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Biomedical subjects

R Burnham

Publications and source records attributed to R Burnham.

27 records · Page 2Linked to original sources
PubMed1993

Electrical stimulation-assisted rowing exercise in spinal cord injured people. A pilot study.

Recently a FES (functional electrical stimulation)-assisted rowing machine was developed to enhance cardiovascular training in people with spinal cord injuries. The machine was assessed in terms of its efficacy as a training tool. Six patients who were quadriplegic (C6-T1) and 2 who were paraplegic (T3-6) completed a series of three tests in succession: (1) leg stimulation only (quadriceps and hamstring groups)--'Stim', (2) arm row only--'Row' and (3) simultaneous row and stimulation--'R & S'. Measurements recorded included oxygen uptake (VO2), minute ventilation (Ve), respiratory exchange ratio (RER), heart rate (HR) and blood pressure (BP). In addition, 6 out of the 8 subjects took part in a qualitative assessment comprising a guided interview exploring the subject's perception of the machine and test. Significant increases in VO2 were demonstrated between the three tests with R & S producing mean steady-state values of 16.34 nm (+/- 0.74) ml/kg/min (83% of maximum). These values represented a 12% increase over Row alone. Of interest was the qualitative assessment which revealed that subjects perceived R & S to be easier than Row despite the higher levels of VO2 observed. The results suggest that the rowing machine represents a potentially valuable hybrid training device that may significantly reduce risk factors for cardiovascular disease and improve the quality of life of people with SCI.

Adult↗
PubMed1993

Evidence of autonomic dysreflexia during functional electrical stimulation in individuals with spinal cord injuries.

The purpose of the investigation was to examine the safety and efficacy of functional electrical stimulation (FES)-assisted hydraulic resistance training in improving cardiovascular fitness in persons with spinal cord injuries. The cardiopulmonary responses of 10 high spinal cord injured (SCI) and five able bodied (AB) subjects were assessed during three bouts of FES-assisted leg extension exercise. The protocol involved three 30-minute tests: (1) unloaded leg extension, (2) hydraulically-resisted leg extension (loaded), and (3) a reproduction of the unloaded and loaded protocols to measure cardiac output (Q). Pre-measurements were made of body mass, mean limb weight, maximal force output and maximal oxygen uptake (incremental arm ergometry). Oxygen uptake (VO2), minute ventilation (Ve), respiratory exchange ratio (RER), heart rate (HR), blood pressure (BP) were recorded before, during and after tests. There was a significant difference in VO2 max between SCI and AB subjects. Cardiac output significantly increased between the loaded and unloaded tests. The significant increases from rest to unloaded and loaded exercise pointed to the potential value of adding resistance to a leg extension training regime. Heart rate and BP of the participants with SCI consistently demonstrated a response suggestive of autonomic dysreflexia. Upon stimulation an immediate increase in (predominantly systolic) BP was observed, followed by a fall in HR. On cessation of stimulation HR exhibited a substantial rebound effect and BP returned to normal levels. This response was highly reproducible and suggests caution be exercised in the use of FES for people with SCI with lesion levels above the major splanchnic outflow (T6).

Adolescent↗
PubMed1993

Nature and standards of gastrointestinal and liver services in the United Kingdom.

1. Purpose of the working party: 1.1 To describe the scope of major digestive and liver disorders and identify changes in patterns of disease. 1.2 To identify diagnostic and therapeutic services required to manage these disorders in the United Kingdom. 1.3 To describe the facilities and staffing required to provide these services. 1.4 To examine the training requirements for medical, nursing, and other support staff. 1.5 To define the part that audit and research should play in the provision and maintenance of high quality gastrointestinal and liver services.

Education, Medical, Graduate↗
PubMed1992

The effects of a reduced exercise duration taper programme on performance and muscle enzymes of endurance cyclists.

The influence of tapering on the metabolic and performance parameters in endurance cyclists was investigated. Cyclists (n = 25) trained 5 days.week-1, 60 min.day-1, at 75-85% maximal oxygen consumption (VO2max) for 8 weeks and were then randomly assigned to a taper group: 4D (4 days; n = 7), 8D (8 days; n = 6), CON (control, 4 days rest; n = 6), NOTAPER (non-taper, continued training; n = 6). Muscle biopsy specimens taken before and after training and tapering were analysed for carnitine palmityltransferase (CPT), citrate synthase, beta-hydroxyacyl CoA dehydrogenase (HOAD), cytochrome oxidase (CYTOX), lactate dehydrogenase, glycogen and protein. Significant increases in VO2max (6%), a 60-min endurance cycle test (34.5%), oxidative enzymes (77-178%), glycogen (35%) and protein (34%) occurred following training. After the taper, HOAD and CPT decreased 25% (P less than 0.05) and 26% respectively, in the CON. Post-taper CYTOX values were different (P less than 0.05) for 4D and 8D compared with CON. Muscle glycogen levels were increased (P less than 0.05) after tapering in the 4D, 8D and CON, but decreased in NOTAPER. Similarly, power output at ventilation threshold was significantly increased in the 4D (27.4 W) and 8D (27 W) groups, but decreased (22 W) in the NOTAPER. These findings suggest that tapering elicited a physiological adaptation by altering oxidative enzymes and muscle glycogen levels. Such an adaptation may influence endurance cycling during a laboratory performance test.

Adult↗
PubMed1989

Ankle and wrist weights: their effect on physiologic responses during treadmill running.

This study examined the effects of ankle and wrist weights on acute physiologic responses during treadmill running. Eight physically active young men completed eight running tests at their predetermined "most comfortable" speeds with zero, 1.6, 3.2, and 4.8 kg of additional weight equally distributed on the ankles or wrists. Energy expenditure and heart rate increased as a linear function of the additional weight placed at both anatomic locations. The magnitudes of these responses were significantly higher with the weights at the ankles than at the wrists, and were independent of the strength and endurance of the pertinent muscle groups involved in overcoming the additional weight. Blood lactate concentrations tended to increase during the loaded runs. However, the values were not significantly different from those observed during control (zero load) runs. Perceived exertion increased significantly over the control value when the heaviest weights were placed at the ankles and wrists. Since ankle and wrist weights increase training intensity and energy expenditure during treadmill running, they may result in greater increases in cardiovascular fitness and greater weight loss than would be realized by training without their use.

Adult↗
PubMedDate not supplied

A confidential study of deaths after emergency medical admission: issues relating to quality of care.

In this retrospective pilot study we examine the feasibility of establishing a confidential enquiry into why some patients die after emergency admission to hospital. After excluding those who died in the first hour or who were admitted for palliative care, pairs of physicians were able to collect quantitative and qualitative data on 200 consecutive deaths. Both physicians reported shortfalls of care in 14 patients and one of the pair in 25 patients whose deaths would not have been the expected outcome. In 25, the shortfalls of care may have contributed to their deaths. Major problems were delays in seeing doctors, inaccurate diagnoses, delays in investigations and initiation of treatment. They occurred mostly in those admitted at night. It is possible that establishing the correct diagnosis and starting appropriate treatment may have been delayed in 64% of the 200 patients. The headline figures appear worse than some previous external assessment studies but this study did concentrate on those in whom problems were more likely. Nevertheless, the frequency is too high to be overlooked. In this feasibility study we have demonstrated that it is practicable for local staff to collect and assess data in hospitals and that the types of problems identified are relevant to anyone planning how to organise emergency care. A larger definitive study should be performed.

Aged↗