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PubMed2006

Extreme rehab.

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Exercise Movement Techniques↗
PubMed2006

An ideal fit.

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Aged↗
PubMedDate not supplied

Cold and heat application in musculoskeletal injury.

In physical therapy there is rarely the opportunity to see patients in the very acute stage, but early intervention by emergency nurses can be the key to faster healing. Follow-up visits in a physical therapy clinic can reinforce proper use of thermomodalities in the home and can introduce appropriate movement techniques, therapeutic exercise programs, RECIPE, hydrotherapy, and modalities for pain to regain function as quickly and as safely as possible.

Cryotherapy↗
PubMed1993

Normal right ventricular systolic and diastolic function assessed by krypton-81m equilibrium ventriculography.

Krypton-81m equilibrium ventriculography was used to study right ventricular function in 23 healthy male volunteers. Technetium-99m lung perfusion scintigraphy was employed to subtract radionuclide activity within lung during image analysis thereby enhancing image quality. The imaging technique was used to generate a time-activity curve for the right ventricle allowing the definition of indices of normal systolic and diastolic function for the right ventricle. At rest, indices of systolic ejection and diastolic filling were comparable to those previously reported for the left ventricle. Using the imaging technique, movement artifact during exercise reduces image quality and limits accurate measurement of these indices to resting studies.

Adult↗
PubMed1988

Correction for patient and organ movement in SPECT: application to exercise thallium-201 cardiac imaging.

We describe a technique for correction of artifacts in exercise 201Tl single photon emission computed tomography (SPECT) images arising from abrupt or gradual translational movement of the heart during acquisition. The procedure involves the tracking of the "center of the heart" in serial projection images using an algorithm which we call "diverging squares". Each projection image is then realigned in the x-y plane so that the heart center conforms to the projected position of a fixed point in space. The shifted projections are reconstructed using the normal filtered backprojection algorithm. In validation studies, the motion correction procedure successfully eliminated movement artifacts in a heart phantom. Image quality was also improved in over one-half of 36 exercise thallium patient studies. The corrected images had smoother and more continuous left ventricular walls, greater clarity of the left ventricular cavity, and reduced streak artifacts. Rest injected or redistribution images, however, were often made worse, due to reduced heart to liver activity ratios and poor tracking of the heart center. Analysis of curves of heart position versus projection angle suggests that translation of the heart is common during imaging after exercise, and results from both abrupt patient movements, and a gradual upward shift of the heart. Our motion correction technique appears to represent a promising new approach for elimination of movement artifacts and enhancement of resolution in exercise 201Tl cardiac SPECT images.

Coronary Disease↗
PubMed2000

A kinetic chain approach for shoulder rehabilitation.

OBJECTIVE: To introduce an approach to shoulder rehabilitation that integrates the kinetic chain throughout the rehabilitation program while providing the theoretical rationale for this program. BACKGROUND: The focus of a typical rehabilitation program is to identify and treat the involved structures. However, in activities of sport and daily life, the body does not operate in isolated segments but rather works as a dynamic unit. Recently, rehabilitation programs have emphasized closed kinetic chain exercises, core-stabilization exercises, and functional programs. These components are implemented as distinct entities and are used toward the end of the rehabilitation program. DESCRIPTION: Kinetic chain shoulder rehabilitation incorporates the kinetic link biomechanical model and proximal-to-distal motor-activation patterns with proprioceptive neuromuscular facilitation and closed kinetic chain exercise techniques. This approach focuses on movement patterns rather than isolated muscle exercises. Patterns sequentially use the leg, trunk, and scapular musculature to activate weakened shoulder musculature, gain active range of motion, and increase strength. The paradigm of kinetic chain shoulder rehabilitation suggests that functional movement patterns and closed kinetic chain exercises should be incorporated throughout the rehabilitation process. CLINICAL ADVANTAGES: The exercises in this approach are consistent with biomechanical models, apply biomechanical and motor control theory, and work toward sport specificity. The exercises are designed to stimulate weakened tissue by motion and force production in the adjacent kinetic link segments.

Journal Article↗
PubMed1998

Qigong Yangsheng as a complementary therapy in the management of asthma: a single-case appraisal.

