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At least 253 records · Page 14Linked to original sources

Ventilatory and heart rate responses at the onset of chair rotation in man.

In the present study, we attempted to confirm whether pulmonary ventilation and heart rate increased immediately after passive chair rotation in man. Inspiratory minute volume (V(I)), tidal volume (V(T)), respiratory frequency (f), and heart rate (HR) were determined by breath-by-breath and beat-by-beat techniques before, during, and after rotation for a total of 45 s. It was found that V(I) significantly increased immediately after chair rotation, but HR remained almost constant. These results suggest that the activation of horizontal semicircular canals is one causal factor of ventilatory response at the onset of exercise with rotational movement in healthy subjects, but heart rate response is not.

Adult↗

[Treatment of bruxism: physiotherapeutic approach].

Epidemiological and experimental studies suggest that there is a relationship between bruxism and pain in the orofacial region, and between bruxism and restricted mandibular movements. However, the exact nature of this relationship remains unclear. Therefore, up till now, the following working hypothesis is used: bruxism can lead to (chronic) pain complaints and restricted mandibular movements, when its intensity exceeds the adaptation capacity of the musculoskeletal structures. In that case, the aims of physical therapy treatment are twofold: to decrease symptoms, such as pain ('symptom therapy'), and to teach the patient to recognise and reduce the bruxism ('behavioral therapy'). Techniques used for symptom treatment are massage and stretching exercises. For the behavioral therapy exercises and myofeedback are often used.

Biofeedback, Psychology↗

[Group music therapy in the comprehensive management of psychosis].

In this paper the Authors propose the use of group music therapy as an integrated part of the treatment of severe mental illness: borderline and psychotic cases. The therapeutical techniques used and their aims are fully described. There are four phases of treatment in the evolution of group music therapy; these take place successively over time and are repeated each time a new patient enters the group: 1) a motor phase in which patients dance, play games with movement and do physical exercises; 2) a receptive phase based on listening to music; 3) an active phase during which they make music and sing; 4) and a predominantly verbal phase during which patients discuss the emotions, thoughts and fantasies experienced while listening to music within the group. Lastly, the paper put forwards and hypothesis based on the therapeutical function of listening to music, taking into account the clinical aspects and concepts of dynamic psychology.

Humans↗

[Cardiokymography: noninvasive assessment of the regional myocardial wall motion in the detection of coronary artery disease (author's transl)].

Cardiokymography is a technique to assess myocardial wall motion by means of an electromagnetic field induced over the left precordium. The normal cardiokymogram (CKG) is characterized predominantly by systolic inward movement. An abnormal contraction pattern--either at rest or provoked by a stress test--reveals a different tracing with decreased or absent systolic inward motion and/or systolic outward motion (bulging). In 50 patients with suspected coronary artery disease (CAD) the CKG was recorded before and after treadmill exercise test and the results compared to coronary angiography. Out of 33 patients with angiographically documented CAD (more than 50% luminal narrowing) 25 showed an abnormal CKG after exercise. There was one false positive postexercise CKG in the group of 17 patients without angiographically documented CAD. The CKG allows the qualitative assessment of regional myocardial wall motion, which is a sensitive and specific marker of ischemia. In conjunction with an ECG-stress test the CKG helps to detect the evolving ischemic abnormalities of myocardial contraction. The CKG represents a marker of ischemia independent of the ECG and helps to improve the diagnostic accuracy of stress testing for detection of CAD. The stress CKG is especially advantageous in those cases in which the interpretation of the stress ECG is difficult or even not possible. Its simple and inexpensive technique makes it a useful adjunct to the stress ECG in the diagnosis of CAD.

Aged↗

Functional and radiological results of open and closed treatment of intracapsular (diacapitular) condylar fractures of the mandible.

