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Sample records for exercise therapy

  1. Exercise therapy in juvenile idiopathic arthritis

    NARCIS (Netherlands)

    Takken, T.; van Brussel, M.; Engelbert, R. H. H.; van der Net, J.; Kuis, W.; Helders, P. J. M.

    2008-01-01

    Exercise therapy is considered an important component of the treatment of arthritis. The efficacy of exercise therapy has been reviewed in adults with rheumatoid arthritis but not in children with juvenile idiopathic arthritis (JIA). To assess the effects of exercise therapy on functional ability,

  2. Treatment goals and treatment in exercise therapy.

    NARCIS (Netherlands)

    Zuijderduin, W.M.; Dekker, J.

    1994-01-01

    In the present study a quantitative description is given of treatment in exercise therapy according to Cesar and according to Mensendieck. Information was gathered from saurvey on exercise therapy in the Netherlands. Characteristics of treatment are described including treatment goals, emphasis of

  3. Exercise therapy for patellofemoral pain syndrome.

    Science.gov (United States)

    Heintjes, E; Berger, M Y; Bierma-Zeinstra, S M A; Bernsen, R M D; Verhaar, J A N; Koes, B W

    2003-01-01

    Patellofemoral pain syndrome (PFPS) is a common problem among adolescents and young adults, characterised by retropatellar pain (behind the kneecap) or peripatellar pain (around the kneecap) when ascending or descending stairs, squatting or sitting with flexed knees. Etiology, structures causing the pain and treatment methods are all debated in literature, but consensus has not been reached so far. Exercise therapy to strengthen the quadriceps is often prescribed, though its efficacy is still debated. This review aims to summarise the evidence of effectiveness of exercise therapy in reducing anterior knee pain and improving knee function in patients with PFPS. We searched the Cochrane Musculoskeletal Injuries Group and Cochrane Rehabilitation and Related Therapies Field specialised registers, the Cochrane Controlled Trials Register, PEDro - The Physiotherapy Evidence Database, MEDLINE, EMBASE, CINAHL, up till December 2001 for controlled trials (randomised or not) comparing exercise therapy with control groups, or comparing different types of exercise therapy. Only trials focusing on exercise therapy in patients with PFPS were considered. Trials in patients with other diagnoses such as tendinitis, Osgood Schlatter syndrome, bursitis, traumatic injuries, osteoarthritis, plica syndrome, Sinding-Larssen-Johansson syndrome and patellar luxations were excluded. From 750 publications 12 trials were selected. All included trials studied quadriceps strengthening exercises. Outcome assessments for knee pain and knee function in daily life were used in a best evidence synthesis to summarise evidence for effectiveness. One high and two low quality studies used a control group not receiving exercise therapy. Significantly greater pain reduction in the exercise groups was found in one high and one low quality study, though at different time points. Only one low quality study reported significantly greater functional improvement with exercise. Five studies compared exercise

  4. Exercise therapy for chronic fatigue syndrome.

    Science.gov (United States)

    Larun, Lillebeth; Brurberg, Kjetil G; Odgaard-Jensen, Jan; Price, Jonathan R

    2017-04-25

    Chronic fatigue syndrome (CFS) is characterised by persistent, medically unexplained fatigue, as well as symptoms such as musculoskeletal pain, sleep disturbance, headaches and impaired concentration and short-term memory. CFS presents as a common, debilitating and serious health problem. Treatment may include physical interventions, such as exercise therapy, which was last reviewed in 2004. The objective of this review was to determine the effects of exercise therapy (ET) for patients with CFS as compared with any other intervention or control.• Exercise therapy versus 'passive control' (e.g. treatment as usual, waiting-list control, relaxation, flexibility).• Exercise therapy versus other active treatment (e.g. cognitive-behavioural therapy (CBT), cognitive treatment, supportive therapy, pacing, pharmacological therapy such as antidepressants).• Exercise therapy in combination with other specified treatment strategies versus other specified treatment strategies (e.g. exercise combined with pharmacological treatment vs pharmacological treatment alone). We searched The Cochrane Collaboration Depression, Anxiety and Neurosis Controlled Trials Register (CCDANCTR), the Cochrane Central Register of Controlled Trials (CENTRAL) and SPORTDiscus up to May 2014 using a comprehensive list of free-text terms for CFS and exercise. We located unpublished or ongoing trials through the World Health Organization (WHO) International Clinical Trials Registry Platform (to May 2014). We screened reference lists of retrieved articles and contacted experts in the field for additional studies SELECTION CRITERIA: Randomised controlled trials involving adults with a primary diagnosis of CFS who were able to participate in exercise therapy. Studies had to compare exercise therapy with passive control, psychological therapies, adaptive pacing therapy or pharmacological therapy. Two review authors independently performed study selection, risk of bias assessments and data extraction. We

  5. [Exercise therapy as a therapeutic concept].

    Science.gov (United States)

    Reer, R; Ziegler, M; Braumann, K-M

    2005-08-01

    Lack of exercise is a primary cause for today's level of morbidity and mortality in the Western world. Thus, exercise as a therapeutic modality has an important role. Beneficial effects of exercise have been extensively documented, specifically in primary and secondary prevention of coronary heart disease (CHD), diabetes mellitus, hypertension, disorders of fat metabolism, heart insufficiency, cancer, etc. A regular (at least 3 x per week) endurance training program of 30-40 min duration at an intensity of 65-70% of VO(2)max involving large muscle groups is recommended. The specific exercise activity can also positively affect individuals with orthopedic disease patterns, i.e., osteoporosis, back pain, postoperative rehabilitation, etc. Endurance strength training in the form of sequential training involving approx. 8-10 different exercises for the most important muscle groups 2 x per week is a suitable exercise therapy. One to three sets with 8-12 repetitions per exercise should be performed until volitional exhaustion of the trained muscle groups among healthy adults and 15-20 repetitions among older and cardiac patients. Apart from a positive effect on the locomotor system, this type of strength training has positive effects on CHD, diabetes mellitus, and cancer.

  6. The effect of exercise therapy on fatigue in multiple sclerosis

    DEFF Research Database (Denmark)

    Andreasen, A; Stenager, E; Dalgas, U

    2011-01-01

    Fatigue occurs in the majority of patients with multiple sclerosis (MS) and therapeutic possibilities are few. Exercise therapy is a therapeutic option but no studies have systematically reviewed the existing literature evaluating the effect of exercise therapy on MS fatigue.......Fatigue occurs in the majority of patients with multiple sclerosis (MS) and therapeutic possibilities are few. Exercise therapy is a therapeutic option but no studies have systematically reviewed the existing literature evaluating the effect of exercise therapy on MS fatigue....

  7. Massage therapy and exercise therapy in patients with multiple sclerosis: a randomized controlled pilot study.

    Science.gov (United States)

    Negahban, Hossein; Rezaie, Solmaz; Goharpey, Shahin

    2013-12-01

    The primary aim was to investigate the comparative effects of massage therapy and exercise therapy on patients with multiple sclerosis. The secondary aim was to investigate whether combination of both massage and exercise has an additive effect. Randomized controlled pilot trial with repeated measurements and blinded assessments. Local Multiple Sclerosis Society. A total of 48 patients with multiple sclerosis were randomly assigned to four equal subgroups labelled as massage therapy, exercise therapy, combined massage-exercise therapy and control group. The treatment group received 15 sessions of supervised intervention for five weeks. The massage therapy group received a standard Swedish massage. The exercise therapy group was given a combined set of strength, stretch, endurance and balance exercises. Patients in the massage-exercise therapy received a combined set of massage and exercise treatments. Patients in the control group were asked to continue their standard medical care. Pain, fatigue, spasticity, balance, gait and quality of life were assessed before and after intervention. Massage therapy resulted in significantly larger improvement in pain reduction (mean change 2.75 points, P = 0.001), dynamic balance (mean change, 3.69 seconds, P = 0.009) and walking speed (mean change, 7.84 seconds, P = 0.007) than exercise therapy. Patients involved in the combined massage-exercise therapy showed significantly larger improvement in pain reduction than those in the exercise therapy (mean change, 1.67 points, P = 0.001). Massage therapy could be more effective than exercise therapy. Moreover, the combination of massage and exercise therapy may be a little more effective than exercise therapy alone.

  8. Therapeutic Efficacy of Exercise and Laser Therapy in the ...

    African Journals Online (AJOL)

    Therapeutic Efficacy of Exercise and Laser Therapy in the Symptomatic Management of Osteoarthritis of the knee joint. ... Both groups received standard care of exercise (mode: low intensity, time: 15 minutes) per session for 6 weeks. In addition to the exercise, the LLLT group received 18 LLLT (Laser class 3b, frequency of ...

  9. Optimizing supervised exercise therapy for patients with intermittent claudication

    NARCIS (Netherlands)

    Nicolaï, Saskia P A; Hendriks, Erik J M; Prins, Martin H; Teijink, Joep A W; van Asselt, Thea

    2010-01-01

    BACKGROUND: The first-line intervention for intermittent claudication is usually supervised exercise therapy (SET). The literature describes a range of exercise programs varying in setting, duration, and content. The purpose of the present study was to examine the exercise protocols offered and to

  10. Exercise therapy for chronic nonspecific low-back pain

    NARCIS (Netherlands)

    van Middelkoop, Marienke; Rubinstein, Sidney M; Verhagen, Arianne P; Ostelo, Raymond W; Koes, Bart W; van Tulder, Maurits W

    Exercise therapy is the most widely used type of conservative treatment for low back pain. Systematic reviews have shown that exercise therapy is effective for chronic but not for acute low back pain. During the past 5 years, many additional trials have been published on chronic low back pain. This

  11. Manual physical therapy and perturbation exercises in knee osteoarthritis

    OpenAIRE

    Rhon, Daniel; Deyle, Gail; Gill, Norman; Rendeiro, Daniel

    2013-01-01

    Objectives: Knee osteoarthritis (OA) causes disability among the elderly and is often associated with impaired balance and proprioception. Perturbation exercises may help improve these impairments. Although manual physical therapy is generally a well-tolerated treatment for knee OA, perturbation exercises have not been evaluated when used with a manual physical therapy approach. The purpose of this study was to observe tolerance to perturbation exercises and the effect of a manual physical th...

  12. Exercise and Movement-based Therapies in Geriatric Pain Management.

    Science.gov (United States)

    Laubenstein, Sean; Beissner, Katherine

    2016-11-01

    Exercise is often recommended for older adults with pain, but pain itself is often a barrier to increased activity. This article reviews the evidence on the impact of various forms of exercise and related movement therapies on older adults with pain problems. The literature is reviewed with respect to published guidelines. When prescribing exercise, it is important to consider appropriate intensity, type, and duration of exercise as well as incorporating a plan for progression. Strategies to ensure adherence to exercise programs are also important. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Exercise therapy in Type 2 diabetes

    NARCIS (Netherlands)

    S.F.E. Praet (Stephan); L.J.C. van Loon (Luc)

    2009-01-01

    textabstractStructured exercise is considered an important cornerstone to achieve good glycemic control and improve cardiovascular risk profile in Type 2 diabetes. Current clinical guidelines acknowledge the therapeutic strength of exercise intervention. This paper reviews the wide

  14. Exercise: An Alternative Therapy for Gestational Diabetes.

    Science.gov (United States)

    Artal, Raul

    1996-01-01

    Exercise is encouraged in the management of pregnant women with gestational diabetes or women with Type II diabetes who become pregnant. Although non-weight-bearing exercises may be best for sedentary women, moderate workouts appear to be safe for most women with gestational diabetes. The role of exercise, risk factors, warning signs, and examples…

  15. Working the Continuum between Therapy and Exercise.

    Science.gov (United States)

    Sova, Ruth

    Because of the relative weightlessness factor, water exercise is an excellent low-impact aerobic activity for people with physical difficulties. Participants should inform their physicians of intentions to begin aquatic exercise, and physicians should advise participants that water exercise is exertive. Program instructors must be prepared to…

  16. Non-specific exercise therapy for benign paroxysmal postural vertigo

    National Research Council Canada - National Science Library

    Nomura, Toshiyuki; Yamamoto, Masahiko; Suzuki, Mitsuya; Yoshida, Tomoe; Ohwada, Satoko; Ikemiyagi, Yoshihiro; Shigeta, Fuyuko; Tamura, Yuya

    2011-01-01

    We treated 1145 patients diagnosed as having benign paroxysmal postural vertigo at the Toho University Medical Center Sakura Hospital from August 2007 to July 2009 by the exercise therapy developed by us...

  17. The effect of exercise therapy on fatigue in multiple sclerosis.

    Science.gov (United States)

    Andreasen, A K; Stenager, E; Dalgas, U

    2011-09-01

    Fatigue occurs in the majority of patients with multiple sclerosis (MS) and therapeutic possibilities are few. Exercise therapy is a therapeutic option but no studies have systematically reviewed the existing literature evaluating the effect of exercise therapy on MS fatigue. To determine the effect of exercise therapy on MS fatigue by systematically reviewing the literature. A comprehensive literature search (PubMed, SweMed +, Embase, Cochrane, CINAHL, PEDro, Sport Discuss and Bibliotek.dk) was conducted. Studies evaluating the effect of exercise therapy on MS fatigue show heterogeneous results and only few studies have evaluated MS fatigue as the primary outcome. The heterogeneous findings seem to be related to the selected study population, which in many studies are non-fatigued. Most studies that have included fatigued patients with MS show positive effects, although it is not clear whether any exercise modalities are superior to others because there are no comparative studies regarding different exercise interventions. Exercise therapy has the potential to induce a positive effect on MS fatigue, but findings are heterogeneous probably because many studies have applied non-fatigued study populations. Furthermore, only few studies have evaluated MS fatigue as the primary outcome measure, emphasizing the need for future studies within this field.

  18. Exercise therapy and other types of physical therapy for patients with neuromuscular diseases: a systematic review.

    NARCIS (Netherlands)

    Cup, E.H.C.; Pieterse, A.J.; Broek-Pastoor, J.M. Ten; Munneke, M.; Engelen, B.G.M. van; Hendricks, H.T.; Wilt, G.J. van der; Oostendorp, R.A.B.

    2007-01-01

    OBJECTIVE: To summarize and critically appraise the available evidence on exercise therapy and other types of physical therapies for patients with neuromuscular diseases (NMD). DATA SOURCES: Cochrane Central Register of Controlled Trials and Cochrane Database of Systematic Reviews, Medline, CINAHL,

  19. Safety of supervised exercise therapy in patients with intermittent claudication

    NARCIS (Netherlands)

    Gommans, Lindy N. M.; Fokkenrood, Hugo J. P.; van Dalen, Hendrika C. W.; Scheltinga, Marc R. M.; Teijink, Joep A. W.; Peters, Ron J. G.

    2015-01-01

    Supervised exercise therapy (SET) is recommended as the primary treatment for patients with intermittent claudication (IC). However, there is concern regarding the safety of performing SET because IC patients are at risk for untoward cardiovascular events. The Dutch physical therapy guideline

  20. [Prevention and treatment of cachexia : Exercise and nutritional therapy].

    Science.gov (United States)

    Wilms, B; Schmid, S M; Luley, K; Wiskemann, J; Lehnert, H

    2016-10-01

    Cachexia is a multifactorial and complex syndrome characterized by progressive functional impairment and ongoing loss in quality of life, which lead to a deterioration of the prognosis for affected patients. The prevalence of cachexia can be very high and is up to 80 % in patients with malignant tumors. The aim of the study was to assess the relevance of exercise and nutrition in the prevention and therapy of cachexia. An evaluation of the current literature on exercise and nutritional therapy in patients with cachexia or with advanced stage diseases where a high prevalence of cachexia is probable, was carried out. There is a lack of scientific evidence for the benefits of exercise in cachexia. A major problem of relevant studies was that cachexia was frequently not defined according to valid criteria; however, data indicate a benefit of exercise training in patients with advanced diseases associated with a high prevalence of cachexia. A solely nutritional intervention and dietary counselling seem to be of minimal benefit. The administration of omega 3 fatty acids is controversially discussed. Although there is a lack of data on the effects of exercise and nutritional therapy in cachexia, there is evidence for the benefits. The present data indicate the necessity for the use of a multimodal treatment including exercise, nutritional and pharmacological therapy in cachexia. There is a great necessity for prospective studies.

  1. Exercise as an Adjuvant Therapy for Hematopoietic Stem Cell Mobilization

    Science.gov (United States)

    Emmons, Russell; Niemiro, Grace M.; De Lisio, Michael

    2016-01-01

    Hematopoietic stem cell transplant (HSCT) using mobilized peripheral blood hematopoietic stem cells (HSPCs) is the only curative strategy for many patients suffering from hematological malignancies. HSPC collection protocols rely on pharmacological agents to mobilize HSPCs to peripheral blood. Limitations including variable donor responses and long dosing protocols merit further investigations into adjuvant therapies to enhance the efficiency of HSPCs collection. Exercise, a safe and feasible intervention in patients undergoing HSCT, has been previously shown to robustly stimulate HSPC mobilization from the bone marrow. Exercise-induced HSPC mobilization is transient limiting its current clinical potential. Thus, a deeper investigation of the mechanisms responsible for exercise-induced HSPC mobilization and the factors responsible for removal of HSPCs from circulation following exercise is warranted. The present review will describe current research on exercise and HSPC mobilization, outline the potential mechanisms responsible for exercise-induced HSPC mobilization, and highlight potential sites for HSPC homing following exercise. We also outline current barriers to the implementation of exercise as an adjuvant therapy for HSPC mobilization and suggest potential strategies to overcome these barriers. PMID:27123008

  2. Exercise as an Adjuvant Therapy for Hematopoietic Stem Cell Mobilization.

    Science.gov (United States)

    Emmons, Russell; Niemiro, Grace M; De Lisio, Michael

    2016-01-01

    Hematopoietic stem cell transplant (HSCT) using mobilized peripheral blood hematopoietic stem cells (HSPCs) is the only curative strategy for many patients suffering from hematological malignancies. HSPC collection protocols rely on pharmacological agents to mobilize HSPCs to peripheral blood. Limitations including variable donor responses and long dosing protocols merit further investigations into adjuvant therapies to enhance the efficiency of HSPCs collection. Exercise, a safe and feasible intervention in patients undergoing HSCT, has been previously shown to robustly stimulate HSPC mobilization from the bone marrow. Exercise-induced HSPC mobilization is transient limiting its current clinical potential. Thus, a deeper investigation of the mechanisms responsible for exercise-induced HSPC mobilization and the factors responsible for removal of HSPCs from circulation following exercise is warranted. The present review will describe current research on exercise and HSPC mobilization, outline the potential mechanisms responsible for exercise-induced HSPC mobilization, and highlight potential sites for HSPC homing following exercise. We also outline current barriers to the implementation of exercise as an adjuvant therapy for HSPC mobilization and suggest potential strategies to overcome these barriers.

  3. Exercise as an Adjuvant Therapy for Hematopoietic Stem Cell Mobilization

    Directory of Open Access Journals (Sweden)

    Russell Emmons

    2016-01-01

    Full Text Available Hematopoietic stem cell transplant (HSCT using mobilized peripheral blood hematopoietic stem cells (HSPCs is the only curative strategy for many patients suffering from hematological malignancies. HSPC collection protocols rely on pharmacological agents to mobilize HSPCs to peripheral blood. Limitations including variable donor responses and long dosing protocols merit further investigations into adjuvant therapies to enhance the efficiency of HSPCs collection. Exercise, a safe and feasible intervention in patients undergoing HSCT, has been previously shown to robustly stimulate HSPC mobilization from the bone marrow. Exercise-induced HSPC mobilization is transient limiting its current clinical potential. Thus, a deeper investigation of the mechanisms responsible for exercise-induced HSPC mobilization and the factors responsible for removal of HSPCs from circulation following exercise is warranted. The present review will describe current research on exercise and HSPC mobilization, outline the potential mechanisms responsible for exercise-induced HSPC mobilization, and highlight potential sites for HSPC homing following exercise. We also outline current barriers to the implementation of exercise as an adjuvant therapy for HSPC mobilization and suggest potential strategies to overcome these barriers.

  4. Manual therapy and exercise for rotator cuff disease.

    Science.gov (United States)

    Page, Matthew J; Green, Sally; McBain, Brodwen; Surace, Stephen J; Deitch, Jessica; Lyttle, Nicolette; Mrocki, Marshall A; Buchbinder, Rachelle

    2016-06-10

    Management of rotator cuff disease often includes manual therapy and exercise, usually delivered together as components of a physical therapy intervention. This review is one of a series of reviews that form an update of the Cochrane review, 'Physiotherapy interventions for shoulder pain'. To synthesise available evidence regarding the benefits and harms of manual therapy and exercise, alone or in combination, for the treatment of people with rotator cuff disease. We searched the Cochrane Central Register of Controlled Trials (CENTRAL; 2015, Issue 3), Ovid MEDLINE (January 1966 to March 2015), Ovid EMBASE (January 1980 to March 2015), CINAHL Plus (EBSCO, January 1937 to March 2015), ClinicalTrials.gov and the WHO ICTRP clinical trials registries up to March 2015, unrestricted by language, and reviewed the reference lists of review articles and retrieved trials, to identify potentially relevant trials. We included randomised and quasi-randomised trials, including adults with rotator cuff disease, and comparing any manual therapy or exercise intervention with placebo, no intervention, a different type of manual therapy or exercise or any other intervention (e.g. glucocorticoid injection). Interventions included mobilisation, manipulation and supervised or home exercises. Trials investigating the primary or add-on effect of manual therapy and exercise were the main comparisons of interest. Main outcomes of interest were overall pain, function, pain on motion, patient-reported global assessment of treatment success, quality of life and the number of participants experiencing adverse events. Two review authors independently selected trials for inclusion, extracted the data, performed a risk of bias assessment and assessed the quality of the body of evidence for the main outcomes using the GRADE approach. We included 60 trials (3620 participants), although only 10 addressed the main comparisons of interest. Overall risk of bias was low in three, unclear in 14 and high in

  5. Manual physical therapy and perturbation exercises in knee osteoarthritis

    Science.gov (United States)

    Rhon, Daniel; Deyle, Gail; Gill, Norman; Rendeiro, Daniel

    2013-01-01

    Objectives: Knee osteoarthritis (OA) causes disability among the elderly and is often associated with impaired balance and proprioception. Perturbation exercises may help improve these impairments. Although manual physical therapy is generally a well-tolerated treatment for knee OA, perturbation exercises have not been evaluated when used with a manual physical therapy approach. The purpose of this study was to observe tolerance to perturbation exercises and the effect of a manual physical therapy approach with perturbation exercises on patients with knee OA. Methods: This was a prospective observational cohort study of 15 patients with knee OA. The Western Ontario and McMaster Universities Arthritis Index (WOMAC), global rating of change (GROC), and 72-hour post-treatment tolerance were primary outcome measures. Patients received perturbation balance exercises along with a manual physical therapy approach, twice weekly for 4 weeks. Follow-up evaluation was done at 1, 3, and 6 months after beginning the program. Results: Mean total WOMAC score significantly improved (P = 0.001) after the 4-week program (total WOMAC: initial, 105; 4 weeks, 56; 3 months, 54; 6 months, 57). Mean improvements were similar to previously published trials of manual physical therapy without perturbation exercises. The GROC score showed a minimal clinically important difference (MCID)≥+3 in 13 patients (87%) at 4 weeks, 12 patients (80%) at 3 months, and 9 patients (60%) at 6 months. No patients reported exacerbation of symptoms within 72 hours following each treatment session. Discussion: A manual physical therapy approach that also included perturbation exercises was well tolerated and resulted in improved outcome scores in patients with knee OA. PMID:24421635

  6. Exercise and comorbidity: the i3-S strategy for developing comorbidity-related adaptations to exercise therapy.

    Science.gov (United States)

    Dekker, Joost; de Rooij, Mariëtte; van der Leeden, Marike

    2016-01-01

    Exercise therapy is effective in a wide range of chronic diseases. Comorbid disease necessitates adaptations to exercise therapy. Guidance on how to develop such adaptations is currently not available. We present an innovative strategy for the development of comorbidity-related adaptations to exercise therapy in an index disease. We previously developed comorbidity-related adaptations to exercise therapy in osteoarthritis. We now broaden this approach into a general strategy for the development of comorbidity-related adaptations to exercise therapy in an index disease. The i3-S strategy consists of four steps. The first three steps involve creating an inventory of comorbid disease, an inventory of contraindications and restrictions on exercise therapy, and an inventory of potential adaptations to exercise therapy. In the fourth step, this information is synthesized into guidance on comorbidity-related adaptations to exercise therapy in the index disease. The adaptations concern physiological, behavioural and environmental factors. In view of the general effectiveness of exercise therapy and the high prevalence of comorbidity in older people, there is a great need for comorbidity-related adaptations to exercise therapy. We recommend to use and evaluate the i3-S strategy in future research. Exercise therapy is effective in a wide range of chronic diseases. Comorbid disease necessitates adaptations to exercise therapy. Guidance on how to develop such adaptations is currently not available. We present an innovative strategy for the development of comorbidity-related adaptations to exercise therapy in an index disease. Researchers and clinicians can use this strategy to develop guidance on the adaptation of exercise therapy to comorbidity.

  7. Comparison of manual therapy and exercise therapy for postural hyperkyphosis: A randomized clinical trial.

    Science.gov (United States)

    Kamali, Fahimeh; Shirazi, Sara Abolahrari; Ebrahimi, Samaneh; Mirshamsi, Maryam; Ghanbari, Ali

    2016-01-01

    To compare the efficacy of a manual therapy and an exercise therapy program in improving postural hyperkyphosis among young adults. Forty-six women between the ages of 18 to 30 years with thoracic kyphosis diagnosed by flexicurve ruler were randomly assigned to either an exercise therapy or a manual therapy group. The exercise therapy program focused on stretching and strengthening exercises in 15 sessions over 5 weeks. The manual therapy group received 15 sessions of manual techniques including massage, mobilization, muscle energy and myofascial release. Kyphosis angle and back extensor muscle strength were measured with a motion analysis system and a dynamometer at the baseline and after treatment. The data were analyzed with paired and independent t-tests. After treatment, the angle of thoracic kyphosis was smaller and back extensor muscle strength was significantly greater in both the exercise and manual therapy groups (p 0.05). Manual therapy was as effective as exercise therapy in reducing kyphosis angle and increasing back extensor muscle strength in young women with postural hyperkyphosis.

  8. Impact of bronchodilator therapy on exercise tolerance in COPD

    Directory of Open Access Journals (Sweden)

    B Aguilaniu

    2010-03-01

    Full Text Available B AguilaniuHYLAB, Laboratory of Clinical Physiology and Exercise, Grenoble, FranceAbstract: Exercise tolerance is an important parameter in patients with COPD and a primary goal of treatment is to reduce dyspnea to facilitate physical activities and improve health-related quality of life. This review examines the link between expiratory flow limitation and dyspnea to explain the rationale for the use of bronchodilators and review the characteristics of different types of exercise tests, with specific focus on which tests are likely to show a response to bronchodilators. An earlier literature search of studies published up to 1999 assessed the effects of bronchodilator therapy on dypsnea and exercise tolerance among patients with COPD. This current review examines the clinical evidence published since 1999. Thirty-one randomized studies of exercise tolerance associated with short- and long-acting β2-agonists and anticholinergics were identified. Evidence for the efficacy of bronchodilators in enhancing exercise capacity is often contradictory and possibly depends on the exercise test and study methodology. However, further studies should confirm the benefit of long-acting bronchodilators in improving spontaneous everyday physical activities.Keywords: COPD, exercise, bronchodilator, walk test, exercise test

  9. Manual therapy and exercise for adhesive capsulitis (frozen shoulder).

    Science.gov (United States)

    Page, Matthew J; Green, Sally; Kramer, Sharon; Johnston, Renea V; McBain, Brodwen; Chau, Marisa; Buchbinder, Rachelle

    2014-08-26

    Adhesive capsulitis (also termed frozen shoulder) is commonly treated by manual therapy and exercise, usually delivered together as components of a physical therapy intervention. This review is one of a series of reviews that form an update of the Cochrane review, 'Physiotherapy interventions for shoulder pain.' To synthesise available evidence regarding the benefits and harms of manual therapy and exercise, alone or in combination, for the treatment of patients with adhesive capsulitis. We searched the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, CINAHL Plus, ClinicalTrials.gov and the WHO ICTRP clinical trials registries up to May 2013, unrestricted by language, and reviewed the reference lists of review articles and retrieved trials, to identify potentially relevant trials. We included randomised controlled trials (RCTs) and quasi-randomised trials, including adults with adhesive capsulitis, and comparing any manual therapy or exercise intervention versus placebo, no intervention, a different type of manual therapy or exercise or any other intervention. Interventions included mobilisation, manipulation and supervised or home exercise, delivered alone or in combination. Trials investigating the primary or adjunct effect of a combination of manual therapy and exercise were the main comparisons of interest. Main outcomes of interest were participant-reported pain relief of 30% or greater, overall pain (mean or mean change), function, global assessment of treatment success, active shoulder abduction, quality of life and the number of participants experiencing adverse events. Two review authors independently selected trials for inclusion, extracted the data, performed a risk of bias assessment and assessed the quality of the body of evidence for the main outcomes using the GRADE approach. We included 32 trials (1836 participants). No trial compared a combination of manual therapy and exercise versus placebo or no intervention. Seven trials

  10. Comparison of manual therapy and exercise therapy in osteoarthritis of the hip: a randomized clinical trial.

    NARCIS (Netherlands)

    Hoeksma, H.L.; Dekker, J.; Ronday, H.K.; Heering, A.; Lubbe, N. van der; Vel, C.; Breedveld, F.C.; Ende, C.H.M. van den

    2004-01-01

    OBJECTIVE: To determine the effectiveness of a manual therapy program compared with an exercise therapy program in patients with osteoarthritis (OA) of the hip. METHODS: A single-blind, randomized clinical trial of 109 hip OA patients was carried out in the outpatient clinic for physical therapy of

  11. Adherence to moderate-intensity exercise during breast cancer therapy.

    Science.gov (United States)

    Pickett, Mary; Mock, Victoria; Ropka, Mary E; Cameron, Lane; Coleman, Meghan; Podewils, Laura

    2002-01-01

    The aims of this pilot study were the following: 1) to examine patterns of adherence to a brisk walking program in women receiving adjuvant chemotherapy or radiation therapy for newly diagnosed breast cancer using a prospective, randomized, controlled experimental design; 2) to examine the influence of disease symptoms and treatment side effects on exercise levels; and 3) to suggest methods that may improve future clinical trials of moderate-intensity exercise in similar populations. Fifty-two patients with newly diagnosed breast cancer were randomly assigned to one of two treatment arms: usual care or usual care plus exercise. Those assigned to the exercise group received a standardized, self-administered, home-based brisk walking intervention in addition to usual care. Each day subjects completed self-report diary forms that elicited information about activity levels, and the occurrence of symptoms and side effects during cancer treatment. Analyses of self-reported daily activity levels revealed a diffusion of treatment effect. Fifty percent of the usual-care group reported maintaining or increasing their physical activity to a moderate-intensity level, while 33% of the exercise group did not exercise at the prescribed levels. Analyses of self-reported disease symptoms and treatment side effects did not reveal clinically meaningful differences between the two groups. The results of this study suggest that women who exercised regularly before receiving a breast cancer diagnosis attempted to maintain their exercise programs. Women who lead sedentary lifestyles may benefit from a structured exercise program that includes information and support related to exercise adherence strategies.

