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Biomedical subjects

P Capodaglio

Publications and source records attributed to P Capodaglio.

At least 19 recordsLinked to original sources
PubMed2005

Muscle function and functional ability improves more in community-dwelling older women with a mixed-strength training programme.

BACKGROUND: Supervised training can reach a limited number of elderly people. OBJECTIVE: To determine the impact of a 1-year mixed-strength training programme on muscle function (MF), functional ability (FA) and physical activity (PA). SETTING: Twice-a-week hospital-based exercise classes and a once-a-week home session. PARTICIPANTS: twenty-eight healthy community-dwelling men and women on the training programme and 20 controls aged over 75 years. METHODS: Training with two multi-gym machines for the lower limbs at 60% of the repetition maximum (1RM). At-home subjects used elastic bands. MEASUREMENTS: Maximum isometric strength of knee extensors (KE), ankle plantar flexors (PF), leg extensor power (LEP), functional reach (FR), chair rise 1 (CR1) and 10 times (CR10), bed rise (BR), six-minute walking test (6MWT), stair climbing (SC), get-up-and-go (GU&G), one-leg standing (1LS). PA was assessed with the Paqap questionnaire. RESULTS: Women were significantly weaker than men at baseline: -47% for KE and -59% for PF. Training induced significant gains in MF and FA in the training females; males improved significantly only in FA. PA levels increased non-significantly (2%) in all of the training group. CONCLUSIONS: Long-term mixed-strength programmes can improve MF and FA in elderly females, and FA in elderly males.

Activities of Daily Living↗
PubMed2004

Impact of physical training and detraining on endothelium-dependent vasodilation in patients with recent acute myocardial infarction.

BACKGROUND: There is evidence that aerobic exercise improves endothelial function in healthy subjects as well as in patients with chronic heart failure. However, it is unknown whether this effect occurs in patients with recent myocardial infarction (AMI). METHODS: Fifty-two patients with a recent first uncomplicated AMI underwent endothelial function evaluation before and after 3 months of moderate aerobic exercise training. We measured brachial artery vasomotor reactivity using flow-mediated dilation (FMD), a cold pressor (CP) test, and sublingual nitroglycerin. Patients were randomized into 2 groups: 28 patients (G1) underwent training, while 24 patients (G2) served as controls. Brachial artery vasomotor reactivity was reassessed after 1 month of detraining (DT). RESULTS: At baseline the FMD was 1.66% +/- 4.11% in G1 and 2.04% +/- 3.4% in G2 (P = NS) and vasoconstriction was evident after a CP test. The diameter reduction was -4.1% +/- 3.89% in G1 and -4.39% +/- 5.67% in G2 (P = NS). At follow-up the FMD had increased to 9.39% +/- 4.87% in G1 (P <.01) and to 4.4% +/- 3.9% in G2 (P <.01 vs G1). Vasoconstriction during a CP test was observed only in G2. Endothelium-independent vasodilation was unchanged in both groups. Effort tolerance increased by 32% in G1 patients (P <.01 versus G2) and was correlated with FMD change (R = 0.51, P <.01). After detraining the FMD was significantly reduced in G1 (P <.01) and a further vasoconstriction was evident after CP testing. CONCLUSIONS: Exercise training improves endothelium-dependent vasodilation in post-AMI patients. This improvement is associated with a significant increase in exercise tolerance. These benefits disappeared after detraining.

Adult↗
PubMed2003

Effect of aging on human muscle architecture.

The effect of aging on human gastrocnemius medialis (GM) muscle architecture was evaluated by comparing morphometric measurements on 14 young (aged 27-42 yr) and on 16 older (aged 70-81 yr) physically active men, matched for height, body mass, and physical activity. GM muscle anatomic cross-sectional area (ACSA) and volume (Vol) were measured by computerized tomography, and GM fascicle length (Lf) and pennation angle (theta) were assessed by ultrasonography. GM physiological cross-sectional area (PCSA) was calculated as the ratio of Vol/Lf. In the elderly, ACSA and Vol were, respectively, 19.1% (P < 0.005) and 25.4% (P < 0.001) smaller than in the young adults. Also, Lf and were found to be smaller in the elderly group by 10.2% (P < 0.01) and 13.2% (P < 0.01), respectively. When the data for the young and elderly adults were pooled together, significantly correlated with ACSA (P < 0.05). Because of the reduced Vol and Lf in the elderly group, the resulting PCSA was found to be 15.2% (P < 0.05) smaller. In conclusion, this study demonstrates that aging significantly affects human skeletal muscle architecture. These structural alterations are expected to have implications for muscle function in old age.

