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Results for “Physical Functional Performance”

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At least 649 records · Page 36Linked to original sources

PubMed2001

The efficacy of home based progressive strength training in older adults with knee osteoarthritis: a randomized controlled trial.

OBJECTIVE: To test the effects of a high intensity home-based progressive strength training program on the clinical signs and symptoms of osteoarthritis (OA) of the knee. METHODS: Forty-six community dwelling patients, aged 55 years or older with knee pain and radiographic evidence of knee OA, were randomized to a 4 month home based progressive strength training program or a nutrition education program (attention control). Thirty-eight patients completed the trial with an adherence of 84% to the intervention and 65% to the attention control. The primary outcome was the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) index pain and physical function subscales. Secondary outcomes included clinical knee examination, muscle strength, physical performance measures, and questionnaires to measure quality of life variables. RESULTS: Patients in the strength training group who completed the trial had a 71% improvement in knee extension strength in the leg reported as most painful versus a 3% improvement in the control group (p < 0.01). In a modified intent to treat analysis, self-reported pain improved by 36% and physical function by 38% in the strength training group versus 11 and 21%, respectively, in the control group (p = 0.01 for between group comparison). In addition, those patients in the strength training group who completed the trial had a 43% mean reduction in pain (p = 0.01 vs controls), a 44% mean improvement in self-reported physical function (p < 0.01 vs controls), and improvements in physical performance, quality of life, and self-efficacy when compared to the control group. CONCLUSION: High intensity, home based strength training can produce substantial improvements in strength, pain, physical function and quality of life in patients with knee OA.

Aged↗

PubMedDate not supplied

Review of scheduled performance assurance inspections.

The frequency of inspection of the authors' scheduled maintenance program was reviewed and modified, using the work of Fennigkoh (1989). This work extended to 2,700 devices located at four hospital sites supported by a regional service. These devices included all clinical equipment, including diagnostic imaging and renal dialysis. Review of the inspection frequencies was necessary as part of the quality assurance program and to ensure consistency between similar devices. Equipment was first evaluated according to four criteria to determine if it should be on the scheduled performance assurance program. These criteria included: equipment function, physical risk to patients, maintenance requirements, and incident or related history. The frequency of inspection of included devices was then assessed according to an algorithm that looked at device maintenance requirements and manufacturers' recommendations. Devices were scheduled for inspection once, twice or, in rare cases, four times per year. The quality of the inspection program was enhanced by a systematic review. As an added bonus, the required staffing resources to comply with the scheduled performance assurance declined by 29%.

Biomedical Engineering↗

PubMed2004

Optimizing physical energy functions for protein folding.

We optimize a physical energy function for proteins with the use of the available structural database and perform three benchmark tests of the performance: (1) recognition of native structures in the background of predefined decoy sets of Levitt, (2) de novo structure prediction using fragment assembly sampling, and (3) molecular dynamics simulations. The energy parameter optimization is based on the energy landscape theory and uses a Monte Carlo search to find a set of parameters that seeks the largest ratio deltaE(s)/DeltaE for all proteins in a training set simultaneously. Here, deltaE(s) is the stability gap between the native and the average in the denatured states and DeltaE is the energy fluctuation among these states. Some of the energy parameters optimized are found to show significant correlation with experimentally observed quantities: (1) In the recognition test, the optimized function assigns the lowest energy to either the native or a near-native structure among many decoy structures for all the proteins studied. (2) Structure prediction with the fragment assembly sampling gives structure models with root mean square deviation less than 6 A in one of the top five cluster centers for five of six proteins studied. (3) Structure prediction using molecular dynamics simulation gives poorer performance, implying the importance of having a more precise description of local structures. The physical energy function solely inferred from a structural database neither utilizes sequence information from the family of the target nor the outcome of the secondary structure prediction but can produce the correct native fold for many small proteins.

Algorithms↗

PubMed1994

Characteristics of low back pain patients who do not complete physiotherapeutic treatment.

Patients' problems in following recommendations of health professionals is an issue of great concern. The purpose of the present study was to investigate whether patients with low back pain (n = 46) who dropped out of a treatment programme differed in characteristics measured prior to treatment from a matched comparison group (n = 46) who completed the programme. Data collected on work disability and sick leave, frequency, duration and intensity of pain, physical function, and personality characteristics were compared. The results indicated that the groups differed significantly on 3 of 16 variables. The non-completers had been on sick leave for a longer time period prior to treatment, experienced more intense pain and performed at a lower level on the test of physical function than those who completed the treatment programme.

Adult↗

PubMed2002

Measurement of facial muscle strength in normal subjects.

