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At least 379 records · Page 21Linked to original sources

PubMed1996

Importance of the right ventricle in valvular heart disease.

The importance of the right ventricle as a determinant of clinical symptoms, exercise capacity, peri-operative survival and postoperative outcome has been underestimated for a long time. Right ventricular ejection fraction has been used as a measure of right ventricular function but has been found to be dependent on loading conditions, ventricular interaction as well as on myocardial structure. Altered left ventricular function in patients with valvular disease influences right ventricular performance mainly by changes in afterload but also by ventricular interaction. Right ventricular function and regional wall motion can be determined with right ventricular angiography, radionuclide ventriculography, two-dimensional echocardiography or magnetic resonance imaging. However, the complex structure of the right ventricle and its pronounced translational movements render quantification difficult. True regional wall motion analysis is, however, possible with myocardial tagging based on magnetic resonance techniques. With this technique a baso-apical shear motion of the right ventricle was observed which was enhanced in patients with aortic stenosis.

Aortic Valve↗

PubMed1978

Rehabilitation of patients with multiple sclerosis.

There are inherent difficulites in the rehabilitation of patients with multiple sclerosis (MS). The clinical manifestations of the disease vary tremendously, as does its natural course. The many theories on the etiology, pathogenesis and treatment of MS are presented. However, at the current time, the patient with MS may be treated with the realistic goal of minimizing the effects of the disease. This is accomplished best in a rehabilitation setting. Diagnosis, prognosis, and factors associated with precipitaiton or exaggeration of symptoms, are discussed. Specific techniques of rehabilitation of decreased motor power, spasticity, ataxia and intention tremor, speech and optic defects, and impaired sensation are presented. Decubiti and ulcerations, bladder and bowel problems, and sexual dysfunction are recognized as common problems and attention must be directed to these. The importance and wide array of emotional difficulties in patients with MS is emphasized, and those patients who may benefit from psychotherapy are discussed.

Ataxia↗

PubMed2004

Muscle plasticity after weight and combined (weight + jump) training.

PURPOSE: The purpose of this study was to compare the effects of jump training as a complement to weight training on jump performance and muscle strategy during the squat and countermovement jump. METHOD: Twenty-two male handball players, between the ages of 17 and 24, and in good health, were randomly divided into three groups. Two were trained groups, weight training (WTG) and jump training combined with weight training (CTG), and one was a control group (CG). Maximal isometric force and maximal concentric power were assessed by a supine leg press, squat jump (SJ), counter movement jump (CMJ), and surface EMG was used to determine changes in muscle adaptation before and after the training period. RESULTS: After 6-wk training programs, the two training groups increased maximal isometric force, maximal concentric power, and squat jump performance. However, only combined training presented a significant increase in height jump performance during the countermovement jump (P < 0.05). EMG analysis (as interpreted through the root mean square values) showed that the SJ was performed similarly before and after the training period for the two training groups. However, during the CMJ, only the CTG group adopted a new technique manifested by a short transition phase together with an increase in knee joint stiffness and knee extensor muscle activation and rectus femoris ratio. CONCLUSION: It was suggested that the central activities in knee joint during the transition phase, in conjunction with intrinsic muscle contractile properties, play a major role in the regulation of performance during a CMJ. Furthermore, our study suggests that a change in maximal strength and/or explosive strength does not necessarily cause changes in combined movement such as the stretch shortening cycle.

Electromyography↗

PubMed1993

Concurrent validity of the ERGOS work simulator versus conventional functional capacity evaluation techniques in a workers' compensation population.

