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Repeated measurement of habitual food intake increases under-reporting and induces selective under-reporting.

The aim of the current study was to measure differences in reporting behaviour between a first occasion of 7 d food recording and a second occasion of 7 d food recording 12 weeks later, in a group of elderly men (n 17) and women (n 17). Half the group followed an exercise intervention. The mean age was 61 (sd 5) years and mean BMI was 26.2 (sd 3.8) kg/m2. Reported energy intake was compared with energy expenditure as calculated from measured BMR and physical activity assessed with a tri-axial accelerometer for movement registration. Total under-reporting was divided into undereating and under-recording. Undereating was calculated from the change in body mass over the recording week and the under-recording was measured using the water balance technique. In the first period, the total under-reporting was 21 % and increased to 27% in the second period In the first period there was no indication for subjects eating less during the recording week, however, in the second period subjects lost body mass during the food recording indicating undereating. The amount of under-recording was calculated at 21% in the first period and 18% in the second period of recording (P 0.28). During the second period subjects selectively under-reported their fat intake and over-reported their protein intake. In conclusion, repeated assessment of food intake caused a higher quantitative and a qualitative under-reporting of food intake. The effect of interventions (dietary or otherwise) on habitual food intake might be confounded by changes in food-reporting behaviour.

Case-Control Studies↗

Simultaneous heart rate-motion sensor technique to estimate energy expenditure.

PURPOSE: Heart rate (HR) and motion sensors represent promising tools for physical activity (PA) assessment, as each provides an estimate of energy expenditure (EE). Although each has inherent limitations, the simultaneous use of HR and motion sensors may increase the accuracy of EE estimates. The primary purpose of this study was to establish the accuracy of predicting EE from the simultaneous HR-motion sensor technique. In addition, the accuracy of EE estimated by the simultaneous HR-motion sensor technique was compared to that of HR and motion sensors used independently. METHODS: Thirty participants (16 men: age, 33.1 +/- 12.2 yr; BMI, 26.1 +/- 0.7 kg.m(-2); and 14 women: age, 31.9 +/- 13.1 yr; BMI, 27.2 +/- 1.1 kg.m(-2) (mean +/- SD)) performed arm and leg work in the laboratory for the purpose of developing individualized HR-VO2 regression equations. Participants then performed physical tasks in a field setting for 15 min each. CSA accelerometers placed on the arm and leg were to discriminate between upper and lower body movement, and HR was then used to predict EE (METs) from the corresponding arm or leg laboratory regression equation. A hip-mounted CSA accelerometer and Yamax pedometer were also used to predict EE. Predicted values (METs) were compared to measured values (METs), obtained via a portable metabolic measurement system (Cosmed K4b(2)). RESULTS: The Yamax pedometer and the CSA accelerometer on the hip significantly underestimated the energy cost of selected physical activities, whereas HR alone significantly overestimated the energy cost of selected physical activities. The simultaneous HR-motion sensor technique showed the strongest relationship with VO(2) (R(2) = 0.81) and did not significantly over- or underpredict the energy cost (P = 0.341). CONCLUSION: The simultaneous HR-motion sensor technique is a good predictor of EE during selected lifestyle activities, and allows researchers to more accurately quantify free-living PA.

Activities of Daily Living↗

Moving towards acceleration for estimates of activity-specific metabolic rate in free-living animals: the case of the cormorant.