The study was performed to evaluate and compare the results of open and closed treatments of diacapitular fractures of the mandible. Following open reduction and internal fixation (ORIF) 14 patients with 15 displaced condylar fractures, which had caused a shortening of the mandibular ramus, were examined clinically (Helkimo index), radiologically (Orthopantomogram, Clementschitsch [reversed Towne's] view, Submentovertex view) and axiographically (CARDIAX). These findings were compared to a group of 29 patients with 34 similar condylar fractures which had been treated using closed techniques. Following ORIF patients showed better radiological results with regard to the mandibular ramus height, resorption and pathological changes to the condyle, compared to the patient group after closed functional treatment. In both groups some signs of dysfunction persisted, although there were slightly better results in the ORIF group. In 30% of the closed treatment group, lateral deviation during mouth opening, crepitus and occlusal disturbances were noted. No cases of occlusal disturbance were observed in the ORIF group. The axiographic examinations revealed a significant limitation of movement of the fractured condyle in both groups. However, after open treatment, the temporomandibular joint displayed significantly less irregularities in the condylar paths. In cases of complex reconstruction of the mandibular condyle, ORIF appears to improve the function of fractured condyles, when combined with a postoperative therapeutic exercise regime.

Adolescent↗

Impedance cardiography applied to maximal arm cranking exercise: a matter of sampling and processing strategy.

PURPOSE: A new ensemble-averaging (EA) approach was developed with the goal of investigating central hemodynamics by transthoracic impedance cardiography during maximal arm cranking. This EA procedure of the first time derivative of impedance changes (dZ/dt) over several cardiac cycles differs from previously reported techniques with respect to cycle selection strategy, according to fixed criteria, and processing methods. METHODS: First, the primary elements of the Kubicek stroke volume (SV) formula, as determined by EA, were compared with the values determined by the standard hand-processing (HP) method over a large range of cardiac outputs. RESULTS: Results showed a very high reliability for ventricular ejection time (r = 0.996), (dZ/dt)min (r = 0.995), SV (r = 0.977), and heart rate (r = 0.999). Second, the EA procedure was applied to six subjects performing a continuous, multistage arm cranking test to volitional fatigue. The present technique allowed for an effective filtering of movement and breathing artifacts of the original signal. Thus, interpretation of the dZ/dt wave form was convenient, even at maximal arm cranking power outputs up to 120 W. Stroke volume ranged from 63.83 to 127.18 mL.beat-1, showing no significant variations with oxygen consumption. Cardiac output increased linearly with oxygen uptake, reaching a mean maximal value of 16 L.min-1. CONCLUSION: The present procedure opens a new field of application to impedance cardiography, permitting to measure cardiac output during maximal arm cranking exercise.

Adult↗

[A new treatment method for sensation of dizziness (author's transl)].

Vestibular habituation training is a treatment technique developed in our department on the basis of the habituation principle. Exercises provoking dizziness stimulate the known adaptative and compensatory functions of the vestibular mechanisms which achieve an alleviation of those patients suffering of such a type of vertigo, we call "provoked" vertigo, i.e. vertigo of peripheral origin elicited by positioning and brisk movements. The theoretical basis as well as our first encouraging results are exposed.

Autogenic Training↗

Seminal fluid analysis and sperm function testing.

The diagnosis of male infertility is a rapidly developing field of investigation. The traditional descriptive approach to semen analysis is still at the heart of the diagnostic workup of male patients and important advances have been made in the standardization of the procedures used to construct the conventional semen profile, as embodied in the WHO handbook. Significant improvements have also been made in the techniques used to assess the quality of sperm motility. While this was once an entirely subjective exercise, the introduction of CASA systems to take objective measurements of the trajectories of human spermatozoa has revolutionized this form of analysis. The speed and accuracy of such systems has permitted detailed analyses of the relationships between sperm movement and sperm function, which has greatly enhanced the diagnostic power of this form of descriptive analysis. Notwithstanding the importance of the descriptive approach to semen analysis, it has also been recognized that to achieve an accurate diagnosis of male infertility such criteria should be supplemented with assays designed to reveal the functional competence of the spermatozoa. Bioassays have therefore been developed to measure such functions as the penetration of cervical mucus, sperm-zona interaction, the acrosome reaction, and sperm-oocyte fusion. All of these assays have been shown to generate information predictive of the fertilizing potential of human spermatozoa in vivo and in vitro. Despite their diagnostic value, the time, expense, and expertise required to run such functional assays has meant that they have not been widely used by infertility specialists. These functional assays are of value, however, in fundamental studies designed to elucidate the biochemical basis of defective sperm function. The first fruits of this research effort are now beginning to appear in the identification of a number of cytoplasmic markers for defective sperm function and the realization that lipid peroxidation plays a key role in the etiology of male infertility. In the wake of these fundamental studies will flow a new generation of biochemical tests for the diagnosis of defective sperm function and, it is hoped, the development of rational therapies with which to treat this condition.

