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At least 1,099 records · Page 61Linked to original sources
PubMed2006

Effect of ciclesonide dose and duration of therapy on exercise-induced bronchoconstriction in patients with asthma.

BACKGROUND: Inhaled corticosteroid therapy improves exercise symptoms in asthmatic subjects. OBJECTIVE: We sought to evaluate exercise-induced bronchoconstriction (EIB) as a method of determining the dose and time responses of inhaled corticosteroid therapy. METHODS: In this double-blind, randomized, cross-over study with 2 parallel arms, 4 doses of inhaled ciclesonide (40 microg and 160 microg or 80 microg and 320 microg) were compared over 3 weeks of treatment. Twenty-six asthmatic subjects (age range, 14-27 years) with baseline FEV1 values of greater than 70% of predicted value were enrolled. The primary outcome was the maximum percentage decrease in FEV1 after standardized exercise challenge. RESULTS: After 1 week of therapy, the mean +/- SEM reduction in maximum decrease in FEV1 in the ciclesonide 40-microg/80-microg dose group was 9% +/- 2.6% (95% CI, 3.9% to 14%), with no additional reduction thereafter. In the ciclesonide 160-microg/320-microg dose group, there was an 8.7% +/- 2.5% (95% CI, 3.7% to 13.7%) reduction in maximum decrease in FEV1 after week 1, which continued in a linear fashion during subsequent weeks of treatment. No difference was found between the 2 treatment arms in the temporal response of EIB to ciclesonide treatment. The maximum percentage attenuation in EIB achieved was 51.1% +/- 7.9%, which was achieved by using the 320-microg dose after 3 weeks of treatment. CONCLUSIONS: A significant improvement in EIB was demonstrated for all doses of ciclesonide. Use of 160 microg/320 microg of ciclesonide resulted in a continuing improvement in FEV1 with time, and no plateau was seen in protective effect during 3 weeks of treatment. CLINICAL IMPLICATIONS: Attenuation in exercise-induced decrease can be seen as early as after 1 week of therapy with inhaled ciclesonide at doses greater than 40 microg. However, maximal attenuation in exercise response continues to increase at doses greater than or equal to 200 microg, even after 3 weeks of therapy.

Administration, Inhalation↗
PubMed1996

Current views on obesity.

Although the disorders associated with obesity have been extensively studied, little attention has been paid to the fact that obesity is itself a chronic disease. This misunderstanding of the nature of obesity has contributed to the stigmatization of obese persons and to the use of inappropriate or inadequate treatment regimens. Although the etiology of obesity is still unclear, genetic, metabolic, and social factors are all believed to play a role in its development and progression. Behavioral therapy, exercise, very-low-calorie diets, drug therapy, and surgery affect the treatment of obesity of differing levels of severity. The regaining of weight following treatments other than surgery is very frequent, in part because periods of weight loss are rarely followed by maintenance programs. An increasing awareness of the chronic, multifactorial nature of obesity will ideally lead to the development of new long-term treatment programs that are safe and effective. Such programs are urgently needed in light of new data that show that the prevalence of obesity is increasing in the United States, as much as 30% in the last decade.

Appetite Depressants↗
PubMed2001

Long-term effects of specific stabilizing exercises for first-episode low back pain.

STUDY DESIGN: A randomized clinical trial with 1-year and 3-year telephone questionnaire follow-ups. OBJECTIVE: To report a specific exercise intervention's long-term effects on recurrence rates in acute, first-episode low back pain patients. SUMMARY OF BACKGROUND DATA: The pain and disability associated with an initial episode of acute low back pain (LBP) is known to resolve spontaneously in the short-term in the majority of cases. However, the recurrence rate is high, and recurrent disabling episodes remain one of the most costly problems in LBP. A deficit in the multifidus muscle has been identified in acute LBP patients, and does not resolve spontaneously on resolution of painful symptoms and resumption of normal activity. Any relation between this deficit and recurrence rate was investigated in the long-term. METHODS: Thirty-nine patients with acute, first-episode LBP were medically managed and randomly allocated to either a control group or specific exercise group. Medical management included advice and use of medications. Intervention consisted of exercises aimed at rehabilitating the multifidus in cocontraction with the transversus abdominis muscle. One year and three years after treatment, telephone questionnaires were conducted with patients. RESULTS: Questionnaire results revealed that patients from the specific exercise group experienced fewer recurrences of LBP than patients from the control group. One year after treatment, specific exercise group recurrence was 30%, and control group recurrence was 84% (P < 0.001). Two to three years after treatment, specific exercise group recurrence was 35%, and control group recurrence was 75% (P < 0.01). CONCLUSION: Long-term results suggest that specific exercise therapy in addition to medical management and resumption of normal activity may be more effective in reducing low back pain recurrences than medical management and normal activity alone.

Adult↗
PubMed2002

Treatment of chronic lower back pain with lumbar extension and whole-body vibration exercise: a randomized controlled trial.

