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Biomedical subjects

M Quittan

Publications and source records attributed to M Quittan.

31 records · Page 2Linked to original sources
PubMed1998

EMG fatigue patterns accompanying isometric fatiguing knee-extensions are different in mono- and bi-articular muscles.

OBJECTIVES AND METHODS: Isometric, fatiguing knee-extensions at 30%, 50% and 70% maximum voluntary contraction (MVC) were performed by 18 healthy human subjects. Surface electromyographic (SEMG) activity was recorded from the mono-articular vastus medialis (VM) and vastus lateralis (VL) muscles, and the bi-articular rectus femoris muscle (RF). To make the bi-articular muscle work under (1) constant and (2) similar working conditions as the two mono-articulars do, the hip was fixed in a flexed position. The root mean square (RMS) SEMG recorded during fatigue was standardized to the respective values of MVC. The mean coefficients of regression of the RMS and median frequency (MF) changes were then analyzed by multivariate analysis of variance. RESULTS: The load effect upon the muscle fatigue changes, as measured by increase in RMS EMG, differed between the bi-articular muscle and the two mono-articulars, in that the parameter dropped with maximum load for the bi-articular, whilst it remained stable or even increased for the mono-articulars. This might suggest that the mono- and bi-articular muscles have different roles in fatigue tasks where the bi-articulars function purely as mono-articulars. By contrast, such a clear dichotomy between the bi-articular RF and the two mono-articulars, VM and VL, was lacking for the fatigue parameter of MF. CONCLUSIONS: As these findings were confined to the changes in RMS EMG, different neuronal coding mechanisms for the mono- and bi-articular muscles in the central nervous system may be inferred.

Adult↗
PubMed1998

Benefit of 6 months long-term physical training in polymyositis/dermatomyositis patients.

OBJECTIVE: The benefit of long-term physical training in patients with chronic polymyositis or dermatomyositis (PM/DM) was studied prospectively. METHODS: Eight patients with chronic PM/DM participated in a training programme for 6 months. A group of five PM/DM patients without any physical training was observed for control purposes. RESULTS: While there was no significant change in serum creatine phosphokinase (CPK) levels, the 'activities of daily living (ADL)' score improved significantly (P < 0.03), peak isometric torque (PIT) generated by muscle groups in the lower extremities rose significantly (P < 0.03) and there was a statistically highly significant increase in peak oxygen uptake (VO2max) relative to body weight (P < 0.02) due to the long-term training. The patients improved their aerobic capacity by 28%, which is clinically significant. In the untrained patients, no improvement in these target parameters was observed. CONCLUSION: In clinically stable DM/PM patients, long-term physical training can safely be performed and is recommended as part of a comprehensive rehabilitation management, particularly in view of the cardiopulmonary risk in these patients.

Activities of Daily Living↗
PubMed1998

Improvement of physical fitness and muscle strength in polymyositis/dermatomyositis patients by a training programme.

In the present investigation, the benefit of physical training in patients with inflammatory myopathy was studied. In this prospective, randomized, controlled study, 14 patients with polymyositis (PM) or dermatomyositis (DM) were investigated. The training, consisting of bicycle exercise and step aerobics, took place over a 6 week period. Baseline and endpoint measurements included an 'activities of daily living' (ADL) score, peak isometric torque (PIT) generated by muscle groups in the lower extremities, peak oxygen consumption (VO2max), and creatine phosphokinase (CPK) levels. There was no significant rise in disease activity in the training group in comparison to the controls. The ADL score for the treatment group, in comparison to the control group, improved (P < 0.02), PIT rose (P < 0.05) and there was a statistically significant increase in oxygen uptake relative to body weight (P < 0.05). No rise in inflammatory activity, but significant improvement in muscle strength, oxygen uptake and well-being, were found in patients with inflammatory myopathy as a result of physical training. Besides medication, a physical training programme consisting mainly of concentric muscle contractions should therefore be an integral part of therapy, particularly in view of the cardiopulmonary risk of these patients.

Adult↗
PubMed1998

Aerobic endurance training program improves exercise performance in lung transplant recipients.