Female↗

Physical therapy management of hand fractures.

Hand fractures can be a complicated management dilemma for both the general clinician and the specialist. To better equip the therapist to treat fractures in the hand, a brief review of bone and articular cartilage healing and the effects of immobilization are reviewed. Active, passive, and resistive exercises for the patient with hand fracture are reviewed in addition to treatment of the associated problems of scar formation, edema, and pain. Static and dynamic splinting techniques are also discussed.

Fracture Fixation↗

Arterial baroreflex resetting during exercise: a current perspective.

Within the past 20 years numerous animal and human experiments have provided supportive evidence of arterial baroreflex resetting during exercise. In addition, it has been demonstrated that both the feedforward mechanism of central command and the feedback mechanism associated with skeletal muscle afferents (the exercise pressor reflex) play both independent and interactive roles in the resetting of the arterial baroreflex with exercise. A fundamental alteration associated with baroreflex resetting during exercise is the movement of the operating point of the reflex away from the centring point and closer to the threshold, thereby increasing the ability of the reflex to buffer hypertensive stimuli. Recent studies suggest that central command and the cardiopulmonary baroreceptors may play a role in this movement of the operating point on the baroreflex-heart rate and baroreflex-blood pressure curve, respectively. Current research is focusing on the investigation of central neural mechanisms involved in cardiovascular control, including use of electrophysiological and molecular biological techniques in rat and mouse models to investigate baroreflex resetting as well as use of state of the art brain imaging techniques in humans. However, the purpose of this review is to describe the role of the arterial baroreflex in the regulation of arterial blood pressure during physical activity from a historical perspective with a particular emphasis on human investigations.

Baroreflex↗

Pain relief using cutaneous modalities, positioning, and movement.

Positioning, movement, and certain cutaneous modalities may be easily used by all caregivers, including the family, to bring comfort and pain relief to terminally ill patients with pain. For such patients, these techniques are most appropriately used in addition to pharmacologic control of pain. Patients themselves may use some of the cutaneous modalities with minimal assistance from others, thereby promoting a sense of independence. Other techniques may be performed by family and friends, providing them with the assurance that they are assisting a loved one. The techniques presented here can be readily used in the home or hospital setting and are relatively low risk, simple, and inexpensive. This paper presents specific guidelines for patients and caregivers in relation to the use of superficial massage, superficial heat and cold, menthol application to skin, transcutaneous electrical nerve stimulation (TENS), positioning, and movement. Because of their simplicity and ease of use, these techniques tend to be overlooked. However, taking the time to introduce these techniques to patients and families often results in a significant contribution to the comfort of the dying patient.

Cryotherapy↗

Physiologic comparison of forward and reverse wheelchair propulsion.

