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Biomedical subjects

E C Hadley

Publications and source records attributed to E C Hadley.

18 recordsLinked to original sources
PubMed1996

Exercise to improve physiologic and functional performance in old age.

The purpose of this article is to evaluate the impact of exercise in elderly men and women. The type and intensity of exercise, the health status of the participants, and the outcomes measured vary widely across studies. In general, studies of exercise interventions in older adults show positive physiologic effects in persons of all ages. Musculoskeletal and cardiovascular systems, regardless of age, can respond to both resistance and aerobic training as measured by impairments such as strength and maximum oxygen uptake. The magnitude of physiologic effect may be dampened in frailer individuals in response to lower intensity exercise stimuli. In the most impaired elders, exercise may help to forestall further decline in physiologic reserve rather than produce significant gains. The extent to which exercise programs impact performance and disability is less clear. Exercise programs in frailer individuals appear to have greater effect on gait speed and chair rise time than similar programs in healthier individuals. The impact of exercise on measures of disability has not been widely reported. Studies reviewed in this article suggest that exercise training in elders is a potential means of reducing the burden of impairments and ultimately improving function.

Activities of Daily Living↗
PubMed1995

The effects of exercise on falls in elderly patients. A preplanned meta-analysis of the FICSIT Trials. Frailty and Injuries: Cooperative Studies of Intervention Techniques.

OBJECTIVE: To determine if short-term exercise reduces falls and fall-related injuries in the elderly. DESIGN: A preplanned meta-analysis of the seven Frailty and Injuries: Cooperative Studies of Intervention Techniques (FICSIT)--independent, randomized, controlled clinical trials that assessed intervention efficacy in reducing falls and frailty in elderly patients. All included an exercise component for 10 to 36 weeks. Fall and injury follow-up was obtained for up to 2 to 4 years. SETTING: Two nursing home and five community-dwelling (three health maintenance organizations) sites. Six were group and center based; one was conducted at home. PARTICIPANTS: Numbers of participants ranged from 100 to 1323 per study. Subjects were mostly ambulatory and cognitively intact, with minimum ages of 60 to 75 years, although some studies required additional deficits, such as functionally dependent in two or more activities of daily living, balance deficits or lower extremity weakness, or high risk of falling. INTERVENTIONS: Exercise components varied across studies in character, duration, frequency, and intensity. Training was performed in one area or more of endurance, flexibility, balance platform, Tai Chi (dynamic balance), and resistance. Several treatment arms included additional nonexercise components, such as behavioral components, medication changes, education, functional activity, or nutritional supplements. MAIN OUTCOME MEASURES: Time to each fall (fall-related injury) by self-report and/or medical records. RESULTS: Using the Andersen-Gill extension of the Cox model that allows multiple fall outcomes per patient, the adjusted fall incidence ratio for treatment arms including general exercise was 0.90 (95% confidence limits [CL], 0.81, 0.99) and for those including balance was 0.83 (95% CL, 0.70, 0.98). No exercise component was significant for injurious falls, but power was low to detect this outcome. CONCLUSIONS: Treatments including exercise for elderly adults reduce the risk of falls.

Accidental Falls↗
PubMed1995

The significance of sarcopenia in old age.

Our knowledge of the significance of sarcopenia in old age is limited by a lack of epidemiologic data, an incomplete assessment of the pathophysiologic consequences of age-related decrements in muscle mass and quality, and poor understanding of the underlying mechanisms responsible for these decrements. These gaps prevent us from fully appreciating the extent of the public health burden that sarcopenia poses, and present major obstacles to the elucidation of therapies to prevent or reverse sarcopenia in the elderly. The National Institute on Aging convened the Workshop on Sarcopenia to address these issues. The primary questions explored at the workshop included: (a) What research is needed to determine the clinical and functional significance of sarcopenia? (b) What research is needed to understand its etiology? and (c) What opportunities are there for determining the efficacy of current or potential interventions to prevent or retard the development of sarcopenia? The research recommendations from the workshop underscored the need for more dialogue between researchers in different fields (e.g., endocrinology, exercise physiology, bone biology) and for multidisciplinary approaches in order to gain greater insight into sarcopenia. The summary of the research directions which follows has been organized according to the primary questions of the workshop.

Aged↗
PubMed1993

A comparison of effectiveness of biofeedback and pelvic muscle exercise treatment of stress incontinence in older community-dwelling women.

BACKGROUND: Research using biofeedback as a treatment for sphincteric incontinence began with Kegel's early studies using a perineometer and pelvic muscle exercises demonstrating a 90% improvement in urine loss symptoms. More recent studies using varying combinations of biofeedback and pelvic muscle exercises found symptom reduction rates of 78% to 90%, but these studies lacked the rigor of a "phase three," or randomized controlled clinical trial. METHODS: A randomized controlled trial assessed the efficacy of biofeedback for older women for treatment of sphincteric incompetence. One hundred thirty-five community-dwelling women were randomized in a single-blind trial to three groups: biofeedback, pelvic muscle exercise, or control. Incontinent episodes were monitored over 8 weeks of treatment and at 3 and 6 months thereafter. RESULTS: The number of incontinent episodes decreased significantly in the biofeedback and pelvic muscle exercise subjects but not in the control subjects for all severity of incontinence frequency subgroups. Improvement was maintained within the moderate and severe symptom subgroups for both treatments for at least 6 months but declined in subjects with mild incontinence frequency. Pelvic muscle activity (EMG) was significantly correlated with decreases in incontinent episodes, and only the biofeedback subjects showed significant improvement in EMGs. CONCLUSIONS: Biofeedback and pelvic muscle exercises are efficacious for sphincteric incompetence in older women. Benefits are maintained and improvement continues for at least 6 months postintervention. These therapies may be useful before considering invasive treatment.