A prospective blinded cohort study was performed in an interdisciplinary vocational evaluation program to investigate the concurrent validity of the ERGOS work simulator in comparison to current methods of evaluation. Seventy men and eight women, aged 22 to 64 years, who attended for a 2-week physical capacity assessment participated in the study. Physical activity factors as defined by the Canadian Classification and Dictionary of Occupations and the American Dictionary of Occupational Titles were assessed for all subjects under three evaluation conditions: the ERGOS work simulator, an exercise-oriented physical evaluation by a rehabilitation therapist, and performance of project-format industrial tasks. In addition, 17 men and 7 women were assessed with VALPAR standardized work sample tests. The statistical significance of the relationships between results obtained by the various evaluation methods was examined. There was a strong correlation between the ERGOS dynamometry and the clinical assessment of strength for all standard movements tested (P < .001). The Methods Time Measurement rating by the ERGOS for dexterity variables, according to industrial engineering standards, tended to rate subjects as more restricted than did the clinical evaluators. There was a significant relationship (P < .001) between the "overall physical activity rating" from ERGOS dynamometry, clinical evaluation, and performance in an industrial workshop setting. There was also a significant relationship (P < .001) between the "overall physical activity rating" for endurance of a full workday produced by the 4-hour ERGOS evaluation and by the 2-week functional capacity evaluation.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1989

Fractionation sensitivity of a functional endpoint: impaired shoulder movement after post-mastectomy radiotherapy.

A clinical radiobiological study of the fractionation sensitivity of impaired shoulder movement after postmastectomy radiotherapy is presented. From 1978 to 1980, 163 breast cancer patients received postmastectomy irradiation delivered in 12 fractions, 2 fractions per week, over a period of 37 to 46 days. The total dose was specified either as a maximum absorbed dose of 51.36 Gy, or as a minimum target dose of 36.6 Gy specified at the level of midaxilla. From 1981 to 1982, 66 patients received a minimum target dose of 40.92 Gy in 22 fractions with 5 fractions per week over a period of 29 to 35 days. The treatment technique remained essentially unchanged during the whole period of 1978 to 1982. Maximal flexion and abduction of the arm were measured with unfixed scapula. A relative score, indicating the grade of impaired shoulder movement on a nominal scale from 0-3, was established by comparison with the mobility of the contralateral arm. In addition, working ability and pain at movement and at rest were evaluated. These performance parameters significantly correlated with the grade of impaired shoulder movement. The occurrence of moderately or severely impaired shoulder movement was analyzed using a mixture model incorporating dose-fractionation, latency, and predisposing clinical factors. The risk of shoulder problems was significantly higher among patients above 60 years of age. The analysis pointed to subcutaneous fibrosis as a disposing factor and indicates that postoperative physical exercise programs are beneficial. Arm edema had no statistically significant influence on shoulder performance. The alpha/beta ratio was estimated at 3.5 Gy with 95% confidence limits (c.l.) [0.7, 6.2] Gy. The length of time to expression of 90% of the ultimate frequency of moderate and severe shoulder impairment was estimated at 3.9 years with 95% confidence limits [3.1, 4.6] years. The nominal standard dose (NSD) formalism failed to produce isoeffective total doses with respect to impaired shoulder movement in the two fractionation schedules. Although the deleterious effects of larger-than-conventional dose fractions have been documented in a number of clinical series, this study represents the first quantitation of the fractionation sensitivity of a functional clinical endpoint.

Adult↗

PubMed2005

[Early diagnosis of the functional relevance of coronary heart disease].

In cases of stable or to a large extent symptom-free coronary heart disease (CHD) and atypical symptomatology, the indication for diagnostic cardiac catheterization is first confirmed by noninvasive diagnostics of ischemia. This can be carried out either with ergometric stress tests or imaging procedures in combination with ergometric or pharmacological stress. Myocardial scintigraphy and stress echocardiography are established techniques and to an increasing extent stress magnetic resonance imaging (MRI). In addition to sensitivity in providing evidence for ischemia, technical improvements in computed tomography (CT) and MRI have opened up new possibilities for visualizing coronary vessels and vascular wall morphology. While CT coronary angiography with its high spatial resolution is on the threshold of clinical application for selected patients, MRI has the potential for furnishing information on wall movement analysis, perfusion, coronary flow measurement, and plaque characterization to become the future cardiovascular "all-round examination".

Coronary Artery Disease↗

PubMed1995

Redistribution of body fluids during postural manipulations.