OBJECTIVES: Conventional wheelchair propulsion is physiologically demanding because of the small muscle mass that is used and the low mechanical efficiency of the movement. Previous research has suggested that a reverse wheeling technique might be more economical than conventional forward wheeling. The present study sought to compare the physiologic demands of forward and reverse wheeling techniques. DESIGN: A repeated measures design was used to compare the dependent variables between forward and reverse wheeling techniques in the same subjects. SETTING: Human exercise research laboratory. PARTICIPANTS: Ten able-bodied men. INTERVENTION: Subjects completed graded, discontinuous exercise tests on a wheelchair ergometer, using both forward and reverse wheeling techniques. MAIN OUTCOME MEASURES: Oxygen uptake (VO2), ventilation (VE), and heart rate were measured during the last 30 seconds of each 3-minute exercise stage. Blood lactate concentration ([La]) and rating of perceived exertion (RPE) were determined immediately after each stage. RESULTS: Repeated measures analysis of variance demonstrated that VO2, VE, heart rate, [La], and RPE were all significantly greater (p < .05) with reverse wheeling compared with forward wheeling. VO2, values with reverse wheeling averaged 9% higher than forward wheeling at identical power outputs. CONCLUSIONS: Reverse wheelchair propulsion is physiologically more demanding than conventional forward wheelchair propulsion and does not appear to offer potential for improving the economy of wheelchair propulsion.

Adult↗

Reanimation of the long-standing partial facial paralysis.

Those unfortunate people who suffer from permanent partial facial paralysis have great difficulty finding surgeons who can offer corrective operations. Improving their function is a most delicate procedure. Great care must be exercised to avoid injuring nerves and muscles which are still operating, although in a greatly diminished state. The pathogenesis must be understood before attempting any corrective procedure. Adequate time must elapse from the moment of injury to surgical intervention, thus allowing for maximal nerve and muscle regeneration. This paper describes techniques that could improve facial movements. The most frequently used procedure is shortening of the levator and/or the zygomatic muscles that are partially atrophied. It must be understood that total reanimation is impossible as of this time.

Adolescent↗

[Role of Gated-SPECT in the early diagnosis of ischaemic cardiopathy in the diabetic patient].

Diabetes presents a higher risk of both symptomatic and asymptomatic coronary artery disease (CAD). Myocardial perfusion SPECT, particularly associated with Gated acquisition, makes it possible to diagnose CAD on the basis of the presence and extent of perfusion defects, and to carry out the stratification of the cardiological risk (infarction or cardiac death) by analyzing the results of perfusion and of the functional data (ejection fraction, EF, and wall movement). Gated myocardial SPECT in the diagnosis and stratification of risk has proved superior to clinical evaluation or the exercise test alone, and it is also superior to echostress/dobutamine in the evaluation of monovasal disease. These data have been confirmed not only in the population at large but also in the diabetic population, making the technique important also in such patients also affected by coronary disease which is earlier and more advanced in diagnosis. Scintigraphic data make it possible to classify patients into various risk categories (low, intermediate and high) on the basis of which a specific therapeutic approach can be established. The present review develops the above concepts, taking into consideration the consolidated studies present in the literature, for the purpose of pinpointing the diagnostic approach in which exercise or SPECT myocardium-scintigraphy can be assigned.

Coronary Artery Disease↗

Regression of juvenile idiopathic scoliosis.

For a young scoliotic boy the customary "wait and watch" management program for rapidly progressive juvenile idiopathic scoliosis was considered unsatisfactory in view of the poor prognosis. The management program devised was based on the congenital postural induction concept of scoliosis with progression accruing from mechanically induced bioengineering fatigue, cumulative molecular scissions, laxity of ligaments, and secondary bone deformation. A coexisting pelvic tilt with restricted movement of the hip and shoulder joints was overlooked initially. Possibly induced simultaneously with the scoliosis, it is considered a contributory factor in scoliosis progression and requires early diagnosis and correction. The rapid improvement in this child's spinal status achieved by physiological traction and specifically designed exercises was such that as a preventive measure the technique warrants further clinical assessment on young scoliotics.

Child, Preschool↗

Development of specific connectivity between premotor neurons and motoneurons in the brain stem and spinal cord.