STUDY OBJECTIVE: To determine whether an aerobic endurance training program (AET) in comparison to normal daily activities improves exercise capacity in lung transplant recipients. PATIENTS AND STUDY DESIGN: Nine lung transplant recipients (12+/-6 months after transplant) were examined. All patients underwent incremental bicycle ergometry with the work rate increased in increments of 20 W every 3 min. Identical exercise tests were performed after 11+/-5 weeks of normal daily activities and then after a 6-week AET. The weekly aerobic training time increased from 60 min at the beginning to 120 min during the last week. Training intensity ranged from 30 to 60% of the maximum heart rate reserve. RESULTS: Normal daily activities had no effect on exercise performance. The AET induced a significant decrease in resting minute ventilation from 14+/-5 to 11+/-3 L/min. At an identical, submaximal level of exercise, a significant decrease in minute ventilation from 47+/-14 L/min to 39+/-13 L/min and heart rate from 144+/-12 to 133+/-17 beats/min, before and after the AET, was noted. The increase in peak oxygen uptake after AET was statistically significant (1.13+/-0.32 to 1.26+/-0.27 L/min). CONCLUSIONS: These data demonstrate that normal daily activities do not affect exercise performance in lung transplant recipients > or = 6 months after lung transplantation. An AET improves submaximal and peak exercise performance significantly.

Activities of Daily Living↗
PubMed1997

[Value of impedance rheography as a screening method in comparison with Doppler index in peripheral arterial occlusive disease].

BACKGROUND: Determination of the ankle-arm-index (AAI) by Doppler ultrasound is the method of choice as a screening test for peripheral arterial occlusive disease (PAOD). The easily performed Impedance Rheography (IR) may serve as an alternative screening method. This study investigates the correlations between parameters obtained by IR curve to the AAI. METHODS: 56 patients (62.8 +/- 13 years, m = 37, f = 19) were included in the study. IR was performed on both shanks using ring electrodes below the knee and above the ankle (bipolar leads, frequency 90 kHz, test voltage 2.5 Vpp). The AAI was obtained by a 8 Mz ultrasound probe. RESULTS: AAI < or = 0.85 showed significant correlations (p < 0.0001) to parameters of the IR curve: Crest Time (GZ, r = 0.67), Rise of the Pulse Wave (PA, r = 0.82), Relative Pulse Volume (RP, r = 0.82) and the Rheographic Quotient (RQ, r = 0.86). AAI > 0.85 showed no or only weak correlations to RI parameters. Underlying the following limits for rheographic parameters (GZ = 159 ms, PA = 3.3, RP = 0.43 vp/s and RQ = 0.4 vp), sensitivity and specify was determined: GZ: 68% and 100%, PA: 84% and 88%, RP: 68% and 92%, RQ: 77% and 88%. CONCLUSIONS: Impedance rheography correlates significantly with the AAI. Therefore this method seems to be well suited as a screening test for PAOD.

Adult↗
PubMed1996

[Description of a patient profile of ambulatory physical medicine facilities].

UNLABELLED: Beside objective diagnosis, the subjective feelings, of patients is of great importance in the field of physical medicine and rehabilitation. Evaluation of demographic data and quality of life of patients referred to an outpatient clinic of physical medicine and rehabilitation. DESIGN: Prospective, multi-center cross sectional study. Evaluation of impairment of the activities of daily living by a questionnaire based on the "Functional Assessment Screening Questionnaire" and the "Oswestry low back pain disability questionnaire" and of the perceived pain by a 100 nm visual analog scale (VAS). 1404 consecutive patients were included, 89% completed the questionnaire (n = 1250). Women 57.6%, men 42.3%, age 54.1 years. 67.6% of all diagnoses were related to the spine (36.7% cervical spine, 32.8% lumbar spine, 30.5% whole spine). 13.8% to joints of the lower and 8.4% to joints of the upper extremities. Intensity of pain was rated: 79.7 mm on the VAS (38.9% of all patients claimed to perceive pain all time). Patients referred to an outpatient facility of physical medicine are impaired in their activities of daily living and their well-being by pain. Further outcome studies of physical medicine outpatient treatment will be based on questionnaires developed in this present study.

Activities of Daily Living↗
PubMed1995

Donor-site morbidity of the gracilis flap.