Inter-compartmental body-fluid distribution is contingent upon posture, exercise state and environmental temperature. This investigation aimed at quantifying the distribution of intra- and extravascular fluid volumes during postural manipulations. Fluid shifts were measured in eight males utilizing a simultaneous, radionuclide dilution technique, in which radioiodinated serum fibrinogen, radiochromated erythrocytes, radiobromine and tritiated water were used to measure plasma, red cell, extracellular and total body water volumes. Subjects were exposed to three postural changes [seated (control), supine and standing] for 30 min at an air temperature of 22.0 degrees C, with each posture separated by 30 min seated rest. Total body water content remained stable throughout postural changes (P = 0.842). Relative to seated volumes, BV increased by 89 mL when supine, and decreased by 406 mL while standing (P = 0.003), with such shifts being primarily a result of plasma movement (P = 0.011). Red cell volume changes were not significant. Vascular fluid lost during standing was filtered into the interstitial compartment (P = 0.014), with the extracellular and intracellular volumes remaining unaffected. (P = 0.271 and P = 0.800, respectively). These observations confirmed the influence of posture on inter-compartmental body-fluid distribution. The intravascular fluid loss when standing was caused by the filtration of plasma into the interstitium, while, during supine rest, intravascular volume increased, reflecting fluid flux from the interstitium to the circulation.

Adult↗

PubMed1992

Intramuscular pressures during exercise: an evaluation of a fiber optic transducer-tipped catheter system.

The efficacy of a modified fibre optic transducer-tipped catheter system for measuring intramuscular pressures during exercise was determined. A microcapillary infusion technique using a catheter was employed as the standard of comparison due to its established dynamic properties. Pressures were measured in the tibialis anterior muscle of six healthy adults at rest before exercise, during isometric and concentric exercise, and at rest after exercise. The fibre optic system measured contraction pressures equal to the microcapillary infusion technique during all phases of the exercise protocols but recorded a lower relaxation pressure during isometric exercise and a lower rest pressure following 20 min of concentric exercise. Negative relaxation pressures were recorded by the fibre optic system for two subjects during continuous concentric exercise. It is hypothesized that a piston effect, due to the sliding of muscle fibres at the catheter tip following a contraction, rendered falsely low pressures during relaxation and that this artefact was reflected in the subsequent rest pressure following exercise. The larger volume (157 mm3) and area (3.49 mm2) of the fibre optic catheter in the muscle made it more prone to this effect than the conventional catheter (39 mm3 and 0.87 mm2, respectively). The fibre optic system may be preferred when recording the muscle contraction pressures during complex limb movements but should not be used when assessing the relaxation pressures or the pressure at rest following exercise.

Adult↗

PubMedDate not supplied

[Patellar fracture after reconstruction of the anterior cruciate ligament--case report].

INTRODUCTION: The most frequent procedure in treatment of acute or chronic anterior cruciate ligament (ACL) rupture is the so called bone-tendon-bone reconstruction. A transverse dislocated patella fracture is a rare complication of this procedure with an incidence of 0.23%-2.3%. In a five year period, (1998-2002), 407 arthroscopic reconstructions of the anterior cruciate ligaments were done at our Clinic, and there was only one case of patella fracture. CASE REPORT: An 18-year-old female patient, a handball player, suffered an acute rupture of anterior cruciate ligament of the left knee, so arthroscopic bone-tendon-bone reconstruction of the anterior cruciate ligament was performed. After adequate skin incision, a bone graft was taken from the patella and upper part of trapezoid tibia, which was 25 mm long, 10 mm wide and 5 mm thick, together with a part of patellar ligament. After the remains of the anterior cruciate ligament had been arthroscopically removed, tunnels were made in tibia and femur and a graft was inserted and fixed with two metal interference screws. Knee stability was tested, and drainage was put in the knee joint. The wound was closed by layers. The quadriceps exercises and passive knee movements started immediately. Full range of movements was accomplished six weeks later when the patient started to walk with full weight-bearing on her operated leg. Three weeks later, (nine weeks after the operation), the patient has accidentally lost her balance and fell. A transverse, dislocated fracture of the left patella was diagnosed and osteosynthesis of the fractured patella with two Kirschner wires and a metallic loop was performed. Postoperatively, full range of movement was allowed. Six months later, the patient felt no pain, there was no swelling, full range of knee movement was achieved, while the Lachman Test was identical in both knees and the pivot shift test was negative. DISCUSSION: Fracture of patella after ACL reconstruction is due to several reasons: size and shape of the graft, technique of its taking, disturbed patellar blood supply, incomplete filling of patella defect after graft taking, and inappropriate postoperative rehabilitation. If a patellar fracture occurs after anterior cruciate ligament reconstruction, the best treatment is firm osteosynthesis, which enables bone healing and immediate continuation of the previously resumed rehabilitation program. However, this complication prolongs the rehabilitation period and slows down return to sports.