OBJECTIVES: Muscle strength is a fundamental measure of function for neuromuscular systems; however, mimetic facial muscle strength has never been recorded. The objective of the present feasibility project was to measure facial muscle strength. STUDY DESIGN: The study design was a prospective experimental trial in 10 normal subjects. Descriptive statistics, tests, and analysis of variance were used to summarize and compare data. METHODS: Subjects were selected by convenience following submission and approval of a prospectively designed protocol and consent form to the Human Studies Committee. Application of a force transducer to the central eyebrow and commissure during eyebrow raising, eyelid closing, smiling, and puckering was performed by two methods: surface adhesion method (n = 5) and direct probe application method (n = 5). Data were recorded in pounds. Three repetitions of each movement were made. RESULTS: Rank order of muscle strengths (in pounds) by the surface adhesion technique was as follows: brow, 0.758; eye, 0.549; pucker, 0.387; and smile, 0.307. By direct probe application the rank order of muscle strengths was as follows: eye, 0.880; brow, 0.773; and smile, 0.730. CONCLUSIONS: Objective measures of facial motion are crucial for quantitative investigations of preventative, therapeutic, reconstructive, and rehabilitative interventions for facial nerve and muscle lesions. Until the present, objective measures required cross-correlations with current standards that were subjective. This is the first time an actual physical measure of facial muscle function has been performed. The purpose of presenting this preliminary work is to stimulate advancement along this line of research.

Adult↗

PubMedDate not supplied

Influence of intensive physical training on urinary nitrate elimination and plasma endothelin-1 levels in patients with congestive heart failure.

BACKGROUND: Congestive heart failure (CHF) is associated with increased peripheral vascular resistance. Exercise-induced shear stress may release endothelial relaxing factors, such as nitric oxide (NO), and inhibit the production of vasoconstrictors such as endothelin-1 (ET-1) thereby modulating vascular tone. We examined the effect of intensive training on ET-1 plasma concentrations and NO-metabolite elimination in patients with CHF after acute myocardial infarction. METHODS: Seventeen patients with CHF after a myocardial infarction were randomized to an exercise group (n = 9), who performed physical training for 8 weeks, or a control group (n = 8) who received usual care. A physical examination, pulmonary function test, and a maximum exercise test were performed, and 24-hour urinary nitrate elimination and ET-1 in plasma were determined before and at the end of the study period. RESULTS: Maximal oxygen uptake remained unchanged in controls (17.9 +/- 1.4 to 18.1 +/- 1.5 mL/(kg min) but increased in the exercise group (from 20.4 +/- 0.75 to 26.7 +/- 1.4 mL/(kg min). After 8 weeks the urinary nitrate elimination in controls was significantly decreased (1.25 +/- 0.20 to 1.03 +/- 0.22 mmol/24 hours; P < 0.001), while it was unchanged in the exercise group (1.26 +/- 0.23 to 1.39 +/- 0.28; P = 0.71). Plasma ET-1 levels did not change after 8 weeks (7.87 +/- 0.62 versus 7.57 +/- 0.75 and 7.13 +/- 0.6 versus 7.35 +/- 0.7 pg/mL for control and exercise groups, respectively). CONCLUSION: In patients with CHF after acute myocardial infarction nitrate elimination decreases over the subsequent 2 months. This trend was reversed by training. Because nitrate elimination mirrors endogenous NO production, these results suggest that training may positively influence endothelial vasodilator function.

Endothelin-1↗

PubMedDate not supplied

Cardiorespiratory response to physical conditioning in children with bronchial asthma.

The relationship of physical conditioning to changes in static lung volumes (hyperinflation) and airway dynamics (bronchoconstriction) as well as to ventilatory gas exchange, heart rate reserve, breathing reserves, and working capacity at a heart rate of 170/min (WC 170) was evaluated in 23 children (16 girls, 7 boys) between 6 and 15 years of age who had perennial asthma. Lung function tests including incremental cycle ergooxymetry were performed before and after a 15-week period of regular physical training (RPT). Lung function data obtained after RPT showed a significant improvement (P less than 0.05) in both hyperinflation and specific airway conductance, whereas oxygen consumption only increased related to lean body mass and heart rate. However, WC 170 and work tolerance during the endurance phase of the exercise test were significantly increased (P less than 0.05 and less than 0.01, respectively). In view of the relationship that has recently been found between exercise tolerance and lung mechanics in adults, the decreased hyperinflation and bronchoconstriction observed in our population after RPT is striking. This finding was presumably a consequence of the effect of RPT on breathing technique and chest wall mechanics. Ventilation of the lungs may improve because of mobilization of the costovertebral articulations, inspiratory muscle relaxation, an optimized force-length relationship of the respiratory muscles, and closer linkage between the diaphragm and intercostal muscles. Therefore, RPT might be an effective addition to standard drug regimens in the management of childhood asthma.

