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PubMed1997

Nitecapone is of benefit to functional performance in experimental heart transplantation.

In heart transplantation, global ischemia of a graft is followed by reperfusion injury. The formation of oxygen free radicals induces arrhythmias and impairs functional recovery of the graft. This study was executed to evaluate the effect of the new antioxidant, nitecapone, on ischemia-reperfusion injury in heart transplantation in rats. Donor hearts were perfused and stored at +4 degrees C for 2 h in either Ringer's solution in the control group (C-group, n = 26) or Ringer's solution with nitecapone (NC) added (NC-group, n = 18). The donor aorta was anastomosed to the recipient's abdominal aorta and the pulmonary artery to the recipient's inferior vena cava. The grafts were classified into three categories based on the functional recovery. The rats in both groups were killed at 10, 30, or 60 min after release of the aortic clamp. Tissue samples for chemiluminescence were obtained from the left ventricle, the right ventricle, and the septum of the heart. All grafts in the NC-group (18/18) began beating after release of the aortic clamp, whereas only 50% (13/26) of the grafts in the C-group recovered (P < 0.0004). Chemiluminescence analysis showed lipid peroxidation values to be higher in the C-group than the NC-group up to 1 h after reperfusion. Also, the right ventricle samples showed lower chemiluminescence values in the NC-group than in the C-group. In conclusion, our results do not support the theory that different regions of the heart have different vulnerability to ischemia-reperfusion injuries. Nitecapone has a beneficial effect on the preservation of the grafts in terms of functional recovery.

Animals↗
PubMed1980

[Evaluation of the hemodynamic reactions of the greater and lesser circulations in performing functional load tests].

A complex of bloodless examination methods (tetrapolar rheography, rheopulmonography, cinecardiography) was used in studying hemodynamics of systemic and pulmonary circulation at rest and after dosed exercises performed in a supine position. Forty-seven healthy persons were examined at rest and 1, 3, 6, 10, and 15 minutes after cessation of the exercise tolerance test. After the test the values of hemodynamics return to the initial levels on the 6th--10th min of rest. It is shown that the suggested complex of examination methods may be used for disclosing latent disorders of adaptation to physical exercise and for control over the efficacy of treatment of patients with diseases of the organs of circulation and respiration.

Adult↗
PubMedDate not supplied

High intensity strength training improves strength and functional performance after stroke.

OBJECTIVE: To evaluate the effects of a progressive resistance strength training program on changes in muscle strength, gait, and balance in older individuals 1 yr after stroke, seven individuals were recruited who were greater than 60-yr-old, 1 yr after stroke, living at home, and able to follow verbal commands. DESIGN: Subjects participated in a 12-wk 2x per wk resistance training program at 70% of 1 repetition maximum. RESULTS: Lower limb strength improved 68% on the affected side and 48% on the intact side during training, with the largest increases observed for hip extension (affected side: 88%, P < 0.01; intact side: 103%, P < 0.001). Repeated chair stand time decreased 21% (P < 0.02). Motor performance assessed by the Motor Assessment Scale improved 9% (P < 0.04) and static and dynamic balance (Berg balance scale) improved 12% (P < 0.004). Progressive resistance training in individuals 1 yr after stroke improves affected and intact side lower limb strength and was associated with gains in chair stand time, balance, and motor performance. CONCLUSIONS: These results support the concept that strength training is an appropriate intervention to improve the quality of physical function in older community dwelling stroke survivors.

Activities of Daily Living↗
PubMed2005

Sustained attention and executive functioning performance in attention-deficit/hyperactivity disorder.

The aim of this study was to further refine the cognitive phenotype of attention-deficit/hyperactivity disorder (ADHD), with respect to the ability to sustain attention and executive functioning. Participants were 34 boys with ADHD (combined type) and 28 normal controls. The groups were closely matched for age and IQ. All participants were 12 years of age. Both groups performed a computerized sustained attention task and a response interference task. Measures related to speed, accuracy, and time on task were collected. We found that children with ADHD performed slower, less accurately, more impulsively, and with less stability than controls. Both groups produced more errors with increasing time on task, reflecting reduced vigilance. Importantly, no interaction with time on task was found. The overall pattern of results suggests that measures related to accuracy are more informative than measures related to speed of responding in refining the cognitive phenotype of ADHD.

Attention↗
PubMed2006

Recent trends in robot-assisted therapy environments to improve real-life functional performance after stroke.