Adult↗
PubMed2003

Strength and power changes of the human plantar flexors and knee extensors in response to resistance training in old age.

AIM: The aim of the present study was to assess and compare the improvements of muscle strength and power induced by a 16-week resistive programme in a population of 16 older men aged 65-81 years. METHODS: Training was performed three times per week at an intensity of 80% of one repetition maximum (1RM) and consisted of both calf raise and leg press exercises. Before-, during- and after-training, maximum isometric and isokinetic torques, maximum power, 1RM, muscle cross-sectional area (CSA) and electromyographic activity (EMG) of the plantar flexors (PF) and knee extensors (KE) were examined. RESULTS: For the KE and PF, respectively, training resulted in a 29.9 +/- 4.4% (mean +/- SE) and 21.6 +/- 5.4% increase in 1RM (P < 0.001-0.01), a 19.4 +/- 4.3 and 12.4 +/- 4.7% (P < 0.001-0.05) increase in maximum isometric torque, and a 24.1 +/- 6.3 and 33.1 +/- 10.9% (P < 0.05) increase in maximum muscle power, calculated from torque-angular velocity curves. The large increase in torque and power was partly accounted by a significant increase in the CSA of the PF (5.0 +/- 0.7%) and KE (7.4 +/- 0.7%), while no significant changes in integrated EMG activity of vastus lateralis and soleus muscles, and in extrapolated maximum shortening velocity were found. After training, a significant increase in torque/CSA (10.3 +/- 4%, P < 0.05) was found for the KE but not for the PF. CONCLUSION: Hence, hypertrophy cannot alone justify the increase in torque, and other factors, such as an increase in individual fibre-specific tension (in the case of KE), a decrease in antagonist muscles' coactivation, an improved co-ordination and an increased neural drive of the other heads of quadriceps may have contributed to the increments in strength. The significant increase in muscle power seems particularly noteworthy with respect to daily activities involving the displacement of the body over time, namely, the generation of muscle power.

Activities of Daily Living↗
PubMed2002

Effectiveness of a home-based strengthening program for elderly males in Italy. A preliminary study.

BACKGROUND AND AIMS: 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. METHODS: 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. RESULTS: 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%. CONCLUSIONS: Home training with elastic bands appears to be an effective low-cost modality of maintaining strength and function in an elderly population.

Activities of Daily Living↗
PubMed2002

Plantar flexor activation capacity and H reflex in older adults: adaptations to strength training.

The purpose of this study was to investigate whether the voluntary neural drive and the excitability of the reflex arc could be modulated by training, even in old age. To this aim, the effects of a 16-wk strengthening program on plantar flexor voluntary activation (VA) and on the maximum Hoffman reflex (H(max))-to-maximum M wave (M(max)) ratio were investigated in 14 elderly men (65-80 yr). After training, isometric maximum voluntary contraction (MVC) increased by 18% (P < 0.05) and weight-lifting ability by 24% (P < 0.001). Twitch contraction time decreased by 8% (P < 0.01), but no changes in half relaxation time and in peak twitch torque were observed. The VA, assessed by twitch interpolation, increased from 95 to 98% (P < 0.05). Pretraining VA, also evaluated from the expected MVC for total twitch occlusion, was 7% higher (P < 0.01) than MVC. This discrepancy persisted after training. The interpolated twitch torque-voluntary torque relationship was fitted by a nonlinear model and was found to deviate from linearity for torque levels >65% MVC. Compared with younger men (24-35 yr), the H(max)- to M(max) ratio and nerve conduction velocity (H index) of the older group were significantly lower (42%, P < 0.05; and 29%, P < 0.001, respectively) and were not modulated by training. In conclusion, older men seem to preserve a high VA of plantar flexors. However, the impaired functionality of the reflex pathway with aging and the lack of modulation with exercise suggest that the decrease in the H(max)- to M(max) ratio and H index may be related to degenerative phenomena.

Adaptation, Physiological↗
PubMed2002

The role of work simulation tests in a comprehensive cardiac rehabilitation program.