Adolescent↗

PubMed1986

[Electrical activity of the brain of children with cerebral palsy and the formation of motor skills using methods of functional bioregulation].

The authors consider the results of a quantitative and qualitative analysis of the bioelectrical brain activity in 175 children aged 5 to 14 years with motor disturbances due to various causes who received a rehabilitative treatment in a specialized child sanatorium. In addition to the traditional methods the authors employed some functional bioregulation techniques. A clinico-physiological analysis was conducted with the help of original evaluation scales. The use of the proposed method for the assessment of clinical efficacy and the employment of mathematical processing of EEG showed a high efficiency of techniques of the purposeful correction of motor disorders and contributed to a better understanding of the mechanisms of readjustments occurring in the CNS in the process of the formation of new motor skills. It was found that alpha-rhythm played the main role in the development of new motor skills.

Action Potentials↗

PubMedDate not supplied

Pre- and posttreatment analysis of clinical symptoms of patients with temporomandibular disorders.

OBJECTIVE: This study treated patients with temporomandibular disc displacement with reduction (with pain, limited mandibular movement, and clicking sound symptoms) using a combination of analgesics, injection, mandibular exercise, and occlusal splints. METHOD AND MATERIALS: Twenty-five patients with temporomandibular joint (TMJ) disorders were evaluated for pretreatment complaints and clinical findings, such as TMJ sounds, mandibular deviation, limited mouth opening, and bilateral magnetic resonance imaging results. Diagnostic treatment was then planned; all patients received occlusal splints, and 10 patients received injections. RESULTS: Evaluations were conducted 1 year after the initial diagnosis and treatment. Complaints (especially of pain) by the patients who received injections had reduced significantly. After 6 months of occlusal splinting, clinical findings of patients with TMJ disc displacement had greatly improved. To manage parafunctional habits of the patients, night plate usage was continued. Therefore, clinical symptom reduction was maintained. CONCLUSION: The use of mandibular manipulation technique can decrease the anterior disc displacement of the TMJ.

Adolescent↗

PubMed1985

[Reconstruction of the neck outline after burns using microsurgical technics].

Cervical burn contractures require early correction because of aesthetic, mechanical and functional reasons. Respiration may be impaired and intubation prove difficult due to contractures. If correction of the contracture is not possible with conventional techniques, then free flaps may be used for neck reconstruction. In this series seven patients had two radial arm flaps, two had latissimus dorsi myocutaneous flaps, one had a latissimus dorsi muscle flap, one a dorsalis pedis flap, and one had a groin flap. Six out of seven free flaps healed without any complications. In one case, using a free groin flap a superficial necrosis was excised and skin grafted. In all cases unrestricted movement of the neck was achieved after physiotherapy. By contouring the flaps a good cosmetic result was achieved.

Adolescent↗

PubMed2006

Muscle activation profiles about the knee during Tai-Chi stepping movement compared to the normal gait step.