Upper and lower limb robotic tools for neuro-rehabilitation are effective in reducing motor impairment but they are limited in their ability to improve real world function. There is a need to improve functional outcomes after robot-assisted therapy. Improvements in the effectiveness of these environments may be achieved by incorporating into their design and control strategies important elements key to inducing motor learning and cerebral plasticity such as mass-practice, feedback, task-engagement, and complex problem solving. This special issue presents nine articles. Novel strategies covered in this issue encourage more natural movements through the use of virtual reality and real objects and faster motor learning through the use of error feedback to guide acquisition of natural movements that are salient to real activities. In addition, several articles describe novel systems and techniques that use of custom and commercial games combined with new low-cost robot systems and a humanoid robot to embody the " supervisory presence" of the therapy as possible solutions to exercise compliance in under-supervised environments such as the home.

Editorial↗
PubMed2000

Functional performance in rheumatoid arthritis.

Patients with rheumatoid arthritis experience varying patterns of disease activity, which can result in irreversible joint damage. The disease requires a multidisciplinary approach to care to suppress the disease process and maintain functional ability. The assessment process must be easy to use, thorough, yet concise.

Activities of Daily Living↗
PubMed2003

Effects of training on functional performance in 65, 75 and 85 year-old women: experiences deriving from community based studies in Odense, Denmark.

The aim of the Odense training studies is to elucidate if regular physical training influences the expected decline in physical functional ability in order to assess capacity for postponing dependence in old age. All participants were healthy community-dwelling women representing three different age-cohorts of 65, 75 and 85 year-old subjects. The 65 and 85 year-old participants of the training group took part in physical class-based exercises for eight months with one session of 60 min a week, whereas the 75 year-old women trained twice a week over eight months. The multicomponent training consisted of various exercises typically involving body awareness, rhythm, aerobic performance (walking), muscle strength and muscle endurance, flexibility, reaction and balance exercises. Physical ability was measured as physical performance test (PPT), isometric muscle strength of the trunk, hip and leg, aerobic capacity and walking speed. This shows that regular training can significantly improve physical ability of elderly women with regard to PPT, maximal oxygen uptake and maximal walking speed, suggesting that both young-old and old-old women are able to benefit from regular tailored exercise training. Thus, physical training of old community-dwelling women appears to represent a prophylactic remedy that merits further research aimed at evaluating the preliminary findings of the present studies in larger, less selective groups of participants.

Aged↗
PubMed1983

Patient profiles: utilization in functional performance assessment.

A computerized XY graphic plotted profile has been developed as a method of displaying patient progress and goals using the Patient Evaluation Conference System (PECS) as the data source. Each profile is a bar graph of functional status and goal scores for specific contact-evaluation points. Contacts are represented by different colors so that one color is superimposed on the other. Individual functional items are plotted on the X-axis at the appropriate level of independent or dependent function, as indicated by the 0 to 7 scale which appears on the Y-axis. The profile is used in goal-oriented team conferences, and provides a focus on particular problems of low status or discrepencies between status and goals. This visual aid can provide a display of rehabilitation progress useful to the patient, family, and staff.

Accidents↗
PubMed2002

ADHD outside the laboratory: boys' executive function performance on tasks in videogame play and on a visit to the zoo.

One current theory of attention-deficit/hyperactivity disorder (ADHD) proposes that a primary deficit in behavioral inhibition gives rise to secondary deficits in 4 executive functions and motor control. To date, empirical support for this model is based primarily on laboratory-based cognitive methods. This study assessed behavioral inhibition and executive functioning in children with ADHD in 2 real-life contexts: videogames (motor-skill target game, cognitively demanding adventure game) and an outing at the zoo (route tasks). Participants were a community sample of 57 boys diagnosed with ADHD (20 inattentive, 37 combined type) and 57 normally developing control boys, matched individually for age and nonverbal IQ. Operationally defined measures of behavioral inhibition and specific executive functions were derived from these activities and assessed under contrasting conditions of low or high working memory and distractor loads. There were no group differences in basic motor skills on the target game, nor in terms of the ability to inhibit a prepotent or ongoing response in the adventure videogame. However, boys with ADHD exhibited more self-talk, more effortful response preparation, and completed fewer challenges in the latter videogame. Also, they manifested inhibition deficits in terms of interference control during the route task at the zoo and took longer to complete the tasks. Typically, these differences were greatest under conditions of high working memory and distractor loads. Findings from this study suggest that cognitive difficulties in ADHD may be context dependent and that ADHD is associated with deficits in some but not all aspects of behavioral inhibition.

Analysis of Variance↗
PubMed2004

Is perception of handicap related to functional performance in persons with vestibular dysfunction?