  12. [Cardiac reserve in Parkinson's disease and exercise therapy].

    Science.gov (United States)

    Hirayama, Masaaki; Nakamura, Tomohiko; Sobue, Gen

    2013-01-01

    The clinical feature of Parkinson's disease (PD) is not based on the identification of the extrapyramidal symptom such as bradykinesia, restinbg tremor, rigidity, but also other non-motor symptom (REM sleep disorder, autonomic dysfunction, hyposmia etc). According to the cardio-sympathetic dysfunction, it is well known abnormal MIBG and orthostatic hypotension finding was seen in early disease stage. Furthermore denervation supersensitivity using β1 stimulant correlates the severity of MIBG image, so that this abnormal cardiac function induces inadequate cardiac capacity for exercise. Inadequate cardiac capacity makes easy fatigability, which correlates the abnormal MIBG image and cardio-sympathetic damage. So it is difficult to prescribe a specific exercise program to meet individual PD patients needs. Music therapy and trunk exercise (for example Tai-Chi exercise) are better suited for PD patients.

  13. Cervicothoracic Manual Therapy Plus Exercise Therapy Versus Exercise Therapy Alone in the Management of Individuals With Shoulder Pain: A Multicenter Randomized Controlled Trial.

    Science.gov (United States)

    Mintken, Paul E; McDevitt, Amy W; Cleland, Joshua A; Boyles, Robert E; Beardslee, Amber R; Burns, Scott A; Haberl, Matthew D; Hinrichs, Lauren A; Michener, Lori A

    2016-08-01

    Study Design Multicenter randomized controlled trial. Background Cervicothoracic manual therapy has been shown to improve pain and disability in individuals with shoulder pain, but the incremental effects of manual therapy in addition to exercise therapy have not been investigated in a randomized controlled trial. Objectives To compare the effects of cervicothoracic manual therapy and exercise therapy to those of exercise therapy alone in individuals with shoulder pain. Methods Individuals (n = 140) with shoulder pain were randomly assigned to receive 2 sessions of cervicothoracic range-of-motion exercises plus 6 sessions of exercise therapy, or 2 sessions of high-dose cervicothoracic manual therapy and range-of-motion exercises plus 6 sessions of exercise therapy (manual therapy plus exercise). Pain and disability were assessed at baseline, 1 week, 4 weeks, and 6 months. The primary aim (treatment group by time) was examined using linear mixed-model analyses and the repeated measure of time for the Shoulder Pain and Disability Index (SPADI), the numeric pain-rating scale, and the shortened version of the Disabilities of the Arm, Shoulder and Hand questionnaire (QuickDASH). Patient-perceived success was assessed and analyzed using the global rating of change (GROC) and the Patient Acceptable Symptom State (PASS), using chi-square tests of independence. Results There were no significant 2-way interactions of group by time or main effects by group for pain or disability. Both groups improved significantly on the SPADI, numeric pain-rating scale, and QuickDASH. Secondary outcomes of success on the GROC and PASS significantly favored the manual therapy-plus-exercise group at 4 weeks (P = .03 and Pmanual therapy to an exercise program did not improve pain or disability in patients with shoulder pain, but did improve patient-perceived success at 4 weeks and 6 months and acceptability of symptoms at 4 weeks. More research is needed on the use of cervicothoracic manual

  14. Exercise therapy for trismus in head and neck cancer

    NARCIS (Netherlands)

    Dijkstra, P.U.; Sterken, M.W.; Spijkervet, F.K.L.; Roodenburg, J.L.N.; Pater, R.

    The aim of this study was to analyze retrospectively effects of exercise therapy on trismus related to head and neck cancer or as a consequence of its treatment, and to compare these effects with trismus not related to head and neck cancer. Medical records of patients referred to the department of

  15. Cognitive Load in Voice Therapy Carry-Over Exercises

    DEFF Research Database (Denmark)

    Iwarsson, Jenny; Morris, David Jackson; Balling, Laura Winther

    2017-01-01

    Purpose The cognitive load generated by online speech production may vary with the nature of the speech task. This article examines 3 speech tasks used in voice therapy carry-over exercises, in which a patient is required to adopt and automatize new voice behaviors, ultimately in daily spontaneous...

  16. Strength training alone, exercise therapy alone, and exercise therapy with passive manual mobilisation each reduce pain and disability in people with knee osteoarthritis: a systematic review

    National Research Council Canada - National Science Library

    Jansen, Mariette J; Viechtbauer, Wolfgang; Lenssen, Antoine F; Hendriks, Erik J.M; de Bie, Rob A

    2011-01-01

    What are the effects of strength training alone, exercise therapy alone, and exercise with additional passive manual mobilisation on pain and function in people with knee osteoarthritis compared to control...

  17. [Progress of foreign clinical research of exercise therapy of knee osteoarthritis].

    Science.gov (United States)

    Lin, Haidan; He, Chengqi

    2008-11-01

    To review the up-to-date development of overseas clinical study on exercise therapy for patients with knee osteoarthritis. The clinical researches of exercise therapy for knee osteoarthritis were summarized by reviewing literature concerned in recent years. Exercise therapy was extensively used in the treatment of knee osteoarthritis not only in hospital but also in community rehabilitation abroad. The main patterns of exercise therapy included muscle strengthening exercise, aerobic exercise and underwater exercise. It was capable of effectively improving patient's independent living ability and live quality, and postponing the time of surgical intervention. But the long-term efficacy of exercise therapy was still under debate. Exercise therapy is an effect method to treat knee osteoarthritis.

  18. Oxygen therapy during exercise training in chronic obstructive pulmonary disease.

    Science.gov (United States)

    Nonoyama, M L; Brooks, D; Lacasse, Y; Guyatt, G H; Goldstein, R S

    2007-04-18

    Exercise training within the context of pulmonary rehabilitation improves outcomes of exercise capacity, dyspnea and health-related quality of life in individuals with chronic obstructive pulmonary disease (COPD). Supplemental oxygen in comparison to placebo increases exercise capacity in patients performing single-assessment exercise tests. The addition of supplemental oxygen during exercise training may enable individuals with COPD to tolerate higher levels of activity with less exertional symptoms, ultimately improving quality of life. To determine how supplemental oxygen in comparison to control (compressed air or room air) during the exercise-training component of a pulmonary rehabilitation program affects exercise capacity, dyspnea and health-related quality of life in individuals with COPD. All records in the Cochrane Airways Group Specialized Register of trials coded as 'COPD' were searched using the following terms: (oxygen* or O2*) AND (exercis* or train* or rehabilitat* or fitness* or physical* or activ* or endur* or exert* or walk* or cycle*). Searching the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library), MEDLINE, EMBASE and CINAHL databases identified studies. The last search was carried out in June 2006. Only randomized controlled trials (RCTs) comparing oxygen-supplemented exercise training to non-supplemented exercise training (control group) were considered for inclusion. Participants were 18 years or older, diagnosed with COPD and did not meet criteria for long-term oxygen therapy. No studies with mixed populations (pulmonary fibrosis, cystic fibrosis, etc) were included. Exercise training was greater than or equal to three weeks in duration and included a minimum of two sessions a week. Two review authors independently selected trials for inclusion in the review and extracted data. Weighted mean differences (WMD) with 95% confidence intervals (CI) were calculated using a random-effects model. Missing data were

  19. Impact of bronchodilator therapy on exercise tolerance in COPD

    Science.gov (United States)

    Aguilaniu, B

    2010-01-01

    Exercise tolerance is an important parameter in patients with COPD and a primary goal of treatment is to reduce dyspnea to facilitate physical activities and improve health-related quality of life. This review examines the link between expiratory flow limitation and dyspnea to explain the rationale for the use of bronchodilators and review the characteristics of different types of exercise tests, with specific focus on which tests are likely to show a response to bronchodilators. An earlier literature search of studies published up to 1999 assessed the effects of bronchodilatort therapy on dypsnea and exercise tolerance among patients with COPD. This current review examines the clinical evidence published since 1999. Thirty-one randomized studies of exercise tolerance associated with short- and long-acting β2-agonists and anticholinergics were identified. Evidence for the efficacy of bronchodilators in enhancing exercise capacity is often contradictory and possibly depends on the exercise test and study methodology. However, further studies should confirm the benefit of long-acting bronchodilators in improving spontaneous everyday physical activities. PMID:20463947

  20. Acceptance and commitment therapy improves exercise tolerance in sedentary women.

    Science.gov (United States)

    Ivanova, Elena; Jensen, Dennis; Cassoff, Jamie; Gu, Fei; Knäuper, Bärbel

    2015-06-01

    To test the efficacy of an acute intervention derived from acceptance and commitment therapy (ACT) for increasing high-intensity constant work rate (CWR) cycle exercise tolerance in a group of low-active women age 18-45 yr. The secondary goals were to examine whether ACT would reduce perceived effort and improve in-task affect during exercise and increase postexercise enjoyment. In a randomized controlled trial, 39 women were randomized to either the experimental (using ACT-based cognitive techniques and listening to music during the CWR exercise tests) or a control group (listening to music during the CWR exercise tests). Before (CWR-1) and after the intervention (CWR-2), participants completed a CWR cycle exercise test at 80% of maximal incremental work rate (Wmax) until volitional exhaustion. On average, ACT (n = 18) and control (n = 21) groups were matched for age, body mass index, weekly leisure activity scores, and Wmax (all P > 0.05). Exercise tolerance time (ETT) increased by 15% from CWR-1 to CWR-2 for the ACT group (392.05 ± 146.4 vs 459.39 ± 209.3 s; mean ± SD) and decreased by 8% (384.71 ± 120.1 vs 353.86 ± 127.9 s) for the control group (P = 0.008). RPE were lower (e.g., by 1.5 Borg 6-20 scale units at 55% of ETT, P ≤ 0.01) during CWR-2 in the ACT versus that in the control group. By contrast, ACT had no effect on in-task affect. Exercise enjoyment was higher after CWR-2 in the ACT group versus that in the control group (P effective intervention for enhancing the established health benefits of high-intensity exercise need to be provided.

  1. Exercise and physical therapy in early management of Parkinson disease.

    Science.gov (United States)

    Alonso-Frech, Fernando; Sanahuja, Juan Juni; Rodriguez, Amelia Mendoza

    2011-11-01

    Experimental research has produced evidence in recent years underlying the beneficial effects that exercise can have in preventing and deceleration of the development of Parkinson disease. These beneficial effects are exerted through various mechanisms such as neuroprotection, neurotransmission, plasticity, neurogenesis, homeostasis, and neurotrophic factors. Studies on clinical application at an early stage are still scarce, although some results are encouraging. There are still many questions to determine the most suitable type of exercise (forced/voluntary), the time of its implementation, the duration, and the combination of strategies. Nonconventional therapies can play an important role in addition to exercise, and are so numerous that they could be adapted to the circumstances of patients, although there is no evidence to date that they could have a neuroprotective effect.

  2. Enhanced Exercise Therapy in Parkinson?s disease: A comparative effectiveness trial

    OpenAIRE

    Ridgel, Angela L.; Walter, Benjamin L.; Tatsuoka, Curtis; Walter, Ellen M.; Col?n-Zimmermann, Kari; Welter, Elisabeth; Sajatovic, Martha

    2015-01-01

    Objectives Exercise can improve motor function in people with Parkinson?s disease but depression reduces the motivation to participate in regular exercise. The aim of this study was to develop a novel Enhanced Exercise Therapy program that uses manual-driven guided exercise and peer-facilitated psychoeducation for individuals with Parkinson?s disease and depression. Design 24 week randomized controlled design. Methods Thirty individuals were randomized to Enhanced Exercise Therapy or self-gui...

  3. VACUUM THERAPY VERSUS ABDOMINAL EXERCISES ON ABDOMINAL OBESITY

    Directory of Open Access Journals (Sweden)

    Nevein Mohammed Mohammed Gharib

    2016-06-01

    Full Text Available Background: Obesity is a medical condition that may adversely affect wellbeing and leading to increased incidence of many health problems. Abdominal obesity tends to be associated with weight gain and obesity and it is significantly connected with different disorders like coronary heart disease and type II diabetes mellitus.This study was conducted to investigate the efficacy of vacuum therapy as compared to abdominal exercises on abdominal obesity in overweight and obese women. Methods: Thirtyoverweight and obese women participated in this study with body mass index > 25 kg/m2andwaist circumference ≥ 85 cm. Their ages ranged from 28 - 40 years old.The subjects were excluded if they have diabetes, abdominal infection diseases or any physical limitation restricting exercise ability. They were randomly allocated into two equal groups; group I and group II. Group I received vacuum therapy sessions (by the use of LPG device in addition to aerobic exercise training. Group II received abdominal exercises in addition to the same aerobic exercisesgiven to group I. This study was extended for successive 8 weeks (3 sessions/ week. All subjects were assessed for thickness ofnthe abdominal skin fold, waist circumference and body mass index. Results: The results of this study showeda significant difference between group I and group II post-interventionas regarding to the mean values of waist circumference and abdominal skin fold thickness (p<0.05. Conclusion: It can be concluded that aerobic exercises combined with vacuum therapy (for three sessions/week for successive 8 weeks have a positive effect on women with abdominal obesity in terms of reducing waist circumference and abdominal skin fold thickness.

  4. EFFECTIVENESS OF MANUAL THERAPY VERSUS EXERCISE THERAPY FOR THE MANAGEMENT OF KNEE OSTEOARTHRITIS IN KARACHI PAKISTAN

    Directory of Open Access Journals (Sweden)

    Ayesha Zakir

    2016-02-01

    Full Text Available Introduction: Among musculoskeletal disorders knee Osteoarthritis (OA is exceedingly prevailing articular disorder affecting people and it is a major cause of disability and socioeconomic burden. It is more common in women than men. Entities with knee OA must often undergo a variety of problems, such as pain and tenderness in joints, movement limitation, crepitus on movement, swelling, recurrent effusion, and local inflammation which ultimately leads to limitation in physical function, like lack of ability to perform Activities of Daily Living (ADL or Instrumental Activities of Daily Living (IADL. For reducing knee pain in osteoarthritis several conventional treatment methods are used world widely but most extensively used in our country are pharmacologic and physical therapy. The objective of the study is to find out the effectiveness of Manual therapy verses Exercise therapy for the management of knee osteoarthritis. Methods: Sixty patients including both male and female with mean age (51years and SD of (5.1 were enrolled in the study and divided randomly in to two groups. Those who were assigned as group A had received Manual therapy and those who were assigned as group B had received Exercise therapy. Participants had received three treatment sessions of 30 min per week for consecutive 4 weeks. OUTCOME MEASURE: WOMAC index score for pain, stiffness and physical function was used to evaluate the baseline score and treatment effects after 12 therapy sessions. Results: Study showed significant improvement in both groups before and after the treatment but in comparison manual therapy group showed significant results with respect to pain subscale (p=0.003 and physical function subscale (p=0.004. Conclusion: Significant difference found between manual therapy and exercise therapy treatment approaches in treating knee osteoarthritis. Findings of this study revealed the fact that short term treatment sessions of manual therapy were superior to

  5. Vestibular Rehabilitation Therapy: Review of Indications, Mechanisms, and Key Exercises

    Science.gov (United States)

    Song, Hyun Seok; Kim, Ji Soo

    2011-01-01

    Vestibular rehabilitation therapy (VRT) is an exercise-based treatment program designed to promote vestibular adaptation and substitution. The goals of VRT are 1) to enhance gaze stability, 2) to enhance postural stability, 3) to improve vertigo, and 4) to improve activities of daily living. VRT facilitates vestibular recovery mechanisms: vestibular adaptation, substitution by the other eye-movement systems, substitution by vision, somatosensory cues, other postural strategies, and habituation. The key exercises for VRT are head-eye movements with various body postures and activities, and maintaining balance with a reduced support base with various orientations of the head and trunk, while performing various upper-extremity tasks, repeating the movements provoking vertigo, and exposing patients gradually to various sensory and motor environments. VRT is indicated for any stable but poorly compensated vestibular lesion, regardless of the patient's age, the cause, and symptom duration and intensity. Vestibular suppressants, visual and somatosensory deprivation, immobilization, old age, concurrent central lesions, and long recovery from symptoms, but there is no difference in the final outcome. As long as exercises are performed several times every day, even brief periods of exercise are sufficient to facilitate vestibular recovery. Here the authors review the mechanisms and the key exercises for each of the VRT goals. PMID:22259614

  6. Comparison of general exercise, motor control exercise and spinal manipulative therapy for chronic low back pain: A randomized trial.

    Science.gov (United States)

    Ferreira, Manuela L; Ferreira, Paulo H; Latimer, Jane; Herbert, Robert D; Hodges, Paul W; Jennings, Matthew D; Maher, Christopher G; Refshauge, Kathryn M

    2007-09-01

    Practice guidelines recommend various types of exercise and manipulative therapy for chronic back pain but there have been few head-to-head comparisons of these interventions. We conducted a randomized controlled trial to compare effects of general exercise, motor control exercise and manipulative therapy on function and perceived effect of intervention in patients with chronic back pain. Two hundred and forty adults with non-specific low back pain 3months were allocated to groups that received 8weeks of general exercise, motor control exercise or spinal manipulative therapy. General exercise included strengthening, stretching and aerobic exercises. Motor control exercise involved retraining specific trunk muscles using ultrasound feedback. Spinal manipulative therapy included joint mobilization and manipulation. Primary outcomes were patient-specific function (PSFS, 3-30) and global perceived effect (GPE, -5 to 5) at 8weeks. These outcomes were also measured at 6 and 12months. Follow-up was 93% at 8weeks and 88% at 6 and 12months. The motor control exercise group had slightly better outcomes than the general exercise group at 8weeks (between-group difference: PSFS 2.9, 95% CI: 0.9-4.8; GPE 1.7, 95% CI: 0.9-2.4), as did the spinal manipulative therapy group (PSFS 2.3, 95% CI: 0.4-4.2; GPE 1.2, 95% CI: 0.4-2.0). The groups had similar outcomes at 6 and 12months. Motor control exercise and spinal manipulative therapy produce slightly better short-term function and perceptions of effect than general exercise, but not better medium or long-term effects, in patients with chronic non-specific back pain.

  7. Effects of adding concentration therapy to Kegel exercise to improve continence after radical prostatectomy, randomized control

    National Research Council Canada - National Science Library

    Kongtragul, Jaruwan; Tukhanon, Wanvara; Tudpudsa, Piyanuch; Suedee, Kanita; Tienchai, Supaporn; Leewansangtong, Sunai; Nualgyong, Chaiyong

    2014-01-01

    .... One hundred thirty five patients were randomized into the intervention group that concentration therapy was added to Kegel exercise, and control group that was Kegel exercise only, using the stratified randomization...

  8. [Non-specific exercise therapy for benign paroxysmal postural vertigo].

    Science.gov (United States)

    Nomura, Toshiyuki; Yamamoto, Masahiko; Suzuki, Mitsuya; Yoshida, Tomoe; Ohwada, Satoko; Ikemiyagi, Yoshihiro; Shigeta, Fuyuko; Tamura, Yuya

    2011-11-01

    We treated 1145 patients diagnosed as having benign paroxysmal postural vertigo at the Toho University Medical Center Sakura Hospital from August 2007 to July 2009 by the exercise therapy developed by us. The most advantageous characteristic of our method is that patients can perform the exercises themselves at their own pace in their homes, even if the affected side cannot be identified and/or the patients have any orthopedic cervical and/or spinal problems. In 80.7% and 91.7% of the patients in our case series, the vertigo was no longer present at one and three months, respectively. In addition, the vertigo disappeared within two weeks in the patients who were examined within one week of the start of the symptom. The longer the period between the onset of vertigo and the hospital visit, the longer the period needed for control of the symptom.

  9. Exercise therapy in multiple sclerosis and its effects on function and the brain

    DEFF Research Database (Denmark)

    Dalgas, Ulrik

    2017-01-01

    to clinically relevant improvements in physical function, but should be considered an adjunct to specific task-based training. Exercise has also shown positive effects on the brain, including improvements in brain volume and cognition. In summary, exercise therapy is a safe and potent nonpharmacological......Exercise therapy is a promising nonpharmacological therapy in people with multiple sclerosis (MS). Although exercise training may induce a transient worsening of symptoms in some MS patients, it is generally considered safe and does not increase the risk of relapses. Exercise training can lead...... intervention in MS, with beneficial effects on both functional capacity and the brain....

  10. Supervised group-exercise therapy versus home-based exercise therapy: Their effects on Quality of Life and cardiovascular risk factors in women with type 2 diabetes.

    Science.gov (United States)

    Dadgostar, Haleh; Firouzinezhad, Sahar; Ansari, Majid; Younespour, Shima; Mahmoudpour, Azam; Khamseh, Mohammad Ebrahim

    2016-01-01

    Exercise is an integral part of diabetes care. In Iranian women with type II diabetes, we compared the effects of supervised group exercise therapy with the effects of home-based exercise therapy on health-related quality of life (HRQOL), anthropometric parameters, glycaemic control and lipid profile. One hundred and two diabetic women were randomised to supervised and home-based groups. Over 12 weeks, participants received supervised group-exercise therapy or a home-based exercise-therapy program. During the intervention, they were assessed three times: at baseline, and at weeks 6 and 12. Generalized Estimating Equation models were used to examine the associations between the type of exercise-therapy program and changes over time in anthropometric and biochemical outcomes, and in HRQOL scales of SF36 questionnaire. Relative to home-based group, supervised group improved significantly regarding role-physical, general health, mean body weight and body mass index from baseline to week 12 (p=0.01). Their reduction in mean body-fat mass from baseline to week 6 (p=0.04) was greater. Similarly, their role-physical, general health and role-emotional improved significantly during the intervention (pwomen. However, home-based exercise therapy also produced significant improvements in glycaemic control, body composition and lipid profile. Whether in a supervised or home-based setting, the exercise intervention can therefore be effective in improving health outcomes in diabetic patients. Copyright © 2016 Diabetes India. Published by Elsevier Ltd. All rights reserved.

  11. Manual Therapy, Exercise, and Traction for Patients With Cervical Radiculopathy: A Randomized Clinical Trial

    National Research Council Canada - National Science Library

    Ian A. Young; Lori A. Michener; Joshua A. Cleland; Arnold J. Aguilera; Alison R. Snyder

    2009-01-01

    .... Preliminary evidence suggests that a multimodal treatment program consisting of manual therapy, exercise, and cervical traction may result in positive outcomes for patients with cervical radiculopathy...

  12. Non-exercise physical therapies for musculoskeletal conditions.

    Science.gov (United States)

    Hurley, Michael V; Bearne, Lindsay M

    2008-06-01

    Management of musculoskeletal conditions by physiotherapy delivers a package of health care designed to reduce pain and improve function. Health-care interventions should be safe, effective, acceptable to patients, deliverable by clinicians, and affordable by health-care providers. Physiotherapy is very safe and popular with patients. While there is good evidence that exercise relieves pain, improves function, and is cost-effective, evidence supporting the use of non-exercise physiotherapeutic interventions is much weaker. There is some support for the efficacy of thermotherapy, transcutaneous electrical neuromuscular stimulation, and massage, all of which are relatively inexpensive and easy to self-administer. There is little evidence to support the efficacy of electrotherapy, acupuncture or manual therapy, which need to be delivered by a therapist, making them expensive and encouraging long-term reliance on others. Despite lack of efficacy, the popularity and powerful placebo effects of physiotherapeutic modalities may have some utility in making more burdensome physiotherapeutic interventions (exercise and self-management advice) more acceptable.

  13. Metrics for Performance Evaluation of Patient Exercises during Physical Therapy.

    Science.gov (United States)

    Vakanski, Aleksandar; Ferguson, Jake M; Lee, Stephen

    2017-06-01

    The article proposes a set of metrics for evaluation of patient performance in physical therapy exercises. Taxonomy is employed that classifies the metrics into quantitative and qualitative categories, based on the level of abstraction of the captured motion sequences. Further, the quantitative metrics are classified into model-less and model-based metrics, in reference to whether the evaluation employs the raw measurements of patient performed motions, or whether the evaluation is based on a mathematical model of the motions. The reviewed metrics include root-mean square distance, Kullback Leibler divergence, log-likelihood, heuristic consistency, Fugl-Meyer Assessment, and similar. The metrics are evaluated for a set of five human motions captured with a Kinect sensor. The metrics can potentially be integrated into a system that employs machine learning for modelling and assessment of the consistency of patient performance in home-based therapy setting. Automated performance evaluation can overcome the inherent subjectivity in human performed therapy assessment, and it can increase the adherence to prescribed therapy plans, and reduce healthcare costs.

  14. An abridged version of the Cochrane review of exercise therapy for chronic fatigue syndrome.

    Science.gov (United States)

    Larun, Lillebeth; Odgaard-Jensen, Jan; Price, Jonathan R; Brurberg, Kjetil G

    2016-04-01

    Chronic fatigue syndrome (CFS), also known as myalgic encephalomyelitis (ME) is estimated to affect between 2 in 1000 and 2 in 100 adults depending on how diagnostic criteria are applied. Patients with CFS have long-lasting fatigue in addition to symptoms including muscle pain, concentration and sleep problems. These symptoms cause significant disability and distress to the people affected. This review is an update of a previous Cochrane review (2004) that showed that exercise therapy was a promising treatment for adults with CFS. The aim of this systematic review was to determine the effects of exercise therapy for patients with CFS. Systematic review. Health care settings. Participants over 18 years with a primary diagnosis of CFS, able to attend an outpatient clinic for exercise therapy, were included. We searched electronic databases, including SPORTDiscus, up to May 2014 using a comprehensive list of free-text terms for CFS and exercise. Randomized clinical trials from all health care settings with participants over 18 years with a primary diagnosis of CFS, able to attend an outpatient clinic for exercise therapy, were included. We have included 8 randomized clinical studies that reported data from 1518 participants. Seven studies used aerobic exercise such as walking, swimming, or cycling and one study used non-aerobic exercise. The exercise therapies lasted between 12 and 26 weeks. Meta-analysis was done when appropriate. Exercise therapy was more effective at reducing fatigue than "passive" treatments or no treatment at end of treatment. Exercise therapy also had a positive effect on people's daily physical functioning, sleep quality and self-rated overall health. Nearly twice as many patients reported improvement self-rated overall health after exercise therapy (40 per 100) compared to standard treatment (22 per 100). The evidence was too sparse and/or of too low quality to conclude if exercise therapy has an effect on pain, quality of life, anxiety or

  15. Enhanced Exercise Therapy in Parkinson’s disease: A comparative effectiveness trial

    Science.gov (United States)

    Ridgel, Angela L.; Walter, Benjamin L.; Tatsuoka, Curtis; Walter, Ellen M.; Colón-Zimmermann, Kari; Welter, Elisabeth; Sajatovic, Martha

    2015-01-01

    Objectives Exercise can improve motor function in people with Parkinson’s disease but depression reduces the motivation to participate in regular exercise. The aim of this study was to develop a novel Enhanced Exercise Therapy program that uses manual-driven guided exercise and peer-facilitated psychoeducation for individuals with Parkinson’s disease and depression. Design 24 week randomized controlled design. Methods Thirty individuals were randomized to Enhanced Exercise Therapy or self-guided therapy, and evaluated at baseline, 12-weeks and at 24-weeks. Enhanced Exercise Therapy included group exercise and group psychoeducation for 12 weeks. Between 13–24 weeks, individuals had access to the fitness facility but group sessions were not held. Self-guided therapy included written guidelines for a self-paced exercise program and psychoeducation. Primary outcome measures included the number of exercise sessions and International Physical Activity Questionnaire score. Secondary measures included resting heart rate, supine blood pressure, estimated VO2max and incidence of orthostatic hypotension. Results Twenty four individuals completed the study (80% retention) and both groups attended similar number of exercise sessions. There were no significant changes in cardiovascular fitness measures but there was a significant increase in the amount of physical activity in the Enhanced Exercise Therapy group and a decrease in the self-guided therapy group during the post-intervention period. Conclusions Enhanced exercise therapy appears to promote engagement in an exercise program and more physical activity, even after group sessions were concluded in individuals with Parkinson’s disease and depression. PMID:25709055

  16. Exercise for women receiving adjuvant therapy for breast cancer.

    Science.gov (United States)

    Furmaniak, Anna C; Menig, Matthias; Markes, Martina H

    2016-09-21

    A huge clinical research database on adjuvant cancer treatment has verified improvements in breast cancer outcomes such as recurrence and mortality rates. On the other hand, adjuvant and neoadjuvant therapy with chemotherapy and radiotherapy impacts on quality of life due to substantial short- and long-term side effects. A number of studies have evaluated the effect of exercise interventions on those side effects. This is an updated version of the original Cochrane review published in 2006. The original review identified some benefits of physical activity on physical fitness and the resulting capacity for performing activities of daily life. It also identified a lack of evidence for other outcomes, providing clear justification for an updated review. To assess the effect of aerobic or resistance exercise interventions during adjuvant treatment for breast cancer on treatment-related side effects such as physical deterioration, fatigue, diminished quality of life, depression, and cognitive dysfunction. We carried out an updated search in the Cochrane Breast Cancer Group Specialised Register (30 March 2015), the Cochrane Central Register of Controlled Trials (CENTRAL) (Issue 2, 2015), MEDLINE (1966 to 30 March 2015), and EMBASE (1966 to 30 March 2015). We did not update the original searches in CINAHL (1982 to 2004), SPORTDiscus (1975 to 2004), PsycINFO (1872 to 2003), SIGLE (1880 to 2004), and ProQuest Digital Dissertations (1861 to 2004). We searched the World Health Organization International Clinical Trials Registry Platform (WHO ICTRP) and ClinicalTrials.gov for ongoing trials on 30 March 2015. We screened references in relevant reviews and published clinical trials. We included randomised controlled trials that examined aerobic or resistance exercise or both in women undergoing adjuvant treatment for breast cancer. Published and unpublished trials were eligible. Two review authors independently performed data extraction, assessed trials, and graded the

  17. Effectiveness of a graded exercise therapy program for patients with chronic shoulder complaints.

    NARCIS (Netherlands)

    Geraets, J.J.; Goossens, M.E.J.B.; Groot, I.J.M. de; Bruijn, C.P. de; Bie, R.A. de; Dinant, G.J.; Heijden, G.W. van der; Heuvel, W.J.A. van den

    2005-01-01

    An operant behavioural and time-contingent graded exercise therapy program was developed to improve functional ability irrespective of pain experience in patients with chronic shoulder complaints. The clinical effectiveness of graded exercise therapy compared to usual care was evaluated in a

  18. Achilles tendon of wistar rats treated with laser therapy and eccentric exercise

    OpenAIRE

    Souza, Maria Verônica de; Silva, Carlos Henrique Osório; Silva, Micheline Ozana da; Costa, Marcela Bueno Martins da; Dornas, Raul Felipe; Borges, Andréa Pacheco Batista; Natali, Antônio José

    2015-01-01

    ABSTRACTIntroduction:Both laser therapy and eccentric exercises are used in tendon injuries. However, the association of these physiotherapeutic modalities is yet little investigated.Objective:To evaluate the effect of low-level laser therapy associated to eccentric exercise (downhill walking) on Achilles tendinopathy of Wistar rats.Method:Eighteen Achilles tendon from 15 adult male Wistar rats were used. Tendons were distributed in six groups (laser, eccentric exercise, laser and eccentric e...