Adolescent↗

PubMed2005

Differences among outcome measures in occupational low back pain.

The rate of recurrence in low back pain patients has been reported as high as 70%; therefore, it is believed that researchers have a poor understanding of low back pain recovery. To enhance our understanding of recovery, a large cross-sectional study was conducted to compare outcome measures of return to work, impairment of activities of daily living, pain symptoms, and functional performance probability. A total of 208 workers were examined. The percentage of workers recovered based on return to work criteria was 99% compared to 25% for impairment of activities of daily living, 17% for symptoms, and 12.5% for functional performance probability. Single functional performance measures of range of motion, velocity, and acceleration had recovery rates of 59, 13, and 10%, respectively. It appears that all these criteria are measuring very different parameters of low back pain recovery. The residual loss in functional performance may indicate a decreased tolerance to physical demand providing potential insight for why recurrent low back pain rates are high.

Activities of Daily Living↗

PubMed1983

Effect of compatibility on goal achievement in patient-physical therapist dyads.

The purpose of this study was to test two hypotheses related to the effect of interpersonal compatibility in patient-physical therapist dyads on goal achievement in a rehabilitation setting. Seventeen patients with spinal cord injuries and the physical therapists primarily responsible for their treatment were asked to participate. The Fundamental Interpersonal Relations Orientation Behavior scale, which includes three interpersonal dimensions--Inclusion, Control, and Affection--was used to assess patient-physical therapist compatibility. Patient performance on four quantitatively measurable functional goals was used as the dependent variable. The results of this study did not support the hypothesis that goal achievement would be greater for patients in compatible patient-physical therapist dyads. Further, compatibility in the dimension of affection was found to be strongly related to a lack of rehabilitation goal achievement.

Achievement↗

PubMed1996

Prognostic factors for functional outcome of total knee replacement: a prospective study.

BACKGROUND: The objective was to investigate whether baseline physical functioning, medical, psychosocial, or demographic variables predict functional outcome in patients undergoing total knee replacement. METHODS: A prospective cohort study was performed between December 1991 and August 1993. Consecutive, unilateral tricompartmental total knee replacement patients aged > or = 55 yr with osteoarthritis, who met criteria, were enrolled and evaluated one month before and 3 months after total knee replacement. The primary outcome measure was the Medical Outcome Study 36 Item Short Form Health Survey (known as the SF36) Physical Functioning Scale score. The outcome evaluator was not involved in patient care. RESULTS: A hierarchical multiple regression analysis was performed to calculate the contribution of baseline variables to TKR outcome. Of the 27% of outcome variance explained by the model, demographic variables accounted for 4%, psychosocial variables (motivation, role functioning-emotional, and social functioning) for 19% (p = .013), medical variables (previous reconstruction, comorbidity, body mass index, bodily pain) for 2%, and baseline physical function for 2%. CONCLUSIONS: Psychosocial variables are significantly related to total knee replacement functional outcome. Assessment of baseline psychological and social functioning may identify a subset of patients at risk for worse outcome. Specific interventions for these patients should be developed and evaluated as components of patient management prior to and after the procedure.

Activities of Daily Living↗

PubMed1995

Neurological dysfunction above cele level in children with spina bifida cystica: a prospective study to three years.

The aim of this study was to characterize the neurological dysfunction above the cele level in children with spina bifida cystica. 22 neonates were investigated prospectively to a median age of three years. Before primary closure of the spinal malformation and at three and 18 months of age, MRI and inspection of vocal cord function were performed. The children were also assessed by a physical therapist at 12 and 24 months, 19 children had a Chiari malformation, 18 children developed neurological dysfunction above the cele level. Children with signs of isolated motor impairment stabilized or improved during the second year. Six children developed severe functional impairment of respiration, feeding and motor performance within the first three months of life. Severe neurological signs/symptoms were associated with myeloschisis, clinical signs of a tethered cord and recurrent periods of shunt dysfunction.

Child, Preschool↗

PubMed1982

Pulmonary function after lobectomy for congenital lobar emphysema and congenital cystic adenomatoid malformation. A follow-up study.