OBJECTIVES: Qigong Yangsheng, the health-promoting method of traditional Chinese medicine that combines movement, mental exercise, and breathing technique, is used in China for the therapy of bronchial asthma, and for some time now has been enjoying an ever-widening acceptance in the Western world as well. This pilot study investigates if Qigong Yangsheng could be used as a complementary therapeutic measure to treat asthma patients in a Western industrialized country. DESIGN: Thirty asthma patients, with varying degrees of illness severity, were taught Qigong Yangsheng under medical supervision. They were asked to exercise independently, if possible, on a daily basis and to keep a diary of their symptoms for half a year including peak-flow measurements three times daily, use of medication, frequency and length of exercise as well as five asthma-relevant symptoms (sleeping through the night, coughing, expectoration, dyspnea, and general well-being). The concept of this study was based on a single-case research design series with baseline, one teaching phase, a phase of self-practice and a refresher teaching course. A 4-week follow-up period was carried out in the same season as the original baseline phase 52 weeks later. RESULTS: An improvement was indicated if subjects showed a decrease of at least 10 percent in peak-flow variability between the 1st and the 52nd week. This occurred more frequently in the group of the exercisers (n = 17) than in the group of nonexercisers (n = 13) (p < 0.01 chi-square with Yates correction). When comparing the study year with the year before the study, there was improvement also in reduced hospitalization rate, less sickness leave, reduced antibiotic use and fewer emergency consultations resulting in reduced treatment costs. CONCLUSION: Qigong Yangsheng is recommended for asthma patients with professional supervision. An improvement in airway capability and a decrease in illness severity can be achieved by regular self-conducted Qigong exercises.

Adult↗
PubMed2000

Ventilatory and circulatory responses at the onset of voluntary exercise and passive movement in children.

The purpose of this study was to investigate whether or not the ventilatory and circulatory responses at the onset of voluntary exercise and passive movement, especially at the initial stage (phase I), in children are the same as in adults. Ten pre-teenage male children and ten adult men participated in this study. Voluntary exercise and passive movement were performed in a sitting position for about 20 s. Both the exercise and the movement consisted of flexion-extensions of the lower leg from a vertical to horizontal position, either voluntarily or passively, with a frequency of about 60 x min(-1). Inspiratory minute ventilation (V1), tidal volume (VT), respiratory frequency, partial pressure of end-tidal CO2 and O2, heart rate (fc) and mean blood pressure (BP) before, during and after exercise or movement were measured using breath-by-breath and beat-to-beat techniques. Cardiorespiratory responses at the onset of voluntary exercise and passive movement were compared with the relative change (delta), which was estimated from the value at rest (100%). In the present study, it was found that: (1) the V1 during voluntary exercise were significantly lower in the children, mainly due to lower deltaVT; (2) the delta(f)c during voluntary exercise was almost the same in both groups, while deltaf(c) was significantly lower in the children during the last part of passive movement; (3) in the voluntary exercise and passive movement, the BP in the children was increased a little or remained close to the value at rest, while it was significantly decreased in the adults. As a result, there were significant differences in deltaBP between the two groups during voluntary exercise. These results suggest that the cardiorespiratory responses at the onset of voluntary exercise and passive movement may be modified during the growth process.

Adult↗
PubMed1981

[A non-invasive approach to pulmonary hemodynamics].

Currently available investigative methods employed in the evaluation of the pulmonary circulation involve cardiac catheterization and, in respect of exercise determinations, only supine data have been recorded. Consequent upon a 3-year study of pulmonary haemodynamics and gas exchange at rest and during exercise on the treadmill in patients with chronic hypoxaemic lung disease, correlations have been established which accurately characterize the venous admixture (QVA/Qt, the quantitative expression of hypoxaemia), cardiac output and pulmonary artery pressure (PA), permitting the prediction of these variables in the erect posture. The employment of fibre-optic oximetry obviates the need for arterial cannulation. The relevant regression formulae are as follows: QVA/Qt = 8,85 x ln (Hb (100 - SaO2) x heart rate/VO2) - 3,66 (r = 0,97; SEE = 2,43) PAm (resting) = 0,4516 (QVA/Qt) + 8,2 (r = 0,90; SEE = 2,7) PAm (exercise) = 1,453 (QVA/Qt) + 3,8 (r = 0,96; SEE = 4,0) Cardiac output may be derived directly from VO2 and the known components of QVA/Qt, and total pulmonary vascular resistance in turn from Qt and PAm. Direct comparison of the predicted values derived by this means with actual determinations yielded no systematic differences. The clinical application of these principles ensures reliable estimates of haemodynamic variables, without resort to invasive techniques, during free movement and graded exercise testing.

Adolescent↗
PubMed2004

Addition of intensive repetition of facilitation exercise to multidisciplinary rehabilitation promotes motor functional recovery of the hemiplegic lower limb.

OBJECTIVE: To evaluate the effects of the intensive repetition of movements elicited by the facilitation technique to improve voluntary movement of a hemiplegic lower limb in patients with brain damage. DESIGN: A multiple-baseline design (A-B-A-B: A without specific therapy, B with specific therapy) across individuals. PATIENTS: The sample comprised 22 subjects with stroke and 2 brain tumour-operated subjects (age: 50.7 +/- 9.6 years, time after onset: 7.1 +/- 2.6 weeks). They were selected from among 165 patients with stroke who were admitted to our rehabilitation centre from September 1, 1995 to March 31, 1997. METHODS: Two 2-week facilitation technique sessions (more than 100 repetitions a day for each of 5 kinds of movement) were applied at 2-week intervals in patients with hemiplegia, who were being treated with continuous conventional rehabilitation exercise without the facilitation technique for hemiplegia. Motor function of the affected lower limb (Brunnstrom Recovery Stage of hemiplegia, the foot-tap test and the strength of knee extension/flexion) and walking velocity were evaluated at 2-week intervals. RESULTS: Significant improvements in Brunnstrom Stage, foot-tapping and the strength of knee extension/flexion of the affected lower limb were seen after the first conventional rehabilitation exercise session and after the first and second facilitation technique and conventional rehabilitation exercise sessions. The improvements after facilitation technique and conventional rehabilitation exercise sessions were significantly greater than those after the preceding conventional rehabilitation exercise sessions. CONCLUSION: Intensive repetition of movement elicited by the facilitation technique (chiefly proprioceptive neuromuscural facilitation pattern, stretch reflex and skin-muscle reflex) improved voluntary movement of a hemiplegic lower limb in patients with brain damage.