Astounding progress has been made during the past decade in understanding the general principles governing the development of the nervous system. An area of prime physiological interest that is being elucidated is how the neural circuitry that governs movement is established. The concerted application of molecular biological, anatomical, and electrophysiological techniques to this problem is yielding gratifying insight into how motoneuron, interneuron, and sensory neuron identities are determined, how these different neuron types establish specific axonal projections, and how they recognize and synapse upon each other in patterns that enable the nervous system to exercise precise control over skeletal musculature. This review is an attempt to convey to the physiologist some of the exciting discoveries that have been made, within a context that is intended to link molecular mechanism to behavioral realization. The focus is restricted to the development of monosynaptic connections onto skeletal motoneurons. Principal topics include the inductive mechanisms that pattern the placement and differentiation of motoneurons, Ia sensory afferents, and premotor interneurons; the molecular guidance mechanisms that pattern the projection of premotor axons in the brain stem and spinal cord; and the precision with which initial synaptic connections onto motoneurons are established, with emphasis on the relative roles played by cellular recognition versus electrical activity. It is hoped that this review will provide a guide to understanding both the existing literature and the advances that await this rapidly developing topic.

Afferent Pathways↗

Warming-up and stretching for improved physical performance and prevention of sports-related injuries.

Competitive and recreational athletes typically perform warm-up and stretching activities to prepare for more strenuous exercise. These preliminary activities are used to enhance physical performance and to prevent sports-related injuries. Warm-up techniques are primarily used to increase body temperature and are classified in 3 major categories: (a) passive warm-up - increases temperature by some external means; (b) general warm-up - increases temperature by nonspecific body movements; and (c) specific warm-up - increases temperature using similar body parts that will be used in the subsequent, more strenuous activity. The best of these appears to be specific warm-up because this method provides a rehearsal of the activity or event. The intensity and duration of warm-up must be individualised according to the athlete's physical capabilities and in consideration of environmental factors which may alter the temperature response. The majority of the benefits of warm-up are related to temperature-dependent physiological processes. An elevation in body temperature produces an increase in the dissociation of oxygen from haemoglobin and myoglobin, a lowering of the activation energy rates of metabolic chemical reactions, an increase in muscle blood flow, a reduction in muscle viscosity, an increase in the sensitivity of nerve receptors, and an increase in the speed of nervous impulses. Warm-up also appears to reduce the incidence and likelihood of sports-related musculoskeletal injuries. Improving flexibility through stretching is another important preparatory activity that has been advocated to improve physical performance. Maintaining good flexibility also aids in the prevention of injuries to the musculoskeletal system. Flexibility is defined as the range of motion possible around a specific joint or a series of articulations and is usually classified as either static or dynamic. Static flexibility refers to the degree to which a joint can be passively moved to the end-points in the range of motion. Dynamic flexibility refers to the degree which a joint can be moved as a result of a muscle contraction and may therefore not be a good indicator of stiffness or looseness of a joint. There are 3 basic categories of stretching techniques: (a) ballistic--which makes use of repetitive bouncing movements; (b) static--which stretches the muscle to the point of slight muscle discomfort and is held for an extended period; and (c) proprioceptive neuromuscular facilitation - which uses alternating contractions and stretching of the muscles. Each of these stretching methods is based on the neurophysiological phenomenon involving the stretch reflex.(ABSTRACT TRUNCATED AT 400 WORDS)

Athletic Injuries↗

The warm-up procedure: to stretch or not to stretch. A brief review.

Stretching exercises are either performed alone or with other exercises as part of the athlete's warm-up. The warm-up is designed to increased muscle/tendon suppleness, stimulate blood flow to the periphery, increase body temperature, and enhance free, coordinated movement. The purpose of this paper is to review the literature regarding stretching, with the aim of defining its role during the warm-up. Implications of stretching on muscle/tendon flexibility, minimizing injury, enhancing athletic performance, and generally preparing the athlete for exercise are discussed. Physiology applied to stretching is also discussed together with different related techniques and practical aspects. A proposed model stretching regime is presented based on the literature reviewed.

Athletic Injuries↗