BACKGROUND: One of the goals of a comprehensive cardiac rehabilitation (CR) program is the patient's return to his or her usual activities. The aims of this paper were to implement an occupational evaluation protocol in a CR and to assess patients' hemodynamic responses and ventricular arrhythmias during work simulation tests. METHODS: After an 8-week outpatient CR, 132 patients performed work simulation, lifting (MH-L) and carrying (MH-C) tests. ECG, heart rate and blood pressure were constantly monitored. RESULTS: The comparison of physiological responses during work simulation and a standard exercise testing provided the following results: 1) maximal heart rate, blood pressure and double product values during WS and MH tests were significantly lower (p < 0.001) than those measured during exercise testing; 2) higher (p < 0.001) double product values were achieved during MH-C as compared to MH-L and work simulation; 3) arrhythmias were more frequent during MH-L as compared to exercise test (p < 0.001). The increment of double product was reached much faster during work simulation and MH tests as compared to exercise testing: according to the multivariate analysis this was a predictor of a greater incidence of arrhythmias. The incidence of arrhythmias during work simulation tests and MH was significantly higher in patients with reduced tolerance to effort, valvular replacement, arrhythmias during holter monitoring, low ejection fraction and effort silent ischaemia. CONCLUSIONS: Work simulation test provide a more personal functional assessment, complementary to the exercise testing. It appears particularly useful in patients with higher functional impairment who are at a higher risk of arrhythmias.

Arrhythmias, Cardiac↗
PubMed2001

Effects of a 16-week progressive high-intensity strength training (HIST) on indexes of bone turnover in men over 65 years: a randomized controlled study.

The aim of the present study was to evaluate the effects of a 16-week progressive high-intensity strength training (HIST) program on peripheral markers of bone turnover (bone Gla protein, BGP; bone alkaline phosphatase, B-AP; N-terminal propeptide of type I procollagen, PINP; C-terminal cross-linked telopeptide of type I collagen, ICTP) in healthy, elderly men over 65 yr of age. Thirty healthy men (aged 65-81 yr), performing light to moderate daily physical activity, were randomly divided into two groups. Group 1 (no.=16) followed a supervised 16-week progressive HIST program, while subjects of group 2 (no.=14), used as controls, were requested to maintain their habitual level of physical activity for 16 weeks. HIST program consisted of 6 different sets of exercise (2 involving the major muscle groups of the lower limb and 4 involving those of the upper limb). Three sessions/ week, during which 10 repetitions of each exercise set were completed, were performed. Lower limb exercises shifted from 50 to 80% of the one maximal repetition (1 MR) during the first month of the protocol and were thereafter maintained at an intensity of 80% 1 MR throughout the training. Upper limb exercises shifted from 40 to 65% of 1 MR with a similar pattern. All sessions were preceded by 15 min of cycloergometer exercise at 50% of maximal oxygen uptake and by a warm-up of 15 repetitions at 20% of 1 MR of each exercise set. The HIST program did not significantly change BGP (mean SE, before: 15.6 +/- 1.2 microg/l vs after: 16.0 +/- 1.2 microg/l, NS) and PINP levels (before: 44.6 +/- 6.7 microg/l vs after: 43.1 +/- 6.0 microg/l, NS). On the contrary, serum B-AP significantly increased (before: 50.2 +/- 6.1 IU/l vs after: 62.3 +/- 7.0 lU/l, p<0.001) and serum ICTP slightly reduced (before: 4.0 +/- 0.3 microg/l vs after: 3.8 +/- 0.3 microg/l, p<0.05). When bone turnover was expressed as the ratio between bone formation to bone resorption (B-AP/ICTP ratio), a significant improvement in this ratio was found in all subjects of group 1 (before: 12.9 +/- 1.3 lU/microg vs after: 17.3 +/- 1.5 IU/microg, p<0.0001), while no significant changes were observed in Group 2. No significant changes of IGF-I levels were observed after the HIST program (before: 94.9 +/- 9.4 microg/l vs after: 89.9 +/- 9.7 microg/l). No significant changes of BGP, PINP, B-AP, ICTP, B-AP-ICTP ratio and IGF-I levels were observed in controls (group 2) during the 16 weeks of observation. Although the positive effects of a progressive HIST program on B-AP levels and B-AP-ICTP ratio seem promising, the support of bone mass measurement and the determination of other bone markers are requested to better identify exercise protocol (duration, intensity) for elderly people.

Aged↗
PubMed1997

A field methodology for ergonomic analysis in occupational manual materials handling.