  19. Exercise therapy for chronic musculoskeletal pain: Innovation by altering pain memories.

    Science.gov (United States)

    Nijs, Jo; Lluch Girbés, Enrique; Lundberg, Mari; Malfliet, Anneleen; Sterling, Michele

    2015-02-01

    Even though nociceptive pathology has often long subsided, the brain of patients with chronic musculoskeletal pain has typically acquired a protective (movement-related) pain memory. Exercise therapy for patients with chronic musculoskeletal pain is often hampered by such pain memories. Here the authors explain how musculoskeletal therapists can alter pain memories in patients with chronic musculoskeletal pain, by integrating pain neuroscience education with exercise interventions. The latter includes applying graded exposure in vivo principles during exercise therapy, for targeting the brain circuitries orchestrated by the amygdala (the memory of fear centre in the brain). Before initiating exercise therapy, a preparatory phase of intensive pain neuroscience education is required. Next, exercise therapy can address movement-related pain memories by applying the 'exposure without danger' principle. By addressing patients' perceptions about exercises, therapists should try to decrease the anticipated danger (threat level) of the exercises by challenging the nature of, and reasoning behind their fears, assuring the safety of the exercises, and increasing confidence in a successful accomplishment of the exercise. This way, exercise therapy accounts for the current understanding of pain neuroscience, including the mechanisms of central sensitization. Copyright © 2014 Elsevier Ltd. All rights reserved.

  20. Exercise following spinal cord injury: physiology to therapy

    Directory of Open Access Journals (Sweden)

    Dolbow DR

    2015-12-01

    Full Text Available David R Dolbow School of Kinesiology, University of Southern Mississippi, Hattiesburg, MS, USA Abstract: Spinal cord injuries (SCIs can have catastrophic effects on individuals resulting in loss of physical abilities and independence. Loss of the ability to perform activities of daily living reduces the quality of life. Furthermore, decreased ability to perform physical activities decreases overall fitness and increases the risk of diseases related to sedentary lifestyle. Activity-based restorative therapies (ABRTs provide an option to help optimize rehabilitation through the restoration of function and the introduction to physical activities via adapted equipment. ABRT programs are typically located in SCI centers, which limit long-term access to those not living near the facilities. Typical rehabilitation clinics not specializing in SCI care are able to provide modified ABRT programs, but lack the staffing and adaptive equipment provided in the larger SCI rehabilitation centers. For long-term rehabilitation and wellness needs, the placement of adaptive equipment in the homes of those with SCI has proven to be beneficial, although costly as highly technical equipment such as functional electrical stimulation cycles usually cost over US$20,000. Community fitness centers offer some possible options for long-term exercise through inclusive fitness programs but many still lack full accessibility for those who are wheelchair reliant and most do not provide specialized adaptive equipment or trained staff to meet the special needs of individuals with SCI and other paralytic conditions. It is important for health care providers to continue to advocate for useful and less expensive adaptive equipment that may provide exercise to paralyzed muscles and greater access and accommodation of wheelchair-reliant individuals by community fitness centers. Keywords: activity-based restorative therapies, functional electrical stimulation, body

  1. Exercise therapy improves both mental and physical health in patients with major depression.

    Science.gov (United States)

    Knapen, Jan; Vancampfort, Davy; Moriën, Yves; Marchal, Yannick

    2015-01-01

    to present clinical guidelines for exercise therapy in depressed patients derived from recent meta-analyses. four meta-analyses on effects of physical exercise on mental and physical in depression were analysed. For mild to moderate depression the effect of exercise may be comparable to antidepressant medication and psychotherapy; for severe depression exercise seems to be a valuable complementary therapy to the traditional treatments. Depression is associated with a high incidence of co-morbid somatic illnesses, especially cardiovascular diseases, type 2 diabetes and metabolic syndrome. Exercise is extremely powerful in preventing and treating these diseases. Physical exercise is an outstanding opportunity for the treatment of patients who have a mix of mental and physical health problems. Exercise therapy also improves body image, patient s coping strategies with stress, quality of life and independence in activities of daily living in older adults. Physical therapists should be aware, that several characteristics of major depression (e.g. loss of interest, motivation and energy, generalised fatigue, a low self-worth and self-confidence, fear to move, and psychosomatic complaints) and physical health problems interfere with participation in exercise. Therefore, motivational strategies should be incorporated in exercise interventions to enhance the patients' motivation and adherence in exercise programs. Implications for Rehabilitation For mild to moderate depression, the effect of exercise may be comparable with antidepressant medication and psychotherapy; for severe depression, exercise seems to be a valuable complementary therapy to the traditional treatments. Exercise therapy also improves physical health, body image, patient's coping strategies with stress, quality of life, and independence in activities of daily living in older adults. Motivational strategies should be incorporated in exercise interventions to enhance the patients' motivation.

  2. The Incremental Effects of Manual Therapy or Booster Sessions in Addition to Exercise Therapy for Knee Osteoarthritis: A Randomized Clinical Trial.

    Science.gov (United States)

    Abbott, J Haxby; Chapple, Catherine M; Fitzgerald, G Kelley; Fritz, Julie M; Childs, John D; Harcombe, Helen; Stout, Kirsten

    2015-12-01

    A factorial randomized controlled trial. To investigate the addition of manual therapy to exercise therapy for the reduction of pain and increase of physical function in people with knee osteoarthritis (OA), and whether "booster sessions" compared to consecutive sessions may improve outcomes. The benefits of providing manual therapy in addition to exercise therapy, or of distributing treatment sessions over time using periodic booster sessions, in people with knee OA are not well established. All participants had knee OA and were provided 12 sessions of multimodal exercise therapy supervised by a physical therapist. Participants were randomly allocated to 1 of 4 groups: exercise therapy in consecutive sessions, exercise therapy distributed over a year using booster sessions, exercise therapy plus manual therapy without booster sessions, and exercise therapy plus manual therapy with booster sessions. The primary outcome measure was the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC score; 0-240 scale) at 1-year follow-up. Secondary outcome measures were the numeric pain-rating scale and physical performance tests. Of 75 participants recruited, 66 (88%) were retained at 1-year follow-up. Factorial analysis of covariance of the main effects showed significant benefit from booster sessions (P = .009) and manual therapy (P = .023) over exercise therapy alone. Group analysis showed that exercise therapy with booster sessions (WOMAC score, -46.0 points; 95% confidence interval [CI]: -80.0, -12.0) and exercise therapy plus manual therapy (WOMAC score, -37.5 points; 95% CI: -69.7, -5.5) had superior effects compared with exercise therapy alone. The combined strategy of exercise therapy plus manual therapy with booster sessions was not superior to exercise therapy alone. Distributing 12 sessions of exercise therapy over a year in the form of booster sessions was more effective than providing 12 consecutive exercise therapy sessions. Providing manual

  3. [Comparing the effects of drug therapy, physical therapy, and exercise on pain, disability, and depression in patients with chronic low back pain].

    Science.gov (United States)

    Ko, Ja Kyung

    2007-08-01

    This research was conducted to compare the effects of drug therapy, physical therapy, and exercise on pain, disability, and depression in patients with chronic low back pain. The research design of this study was a nonequivalent control group pretest-posttest design. The subjects of this study were 28 patients for the drug therapy & physical therapy, 24 patients for the drug therapy & exercise, and 22 patients for the physical therapy & exercise. Data was collected by MVAS, Oswestry disability questionnaires, and questionnaires of depression. It was analyzed by paired t-test for effectiveness, ANOVA, and Scheffe for comparison of the effects of the 3 experimental treatments, using SPSS/WIN 12.0. There were no effects of drug therapy & physical therapy on pain, disability, and depression. However, there were effects of drug therapy & exercise and the physical therapy & exercise on pain, disability, and depression. The effects of physical therapy & exercise on pain, disability, and depression were the greatest, but there was no statistically significant differences between the drug therapy & exercise and the physical therapy & exercise. Exercise is regarded as a more effective and easily accessible nursing intervention to apply alone than drug therapy or physical therapy simultaneously in reducing pain, disability and depression.

  4. Agreements and disagreements in exercise therapy prescriptions after hip replacement among rehabilitation professionals: a multicenter survey.

    Science.gov (United States)

    Eulenburg, Christine; Rahlf, Anna-Lina; Kutasow, Andrej; Zech, Astrid

    2015-08-05

    Exercise therapy following total hip replacement (THR) is considered to be important during the initial postoperative care, but till date only a few evidence-based recommendations exist. The aim of this survey was to identify prescription standards among different rehabilitation professionals, for the exercise therapy management after THR in Germany. The study was a cross-sectional survey. Standardized questionnaires were sent to 38 eligible rehabilitation facilities in Germany. Participating surgeons, orthopaedic physicians, physiotherapists and exercise therapists rated the optimal early weight-bearing, resistance training, key components and dose of exercise therapy, and the hip loading during exercising. The returned questionnaires were then analyzed for level of agreement (≥80%) among respondents. 313 rehabilitation professionals from 28 clinics returned completed questionnaires and were considered eligible for analysis. Out of total respondents, 53.9% (cemented THR) and 18.2% (uncemented THR) recommended full weight-bearing within five days after surgery. Commencement of resistance training later than three weeks after surgery is recommended by 20.6% (36%) for cemented (uncemented) prosthesis. Feedback varied significantly amongst the professions. Regarding the overall objectives of rehabilitation after hip replacement, respondents agree in six out of eight requested items. Agreement concerning priorities of specific exercises was achieved in three out of twelve items. The recommended exercise therapy dose varied significantly with working experience (p = 0.02). Rehabilitation professionals mainly disagreed with the exercise therapy prescriptions following the total hip replacement during the initial postoperative care in Germany.

  5. Exercise therapy improves mental and physical health in schizophrenia: a randomised controlled trial.

    Science.gov (United States)

    Scheewe, T W; Backx, F J G; Takken, T; Jörg, F; van Strater, A C P; Kroes, A G; Kahn, R S; Cahn, W

    2013-06-01

    The objective of this multicenter randomised clinical trial was to examine the effect of exercise versus occupational therapy on mental and physical health in schizophrenia patients. Sixty-three patients with schizophrenia were randomly assigned to 2 h of structured exercise (n = 31) or occupational therapy (n = 32) weekly for 6 months. Symptoms (Positive and Negative Syndrome Scale) and cardiovascular fitness levels (Wpeak and VO2peak ), as assessed with a cardiopulmonary exercise test, were the primary outcome measures. Secondary outcome measures were the Montgomery and Åsberg Depression Rating Scale, Camberwell Assessment of Needs, body mass index, body fat percentage, and metabolic syndrome (MetS). Intention-to-treat analyses showed exercise therapy had a trend-level effect on depressive symptoms (P = 0.07) and a significant effect on cardiovascular fitness, measured by Wpeak (P occupational therapy. Per protocol analyses showed that exercise therapy reduced symptoms of schizophrenia (P = 0.001), depression (P = 0.012), need of care (P = 0.050), and increased cardiovascular fitness (P occupational therapy. No effect for MetS (factors) was found except a trend reduction in triglycerides (P = 0.08). Exercise therapy, when performed once to twice a week, improved mental health and cardiovascular fitness and reduced need of care in patients with schizophrenia. © 2012 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  6. Physical activity and exercise adherence in physical therapy exercise treatment in patients with osteoarthritis of hip or knee.

    NARCIS (Netherlands)

    Pisters, M.F.; Veenhof, C.; Bakker, D. de; Schellevis, F.G.; Dekker, J.

    2008-01-01

    Purpose: a lack of regular physical activity in patients with osteoarthritis (OA) of the hip and/or knee is an important risk factor for functional decline. The ultimate goal of exercise therapy is to improve the overall physical function and to help individuals meet the demands of daily living.

  7. Is the Severity of Knee Osteoarthritis on Magnetic Resonance Imaging Associated With Outcome of Exercise Therapy?

    NARCIS (Netherlands)

    Knoop, J.; Dekker, J.; van der Leeden, M.; van der Esch, M.; Klein, J.P.; Hunter, D.J.; Roorda, L.D.; Steultjens, M.P.M.; Lems, W.F.

    2014-01-01

    Objective To evaluate associations between severity of knee osteoarthritis (OA) on magnetic resonance imaging (MRI) and treatment outcomes in knee OA patients treated with exercise therapy in an exploratory study. Methods Ninety-five participants with knee OA in a 12-week exercise program had

  8. Effects of 12-week combined exercise therapy on oxidative stress in female fibromyalgia patients.

    Science.gov (United States)

    Sarıfakıoğlu, Banu; Güzelant, Aliye Yıldırım; Güzel, Eda Celik; Güzel, Savaş; Kızıler, Ali Rıza

    2014-10-01

    The aims of this study were to investigate the effect of exercise therapy on the oxidative stress in fibromyalgia patients and relationship between oxidative stress and fibromyalgia symptoms. Thirty women diagnosed with fibromyalgia according to the American College of Rheumatology preliminary criteria, and 23 healthy women whose age- and weight-matched women were enrolled the study. Pain intensity with visual analog scale (VAS), the number of tender points, the fibromyalgia impact questionnaire (FIQ), the Beck depression inventory (BDI) were evaluated. The oxidative stress parameters thiobarbituric acid reactive substances, protein carbonyls, and nitric oxide, and antioxidant parameters thiols and catalase were investigated in patients and control group. After, combined aerobic and strengthen exercise regimen was given to fibromyalgia group. Exercise therapy consisted of a warming period of 10 min, aerobic exercises period of 20 min, muscle strengthening exercises for 20 min, and 10 min cooling down period. Therapy was lasting 1 h three times per week over a 12-week period. All parameters were reevaluated after the treatment in the patient group. The oxidative stress parameters levels were significantly higher, and antioxidant parameters were significantly lower in patients with fibromyalgia than in the controls. VAS, FIQ, and BDI scores decreased significantly with exercise therapy. The exercise improved all parameters of oxidative stress and antioxidant parameters. Also, all clinical parameters were improved with exercise. We should focus on oxidative stress in the treatment for fibromyalgia with the main objective of reducing oxidative load.

  9. Effects of aerobic exercise and drug therapy on blood pressure and ...

    African Journals Online (AJOL)

    EB

    Key words: Aerobic exercise, drug therapy, blood pressure, randomised controlled trial. African Health ... of home settings, and that could allow for supports in terms of family ... not and whether each number in a set should remain unique ...

  10. Supervised Exercise Therapy for Intermittent Claudication Is Increasingly Endorsed by Dutch Vascular Surgeons

    NARCIS (Netherlands)

    Hageman, David; Lauret, Gert-Jan; Gommans, Lindy N. M.; Koelemay, Mark J. W.; van Sambeek, Marc R. H. M.; Scheltinga, Marc R. M.; Teijink, Joep A. W.

    2018-01-01

    Although supervised exercise therapy (SET) is generally accepted as an effective noninvasive treatment for intermittent claudication (IC), Dutch vascular surgeons were initially somewhat hesitant as reported by a 2011 questionnaire study. Later on, a nationwide multidisciplinary network for SET was

  11. Tailored cognitive-behavioural therapy and exercise training improves the physical fitness of patients with fibromyalgia

    NARCIS (Netherlands)

    Spillekom-van Koulil, S.; Lankveld, W.G.J.M. van; Kraaimaat, F.W.; Helmond, T. van; Vedder, A.; Hoorn, H. van; Donders, A.R.T.; Wirken, L.; Cats, H.; Riel, P.L.C.M. van; Evers, A.W.M.

    2011-01-01

    OBJECTIVES: Patients with fibromyalgia have diminished levels of physical fitness, which may lead to functional disability and exacerbating complaints. Multidisciplinary treatment comprising cognitive-behavioural therapy (CBT) and exercise training has been shown to be effective in improving

  12. The effects of therapy on spasticity utilizing a motorized exercise-cycle

    National Research Council Canada - National Science Library

    Rösche, J; Paulus, C; Maisch, U; Kaspar, A; Mauch, E; Kornhuber, H H

    1997-01-01

    .... In this study it is shown that F-wave amplitudes can also be used to document changes of motor neuron excitability as an effect of the therapy with a motorized exercise-cycle, which moves the legs...

  13. The effectiveness of technology-supported exercise therapy for low back pain: a systematic review.

    OpenAIRE

    Matheve, Thomas; Brumagne, Simon; Timmermans, Annick

    2017-01-01

    Various technological systems have been developed to assist exercise therapy for low back pain. The aim of this systematic review was to provide an overview and to assess the effectiveness of the available technology-supported exercise therapy (TSET) programs for low back pain. The electronic databases Pubmed, Embase, Cochrane Central Register of Controlled Trials, PEDro, IEEE, and ACM were searched until January 2016. Randomized controlled trials (RCTs) using electronic technological systems...

  14. Effect of therapeutic exercise versus manual therapy on athletes with chronic low back pain.

    Science.gov (United States)

    Dvorak, Haley; Kujat, Christina; Brumitt, Jason

    2011-11-01

    Rehabilitation professionals treat individuals suffering from chronic low back pain (CLBP) using a variety of treatment approaches including manual therapy and the prescription of therapeutic exercises. The use of manual therapy, specifically joint mobilization of the lumbar spine, may significantly decrease a patient's pain and contribute to improvement in his or her functioning. Exercise may also improve pain and functioning, with some patients reporting gains up to 1 year after the last treatment session.

  15. Stabilization exercise compared to general exercises or manual therapy for the management of low back pain: A systematic review and meta-analysis.

    Science.gov (United States)

    Gomes-Neto, Mansueto; Lopes, Jordana Moura; Conceição, Cristiano Sena; Araujo, Anderson; Brasileiro, Alécio; Sousa, Camila; Carvalho, Vitor Oliveira; Arcanjo, Fabio Luciano

    2017-01-01

    We performed a systematic review with a meta-analysis to examine the efficacy of stabilization exercises versus general exercises or manual therapy in patients with low back pain. We searched MEDLINE, Cochrane Controlled Trials, Scielo, and CINAHL (from the earliest date available to November 2014) for randomized controlled trials that examined the efficacy of stabilization exercises compared to general exercises or manual therapy on pain, disability, and function in patients with low back pain. Weighted mean differences (WMD) and 95% confidence intervals were calculated. Eleven studies met the inclusion criteria (413 stabilization exercises patients, 297 general exercises patients, and 185 manual therapy patients). Stabilization exercises may provide greater benefit than general exercise for pain reduction and improvement in disability. Stabilization exercise improved pain with a WMD of -1.03 (95% CI: -1.29 to -0.27) and improved disability with a WMD of -5.41 (95% CI: -8.34 to -2.49). There were no significant differences in pain and disability scores among participants in the stabilization exercise group compared to those in the manual therapy group. Stabilization exercises were as efficacious as manual therapy in decreasing pain and disability and should be encouraged as part of musculoskeletal rehabilitation for low back pain. Copyright © 2016 Elsevier Ltd. All rights reserved.

  16. Effectiveness of manual therapy or pulsed shortwave diathermy in addition to advice and exercise for neck disorders: a pragmatic randomized controlled trial in physical therapy clinics.

    Science.gov (United States)

    Dziedzic, Krysia; Hill, Jonathan; Lewis, Martyn; Sim, Julius; Daniels, Jane; Hay, Elaine M

    2005-04-15

    To determine whether manual therapy or pulsed shortwave diathermy, in addition to advice and exercise, provide better clinical outcome at 6 months than advice and exercise alone in primary care patients with nonspecific neck disorders. This was a multicenter, 3-arm randomized controlled trial in 15 physical therapy departments. Of the 735 screened patients, 350 were recruited to the study (mean age 51 years) from July 2000 to June 2002. Participants were randomized to advice and exercise plus manual therapy, advice and exercise plus pulsed shortwave, or advice and exercise alone. Assessments were undertaken at baseline, 6 weeks, and 6 months. The primary outcome was the Northwick Park Neck Pain Questionnaire. Analysis was by intention to treat. Of the participants, 115 were allocated to advice and exercise, 114 to advice and exercise plus manual therapy, and 121 to advice and exercise plus pulsed shortwave; 98% received the allocated treatment. There was 93% followup at 6 months. The mean +/- SD fall in Northwick Park score at 6 months was 11.5 +/- 15.7 for advice and exercise alone, 10.2 +/- 14.1 for advice and exercise plus manual therapy, and 10.3 +/- 15.0 for advice and exercise plus pulsed shortwave. There were no statistically significant differences in mean changes between groups. The addition of pulsed shortwave or manual therapy to advice and exercise did not provide any additional benefits in the physical therapy treatment of neck disorders.

  17. No effects of functional exercise therapy on walking biomechanics in patients with knee osteoarthritis

    DEFF Research Database (Denmark)

    Henriksen, Marius; Klokker, Louise; Bartholdy, Cecilie

    2016-01-01

    AIM: To assess the effects of a functional and individualised exercise programme on gait biomechanics during walking in people with knee OA. METHODS: Sixty participants were randomised to 12 weeks of facility-based functional and individualised neuromuscular exercise therapy (ET), 3 sessions per...... limited confidence in the findings due to multiple statistical tests and lack of biomechanical logics. Therefore we conclude that a 12-week supervised individualised neuromuscular exercise programme has no effects on gait biomechanics. Future studies should focus on exercise programmes specifically...

  18. Effect of Different Types of Exercise in HIV + Mozambican Women Using Antiretroviral Therapy

    OpenAIRE

    Mangona, Luc?lia; Daca, Tim?teo; Tchonga, Francisco; Bule, Odete; Bhatt, Nilesh; Jani, Ilesh; Damasceno, Albertino; Prista, Ant?nio

    2015-01-01

    The aim of this study was to evaluate and compare the effect of two types of exercises interventions on the regularity and health-related physical fitness in HIV-infected individuals who use antiretroviral therapy (ART). A total of 53 HIV+ African women (mean age=39.5?8.4 years) on ART participated in the study. Subjects were randomly divided into 3 groups, namely, formal exercise (FEG), playful exercise (PEG) and control (CG). During 12 weeks, the exercise groups underwent a program of 1-hou...

  19. Exercise Therapy and Glycaemic Control in Diabetic Persons at the ...

    African Journals Online (AJOL)

    14.2) years. Fifty persons (55.6%) perform exercisesand 24 (48%) persons exercise daily. Brisk walking was the most common exercise (44%) and the least common were Table Tennis, Swimming and Weight lifting (2% each). There were no ...

  20. Effects of adding concentration therapy to Kegel exercise to improve continence after radical prostatectomy, randomized control.

    Science.gov (United States)

    Kongtragul, Jaruwan; Tukhanon, Wanvara; Tudpudsa, Piyanuch; Suedee, Kanita; Tienchai, Supaporn; Leewansangtong, Sunai; Nualgyong, Chaiyong

    2014-05-01

    To compare the efficacy of pelvic floor muscle exercise with the concentration therapy versus pelvic floor muscle exercise alone after radical prostatectomy. One hundred thirty five patients were randomized into the intervention group that concentration therapy was added to Kegel exercise, and control group that was Kegel exercise only, using the stratified randomization (stratified by taking the catheter off before and after discharge) and type of surgery. Incontinence was defined as a loss of urine equal or more than to 2 grams in one-hour pad test, before and after the test in each sample group. Follow-up results were obtained by phone visit at 3, 4, 5, 6, 8, 10, and 12 weeks after surgery In the intervention group, 65 of 68 cases (95.6%) had continence in three months, compared to 48 of 67 (71.6%) in the control group, with significant statistical difference (p-value Kegel exercise had significantly improved continence after radical prostatectomy

  1. A 12-Week Exercise Therapy Program in Middle-Aged Patients With Degenerative Meniscus Tears

    DEFF Research Database (Denmark)

    Stensrud, Silje; Roos, Ewa M.; Risberg, May Arna

    2012-01-01

    Normal 0 false false false EN-US X-NONE X-NONE MicrosoftInternetExplorer4 STUDY DESIGN: Case Series. BACKGROUND: Exercise is a viable treatment alternative to arthroscopic partial meniscectomy in patients with degenerative meniscus tears. No study has reported in detail type of exercises, progres...... if this specific program is significantly better than other interventions. LEVEL OF EVIDENCE: Therapy, level 4. J Orthop Sports Phys Ther, Epub 5 September 2012. doi:10.2519/jospt.2012.4165......., progression, tolerance, and potential benefit from an exercise therapy program in these patients who have not had surgery. This study describes a progressive exercise therapy program aiming at improving neuromuscular function and muscle strength in middle-aged patients with degenerative meniscus tears...

  2. Patients' views toward knee osteoarthritis exercise therapy and factors influencing adherence - a survey in China.

    Science.gov (United States)

    Zhou, Zhiwei; Hou, Yunfei; Lin, Jianhao; Wang, Kai; Liu, Qiang

    2018-01-16

    To understand the views toward exercise therapy for knee osteoarthritis (KOA) in China and to analyze factors affecting treatment adherence. A survey-based study, which included multiple choice and open-ended questions on knee OA exercise therapy was conducted in a Chinese population. The content included the respondents' attitudes and beliefs, willingness to receive treatment, and reasons why they could or could not adhere to the treatment. We used Chi-squared tests to compare cognitive differences between the patients and non-patient groups. A total of 1,069 people responded to the questionnaire, and the response rate was 81.8%. A total of 93.6% of the patients thought that they could adhere to the exercise treatment if they received professional advice and prescriptions. The following questionnaire items achieved consensus: 'Increasing the strength of the muscles around the knee stops the knee pain from getting worse,' 'It is the person's own responsibility to continue doing their exercise program,' 'How helpful the exercise program will be determines how well a person sticks to it,' 'Health professionals should educate patients with knee pain about how to change their lifestyle for the better,' and 'Exercise for knee pain is most helpful when it is designed for each person, to suit their own particular needs.' Patient adherence was affected by multiple factors, and some negative factors included 'forgetfulness,' 'getting joint symptoms improved after therapy,' 'professional guidance, subsequent monitoring and supervision,' 'willing to enhance overall health and quality of life,' 'having no time,' 'occupational factors,' 'considering that the pain would worsen while/after exercise,' and 'family factors.' A general Chinese population accepted exercise therapy for treating KOA in our survey. Education is necessary because patients were uncertain and had misunderstandings regarding the potential benefits of exercise therapy. Some factors related to treatment

  3. Daily Events for Clinical Couples: Examining Therapy Interventions, Positive Events, Arguments, and Exercise in the Beginning Stage of Therapy.

    Science.gov (United States)

    Johnson, Lee N; Mennenga, Kayla D; Oka, Megan; Tambling, Rachel B; Anderson, Shayne R; Yorgason, Jeremy

    2017-06-15

    This study examined the daily association of several events within the beginning phase of couple therapy. Events examined were as follows: trying something from therapy, an argument, a positive event, and physical exercise. Participants were 33 couples in a treatment-as-usual setting who completed the Daily Diary of Events in Couple Therapy (DDECT). A dyadic multilevel model was used to explore the daily associations between predictor and outcome variables. Results showed when male partners tried something from therapy at rates greater than the average their female partners reported a more positive relationship while when female partners tried something from therapy at rates greater than the average it contributed to a more negative relationship. In addition, results showed that clients in couple therapy rarely try things from therapy on a daily basis. Finally, relative to other predictors trying something from therapy had a smaller, but significant relationship with outcomes. © 2017 Family Process Institute.

  4. Exercise Therapy in Spinobulbar Muscular Atrophy and Other Neuromuscular Disorders

    DEFF Research Database (Denmark)

    Dahlqvist, Julia Rebecka; Vissing, John

    2016-01-01

    There is no curative treatment for most neuromuscular disorders. Exercise, as a treatment for these diseases, has therefore received growing attention. When executed properly, exercise can maintain and improve health and reduce the risk of cardiovascular disease, obesity, and diabetes. In persons...... in patients with neuromuscular diseases associated with weakness and wasting. We review studies that have investigated different types of exercise in both myopathies and motor neuron diseases, with particular emphasis on training of persons affected by spinobulbar muscular atrophy (SBMA). Finally, we provide...

