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At least 433 records · Page 24Linked to original sources

PubMed1987

Exercise treatment for paroxysmal positional vertigo: comparison of two types of exercises.

The use of exercises can be an excellent method for treating benign paroxysmal positional vertigo (BPPV). We compared the results obtained by a progressive training method, vestibular habituation training (VHT), with a brisk exercise method. While VHT can be applied in all kinds of "provoked" (positional) vertigo of peripheral origin, the brisk method can be used only in typical BPPV, provided the vertigo is unilaterally provoked. A series of patients with such typical "unilateral" cases were treated by the brisk method and were compared with a second series of identical cases treated by the VHT technique. The results after 1 week seemed to be different: with the brisk method 52% of the patients were free of vertigo, while only 32% with VHT were vertigo free. This difference is not statistically significant. However, those cases treated by VHT and still having vertigo after 1 week had a striking reduction in the severity of their vertigo, as estimated by the score-system used. In contrast, the scores were unchanged for those cases not responding to the brisk method. Continuation of treatment of these latter cases using VHT exercises showed that the final result after 6 weeks was equal for both groups.

Exercise Therapy↗

PubMed1996

Passive care and active rehabilitation in a patient with failed back surgery syndrome.

OBJECTIVE: To describe the results of chiropractic care combined with rehabilitative exercise protocol for a 41-yr-old male patient suffering from failed back surgery syndrome. CLINICAL FEATURES: A 41-yr-old man, who herniated his L4-L5 disc 4 yr before presentation and had undergone two surgeries to relieve his symptoms, sought chiropractic care for complaints of chronic, severe low back pain and leg pain with sensorimotor deficits. INTERVENTION AND OUTCOME: A 16-wk treatment protocol coupled passive chiropractic care (including adjustment, electric stimulation, stretching, massage and moist hot packs), with active rehabilitative exercise (including pelvic stabilization, muscle strengthening, proprioceptive training and movement training). Outcome measures included weekly assessment of the patient's active thoracolumbar flexion and extension by a goniometer. The Low Back Pain and Disability Questionnaire (Revised Oswestry) and visual analogue pain scale were administered weekly. In addition, daily activities such as ability to walk without a cane and hours of painfree sleep per night were noted each visit. After 16 wk of care, thoracolumbar ranges of motion were restored to normal, pain was reduced from "severe" to "moderate" and ability to perform daily activities was increased. The patient no longer required a cane to walk and was able to walk up to 7 miles without difficulty. Sleep increased from 5 to 7-9 hours per night. The patient halted use of pain medications, except for occasional days when he felt a significant increase in pain. CONCLUSION: A multifactorial treatment approach using passive care plus active rehabilitative exercises can be effective in the treatment of chronic low back pain associated with failed back surgery syndrome. Chiropractors who are trained in rehabilitation techniques will be well prepared to provide comprehensive care to such patients.

Adult↗

PubMed1991

Physical therapy program for vestibular rehabilitation.

Dizziness and balance disorders are among the most frustrating problems for many physicians to treat. Traditional interventions such as medication or surgical procedures offer limited improvement for many patients. Although generic habituation exercises have existed for years, the merits of vestibular rehabilitation are only beginning to be recognized. Current retrospective studies indicate that 85 percent of patients with chronic vestibular dysfunction gain at least partial relief of their symptoms after undergoing vestibular rehabilitation, with approximately 30 percent of patients being completely cured. This modality provides a valuable and rational complement to current established methods of treating the patient with dizziness. Many physicians and physical therapists may be unfamiliar with these new techniques and require clarification of the actual therapeutic approaches in use. This article describes the current evaluation and treatment approach utilized in the vestibular rehabilitation program at the University of Michigan Medical Center.

Adult↗

PubMed1990

Drop jumping as a training method for jumping ability.