STUDY DESIGN: A randomized controlled trial with a 6-month follow-up period was conducted. OBJECTIVE: To compare lumbar extension exercise and whole-body vibration exercise for chronic lower back pain. SUMMARY OF BACKGROUND DATA: Chronic lower back pain involves muscular as well as connective and neural systems. Different types of physiotherapy are applied for its treatment. Industrial vibration is regarded as a risk factor. Recently, vibration exercise has been developed as a new type of physiotherapy. It is thought to activate muscles via reflexes. METHODS: In this study, 60 patients with chronic lower back pain devoid of "specific" spine diseases, who had a mean age of 51.7 years and a pain history of 13.1 years, practiced either isodynamic lumbar extension or vibration exercise for 3 months. Outcome measures were lumbar extension torque, pain sensation (visual analog scale), and pain-related disability (pain disability index). RESULTS: A significant and comparable reduction in pain sensation and pain-related disability was observed in both groups. Lumbar extension torque increased significantly in the vibration exercise group (30.1 Nm/kg), but significantly more in the lumbar extension group (+59.2 Nm/kg; SEM 10.2; P < 0.05). No correlation was found between gain in lumbar torque and pain relief or pain-related disability (P > 0.2). CONCLUSIONS: The current data indicate that poor lumbar muscle force probably is not the exclusive cause of chronic lower back pain. Different types of exercise therapy tend to yield comparable results. Interestingly, well-controlled vibration may be the cure rather than the cause of lower back pain.

Chronic Disease↗
PubMed1990

Is percutaneous transluminal angioplasty better than exercise for claudication? Preliminary results from a prospective randomised trial.

Percutaneous transluminal angioplasty (PTA) is a commonly performed procedure for the treatment of intermittent claudication despite the lack of controlled studies. The aim of this study was to compare PTA with supervised exercise therapy for patients with arterial occlusive disease judged suitable for PTA at angiography. Patients were assessed before treatment commenced and at three monthly intervals afterwards. Assessment included measurement of resting ankle brachial pressure indices (ABPI), and claudicating and maximum walking distances on a treadmill up a 10 degrees incline. Twenty patients were randomised to receive PTA and 16 exercise. The groups were similar in age, sex, smoking habits and arteriographic pattern of disease. In the PTA group two patients had angioplasties that were technically unsuccessful and two other patients subsequently required surgery. One patient in the exercise group subsequently had a PTA. After PTA, mean ABPI were significantly improved at 3, 6 and 9 months (P less than 0.01) without a corresponding significant increase in mean maximum walking distances. However in the exercise group despite no increase in mean ABPI, mean maximum walking distances increased progressively, with significant increases at 6, 9 and 12 months (P less than 0.01).

Aged↗
PubMed2005

[Non-pharmacological treatment of hypertension in the elderly].

We reviewed non-pharmacological treatment of hypertension in the elderly. Although hypotensive effect of salt restriction was evident, severe salt restriction might result in impairment of QOL by decrease in appetite and consequent nutritional deterioration. Hypotensive effect of mild to moderate aerobic exercise was also evident. Our previous report indicated that decrease in blood pressure was less in older subjects than in younger group. Another study showed that blood pressure decreased even during 3 to 9 months after the beginning of exercise therapy. These findings might indicate that decrease in blood pressure in the elderly was slower than in younger subjects.

Aged↗
PubMed2002

Multidimensional scaling analysis of techniques used by physiotherapists in Southeast Australia: a cross-national replication.

Much of the research concerning techniques used by physiotherapists has focused upon electrothermal agents, so neglecting fundamental questions concerning practice and differences in technique use. A recent study in England addressed these deficits, and determined that techniques were used in ordered combinations, which differentiate the profession into 'typologies' or specialities. The purpose of the present study was to determine whether a similar picture would emerge in Australia, and to determine the type and extent of technique use amongst Australian physiotherapists. This replication study comprised a questionnaire survey of 141 hospital physiotherapists working in Southeast Australia. Information concerning the range and frequency of techniques used over the preceding six months was obtained. Descriptive analyses indicated high frequency use of exercise therapy, manipulation, heat packs, massage and ultrasound. Multidimensional scaling revealed a clear structure concerning combination use of techniques, and a coherent typology based on this usage. Differentiation of the profession according to the typologies supports the specialist areas identified in England, namely respiratory, neurological and orthopaedic/musculoskeletal physiotherapy. A further subdivision of the latter was possible in Australia, with the emergence of both a manipulative speciality, and an exercise rehabilitation speciality. While this study confirms the findings of the earlier research, it identifies important differences in practice between Australia and England.

Adult↗
PubMed2005

Physiotherapy management of low back pain: does practice match the Dutch guidelines?