To determine whether there is a specific donor-site morbidity inherent in the elevation of the gracilis flap, we retrospectively examined 42 patients who underwent elevation of their gracilis muscles. We found, on dynamometric measurement, that the adduction strength of the hip joint was decreased by 11 percent when the gracilis muscle was elevated. This decrease in strength was not noticed by the patients. We also found an area of hypesthesia corresponding to the cutaneous territory of the obturator nerve in 40.5 percent of the patients. In addition, many patients were dissatisfied with the aesthetic appearance of the donor site, and a contour deformity of the thigh was present when a myocutaneous flap was elevated. Therefore, we conclude that the gracilis flap has a low but definite rate of donor-site morbidity. The advantages of the flap outweigh by far, however, the sequelae at the donor site.

Adult↗
PubMed1994

[Rehabilitation in coronary heart disease. Value, indications and contraindications of exercise therapy].

In the rehabilitation of patients with coronary heart disease, physical therapy, in particular kinesitherapy plays a central role. The effects of regular endurance training are multifarious, ranging from improvements in functional capacity to a reduction in risk factors and to psychosocial aspects. At the beginning of the rehabilitation program in particular, safety and close supervision are of primary importance, and training on the bicycle ergometer is a first choice method. Depending upon the extent of the coronary heart disease, for example disordered functioning of the left ventricle or postoperative status following revascularisation surgery, modification and adaptation of the treatment regimen may be required. The risk of a cardiovascular incident occurring is low, and extensive studies performed in recent years have shown a reduction in cardiovascular mortality through the use of long-term rehabilitation programs.

Contraindications↗
PubMed1994

[Thermo- and hydrotherapy].

Muscle spasm can be reduced by heat as well as by therapeutic cold. However, in upper motor neuron lesions, cold is more effective in reducing the spasticity. This effect lasts long enough to be of therapeutic value. Water immersion supports the reduction of muscle tone. Pain may be reduced by both thermal stimuli. The pain threshold seems to be elevated by the direct effect of both heat and cold on the free nerve endings and the pain-killing fibers. The tendency to bleed is increased with heat application and decreased with cold therapy. Edema resulting from trauma is increased with heat, and decreased in its development by cold application. Joint stiffness is decreased with heat application and increased with cold application. Water immersion removes weight from the joints and facilitates mobility.

Cryotherapy↗
PubMed1994

[The concept of myocardial infarct rehabilitation in phase III].

The benefit of outpatient rehabilitation in coronary artery disease is well documented in literature. Despite this, there is evident lack of rehabilitation facilities during phase III WHO in our country. Departments of Physical Medicine and Rehabilitation seem to be well suited to run ambulant rehabilitation programmes. Therefore we developed a comprehensive rehabilitation programme including physical training, dietary counselling and teaching lessons for patients. Physical training is strictly aerobic according to the guidelines of medical training therapy. Training time will rise systematically. To keep risks low, precise in- and exclusion criteria are defined. Regular training for the staff is mandatory. Uniformity of therapeutic interventions and documentation provide quick evaluation of therapeutic success.

Ambulatory Care↗
PubMed1993

[Ambulatory medical training therapy in coronary heart disease].

Physical exercise plays a central role within cardiac rehabilitation. Most often, endurance exercises are restricted only to inpatient rehabilitation regimes. According to the guidelines of sports medicine, endurance training is only effective if it is performed regularly and systematically. With regards to safety and best control, bicycle ergometer is the training device of choice for the cardiac patient. Prescription and organisation of endurance training sessions in cardiac rehabilitation are discussed. Beside the well accepted changes of risk-factors by regular endurance training, studies of pooled data showed a significant reduction of mortality of patients in the rehabilitation groups. The lack of data regarding training time and intensity within the single studies was remarkable.

Coronary Circulation↗
PubMed1991

[Rehabilitation following myocardial infarct].

Today rehabilitation after myocardial-infarction is a routine measure in most countries, yet its effectiveness is still under discussion. Rehabilitation aims at ameliorating the quality of life and at preventing a cardiovascular reevent, in other words at prolonging life. The latter "hard" endpoints is best amenable to quantification. Only recent meta-analyses of pooled data were able to show that rehabilitation in fact does prolong life. The relative importance of physical exercise in mostly complex rehabilitation programs is even less clear. This analyses implies a benefit, yet the exact proof is still missing. If rehabilitation could be shown to improve quality of life, its application would, of course, be justified even if it did fail to prolong life. Important open questions relate to the optimizing of rehabilitation: duration, frequency, intensity as well as age and sex of responders. Answering these will be a challenge for tomorrow's rehabilitation medicine.

Combined Modality Therapy↗