Aged↗
PubMed1993

Frailty and injuries in later life: the FICSIT trials.

Physical frailty and fall-related injuries present two of the biggest threats to older people's functioning and quality of life. The Frailty and Injuries: Cooperative Studies of Intervention Techniques (FICSIT) trials represent a set of eight different clinical trials concerning physical frailty and injuries in later life. This report documents the history and organization of the trials and provides an overview of the measures being collected at multiple sites and the analytic strategies to be used for multi-site investigations.

Accidental Falls↗
PubMed1991

Efficacy of bladder training in older women with urinary incontinence.

The efficacy of bladder training was evaluated in a randomized clinical trial involving 123 noninstitutionalized women 55 years and older with urinary incontinence. Subjects were urodynamically categorized as those with urethral sphincteric incompetence (N = 88) and those with detrusor instability with or without concomitant sphincteric incompetence (N = 35). Bladder training reduced the number of incontinent episodes by 57%; the effect was similar for both urodynamic diagnostic groups. The quantity of fluid loss was reduced by 54%. This was greater for patients with detrusor instability than for those without it. Diurnal and nocturnal voluntary micturitions were also reduced. The effect on nocturnal micturition, however, was not observed in subjects with unstable detrusor function. It is recommended that bladder training be considered as an initial step in treatment of women with urinary incontinence. Provided prior comprehensive clinical evaluation is done, it can be prescribed without the need for urodynamic characterization.

Aged↗
PubMed1989

A clinical trial of a behavioral therapy to reduce urinary incontinence in nursing homes. Outcome and implications.

One hundred thirty-three incontinent women in seven nursing homes were assigned randomly to a 13-week behavior therapy program for urinary incontinence or to a control group that received usual incontinence-related care. The therapy became effective after 6 weeks of training. By the final month of training, the treatment women's wet episodes had been reduced by 0.6 episodes per day, a 26% reduction over baseline. This reduction in the number of wet episodes was statistically significant, both with respect to this group's baseline levels of incontinence and in comparison with the performance of the control women. The number of wet episodes in the control group remained about the same throughout training and the 22-week follow-up period. The treatment women improved partly because they learned to request help, a response prompted and reinforced by the program. Trainees with a high frequency of incontinence during baseline, the more cognitively intact residents, and residents with normal bladder capacity responded better to this behavior therapy program.

Aged↗
PubMed1986

Bladder training and related therapies for urinary incontinence in older people.

In recent years, several studies have reported that bladder training, a behavioral intervention in which the interval between voluntary voidings is gradually extended, is an effective therapy for "urge" urinary incontinence (incontinence often associated with inability to inhibit detrusor contractions). Related behavioral therapies may also be effective for incontinence associated with impaired mobility and cognitive status. Because all of these types of incontinence are particularly common among older persons, the effectiveness of these therapies in this age group deserves attention. However, few well-controlled trials have been conducted with older subjects. There are many pathophysiologic types of incontinence among the older population, which is also heterogeneous in important clinical and functional characteristics that affect response to treatment. Hence, clinical trials that characterize subjects' urodynamic, neurologic, cognitive, and functional status, as well as the presence of other diseases and medication use, are needed to determine which elderly persons are likely to respond to particular behavioral regimens for urinary incontinence.

Aged↗
PubMed1983

The relationship between the osmotic fragility of human erythrocytes and cell age.

Erythrocytes in a normal blood sample are hemolyzed over a range of hypotonic salt concentrations. In order to investigate the relationship between the distribution of osmotic fragilities and the distribution of cellular ages, the osmotic fragility has been compared with three indices of cellular age. The activity of glutamic-oxalacetic transaminase (GOT) and the percentage hemoglobin A1C were measured in samples hemolyzed in different hypotonic salt concentrations. The osmotic fragility curve was also obtained for cells of different density separated by centrifugation. These experiments indicate that the fragility distribution is not an accurate reflection of the distribution of cellular ages. The mean fragility for older cells is higher than that of younger cells. However, cellular aging does not produce a gradual increase in osmotic fragility. Instead, it seems to produce changes which can both increase and decrease the fragility, resulting in a broader distribution of fragilities with some of the older cells actually less fragile than the younger ones.

Adult↗
PubMed1979

Trypsinization frequency and loss of proliferative capacity in WI-38 cells.

The effect of the trypsinization procedure employed in routine serial subcultivation on the proliferative life span of WI-38 cells was studied by varying the frequency of trypsinization and by using a nonenzymatic subcultivation technique. The results indicate that recurrent trypsinization does not contribute to loss of proliferative capacity and may, in fact, delay this loss to some degree.

Cell Division↗