The purpose of this study is to explore adherence by Dutch physiotherapists to the physiotherapists' guideline for non-specific low back pain. For this study data from the National Information Service for Allied Health Care were used. This is a registration network that continuously collects information about physiotherapy patients and their treatment episodes. Within this network, adherence to the low back pain guideline was assessed by three criteria based on the guideline. These criteria concerned the number of sessions, the treatment goals, and the interventions. Data from patients with 'non-specific low back pain' as the reason for referral and a completed treatment episode were selected (n = 1254); 90 therapists in 40 practices treated these patients. The criterion concerning the number of sessions applied only for patients with acute complaints and was met in 17% of these patients. In about half of the patients the criterion for the treatment goals as well as the criterion relating to the interventions was met. Treatment goals are aimed mainly at improving mobility functions and changing body position. In more than three-quarters of the treatment episodes manual interventions (massage or manual manipulation) and exercise therapy were used frequently. As considerable variation in guideline adherence was shown to exist among therapists, there is clearly room for improvement in the quality of the care.

Adult↗
PubMed1982

Rehabilitation management of muscular dystrophy and related disorders: I. The role of exercise.

When evaluating the effect of a modality such as exercise, maturation in children, the rate of progression of the disease, and the degree of weakness should be considered. The two major factors critical in producing overwork weakness are the degree of weakness at the time the exercise program is started and the intensity of the exercise training program. Exercise therapy is apparently not harmful and may be beneficial in patients with motor unit diseases if it is started early in the course of the diseases when muscle fiber degeneration is minimal, and is carried out at submaximal levels.

Animals↗
PubMed1987

[Attitude of community physicians and patients with hypertension toward implementation of rehabilitation measures in ambulatory clinics].

Altogether 500 persons with borderline arterial hypertension and patients with essential hypertension and 58 community internists were interviewed with the help of special questionnaires as to opportunities of various rehabilitation measures in outpatient clinics. The problem of the internists' and patients' attitude towards nonmedicamentous (salt-free diet, exercise therapy and autotraining) and medicamentous (intermittent and continuous antihypertensive therapy) methods was discussed. The authors provided information on the main reasons for the rejection of patients with essential hypertension of regular treatment in a clinic.

Adult↗
PubMed1984

Cardiac abnormalities and exercise tolerance in patients receiving renal replacement therapy.

The exercise tolerance of the survivors of a consecutive group of 100 patients in a renal dialysis and transplant programme was compared with the prevalence of cardiac abnormalities detected by exercise testing, echocardiography, and radionuclide angiography. Fifty four patients attended for investigation 27 (SD 7) months after starting renal replacement therapy. Forty three of them (80%) were receiving antihypertensive treatment. Their performance on a bicycle ergometer exercise test was compared with that of 62 normal subjects and the patients divided into five groups of decreasing ability. The exercise tolerance of the patients was very poor, only 17 performing within the normal range. Impairment in exercise capacity was not explained by the type or quality of renal replacement therapy. Fourteen patients developed ischaemic electrocardiographic changes on exercise. Left ventricular ejection fraction was assessed by gated blood pool scanning in 37 patients; all nine of the patients with an abnormally low radionuclide ejection fraction also had abnormal exercise tolerance. Satisfactory M mode echocardiograms were obtained from 45 of the patients, and only two were normal. Left ventricular hypertrophy was detected in 25 (56%) of the echocardiograms, and abnormalities indicating impaired left ventricular function were common and widespread. Grouping all the abnormal cardiac features together for the patients in each exercise group showed a striking linear trend of increasing proportion of cardiac abnormalities with worsening exercise tolerance among the five exercise groups (p less than 0.001). The proportion of patients becoming unemployed within one year of starting renal replacement therapy similarly increased, from nil to 60% from the best exercise group to the most incapacitated. Twenty nine of the original cohort of 100 patients subsequently died, cardiovascular disease accounting for 12 (41%) of these deaths. Diminished exercise tolerance in patients receiving renal replacement therapy is strongly associated with cardiac abnormalities and reduced employment prospects.

Adolescent↗
PubMed1997

Therapeutic effects of restricted diet and exercise in obese patients with fatty liver.

BACKGROUND/AIMS: The incidence of obese patients with fatty liver has recently increased in Japan as well as in the United States and Europe. Fatty liver may occasionally progress to liver cirrhosis. In this study, we have compared the effects of restricted diet and exercise versus no treatment in obese patients with fatty liver. METHODS: Twenty-five obese patients with fatty liver were divided into treated and control groups. Fifteen obese patients followed a program of restricted diet (ideal weight x 25 Cal x kg(-1)) and exercise (walking or jogging) for a trial period of 3 months. No changes in diet or lifestyle were made by the other 10 patients during the same trial period. Blood biochemical tests and liver histology were compared in all patients before and after the trial. RESULTS: In the treated group, weight, blood biochemical data such as aminotransferase, albumin, cholinesterase, total cholesterol and fasting blood glucose values, and steatosis were significantly decreased after the trial. In the control group, there were no significant differences in the clinical and histological findings before and after the trial. CONCLUSIONS: These results indicate that restricted diet and exercise therapy, such as walking and jogging, are useful means of improving blood biochemical data and histological findings in liver tissues related to fatty liver.

Adolescent↗