Eight patients with congenital lobar emphysema and eight with congenital cystic adenomatoid malformations were operated upon between 1970 and 1978. A lobectomy was performed in all cases. At follow-up after 3 to 11 years all of the patients without concomitant disease or malformations were subjectively well with a physical performance equal to those of their playmates. Lung function tests indicated lung volumes of about 90% of predicted normal values, indicating some compensatory growth of the remaining lung tissue. Functional impairment owing to loss of lung tissue or residual disease was ruled out by the existence of a normal working capacity and maintenance of the alveolar gas exchange during intense exercise.

Carbon Dioxide↗

PubMed1999

The gastrointestinal system--an essential target organ of the athlete's health and physical performance.

An athlete's ability to reach maximum performance is a direct result of physical and muscular performance, muscular and systemic stress tolerance, control and regulation of immune function, and adaptation to physical stress. In this complex sense, the gastrointestinal (GI) tract is also part of the system that controls and regulates adaptation and regeneration of the athlete. A well-balanced GI immune system and an optimized immune competence may protect the athlete from harmful pathogens; it may also protect against dietary as well as inhaled antigens. However, under conditions of mechanical and biochemical stress, the integrity of the GI mucosal block, particularly the epithelial hood, can be damaged, leading to a pathological uptake of toxic or immunogenic substrates. This may occur in endurance athletes, since gut symptomatology, nausea, vomiting, pain, bloating, diarrhea, cramping, and bleeding can be observed in up to half of all participants in endurance events. In addition, composition of stool and fecal microflora in endurance athletes has shown that there may be a specific need for nutritional support for mucosal immunity in highly trained but chronically stressed athletes. Proper diet during training and competition is a significant factor in guarding against GI symptoms and exercise-induced gastrointestinal side effects that may compromise immune competence and physical performance. The present review presents some important suggestions on the possible role of the GI tract in human performance and stress tolerance, and offers new insights about the influence of food quality on the immune system of the gut.

Digestive System↗

PubMed2005

Relationship between falls and physical performance measures among community-dwelling elderly women in Japan.

BACKGROUND AND AIMS: The relationship between falls and physical performance has focused on the frail elderly who have several health problems, particularly those in nursing homes or care facilities. It is important to clarify the relationship between falls and physical performance among the community-dwelling elderly. METHODS: We examined the relationship between falls and physical performance measures (grip strength, chair stand time, functional reach, usual walking speed) among 402 community-dwelling Japanese elderly women aged 60 years and over. RESULTS: Overall prevalence of falls was 21.1%, and increased with age. In univariate analysis, grip strength and functional reach were not significantly different between women who did and did not fall. Chair stand time of women who fell was longer than that of women who did not (p = 0.05), and the usual walking speed of women who fell was significantly slower than that of women who did not fall (p < 0.0001). Physical functioning significantly decreased with age; grip strength, functional reach and usual walking speed decreased, and chair stand time increased. Logistic regression analysis, adjusting for age and other covariates, showed that slower usual walking speed was significantly associated with falls, but grip strength and functional reach were not. Increased chair stand time had a borderline association (p = 0.1). CONCLUSIONS: Our findings indicate that poor lower extremity function, especially walking ability, is an important risk factor for falls in elderly Japanese community-dwelling women.

Accidental Falls↗

PubMed2000

Effect of precooling on physical performance in multiple sclerosis.

Many individuals with MS experience heat sensitivity that may be associated with transient increases in the frequency of clinical signs and symptoms. Although physical activity may be beneficial for those with MS, induced thermal loads may preclude participation in exercise and other daily activities. This project was designed to evaluate the effects of precooling on physical function. Six thermosensitive MS patients were studied. Participants performed a graded exercise test to determine maximal oxygen uptake (VO2max) on a combined arm-leg ergometer. Thermal load was induced by 30 min of exercise under noncooled and precooled conditions at a workrate corresponding to 60% VO2max. Precooling consisted of 30 min lower body immersion in 16 - 17 degrees C water. Fatigue and 25-ft walk performance were assessed before, immediately after, and 30 min following exercise. No treatment differences in VO2 were observed. Rectal temperature, heart rate, and rating of perceived exertion (RPE) were significantly lower during the precooled exercise trial compared to the noncooled trial. Immediately following exercise, 25-ft walk performance and fatigue scores showed significantly greater deterioration in the noncooled condition. Precooling was effective in preventing gains in core temperature with physical work and may allow heat-sensitive individuals with MS to exercise with greater physical comfort.

Adult↗

PubMed2004

A randomized, controlled trial of aerobic exercise for treatment-related fatigue in men receiving radical external beam radiotherapy for localized prostate carcinoma.