A methodology is presented for the 'on-site' evaluation of work-related physical activities. In a first session, video recordings were made of six industrial plant workers during their routine occupational tasks. Heart rate (HR) and subjective perception of effort were monitored. The video recordings were then analysed with appropriate software to determine the musculo-skeletal load ('Vision 3000', Promatek, Montreal) and to evaluate energy expenditure ('Energy', University of Michigan). The indirect estimates of energy expenditure were validated in a second session by monitoring the six subjects' oxygen consumption (VO2) during the same activities with a portable telemetric oxygen uptake analyser (Cosmed 'K2', Rome). No statistically significant differences were found between direct measurements of VO2 and the computerised estimates of energy expenditure. Biomechanical parameters obtained in the two sessions did not differ. Therefore, we conclude that the 'Energy' programme and the 'Vision 3000' program provide a fast and reliable profile of job requirements.

Adult↗
PubMed1997

Reliability of a hand gripping endurance test.

The aim of this study was to assess the reproducibility of a new endurance test for hand grip movements. On six occasions separated by at least 3 days, 30 healthy subjects performed six maximal endurance tests in two different positions with a hand grip tool attached to an isokinetic dynamometer. The test consisted of repeated maximal grip movements (1-min bouts for men and 30-s bouts for women subjects) at an angular velocity of 45 degrees/s. A custom-made PC programme was used to collect data on peak torque and mechanical work, and to provide the following parameters: basal torque, basal work, time until basal values fell to 20, 30 and 50% of the initial peak values, slopes of decay of torque and work over time. The intraclass correlation coefficient (ICCC) was then computed to assess the reproducibility of the parameters obtained during the tests. An 'almost perfect' (0.8 < ICCC = 1) reproducibility of the basal torque values in both positions and a 'substantial' (0.6 < ICCC = 0.8) or 'almost perfect' reproducibility of the slope values referred to the torque decay over time was observed. Feasible applications of this new endurance test in ergonomics and vocational rehabilitation are discussed.

Adult↗
PubMed1996

Tolerable exercise intensity in the early rehabilitation of paraplegic patients. A preliminary study.

Accessible indicators for setting exertion levels in newly injured paraplegias could be useful to improve their daily and occupational performances in less time than is presently required. Eight male newly injured paraplegic subjects performed progressive resisted and endurance exercise tests on an arm cranking ergometer. Cardiorespiratory parameters during exercise were monitored with an oxygen uptake analyzer and perceived exertion was rated on Borg's 10-point scale. Four subjects (Group A) underwent an 'enhanced' rehabilitation protocol which included aerobic arm training sessions. The prescription of exercise intensity was tailored to each subject's tolerable power output for prolonged exertion. The remaining four (Group B) followed a 'conventional' rehabilitation program. Tests were repeated in both groups after 6 weeks. We observed a greater improvement in endurance capacity in Group A than in Group B after completion of the rehabilitation program. A 6-week 'enhanced' rehabilitation program based on a 'moderate' intensity of exercise was well tolerated and effective in improving the fitness levels of newly injured paraplegic subjects. Subjective perception has been shown to be a simple and accessible indicator for setting exertion levels.

Adult↗
PubMed1996

Predicting endurance limits in arm cranking exercise with a subjectively based method.

The purpose of this study was to compare a method for predicting endurance capacity at different workloads based on subjective perception of effort with the technique for determining 'critical power' (CP) proposed by Moritani et al. (1981). Three trained paraplegic subjects performed two protocols during separate sessions. The 'subjective' protocol consisted of graded and continuous tests on an arm crank ergometer, during which cardiorespiratory (heart rate, oxygen consumption, ventilation and respiratory exchange ratio) and subjective (Borg's 10-point scale) parameters were monitored continuously. A statistical regression analysis for power functions was performed to obtain the individual ¿iso-perception' curves in a power/duration reference system. The other protocol consisted of the determination of the CP of the muscle groups involved in arm cranking exercises according to the protocol proposed by Moritani et al. (1981). Subjects performed three tests in which the power output remained constant (50, 37.5 and 25 W) and led to the onset of muscular fatigue. The results of the two protocols were compared. The validity of the subjective perception of effort as a predictor of individual endurance capacity was confirmed by the relationship between time to exhaustion and work performed during constant-power tests as proposed by Moritani et al. (1981).

Adult↗
PubMed1996

Individual profiles of dyspnoea and fatigue in chronic bronchitic patients, defined by intensity and duration of submaximal workloads performed.