1. Time and energy are key currencies in animal ecology, and judicious management of these is a primary focus for natural selection. At present, however, there are only two main methods for estimation of rate of energy expenditure in the field, heart rate and doubly labelled water, both of which have been used with success; but both also have their limitations. 2. The deployment of data loggers that measure acceleration is emerging as a powerful tool for quantifying the behaviour of free-living animals. Given that animal movement requires the use of energy, the accelerometry technique potentially has application in the quantification of rate of energy expenditure during activity. 3. In the present study, we test the hypothesis that acceleration can serve as a proxy for rate of energy expenditure in free-living animals. We measured rate of energy expenditure as rates of O2 consumption (VO2) and CO2 production (VCO2) in great cormorants (Phalacrocorax carbo) at rest and during pedestrian exercise. VO2 and VCO2 were then related to overall dynamic body acceleration (ODBA) measured with an externally attached three-axis accelerometer. 4. Both VO2 and VCO2 were significantly positively associated with ODBA in great cormorants. This suggests that accelerometric measurements of ODBA can be used to estimate VO2 and VCO2 and, with some additional assumptions regarding metabolic substrate use and the energy equivalence of O2 and CO2, that ODBA can be used to estimate the activity specific rate of energy expenditure of free-living cormorants. 5. To verify that the approach identifies expected trends in from situations with variable power requirements, we measured ODBA in free-living imperial cormorants (Phalacrocorax atriceps) during foraging trips. We compared ODBA during return and outward foraging flights, when birds are expected to be laden and not laden with captured fish, respectively. We also examined changes in ODBA during the descent phase of diving, when power requirements are predicted to decrease with depth due to changes in buoyancy associated with compression of plumage and respiratory air. 6. In free-living imperial cormorants, ODBA, and hence estimated VO2, was higher during the return flight of a foraging bout, and decreased with depth during the descent phase of a dive, supporting the use of accelerometry for the determination of activity-specific rate of energy expenditure.

Acceleration↗

[The rehabilitative therapy of patients with persistent paralysis of the mimetic muscles].

Based on the well-known rearrangement of the intracentral relationships when forming a new movement, the authors have developed a technique of functional rearrangement of the sternocleidomastoid muscle displaced on the angle of the mouth. The technique allowed the authors to improve the patients' appearance, to facilitate articulation and taking food.

Adult↗

Impression procedure for patients with severely limited mouth opening.

Patients with limited mouth opening are a common occurrence in prosthodontic practice. The majority of these patients can be treated with exercise and stretching movements before impressions are made. Some will not respond to these procedures because of facial scarring and surgical manipulation of the facial muscles. This article presents an impression procedure for overcoming such reduced mouth opening.

Dental Impression Technique↗

Energy flow during Olympic weight lifting.

Data obtained from 16-mm film of world caliber Olympic weight lifters performing at major competitions were analyzed to study energy changes during body segment and barbell movements, energy transfer to the barbell, and energy transfer between segments during the lifting movements contested. Determination of barbell and body segment kinematics and use of rigid-link modeling and energy flow techniques permitted the calculation of segment energy content and energy transfer between segments. Energy generation within and transfer to and from segments were determined at 0.04-s intervals by comparing mechanical energy changes of a segment with energy transfer at the joints, calculated from the scalar product of net joint force with absolute joint velocity, and the product of net joint torque due to muscular activity with absolute segment angular velocity. The results provided a detailed understanding of the magnitude and temporal input of energy from dominant muscle groups during a lift. This information also provided a means of quantifying lifting technique. Comparison of segment energy changes determined by the two methods were satisfactory but could likely be improved by employing more sophisticated data smoothing methods. The procedures used in this study could easily be applied to weight training and rehabilitative exercises to help determine their efficacy in producing desired results or to ergonomic situations where a more detailed understanding of the demands made on the body during lifting tasks would be useful.

Biomechanical Phenomena↗

Feasibility of ambulatory, continuous 24-hour finger arterial pressure recording.

We tested Portapres, an innovative portable, battery-operated device for the continuous, noninvasive, 24-hour ambulatory measurement of blood pressure in the finger. Portapres is based on Finapres, a stationary device for the measurement of finger arterial pressure. Systems were added to record signals on tape, to alternate measurements between fingers automatically each 30 minutes, and to correct for the hydrostatic height of the hand. We compared the pressure as measured by Portapres with contralateral intrabrachial pressure measured with an Oxford device. Results were obtained in eight volunteers and 16 hypertensive patients. Time lost due to artifact was about 10% for each device. In two patients a full 24-hour Oxford profile was not obtained. In the remaining 22 subjects finger systolic, diastolic, and mean pressures differed +1 (SD 9), -8 (6), and -10 (6) mm Hg, respectively, from intrabrachial pressure. These diastolic and mean pressure underestimations are similar to what was found earlier for Finapres, are typical for the technique, and are systematic. Avoiding brisk hand movements resulted in fewer waveform artifacts. The hand had to be kept covered to continue recording at low outside temperatures. Sleep was not disturbed by Portapres, and arterial pressure showed a marked fall during siesta and nighttime. There were no major limitations in behavior, and no discomfort that originated from continuous monitoring was reported. Measurements continued normally during physical exercise. Portapres provides for the first time continuous 24-hour, noninvasive ambulatory blood pressure waveform monitoring and offers real and obvious advantages over current noninvasive and invasive devices.