The purpose of this study was to investigate knee muscle activity patterns in experienced Tai-Chi (TC) practitioners during normal walking and TC stepping. The electromyographic (EMG) activity of vastus lateralis (VL), vastus medialis (VM), bicep femoris (BF), and gastrocnemius (GS) muscles of 11 subjects (five females and six males) during the stance phase of normal walking was compared to stance phase of a TC step. Knee joint motion was also monitored by using an Optotrak motion analysis system. Raw EMG was processed by root-mean-square (RMS) technique using a time constant of 50 ms, and normalized to maximum of voluntary contraction for each muscle, referred to as normalized RMS (nRMS). Peak nRMS and co-contraction (quantified by co-contraction index) during stance phase of a gait cycle and a TC step were calculated. Paired t-tests were used to compare the difference for each muscle group peak and co-contraction pair between the tasks. The results showed that only peak values of nRMS in quadriceps and co-contraction were significantly greater in TC stepping compared to normal walking (Peak values of nRMS for VL were 26.93% for normal walking and 52.14% for TC step, p=0.001; VM are 29.12% for normal walking and 51.93% for TC stepping, p=0.028). Mean co-contraction index for VL-BF muscle pairs was 13.24+/-11.02% during TC stepping and 9.47+/-7.77% in stance phase of normal walking (p=0.023). There was no significant difference in peak values of nRMS in the other two muscles during TC stepping compared to normal walking. Preliminary EMG profiles in this study demonstrated that experienced TC practitioners used relatively higher levels of knee muscle activation patterns with greater co-contraction during TC exercise compared to normal walking.

Electromyography↗

PubMed1981

Closed intramedullary nailing of femoral shaft fractures. A review of one hundred and twelve cases treated by the Küntscher technique.

Since May 1972, the standard treatment of femoral shaft fractures at the Western General Hospital has been the closed femoral nailing technique of Küntscher. We have found that the use of intraoperative skeletal traction eliminates the need for immediate operation, preoperative skeletal traction, or the use of a distraction apparatus to prevent preoperative shortening. By the use of a cross-pinning technique, the closed femoral nailing method has been extended to include severely comminuted fractures of the femoral shaft and fractures of the distal third of the femur, with effective control of shortening and rotatory deformity. This allows early mobilization and discharge from the hospital for patients with these difficult fractures. One hundred and twelve consecutive traumatic fractures of the femoral shaft treated in this manner united within three to six months. The clinical results in terms of early joint movement, early weight-bearing, and rapid discharge from the hospital have been excellent.

Bone Nails↗

PubMed1998

[Effect of loading suit "Penguin" on human metabolism during movements].

Additional energy expenses due to stretching of the elastic elements of anti-loading suit (ALS) "Penguin" as a whole (shoulders-feet) or only its lower part (waist-feet) in the course of cyclic leg movements were measured in five female and five male volunteers. ALS design enabled tensometric monitoring of efforts applied to specific elastic elements, and total efforts applied to the shoulder or pelvic girdles separately. Energy spend were determined with the indirect calorimetric techniques from the data of the expired air analysis. Registered were electromyograms of m. longus spinae, femoral extensor (m. biceps femoris) and femoral flexor (m. rectus femoris), and m. gastrocnemius. On the first stage, bicycle ergometer was pedaled w/o loading with a frequency of 60 cycles/min. The next stage included testing by incremental loading in which pedaling ceased at the pulse rate of 150/min. Results of the experiments that did not require stretching elastic parts of the suit and in which the total strain effort made up 20 to 25 kg and 15 to 16 kg by males and females, respectively, were compared. It was ascertained that ALS enhanced metabolism during motion by 20 to 30%; however, there was no significant difference in energy expenses when loaded by the whole suit or only its lower part.

Adaptation, Physiological↗

PubMed1997

Estimation of body composition in competitive swimmers by means of three different techniques.