BACKGROUND: Advice to rest and take things easy if patients become fatigued during radiotherapy may be detrimental. Aerobic walking improves physical functioning and has been an intervention for chemotherapy-related fatigue. A prospective, randomized, controlled trial was performed to determine whether aerobic exercise would reduce the incidence of fatigue and prevent deterioration in physical functioning during radiotherapy for localized prostate carcinoma. METHODS: Sixty-six men were randomized before they received radical radiotherapy for localized prostate carcinoma, with 33 men randomized to an exercise group and 33 men randomized to a control group. Outcome measures were fatigue and distance walked in a modified shuttle test before and after radiotherapy. RESULTS: There were no significant between group differences noted with regard to fatigue scores at baseline (P = 0.55) or after 4 weeks of radiotherapy (P = 0.18). Men in the control group had significant increases in fatigue scores from baseline to the end of radiotherapy (P = 0.013), with no significant increases observed in the exercise group (P = 0.203). A nonsignificant reduction (2.4%) in shuttle test distance at the end of radiotherapy was observed in the control group; however, in the exercise group, there was a significant increase (13.2%) in distance walked (P = 0.0003). CONCLUSIONS: Men who followed advice to rest and take things easy if they became fatigued demonstrated a slight deterioration in physical functioning and a significant increase in fatigue at the end of radiotherapy. Home-based, moderate-intensity walking produced a significant improvement in physical functioning with no significant increase in fatigue. Improved physical functioning may be necessary to combat radiation fatigue.

Adenocarcinoma↗

PubMed2004

Age-related declines in anaerobic muscular performance: weightlifting and powerlifting.

PURPOSE: One approach to studying the effects of aging on physiological functional capacity (PFC) in humans is to analyze the peak physical performance of trained athletes with increasing age. The primary aim of the present study was to determine weightlifting and powerlifting performance with increasing age in both men and women. METHODS: We performed a retrospective analysis of top age-group weightlifting and powerlifting records compiled from the U.S. Weightlifting and U.S. Powerlifting Organizations. RESULTS: Regression analyses showed that in both men and women weightlifting and powerlifting performance declined curvilinearly and linearly, respectively. The rate and the overall magnitude of declines in performance with age were markedly greater (P < 0.05) in weightlifting than in powerlifting. The rates of age-related decline in muscular power were not different between upper body (bench press) and lower body (squat). Similarly, the age-related declines were not different between snatch and clean and jerk in weightlifting events. The magnitude of the declines with age was greater (P < 0.05) in women than in men in weightlifting; no such sex-related differences were observed in powerlifting performance. CONCLUSIONS: The findings in this cross-sectional study indicate that 1) peak anaerobic muscular power, as assessed by peak lifting performance, decreases progressively even from earlier ages than previously thought; 2) the overall magnitude of decline in peak muscular power appears to be greater in tasks requiring more complex and powerful movements; 3) the age-related rates of decline are greater in women than in men only in the events that require more complex and explosive power; and 4) upper- and lower-body muscular power demonstrate similar rate of decline with age.

Adult↗

PubMed2003

Incidence of injury and physical performance adaptations during military training.

OBJECTIVE: Strenuous physical activity, such as military training, is known to demand a high degree of physical performance and to cause overuse injuries. However, the exact relation between injury incidence and physical fitness level and the influence of military training on measures of functional performance, such as intermittent endurance capacity and maximal jump performance, are not fully described. METHODS: A total of 330 military conscripts were prospectively followed during military basic training. They were divided into 4 self-assessed physical fitness level groups (well trained, trained, less trained, and untrained) and underwent physical performance tests together with registration of injury incidence. RESULTS: Twelve weeks of military basic training was found to result in an overall injury rate of 28%, with an inverse relation between physical fitness level and incidence of overuse injury (P < 0.0001). Furthermore a fourfold higher injury rate was observed in the previously untrained soldiers compared with the well-trained soldiers. An increase in intermittent endurance capacity (20-m intermittent shuttle run test) was seen in all groups, (13 to 62%, P < 0.05), whereas only the previously untrained group of soldiers improved in aerobic capacity (8 and 16%, P < 0.05; maximal oxygen uptake and Coopers 12-minute running test). Maximal jump performance, both with and without backpack loading (15 kg), decreased (5 to 13%, P < 0.05) in 93% of the soldiers despite weight loss. CONCLUSIONS: Military basic training has a positive effect on intermittent endurance capacity but a detrimental effect on jump performance. Furthermore, low levels of physical fitness are strongly associated with proneness toward overuse injury development in soldiers going through intense training.

Adaptation, Physiological↗