Adult↗

The effects of arms and countermovement on vertical jumping.

Countermovement and arm-swing characterize most jumping. For determination of their effects and interaction, 18 males jumped for maximal height from a force platform in all four combinations of arm-swing/no-arm-swing and countermovement/no-countermovement. For all jumps, vertical velocity peaked 0.03 s before and dropped 6-7% by takeoff. Peak positive power averaged over 3,000 W, and occurred about 0.07 s before takeoff, shortly after peak vertical ground reaction force (VGRF) and just before peak vertical velocity. Both countermovement and arm-swing significantly (P less than 0.05) improved jump height, but arm-swing's effect was greater, enhancing peak total body center of mass (TBCM) rise both pre and posttakeoff. Countermovement only affected the post-takeoff rise. The arm-swing resulted in higher peak VGRF and peak positive power. During countermovement, the use of arms resulted in less unweighting, slower and less extensive TBCM drop, and less negative power. Countermovement increased pretakeoff jump duration by 71-76%, increased average positive power, and yielded large positive and negative impulses. High test-retest reliability was shown for jump descriptive variables. Body weight together with peak posttakeoff TBCM rise effectively predicted peak power (multiple R2 = 0.89, standard error of estimate = 243 W). The results lend insight into which jumping techniques are most appropriate for given sports situations and indicate that a jump test can effectively be used to estimate peak power output.

Adult↗

Assessment of 3-D joint contact load predictions during postural/stretching exercises in aged females.

Our goal was to estimate knee and hip joint contact forces during a variety of unconstrained "stretching" exercises that are often recommended for people with arthritis. The population of interest was aged females with and without significant osteoarthritis (OA). Three-dimensional (3-D) kinematic, force platform, and selected electromyographic (EMG) data were measured. A relatively standard and reasonably efficient technique was used for all subjects and tasks: inverse dynamics to estimate joint reaction forces and net moments, followed by heuristic reductionist techniques for predicting muscle load-sharing. Muscle force predictions were compatible with measured EMG activity for some tasks but less so for others, especially those with significant axial and medio-lateral movement components or high co-contraction. Such results suggest several improvements, which come at computational cost: 3-D joint models which better document muscle and passive tissue loading-sharing in abduction and axial torsion, and dynamic or novel static optimization approaches that can inherently predict muscle co-contraction. Nonetheless, the predicted joint contact loadings provide estimates that are essentially lower bounds on the likely joint contact loads. Based on our results we suggest that the side-kick and back-kick tasks be modified because the loading levels on the support leg are potentially excessive for the aged arthritic population.

Aged↗

Air-plethysmography and the effect of elastic compression on venous hemodynamics of the leg.

Leg volume changes during exercise have been measured in absolute units (milliliters) by means of a new method of air-plethysmography. Venous volume (VV), venous filling time, and venous filling index on standing from the recumbent position, ejected volume (EV) and ejection fraction (EF = EV x 100/VV) with one tiptoe movement, and residual volume (RV) and residual volume fraction (RVF = RV x 100/VV) after 10 tiptoe movements were measured in normal limbs, limbs with superficial venous incompetence, and limbs with deep venous disease. The same measurements were repeated with a graduated medium compression stocking in limbs with SVI and graduated high compression stockings in limbs with DVD. Ambulatory venous pressure was measured at the same time, with a needle in a vein in the foot. The results indicate that this method of air-plethysmography is not only of diagnostic value but offers a new and unique technique to assess and study the hemodynamic effects of different forms of elastic compression. The lower ambulatory venous pressure, produced by the elastic compression, was the result of a reduction in reflux and an improvement in the calf muscle ejecting ability during rhythmic exercise.