Up to now controversial reports have been published in regard to the beneficial effects of swimming, a non-weight-bearing activity, on bone mass (BM). Therefore, the aim of this study was to investigate the effects of competitive swimming practice on the bone mineral density (BMD) and bone mineral content (BMC) as well as on the different factors of body composition. For this purpose, competitive swimmers (16 males and 16 females) were selected as subjects in order to investigate the influence of swimming on the three main factors of body composition (BMC, lean body mass [LBM] and body fat [BF]) of the human body. The latter were estimated using three different approaches: the skinfold, the dual energy x-ray absorptiometry (DEXA) and the whole body potassium (K-40) methods. Since BM and LBM are also related, the possible correlations between shoulder strength (extensions and flexion movements) and performance with BMD, BMC, LBM and BF were also investigated. Our results showed that BMD was not affected by swimming exercise since z (%) values were similar between swimmers and their respective age-matched controls. Swimmers also showed lower BF and increased LBM in the region of upper extremities (arms and trunk) as compared to their lower extremities (legs), a finding which is typical for the sport they are trained for. Also, comparison between sexes showed that males had a more central distribution of fat when compared to females, in which BF was built up in the region of legs. Furthermore, shoulder strength and performance were significantly related (p < 0.05) to age, BMC, and LBM while performance was also significantly related (p < 0.05) to all the other BM indices. So, mineralization of the bone is important for shoulder muscular strength which is subsequently related to performance. We used the DEXA because it enabled the direct estimation of the three factors of body composition (BM, BF and LBM).

Absorptiometry, Photon↗

PubMed1998

A mathematical high bar-human body model for analysing and interpreting mechanical-energetic processes on the high bar.

The aims of this study were: 1. To study the transfer of energy between the high bar and the gymnast. 2. To develop criteria from the utilisation of high bar elasticity and the utilisation of muscle capacity to assess the effectiveness of a movement solution. 3. To study the influence of varying segment movement upon release parameters. For these purposes a model of the human body attached to the high bar (high bar-human body model) was developed. The human body was modelled using a 15-segment body system. The joint-beam element method (superelement) was employed for modelling the high bar. A superelement consists of four rigid segments connected by joints (two Cardan joints and one rotational-translational joint) and springs (seven rotation springs and one tension-compression spring). The high bar was modelled using three superelements. The input data required for the high bar human body model were collected with video-kinematographic (50 Hz) and dynamometric (500 Hz) techniques. Masses and moments of inertia of the 15 segments were calculated using the data from the Zatsiorsky et al. (1984) model. There are two major phases characteristic of the giant swing prior to dismounts from the high bar. In the first phase the gymnast attempts to supply energy to the high bar-humanbody system through muscle activity and to store this energy in the high bar. The difference between the energy transferred to the high bar and the reduction in the total energy of the body could be adopted as a criterion for the utilisation of high bar elasticity. The energy previously transferred into the high bar is returned to the body during the second phase. An advantageous increase in total body energy at the end of the exercise could only be obtained through muscle energy supply. An index characterising the utilisation of muscle capacity was developed out of the difference between the increase in total body energy and the energy returned from the high bar. A delayed and initially slow but even reduction of hip and shoulder angles provided more advantageous release conditions. The total body energy could be improved by up to 15%, the vertical CM release velocity by up to 10% and the angular momentum by up to 35%.

Algorithms↗

PubMed2002

Air pollution modeling: a tool for management of regional air quality.

Ambient air composition over the earth has undergone several changes. Anthropogenic pollutants generated locally often have regional air quality affected significantly. In addition to the short-term episodic effects, atmospheric pollutants are known to generate long-term adverse effects, which are difficult to forecast statistically. The air pollution dispersion modeling exercise forecasts fairly accurate air quality for a given emission scenario, incorporating geographical and meteorological conditions. Industrial Source Complex Dispersion Model is used to forecast ground level concentrations (GLC) of an industrial region as case study. The usefulness of mathematical modeling and computational simulation techniques used to predict the horizontal and vertical pollutant concentrations of pollutants are explained in this paper. Finally a case study of an industrial area in Gujarat region is presented to arrive at setting up of air quality monitoring station for monitoring/management of regional air quality.

Air Movements↗