  5. Clinical outcomes following manual physical therapy and exercise for hip osteoarthritis: a case series.

    NARCIS (Netherlands)

    MacDonald, C.W.; Whitman, J.M.; Cleland, J.A.; Smith, M.; Hoeksma, H.L.

    2006-01-01

    Study Design: Case series describing the outcomes of individual patients with hip osteoarthritis treated with manual physical therapy and exercise. Case Description: Seven patients referred to physical therapy with hip osteoarthritis and/or hip pain were included in this case series. All patients

  6. Combined spa-exercise therapy is effective in patients with ankylosing spondylitis: a randomized controlled trial

    NARCIS (Netherlands)

    van Tubergen, A.; Landewé, R.; van der Heijde, D.; Hidding, A.; Wolter, N.; Asscher, M.; Falkenbach, A.; Genth, E.; Thè, H. G.; van der Linden, S.

    2001-01-01

    To determine the efficacy of combined spa-exercise therapy in addition to standard treatment with drugs and weekly group physical therapy in patients with ankylosing spondylitis (AS). A total of 120 Dutch outpatients with AS were randomly allocated into 3 groups of 40 patients each. Group 1 (mean

  7. Spinal Manipulative Therapy and Exercise for Seniors with Chronic Neck Pain

    DEFF Research Database (Denmark)

    Maiers, Michele; Bronfort, Gert; Evans, Roni

    2014-01-01

    Neck pain, common among the elderly population, has considerable implications on health and quality of life. Evidence supports the use of spinal manipulative therapy and exercise to treat neck pain; however, no studies to date have evaluated the effectiveness of these therapies specifically...

  8. Effects of aerobic exercise and drug therapy on blood pressure and ...

    African Journals Online (AJOL)

    They were randomly assigned to drug therapy (Normoretic: Hydrochlorothiazide + amiloride hydrochloride, and Amlodipine) (control: n=33) and aerobic dance combined with drug therapy (exercise: n=30) groups. Intervention in each group lasted 12 weeks. BP was measured at baseline and during and pos-intervention.

  9. Manual therapy associated with upper limb exercises vs. exercises alone for shoulder rehabilitation in postoperative breast cancer.

    Science.gov (United States)

    Pace do Amaral, Maria Teresa; Freire de Oliveira, Mariana Maia; Ferreira, Néville de Oliveira; Guimarães, Renata Vidigal; Sarian, Luís Otávio; Gurgel, Maria Salete Costa

    2012-05-01

    Our objective was to evaluate the effectiveness of manual therapy (MT) associated with upper limb (UL) exercises in women with impaired shoulder range of motion (ROM) after axillary lymph node dissection (ALND) for breast cancer. A randomized, prospective, blinded clinical trial with 131 women with a ROM  oncological treatment between groups, and ANOVA for repeat measures was used. No difference in recovery of shoulder ROM as well as UL function was observed between groups. Improvement in ROM was gradual from the 1st to the 18th month, and the function achieving a good classification at 18th month. MT associated with exercises did not enhance the results obtained with exercises alone for shoulder ROM and ipsilateral UL function.

  10. Exercise therapy after ultrasound-guided corticosteroid injections in patients with subacromial pain syndrome

    DEFF Research Database (Denmark)

    Ellegaard, Karen; Christensen, Robin; Rosager, Sara

    2016-01-01

    BACKGROUND: Subacromial pain syndrome (SAPS) accounts for around 50 % of all cases of shoulder pain. The most commonly used treatments are glucocorticosteroid (steroid) injections and exercise therapy; however, despite treatment SAPS patients often experience relapse of their symptoms. Therefore...... the clinical effect of combining steroid and exercise therapy is highly relevant to clarify. The aim of this randomized controlled trial was to investigate if exercise therapy added to steroid injection in patients with SAPS will improve the effect of the injection therapy on shoulder pain. METHODS......: In this two-arm randomized trial running over 26 weeks, patients with unilateral shoulder pain (> 4 weeks) and thickened subacromial bursa (> 2 mm on US) were included. At baseline all participants received two steroid injections into the painful shoulder with an interval of one week. Subsequently they were...

  11. Effects of Exercise Therapy on Postural Instability in Parkinson Disease: A Meta-analysis.

    Science.gov (United States)

    Klamroth, Sarah; Steib, Simon; Devan, Surendar; Pfeifer, Klaus

    2016-01-01

    Exercise therapy is a common intervention for improving postural stability. The purpose of this meta-analysis was to assess the effect of exercise therapy on postural instability in persons with Parkinson disease (PD) based on the available literature, and to evaluate the efficacy across various types of exercise interventions. In January 2015, electronic databases (PubMed, Scopus, PEDro) and study reference lists were searched for randomized controlled trials with moderate or high methodological quality (PEDro score ≥ 5), investigating the effect of exercise on postural instability in persons with PD. Three reviewers extracted data and assessed quality. Postural stability as measured using the Berg Balance Scale, postural sway, Timed Up and Go, or Functional Reach test. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) were calculated. Twenty-two trials, with a total of 1072 participants, were eligible for inclusion. The pooled estimates of effects showed significantly improved postural instability (SMD, 0.23; 95% CI, 0.10-0.36; P exercise therapy, in comparison with no exercise or sham treatment. Exercise interventions specifically addressing components of balance dysfunction demonstrated the largest efficacy, with moderate to high effect sizes (SMD, 0.43; 95% CI, 0.21-0.66; P exercise programs (SMD, 0.02; 95% CI -0.20 to 0.25; P = 0.86). Exercise therapies specifically addressing balance dysfunction are an important treatment option for improving postural stability in persons with PD. Future studies should investigate sustainability of the short-term effects and establish the dose-response relationship of balance training in persons with PD.Video abstract available for additional insights from the authors (see Video, Supplemental Digital Content 1, http://links.lww.com/JNPT/A121).

  12. Exercise therapy, manual therapy, or both, for osteoarthritis of the hip or knee: a factorial randomised controlled trial protocol

    Directory of Open Access Journals (Sweden)

    Baxter G David

    2009-02-01

    Full Text Available Abstract Background Non-pharmacological, non-surgical interventions are recommended as the first line of treatment for osteoarthritis (OA of the hip and knee. There is evidence that exercise therapy is effective for reducing pain and improving function in patients with knee OA, some evidence that exercise therapy is effective for hip OA, and early indications that manual therapy may be efficacious for hip and knee OA. There is little evidence as to which approach is more effective, if benefits endure, or if providing these therapies is cost-effective for the management of this disorder. The MOA Trial (Management of OsteoArthritis aims to test the effectiveness of two physiotherapy interventions for improving disability and pain in adults with hip or knee OA in New Zealand. Specifically, our primary objectives are to investigate whether: 1. Exercise therapy versus no exercise therapy improves disability at 12 months; 2. Manual physiotherapy versus no manual therapy improves disability at 12 months; 3. Providing physiotherapy programmes in addition to usual care is more cost-effective than usual care alone in the management of osteoarthritis at 24 months. Methods This is a 2 × 2 factorial randomised controlled trial. We plan to recruit 224 participants with hip or knee OA. Eligible participants will be randomly allocated to receive either: (a a supervised multi-modal exercise therapy programme; (b an individualised manual therapy programme; (c both exercise therapy and manual therapy; or, (d no trial physiotherapy. All participants will continue to receive usual medical care. The outcome assessors, orthopaedic surgeons, general medical practitioners, and statistician will be blind to group allocation until the statistical analysis is completed. The trial is funded by Health Research Council of New Zealand Project Grants (Project numbers 07/199, 07/200. Discussion The MOA Trial will be the first to investigate the effectiveness and cost

  13. INFLUENCE OF MUSIC THERAPY AND BREATHING EXERCISES ON ANXIETY IN POST-OPERATIVE CARDIAC DISEASED INDIVIDUALS

    Directory of Open Access Journals (Sweden)

    C. Janardan

    2016-02-01

    Full Text Available Background: Asian Indians have a higher operative and overall increased mortality following coronary bypass surgery. They also have higher rates of post operative complications and repeat surgeries. Apart from physiological complications like post-operative pain, atelectasis, deep vein thrombosis, the psychological disorders are like anxiety and stress also predominantly play a major role in the morbidity of the post-surgical conditions. The aim of study is to know the influence of music therapy and breathing exercises on post-surgical cardiac diseased individuals. To evaluate the influence of music therapy and breathing exercises on physiological parameters(BP,HR,RR in post surgical cardiac diseased individuals by using electro cardio monitor and state-trait anxiety scale. Methods: Subjects were randomly divided into two groups. Experimental group, where the subjects received music therapy and breathing exercises. Control group, where the subjects received breathing exercises. All the participants were assessed with STAI scale and physiological parameters like blood pressure, heart rate and respiration rate for both groups before and after the treatment. Paired sample t-test was used to compare the STAI scale and physiological parameters within the groups. Result: Results showed a significant improvement in both the groups but, more improvement was seen in experimental group compared to control group. Conclusion: Results suggested that music therapy and breathing exercises influences more effective than breathing exercises alone.

  14. Exercise therapy is evidence-based treatment of shoulder impingement syndrome. Current practice or recommendation only.

    Science.gov (United States)

    Ylinen, J; Vuorenmaa, M; Paloneva, J; Kiviranta, I; Kautiainen, H; Oikari, M; Häkkinen, A

    2013-08-01

    Subacromial impingement syndrome is the most common indication for shoulder operation. However, exercise therapy for the conservative treatment is recommended in the first instance. To evaluate the implementation of exercise therapy in impingement syndrome. Retrospective study using structured postal questionnaire and data collected from hospital archive. A total of 104 consecutive patients who had undergone shoulder surgery due to impingement syndrome. Patients were asked about therapy modalities that they had received before and after the operation as well as pain (VAS) and functional impairment (ASES) at one-year follow-up. Before surgery 49% of patients had not received advice for shoulder muscle exercises. After operation all patients had received mobility exercises, but one quarter of patients still reported that they had not received instructions about shoulder strength exercises. At the follow-up the means of the ASES index was 85 and use of NSAID had decreased by 75%. However, 15% of patients had moderate functional impairment (ASES under 60). About half of patients reported that they had not received advice for rotator cuff exercise therapy before surgery even though with it surgery would probably have been avoided in many cases. Although symptoms in most patients had decreased after operation, several patients still suffered from pain and decreased function. Still several patients had not received advice for shoulder strengthening exercises that are important to recovery. The adherence to the current recommendations about exercise therapy is insufficient in clinical practice. Thus we recommend that it should be monitored in all institutions in which shoulder pain is treated.

  15. Exercise Therapy for Parkinson's Disease: Pedaling Rate Is Related to Changes in Motor Connectivity.

    Science.gov (United States)

    Shah, Chintan; Beall, Erik B; Frankemolle, Anneke M M; Penko, Amanda; Phillips, Michael D; Lowe, Mark J; Alberts, Jay L

    2016-02-01

    Forced-rate lower-extremity exercise has recently emerged as a potential safe and low-cost therapy for Parkinson's disease (PD). The efficacy is believed to be dependent on pedaling rate, with rates above the subjects' voluntary exercise rates being most beneficial. In this study, we use functional connectivity magnetic resonance imaging (MRI) to further elucidate the mechanism underlying this effect. Twenty-seven PD patients were randomized to complete 8 weeks of forced-rate exercise (FE) or voluntary-rate exercise (VE). Exercise was delivered using a specialized stationary bicycle, which can augment patients' voluntary exercise rates. The FE group received assistance from the cycle. Imaging was conducted at baseline, end of therapy, and after 4 weeks of follow-up. Functional connectivity (FC) was determined via seed-based correlation analysis, using activation-based seeds in the primary motor cortex (M1). The change in FC after exercise was compared using linear correlation with pedaling rate. Results of the correlation analysis showed a strong positive correlation between pedaling rate and change in FC from the most affected M1 to the ipsilateral thalamus. This effect persisted after 4 weeks of follow-up. These results indicate that a plausible mechanism for the therapeutic efficacy of high-rate exercise in PD is that it improves thalamo-cortical connectivity.

  16. Altered Blood Flow Response to Small Muscle Mass Exercise in Cancer Survivors Treated With Adjuvant Therapy.

    Science.gov (United States)

    Didier, Kaylin D; Ederer, Austin K; Reiter, Landon K; Brown, Michael; Hardy, Rachel; Caldwell, Jacob; Black, Christopher; Bemben, Michael G; Ade, Carl J

    2017-02-07

    Adjuvant cancer treatments have been shown to decrease cardiac function. In addition to changes in cardiovascular risk, there are several additional functional consequences including decreases in exercise capacity and increased incidence of cancer-related fatigue. However, the effects of adjuvant cancer treatment on peripheral vascular function during exercise in cancer survivors have not been well documented. We investigated the vascular responses to exercise in cancer survivors previously treated with adjuvant cancer therapies. Peripheral vascular responses were investigated in 11 cancer survivors previously treated with adjuvant cancer therapies (age 58±6 years, 34±30 months from diagnosis) and 9 healthy controls group matched for age, sex, and maximal voluntary contraction. A dynamic handgrip exercise test at 20% maximal voluntary contraction was performed with simultaneous measurements of forearm blood flow and mean arterial pressure. Forearm vascular conductance was calculated from forearm blood flow and mean arterial pressure. Left ventricular ejection time index (LVETi) was derived from the arterial pressure wave form. Forearm blood flow was attenuated in cancer therapies compared to control at 20% maximal voluntary contraction (189.8±53.8 vs 247.9±80.3 mL·min(-1), respectively). Forearm vascular conductance was not different between groups at rest or during exercise. Mean arterial pressure response to exercise was attenuated in cancer therapies compared to controls (107.8±10.8 vs 119.2±16.2 mm Hg). LEVTi was lower in cancer therapies compared to controls. These data suggest an attenuated exercise blood flow response in cancer survivors ≈34 months following adjuvant cancer therapy that may be attributed to an attenuated increase in mean arterial pressure. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  17. Home IV Antibiotic Therapy and Exercise Capacity in Children with CF: A Case Series.

    Science.gov (United States)

    Cox, Narelle S; McKay, Karen O; Follett, Jennifer M; Alison, Jennifer A

    2011-03-01

    This case series describes the effect of home intravenous (IV) antibiotic therapy on spirometry and exercise capacity in a group of children with cystic fibrosis (CF). Outcomes from 10 children with CF who were prescribed a 14-day course of home IV antibiotics for a respiratory exacerbation are reported. All children performed spirometry and a modified shuttle test (MST) before and after 14-days of home IV therapy. After 14 days, FEV(1) increased by mean (± SE) 12 ± 4 % (p < 0.05) but mean MST did not improve compared to baseline. All children improved or maintained spirometry values with treatment, however, only 5 improved MST distance. After 14 days of home IV antibiotic therapy, a significant improvement in spirometry, but not exercise capacity, was seen in this small series of children with CF. The lack of improvement in exercise capacity for all children following home IV antibiotic therapy suggests factors other than spirometry determine exercise capacity. Identifying and investigating the factors that influence exercise capacity during home IV antibiotic therapy requires further investigation.

  18. Exercises

    Science.gov (United States)

    ... exercising. Count out loud as you do the exercises. View Chronic Obstructive Pulmonary Disease (COPD) Home Techniques to ... Intimacy Importance of Being Together Body Changes with Age Communicating with Your Partner Exercise and Sexual Activity Less Strenuous Positions for Sexual ...

  19. Exercise training as a therapy for chronic heart failure: can older people benefit?

    Science.gov (United States)

    Witham, Miles D; Struthers, Allan D; McMurdo, Marion E T

    2003-05-01

    Despite recent advances in pharmacological therapy, chronic heart failure remains a major cause of morbidity and mortality in older people. Studies of exercise training in younger, carefully selected patients with heart failure have shown improvements in symptoms and exercise capacity and in many pathophysiological aspects of heart failure, including skeletal myopathy, ergoreceptor function, heart rate variability, endothelial function, and cytokine expression. Data on mortality and hospitalization are lacking, and effects on everyday activity, depression, and quality of life are unclear. Exercise therapy for patients with heart failure appears to be safe and has the potential to improve function and quality of life in older people with heart failure. To realize these potential benefits, exercise programs that are suitable for older, frail people need to be established and tested in an older, frail, unselected population with comorbidities.

  20. Effect of exercise therapy on neuromuscular activity and knee strength in female adolescents with patellofemoral pain

    DEFF Research Database (Denmark)

    Rathleff, Michael S.; Samani, Afshin; Olesen, Jens L.

    2016-01-01

    BACKGROUND: Female adolescents with patellofemoral pain are characterized by altered neuromuscular knee control and reduced maximal quadriceps torque. The purpose of this study is to investigate whether exercise therapy and patient education are associated with larger improvements in neuromuscular...... knee control and maximal quadriceps torque compared with patient education alone. METHODS: This is an ancillary analysis of a cluster randomized controlled trial investigating the effect of patient education and exercise therapy on self-reported recovery in 121 adolescents with patellofemoral pain...... flexion/extension kinematics and maximal quadriceps torque. FINDINGS: There was an 8-15% greater decrease in the complexity of surface electromyography suggesting an improvement in neuromuscular knee control among those randomized to exercise therapy (0.08

  1. Statin Therapy as Primary Prevention in Exercising Adults: Best Evidence for Avoiding Myalgia.

    Science.gov (United States)

    Bosomworth, N John

    This review aims to determine whether active adults who begin statins and develop myalgia reduce or stop activity to become less symptomatic. If this occurs, strategies to mitigate symptoms are explored. Should these strategies fail, the question of whether exercise is an adequate alternative to statin therapy is addressed. PubMed, Google Scholar, and the Cochrane Database were searched with keywords designed to retrieve information on statin myopathy in exercising adults. Statins are well tolerated by most people who exercise; however, caution is warranted in those who exercise at high levels, in the elderly, and in those receiving high-dose therapy. Several strategies improve statin tolerance while maintaining exercise levels, based on low-quality evidence. If statins are not tolerated, a continuing physical activity program can provide equivalent or superior cardiometabolic protection. Statins may occasionally present a barrier to physical activity. A number of strategies exist that can reduce the risk of myopathy. If a choice between exercise and statins becomes necessary, exercise provides equal benefit in terms of cardiovascular protection and superior mortality reduction, with improved quality of life. © Copyright 2016 by the American Board of Family Medicine.

  2. Effectiveness of core stabilization exercises and routine exercise therapy in management of pain in chronic non-specific low back pain: A randomized controlled clinical trial.

    Science.gov (United States)

    Akhtar, Muhammad Waseem; Karimi, Hossein; Gilani, Syed Amir

    2017-01-01

    Low back pain is a frequent problem faced by the majority of people at some point in their lifetime. Exercise therapy has been advocated an effective treatment for chronic low back pain. However, there is lack of consensus on the best exercise treatment and numerous studies are underway. Conclusive studies are lacking especially in this part of the world. Thisstudy was designed to compare the effectiveness of specific stabilization exercises with routine physical therapy exerciseprovided in patients with nonspecific chronic mechanical low back pain. This is single blinded randomized control trial that was conducted at the department of physical therapy Orthopedic and Spine Institute, Johar Town, Lahore in which 120 subjects with nonspecific chronic low back pain participated. Subjects with the age between 20 to 60 years and primary complaint of chronic low back pain were recruited after giving an informed consent. Participants were randomly assigned to two treatment groups A & B which were treated with core stabilization exercise and routine physical therapy exercise respectively. TENS and ultrasound were given as therapeutic modalities to both treatment groups. Outcomes of the treatment were recorded using Visual Analogue Scale (VAS) pretreatment, at 2 nd , 4 th and 6 th week post treatment. The results of this study illustrate that clinical and therapeutic effects of core stabilization exercise program over the period of six weeks are more effective in terms of reduction in pain, compared to routine physical therapy exercise for similar duration. This study found significant reduction in pain across the two groups at 2 nd , 4 th and 6 th week of treatment with p value less than 0.05. There was a mean reduction of 3.08 and 1.71 on VAS across the core stabilization group and routine physical therapy exercise group respectively. Core stabilization exercise is more effective than routine physical therapy exercise in terms of greater reduction in pain in patients with

  3. Effectiveness of core stabilization exercises and routine exercise therapy in management of pain in chronic non-specific low back pain: A randomized controlled clinical trial

    Science.gov (United States)

    Akhtar, Muhammad Waseem; Karimi, Hossein; Gilani, Syed Amir

    2017-01-01

    Background & Objective: Low back pain is a frequent problem faced by the majority of people at some point in their lifetime. Exercise therapy has been advocated an effective treatment for chronic low back pain. However, there is lack of consensus on the best exercise treatment and numerous studies are underway. Conclusive studies are lacking especially in this part of the world. Thisstudy was designed to compare the effectiveness of specific stabilization exercises with routine physical therapy exerciseprovided in patients with nonspecific chronic mechanical low back pain. Methods: This is single blinded randomized control trial that was conducted at the department of physical therapy Orthopedic and Spine Institute, Johar Town, Lahore in which 120 subjects with nonspecific chronic low back pain participated. Subjects with the age between 20 to 60 years and primary complaint of chronic low back pain were recruited after giving an informed consent. Participants were randomly assigned to two treatment groups A & B which were treated with core stabilization exercise and routine physical therapy exercise respectively. TENS and ultrasound were given as therapeutic modalities to both treatment groups. Outcomes of the treatment were recorded using Visual Analogue Scale (VAS) pretreatment, at 2nd, 4th and 6th week post treatment. Results: The results of this study illustrate that clinical and therapeutic effects of core stabilization exercise program over the period of six weeks are more effective in terms of reduction in pain, compared to routine physical therapy exercise for similar duration. This study found significant reduction in pain across the two groups at 2nd, 4th and 6th week of treatment with p value less than 0.05. There was a mean reduction of 3.08 and 1.71 on VAS across the core stabilization group and routine physical therapy exercise group respectively. Conclusion: Core stabilization exercise is more effective than routine physical therapy exercise in terms

  4. Effect of Different Types of Exercise in HIV + Mozambican Women Using Antiretroviral Therapy.

    Science.gov (United States)

    Mangona, Lucília; Daca, Timóteo; Tchonga, Francisco; Bule, Odete; Bhatt, Nilesh; Jani, Ilesh; Damasceno, Albertino; Prista, António

    2015-01-01

    The aim of this study was to evaluate and compare the effect of two types of exercises interventions on the regularity and health-related physical fitness in HIV-infected individuals who use antiretroviral therapy (ART). A total of 53 HIV+ African women (mean age=39.5±8.4 years) on ART participated in the study. Subjects were randomly divided into 3 groups, namely, formal exercise (FEG), playful exercise (PEG) and control (CG). During 12 weeks, the exercise groups underwent a program of 1-hour duration with a frequency of 3 times a week. The FEG performed a protocol that included 20 minutes of exercise, cycling at 60 % of V̇O2peak, increasing to 75 % and 85 % in the 4th and 8th weeks, respectively, and a muscular endurance circuit consisted of 6 exercises at 15 repetitions per minute (RM). The PEG followed a program consisting of active games. Before and after the intervention the participants were submitted to a clinical evaluation including immunological parameters (CD4+), cardiovascular risk factors, physical fitness and anthropometry. Comparison of somatic variables before and after the program showed no exercise effect. Immunological and cardiovascular variables were also independent of the exercise group. The main effect was found in cardiorespiratory fitness: exercise groups increased significantly in V̇O2peak (FEG=14.7 %; PEG=11.1 %) with no significant differences in CG. The percentage of high attendance was identical between the two groups. It was concluded that there is no contraindication for exercise in this type of population and the beneficial effect was mainly in cardiorespiratory fitness, regardless of the type of exercise performed.

  5. Achilles tendon of wistar rats treated with laser therapy and eccentric exercise

    Directory of Open Access Journals (Sweden)

    Maria Verônica de Souza

    2015-10-01

    Full Text Available ABSTRACTIntroduction:Both laser therapy and eccentric exercises are used in tendon injuries. However, the association of these physiotherapeutic modalities is yet little investigated.Objective:To evaluate the effect of low-level laser therapy associated to eccentric exercise (downhill walking on Achilles tendinopathy of Wistar rats.Method:Eighteen Achilles tendon from 15 adult male Wistar rats were used. Tendons were distributed in six groups (laser, eccentric exercise, laser and eccentric exercise, rest, contralateral tendon, and healthy tendon. Unilateral tendinopathy was surgically induced by transversal compression followed by scarification of tendon fibers. The treatments laser therapy (904 nm, 3J/cm² and/or eccentric exercise (downhill walking; 12 m/min; 50 min/day; 15o inclination treadmill began 24 hours after surgery and remained for 20 days. Clinical and biomechanical analyzes were conducted. Achilles tendon was macroscopically evaluated and the transversal diameter measured. Euthanasia was performed 21 days after lesion induction. Tendons of both limbs were collected and frozen at -20°C until biomechanical analysis, on which the characteristic of maximum load (N, stress at ultimate (MPa and maximum extension (mm were analyzed.Results:Swelling was observed within 72 hours postoperative. No fibrous adhesions were observed nor increase in transversal diameter of tendons. Animals with the exercised tendons, but not treated with laser therapy, presented lower (p=0.0000 locomotor capacity. No difference occurred be-tween groups for the biomechanical characteristics maximum load (p=0.4379, stress at ultimate (p=0.4605 and maximum extension (p=0.3820 evaluated, even considering healthy and contralateral tendons.Conclusion:The concomitant use of low-level laser and the eccentric exercise of downhill walking, starting 24 hours after surgically induced tendinopathy, do not result in a tendon with the same biomechanical resistance or elasticity

  6. Maximal exercise testing of men with prostate cancer being treated with androgen deprivation therapy.

    Science.gov (United States)

    Wall, Bradley A; Galvão, Daniel A; Fatehee, Naeem; Taaffe, Dennis R; Spry, Nigel; Joseph, David; Newton, Robert U

    2014-12-01

    Exercise is being increasingly established as a key adjuvant therapy in clinical oncology. As research has demonstrated the beneficial effect of exercise for cancer management, a growing number of patients with cancer are undertaking structured exercise programs. This study aimed to determine the safety and feasibility of formal exercise testing in clinical settings as it is becoming increasingly used as a screening tool and for exercise prescription purposes. One hundred and twelve patients with prostate cancer undergoing androgen deprivation therapy (ADT) took part in a physician-supervised multistage maximal stress test (Bruce protocol). Sixty patients had been on ADT for 3 months (chronic). Of these men, 85% were able to meet the criteria for the attainment of V˙O2max, whereas three positive tests (3.2%) were observed. The three participants who recorded a positive stress test underwent further medical examination and were subsequently cleared of clinically significant cardiovascular disease. Apart from the relatively low V˙O2max (24.7 ± 6.0 mL·kg·min, 10th-15th percentile), compared with normative data in healthy age-matched controls, the cardiovascular response to exercise was similar in this cancer population. Moreover, treatment duration did not seem to influence cardiovascular responses to exercise. This early evidence suggests that risk of adverse events during maximal exercise testing is relatively low in this population and certainly no higher than that in ages-matched, apparently healthy individuals. Maximal exercise testing was demonstrated to be feasible and safe, providing a direct assessment of V˙O2max. The relatively low number of positive tests in this study suggests that the risk of adverse events is relatively low in this population and certainly no higher than that in age-matched, apparently healthy individuals.

  7. Manual therapy and therapeutic exercise in the treatment of osteoarthritis of the hip: a systematic review.

    Science.gov (United States)

    Romeo, A; Parazza, S; Boschi, M; Nava, T; Vanti, C

    2013-05-27

    This systematic review aimed at investigating the role of therapeutic exercise and/or manual therapy in the treatment of hip osteoarthritis (OA). Two independent reviewers (AR, CV) searched PubMed, Cinahl, Cochrane Library, PEDro and Scopus databases and a third one (SP) was consulted in case of disagreement. The research criteria were publication period (from May 2007 to April 2012) and publication language (English or Italian). Ten randomized controlled trials matched inclusion criteria, eight of which concerning therapeutic exercise and two manual therapy. Few good quality studies were found. At mid- and long-term follow-up land-based exercises showed insufficient evidence of effectiveness with respect to pain and quality of life, but positive results were found for physical function. Water exercises significantly reduced fall risk when combined with functional exercises. Programs containing progressive and gradual exposure of difficult activities, education and exercises promoted better outcomes, higher adherence to home program and increased amount of physical activity, especially walking. Manual therapy seemed to reduce pain and decrease disability at short-term. Less use of nonsteroidal anti-inflammatory drugs was statistically significant at long-term follow-up in patients treated with manual therapy. The relationship between clinical results and radiological grade of OA was not investigated. Encouraging results were found in recent literature for manual therapy and functional training. Further research is needed to elucidate this issue through high-quality trials, especially addressing the aspects that have not been thoroughly explored yet, for instance type, amount and scheduling of conservative treatment.

  8. Manual therapy and therapeutic exercise in the treatment of osteoarthritis of the hip: a systematic review

    Directory of Open Access Journals (Sweden)

    A. Romeo

    2013-05-01

    Full Text Available This systematic review aimed at investigating the role of therapeutic exercise and/or manual therapy in the treatment of hip osteoarthritis (OA. Two independent reviewers (AR, CV searched PubMed, Cinahl, Cochrane Library, PEDro and Scopus databases and a third one (SP was consulted in case of disagreement. The research criteria were publication period (from May 2007 to April 2012 and publication language (English or Italian. Ten randomized controlled trials matched inclusion criteria, eight of which concerning therapeutic exercise and two manual therapy. Few good quality studies were found. At mid- and long-term follow-up land-based exercises showed insufficient evidence of effectiveness with respect to pain and quality of life, but positive results were found for physical function. Water exercises significantly reduced fall risk when combined with functional exercises. Programs containing progressive and gradual exposure of difficult activities, education and exercises promoted better outcomes, higher adherence to home program and increased amount of physical activity, especially walking. Manual therapy seemed to reduce pain and decrease disability at short-term. Less use of nonsteroidal anti-inflammatory drugs was statistically significant at long-term follow-up in patients treated with manual therapy. The relationship between clinical results and radiological grade of OA was not investigated. Encouraging results were found in recent literature for manual therapy and functional training. Further research is needed to elucidate this issue through high-quality trials, especially addressing the aspects that have not been thoroughly explored yet, for instance type, amount and scheduling of conservative treatment.