Adult↗

A novel method for locomotion training.

This article describes a novel therapeutic system for locomotion training and learning for patients with a wide range of neurological and musculoskeletal disorders. The technique embraces the notion that locomotion therapy should be goal oriented and task specific. The task specificity includes a partial weight-bearing device that permits the posture/equilibrium, movement, and weight-bearing components of gait function to operate concurrently, even in patients with serious deficits. In addition, it allows interaction with therapists and others to facilitate locomotion control, particularly during the early stages of gait therapy. Neurobiological bases for this technique and early clinical results are discussed, and two case studies of patients with traumatic brain injury (TBI) are presented. Although well-designed efficacy studies are needed, clearly this therapeutic approach to locomotor disorders among TBI patients meets the various criteria for recovery of gait function established in this article.

Adolescent↗

Simultaneous measurement of heart rate and body motion to quantitate physical activity.

None of the various methods used to measure habitual physical activity over days, weeks, or years in the general population have yet proven entirely satisfactory. A major problem is that no "gold standard" exists for the validation of various questionnaires, logs, or diaries that can be used in large sample population studies. Attempts have been made to accurately measure the activity profile by using heart rate or various motion sensors or accelerometers, but each approach has had significant limitations. The availability of new solid state recording techniques and computer-based analytic and display procedures now makes it possible to simultaneously record heart rate and body movement continuously for days and to combine the analysis of these data using customized software. Preliminary evaluation of this concept of simultaneous recording and analysis of heart rate and body motion via movement sensors on an arm and leg were conducted in 19 men. Subjects performed a variety of exercises in the laboratory during which heart rate, leg motion, arm motion, and oxygen uptake were recorded. Various issues regarding the prediction of energy expenditure from heart rate and body movement independently and in combination were evaluated. The results demonstrate that the accuracy of estimating oxygen uptake during a wide range of activities is improved when individualized heart rate--oxygen uptake regressions are used and heart rate and body movement are analyzed simultaneously rather that separately.

Adult↗

The contraction stress test.

The CST is one of the first forms of fetal surveillance; it is still the only form that tries to use the principle of induced stress to reveal marginal placental insufficiency. With the expansion of biophysical evaluation, there are many choices in antenatal testing. Clearly the CST should not be the only form of testing to follow high-risk pregnancies. However, its proved efficacy and close correlation with intrapartum monitoring make it an essential tool. With nipple stimulation techniques, it is an easy and quick method for evaluating the fetus. Clinicians who follow high-risk pregnancies need to understand fully the administration and proper interpretation of the CST.

Animals↗

[Method of electromyographic feedback in the complex rehabilitative therapy of patients with post-stroke movement disorders].

The author has developed techniques of staged training by the EMG-biological feedback (EMG-BFB) method with the use of visual and sound control in patients with various degrees of motor disorders. A new variant of the EMG-BFB method (multichannel) is offered which has made it possible to use the method not only for training weakened muscles and reducing spasticity in their antagonists but also for improving motor coordination. A comparative study of the efficacy of the conventional complex of therapeutic exercises and the effectiveness of the therapeutic physical training in conjunction with the EMG-BFB method has demonstrated the latter to be 15% more effective on an average.

Biofeedback, Psychology↗

Control of nocturnal hypoventilation by nasal intermittent positive pressure ventilation.

Ten patients with respiratory failure and nocturnal hypoventilation were treated for three to nine months by nasal intermittent positive pressure ventilation. Four patients had chronic obstructive lung disease (median FEV1 19% predicted) and six restrictive chest wall disorders (median FVC 25% predicted); eight of the patients also had cardiac failure. The median daytime arterial oxygen tension, measured before and after at least three months' treatment, increased from 6.2 (range 5.4-9.6) to 9.1 (7.1-9.8) kPa in those with restrictive disease (p less than 0.05), and from 6.0 (5.7-6.5) to 7.1 (6.3-7.7) kPa in the four with airflow limitation (NS). Median values for arterial carbon dioxide tension over the same time fell from 8.2 (range 6.7-9.8) to 6.5 (6.0-6.9) kPa in the group with restrictive disease (p less than 0.05) and from 8.2 (7.0-9.2) to 7.1 (4.9-7.7) kPa in those with airflow limitation (p less than 0.02). Total sleep time while patients were using nasal positive pressure ventilation varied from 155 to 379 (median 341) minutes, and included 4-26% rapid eye movement sleep (median 14%). The percentage of monitored time during the night in which the arterial oxygen saturation was less than 80% fell from a median (range) of 96 (3-100) to 4 (0-9) in the six patients with restrictive disease and from 100 (98-100) to 40 (2-51) in those with airflow limitation. There were no changes in spirometric values but exercise tolerance improved in all patients. The technique may prove an acceptable alternative to long term domiciliary oxygen therapy in selected patients.