Vertical jumping ability is of importance for good performance in sports such as basketball and volleyball. Coaches are in need of exercises that consume only little time and still help to improve their players' jumping ability, without involving a high risk of injury. Drop jumping is assumed to satisfy these requirements. This assumption is supported by a review of results of training studies. However, it appears that regular jumping exercises can be just as helpful. The same holds for exercises with weights, provided the subjects have no weight-training history. In fact, for unskilled jumpers who have no weight-training history, the effects of training programmes utilising these different exercises are additive. The most effective, efficient and safe way for a coach to improve the jumping achievement of his athletes may well be to submit them first to a training programme utilising regular jumps, then to a weight-training programme and finally to a drop jump training programme. In drop jump training programmes themselves, the improvement in jumping height varies greatly among studies. This variation cannot be explained satisfactorily with the information available on subjects and training programmes. Given the current state of knowledge, coaches seem to have no other option than to strictly copy a programme which has proved to be very effective. Obviously there is a need for more systematic research of the relationship between design and effect of drop jump training programmes. The most important variable to be controlled is drop jumping technique. From a review of biomechanical studies of drop jumping, it becomes clear that jumping technique strongly affects the mechanical output of muscles. The biomechanics of 2 techniques are discussed. In the bounce drop jump the downward movement after the drop is reversed as soon as possible into an upward push-off, while in the countermovement drop jump this is done more gradually by increasing the amplitude of the downward movement after landing. It is speculated that the bounce drop jump might trigger improvement of the power output capacity of muscles, whereas the repetition of the countermovement drop jump may help to improve coordination. Future training studies are needed to determine whether drop jumping technique really affects the outcome of the training, and if so, which technique should be preferred. Also, further biomechanical research is needed to determine kinematics and kinetics of other drop jumping techniques, and to trace potential dangers. The author urges for a close cooperation between coaches and scientists in future research.

Athletic Injuries↗

PubMed2003

Prolonged exercise induces angiogenesis and increases cerebral blood volume in primary motor cortex of the rat.

Plastic changes in motor cortex capillary structure and function were examined in three separate experiments in adult rats following prolonged exercise. The first two experiments employed T-two-star (T(2)*)-weighted and flow-alternating inversion recovery (FAIR) functional magnetic resonance imaging to assess chronic changes in blood volume and flow as a result of exercise. The third experiment used an antibody against the CD61 integrin expressed on developing capillaries to determine if motor cortex capillaries undergo structural modifications. In experiment 1, T(2)*-weighted images of forelimb regions of motor cortex were obtained following 30 days of either repetitive activity on a running wheel or relative inactivity. The proton signal intensity was markedly reduced in the motor cortex of exercised animals compared with that of controls. This reduction was not attributable to alterations of vascular iron levels. These results are therefore most consistent with increased capillary perfusion or blood volume of forelimb regions of motor cortex. FAIR images acquired during experiment 2 under normocapnic and hypercapnic conditions indicated that resting cerebral blood flow was not altered under normal conditions but was elevated in response to high levels of CO(2), suggesting that prolonged exercise increases the size of a capillary reserve. Finally, the immunohistological data indicated that exercise induces robust growth of capillaries (angiogenesis) within 30 days from the onset of the exercise regimen. Analysis of other regions failed to find any changes in perfusion or capillary structure suggesting that this motor activity-induced plasticity may be specific to motor cortex.These data indicate that capillary growth occurs in motor areas of the cerebral cortex as a robust adaptation to prolonged motor activity. In addition to capillary growth, the vascular system also experiences heightened flow under conditions of activation. These changes are chronic and observable even in the anesthetized animal and are measurable using noninvasive techniques.

Aging↗

PubMed1982

Exercise-induced amplitude modification of physiological action tremor of the ankle.

To determine whether exercise would affect physiological action tremor (PAT), normal male and female subjects exercised either by running or lifting weights. Surface electromyograms and acceleration recordings were analyzed using power spectral techniques to quantitate variations in amplitude and/or frequency of PAT. The results of this study show that running causes an increase in the amplitude of PAT. By having subjects run successively longer distances, a graded increase in amplitude of PAT was observed. After the subjects ran for long periods of time, PAT continued as an overt continuous oscillation. This oscillation did not greatly differ from pathological clonus. Furthermore, exercising the upper body alone by lifting weights increased the amplitude of PAT of the ankle. The results suggest that the exercise may cause alterations in the gain of the spinal reflexes which may lead to an underdamping of PAT. As the gain of the reflexes controlling PAT increases, this may lead to overt continuous oscillations, such as physiological or pathological clonus.

Ankle↗

PubMed1999

[Myocardial perfusion scintigraphy with 99mTC-sestamibi and gated SPECT and myocardial perfusion scintigraphy with reinjection of 201Tl at 24 hours. Are the techniques comparable?].

AIM: To compare the results obtained with 99mTc-sestamibi and gated-SPECT (gated SPECT in stress and rest) with 201Tl (stress, redistribution, and 24 hour reinjection SPECT). METHODS: Twenty patients underwent two SPECT studies, one with 201Tl and the other with 99mTc-sestamibi. RESULTS: Using 201Tl as a reference, 177 segments were considered normal, 31 viable and 32 with myocardial necrosis. The overall concordance with 99mTc-sestamibi was 84.2%. In the subgroup of defects that improved after reinjection of 201Tl, it was much less (45%), even after wall thickness and movement (55%) were analyzed. CONCLUSION: The overall concordance between 201Tl scintigraphy compared to 99mTc-sestamibi is acceptable. Correlation is low in the viable segments with 99mTc-sestamibi, even after analyzing the Gated-SPECT.