The subjective perception of fatigue and dyspnoea during submaximal exercise was studied in 10 chronic bronchitic patients using Borg's CR10 scale, with the aim of developing a model for the assessment of sustainable workloads (through the definition of individual perceptual profiles). Each subject performed five trials, consisting of steptests at constant submaximal workloads. Fatigue (CRf) and dyspnoea (CRd) perceptions, heart rate (HR) and duration times were measured. Maximal duration was set at 30 min. The trial was stopped if a fatigue/dyspnoea score of 7 ("very strong") or 85% of the maximum HR was reached. The growth of fatigue and dyspnoea perceptions (R) as functions of time (S) were expressed by the formula: R = a + c (S-b)n. Parameters a, b, c and n calculated for each subject and trial were (mean and SD): a = 0.49 (0.31); b = 2 (0); c = 1.3 (0.61); and n = 0.55 (0.2) for dyspnoea; a = 0.51 (0.27); b = 2 (0); c = 1.4 (0.75); and n = 0.55 (0.2) for fatigue. Individual CR3 "iso-perception" curves (W = k t alpha) for fatigue and dyspnoea in a workload/duration reference system were computed from the experimental data obtained during the five trials. Mean values of the exponent alpha were (.0.5) +/- (-0.23) for dyspnoea, and (-0.41) +/- (-0.22) for fatigue. The CR3 "iso-perception" curves represented the subjectively acceptable level of exertion (defined for load and duration). By doubling the duration and workload, CRd score increments of 1.55 (SD 0.46) and 4.9 (SD 0.42), respectively, were computed. Subjective perceptions are correlated to the intensity and duration of submaximal workload performed, and can be used in conjunction with physiological parameters to predict acceptable workloads in chronic bronchitic patients.

Bronchitis↗
PubMedDate not supplied

Work-related posttraumatic upper limb disorder. A case report.

In this paper we describe a patient with mor-sensory loss in the right forearm and hand, which persisted more than 2 years after work-related crush trauma of the left hand. Radiographic and electromyographic investigations, somatosensory evoked potentials, CT scans of the encephalus as well as the Minnesota Multiphasic Personality Inventory and the Roarschach test have been performed. On the basis of these investigations, we think this represents a case of conversion disorder with somatic features. Included is a brief overview of other psychological illness with physical findings involving the upper limb.

Accidents, Occupational↗
PubMedDate not supplied

[Multifactorial ergonomic evaluation of the hospital nursing activity in assisting not self-sufficient patients].

8 Institutes of Health Care and Research of Northern-Central Italy participated in the study, which consisted of on-site investigations, interviews with the chief-nurse, and monitoring of physiological and subjective variables. We studied the most critical phases in the laboratory, by means of video-graphical systems for biomechanical and postural analysis. The outlined profile shows a demanding activity, yielding important risk factors relative to musculoskeletal lesions. The preventive attitude (education, training) must be implemented by ergonomic interventions, aimed to minimize the risk related to manual handling.

Ergonomics↗
PubMedDate not supplied

[A project for the occupational reintegration of impaired subjects].

In this paper we have explained the criteria for an integrated socio-medical intervention (Local Health Care Institution, Cooperation, Scientific Institute of Care and Research) within the frame of a Communitary Initiative titled "Local network for return to work of persons with social disadvantage". The goal of the Initiative is to "create and experiment new facilities to support intervention strategies for return-to-work, and to start a virtuous circle matching the demands of both the disadvantaged persons and the local labour market". In the paper we describe the functional evaluations, performed in the Medical Center of Pavia by specialists in the field of Rehabilitation, Psychology and Ergonomy, and the following return-to-work phase, performed by operators of the Cooperation.

Persons with Disabilities↗
PubMedDate not supplied

[Physical exercise in the prevention of musculoskeletal diseases in the elderly worker].

This paper reviews the impact of ageing on physical work capacity in the elderly worker and the benefits of exercise programmes designed for the prevention of musculo-skeletal complaints. Physical work capacity generally declines significantly after 50 years of age as a consequence of a reduction in aerobic capacity and muscle strength. The latter is accompanied by a decline in the fatigue threshold. This, in combination with a reduced recovery capacity after exercise, may lead to chronic overload of muscles and tendons in the elderly worker. Thus, it has been proposed that physical exercise programmes may prevent the onset of musculo-skeletal disorders. The effectiveness of different physical exercise programmes proposed in the literature for the prevention of musculo-skeletal disorders is reviewed here. The adoption of an active life-style and the rational use of ergonomic interventions, such as automatization of certain work processes, also appear to be crucial in minimizing the impact of ageing on work ability and capacity in the elderly worker.

Adult↗