  9. Inspiratory muscle conditioning exercise and diaphragm gene therapy in Pompe disease: Clinical evidence of respiratory plasticity.

    Science.gov (United States)

    Smith, Barbara K; Martin, A Daniel; Lawson, Lee Ann; Vernot, Valerie; Marcus, Jordan; Islam, Saleem; Shafi, Nadeem; Corti, Manuela; Collins, Shelley W; Byrne, Barry J

    2017-01-01

    Pompe disease is an inherited disorder due to a mutation in the gene that encodes acid α-glucosidase (GAA). Children with infantile-onset Pompe disease develop progressive hypotonic weakness and cardiopulmonary insufficiency that may eventually require mechanical ventilation (MV). Our team conducted a first in human trial of diaphragmatic gene therapy (AAV1-CMV-GAA) to treat respiratory neural dysfunction in infantile-onset Pompe. Subjects (aged 2-15years, full-time MV: n=5, partial/no MV: n=4) underwent a period of preoperative inspiratory muscle conditioning exercise. The change in respiratory function after exercise alone was compared to the change in function after intramuscular delivery of AAV1-CMV-GAA to the diaphragm with continued exercise. Since AAV-mediated gene therapy can reach phrenic motoneurons via retrograde transduction, we hypothesized that AAV1-CMV-GAA would improve dynamic respiratory motor function to a greater degree than exercise alone. Dependent measures were maximal inspiratory pressure (MIP), respiratory responses to inspiratory threshold loads (load compensation: LC), and physical evidence of diaphragm activity (descent on MRI, EMG activity). Exercise alone did not change function. After AAV1-CMV-GAA, MIP was unchanged. Flow and volume LC responses increased after dosing (pAAV1-CMV-GAA and exercise training conferred benefits to dynamic motor function of the diaphragm. Children with a higher baseline neuromuscular function may have greater potential for functional gains. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Long-Term Effect of Exercise Therapy and Patient Education on Impairments and Activity Limitations in People With Hip Osteoarthritis

    DEFF Research Database (Denmark)

    Svege, Ida; Fernandes, L.; Nordsletten, L

    2016-01-01

    Background. The effect of exercise on specific impairments and activity limitations in people with hip osteoarthritis (OA) is limited. Objective. The study objective was to evaluate the long-term effect of exercise therapy and patient education on range of motion (ROM), muscle strength, physical ...... results for ROM, muscle strength, physical fitness, and walking capacity, but exercise in addition to patient education resulted in less pain during walking in the long term. © 2016 American Physical Therapy Association....

  11. Delaying ACL reconstruction and treating with exercise therapy alone may alter prognostic factors for 5-year outcome

    DEFF Research Database (Denmark)

    Filbay, Stephanie R; Roos, Ewa M; Frobell, Richard B

    2017-01-01

    , body mass index, preinjury activity level, education and smoking. RESULTS: For all participants (n=118), graft/contralateral ACL rupture, non-ACL surgery and worse baseline 36-item Short-Form Mental Component Scores were associated with worse outcomes. Treatment with exercise therapy alone......AIM: Identify injury-related, patient-reported and treatment-related prognostic factors for 5-year outcomes in acutely ACL-ruptured individuals managed with early reconstruction plus exercise therapy, exercise therapy plus delayed reconstruction or exercise therapy alone. METHODS: Exploratory...... was a prognostic factor for less knee symptoms compared with early reconstruction plus exercise therapy (regression coefficient 10.1, 95% CI 2.3 to 17.9). Baseline meniscus lesion was associated with worse sport/recreation function (-14.4, 95% CI -27.6 to -1.3) and osteochondral lesions were associated with worse...

  12. Influence of the physical environment on treatment effect in exercise therapy for knee or hip pain

    DEFF Research Database (Denmark)

    Sandal, Louise Fleng

    ) exploring experiences and perceptions of the physical environments. The waiting-list group reported no significant improvement (-0.05 GPE, CI 95% -0.5 to 0.4). Contrary to the study hypothesis, participants exercising in the standard environment reported greater improvement in GPE (0.98, CI 95% 0.5 to 1......-care settings. The physical environment is easier to standardize and may act as a context factor and influence treatment outcomes. Studies from hospital environments have shown that the physical environment influences health outcomes, patients, and clinicians. It is unknown if the physical environment affects...... treatment outcomes in other health-care settings, such as rehabilitation and exercise therapy settings. The aim of this thesis was to investigate the role of the physical environment as a contributor to context effects in the treatment response from exercise therapy as treatment for muskuloskeletal pain...

  13. Growth hormone responses to continuous and intermittent exercise in females under oral contraceptive therapy.

    Science.gov (United States)

    Bernardes, R P; Radomski, M W

    1998-12-01

    In this study we investigated the effect of oral contraceptive (OC) use (OCU) and non-use (OCNU) on growth hormone (GH) responses to exercise in the same females (n = 7, age 22-31 years) during the normal course of OC therapy. Continuous (60% maximum oxygen consumption, VO2max for 20 min) and intermittent exercise (>80% VO2max) protocols of equal total duration, and similar external work were performed during phases of OCNU (days 3-5 of the menstrual cycle) and OCU (days 7-11). Levels of GH, lactate, 17 beta-estradiol, and progesterone were measured. Lactate responses were significantly greater (Pmenstrual cycle to benefit from an increased GH response to exercise during phases of OC use or the luteal phase of women not on OC therapy.

  14. Exercise therapy for trismus secondary to head and neck cancer : A systematic review

    NARCIS (Netherlands)

    Kamstra, Jolanda I.; van Leeuwen, M.; Roodenburg, Jan L. N.; Dijkstra, Pieter U.

    2017-01-01

    Background. Effects of exercise therapy for trismus secondary to head and neck cancer have not been reviewed systematically since 2004. Methods. Four databases were searched. The quality of observational studies and randomized controlled trials was assessed. Results. Two hundred eleven articles were

  15. Exercise therapy for trismus secondary to head and neck cancer : A systematic review

    NARCIS (Netherlands)

    Kamstra, Jolanda I; van Leeuwen, Marianne; Roodenburg, Jan L N; Dijkstra, Pieter U

    BACKGROUND: Effects of exercise therapy for trismus secondary to head and neck cancer have not been reviewed systematically since 2004. METHODS: Four databases were searched. The quality of observational studies and randomized controlled trials was assessed. RESULTS: Two hundred eleven articles were

  16. [Physical exercise therapy before and after major surgery: effective or not?

    NARCIS (Netherlands)

    Elings, J.; Hoogeboom, T.J.; Dronkers, J.J.; Hulzebos, E.H.; Meeteren, N.L. van

    2015-01-01

    Loss of functional status before, during and after major surgery is a common problem in elderly patients. One of the most important causes is patient inactivity. Pre- and postoperative physical exercise therapy is thought to reduce or even prevent the negative effects of hospital admission for major

  17. Effectiveness of exercise therapy: a best-evidence summary of systematic reviews.

    NARCIS (Netherlands)

    Smidt, N.; Vet, H.C.W. de; Bouter, L.M.; Dekker, J.; Arendzen, J.H.; Bie, R.A. de; Bierma-Zeinstra, S.M.; Helders, P.J.M.; Keus, S.H.J.; Kwakkel, G.; Lenssen, T.; Oostendorp, R.A.B.; Ostelo, R.W.J.G.; Reijman, M.; Terwee, C.B.; Theunissen, C.; Thomas, S.; Baar, M.E. van; Hul, A. van 't; Peppen, R.P. van; Verhagen, A.; Windt, D.A.W.M. van der

    2005-01-01

    The purpose of this project was to summarise the available evidence on the effectiveness of exercise therapy for patients with disorders of the musculoskeletal, nervous, respiratory, and cardiovascular systems. Systematic reviews were identified by means of a comprehensive search strategy in 11

  18. Effects of aerobic exercise and drug therapy on blood pressure and ...

    African Journals Online (AJOL)

    EB

    Abstract. Background: Although aerobic exercise has been shown to lower blood pressure (BP) in human beings, its additive BP- reducing effect on antihypertensive drug therapy seems to have been investigated in only laboratory animals. Objectives: This study investigated the effects of aerobic dance combined with ...

  19. Gender differences following supervised exercise therapy in patients with intermittent claudication

    NARCIS (Netherlands)

    Gommans, L.N.; Scheltinga, M.R.; Sambeek, M.R. van; Maas, A.H.E.M.; Bendermacher, B.L.; Teijink, J.A.

    2015-01-01

    OBJECTIVE: Prevalence of peripheral arterial disease is equal in men and women. However, women seem to suffer more from the burden of disease. Current studies on gender-related outcomes following supervised exercise therapy (SET) for intermittent claudication (IC) yield conflicting results. METHODS:

  20. Exercise Therapy in Juvenile Idiopathic Arthritis: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Kuntze, Gregor; Nesbitt, Colleen; Whittaker, Jackie L; Nettel-Aguirre, Alberto; Toomey, Clodagh; Esau, Shane; Doyle-Baker, Patricia K; Shank, Jena; Brooks, Julia; Benseler, Susanne; Emery, Carolyn A

    2017-07-18

    To conduct a systematic review to evaluate the efficacy of exercise interventions in improving outcomes across domains of functioning and disability in children and adolescents with juvenile idiopathic arthritis (JIA). Seven electronic databases were systematically searched up to November 16, 2016. Original data, analytic prospective design, physical therapy-led exercise intervention evaluation, children and adolescents with JIA, and assessment of functional, structural, activity, participation, or quality of life outcomes. Two authors screened search results, and discrepancies were resolved by consensus. Of 5037 potentially relevant studies, 9 randomized controlled trials and 1 cohort study were included and scored. Study quality (Downs and Black quality assessment tool) and level of evidence (Oxford Centre of Evidence-Based Medicine model) were assessed and meta-analysis conducted where appropriate. Alternatively, a descriptive summary approach was chosen. All randomized controlled trials were moderate-quality intervention studies (level 2b evidence; median Downs and Black score, 20 out of 32; range, 15-27). Interventions included aquatic, strengthening, proprioceptive, aerobic, and Pilates exercises. Pediatric activity capacity (Child Health Assessment Questionnaire) improved with exercise (mean difference, .45; 95% confidence interval, .05-.76). Furthermore, descriptive summaries indicated improved activity capacity, body function and structure (pain and muscle strength), and quality of life outcomes. Exercise therapy appears to be well tolerated and beneficial across clinically relevant outcomes in patients with JIA. The paucity of high-quality evidence and study heterogeneity limited the ability to provide conclusive, generalizing evidence for the efficacy of exercise therapy and to provide specific recommendations for clinical practice at this time. Future research evaluating exercise program implementation using validated outcomes and detailed adherence and

  1. Occupational therapy-based and evidence-supported recommendations for assessment and exercises in hand osteoarthritis.

    Science.gov (United States)

    Kjeken, Ingvild

    2011-12-01

    The aims of this study were to develop recommendations for occupational therapy assessment and design of hand exercise programmes in patients with hand osteoarthritis. An expert group followed a Delphi procedure to reach consensus for up to 10 recommendations for assessment and exercises, respectively. Thereafter, an evidence-based approach was used to identify and appraise research evidence supporting each recommendation, before the recommendations were validated by the expert group. The process resulted in 10 recommendations for assessment and eight for design of exercise programmes. The literature search revealed that there is a paucity of clinical trials to guide recommendations for hand osteoarthritis, and the evidence for the majority of the recommendations was based on expert opinions. Also, even if a systematic review demonstrates some evidence for the efficacy of strength training exercises in hand OA, the evidence for any specific exercise is limited to expert opinions. A first set of recommendations for assessment and exercise in hand osteoarthritis has been developed. For many of the recommendations there is a paucity of research evidence. High-quality studies are therefore needed to establish a high level of evidence concerning functional assessment and the effect of hand exercises in hand osteoarthritis.

  2. The Effects Combining Cryocompression Therapy following an Acute Bout of Resistance Exercise on Performance and Recovery

    Science.gov (United States)

    DuPont, William H.; Meuris, Brek J.; Hardesty, Vincent H.; Barnhart, Emily C.; Tompkins, Landon H.; Golden, Morricia J.P.; Usher, Clayton J.; Spence, Paul A.; Caldwell, Lydia K.; Post, Emily M.; Beeler, Matthew K.; Kraemer, William J.

    2017-01-01

    Compression and cold therapy used separately have shown to reduce negative effects of tissue damage. The combining compression and cold therapy (cryocompression) as a single recovery modality has yet to be fully examined. To examine the effects of cryocompression on recovery following a bout of heavy resistance exercise, recreationally resistance trained men (n =16) were recruited, matched, and randomly assigned to either a cryocompression group (CRC) or control group (CON). Testing was performed before and then immediately after exercise, 60 minutes, 24 hours, and 48 hours after a heavy resistance exercise workout (barbell back squats for 4 sets of 6 reps at 80% 1RM, 90 sec rest between sets, stiff legged deadlifts for 4 sets of 8 reps at 1.0 X body mass with 60 sec rest between sets, 4 sets of 10 eccentric Nordic hamstring curls, 45 sec rest between sets). The CRC group used the CRC system for 20-mins of cryocompression treatment immediately after exercise, 24 hours, and 48 hours after exercise. CON sat quietly for 20-mins at the same time points. Muscle damage [creatine kinase], soreness (visual analog scale, 0-100), pain (McGill Pain Q, 0-5), fatigue, sleep quality, and jump power were significantly (p workout. Key points The combination of circulatory cooling and compression technology enhances recovery from heavy resistance exercise. Sleep quality is enhanced following the use of cyo-compression when compared to typical no intervention control conditions following heavy resistance exercise. Muscle damage markers, pain and soreness markers are improved with cryocompression when compared to no interventional control conditions following heavy resistance exercise. PMID:28912650

  3. The Effects Combining Cryocompression Therapy following an Acute Bout of Resistance Exercise on Performance and Recovery

    Directory of Open Access Journals (Sweden)

    William H. DuPont, Brek J. Meuris, Vincent H. Hardesty, Emily C. Barnhart, Landon H. Tompkins, Morricia J.P. Golden, Clayton J. Usher, Paul A. Spence, Lydia K. Caldwell, Emily M. Post, Matthew K. Beeler, William J. Kraemer

    2017-09-01

    Full Text Available Compression and cold therapy used separately have shown to reduce negative effects of tissue damage. The combining compression and cold therapy (cryocompression as a single recovery modality has yet to be fully examined. To examine the effects of cryocompression on recovery following a bout of heavy resistance exercise, recreationally resistance trained men (n =16 were recruited, matched, and randomly assigned to either a cryocompression group (CRC or control group (CON. Testing was performed before and then immediately after exercise, 60 minutes, 24 hours, and 48 hours after a heavy resistance exercise workout (barbell back squats for 4 sets of 6 reps at 80% 1RM, 90 sec rest between sets, stiff legged deadlifts for 4 sets of 8 reps at 1.0 X body mass with 60 sec rest between sets, 4 sets of 10 eccentric Nordic hamstring curls, 45 sec rest between sets. The CRC group used the CRC system for 20-mins of cryocompression treatment immediately after exercise, 24 hours, and 48 hours after exercise. CON sat quietly for 20-mins at the same time points. Muscle damage [creatine kinase], soreness (visual analog scale, 0-100, pain (McGill Pain Q, 0-5, fatigue, sleep quality, and jump power were significantly (p < 0.05 improved for CRC compared to CON at 24 and 48 hours after exercise. Pain was also significantly lower for CRC compared to CON at 60-mins post exercise. These findings show that cryocompression can enhance recovery and performance following a heavy resistance exercise workout.

  4. [Clinical research of knee joint motor impairment after fracture operation treated with relaxing needling manipulation combined with exercise therapy].

    Science.gov (United States)

    Luo, Kaimin; Qi, Tianchen; Yang, Lin; Hou, Zhi

    2015-09-01

    To compare the clinical efficacy on the motor impairment of knee joint after tracture operation between the combined therapeutic method of relaxing needling manipulation and exercise therapy and the simple exercise therapy. Sixty-four patients after the operation for the fracture of femoral shaft were randomized into a relaxing needling combined with exercise therapy group (group A) and an exercise therapy group (group B), 32 cases in each one. In the group A, the relaxing needling manipulation was applied to the local painful area of knee or the stiff soft tissues. Additionally, the exercise therapy was used in combination. In the group B, the exercise therapy was applied simply. Hospital for special surgery (HSS) pain score, the range of movement (ROM) of knee joint and Lysholm score were compared before and 60 days after treatment in the patients of the two groups. The efficacy was compared between the two groups. After treatment, HSS pain score, ROM and Lysholm score were all improved in the two groups, presenting the significant differences as compared with those before treatment (all Pexercise therapy achieves the significant efficacy on the motor impairment of knee joint after the operation for the fracture of femoral shaft, superior to the simple exercise therapy.

  5. Histomorphometric analysis of the Achilles tendon of Wistar rats treated with laser therapy and eccentric exercise

    Directory of Open Access Journals (Sweden)

    Maria V. de Souza

    2015-12-01

    Full Text Available Abstract: Low-level laser therapy is recommended for the treatment of tendinopathies despite the contradictory results related to the ideal dose of energy, wavelength and time of application. This study aimed to assess the effects of laser therapy and eccentric exercise on tendinopathy of the Achilles tendon of Wistar rats. Forty-eight adult male rats were randomly distributed into four groups (L= laser; E= eccentric exercise; LE = laser and eccentric exercise; and R= rest. Laser therapy (904nm/3J/cm2 and/or eccentric exercise (downhill walking; 15o incline treadmill; 12m/min; 50min/day was started 24h after induction of unilateral tendinopathy and remained for 20 days. At 3, 7, 14 and 21 days after lesion induction, three rats from each group were euthanized and the tendons were collected for histological and morphometric analyses. There was no difference among groups or among times for the characteristics hemorrhage (p=0.4154, fibrinous adhesion formation (p=0.0712, and organization of collagen fibers (p=0.2583 and of the connective tissue (p=0.1046. For these groups, regardless of the time, eccentric exercise led to epitenon thickening (p=0.0204, which was lower in the group treated with laser therapy. Histological analysis revealed differences (p=0.0032 in the number of inflammatory cells over time. They were more numerous in the group that only exercised. This result was confirmed by morphometric analysis, which showed a significant interaction (groups x time for this characteristic. Eccentric exercise increased (p=0.0014 the inflammatory infiltrate over time (3 and 21 days. However, association with laser therapy reduced inflammatory reaction. On the other hand, the combination of the treatments increased angiogenesis in morphometric (p=0.0000 and histological (p=0.0006 analyses compared with the other groups, while the isolated application of low-level laser reduced this characteristic over time. Animals maintained at rest presented the

  6. Exercise therapy for improved neck muscle function in helicopter aircrew.

    Science.gov (United States)

    Salmon, Danielle M; Harrison, Michael F; Sharpe, Donald; Candow, Darren; Albert, Wayne J; Neary, J Patrick

    2013-10-01

    To address the high prevalence of neck dysfunction in helicopter aircrew, a 12-wk training program was designed to examine the effects on neck muscular strength and endurance. Subjects were recruited from Canadian Forces (CF) helicopter aircrew and randomized into either a neck coordination training program (CTP; N = 10), an endurance training program (ETP; N = 11), or a nontreatment control (CON; N = 8). Baseline assessments determined maximal voluntary contraction (MVC) strength and endurance capacity using a submaximal contraction to fatigue at 70% of their MVC for extension, flexion, and left (Ltflx) and right (Rtflx) lateral flexion. The ETP subjects performed dynamic contractions at 30% of their MVC in the four testing directions using a head harness and Thera-band tubing. The CTP consisted of exercises that focused on strengthening the deep cervical musculature using the mass of the head as resistance and progressing to exercises that incorporated the superficial cervical muscles. Post-intervention, the ETP achieved the only statistically significant increase in maximal force when compared to the CON (14.4%). Improved times to fatigue were achieved by the CTP for flexion (26.34 +/- 20.72 s), Ltflx (23.54 +/- 13.94 s), and Rtflx (28.72 +/- 4.88 s). The provision of an ETP and CTP resulted in a positive trend toward improved maximal force and muscular endurance. The greatest improvements in endurance and strength were found for those subjects assigned to the CTP treatment. Our research demonstrates the importance of including a designed and supervised training program into the daily routine of helicopter aviators.

  7. Sexuality and exercise in men undergoing androgen deprivation therapy for prostate cancer.

    Science.gov (United States)

    Hamilton, K; Chambers, S K; Legg, M; Oliffe, J L; Cormie, P

    2015-01-01

    Androgen deprivation therapy (ADT) for the management of prostate cancer results in a range of side effects including sexual dysfunction. Exercise is proposed as a potentially effective therapy to counteract changes in sexual function. The current study explored the impact of ADT on men's sexuality and the effect of exercise on this experience. Semi-structured, in-depth interviews were conducted with 18 men (age = 63.1 ± 3.8) who were on ADT for prostate cancer for ≤12 months and who were part of a pre-existing exercise intervention trial. Sexual concerns for men included changes in body image, partner relationships, sex drive, sexual performance and masculinity. In coping with these concerns, men described a sense of personal acceptance of sexual changes through a shift in priorities and values away from penetrative sexual intercourse, knowledge and understanding about ADT, and partner support. Exercise in a group-based setting contributed to the acceptance of sexual changes through affirming strength-based aspects of masculinity and peer support. Exercise appears to have utility as a strategy to assist men to manage the negative impact of ADT on sexuality and masculinity more broadly.

  8. Effect of exercise augmentation of cognitive behavioural therapy for the treatment of suicidal ideation and depression.

    Science.gov (United States)

    Abdollahi, Abbas; LeBouthillier, Daniel M; Najafi, Mahmoud; Asmundson, Gordon J G; Hosseinian, Simin; Shahidi, Shahriar; Carlbring, Per; Kalhori, Atefeh; Sadeghi, Hassan; Jalili, Marzieh

    2017-09-01

    Suicidal ideation and depression are prevalent and costly conditions that reduce quality of life. This study was designed to determine the efficacy of exercise as an adjunct to cognitive behavioural therapy (CBT) for suicidal ideation and depression among depressed individuals. In a randomized clinical trial, 54 mildly to moderately depressed patients (54% female, mean age=48.25) were assigned to a combined CBT and exercise group or to a CBT only group. Both groups received one weekly session of therapy for 12 weeks, while the combined group also completed exercise three times weekly over the same period. Self-reported suicidal ideation, depression, and activities of daily living were measured at the beginning and the end of treatment. Multilevel modelling revealed greater improvements in suicidal ideation, depression, and activities of daily living in the combined CBT and exercise group, compared to the CBT only group. No follow-up data were collected, so the long-term effects (i.e., maintenance of gains) is unclear. The findings revealed that exercise adjunct to CBT effectively decreases both depressive symptoms and suicidal ideation in mildly to moderately depressed individuals. Copyright © 2017 Elsevier B.V. All rights reserved.

  9. [Impact of exercise, sport and rehabilitation therapy in asthma and COPD].

    Science.gov (United States)

    Rohrer, Valérie; Schmidt-Trucksäss, Arno

    2014-05-01

    Patients with chronic obstructive pulmonary disease (COPD) and Asthma share increased physical inactivity as a characteristic and risk factor for the aggravation of their symptoms and marker of their health condition, respectively. Physical inactivity may be objectively measured by means of accelerometry superior to questionnaires. Physical inactivity is the reason for a reduced endurance capacity and a reduction of strength with concomitant decrease of skeletal muscle mass aggravating inflammation as a common pathophysiologic soil. Endurance training is recommended in the form of continuous and interval training having similar effects on endurance capacity executed on either a bike or as walking in patients with COPD und Asthma. Walking inherits the potential additional benefit of a reduction of fall risk which needs additional scientific evidence. This holds true especially for elderly subjects. Strength training is important because of the frequently atrophied skeletal musculature, which triggers the increase of the exercise-induced ventilation by early lactate acidosis and thereby aggravates dyspnea during exercise. An important aspect of therapy is the maintenance of the individualized training after discharge from hospital in the domestic environment taking into consideration training facilities, encounter groups and social circumstances. The objective measurement of physical activity has the potential to guide and control therapy. Because of the frequently present cardio-metabolic comorbidities the assessment of the exercise capacity as well an evaluation of nutrition should be included into a holistic therapeutical approach. An optimized bronchospasmolytic and anti-inflammatory therapy is the basis for a sufficient response to exercise training. In patients with asthma, a warm-up phase of at least 15 min prior to exercise is recommended. Redundant fear of exercise-induced attacks of asthma shall be avoided by doing so. If necessary, additional psychological

  10. Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Armijo-Olivo, Susan; Pitance, Laurent; Singh, Vandana; Neto, Francisco; Thie, Norman; Michelotti, Ambra

    2016-01-01

    Manual therapy (MT) and exercise have been extensively used to treat people with musculoskeletal conditions such as temporomandibular disorders (TMD). The evidence regarding their effectiveness provided by early systematic reviews is outdated. The aim of this study was to summarize evidence from and evaluate the methodological quality of randomized controlled trials that examined the effectiveness of MT and therapeutic exercise interventions compared with other active interventions or standard care for treatment of TMD. Electronic data searches of 6 databases were performed, in addition to a manual search. Randomized controlled trials involving adults with TMD that compared any type of MT intervention (eg, mobilization, manipulation) or exercise therapy with a placebo intervention, controlled comparison intervention, or standard care were included. The main outcomes of this systematic review were pain, range of motion, and oral function. Forty-eight studies met the inclusion criteria and were analyzed. Data were extracted in duplicate on specific study characteristics. The overall evidence for this systematic review was considered low. The trials included in this review had unclear or high risk of bias. Thus, the evidence was generally downgraded based on assessments of risk of bias. Most of the effect sizes were low to moderate, with no clear indication of superiority of exercises versus other conservative treatments for TMD. However, MT alone or in combination with exercises at the jaw or cervical level showed promising effects. Quality of the evidence and heterogeneity of the studies were limitations of the study. No high-quality evidence was found, indicating that there is great uncertainty about the effectiveness of exercise and MT for treatment of TMD. © 2016 American Physical Therapy Association.

  11. Long-term effects of exercise and physical therapy in people with Parkinson disease.

    Science.gov (United States)

    Mak, Margaret K; Wong-Yu, Irene S; Shen, Xia; Chung, Chloe L

    2017-11-01

    Parkinson disease (PD) is a progressive, neurodegenerative movement disorder with symptoms reflecting various impairments and functional limitations, such as postural instability, gait disturbance, immobility and falls. In addition to pharmacological and surgical management of PD, exercise and physical therapy interventions are also being actively researched. This Review provides an overview of the effects of PD on physical activity - including muscle weakness, reduced aerobic capacity, gait impairment, balance disorders and falls. Previously published reviews have discussed only the short-term benefits of exercises and physical therapy for people with PD. However, owing to the progressive nature of PD, the present Review focuses on the long-term effects of such interventions. We also discuss exercise-induced neuroplasticity, present data on the possible risks and adverse effects of exercise training, make recommendations for clinical practice, and describe new treatment approaches. Evidence suggests that a minimum of 4 weeks of gait training or 8 weeks of balance training can have positive effects that persist for 3-12 months after treatment completion. Sustained strength training, aerobic training, tai chi or dance therapy lasting at least 12 weeks can produce long-term beneficial effects. Further studies are needed to verify disease-modifying effects of these interventions.

  12. Preoperative exercise therapy for elective major abdominal surgery: a systematic review.

    Science.gov (United States)

    Pouwels, Sjaak; Stokmans, Rutger A; Willigendael, Edith M; Nienhuijs, Simon W; Rosman, Camiel; van Ramshorst, Bert; Teijink, Joep A W

    2014-01-01

    The impact of postoperative complications after Major Abdominal Surgery (MAS) is substantial, especially when socio-economical aspects are taken into account. This systematic review focuses on the effects of preoperative exercise therapy (PEXT) on physical fitness prior to MAS, length of hospital admission and postoperative complications in patients eligible for MAS, and on what is known about the most effective kind of exercise regime. A systematic search identified randomised controlled trials on exercise therapy and pulmonary physiotherapy prior to MAS. The methodological quality of the included studies was rated using the 'Delphi List For Quality Assessment of Randomised Clinical Trials'. The level of agreement between the two reviewers was estimated with Cohen's kappa. A total of 6 studies were included, whose methodological quality ranged from moderate to good. Cohen's kappa was 0.90. Three studies reported on improving physical fitness prior to MAS with the aid of PEXT. Two studies reported on the effect of training on postoperative complications, showing contradictory results. Three studies focused on the effect of preoperative chest physiotherapy on postoperative lung function parameters after MAS. While the effects seem positive, the optimal training regime is still unclear. Preoperative exercise therapy might be effective in improving the physical fitness of patients prior to major abdominal surgery, and preoperative chest physiotherapy seems effective in reducing pulmonary complications. However consensus on training method is lacking. Future research should focus on the method and effect of PEXT before high-risk surgical procedures. Copyright © 2013 Surgical Associates Ltd. All rights reserved.

  13. Physical Therapy and Exercise Interventions in Huntington's Disease: A Mixed Methods Systematic Review.

    Science.gov (United States)

    Fritz, Nora E; Rao, Ashwini K; Kegelmeyer, Deb; Kloos, Anne; Busse, Monica; Hartel, Lynda; Carrier, Judith; Quinn, Lori

    2017-01-01

    A number of studies evaluating physical therapy and exercise interventions in Huntington's disease have been conducted over the past 15 years. However, an assessment of the quality and strength of the evidence in support of these interventions is lacking. The purpose of this systematic review was to investigate the effectiveness of physical therapy and exercise interventions in people with Huntington's disease, and to examine the perceptions of patients, families and caregivers of these interventions. This mixed-methods systematic review utilized the Joanna Briggs Institute (JBI) approach and extraction tools to evaluate the literature from January 2003 until May 2016. The review considered interventions that included exercise and physical therapy interventions, and included both quantitative and qualitative outcome measures. Twenty (20) studies met the inclusion criteria, including eighteen (18) that had quantitative outcome measures and two (2) that utilized qualitative methods. JBI Levels of evidence for the 18 quantitative studies were as follows: Eight studies were at evidence Level 1, seven were at Level 2, two were at Level 3, and one was at Level 4. Our review suggests that there is preliminary support for the benefits of exercise and physical activity in Huntington's disease in terms of motor function, gait speed, and balance, as well as a range of physical and social benefits identified through patient-reported outcomes. Variability in mode of intervention as well as outcome measures limits the interpretability of these studies, and high-quality studies that incorporate adaptive trial designs for this rare disease are needed.