Adult↗

PubMed2004

Biomechanical attributes of lunging activities for older adults.

The purpose of this study was to characterize the mechanical demands of the lower-extremity musculature during the standing forward lunge (FL) and the standing lateral lunge (LL) exercises performed by older adults. Twenty healthy older adults (9 men, 11 women, mean age 75.0 +/- 4.4 years) performed FL and LL while instrumented for biomechanical analysis. Lower-extremity net joint moments, powers, impulse, and mechanical energy expenditure were determined using standard inverse dynamics techniques. The FL preferentially targeted the hip extensors, producing a greater flexion angle (12.8%), peak joint moment (13.6%), joint power (56.5%), and mechanical energy expenditure (25.1%). Conversely, LL targeted the ankle plantar flexors, producing greater dorsiflexion angles (19.3%), joint moments (40.9%), impulse (87.0%), and mechanical energy expenditure (61.1%). Kinetic differences at the knee were less consistent. Fitness professionals may use this information to better match the biomechanical attributes of FL and LL activities with the needs of the trainee.

Aged↗

PubMed1993

Postexercise depression of motor evoked potentials: a measure of central nervous system fatigue.

Fatigue of voluntary muscular effort is a complex and multifaceted phenomenon. Fatigue of peripheral nervous system components, including the contractile apparatus and the neuromuscular junction, has been well studied. Central nervous system components also fatigue, but studies have lagged for want of objective methods. Transcranial magnetic stimulation is a relatively new technique that can be used to assess central nervous system excitability from the motor cortex to the alpha-motoneuron. In six normal volunteers, including four of the investigators, the amplitudes of motor evoked potentials elicited by transcranial magnetic stimulation were transiently decreased after exercise, indicating fatigue of motor pathways in the central nervous system. The decrease in amplitude was associated with a feeling of fatigue. The mechanism of this phenomenon is apparently decreased efficiency in the generation of the motor command in the motor cortex.

Central Nervous System↗

PubMed2003

Electromyographic biofeedback in the treatment of the hemiplegic hand: a placebo-controlled study.

OBJECTIVE: To evaluate the efficacy of electromyographic (EMG) biofeedback treatment in the functional recovery of the hemiplegic hand. DESIGN: A total of 27 patients were randomly assigned to EMG biofeedback or placebo EMG biofeedback groups. Both treatments were applied five times a week for a period of 20 days. In addition, the patients in both groups received an exercise program according to the Brunnstrom's neurophysiologic approach. Goniometric measurements for wrist extension, scale for judging the performance of drinking from a glass, Brunnstrom's stages of recovery for hand, and surface EMG potentials were used for the clinical assessments. All patients were assessed before treatment and after 20 treatment sessions. RESULTS: The results showed that there were statistically significant improvements in all variables in both groups, but the improvements in active range of motion and surface EMG potentials were significantly greater in the EMG biofeedback group at the end of the treatment. CONCLUSION: Our study demonstrates the potential benefits of EMG biofeedback in conjunction with neurophysiologic rehabilitation technique to maximize the hand function in hemiplegic patients.

Adult↗

PubMed1976

Measurement of cardiac output by electrical impedance at rest and during exercise.

A comparison was made between cardiac output values determined by the dye dilution and electrical impedance methods in ten subjects at rest and during graded exercise on a bicycle ergometer. The cardiac output values determined by the two methods were linearly related and significantly (P less than 0.001) correlated (r = 0.90). Movement artifact associated with exercise at maximum or near-maximum work loads caused severe distortion of the dZ/dt wave form and prevented calculation of impedance cardiac output at these levels of work. Use of the lowest value of L (distance between mean value of L in the impedance stroke volume equation (SV = p(L2/ZO2) (dZ/dt)mt), resulted in nearly identical values for the least-squares line and equalvalue line of impedance and dye cardiac outputs. Although absolute values of cardiac output determined by the two methods were not identical in all subjects the changes in cardiac output were nearly identical during the different levels of exercise. The data support the validity of the impedance method as a noninvasive, atraumatic measure of cardiac output at rest and during graded exercise.

Adult↗

PubMed2006

Epicondylar injury in sport: epidemiology, type, mechanisms, assessment, management and prevention.