Adult↗

Interventions in chronic pain management. 3. New frontiers in pain management: complementary techniques.

UNLABELLED: This self-directed learning module highlights complementary and alternative therapies that are often used by patients seen in the typical physiatric practice. This article contains information on acupuncture and its use to treat low back pain, recent therapeutic approaches to lateral epicondylitis, movement therapies appropriate for the osteoporotic patient, and spa therapies. Scientific literature and standards of clinical practice in these areas have been reviewed to put forth the most recent recommendations regarding these diagnoses and therapeutic interventions. OVERALL ARTICLE OBJECTIVES: (a) To familiarize the physiatrist with complementary techniques that are increasingly popular in the United States and (b) to identify when therapies, such as acupuncture, movement therapies, bodywork, and the like, may be integrated into a comprehensive treatment approach for common physiatric clinical scenarios.

Balneology↗

Computer games as a means of movement rehabilitation.

In order to improve arm control in a child with Erb's palsy, a computer game was used in which participation required the movement of a lever, controlled by the child's arm. Counter-balancing weights were used to facilitate movement but counteract pathological compensatory movements. The use of this system (with appropriate modifications at successive stages of therapy) produced a substantial improvement in arm control. It was concluded that the use of such techniques capitalizes on the child's motivation to succeed, and has advantages over traditional physiotherapy that relies on passive, repetitive movements and sometimes painful limb manipulation. In this situation the child made spontaneous, voluntary movements, concentrating on the outcome of movements rather than the actions per se.

Adolescent↗

Development of a cadence curl-up test for college students.

The purpose of this study was to evaluate a cadence curl-up test in a college population as compared to the American Alliance for Health, Physical Education, Recreation and Dance (AAHPERD) 1-min sit-up test (Association for Research and Professional Councils and Societies, 1985) and the Robertson 1-min curl-up test (Robertson & Magnusdottir, 1987). A cadence curl-up test, referred to as the GT curl-up test, was set at 25 repetitions per minute. A total of 205 college students completed three trials consisting of one AAHPERD sit-up trial and two GT curl-up trials. A subsample (n = 85) completed the Robertson curl-up test as a fourth trial. Trials were counterbalanced with 7 days rest between each test. To evaluate content validity, electromyography signals from selected muscle sites were measured on 6 participants for each of the three tests. Mean scores and standard deviations for the GT curl-up test, AAHPERD sit-up test, and Robertson curl-up test were M = 46.2, SD = 17.8; M = 46.4, SD = 10.2; and M = 69.7, SD = 14.1), respectively. Pearson product moment correlations among the three tests were low to moderate (r < or = .50). The intraclass correlation reliability estimate for the GT curl-up test was 0.92. In 1-min speed tests, repeated rapid trunk flexion can adversely affect technique and has raised safety concerns (Jette, Sidney & Cicutti, 1984; Faulkner, Sprigings, McQuarrie, & Bell, 1989; Cooper Institute for Aerobics Research, 1994). The Robertson test also requires the use of a curl-up frame. In the GT cadence test these drawbacks are minimized due to a slower, more controlled movement with an objective endpoint that is not dependent on special equipment. Moreover, our EMG findings supported previous reports that curl-up exercise with feet unanchored minimizes rectus femoris involvement. Based on the results of this study, the CT curl-up test was found to be a reliable field test with logical validity supporting its relevance as an index of abdominal muscular endurance among college students.

Abdomen↗