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PubMed1984

[Effect of an inpatient exercise therapy program on the R and RS amplitude in the stress ECG].

The ECG after work of 60 patients after an acute myocardial infarction was examined before and after a 4-week physical training as well as 6 months after the acute phase of the infarction. In the precordial leads the changes of the amplitude of the R-waves and the RS-complex as well as the depression of the ST-segment during the bicycle ergometer load and the delta-values were determined. The investigations evoked to the end of the training programme a significant decrease of the delta-values, which again increased at a later control. The change is explained by the haemodynamic and anti-ischaemic effect of the training programme.

Adult↗
PubMed1976

[Combination of physiotherapeutic exercise therapy with bencyclane in intermittent claudication (author's transl)].

Earlier investigations had shown that an intensive physiotherapy program with 30 treatments in 6 weeks was the most rational therapy for intermittent claudication, but the question whether the therapeutic success could be improved by the addition of "vasoactive" substances remained open. For this reason, bencyclane was added to the basic physiotherapy in a double blind trial involving 109 ambulant patients. 91 or these were evaluated. The treatment group (n = 45) showed a greater increase in walking distance of 21.7% compared with the placebo group (n = 46). Also in the evaluation of the therapeutic success rate, the treatment group showed better results (84.4%) than the placebo group (71.7%). From this it can be concluded that the basic physiotherapy can be effectively supported with bencyclane.

Adult↗
PubMed1993

Exercise therapy effects on functional radiographic findings and segmental electromyographic activity in lumbar spine instability.

Flexion-extension and traction-compression radiographs as well as functional electromyographic (EMG) analysis were used to assess nine patients with chronic low back pain and segmental instability symptoms. After a treatment program, at which time most of the patients were asymptomatic and their physical status normalized, the patients were reexamined using EMG and radiographs. No significant change was found in the functional radiographic examination, whereas the myographic findings were significantly improved. Although the number of subjects was small, the results suggest that radiographic findings correlate poorly with clinical findings. Because of the improvement of the physical and myographic findings, the term "segmental dysfunction" may better describe the disability and symptoms than does the term "segmental instability."

Adult↗
PubMed1994

[Rehabilitation in coronary heart disease. Value, indications and contraindications of exercise therapy].

In the rehabilitation of patients with coronary heart disease, physical therapy, in particular kinesitherapy plays a central role. The effects of regular endurance training are multifarious, ranging from improvements in functional capacity to a reduction in risk factors and to psychosocial aspects. At the beginning of the rehabilitation program in particular, safety and close supervision are of primary importance, and training on the bicycle ergometer is a first choice method. Depending upon the extent of the coronary heart disease, for example disordered functioning of the left ventricle or postoperative status following revascularisation surgery, modification and adaptation of the treatment regimen may be required. The risk of a cardiovascular incident occurring is low, and extensive studies performed in recent years have shown a reduction in cardiovascular mortality through the use of long-term rehabilitation programs.

Contraindications↗
PubMedDate not supplied

[Indication for exercise therapy in infancy in the prevention of childhood cerebral palsy].

As in physiotherapy of cerebral palsy early therapy is desired, if possible even in early infancy, a period, when a safe diagnosis does not yet exist, infants at risk have to be identified. The resulting difficulties in early diagnosis and inevitability of treating a considerable number of not affected infants are discussed. The most common methods of physiotherapy are briefly described and evaluated critically concerning possible side effects as well. Superiority in effectivity improving motor efficiency of one method over another cannot be proven. It is shown, however, that in the Vojta method adverse psychological side effects cannot be excluded. Therefore, physiotherapy being a purely prophylactic and not a therapeutic procedure in the multitude of cases should be considered in ordering and selecting a particular method and the one according to Bobath should be favoured.

Cerebral Palsy↗
PubMed1992

Rationale of exercise therapy in patients with angina pectoris with normal and impaired ventricular function.

The implementation of comprehensive coronary care (CCC), including multiple measures involving physical, psychologic, and pharmacologic procedures, together with a new concept of pharmacologic and surgical revascularization, have caused a remarkable improvement in the treatment of coronary patients with angina pectoris. The role of physical training per se is one measure of CCC and one must observe the fact that a single factor cannot be expected to influence a multifactorial disease. The irrefutable evidence that shows that physical training has an effect on longevity is lacking. On the other hand, a number of important physiologic and psychologic benefits have been found to be accompanying a prolonged physical training program in coronary patients suffering from angina pectoris before or after coronary artery bypass graft (CABG). The effect of training is an improvement of cardiocirculatory performance for given work tasks. This includes a decrease of heart rate, systolic blood pressure, the rate-pressure product, an increase of stroke volume, overall physical work performance, oxygen pulse, and in some instances, the rise of the angina pectoris threshold heart rate and threshold rate-pressure product in patients with angina pectoris.

Angina Pectoris↗
PubMed1994

[Beneficial effect of exercise therapy in urinary incontinence in family practice depends largely on therapy compliance and motivation].