Epicondylar injuries in sports with overhead or repetitive arm actions are frequent and often severe. Acute injury that results in inflammation should be termed epicondylitis and is usually the result of large valgus forces with medial distraction and lateral compression. Epicondylosis develops over a longer period of time from repetitive forces and results in structural changes in the tendon. Epicondylalgia refers to elbow pain at either the medial or lateral epicondyl of the elbow related to tendinopathy of the common flexor or extensor tendon origins at these points. Pain is usually associated with gripping, resisted wrist extension and certain movements such as in tennis and golf, hence the common terms 'tennis elbow' (lateral epicondylsis) and 'golf elbow' (medial epicondylossi). A variety of assessment and diagnostic tools are available to aid the clinician in their comprehensive evaluation of the patient to ensure correct diagnosis and the appropriate conservative or surgical management strategy. Corticosteroids and elbow straps are often used for treatment; however, there is only very limited prospective clinical or experimental evidence for their effectiveness. The most effective modalities of treatment are probably rest (the absence of painful activity) combined with cryotherapy in the acute stage then NSAIDs and heat in its various modalities including ultrasound. Cortisone injections may be used to create a pain-free window of opportunity to optimise the athletes' rehabilitation exercises. Medical practitioners should have a good understanding of the mechanisms of injury in order to help treat and prevent the re-occurrence of injuries. More emphasis by medical and sport science personnel working with coaches and athletes needs to be placed on prevention of elbow injury in sport through improved joint strength, biomechanically sound sport technique and use of appropriate sport equipment.

Humans↗

PubMed1977

Thyroid radiation dose during panoramic and cephalometric dental x-ray examinations.

Radiation exposure from panoramic equipment can be reduced significantly by use of smaller film, adjustment of the beam height to the height of the smaller film, and careful positioning of patients. These techniques have no adverse effect on the quality of the diagnostic information needed in dentistry. In addition to describing methods of reducing exposures from panoramic machines, this study demonstrates that the use of a barrier collar during static, cephalometric examinations can appreciably reduce thyroid exposure. Since the objective is to obtain diagnostic information from the film without irradiating the thyroid, the application of a lead-impregnated collar is a minor inconvenience, easily borne by the patient and operator. It should be noted that the use of the collar during panoramic examinations affords little or no protection since the relative motion of the panoramic machine places the axis of movement inside the head and neck of the patient. While the evolution of diagnostic radiology may have reached a high level of technical refinement of equipment and film the clinician still must avoid unnecessary exposure for X-ray examinations and must carefully select the best type of examination to be used for each patient. For example, a complete panoramic examination to determine the position of a known unerupted third molar tooth is probably not an exercise of good judgment since other examinations, such as periapical, could yield the same information with less exposure. Decisions must be made with good judgment, value being placed on relative risks versus the benefits of diagnostic yield.

Adolescent↗

PubMed1999

Constraint-Induced Movement Therapy: a new family of techniques with broad application to physical rehabilitation--a clinical review.

A new family of rehabilitation techniques, termed Constraint-Induced Movement Therapy or CI Therapy, has been developed that controlled experiments have shown is effective in producing large improvements in limb use in the real-world environment after cerebrovascular accident (CVA). The signature therapy involves constraining movements of the less-affected arm with a sling for 90% of waking hours for 2 weeks, while intensively training use of the more-affected arm. The common therapeutic factor in all CI Therapy techniques would appear to be inducing concentrated, repetitive practice of use of the more-affected limb. A number of neuroimaging and transcranial magnetic stimulation studies have shown that the massed practice of CI Therapy produces a massive use-dependent cortical reorganization that increases the area of cortex involved in the innervation of movement of the more-affected limb. The CI Therapy approach has been used successfully to date for the upper limb of patients with chronic and subacute CVA and patients with chronic traumatic brain injury and for the lower limb of patients with CVA, incomplete spinal cord injury, and fractured hip. The approach has recently been extended to focal hand dystonia of musicians and possibly phantom limb pain.

Activities of Daily Living↗

PubMed1979

Ipsilateral and contralateral effects of proprioceptive neuromuscular facilitation techniques on hip motion and electromyographic activity.

The effects of two proprioceptive neuromuscular facilitation techniques on increasing the range of hip flexion during active straight leg raising were compared in 30 normal women. Subjects were randomly assigned into contract-relax, hold-relax, or control groups and were tested with the pelvis stabilized. An exercise technique was applied to the right lower extremity in two diagonal patterns while electrical activity was monitored from the contralateral rectus femoris, vastus medialis, semimembranosus, and biceps femoris muscles. Comparison of pretest and posttest measurements of the angle of straight leg raising of both lower extremities indicated that the increase in range of motion of the right lower extremity in subjects in the contract-relax group was significantly greater than that in the hold-relax and control groups. For the unexercised extremity, the increase in motion in subjects in the contract-relax group was significantly greater than that in the control group. Of the 30 subjects, 29 showed evidence of electrical activity in the contralateral limb when the right lower extremity was contracting against resistance.

