigate the effects of distraction tasks varying in attentional demand on the perception of exercise-induced symptoms and on exercise performance. Tasks were constructed to vary in attentional demand but not in emotional engagement in order to isolate the former. Sixty females rode a bicycle ergometer while they participated in one of three experimental conditions: high demand distraction, low demand distraction, or no systematic distraction. Measures of mood, perceived exertion during exercise, physical symptoms following exercise, and timed riding tolerance were collected and analyzed. Level of distraction had little effect on mood, which confirmed that the tasks were not differentially emotionally arousing. Contrary to theoretical predictions, level of distraction led to no differences in exercise performance or symptom reports across the three groups. Limitations of the 'competition of cues' explanation for the efficacy of distraction as an intervention to reduce symptom perception and increase exercise performance are discussed.

Attention↗

PubMed1989

Life events, fitness, hardiness, and health: a simultaneous analysis of proposed stress-resistance effects.

The effects of exercise participation, self-perceived fitness level, and dispositional hardiness for promoting stress resistance were examined in a sample of 373 college students. Self-report measures of stressful life experience and recent physical illness were positively correlated, and fitness and hardiness were negatively correlated with illness as expected. Multiple regression analyses indicated that neither fitness nor hardiness provided a stress-moderator effect because neither was found to significantly interact with stress in the prediction of illness scores. Structural equation analyses suggested that hardiness may affect health indirectly by first influencing either the occurrence or subjective interpretation of stressful life events. No direct effect on health was found for exercise participation, although exercise may reduce illness indirectly by improving fitness. Implications for the multivariate modeling of proposed stress-resistance-enhancing effects are discussed.

Adaptation, Psychological↗

PubMed1989

Acute emotional and psychophysiological effects of aerobic exercise.

An experiment was conducted to examine the acute emotional and psychophysiological effects of a single bout of aerobic exercise. Forty active and 40 inactive college students were randomly assigned to an aerobic exercise or a waiting-period control condition. Self-report measures of mood and cardiovascular response measures to challenging cognitive tasks were collected before and after the 20-min exercise/control period to examine any exercise-induced changes. The results indicated that mood was significantly altered by the exercise activity, with reductions in tension and anxiety specifically evident. Exercise was not found to have any effects on cardiovascular reactivity. A test of aerobic fitness confirmed fitness differences between active and inactive participants, but no mood or reactivity effects related to activity status were obtained. These results suggest that both active and inactive individuals experience acute reductions in anxiety following single bouts of exercise, even in the absence of changes in cardiovascular reactivity. Implications for the continued investigation of the acute effects of exercise are discussed.

Adult↗

PubMed1989

Discriminant and convergent validity of self-report measures of affective distress in patients with rheumatoid arthritis.

The discriminant and convergent validity of several self-report measures of affective distress commonly administered to patients with rheumatoid arthritis (RA) were examined. Fifty-two patients with RA completed the Arthritis Helplessness Index, the Beck Depression Inventory, Spielberger's State Anxiety and Trait Anxiety Inventories, and the Arthritis Impact Measurement Depression and Anxiety Scales. Correlational and factor analyses revealed that the measures of anxiety and depression demonstrated adequate convergent validity but poor discriminant validity. Our results suggest that these measures index a general feeling of distress rather than discrete affective difficulties. The ability of these measures to assess separate problems of anxiety and depression among RA patients is questioned.

Adult↗

PubMed1988

Effects of aerobic exercise training and relaxation training on cardiovascular activity during psychological stress.

Students who reported experiencing a high number of stressful life events were randomly assigned to: (a) an aerobic training condition, (b) a relaxation training condition, or (c) a no treatment control condition. Immediately before and after the 11 week training/control period, subjects' aerobic fitness and cardiovascular responses to acute psychological stress were assessed. Results indicated that: (1) subjects in the aerobic training condition showed significantly greater improvements in aerobic fitness than subjects in the other conditions, and (2) the subjects in the aerobic training condition showed significantly greater reductions in heart rate during all phases of the stress than subjects in the other conditions. Post-training differences between aerobic and control conditions during the moderate psychological stress were as great as 17 b.p.m. These results provide evidence for the utility of aerobic training for reducing cardiovascular activity during psychological stress, and they are consistent with earlier findings linking fitness to less illness following stress, reductions in depression and enhanced recovery in cardiac patients.

Adaptation, Psychological↗

PubMed1986

Functional connections among cortical regions: topography of EEG coherence.

The covariance among EEG signals can be examined with coherence analysis. Evidence that the right hemisphere has a more diffuse receptotopic organization than the left, together with evidence that it may have a higher proportion of white to gray matter, suggests a high degree of functional connectedness among right hemisphere regions. To determine whether this is reflected in greater EEG coherence among right than left hemisphere locations, we constructed a matrix of cross-spectra among all unique pairs of EEG channels in an 8-channel montage, then statistically de-structured this matrix to examine multiple coherences and both inter- and intra-hemispheric partial multiple coherences. Analyses on data from the resting EEGs of 14 right-handed men examined weekly for several months showed higher coherences for right hemisphere locations. For the inter-hemispheric partial multiple coherences the frontal lobe values were also higher on the right, but the occipital inter-hemispheric coherences were higher on the left. These asymmetries have interesting parallels with anatomical asymmetries of the human cortex and may have functional implications.

Adult↗

PubMed1985

Memory span and long-term memory deficits in brain-impaired patients.

Measures of verbal and visuospatial memory span and long-term memory were obtained from 21 brain-impaired and 21 neurologically unimpaired Veterans Administration medical patients. Significant deficits in both memory span and long-term memory were observed in the brain-impaired patients. Contrary to predictions from the experimental literature, memory span tests that require more processing of item content and location were not superior in detecting the memory span deficits. Discriminant function analyses revealed that measures of verbal and visuospatial long-term memory provided unique discrimination between the brain-impaired and unimpaired patients. However, when memory span measures were analyzed alone, inclusion of more than one measure of memory span did not provide additional unique discrimination. Implications for the clinical assessment of memory functioning are discussed.

Brain Damage, Chronic↗