OBJECTIVE: The purpose of this study was to determine if scores between 0 and 30 (mild), 31 and 60 (moderate), and 61 and 100 (severe) on the Dizziness Handicap Inventory (DHI) differentiated a person's functional abilities. STUDY DESIGN: Retrospective case series. SETTING: Tertiary balance outpatient center. PATIENTS: Patients (n = 85; mean age, 61 years) with a variety of vestibular diagnoses participated. INTERVENTIONS: Patients completed the DHI, the Dynamic Gait Index (DGI), the 5 times sit to stand test (FTSST), the Activities-specific Balance Confidence (ABC) scale, gait speed, and the Timed "Up & Go" (TUG) during the same session. Reported numbers of falls within the last 4 weeks were recorded. MAIN OUTCOME MEASURES: The DGI, FTSST, ABC, gait speed, TUG, and gait speed were compared among DHI groups. RESULTS: Significant differences were identified using an analysis of variance between DHI groups on the DGI, the FTSST, ABC, and number of falls (p < 0.05). A significant difference was found between DHI groups (mild vs. severe and moderate vs. severe) on the DGI (p < 0.05) with greater DHI scores exhibiting more impaired walking. The FTSST was different between DHI groups mild and severe and DHI groups moderate and severe (p < 0.05), with slower FTSST scores with higher DHI scores. Reported falls were higher among the severe DHI group and the other 2 DHI groups (p < 0.05). All 3 DHI groupings were different from each other on the ABC (p < 0.001). CONCLUSION: Patients who perceive a greater handicap as a result of dizziness demonstrate greater functional impairment than patients who perceive less handicap from dizziness.

Adolescent↗
PubMed2006

Pretreatment with transmyocardial revascularization might improve ischemic myocardial function performed with cell transplantation.

BACKGROUND: Cells transplanted into the myocardial infarct areas might be lost because of the lack of blood supply to these myocardium areas. The hypothesis that pretreatment with angiogenic therapy induced by transmyocardial revascularization (TMR) might improve ischemic myocardial function, followed by cell transplantation was tested. METHODS AND RESULTS: After the ligation of the left anterior descending coronary artery, rats were treated with TMR. Two weeks, embryonic stem cells were transplanted into an injured heart. Four weeks after cell transplantation, cardiac function was assessed by homodynamic measurements. Capillary density and infarct size in the infarct myocardium were measured by using a previous experimental method. Graft histology and morphology was also evaluated. Four weeks after the operation, myocardial infarct (MI) rats treated with TMR and cell transplantation showed significantly higher cardiac function in hemodynamic measurements (p < 0.01) than that of MI rats receiving cell transplantation or TMR alone. A significant increase in capillary density and reduction in infarct size was observed in the MI rats that received a combined therapy (p < 0.01). CONCLUSION: Pretreatment of an infarct region of the heart with angiogenesis induced by TMR can enhance the efficacy of a cell graft and attenuate the progression of cardiac dysfunction in the rat model.

Angiogenic Proteins↗
PubMedDate not supplied

Kinesiologic measurements of functional performance before and after geometric total knee replacemtn: one-year follow-up of twenty cases.

Kinesiologic measurements were made in patients with severe arthritis before and after geometric total knee replacements to evaluate the nature, rate and extent of change in their functional ability. Preoperatively, patients with rheumatoid arthritis functioned at lower levels than patients with osteoarthritis. Most patients with rheumatoid arthritis improved steadily after surgery, while progress of those with osteoarthritis was often irregular. The group with rheumatoid arthritis improved more than those with osteoarthritis, but they did not generally reach the functional level attained by the patients with osteoarthritis, and neither group reached the lower limits of normal variability 1 year postoperatively. On the average, both groups gained knee extensions, lost knee flexion, and gained isometric knee flexor muscle strength postoperatively. Every patient with osteoarthritis lost extensor muscle strength 1 year after surgery, while most with rheumatoid arthritis gained. During quiet standing, most patients had straighter knees postoperatively and bore a greater percent of body weight on the operated limb. Patients with rheumatoid arthritis improved more than patients with osteoarthritis in the type and amount of force applied to canes and crutches. Most patients walked faster postoperatively, took longer and more rapid steps, improved the pattern of knee motion used, and had smoother forward, lateral and vertical head motion.

Aged↗
PubMed2005

In-vitro assessment of the functional performance of the decellularized intact porcine aortic root.