Adult↗

PubMed1986

Negative vergence training in humans.

Two healthy subjects (male and female, ages 22 and 25 years) spent 50 h over a period of 7 consecutive weeks training the negative vergence system. The training was performed in two 45-min daily sessions, usually immediately before and after the workday. The training was exclusively negative vergence training using devices such as variable vectograms, the aperture rule, the synoptophore, and loose or bar prisms. An extensive examination of the visual systems before, after, and periodically during the training demonstrated that the negative vergences increased at distance by 5.0 delta and at near by 9.1 delta (using hand-held prisms, bar prisms, and the synoptophore). The phorias of both subjects became more exophoric or less esophoric at both distance and near by 3.6 delta (using average of changes on the cover test, von Graefe subjective phoria technique, and the synoptophore). A haploscope equipped with a coincidence optometer showed only small increases in vergence amplitude but confirmed that the lag of accommodation became more stable after the training than it was before. Other testing suggested that the negative relative accommodation, the angle of deviation at both distance and near, positive vergences, the associated phoria, and the slope of the fixation disparity curve changed significantly over the period of training. I conclude that negative vergence training can increase the negative vergence capabilities and also affect the phoria position of the eyes via feed-back into the slow vergence system.

Accommodation, Ocular↗

PubMed2006

A clinical study on ankylosis of the temporomandibular joint.

INTRODUCTION: Restoration of normal function and jaw movement in patients with temporomandibular joint (TMJ) ankylosis is difficult. Various techniques have been defined for the treatment of the condition. PATIENTS: This study is based on the pre-, intra- and post-operative evaluation of 78 TMJ operations in 59 patients who were treated for TMJ ankylosis between 1985 and 2002. METHODS: The patients in this study were evaluated with regard to age, gender, aetiology of ankylosis, ankylosis type/classification, existing facial asymmetry, maximal pre- and post-operative mouth opening, the arthroplasty methods (gap and interpositional arthroplasty) including complications and recurrence of ankylosis. RESULTS: Falls represented the most widespread aetiological factor (85%), and women constituted the group with the highest incidence of ankylosis (61%). Forty cases were unilateral (68%) and 19 bilateral (32%); 82% (64 joints) were of the bony type. Gap arthroplasty was applied in 34 of the 59 cases (58%) and interpositional arthroplasty in the remaining 25 (42%). Pre- and post-operative mean mouth opening were 3.5+/-1.7 and 30.7+/-3.0mm, respectively. Re-ankylosis was noted in 5%. CONCLUSION: In addition to radical and sufficient resection of the ankylosed bone, early post-operative exercises, appropriate physiotherapy and close follow-up of the patient play an important role in the prevention of post-operative adhesions and re-ankylosis.

Adolescent↗

PubMed1979

[Intensive care in chest trauma (author's transl)].

A statistical analysis of the case material at the Intensive Care Unit, Freiburg, for the years 1975 and 1976 established that 40% and 39% respectively of patients with multiple injuries had also suffered a chest trauma and that the latter was the direct cause of respiratory insufficiency in 61% (1975) and 57% (1976) of patients in need of controlled respiration, i.e. respiratory insufficiency dominated the clinical and pathophysiological picture. The causes were: restricted respiratory movements due to pain, compression of the lungs or pathological changes in the injured lung, and they affected the normal gaseous exchange in a variety of ways. Alveolar hypoventilation with disturbance of ventilation-perfusion, increase in the functional shunt volume, rise in the functional dead space combined with reduced functional residual capacity and compliance result, if left uncorrected, in a drastic increase of resistance on the part of the pulmonary vessels and finally in, often fatal, hyoxaemia and hypercapnia. Regular estimations of the arterial blood gases in air and pure oxygen, of the arterio-alveolar difference in oxygen pressure, shunt volume, dead space and effective compliance of the chest wall and lungs are, therefore, essential. Treatment in an intensive care unit comprises the relief of any acute condition, such as tension pneumothorax, haemothorax, and general measures. Means to relieve pain in patients whose chest injuries are not sufficiently severe to require artificial ventilation are: intercostal blocking, acupuncture or peridural analgesia; efficient breathing exercises are important. The indications for artificial ventilation should be interpreted generously and the decision to perform it should be made at an early stage. The technique is determined by the type of pathological changes in the gaseous exchange and should aim at restoring normal conditions as far as possible.

Blood Gas Analysis↗