  14. Therapeutic laryngoscopy during exercise: A novel non-surgical therapy for refractory EILO.

    Science.gov (United States)

    Olin, J Tod; Deardorff, Emily H; Fan, Elizabeth M; Johnston, Kristina L; Keever, Valerie L; Moore, Camille M; Bender, Bruce G

    2017-06-01

    Exercise-induced laryngeal obstruction (EILO) may affect as many as 6% of the adolescent population, with some patients experiencing symptoms refractory to conservative interventions. This report describes therapeutic laryngoscopy during exercise, a novel, non-surgical intervention that harnesses real-time laryngoscopy video as biofeedback to control laryngeal aperture during high-intensity exercise. Additionally, we quantitate patient-reported perceptions of procedure safety, tolerability, learning value, and effectiveness. Clinical EILO patients with symptoms refractory to conventional respiratory retraining and other therapies were referred for the procedure which features laryngoscopy video as biofeedback during serial physician-guided 1-min exercise sprints. We quantify perceptions of procedure safety, tolerability, learning value, and effectiveness through questionnaires offered to all patients as well as observers of the procedure. Forty-one patients and 37 parent observers were approached for feedback; 88% of patients and 95% of observers consented to participation. Patients and observers reported perceptions of safety and tolerability (81% and 86%, respectively), learning value (78% and 91%, respectively), and effectiveness (58% and 80%, respectively) with patient age predicting some responses. Seventy-five percent of patients noted that "Since the procedure, my breathing during exercise has improved," and 85% of this group noted that therapeutic laryngoscopy during exercise was "the most important therapy leading to my breathing improvement." The procedure also provided insight into the psychological experience of patients, a domain not clinically apparent prior to the procedure. Our data support further study of therapeutic laryngoscopy during exercise as a possible intervention for patients with refractory EILO. Pediatr Pulmonol. 2017;52:813-819. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  15. Paraoxonase responses to exercise and niacin therapy in men with metabolic syndrome.

    Science.gov (United States)

    Taylor, James Kyle; Plaisance, Eric P; Mahurin, A Jack; Mestek, Michael L; Moncada-Jimenez, Jose; Grandjean, Peter W

    2015-01-01

    Our purpose was to characterize changes in paraoxonase 1 (PON1) activity and concentration after single aerobic exercise sessions conducted before and after 6 weeks of niacin therapy in men with metabolic syndrome (MetS). Twelve men with MetS expended 500 kcal by walking at 65% of VO2max before and after a 6-week regimen of niacin. Niacin doses were titrated by 500 mg/week from 500 to 1500 mg/day and maintained at 1500 mg/day for the last 4 weeks. Fasting blood samples were collected before and 24 hours after each exercise session and analyzed for PON1 activity, PON1 concentration, myeloperoxidase (MPO), apolipoprotein A1, oxidized low-density lipoprotein (oLDL), lipoprotein particle sizes and concentrations. PON1 activity, PON1 concentration, MPO, and oLDL were unaltered following the independent effects of exercise and niacin (P > 0.05 for all). High-density lipoprotein particle size decreased by 3% (P = 0.040) and concentrations of small very low-density lipoprotein increased (P = 0.016) following exercise. PON1 activity increased 6.1% (P = 0.037) and PON1 concentrations increased 11.3% (P = 0.015) with the combination of exercise and niacin. Exercise and niacin works synergistically to increase PON1 activity and concentration with little or no changes in lipoproteins or markers of lipid oxidation.

  16. The clinical and sonographic effects of kinesiotaping and exercise in comparison with manual therapy and exercise for patients with subacromial impingement syndrome: a preliminary trial.

    Science.gov (United States)

    Kaya, Derya Ozer; Baltaci, Gul; Toprak, Ugur; Atay, Ahmet Ozgur

    2014-01-01

    The purpose of this study was to compare the effects of manual therapy with exercise to kinesiotaping with exercise for patients with subacromial impingement syndrome. Randomized clinical before and after trial was used. Fifty-four patients diagnosed as having subacromial impingement syndrome who were referred for outpatient treatment were included. Eligible patients (between 30 and 60 years old, with unilateral shoulder pain) were randomly allocated to 2 study groups: kinesiotaping with exercise (n = 28) or manual therapy with exercise (n = 26). In addition, patients were advised to use cold packs 5 times per day to control for pain. Visual analog scale for pain, Disability of Arm and Shoulder Questionnaire for function, and diagnostic ultrasound assessment for supraspinatus tendon thickness were used as main outcome measures. Assessments were applied at the baseline and after completing 6 weeks of related interventions. At the baseline, there was no difference between the 2 group characteristics (P > .05). There were significant differences in both groups before and after treatment in terms of pain decrease and improvement of Disability of Arm and Shoulder Questionnaire scores (P .05). The only difference between the groups was at night pain, resulting in favor of the kinesiotaping with exercise group (P < .05). For the group of subjects studied, no differences were found between kinesiotaping with exercise and manual therapy with exercise. Both treatments may have similar results in reducing pain and disability in subacromial impingement in 6 weeks. Copyright © 2014 National University of Health Sciences. Published by Elsevier Inc. All rights reserved.

  17. Supervised exercise therapy in the management of peripheral arterial disease - an assessment of compliance.

    Science.gov (United States)

    Aherne, Thomas M; Kheirelseid, Elrasheid A H; Boland, Michael; Carr, Shane; Al-Zabi, Thekra; Bashar, Khalid; Moneley, Daragh; Leahy, Austin; McCaffrey, Noel; Naughton, Peter

    2017-05-01

    Supervised exercise therapy (SET) is an effective option in the management of peripheral arterial disease (PAD). Unfortunately, poor compliance remains prevalent. This study aimed to assess patient exercise compliance and to identify factors influencing symptomatic improvement and SET participation. Data regarding attendance at SET for this cohort study were extracted from a prospectively maintained database of patients with claudication attending SET at Dublin City University. All patients had ankle brachial index confirmed PAD with associated intermittent claudication. Exercise performance and symptomatic data were gathered retrospectively using patient charts and interviews. Ninety-eight patients were referred for SET during the study period. The mean age was 69.2 (± 10.1) with 18 % being female. Median follow-up was 25.1 months (IQ range 17.0-31.6). Overall, the mean number of sessions attended per patient was 19.5. Exercise compliance was associated with a significant improvement in symptoms (p = 0.001). Other factors including anatomical level of claudication (P = 0.042) and educational level (p = 0.007) were found to affect the outcome of SET. Multivariate analysis revealed hypertension as a predictor of symptomatic outcome after SET (p = 0.045). Furthermore, ex-smokers (p = 0.021) and those previously diagnosed with hypercholesterolaemia (p = 0.020) or ischaemic heart disease (p = 0.029) had superior exercise compliance. Using linear regression, smoking history (p = 0.024) was identified as a predictor of compliance to SET. Establishing exercise compliance remains challenging in the PAD cohort. Pre-exercise patient education and personalised exercise prescriptions may result in improvements in function and compliance.

  18. Feasibility and initial effectiveness of home exercise during maintenance therapy for childhood acute lymphoblastic leukemia.

    Science.gov (United States)

    Esbenshade, Adam J; Friedman, Debra L; Smith, Webb A; Jeha, Sima; Pui, Ching-Hon; Robison, Leslie L; Ness, Kirsten K

    2014-01-01

    Children with acute lymphoblastic leukemia (ALL) are at increased risk of obesity and deconditioning from cancer therapy. This pilot study assessed feasibility/initial efficacy of an exercise intervention for patients with ALL undergoing maintenance therapy. Participants were aged 5 to 10 years, receiving maintenance therapy, in first remission. A 6-month home-based intervention, with written and video instruction, was supervised with weekly calls from an exercise coach. Pre- and poststudy testing addressed strength, flexibility, fitness, and motor function. Seventeen patients enrolled (participation 63%). Twelve (71%) finished the intervention, completing 81.7 ± 7.2% of prescribed sessions. Improvements of 5% or more occurred in 67% for knee and 75% for grip strength, 58% for hamstring/low-back and 83% for ankle flexibility, 75% for the 6-Minute Walk Test, and 33% for performance on the Bruininks-Oseretsky Test of Motor Proficiency Version 2. This pilot study demonstrated that exercise intervention during ALL therapy is feasible and has promise for efficacy.

  19. Aerobic Exercise and Pharmacological Therapies for Skeletal Myopathy in Heart Failure: Similarities and Differences

    Directory of Open Access Journals (Sweden)

    Aline V. Bacurau

    2016-01-01

    Full Text Available Skeletal myopathy has been identified as a major comorbidity of heart failure (HF affecting up to 20% of ambulatory patients leading to shortness of breath, early fatigue, and exercise intolerance. Neurohumoral blockade, through the inhibition of renin angiotensin aldosterone system (RAS and β-adrenergic receptor blockade (β-blockers, is a mandatory pharmacological therapy of HF since it reduces symptoms, mortality, and sudden death. However, the effect of these drugs on skeletal myopathy needs to be clarified, since exercise intolerance remains in HF patients optimized with β-blockers and inhibitors of RAS. Aerobic exercise training (AET is efficient in counteracting skeletal myopathy and in improving functional capacity and quality of life. Indeed, AET has beneficial effects on failing heart itself despite being of less magnitude compared with neurohumoral blockade. In this way, AET should be implemented in the care standards, together with pharmacological therapies. Since both neurohumoral inhibition and AET have a direct and/or indirect impact on skeletal muscle, this review aims to provide an overview of the isolated effects of these therapeutic approaches in counteracting skeletal myopathy in HF. The similarities and dissimilarities of neurohumoral inhibition and AET therapies are also discussed to identify potential advantageous effects of these combined therapies for treating HF.

  20. Exercise training and music therapy in elderly with depressive syndrome: a pilot study.

    Science.gov (United States)

    Verrusio, W; Andreozzi, P; Marigliano, B; Renzi, A; Gianturco, V; Pecci, M T; Ettorre, E; Cacciafesta, M; Gueli, N

    2014-08-01

    Recent studies have thrown doubt on the true effectiveness of anti-depressants in light and moderate depression. The aim of this study is to evaluate the impact of physical training and music therapy on a sample group of subjects affected by light to moderate depression versus subjects treated with pharmacological therapy only. Randomized controlled study. Patients were randomized into two groups. Subjects in the pharmacotherapy group received a therapy with antidepressant drugs; the exercise/music therapy group was assigned to receive physical exercise training combined with listening to music. The effects of interventions were assessed by differences in changes in mood state between the two groups. Medically eligible patients were screened with the Hamilton Anxiety Scale and with the Geriatric Depression Scale. We used plasmatic cytokine dosage as a stress marker. We recruited 24 subjects (mean age: 75.5 ± 7.4, 11 M/13 F). In the pharmacotherapy group there was a significant improvement in anxiety only (pmusic therapy was a reduction in anxiety and in depression at 3-months and at 6-months (pmusic therapy in depressed subjects. Copyright © 2014 Elsevier Ltd. All rights reserved.

  1. Aquatic Exercise Therapy for People With Parkinson Disease: A Randomized Controlled Trial.

    Science.gov (United States)

    Carroll, Louise M; Volpe, Daniele; Morris, Meg E; Saunders, Jean; Clifford, Amanda M

    2017-04-01

    To evaluate the effects of aquatic exercise therapy on gait variability and disability compared with usual care for people with Parkinson disease (PD). Single-blind randomized controlled trial. Community-based hydrotherapy pool. Individuals with PD (Hoehn-Yahr stages I-III) (N=21). Participants were randomly assigned to either an aquatic exercise therapy group (45min, twice a week for 6wk) or a group that received usual care. The primary outcome measure was gait variability as measured using a motion capture system. Secondary outcomes were quality of life measured on the Parkinson's Disease Questionnaire-39 and freezing of gait and motor disability quantified by the Unified Parkinson's Disease Rating Scale. Feasibility was evaluated by measuring safety, adverse events, and participant satisfaction. People in the aquatic therapy group and usual care group showed similar small improvements in gait variability. The aquatic therapy group showed greater improvements in disability than the usual care group (PAquatic therapy sessions were safe and enjoyable with no adverse events. Aquatic therapy appears feasible and safe for some people in the early stages of PD. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  2. Relationship Between Reverse Remodeling and Cardiopulmonary Exercise Capacity in Heart Failure Patients Undergoing Cardiac Resynchronization Therapy

    DEFF Research Database (Denmark)

    Mastenbroek, Mirjam H; Sant, Jetske Van't; Versteeg, Henneke

    2016-01-01

    BACKGROUND: Studies on the relationship between left ventricular reverse remodeling and cardiopulmonary exercise capacity in heart failure patients undergoing cardiac resynchronization therapy (CRT) are scarce and inconclusive. METHODS AND RESULTS: Eighty-four patients with a 1st-time CRT...... response (left ventricular end-systolic volume decrease ≥15%) and a comprehensive set of CPX results was examined. Echocardiographic responders (54%) demonstrated higher peak oxygen consumption and better exercise performance than nonresponders at baseline and at 6-month follow-up. Furthermore, only...... correlates of higher average oxygen consumption during exercise, and that nonischemic etiology and smaller pre-implantation QRS width were associated with better ventilatory efficiency over time. CONCLUSIONS: During the first 6 months of CRT there was a significant positive association between reverse...

  3. Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis

    Science.gov (United States)

    Pitance, Laurent; Singh, Vandana; Neto, Francisco; Thie, Norman; Michelotti, Ambra

    2016-01-01

    Background Manual therapy (MT) and exercise have been extensively used to treat people with musculoskeletal conditions such as temporomandibular disorders (TMD). The evidence regarding their effectiveness provided by early systematic reviews is outdated. Purpose The aim of this study was to summarize evidence from and evaluate the methodological quality of randomized controlled trials that examined the effectiveness of MT and therapeutic exercise interventions compared with other active interventions or standard care for treatment of TMD. Data Sources Electronic data searches of 6 databases were performed, in addition to a manual search. Study Selection Randomized controlled trials involving adults with TMD that compared any type of MT intervention (eg, mobilization, manipulation) or exercise therapy with a placebo intervention, controlled comparison intervention, or standard care were included. The main outcomes of this systematic review were pain, range of motion, and oral function. Forty-eight studies met the inclusion criteria and were analyzed. Data Extraction Data were extracted in duplicate on specific study characteristics. Data Synthesis The overall evidence for this systematic review was considered low. The trials included in this review had unclear or high risk of bias. Thus, the evidence was generally downgraded based on assessments of risk of bias. Most of the effect sizes were low to moderate, with no clear indication of superiority of exercises versus other conservative treatments for TMD. However, MT alone or in combination with exercises at the jaw or cervical level showed promising effects. Limitations Quality of the evidence and heterogeneity of the studies were limitations of the study. Conclusions No high-quality evidence was found, indicating that there is great uncertainty about the effectiveness of exercise and MT for treatment of TMD. PMID:26294683

  4. Postural deviations from chronic low back pain and correction through exercise therapy

    Directory of Open Access Journals (Sweden)

    Farahpour N

    2007-06-01

    Full Text Available Background: It has been shown that five deficits of the proprioceptive system and poor motor skills are associated with chronic low back pain (CLBP. However, the exact mechanism is unknown. The objectives of this study were to assess the dynamic postural balance behavior of CLBP patients, as well as the effects of a specific exercise therapy for the treatment of CLBP and related postural imbalances. Methods: Sixteen females with CLBP and 30 healthy females all between 20 and 40 years of age, of similar height and weight, voluntarily participated in this study. Patients underwent a three-month therapeutic exercise program. The disability and back pain of the patients were measured using the Oswestry and Quebec questionnaires, respectively. A dynamic stability platform system (Biodex was used to evaluate the postural imbalances in both groups. All measurements of the experimental group were repeated after the therapy. Results: Overall deviation of center of gravity (COG from COBOS in patients and controls were 3 (±0.3 and 1.3 (±0.2, respectively. Thus, postural imbalances were 2.3 times greater in the patients than those of the controls. After the treatment, the disability and pain of the patients were diminished by 53% and 58%, respectively. Furthermore, with the improvement of the patients COG deviation, both groups had similar posture. Conclusions: The postural orientation of CLBP patients was significantly improved by the therapeutic exercise program. The applied exercise therapy significantly reduced both the pain and the disability of the patients. Based on these conclusions, we recommend that postural correction be included in regular therapeutic exercise programs.

  5. Exercise therapy versus arthroscopic partial meniscectomy for degenerative meniscal tear in middle aged patients

    DEFF Research Database (Denmark)

    Kise, Nina Jullum; Risberg, May Arna; Stensrud, Silje

    2016-01-01

    OBJECTIVE: To determine if exercise therapy is superior to arthroscopic partial meniscectomy for knee function in middle aged patients with degenerative meniscal tears. DESIGN: Randomised controlled superiority trial. SETTING: Orthopaedic departments at two public hospitals and two physiotherapy...... clinics in Norway. PARTICIPANTS: 140 adults, mean age 49.5 years (range 35.7-59.9), with degenerative medial meniscal tear verified by magnetic resonance imaging. 96% had no definitive radiographic evidence of osteoarthritis. INTERVENTIONS: 12 week supervised exercise therapy alone or arthroscopic partial...... meniscectomy alone. MAIN OUTCOME MEASURES: Intention to treat analysis of between group difference in change in knee injury and osteoarthritis outcome score (KOOS4), defined a priori as the mean score for four of five KOOS subscale scores (pain, other symptoms, function in sport and recreation, and knee...

  6. Exercise therapy versus arthroscopic partial meniscectomy for degenerative meniscal tear in middle aged patients

    DEFF Research Database (Denmark)

    Kise, Nina Jullum; Risberg, May Arna; Stensrud, Silje

    2016-01-01

    Objective To determine if exercise therapy is superior to arthroscopic partial meniscectomy for knee function in middle aged patients with degenerative meniscal tears. Design Randomised controlled superiority trial. Setting Orthopaedic departments at two public hospitals and two physiotherapy...... clinics in Norway. Participants 140 adults, mean age 49.5 years (range 35.7-59.9), with degenerative medial meniscal tear verified by magnetic resonance imaging. 96% had no definitive radiographic evidence of osteoarthritis. Interventions 12 week supervised exercise therapy alone or arthroscopic partial...... meniscectomy alone. Main outcome measures Intention to treat analysis of between group difference in change in knee injury and osteoarthritis outcome score (KOOS 4), defined a priori as the mean score for four of five KOOS subscale scores (pain, other symptoms, function in sport and recreation, and knee...

  7. Prevention: Exercise

    Medline Plus

    Full Text Available ... Exercises Electrothermal Modalities Ergonomic Changes Hydrotherapy Manual Therapy Physical Therapy Postural Training Traction Watchful Waiting and Education Injection Treatments for Spinal Pain Epidural Steroid Injections ...

  8. The effectiveness of technology-supported exercise therapy for low back pain: A systematic review

    OpenAIRE

    Matheve, Thomas; Timmermans, Annick

    2014-01-01

    AIM The aim of this systematic review is (1) to provide an overview of the available Technology Supported Exercise Therapy (TSET) programs for low back pain, and (2) to assess the effectiveness of TSET compared to other forms of rehabilitation, placebo interventions or no treatment. METHODS Electronic databases (Pubmed, Embase, Cochrane Central Register of Controlled Trials, PEDro, IEEE and ACM) were searched until January 2014. Randomized controlled trials comparing TSET to other forms...

  9. An educational tool of exercise therapy for people with early symptoms of hip osteoarthritis

    OpenAIRE

    Nikula, Linda

    2010-01-01

    The purpose of this thesis was to create an educational tool to increase the knowledge of hip osteoarthritis and the awareness of the benefits of exercise therapy among people with early symptoms of hip osteoarthritis. In addition, physiotherapy students may increase their knowledge about hip osteoarthritis by utilizing this tool as part of their studies. Hip osteoarthritis is a disorder affecting many people. It is the most common reason for total hip surgery, thus, overloading the hea...

  10. Hyperpolarized Helium-3 MRI of exercise-induced bronchoconstriction during challenge and therapy.

    Science.gov (United States)

    Kruger, Stanley J; Niles, David J; Dardzinski, Bernard; Harman, Amy; Jarjour, Nizar N; Ruddy, Marcella; Nagle, Scott K; Francois, Christopher J; Sorkness, Ronald L; Burton, Ryan M; Munoz del Rio, Alejandro; Fain, Sean B

    2014-05-01

    To investigate the utility of hyperpolarized He-3 MRI for detecting regional lung ventilated volume (VV) changes in response to exercise challenge and leukotriene inhibitor montelukast, human subjects with exercise induced bronchoconstriction (EIB) were recruited. This condition is described by airway constriction following exercise leading to reduced forced expiratory volume in 1 second (FEV1) coinciding with ventilation defects on hyperpolarized He-3 MRI. Thirteen EIB subjects underwent spirometry and He-3 MRI at baseline, postexercise, and postrecovery at multiple visits. On one visit montelukast was given and on two visits placebo was given. Regional VV was calculated in the apical/basilar dimension, in the anterior/posterior dimension, and for the entire lung volume. The whole lung VV was used as an end-point and compared with spirometry. Postchallenge FEV1 dropped with placebo but not with treatment, while postchallenge VV dropped more with placebo than treatment. Sources of variability for VV included region (anterior/posterior), scan, and treatment. VV correlated with FEV1/ forced vital capacity (FVC) and forced expiratory flow between 25 and 75% of FVC and showed gravitational dependence after exercise challenge. A paradigm testing the response of ventilation to montelukast revealed both a whole-lung and regional response to exercise challenge and therapy in EIB subjects. Copyright © 2013 Wiley Periodicals, Inc.

  11. Aerobic exercise as a therapy option for migraine: a pilot study.

    Science.gov (United States)

    Darabaneanu, S; Overath, C H; Rubin, D; Lüthje, S; Sye, W; Niederberger, U; Gerber, W-D; Weisser, B

    2011-06-01

    Exercise is assumed to have a positive effect on migraine. However, none of the few studies on this topic can prove the expected positive influence of exercise. Therefore, the aim of this pilot study was to develop a training program suitable for migraine patients and to examine its effect on migraine. 16 patients were examined. 8 migraine patients completed a 10-week aerobic running exercise program consisting of 3 workouts per week. The program was developed by sports scientists especially to increase the fitness level. Physical fitness, i. e., physical working capacity, was assessed using a PWC 150 test. There was also a control group of 8 patients without any special physical training. Migraine patients of the exercise group showed both a reduction in the number of migraine days per month (p=0.048) and the intensity of the attacks (p=0.028). An increase in fitness level resulted in a lowered stress level. Stress strategies like "displacement activity" (r=-0.715; p=0.046), "looking for self-affirmation" (r=-0.742; p=0.035) and "feelings of aggression" (r=-0.802; p=0.017) were reduced. Increasing the level of fitness (PWC 150) is one predictor for migraine improvement (r=0.409, p=0.031). Aerobic exercise which leads to a better fitness level is an alternative therapy method for migraine. © Georg Thieme Verlag KG Stuttgart · New York.

  12. Exercise-induced release of pharmacologically active substances and their relevance for therapy of hepatic injury

    Directory of Open Access Journals (Sweden)

    Hans-Theo Schon

    2016-08-01

    Full Text Available Chronic liver disease features constant parenchymal injury and repair together with an increasing hepatic impairment, finally leading to fibrosis and cirrhosis and a heightened risk of hepatocellular carcinoma. Closely related to the rise in obesity, the worldwide prevalence of nonalcoholic fatty liver disease, the most common form of chronic liver disease, has reached an epidemic dimension and is estimated to afflict up to 46 percent of the general population, including more than one out of three U.S. citizens. Up to now there is no effective drug treatment available, which is why recommendations encompass both exercise programs and changes in dietary habits. Exercise is well-known for unleashing potent anti-inflammatory effects, which can principally counteract liver inflammation and chronic low-grade inflammation. This review article summarizes the underlying mechanisms responsible for the exercise-mediated anti-inflammatory effects, illustrates the application in animal models as well as in humans, and highlights the therapeutic value when possible. Based on the available results there is no doubt that exercise can even be beneficial in an advanced stage of liver disease and it is the goal of this review article to provide evidence for the therapeutic impact on fibrosis, cirrhosis, and hepatocellular carcinoma and to assess whether exercise might be of value as adjuvant therapy in the treatment of chronic liver disease. In principle, all exercise programs carried out in these high-risk patients should be guided and observed by qualified healthcare professionals to guarantee the patients' safety. Nevertheless, it is also necessary to additionally determine the optimal amount and intensity of exercise to maximize its value, which is why further studies are essential.

  13. Use of participant focus groups to identify barriers and facilitators to worksite exercise therapy adherence in randomized controlled trials involving firefighters

    Directory of Open Access Journals (Sweden)

    Mayer JM

    2013-03-01

    Full Text Available John M Mayer,1 James L Nuzzo,1 Simon Dagenais2 1School of Physical Therapy and Rehabilitation Sciences, College of Medicine, University of South Florida, Tampa, FL, 2Palladian Health, West Seneca, NY, USA Background: Firefighters are at increased risk for back injuries, which may be mitigated through exercise therapy to increase trunk muscle endurance. However, long-term adherence to exercise therapy is generally poor, limiting its potential benefits. Focus groups can be used to identify key barriers and facilitators to exercise adherence among study participants. Objective: To explore barriers and facilitators to worksite exercise therapy adherence among firefighters to inform future randomized controlled trials (RCTs. Methods: Participants enrolled in a previous RCT requiring twice-weekly worksite exercise therapy for 24 weeks were asked to take part in moderated focus group discussions centered on eight open-ended questions related to exercise adherence. Responses were analyzed qualitatively using a social ecological framework to identify key intrapersonal, interpersonal, and institutional barriers and potential facilitators to exercise adherence. Results: A total of 27 participants were included in the four focus group discussions, representing 50% of those assigned to a worksite exercise therapy group in the previous RCT, in which only 67% of scheduled exercise therapy sessions were completed. Lack of self-motivation was cited as the key intrapersonal barrier to adherence, while lack of peer support was the key interpersonal barrier reported, and lack of time to exercise during work shifts was the key institutional barrier identified. Conclusion: Focus group discussions identified both key barriers and potential facilitators to increase worksite exercise therapy adherence among firefighters. Future studies should consider educating and reminding participants about the benefits of exercise, providing individual and group incentives based on

  14. The Effectiveness of Technology-Supported Exercise Therapy for Low Back Pain: A Systematic Review.

    Science.gov (United States)

    Matheve, Thomas; Brumagne, Simon; Timmermans, Annick A A

    2017-05-01

    Various technological systems have been developed to assist exercise therapy for low back pain. The aim of this systematic review was to provide an overview and to assess the effectiveness of the available technology-supported exercise therapy (TSET) programs for low back pain. The electronic databases Pubmed, Embase, Cochrane Central Register of Controlled Trials, PEDro, IEEE, and ACM were searched until January 2016. Randomized controlled trials (RCTs) using electronic technological systems simultaneously with exercise therapy for patients with low back pain were included. Twenty-five RCTs met the inclusion criteria. Seventeen studies involved patients with chronic low back pain, and electromyography biofeedback was the most prevalent type of technological support. This review shows that TSET seems to improve pain, disability, and quality of life for patients with low back pain, and that a standard treatment combined with an additional TSET program might be superior to a standard treatment alone. However, TSET seems not more effective compared to other interventions or a placebo intervention for improving these outcomes, which may partially be explained by the analytical approach of the current TSET-programs. For most technologies, only a limited number of RCTs are available, making it difficult to draw firm conclusions about the effectiveness of individual technological systems.

  15. Aerobic Exercise as an Adjunct Therapy for Improving Cognitive Function in Heart Failure

    Directory of Open Access Journals (Sweden)

    Rebecca A. Gary

    2014-01-01

    Full Text Available Persons with heart failure (HF are typically older and are at a much higher risk for developing cognitive impairment (CI than persons without HF. Increasingly, CI is recognized as a significant, independent predictor of worse clinical outcomes, more frequent hospital readmissions, and higher mortality rates in persons with HF. CI can have devastating effects on ability to carry out HF effective self-care behaviors. If CI occurs, however, there are currently no evidence based guidelines on how to manage or improve cognitive function in this population. Improvement in cognition has been reported following some therapies in HF and is thought to be the consequence of enhanced cerebral perfusion and oxygenation, suggesting that CI may be amenable to intervention. Because there is substantial neuronal loss with dementia and no effective restorative therapies, interventions that slow, reverse, or prevent cognitive decline are essential. Aerobic exercise is documented to increase cerebral perfusion and oxygenation by promoting neuroplasticity and neurogenesis and, in turn, cognitive functioning. Few studies have examined exercise as a potential adjunct therapy for attenuating or alleviating cognitive decline in HF. In this review, the potential benefit of aerobic exercise on cognitive functioning in HF is presented along with future research directions.

  16. Delaying ACL reconstruction and treating with exercise therapy alone may alter prognostic factors for 5-year outcome

    DEFF Research Database (Denmark)

    Filbay, Stephanie R; Roos, Ewa M; Frobell, Richard B

    2017-01-01

    analysis of the Knee Anterior Cruciate Ligament, Nonsurgical versus Surgical Treatment (KANON) trial (ISRCTN84752559). Relationships between prognostic factors (baseline cartilage, meniscus and osteochondral damage, baseline extension deficit, baseline patient-reported outcomes, number of rehabilitation......AIM: Identify injury-related, patient-reported and treatment-related prognostic factors for 5-year outcomes in acutely ACL-ruptured individuals managed with early reconstruction plus exercise therapy, exercise therapy plus delayed reconstruction or exercise therapy alone. METHODS: Exploratory...... was a prognostic factor for less knee symptoms compared with early reconstruction plus exercise therapy (regression coefficient 10.1, 95% CI 2.3 to 17.9). Baseline meniscus lesion was associated with worse sport/recreation function (-14.4, 95% CI -27.6 to -1.3) and osteochondral lesions were associated with worse...