BACKGROUND AND AIMS OF THE STUDY: Tissue-engineered heart valves offer the potential to deliver a heart valve replacement that will develop with the young patient. The present authors' approach is to use decellularized aortic heart valves reseeded in vitro or in vivo with the patient's own cells. It has been reported that treatment of porcine aortic valve leaflets with 0.1% (w/v) sodium dodecyl sulfate (SDS) in hypotonic buffer produced complete leaflet acellularity without affecting tissue strength. The present study aim was to investigate the effect of an additional treatment incorporating 1.25% (w/v) trypsin and 0.1% (w/v) SDS on the biomechanics and hydrodynamics of the aortic root. This treatment has been shown to produce decellularization of both the aorta and valve leaflets. METHODS: Fresh porcine aortic roots were treated to reduce the thickness of their aortic wall, and incubated in hypotonic buffer for 24 h. The leaflets were masked with agarose gel, and the aorta was treated with 1.25% (w/v) trypsin for 4 h at 37 degrees C. The trypsin and agarose were removed and the roots incubated with 0.1% (w/v) SDS in hypotonic buffer for 24 h. Fresh and treated circumferential and axial aortic specimens were subjected to uniaxial tensile testing, while intact porcine aortic roots were subjected to dilation and pulsatile flow testing. RESULTS: Decellularized aortic wall specimens demonstrated significantly decreased elastin phase slope and increased transition strain compared to the fresh control. However, the treatment did not impair tissue strength. Decellularized intact roots presented complete leaflet competence under systemic pressures, increased dilation and effective orifice areas, reduced pressure gradients, physiological leaflet kinematics and reduced leaflet deformation. CONCLUSION: The excellent leaflet kinematics and hydrodynamic performance of the decellularized roots, coupled with the excellent biomechanical characteristics of their aortic wall, form a promising platform for the creation of an acellular valve scaffold with adequate mechanical strength and functionality to accommodate dynamic cell repopulation in vitro or in vivo. This approach can be used for both allogeneic and xenogeneic tissue matrices.

Animals↗
PubMed2002

Predicting functional performance by patients with Alzheimer's disease using the Problems in Everyday Living (PEDL) Test: a preliminary study.

Findings from a recent population-based survey indicate that about 33% of patients with dementia reside alone. Because many of these patients may not have a caregiver who visits them regularly, the need for a neuropsychological (NP) test to predict patients' functional competence to live alone safely is evident. In this study, we compared the accuracy of predicting Instrumental and Basic Activities (IADLs and ADLs) of 22 patients with Alzheimer's disease using several standard NP tests and the newly developed Problems in Everyday Living (PEDL) test. Performance of IADLs and ADLs as rated by caregivers was significantly correlated with performance on the PEDL, the Mini-Mental State Exam (MMSE), and with the Shipley Institute of Living Test of Verbal Abstraction (SILS-A), but not with vocabulary or naming. The PEDL was the best predictor of IADL scores (r = 0.71), compared to the MMSE (r = 0.52) and the SILS-A (r = 0.57), while the MMSE was the best predictor of ADL performance (r = 0.69), compared to the PEDL (r = 0.58) and the SILS-A (r = 0.50).

Activities of Daily Living↗
PubMedDate not supplied

[Changes in cognitive function performance in patients after anesthesia].

This study evaluates the mental performance of 112 patients (ASA grade 1 and 2) submitted to Orthopaedic, Urologic, Gynecologic, General and ENT surgery in Santo Antonio General Hospital. These patients received different types of anaesthesia: General Balanced Anaesthesia--GBA (n = 80), Total Intravenous Anaesthesia--TIVA (n = 17) and Regional Anaesthesia--RA (n = 15). Cognitive function was tested using the mini mental state test (MMS), which was done 24 hours before and 24 hours after anaesthesia. There was a high correlation between pre and postoperative MMS scores (R = 0.94). Patients in the GBA group show a significant (p < 0.001) decrease in cognitive performance 24 hours after surgery in comparison to the preoperative test. No differences were observed between the pre and postoperative MMS tests in the TIVA and RA groups.

Adult↗
PubMed1997

Effect of the preweaning nutritional state on the cardiac protein profile and functional performance of the rat heart.

The aim of the study was to find out whether the changes in nutritional status induced by different litter size during early postnatal development can influence quantitative and qualitative protein remodeling and contractile performance of the myocardium. Male Wistar rats born at the same day were pooled together at 2 days postbirth and assigned by random selection to dams in groups of 4, 8 or 16 rats/litter. The animals were investigated at the age of 4 and 16 weeks. The results revealed that the early postnatal nutritional modification altered weight parameters: whereas lower heart weight persisted in slow-growing rats until 16 weeks, higher body weight of fast-growing rats returned to the control level at the age of 16 weeks. Altered nutritional status influenced also protein remodeling of the myocardium: the concentration of all noncollagenous proteins (fractions of metabolic and contractile proteins) significantly increased in slow-growing rats, on the other hand, the concentration of collagenous proteins (pepsin-soluble and -insoluble fractions) was higher in fast-growing animals. The changes were, however, only transitional: three months after the end of the weaning period most protein changes returned to the control level. However, higher concentration of total blood lipids and triglycerides in fast-growing rats persisted until adulthood. Nutritional changes had, however, only minor effect on ventricular performance. No differences among groups were observed in basal values of the left ventricular pressure, while the maximum pressure attained after an acute ventricular loading and the contractile reserve were significantly decreased in slow-growing 4 week old rats. The functional consequence of altered nutritional status during weaning was only transitional, in agreement with the transient character of most structural and biochemical markers of myocardial remodeling.

Animal Nutritional Physiological Phenomena↗