OBJECTIVE: Determining the factors which influence the success of training therapy in women suffering from urinary incontinence. DESIGN: Descriptive. SETTING: Thirteen general practices in Nijmegen and environs, the Netherlands. METHOD: A total of 110 women between 20 and 65 years old, suffering from urinary incontinence were examined by their general practitioners. Age, personality, parity, psychological features and type, duration, severity, beginning of the disease, as well as the presence of cystocele or prolapse were recorded. Women were asked about their own experiences regarding factors that influenced success. The treatment consisted of training of pelvic muscles in stress incontinence and bladder training in urge incontinence. Outcomes and compliance were measured 3 and 12 months after start of treatment by means of a so-called incontinence diary. RESULTS: After 3 months the mean frequency of urine loss per week diminished from 21 to 8, and after 12 months to 6 times. Compliance was the most important contribution to success. Patients were more motivated to practise when the subjective burden of the urine loss was more severe. Other features did not influence success.

Adult↗
PubMed2005

The efficacy of Schroth s 3-dimensional exercise therapy in the treatment of adolescent idiopathic scoliosis in Turkey.

OBJECTIVE: To determine the effectiveness of 3-dimensional therapy in the treatment of adolescent idiopathic scoliosis. METHODS: We carried out this study with 50 patients whose average age was 14.15 +/- 1.69 years at the Physical Therapy and Rehabilitation School, Hacettepe University, Ankara, Turkey, from 1999 to 2004. We treated them as outpatients, 5 days a week, in a 4-hour program for the first 6 weeks. After that, they continued with the same program at home. We evaluated the Cobb angle, vital capacity and muscle strength of the patients before treatment, and after 6 weeks, 6 months and one year, and compared all the results. RESULTS: The average Cobb angle, which was 26.1 degrees on average before treatment, was 23.45 degrees after 6 weeks, 19.25 degrees after 6 months and 17.85 degrees after one year (p<0.01). The vital capacities, which were on average 2795 ml before treatment, reached 2956 ml after 6 weeks, 3125 ml after 6 months and 3215 ml after one year (p<0.01). Similarly, according to the results of evaluations after 6 weeks, 6 months and one year, we observed an increase in muscle strength and recovery of the postural defects in all patients (p<0.01). CONCLUSION: Schroth s technique positively influenced the Cobb angle, vital capacity, strength and postural defects in outpatient adolescents.

Adolescent↗
PubMed1994

[Clinical estimation of late treatment results in posttraumatic Sudeck's dystrophy treated with mannitol, calcitonin and exercise therapy].

The author presents late results of treating 60 patients with posttraumatic Sudeck's dystrophy of upper extremity. The treatment was conducted by 3 methods: 30 patients were receiving mannitol for 1 month, 15 subjects were given calcitonin intramuscularly for 1 month, and programmed rehabilitation according to Mucha's scheme was applied in 15 patients. The results were estimated within the period of 1/2--2 years since the commencement of therapy. The evaluation of the results was accomplished by 3-degree classification namely: good, fair, poor. Main attention was focussed on the rest pain regression and improvement of the hand grasping function. In the total group of 60 patients under treatment, there were 38 persons with good results (62%), in 16 the result was fair (27%) and in 6 persons the outcome was poor (11%). It has been recorded that the treatment during the I stage of disease by all the three methods used was uniformly effective. In the treatment of the II stage the most efficacious was mannitol (statistically significant). Mannitol best influenced the improvement of hand grasping strength after the treatment, as well as regression of DS typical changes in RTG and bone scan. It has been also ascertained that for achievement of good results--regardless of the therapeutic method--the greatest influence was exerted by: the time shorter than 3 months elapsing from the trauma to the onset of the treatment, initial deficit in flexion of the fingers smaller than 3 cm, the presence of typical for DS changes in bone scintigraphy as well as I stage of the disease.

Calcitonin↗
PubMed2006

Treating claudication in 5 words (stop smoking and keep walking) is no longer enough: an audit of risk factor management in patients prescribed exercise therapy in New Zealand.

AIM: To assess the documentation and modification of vascular risk factors in patients with intermittent claudication enrolled in an exercise programme in Christchurch, New Zealand. PATIENTS/METHOD: A retrospective review of case notes of patients who presented to the vascular outpatient department with intermittent claudication and were given "Green Prescriptions" for an exercise programme was performed. Referral letters, clinic letters, vascular nurse notes, and handwritten hospital notes were searched for evidence of documentation of risk factors for atherosclerosis. Modification of these risk factors was also noted. Positive attempts at risk factor modification included starting or asking the GP to start a medication or asking the GP to assist with smoking cessation. RESULTS: Sixty patient notes were reviewed which included 81 referral letters (66 from GPs), 118 surgeon letters/clinic notes, and 43 vascular nurse assessments. Of the 60 patients referred, risk factor documentation (positive or negative) was antiplatelet therapy (40), hypertension (48), hyperlipidaemia (39), current tobacco use (40), diabetes mellitus (37), and coronary artery disease (38). Vascular surgeons saw 58 patients and documentation was antiplatelet therapy (42), hypertension (46), hyperlipidaemia (45), current tobacco use (48), diabetes mellitus (44), and coronary artery disease (29). Attempted modification of risk factors by vascular surgeons occurred in 12 patients for antiplatelet therapy, 11 patients for lipid lowering therapy, and 10 for current smokers. Forty-three vascular nurse assessments resulted in documentation of antiplatelet therapy (0), hypertension (42), hyperlipidaemia (42), current tobacco use (43), diabetes mellitus (42), and coronary artery disease (6). CONCLUSION: There is suboptimal communication of vascular risk factors by referrers to specialist vascular services. The recording and modification of risk factors for atherosclerosis in our unit compares favourably with other reported series, but improvement is needed. Furthermore, the role of clinicians with an interest in risk factor management, and patients' understanding of their vascular risk factors, needs clarification.