  17. Review Paper: Introduction of Pediatric Balance Therapy in Children with Vestibular Dysfunction: Review of Indications, Mechanisms, and Key Exercises

    Directory of Open Access Journals (Sweden)

    Younes Lotfi

    2016-03-01

    ignoring other balance subsystems. Hence, a modified VRT program, named pediatric balance therapy with special modifications in exercises, was developed for children with vestibular disorders, in accordance to the whole balance system.

  18. Alfredson versus Silbernagel exercise therapy in chronic midportion Achilles tendinopathy : Study protocol for a randomized controlled trial

    NARCIS (Netherlands)

    Habets, Bas; Van Cingel, Robert E.H.; Backx, Frank J.G.; Huisstede, Bionka M.A.

    2017-01-01

    Background: Midportion Achilles tendinopathy (AT) is a common overuse injury, usually requiring several months of rehabilitation. Exercise therapy of the ankle plantar flexors (i.e. tendon loading) is considered crucial during conservative rehabilitation. Alfredson's isolated eccentric and

  19. Eccentric versus conventional exercise therapy in patients with rotator cuff tendinopathy: a randomized, single blinded, clinical trial

    NARCIS (Netherlands)

    Dejaco, B.; Habets, B.; Loon, C.J.M. van; Grinsven, S. van; Cingel, R.E. van

    2017-01-01

    PURPOSE: To investigate the effectiveness of isolated eccentric versus conventional exercise therapy in patients with rotator cuff tendinopathy. METHODS: Thirty-six patients with rotator cuff tendinopathy, diagnosed by an orthopaedic surgeon, were included and randomly allocated to an isolated

  20. The effect of aquatic exercise therapy on muscle strength and joint′s range of motion in hemophilia patients

    Directory of Open Access Journals (Sweden)

    Mehdi Kargarfard

    2013-01-01

    Conclusion: The results showed that aquatic exercise therapy can be a useful method to improve joints′ strength and range of motion in hemophilia patients in order to improve their daily functioning and quality of life.

  1. An exercise therapy program can increase oxygenation and blood volume of the erector spinae muscle during exercise in chronic low back pain patients.

    Science.gov (United States)

    Olivier, Nicolas; Thevenon, André; Berthoin, Serge; Prieur, Fabrice

    2013-03-01

    To determine whether erector spinae muscle oxygenation (OXY) and blood volume during a progressive isoinertial lifting evaluation (PILE) are modified by an exercise therapy program. Pre- (t1) and post- (t2) exercise therapy experimental design. Hospital. Subjects with chronic low back pain (LBP group) (n=24) and healthy subjects (control group) (n=24) were evaluated. Exercise program. The control group was evaluated once, and the LBP group was evaluated before (t1) the exercise therapy program and 28 days thereafter (t2). The maximal load lifted, total work, and total power were determined using the PILE test. Continuous-wave near-infrared spectroscopy was used to measure OXY and blood volume during the PILE test. The maximal load lifted, total power, and total work were significantly lower in the LBP group (-42%±5%, -46%±6%, and -67%±6% at t1, respectively; Ptherapy program (+20%±3%, +56%±4%, and +61%±5%; Poxygen at the level of the erector spinae muscle, which can be partly restored by an exercise therapy program. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  2. Exercise

    Science.gov (United States)

    ... it can lead to weakness of muscles, decreased bone density with an increased risk of fracture, and shallow, inefficient breathing. An exercise program needs to fit the capabilities and limitations ...

  3. Health behaviour change theories: contributions to an ICF-based behavioural exercise therapy for individuals with chronic diseases.

    Science.gov (United States)

    Geidl, Wolfgang; Semrau, Jana; Pfeifer, Klaus

    2014-01-01

    The purpose of this perspective is (1) to incorporate recent psychological health behaviour change (HBC) theories into exercise therapeutic programmes, and (2) to introduce the International Classification of Functioning (ICF)-based concept of a behavioural exercise therapy (BET). Relevant personal modifiable factors of physical activity (PA) were identified based on three recent psychological HBC theories. Following the principles of intervention mapping, a matrix of proximal programme objectives specifies desirable parameter values for each personal factor. As a result of analysing reviews on behavioural techniques and intervention programmes of the German rehabilitation setting, we identified exercise-related techniques that impact the personal determinants. Finally, the techniques were integrated into an ICF-based BET concept. Individuals' attitudes, skills, emotions, beliefs and knowledge are important personal factors of PA behaviour. BET systematically addresses these personal factors by a systematic combination of adequate exercise contents with related behavioural techniques. The presented 28 intervention techniques serve as a theory-driven "tool box" for designing complex BET programmes to promote PA. The current paper highlights the usefulness of theory-based integrative research in the field of exercise therapy, offers explicit methods and contents for physical therapists to promote PA behaviour, and introduces the ICF-based conceptual idea of a BET. Implications for Rehabilitation Irrespective of the clients' indication, therapeutic exercise programmes should incorporate effective, theory-based approaches to promote physical activity. Central determinants of physical activity behaviour are a number of personal factors: individuals' attitudes, skills, emotions, beliefs and knowledge. Clinicians implementing exercise therapy should set it within a wider theoretical framework including the personal factors that influence physical activity. To increase

  4. A randomized study comparing the Shaker exercise with traditional therapy: a preliminary study.

    Science.gov (United States)

    Logemann, Jeri A; Rademaker, Alfred; Pauloski, Barbara Roa; Kelly, Amy; Stangl-McBreen, Carrie; Antinoja, Jodi; Grande, Barbara; Farquharson, Julie; Kern, Mark; Easterling, Caryn; Shaker, Reza

    2009-12-01

    Seven institutions participated in this small clinical trial that included 19 patients who exhibited oropharyngeal dysphagia on videofluorography (VFG) involving the upper esophageal sphincter (UES) and who had a 3-month history of aspiration. All patients were randomized to either traditional swallowing therapy or the Shaker exercise for 6 weeks. Each patient received a modified barium swallow pre- and post-therapy, including two swallows each of 3 ml and 5 ml liquid barium and 3 ml barium pudding. Each videofluorographic study was sent to a central laboratory and digitized in order to measure hyoid and larynx movement as well as UES opening. Fourteen patients received both pre-and post-therapy VFG studies. There was significantly less aspiration post-therapy in patients in the Shaker group. Residue in the various oral and pharyngeal locations did not differ between the groups. With traditional therapy, there were several significant increases from pre- to post-therapy, including superior laryngeal movement and superior hyoid movement on 3-ml pudding swallows and anterior laryngeal movement on 3-ml liquid boluses, indicating significant improvement in swallowing physiology. After both types of therapy there is a significant increase in UES opening width on 3-ml paste swallows.

  5. Randomised controlled trial examining the effect of exercise in people with rheumatoid arthritis taking anti-TNFα therapy medication.

    LENUS (Irish Health Repository)

    Reid, Angela

    2011-01-01

    Substantial progress has been made in the medical management of rheumatoid arthritis (RA) over the past decade with the introduction of biologic therapies, including anti-tumour necrosis factor alpha (anti-TNFα) therapy medications. However, individuals with RA taking anti-TNFα medication continue to experience physical, psychological and functional consequences, which could potentially benefit from rehabilitation. There is evidence that therapeutic exercise should be included as an intervention for people with RA, but to date there is little evidence of the benefits of therapeutic exercise for people with RA on anti-TNFα therapy medication. A protocol for a multicentre randomised controlled three-armed study which aims to examine the effect of dynamic group exercise therapy on land or in water for people with RA taking anti-TNFα therapy medication is described.

  6. Randomised controlled trial examining the effect of exercise in people with rheumatoid arthritis taking anti-TNFα therapy medication

    Directory of Open Access Journals (Sweden)

    Veale Douglas J

    2011-01-01

    Full Text Available Abstract Background Substantial progress has been made in the medical management of rheumatoid arthritis (RA over the past decade with the introduction of biologic therapies, including anti-tumour necrosis factor alpha (anti-TNFα therapy medications. However, individuals with RA taking anti-TNFα medication continue to experience physical, psychological and functional consequences, which could potentially benefit from rehabilitation. There is evidence that therapeutic exercise should be included as an intervention for people with RA, but to date there is little evidence of the benefits of therapeutic exercise for people with RA on anti-TNFα therapy medication. A protocol for a multicentre randomised controlled three-armed study which aims to examine the effect of dynamic group exercise therapy on land or in water for people with RA taking anti-TNFα therapy medication is described. Methods/Design Six hundred and eighteen individuals with RA, on anti-TNFα therapy medication, will be randomised into one of 3 groups: a land-based exercise group; a water-based exercise group or a control group. The land and water-based groups will exercise for one hour, twice a week for eight weeks. The control group will receive no intervention and will be asked not to alter their exercise habits for the duration of the study. The primary outcome measure, the Stanford Health Assessment Questionnaire Disability Index (HAQ-DI which measures functional ability, and secondary measures of pain, fatigue and quality of life, will be assessed at baseline, eight and 24 weeks by an independent assessor unaware of group allocation. Changes in outcome from 0 to 8 weeks and 0 to 24 weeks in the 'land-based exercise group versus control group' and the 'water-based exercise group versus control group' will be examined. Analysis will be conducted on an intention to treat basis. Discussion This trial will evaluate the effectiveness of group exercise therapy on land or in water

  7. Effectiveness of resistance exercise compared to aerobic exercise without insulin therapy in patients with type 2 diabetes mellitus: a meta-analysis.

    Science.gov (United States)

    Nery, Cybelle; Moraes, Silvia Regina Arruda De; Novaes, Karyne Albino; Bezerra, Márcio Almeida; Silveira, Patrícia Verçoza De Castro; Lemos, Andrea

    Physical exercise has been used to mitigate the metabolic effects of diabetes mellitus. To evaluate the effect of resistance exercise when compared to aerobic exercise without insulin therapy on metabolic and clinical outcomes in patients with type 2 diabetes mellitus. Papers were searched on the databases MEDLINE/PubMed, CINAHL, SPORTDiscus, LILACS, and SCIELO, without language or date of publication limits. Clinical trials that compared resistance exercise to aerobic exercise in adults with type 2 diabetes mellitus who did not use insulin therapy were included. The quality of evidence and risk of bias were assessed using the GRADE system and the Cochrane Risk of Bias tool, respectively. Meta-analysis was also used, whenever possible. Two reviewers extracted the data independently. Eight eligible articles were included in this study, with a total of 336 individuals, with a mean age of 48-58 years. The protocols of aerobic and resistance exercise varied in duration from eight to 22 weeks, 30-60min/day, three to five times/week. Overall the available evidence came from a very low quality of evidence and there was an increase in Maximal oxygen consumption (mean difference: -2.86; 95% CI: -3.90 to -1.81; random effect) for the resistance exercise and no difference was found in Glycated hemoglobin, Body mass index, High-density lipoprotein cholesterol, Low-density lipoprotein cholesterol, triglycerides, and total cholesterol. Resistance exercise appears to be more effective in promoting an increase in Maximal oxygen consumption in protocols longer than 12 weeks and there is no difference in the control of glycemic and lipid levels between the two types of exercise. Copyright © 2017 Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia. Publicado por Elsevier Editora Ltda. All rights reserved.

  8. A Comparison of the Effects of Stabilization Exercises Plus Manual Therapy to Those of Stabilization Exercises Alone in Patients With Nonspecific Mechanical Neck Pain: A Randomized Clinical Trial.

    Science.gov (United States)

    Celenay, Seyda Toprak; Akbayrak, Turkan; Kaya, Derya Ozer

    2016-02-01

    Randomized clinical trial. Little is known about the efficacy of providing manual therapy in addition to cervical and scapulothoracic stabilization exercises in people with mechanical neck pain (MNP). Objectives To compare the effects of stabilization exercises plus manual therapy to those of stabilization exercises alone on disability, pain, range of motion (ROM), and quality of life in patients with MNP. One hundred two patients with MNP (18-65 years of age) were recruited and randomly allocated into 2 groups: stabilization exercise without (n = 51) and with (n = 51) manual therapy. The program was carried out 3 days per week for 4 weeks. The Neck Disability Index, visual analog pain scale, digital algometry of pressure pain threshold, goniometric measurements, and Medical Outcomes Study 36-Item Short-Form Health Survey were used to assess participants at baseline and after 4 weeks. Improvements in Neck Disability Index score, night pain, rotation ROM, and the Medical Outcomes Study 36-Item Short-Form Health Survey score were greater in the group that received stabilization exercise with manual therapy compared to the group that only received stabilization exercise. Between-group differences (95% confidence interval) were 2.2 (0.1, 4.3) points for the Neck Disability Index, 1.1 (0.0, 2.3) cm for pain at night measured on the visual analog scale, -4.3° (-8.1°, -0.5°) and -5.0° (-8.2°, -1.7°) for right and left rotation ROM, respectively, and -2.9 (-5.4, -0.4) points and -3.1 (-6.2, 0.0) points for the Medical Outcomes Study 36-Item Short-Form Health Survey physical and mental components, respectively. Changes in resting and activity pain, pressure pain threshold, and cervical extension or lateral flexion ROM did not differ significantly between the groups. Pressure pain threshold increased only in those who received stabilization exercise with manual therapy (Pmanual therapy may be superior to stabilization exercises alone for improving disability, pain

  9. A Pilot Prospective Randomized Control Trial Comparing Exercises Using Videogame Therapy to Standard Physical Therapy: 6 Months Follow-Up.

    Science.gov (United States)

    Parry, Ingrid; Painting, Lynda; Bagley, Anita; Kawada, Jason; Molitor, Fred; Sen, Soman; Greenhalgh, David G; Palmieri, Tina L

    2015-01-01

    Commercially available, interactive videogames that use body movements for interaction are used clinically in burn rehabilitation and have been shown to facilitate functional range of motion (ROM) but their efficacy with burn patients has not yet been proven. The purpose of this pilot randomized control study was to prospectively compare planar and functional ROM, compliance, pain, enjoyment, and exertion in pediatric burn patients receiving two types of rehabilitation therapy. Seventeen school-aged children with 31 affected limbs who demonstrated limited shoulder ROM from burn injury were randomized to receive exercises using either standard therapy ROM activities (ST) or interactive videogame therapy (VGT). Patients received 3 weeks of the designated therapy intervention twice daily. They were then given a corresponding home program of the same type of therapy to perform regularly for 6 months. Standard goniometry and three-dimensional motion analysis during functional tasks were used to assess ROM. Measures were taken at baseline, 3 weeks, 3 months, and 6 months. Pain was measured before and after each treatment session during the 3-week intervention. There was no difference in compliance, enjoyment, or exertion between the groups. Patients in both the ST and VGT groups showed significant improvement in shoulder flexion (P videogames were equally effective as traditional therapy for overall ROM gains and resulted in quicker recovery of motion with less pain experienced. Such videogames are a useful adjunct to therapy and should be considered as part of a holistic approach to rehabilitation within the hospital and at home after discharge in pediatric patients recovering from burn injury.

  10. Effects of Nia exercise in women receiving radiation therapy for breast cancer.

    Science.gov (United States)

    Reis, Debra; Walsh, M Eileen; Young-McCaughan, Stacey; Jones, Tisha

    2013-09-01

    To compare a 12-week nontraditional exercise Nia program practiced at home to usual care on fatigue, quality of life (QOL), aerobic capacity, and shoulder flexibility in women with breast cancer undergoing radiation therapy. Randomized clinical trial. Large community-based hospital in the midwestern United States. 41 women with stage I, II, or III breast cancer starting radiation therapy. 22 women were randomized to the Nia group and 19 to the usual care group. Those in the Nia group were instructed to practice Nia 20-60 minutes three times per week for 12 weeks. Those in the usual care group were instructed to continue normal activities. Fatigue, QOL, aerobic capacity, and shoulder flexibility. Controlling for baseline scores, change over time between groups was significantly different for the women who practiced Nia at least 13 times during the 12-week period; those in the Nia intervention reported significantly less fatigue between weeks 6 and 12, as compared to control group (p = 0.05). No statistical differences in QOL, aerobic capacity, or shoulder flexibility were found, but trends favoring Nia were identified. For women undergoing radiation therapy for breast cancer, Nia can help relieve fatigue. Additional research in arm and shoulder mobility and preservation also may be beneficial. Oncology nurses are in a unique position to offer suggestions to help manage fatigue, and Nia could be considered as part of a cancer survivorship program. Exercise is beneficial for women with breast cancer, and interest is growing in nontraditional exercise options. Nia can benefit women with breast cancer undergoing radiation therapy.

  11. A pilot study of exercise in men with prostate cancer receiving androgen deprivation therapy

    Directory of Open Access Journals (Sweden)

    Lee C

    2012-03-01

    Full Text Available Abstract Background Androgen deprivation therapy (ADT is the mainstay therapy for men with prostate cancer. However, there are musculoskeletal side effects from ADT that increase the risk for osteoporosis and fracture, and can compromise the quality of life of these individuals. The objectives of this study are to determine the efficacy of a home-based walking exercise program in promoting bone health, physical function and quality of life in men with prostate cancer receiving ADT. Methods/Design A 12-month prospective, single-blinded, randomized controlled trial will be conducted to compare the Exercise Group with the Control Group. Sixty men with prostate cancer who will be starting ADT will be recruited and randomly assigned to one of the two groups: the Exercise Group will receive instructions in setting up an individualized 12-month home-based walking exercise program, while the Control Group will receive standard medical advice from the attending physician. A number of outcome measures will be used to assess bone health, physical function, and health-related quality of life. At baseline and 12 months, bone health will be assessed using dual-energy X-ray absorptiometry. At baseline and every 3 months up to 12 months, physical function will be evaluated using the Functional Assessment of Chronic Illness Therapy - Fatigue Scale, Activities-specific Balance Confidence Scale, Short Physical Performance Battery, and Six-Minute Walk Test; and health-related quality of life will be assessed using the Functional Assessment of Cancer Therapy Prostate Module and the Medical Outcomes Study 12-item Short Form Health Survey Version 2. A mixed multiple analysis of variance will be used to analyze the data. Discussion Musculoskeletal health management remains a challenge in men with prostate cancer receiving ADT. This study addresses this issue by designing a simple and accessible home-based walking exercise program that will potentially have significant

  12. Active exercises utilizing a facilitating device in the treatment of lymphedema resulting from breast cancer therapy

    Directory of Open Access Journals (Sweden)

    de Fátima Guerreiro Godoy, Maria

    2010-01-01

    Full Text Available The aim of this study was to evaluate the reduction in volume of arm lymphedema secondary to breast cancer therapy utilizing an exercise facilitating device. Twenty-one women with arm lymphedema resulting from the surgical and radiotherapeutic treatment of breast cancer were randomly selected. Evaluation was made by water-displacement volumetry before and after each session. The patients were submitted to a series of active exercises using a facilitating device for four 12-minute sessions with intervals of 3 minutes between sessions in the sitting position with alignment of the spinal column. The lymphedematous arm was maintained under compression using a cotton-polyester sleeve. The active exercising device used was a mobile flexion bar fixed on a metal base at a height of 30 cm from the tabletop and at a distance of 10 cm from the patient’s body. The paired t-test was utilized for statistical analysis with an alpha error of 5% (p-value ≤0.05 being considered significant. The initial mean volume of the arms was 2,089.9 and the final volume was 2,023.0 mL with a mean loss of 66.9 mL (p-value <0.001. In conclusion, active exercises utilizing facilitating devices can contribute to a reduction in size of lymphedematous limbs.

  13. The effect of manual therapy with augmentative exercises for neck pain: a randomised clinical trial.

    Science.gov (United States)

    Petersen, Shannon Bravo; Cook, Chad; Donaldson, Megan; Hassen, Amy; Ellis, Alyson; Learman, Ken

    2015-12-01

    To compare the effect of manual therapy (MT) and an augmentative exercise programme (AEP) versus MT and general neck range of motion (ROM) on functional outcomes for patients with neck pain. A secondary objective was to examine changes in self-report measures and quantitative sensory testing (QST) following MT and AEP. This was a randomised clinical trial. Seventy-two patients with neck pain were recruited. All patients received a single session of MT. Patients were randomly assigned to MT+AEP or MT+ROM. Clinical self-report outcome measures for disability and pain, and QST measures (pain and vibration thresholds) were collected at baseline, post MT treatment, at ∼48 hours, and at ∼96 hours. Repeated measures ANOVA and MANOVA were used to analyse within and between-group effects for clinical and QST measures. There were no between-group differences for disability, pain and QST measures. There was, however, a significant difference between groups for Global Rating of Change (GRoC) scores (P = 0.037). Patients in both groups showed improvements in pain, disability and trapezius pressure-pain threshold (PPT) (all P < 0.001). Augmentative exercise programme does not significantly improve disability, pain or QST measures in patients with chronic neck pain although it may enhance their GRoC scores. Over a 96-hour period, patients benefitted from MT plus exercise whether the exercise was general or specific.

  14. Robot-assisted mirroring exercise as a physical therapy for hemiparesis rehabilitation.

    Science.gov (United States)

    Jihun Kim; Jaehyo Kim

    2017-07-01

    The paper suggests a therapeutic device for hemiparesis that combines robot-assisted rehabilitation and mirror therapy. The robot, which consists of a motor, a position sensor, and a torque sensor, is provided not only to the paralyzed wrist, but also to the unaffected wrist to induce a symmetric movement between the joints. As a user rotates his healthy wrist to the direction of either flexion or extension, the motor on the damaged side rotates and reflects the motion of the normal side to the symmetric angular position. To verify performance of the device, five stroke patients joined a clinical experiment to practice a 10-minute mirroring exercise. Subjects on Brunnstrom stage 3 had shown relatively high repulsive torques due to severe spasticity toward their neutral wrist positions with a maximum magnitude of 0.300kgfm, which was reduced to 0.161kgfm after the exercise. Subjects on stage 5 practiced active bilateral exercises using both wrists with a small repulsive torque of 0.052kgfm only at the extreme extensional angle. The range of motion of affected wrist increased as a result of decrease in spasticity. The therapeutic device not only guided a voluntary exercise to loose spasticity and increase ROM of affected wrist, but also helped distinguish patients with different Brunnstrom stages according to the size of repulsive torque and phase difference between the torque and the wrist position.

  15. Effects of Community Exercise Therapy on Metabolic, Brain, Physical, and Cognitive Function Following Stroke: A Randomized Controlled Pilot Trial.

    Science.gov (United States)

    Moore, Sarah A; Hallsworth, Kate; Jakovljevic, Djordje G; Blamire, Andrew M; He, Jiabao; Ford, Gary A; Rochester, Lynn; Trenell, Michael I

    2015-08-01

    Exercise therapy could potentially modify metabolic risk factors and brain physiology alongside improving function post stroke. To explore the short-term metabolic, brain, cognitive, and functional effects of exercise following stroke. A total of 40 participants (>50 years, >6 months post stroke, independently mobile) were recruited to a single-blind, parallel, randomized controlled trial of community-based exercise (19 weeks, 3 times/wk, "exercise" group) or stretching ("control" group). Primary outcome measures were glucose control and cerebral blood flow. Secondary outcome measures were cardiorespiratory fitness, blood pressure, lipid profile, body composition, cerebral tissue atrophy and regional brain metabolism, and physical and cognitive function. Exercise did not change glucose control (homeostasis model assessment 1·5 ± 0·8 to 1·5 ± 0·7 vs 1·6 ± 0·8 to 1·7 ± 0·7, P = .97; CI = -0·5 to 0·49). Medial temporal lobe tissue blood flow increased with exercise (38 ± 8 to 42 ± 10 mL/100 g/min; P physical function, and cognition also improved with exercise. Exercise therapy improves short-term metabolic, brain, physical, and cognitive function, without changes in glucose control following stroke. The long-term impact of exercise on stroke recurrence, cardiovascular health, and disability should now be explored. © The Author(s) 2014.

  16. No Reduction of Severe Fatigue in Patients With Postpolio Syndrome by Exercise Therapy or Cognitive Behavioral Therapy: Results of an RCT

    NARCIS (Netherlands)

    Koopman, Fieke S.; Voorn, Eric L.; Beelen, Anita; Bleijenberg, Gijs; de Visser, Marianne; Brehm, Merel A.; Nollet, Frans

    2016-01-01

    People with postpolio syndrome (PPS) commonly experience severe fatigue that persists over time and negatively affects functioning and health-related quality of life (HRQoL). To study the efficacy of exercise therapy (ET) and cognitive behavioral therapy (CBT) on reducing fatigue and improving

  17. [Effects of exercise therapy at the intensity of anaerobic threshold for exercise tolerance in patients with chronic stable coronary artery disease].

    Science.gov (United States)

    Che, Lin; Gong, Zhu; Jiang, Jin-fa; Xu, Wen-jun; Deng, Bing; Xu, Jia-hong; Yan, Wen-wen; Zhang, Qi-ping; Wang, Le-min

    2011-06-28

    To investigate the effects of exercise therapy at the intensity of anaerobic threshold (AT) for exercise tolerance in patients with chronic stable coronary artery disease. Forty-three patients with chronic stable coronary artery disease (3 patients after coronary arterial bypass graft (CABG) surgery, 22 patients with old myocardial infarction and 18 unstable angina pectoris undergoing successful percutaneous coronary intervention (PCI) finished twice cardiopulmonary exercise test (CPET) and followed their rehabilitation program for 3 months. Thirty-two patients finished their aerobic exercise therapy based on their individual anaerobic thresholds while 11 patients had no exercise therapy. The heart rate at AT intensity (97 ± 9/min) was lower than their traditional minimal target heart rate (112 ± 7/min) and lower than heart rate (115 ± 11/min) at ischemic threshold post-CPET. The O(2) consumption (10.7 ± 2.4 to 12.6 ± 2.9 ml×min(-1)×kg(-1)) (P = 0.04) and workload (37 ± 18 to 47 ± 13 J/s) (P = 0.04) at AT level and the O(2) consumption (15.3 ± 3.1 to 20.6 ± 4.2 ml×min(-1)×kg(-1), P = 0.02) and workload(68 ± 12 and 87 ± 14 J/s, P = 0.01) at peak level markedly increased after 3 months in the exercise group. And the O(2) consumption (15.3 ± 2.9 to 16.2 ± 3.1 ml×min(-1)×kg(-1)) and workload (65 ± 13 to 73 ± 16 J/s) at peak level mild increased after 3 months in the non-exercise group, but their O(2) consumption (11.0 ± 2.7 to 11.3 ± 2.8 ml×min(-1)×kg(-1)) and workload (38 ± 11 to 37 ± 9 J/s) at AT level had no obvious change. AT exercise intensity was lower than ischemic threshold post-CPET. Exercise therapy at the intensity of anaerobic threshold can improve oxygen capacity and exercise tolerance.

  18. An exercise-based physical therapy program for patients with patellar tendinopathy after platelet-rich plasma injection

    NARCIS (Netherlands)

    van Ark, Mathijs; van den Akker-Scheek, Inge; Meijer, L.T.B.; Zwerver, Hans

    Objectives: To describe a post platelet-rich plasma (PRP) injection, exercise-based physical therapy program, investigate feasibility and report the first results of patellar tendinopathy patients treated with PRP injection combined with the physical therapy program. Study Design: Case-series.

  19. Experiences and perspectives of patients with post-polio syndrome and therapists with exercise and cognitive behavioural therapy

    NARCIS (Netherlands)

    Bakker, Minne; Schipper, Karen; Koopman, Fieke S.; Nollet, Frans; Abma, Tineke A.