Activities of Daily Living↗
PubMed2006

Neuro-mechanical and chemical influences on locomotor respiratory coupling in humans.

Mechanisms of coordination between breathing and movement during dynamic exercise are still a matter of debate. This study aimed to examine the degree of coordination between breathing and arm propulsion patterns and to compare the relative contribution of neuro-mechanical and chemical factors. Thirteen trained cross-country skiers performed constant submaximal 6-min roller skiing exercises on a motorized driven treadmill in two different poling techniques (V2A and V2 skating techniques) at two exercise intensity levels corresponding to the first and second ventilatory thresholds. The timing of arm propulsion movements in V2A and V2 techniques was considered as a mechanical/neural influence on breathing whereas exercise intensity represented the metabolic demand to breathing. The degree of coordination, expressed as the percentage of breaths presenting a constant phase interval (time between an arbitrarily chosen point of the arm movement cycle and the onset of expiration) was significantly higher in V2A than V2 (P<0.05) while exercise intensity had no effect on the degree of coordination. We concluded that locomotor-respiratory coupling occurs in cross-country skiing as simulated by roller skiing because of strong influences from neuro-mechanical factors.

Adult↗
PubMed1998

The cardiovascular responses of male subjects to kung fu techniques. Expert/novice paradigm.

BACKGROUND: The primary aim was to assess cardiovascular responses of expert and novice subjects to kung fu techniques. It was hypothesised that experienced subjects would demonstrate improved economy of movement during the techniques, evidenced by reduced exercise intensity. METHODS EXPERIMENTAL DESIGN: a comparative design was established utilising two groups; experienced (group E), and novice (group N). SETTING: the experimentation took place under laboratory conditions, but was designed to maximise external validity. PARTICIPANTS: the only preselection variables were regular attendance at training and experience. Nine experienced males (group E, exp 9.5 +/- 5.2 yrs) and nine novice males (group N, exp 1.2 +/- 0.1 yrs) participated. The only exclusion guidelines were contraindications to participate within a maximal test, no subjects were excluded upon this basis. INTERVENTIONS: N/A. MEASURES: each subject participated in three kung fu protocols (forms, kicking and punching). Each protocol, randomly allocated, consisted of ten work (30 sec) and ten rest periods (30 sec). MEASURES taken during the protocols were heart rate (HR) and oxygen consumption (VO2). These were expressed as a percentage of maximal values to reflect exercise intensity. RESULTS: During both the form protocol and punching protocol group E were found to be working at a significantly (p < 0.05) lower % VO2 max than group N (forms--group E = 71.5 +/- 5.3, group N = 82.1 +/- 6.1; punching--group E = 37.5 +/- 2.1, group N = 40.6 +/- 2.6, p < 0.05). This suggests that experienced subjects were more economical when performing similar movement patterns. CONCLUSIONS: It was concluded that cardiovascular responses to kung fu techniques differ depending upon experience level. It is difficult to directly relate this to improved economy since work output could not be accurately quantified. It was also found that kung fu protocols elicited exercise intensity into the cardiovascular training zone.

Adult↗
PubMed1991

A comparison of techniques to enhance the evaluation of equine laryngeal function.

This study was designed to define a simple, unequivocal test for the evaluation of laryngeal function and the diagnosis of idiopathic laryngeal hemiplegia (ILH). ILH is a disorder that results from left recurrent laryngeal neuropathy and in which there is no movement of the left arytenoid cartilage and vocal fold. Laryngeal function was evaluated in seven horses using four techniques designed to stimulate laryngeal movements:-nasal occlusion, exercise, swallowing and administration of a respiratory stimulant. In addition, the effects of sedation and twitching on the endoscopic examination were also examined. The cross-sectional area of the rima glottidis was measured in each horse at rest and after each technique was performed. There was no statistically significant difference in the increase in area seen after nasal occlusion or exercise. Doxapram hydrochloride increased the cross-sectional area of the rima glottidis, whereas xylazine caused a decrease. Neither of these pharmacological agents exaggerated or decreased the amount of asynchronous movement or tremoring of the arytenoid cartilages. Manual occlusion of the external nares during endoscopy is a simple, yet effective method of stimulating arytenoid function and hence diagnosing ILH.

Animals↗