Adult↗
PubMed1977

[Exercise therapy in coronary disease. An overall practical model for long-term rehabilitation].

This report concerns a model for multifactorial rehabilitation after myocardial infarction (MI), with minimum requirements of personnel, space and equipment. Groups of patients are treated twice weekly, in a gymnasium of a school. Survivors of MI increased their exercise capacity from 77% to 93% of sex- and age adjusted normal within 3 to 6 months of therapy (mean values, P less than 0.001). A similar improvement was observed regardless of whether exercise training was started soon (less than 6 months) or late (greater than 12 months) after MI, indicating that exercise capacity increased with training, but was not dependent on time alone. The majority of 87 patients who answered a questionnaire, indicated that in their opinion a strictly organized program requiring a regular attendance was important for the rehabilitation and 89% thought that their participation had resulted in physical and psychological benefits. Two groups of survivors of MI were compared by use of the "Freiburger personality inventory" (FPI). Patients who were more physically impaired, showed a greater degree of a sort of psychosomatic disorder as indicated by the ratings of scale 1 of the FPI. The described program has proved successful, as it resulted in an increase of exercise capacity. This may have a favorable influence on a sort of psychosomatic disorder encountered in patients with healed MI. Beneficial physical and psychological effects were reported by the participants.

Evaluation Studies as Topic↗
PubMed2002

Intermittent claudication: cost-effectiveness of revascularization versus exercise therapy.

PURPOSE: To compare the costs, effectiveness, and cost-effectiveness of alternative treatment strategies for intermittent claudication. MATERIALS AND METHODS: By combining data from the literature and original patient data, a Markov decision model was developed to evaluate the societal cost-effectiveness. Patients presented with previously untreated intermittent claudication, and treatment options were exercise, percutaneous transluminal angioplasty (with stent placement, if necessary), and/or bypass surgery. Treatment strategies were defined as the initial therapy in combination with secondary treatment options should the initial therapy fail. The main outcome measures were quality-adjusted life days, expected lifetime costs (in 1995 U.S. dollars), and incremental cost-effectiveness ratios. RESULTS: Compared with an exercise program, revascularization (either angioplasty or bypass surgery) improved effectiveness by 33-61 quality-adjusted life days among patients with no history of coronary artery disease. The incremental cost-effectiveness ratio was $38,000 per quality-adjusted life year gained when angioplasty was performed whenever feasible, as compared with exercise alone, and $311,000 with additional bypass surgery. The incremental cost-effectiveness ratios were sensitive to age, history of coronary artery disease, estimated health values for no or mild claudication versus severe claudication, and revascularization costs. CONCLUSION: The results suggest that, on average, the expected gain in effectiveness achieved with bypass surgery for intermittent claudication is small compared with the costs. Angioplasty performed whenever feasible was more effective than was exercise alone, and the cost-effectiveness ratio was within the generally accepted range.

Angioplasty↗
PubMed2006

The role of exercise therapy in the treatment of patients with systolic heart failure.

The predominant benefits of exercise training in systolic heart failure have been seen with aerobic training, although some information exists for the beneficial effects of resistive training as well. Although men clearly benefit from exercise training, the effects of exercise in women are less clear. Most of the studies have used supervised training 3 to 5 days a week for 8 weeks to 6 months, with 30 to 60 minutes of exercise per session. However, home exercise has been reported in a few studies, and appears to be safe and possibly efficacious. The effects of training on mortality are unknown at this time, although no study has demonstrated increased adverse events associated with training. Exercise training should be recommended for patients with stable New York Heart Association class II to III heart failure.

Journal Article↗
PubMed2004

Preference for progressive delays and concurrent physical therapy exercise in an adult with acquired brain injury.

The purpose of this study was to increase self-control and engagement in a physical therapy task (head holding) for a man with acquired traumatic brain injury. Once impulsivity was observed (i.e., repeated impulsive choices), an experimental condition was introduced that consisted of choices between a small immediate reinforcer, a large fixed-delay reinforcer, and a large progressive-delay reinforcer. The participant showed a preference for the progressive-delay option, even when the duration of the delay exceeded that of the fixed delay. The results have implications for establishing optimal choice making and teaching life-enhancing skills.

Adult↗