    2016-01-01

    Many persons affected with poliomyelitis develop post-polio syndrome (PPS) later in their life. Recently, the effectiveness of Exercise Therapy (ET) and Cognitive Behavioural Therapy (CBT) for PPS has been evaluated in a randomized controlled trial, but did not show a decrease in fatigue or

  20. Validation of a Self-Monitoring Tool for Use in Exercise Therapy.

    Science.gov (United States)

    Powierza, Camilla S; Clark, Michael D; Hughes, Jaime M; Carneiro, Kevin A; Mihalik, Jason P

    2017-11-01

    Aerobic exercise at a subsymptom heart rate has been recommended as therapy for postconcussion syndrome. Assessing adherence with an accurate heart rate-monitoring instrument is difficult, limiting the proliferation of large-scale randomized controlled trials. To evaluate the validity of the Fitbit Charge HR compared with electrocardiogram (EKG) to monitor heart rate during a treadmill-based exercise protocol. A methods comparison study. Sports medicine research center within a tertiary care institution. A convenience sample of 22 healthy participants (12 female) aged 18-26 years (mean age: 22 ± 2 years). Fitbit Charge HR heart rate measurements were compared with EKG data concurrently collected while participants completed the Buffalo Concussion Treadmill Test. Agreement between Fitbit Charge HR and EKG was assessed by intraclass correlation coefficients (ICC3,1), Bland-Altman limits of agreement, and percent error. We observed a strong single-measure absolute agreement between Fitbit Charge HR and EKG (intraclass correlation coefficient = 0.83; 95% confidence interval 0.67-0.90). Fitbit Charge HR underestimated heart rate compared with EKG (mean difference = -6.04 bpm; standard deviation = 10.40 bpm; Bland-Altman 95% limits of agreement = -26.42 to 14.35 bpm). A total of 69.9% of Fitbit heart rate measurements were within 10% error compared with EKG, and 91.5% of all heart rate measurements were within 20% error. Although the mean bias in measuring heart rate was relatively small, the limits of agreement between the Fitbit Charge HR and EKG were broad. Thus, the Fitbit Charge HR would not be a suitable option for monitoring heart rate within a narrow range. For the purposes of postconcussion exercise therapy, the relatively inexpensive cost, easy implementation, and low maintenance make Fitbit Charge HR a viable option for assessing adherence to an exercise program when expensive clinical equipment is unavailable. II. Copyright © 2017 American Academy of

  1. Spinal manipulative therapy and exercise for seniors with chronic neck pain.

    Science.gov (United States)

    Maiers, Michele; Bronfort, Gert; Evans, Roni; Hartvigsen, Jan; Svendsen, Kenneth; Bracha, Yiscah; Schulz, Craig; Schulz, Karen; Grimm, Richard

    2014-09-01

    Neck pain, common among the elderly population, has considerable implications on health and quality of life. Evidence supports the use of spinal manipulative therapy (SMT) and exercise to treat neck pain; however, no studies to date have evaluated the effectiveness of these therapies specifically in seniors. To assess the relative effectiveness of SMT and supervised rehabilitative exercise, both in combination with and compared to home exercise (HE) alone for neck pain in individuals ages 65 years or older. Randomized clinical trial. Individuals 65 years of age or older with a primary complaint of mechanical neck pain, rated ≥3 (0-10) for 12 weeks or longer in duration. Patient self-report outcomes were collected at baseline and 4, 12, 26, and 52 weeks after randomization. The primary outcome was pain, measured by an 11-box numerical rating scale. Secondary outcomes included disability (Neck Disability Index), general health status (Medical Outcomes Study Short Form-36), satisfaction (7-point scale), improvement (9-point scale), and medication use (days per week). This study was funded by the US Department of Health and Human Services, Health Resources and Services Administration. Linear mixed model analyses were used for comparisons at individual time points and for short- and long-term analyses. Blinded evaluations of objective outcomes were performed at baseline and 12 weeks. Adverse event data were collected at each treatment visit. A total of 241 participants were randomized, with 95% reporting primary outcome data at all time points. After 12 weeks of treatment, the SMT with home exercise group demonstrated a 10% greater decrease in pain compared with the HE-alone group, and 5% change over supervised plus home exercise. A decrease in pain favoring supervised plus HE over HE alone did not reach statistical significance. Compared with the HE group, both combination groups reported greater improvement at week 12 and more satisfaction at all time points

  2. Exercise preferences among men with prostate cancer receiving androgen-deprivation therapy.

    Science.gov (United States)

    Harrington, Joanne M; Schwenke, Dawn C; Epstein, Dana R

    2013-09-01

    To investigate acceptability of and preferences for physical activity participation in men receiving androgen-deprivation therapy (ADT) for prostate cancer, to identify influencing clinical and demographic factors, and to determine the percentage meeting national exercise guidelines. Cross-sectional, descriptive. Ambulatory care clinic of a large medical center. 135 men receiving ADT. A structured interview with a systematic procedure was used to elicit preferences for physical activity. Exercise preferences and acceptability; evidence-based exercise intervention. Participants expressed high levels of acceptability of and willingness to participate in aerobic (64% and 79%) and muscle-strengthening (79% and 81%) programs. Preferences were expressed for muscle-strengthening activities performed at home, either alone or in the company of a family member. Flexible, spontaneous, and self-paced programs were preferred. Significant associations were identified for distance, age, obesity, duration of ADT, and meeting American College of Sports Medicine (ACSM) and American Heart Association (AHA) guidelines. Nineteen percent of the study population met the guidelines for weekly physical activity. High levels of expressed acceptance of and willingness to participate in physical activity programs as well as the small number of participants meeting ACSM and AHA guidelines suggest feasibility of and support the need for the development of exercise programs in this population. Incorporating patient preferences and evidence-based practice is integral to providing high-quality patient-centered care and is the foundation for appropriate intervention programs. Insight from this study will facilitate the design of programs that better reflect actual preferences of prostate cancer survivors. ADT-induced changes in body composition are believed to contribute to a reduction in insulin sensitivity and dyslipidemia that contribute to increased cardiovascular risk profile. Exercise has the

  3. Exercise

    DEFF Research Database (Denmark)

    Idorn, Manja; thor Straten, Eivind Per

    2016-01-01

    We recently demonstrated that voluntary exercise leads to an influx of immune cells in tumors and a greater than 60% reduction in tumor incidence and growth across several mouse models. Improved immunological control of tumor progression may have important clinical implications in the prevention...... and treatment of cancer in humans....

  4. Unloaded movement facilitation exercise compared to no exercise or alternative therapy on outcomes for people with nonspecific chronic low back pain: a systematic review.

    Science.gov (United States)

    Slade, Susan C; Keating, Jennifer L

    2007-05-01

    The purpose of this study was to determine the effect of unloaded movement facilitation exercises on outcomes for people with nonspecific chronic low back pain (NSCLBP). This systematic review was conducted according to Cochrane Back Review Group and Quality of Reporting of Meta-analyses (QUORUM) guidelines. Exercise effects were reported as standardized mean difference (SMD) with 95% confidence intervals (95% CI). Six high-quality randomized controlled trials were included. For NSCLBP effects favored McKenzie therapy over intensive trunk strengthening for pain: SMD: short-term: 0.35 (0.10, 0.59); long-term 0.36 (0.12, 0.61) and short-term function: SMD: 0.45 (0.20, 0.70) and were comparable for medium-term function: SMD: 0.15 (-0.90, 0.40). Effects of favored McKenzie therapy were comparable to specific spinal stabilization exercises for short-term pain: SMD: 0.63 (-0.11, 1.38) and function: SMD: 0.47 (-0.27, 1.20). Pooled effects favored McKenzie therapy over other exercises for short-term pain (pooled SMD: 0.38 (0.14, 0.61)) and were comparable for short-term function: SMD: 0.10 (-0.20, 0.40). Yoga compared to trunk strengthening produced comparable effects for pain: (SMD: short-term: 0.13 (-0.46, 0.71); medium-term 0.51 (-0.08, 1.11)) and function SMD: short-term: 0.51 (-0.08, 1.10); medium-term 0.38 (-0.22, 0.97)). Compared to education, effects of yoga were large for medium-term pain and function (pooled SMDs: 0.92 (0.47, 1.37); 0.95 (0.50, 1.40)). Effects favored unloaded movement facilitation exercises of McKenzie compared to other or no exercise and were comparable for yoga. For NSCLBP, there is strong evidence that unloaded movement facilitation exercise, compared to no exercise, improves pain and function. Compared to other types of exercise, including effort-intensive strengthening and time-intensive stabilization exercise, the effects are comparable. This challenges the role of strengthening for NSCLBP.

  5. The use of exercise interventions to overcome adverse effects of androgen deprivation therapy

    DEFF Research Database (Denmark)

    Østergren, Peter Busch; Kistorp, Caroline; Bennedbæk, Finn Noe

    2016-01-01

    Androgen deprivation therapy (ADT) induces severe hypogonadism and is associated with several adverse effects that negatively affect health and quality of life in patients with prostate cancer. ADT changes body composition characterized by an increase in fat mass and a reduction in muscle mass...... existing cardiovascular disease. In this initial phase of ADT, metabolic changes are also most prominent. In addition, ADT increases the rate of bone loss and fracture risk. Currently available evidence supports the use of exercise interventions to improve physical function and mitigate ADT-induced fatigue...

  6. Exercise or basic body awareness therapy as add-on treatment for major depression: a controlled study.

    Science.gov (United States)

    Danielsson, Louise; Papoulias, Ilias; Petersson, Eva-Lisa; Carlsson, Jane; Waern, Margda

    2014-10-01

    While physical exercise as adjunctive treatment for major depression has received considerable attention in recent years, the evidence is conflicting. This study evaluates the effects of two different add-on treatments: exercise and basic body awareness therapy. Randomized controlled trial with two intervention groups and one control, including 62 adults on antidepressant medication, who fulfilled criteria for current major depression as determined by the Mini International Neuropsychiatric Interview. Interventions (10 weeks) were aerobic exercise or basic body awareness therapy (BBAT), compared to a single consultation with advice on physical activity. Primary outcome was depression severity, rated by a blinded assessor using the Montgomery Asberg Rating Scale (MADRS). Secondary outcomes were global function, cardiovascular fitness, self-rated depression, anxiety and body awareness. Improvements in MADRS score (mean change=-10.3, 95% CI (-13.5 to -7.1), p=0.038) and cardiovascular fitness (mean change=2.4ml oxygen/kg/min, 95% CI (1.5 to 3.3), p=0.017) were observed in the exercise group. Per-protocol analysis confirmed the effects of exercise, and indicated that BBAT has an effect on self-rated depression. The small sample size and the challenge of missing data. Participants׳ positive expectations regarding the exercise intervention need to be considered. Exercise in a physical therapy setting seems to have effect on depression severity and fitness, in major depression. Our findings suggest that physical therapy can be a viable clinical strategy to inspire and guide persons with major depression to exercise. More research is needed to clarify the effects of basic body awareness therapy. Copyright © 2014 Elsevier B.V. All rights reserved.

  7. Inflammatory cytokine response to exercise in alpha-1-antitrypsin deficient COPD patients 'on' or 'off' augmentation therapy

    OpenAIRE

    Olfert, IM; Malek, MH; Eagan, TML; Wagner, H; Wagner, PD

    2014-01-01

    Background: There is still limited information on systemic inflammation in alpha-1-antitrypsin-deficient (AATD) COPD patients and what effect alpha-1-antitrypsin augmentation therapy and/or exercise might have on circulating inflammatory cytokines. We hypothesized that AATD COPD patients on augmentation therapy (AATD + AUG) would have lower circulating and skeletal muscle inflammatory cytokines compared to AATD COPD patients not receiving augmentation therapy (AATD-AUG) and/or the typical non...

  8. The effect of trigger point therapy and medicine ball exercises vs trigger point therapy and stretching on hip rotational biomechanics of the golf swings

    Directory of Open Access Journals (Sweden)

    S. L. Quinn

    2013-01-01

    Full Text Available Background: Elite golfers sustain a large number of lumbar spine injuries. Poor rotational biomechanics, which may occur as a result of a shortened iliopsoas muscle, increase the incidence of lumbar spine injuries in golfers. Stretches and medicine ball exercises are often used as part of golf training programmes in an attempt to restore hip flexor length and improve rotational biomechanics. The aim of this study was to ascertain the effect of a combination of trigger point therapy and medicine ball exercises compared to a combination of trigger point therapy and stretching on rotational bio-mechanics of the golf swing. Method: This is a randomised controlled trial consisting of two experimental groups (trigger point therapy and stretching vs. trigger point therapy and medicine ball exercises and one control group (no intervention. Hip flexor length and 3D biomechanical analysis of the golf swing was performed at baseline and one week later. Results: One-hundred elite male golfers participated in this study. Rotational biomechanics, specifically downswing hip turn in the group that received trigger point therapy combined with medicine ball exercises, showed statistically significant improvement at reassessment compared to the control group (p=0.0328. Conclusion: Rotational biomechanics (downswing hip turn improved following a combination of trigger point therapy treatment and a one week programme of medicine ball exercises. This is postulated to have occurred through neural reorganisation and not through improved tensile muscle strength. This improvement in rotational biomechanics has the potential to decrease lumbar spine injury incidence in elite golfers. This study advocates the use of trigger point therapy combined with medicine ball exercises in the treatment of golfers with shortened hip flexors.

  9. Effective Therapy Using Voglibose for Nonalcoholic Steatohepatitis in a Patient with Insufficient Dietary and Exercise Therapy: Exploring Other Treatment Possibilities

    Directory of Open Access Journals (Sweden)

    Kazuki Nagai

    2011-06-01

    Full Text Available A 56-year-old Japanese female with a 10-year history of thyroiditis presented to our institution. The laboratory data and clinical findings suggested that the patient had complicated nonalcoholic fatty liver disease or nonalcoholic steatohepatitis (NASH with autoimmune hepatitis according to the criteria by the application of the International Autoimmune Hepatitis score. The patient could not manage by herself so dietary- and exercise-based treatment was difficult. Accordingly, ursodeoxycholic acid and ezetimibe therapy was started and continued until the performance of a liver needle biopsy to define the diagnosis. However, no improvement in liver function was observed. In addition, pathological findings indicated that the patient had NASH. The patient was finally diagnosed as having NASH. Therefore, voglibose was added to the ursodeoxycholic acid and ezetimibe therapy, and this addition of voglibose actually took effect. The patient’s serum aspartate transaminase and alanine aminotransferase levels decreased dramatically. This report is the first to document other treatment possibilities of NASH in a case when dietary therapy is difficult.

  10. [Clinical Observation of Heat-sensitive Moxibustion Combined with Kegel Exercise Therapy for Female Stress Urinary Incontinence].

    Science.gov (United States)

    Hu, Dan; Deng, Peng; Jiao, Lin; Xiong, Jun; Xie, Ding-Yi; Chen, Ri-Xin

    2017-08-25

    To compare the clinical effects of heat-sensitive moxibustion combined with kegel exercise therapy and simple kegel exercise therapy on female stress urinary incontinence. Forty-five female patients with stress urinary incontinence were randomly divided into a treatment group ( n =23) and a control group ( n =22). Kegel exercise therapy was applied in the two groups. Heat-sensitive moxibustion was used at Zhongji (CV 3), Qihai (CV 6), Ciliao (BL 32) and Shen-shu (BL 23) in the treatment group, once a day for the first 10 times, and once every other day until 5 sessions were given, 10 times as one session. 1-hour pad test, International Incontinence Advisory Board questionnaire (ICIQ-SF) and the number of urine leakage were observed before and after treatment. And the clinical effect was evaluated. The curative rate of 43.48%(10/23) and the total effective rate of 95.65%(22/23) in the treatment group were respectively better than those of 18.18% (4/22) and 63.64%(14/22) in the control group (both P kegel exercise therapy achieves better effect than simple kegel exercise therapy on female stress urinary incontinence.

  11. Comparison of the Balance Performance of the Children with Spastic Cerebral Palsy before and after Exercise Therapy Program

    Directory of Open Access Journals (Sweden)

    Keyvan Sharif-Moradi

    2006-04-01

    Full Text Available Objective: This research is aimed to evaluate precisely a dynamic stability platform system to measure the center of gravity's sways around with fluctuations of cerebral spastic palsy children, before an after exercise therapy. Materials & Methods: Ten children with spastic diplegia cerebral palsy between 8 to15 years of age, wre participated in this quasi experimental (after – before study. Their mean weight and height were (30.8kg ± 5.7kg and (1.35m±0.09m respectively. Subjects underwent a 12 weeks of exercise therapy. A dynamic stability platform system (BIODEX was used to measure the center of gravity’s sway around the center of base of support (COBOS. The balance tests were repeated on stable, almost stable and unstable base of support as well as with and without shoes. Results: Findings showed that the mean sway of center of gravity of the cerebral palsy children was significantly decrease after exercise therapy by 0.2 degrees (P=0.001. The greatest improvement achieved on AP directions in all conditions. Wearing shoes resulted in a significant decrease on the body sway. Conclusion: Exercise therapy significantly improved body balance in CP children. The function of the proprioceptives of the hip and trunk can be improved by exercise therapy and therefore should be considered in rehabilitation program.

  12. Cardiac Resynchronization Therapy Relieves Intractable Angina Due to Exercise-Induced Left Bundle Branch Block Without Left Ventricular Systolic Dysfunction: A Detailed Case Study.

    Science.gov (United States)

    Czuriga, Daniel; Lim, Pitt O

    2016-05-01

    Exercise-induced left bundle branch block is rare and can be demonstrated with exercise testing. When the heart rate reaches a certain threshold, the QRS widens into left bundle branch block. This paper describes a patient with exercise-induced left bundle branch block related angina and dyspnea, who responded to cardiac resynchronization therapy. We documented the potential benefits of cardiac resynchronization therapy with a left ventricular rapid pacing study prior to its implantation. Although exercise-induced left bundle branch block is not a current indication for cardiac resynchronization therapy in patients such as ours, it could be considered when conventional drug therapy fails. © 2016 Wiley Periodicals, Inc.

  13. Tailored cognitive-behavioural therapy and exercise training improves the physical fitness of patients with fibromyalgia.

    Science.gov (United States)

    van Koulil, S; van Lankveld, W; Kraaimaat, F W; van Helmond, T; Vedder, A; van Hoorn, H; Donders, A R T; Wirken, L; Cats, H; van Riel, P L C M; Evers, A W M

    2011-12-01

    Patients with fibromyalgia have diminished levels of physical fitness, which may lead to functional disability and exacerbating complaints. Multidisciplinary treatment comprising cognitive-behavioural therapy (CBT) and exercise training has been shown to be effective in improving physical fitness. However, due to the high drop-out rates and large variability in patients' functioning, it was proposed that a tailored treatment approach might yield more promising treatment outcomes. High-risk fibromyalgia patients were randomly assigned to a waiting list control group (WLC) or a treatment condition (TC), with the treatment consisting of 16 twice-weekly sessions of CBT and exercise training tailored to the patient's cognitive-behavioural pattern. Physical fitness was assessed with two physical tests before and 3 months after treatment and at corresponding intervals in the WLC. Treatment effects were evaluated using linear mixed models. The level of physical fitness had improved significantly in the TC compared with the WLC. Attrition rates were low, effect sizes large and reliable change indices indicated a clinically relevant improvement among the TC. A tailored multidisciplinary treatment approach for fibromyalgia consisting of CBT and exercise training is well tolerated, yields clinically relevant changes, and appears a promising approach to improve patients' physical fitness. ClinicalTrials.gov ID NCT00268606.

  14. Exercise Therapy Augments the Ischemia-Induced Proangiogenic State and Results in Sustained Improvement after Stroke

    Directory of Open Access Journals (Sweden)

    Man He

    2013-04-01

    Full Text Available The induction of angiogenesis will stimulate endogenous recovery mechanisms, which are involved in the long-term repair and restoration process of the brain after an ischemic event. Here, we tested whether exercise influences the pro-angiogenic factors and outcomes after cerebral infarction in rats. Wistar rats were exposed to two hours of middle-cerebral artery occlusion and reperfusion. Different durations of treadmill training were performed on the rats. The expression of matrix metalloproteinase 2 (MMP2 and vascular endothelial growth factor (VEGF-related genes and proteins were higher over time post-ischemia, and exercise enhanced their expression. Sixteen days post-ischemia, the regional cerebral blood flow in the ischemic striatum was significantly increased in the running group over the sedentary. Although no difference was seen in infarct size between the running and sedentary groups, running evidently improved the neurobehavioral score. The effects of running on MMP2 expression, regional cerebral blood flow and outcome were abolished when animals were treated with bevacizumab (BEV, a VEGF-targeting antibody. Exercise therapy improves long-term stroke outcome by MMP2-VEGF-dependent mechanisms related to improved cerebral blood flow.

  15. Characterization of Exercise and Alcohol Self-Management Behaviors of Type 1 Diabetes Patients on Insulin Pump Therapy.

    Science.gov (United States)

    Grando, Maria Adela; Groat, Danielle; Soni, Hiral; Boyle, Mary; Bailey, Marilyn; Thompson, Bithika; Cook, Curtiss B

    2017-03-01

    There is a lack of systematic ways to analyze how diabetes patients use their insulin pumps to self-manage blood glucose to compensate for alcohol ingestion and exercise. The objective was to analyze "real-life" insulin dosing decisions occurring in conjunction with alcohol intake and exercise among patients using insulin pumps. We recruited adult type 1 diabetes (T1D) patients on insulin pump therapy. Participants were asked to maintain their daily routines, including those related to exercising and consuming alcohol, and keep a 30-day journal on exercise performed and alcohol consumed. Thirty days of insulin pump data were downloaded. Participants' actual insulin dosing behaviors were compared against their self-reported behaviors in the setting of exercise and alcohol. Nineteen T1D patients were recruited and over 4000 interactions with the insulin pump were analyzed. The analysis exposed variability in how subjects perceived the effects of exercise/alcohol on their blood glucose, inconsistencies between self-reported and observed behaviors, and higher rates of blood glucose control behaviors for exercise versus alcohol. Compensation techniques and perceptions on how exercise and alcohol affect their blood glucose levels vary between patients. Improved individualized educational techniques that take into consideration a patient's unique life style are needed to help patients effectively apply alcohol and exercise compensation techniques.

  16. Integrating diet and exercise into care of prostate cancer patients on androgen deprivation therapy

    Directory of Open Access Journals (Sweden)

    Moyad MA

    2016-08-01

    Full Text Available Mark A Moyad,1 Robert U Newton,2 Ulf W Tunn,3 Damian Gruca4 1Department of Urology, University of Michigan Medical Center, Ann Arbor, MI, USA; 2Exercise Medicine Research Institute, Edith Cowan University, Joondalup, WA, Australia; 3Urological Clinic, Facharztzentrum Academic Hospital Sana Klinikum Offenbach, Offenbach/Main, 4Global Medical Affairs, AbbVie Deutschland, Ludwigshafen, Germany Abstract: Improved diagnosis and treatment regimens have resulted in greater longevity for men with prostate cancer. This has led to an increase in both androgen deprivation therapy (ADT use and duration of exposure, and therefore to its associated adverse effects, such as sexual dysfunction, osteoporosis, reduced muscle mass, increased fat mass, and increased incidence of cardiovascular disease and type 2 diabetes. Given that the adverse effects of ADT are systemic, often debilitating, and difficult to treat, efforts continue in the development of new strategies for long-term management of prostate cancer. The PubMed database was searched to select trials, reviews, and meta-analyses in English using such search terms as “prostate cancer” and “androgen deprivation therapy”, “cardiovascular risk”, “lean body mass”, “exercise”, and “diet”. The initial searches produced 379 articles with dates 2005 or more recent. Articles published after 2004 were favored. This review utilizes the latest data to provide a status update on the effects of exercise and diet on patients with prostate cancer, focusing on ADT-associated side effects, and it discusses the evidence for such interventions. Since the evidence of large-scale trials in patients with prostate cancer is missing, and an extrapolation of supporting data to all patient subgroups cannot be provided, individualized risk assessments remain necessary before the initiation of exercise and diet programs. Exercise, diet, and nutritional supplementation interventions have the potential to

  17. Supervised exercise therapy versus usual care for patellofemoral pain syndrome: an open label randomised controlled trial.

    Science.gov (United States)

    van Linschoten, R; van Middelkoop, M; Berger, M Y; Heintjes, E M; Verhaar, J A N; Willemsen, S P; Koes, B W; Bierma-Zeinstra, S M

    2009-10-20

    To assess the effectiveness of supervised exercise therapy compared with usual care with respect to recovery, pain, and function in patients with patellofemoral pain syndrome. Open label randomised controlled trial. General practice and sport physician practice. Patients with a new episode of patellofemoral pain syndrome recruited by their general practitioner or sport physician. The intervention group received a standardised exercise programme for 6 weeks tailored to individual performance and supervised by a physical therapist, and were instructed to practise the tailored exercises at home for 3 months. The control group were assigned usual care, which comprised a "wait and see" approach of rest during periods of pain and refraining from pain provoking activities. Both the intervention group and the control group received written information about patellofemoral pain syndrome and general instructions for home exercises. The primary outcomes were self reported recovery (7 point Likert scale), pain at rest and pain on activity (0-10 point numerical rating scale), and function (0-100 point Kujala patellofemoral score) at 3 months and 12 months follow-up. A total of 131 participants were included in the study: 65 in the intervention group and 66 in the control group. After 3 months, the intervention group showed better outcomes than the control group with regard to pain at rest (adjusted difference -1.07, 95% confidence interval -1.92 to -0.22; effect size 0.47), pain on activity (-1.00, -1.91 to -0.08; 0.45), and function (4.92, 0.14 to 9.72; 0.34). At 12 months, the intervention group continued to show better outcomes than the control group with regard to pain (adjusted difference in pain at rest -1.29, -2.16 to -0.42; effect size 0.56; pain on activity -1.19, -2.22 to -0.16; effect size 0.54), but not function (4.52, -0.73 to 9.76). A higher proportion of patients in the exercise group than in the control group reported recovery (41.9% v 35.0% at 3 months and 62

  18. Effectiveness of the massage tuina and the Williams exercise like therapy in the hernia lumbar discal.

    Directory of Open Access Journals (Sweden)

    Andrés Alberto Padilla Rubio

    2012-06-01

    Full Text Available The high incidence of the hernia lumbar discal is known in relatively young people. It was carried out a prospective, longitudinal, explaratory and applicable study in the Provincial Hospital of Rehabilitation Faustino Pérez of Sancti Spiritus, between April of 2007 and September of 2008 with the objective of determining the effectiveness of this therapy in 40 patients that presented lumbar pain secondary to hernia lumbar discal. Twenty sick persons received massage and exercises, while at the twenty remaining were applied massage Tuina, being instructed in a group of postural care. The investigation denoted a bigger frequency of patient among 30 and 39 years and masculine sex that they carried out heavy work or intermediate. Decreased the frequency and intensity of the pain and the restrictions to carry out activities, in the two groups, when evaluating four moments, the very good therapeutic evaluation prevailed (50% followed by the excellent one (32.5%. The massage Tuina is an effective therapy to alleviate pain and to increase activity of the patients with hernia lumbar discal, mainly when it is used alone or associated to Williams exercises, from the last one better results are obtained.

  19. Treating trismus: A prospective study on effect and compliance to jaw exercise therapy in head and neck cancer.

    Science.gov (United States)

    Pauli, Nina; Andréll, Paulin; Johansson, Mia; Fagerberg-Mohlin, Bodil; Finizia, Caterina

    2015-12-01

    Trismus after head and neck cancer is a symptom associated with pain and negatively affected health-related quality of life. The purpose of this study was to compare two different jaw exercise devices and the compliance to exercise. Fifty patients with head and neck cancer were randomized to jaw exercise with either the TheraBite or Engström jaw device in a 10-week exercise program. Patients were regularly assessed by an oral surgeon, filled in exercise diaries, and answered the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 Head and Neck 35-questions (EORTC QLQ H&N35) and the Gothenburg Trismus Questionnaire (GTQ). Both groups improved their mouth opening, 7.2 mm (22.9%) and 5.5 mm (17.6%) for TheraBite and Engström, respectively. The largest increase in mouth opening and highest compliance to exercise was seen during the 4 first weeks. Jaw exercise therapy effectively improved mouth opening capacity and led to less trismus-related symptoms. Both jaw devices were proved efficient and compliance to exercise was comparable. © 2014 Wiley Periodicals, Inc.

  20. Exercise therapy for bone and muscle health: an overview of systematic reviews

    Directory of Open Access Journals (Sweden)

    Hagen Kåre

    2012-12-01

    Full Text Available Abstract Background Musculoskeletal conditions (MSCs are widely prevalent in present-day society, with resultant high healthcare costs and substantial negative effects on patient health and quality of life. The main aim of this overview was to synthesize evidence from systematic reviews on the effects of exercise therapy (ET on pain and physical function for patients with MSCs. In addition, the evidence for the effect of ET on disease pathogenesis, and whether particular components of exercise programs are associated with the size of the treatment effects, was also explored. Methods We included four common conditions: fibromyalgia (FM, low back pain (LBP, neck pain (NP, and shoulder pain (SP, and four specific musculoskeletal diseases: osteoarthritis (OA, rheumatoid arthritis (RA, ankylosing spondylitis (AS, and osteoporosis (OP. We first included Cochrane reviews with the most recent update being January 2007 or later, and then searched for non-Cochrane reviews published after this date. Pain and physical functioning were selected as primary outcomes. Results We identified 9 reviews, comprising a total of 224 trials and 24,059 patients. In addition, one review addressing the effect of exercise on pathogenesis was included. Overall, we found solid evidence supporting ET in the management of MSCs, but there were substantial differences in the level of research evidence between the included diagnostic groups. The standardized mean differences for knee OA, LBP, FM, and SP varied between 0.30 and 0.65 and were significantly in favor of exercise for both pain and function. For NP, hip OA, RA, and AS, the effect estimates were generally smaller and not always significant. There was little or no evidence that ET can influence disease pathogenesis. The only exception was for osteoporosis, where there was evidence that ET increases bone mineral density in postmenopausal women, but no significant effects were found for clinically relevant outcomes

  1. Dose-Response Effects of Tai Chi and Physical Therapy Exercise Interventions in Symptomatic Knee Osteoarthritis.

    Science.gov (United States)

    Lee, Augustine C; Harvey, William F; Price, Lori Lyn; Han, Xingyi; Driban, Jeffrey B; Iversen, Maura D; Desai, Sima A; Knopp, Hans E; Wang, Chenchen

    2018-01-30

    Therapeutic exercise is a currently recommended non-pharmacological treatment for knee osteoarthritis (KOA). The optimal treatment dose (frequency or duration) has not been determined. To examine dose-response relationships, minimal effective dose, and baseline factors associated with the timing of response from two exercise interventions in KOA. Secondary analysis of a single-blind, randomized trial comparing 12-week Tai Chi and Physical Therapy exercise programs (Trial Registry #NCT01258985). Urban tertiary care academic hospital PARTICIPANTS: 182 participants with symptomatic KOA (mean age 61 years; BMI 32kg/m2, 70% female; 55% white). We defined dose as cumulative attendance-weeks of intervention, and treatment response as ≥20% and ≥50% improvement in pain and function. Using log-rank tests, we compared time-to-response between interventions; and used Cox regression to examine baseline factors associated with timing of response, including physical and psychosocial health, physical performance, outcome expectations, self-efficacy, and biomechanical factors. Weekly Western Ontario and McMasters Osteoarthritis Index (WOMAC) pain (0 to 500) and function (0 to 1700) scores. Both interventions had an approximately linear dose-response effect resulting in a 9 to 11-point reduction in WOMAC pain and a 32 to 41-point improvement in function per attendance-week. There was no significant difference in overall time-to-response for pain and function between treatment groups. Median time-to-response for ≥20% improvement in pain and function was 2 attendance-weeks and 4 to 5 attendance-weeks for ≥50% improvement. On multivariable models, outcome expectations were independently associated with incident function response (Hazard Ratio: 1.47; 95% CI: 1.004 to 2.14). Both interventions have approximately linear dose-dependent effects on pain and function, their minimum effective doses range from 2-5 weeks, and patient perceived benefits of exercise influence the timing of

  2. Effects of positive airway pressure therapy on exercise parameters in obstructive sleep apnea.

    Science.gov (United States)

    Ozsarac, Ilker; Bayram, Nazan; Uyar, Meral; Kosovali, Deniz; Gundogdu, Nevhiz; Filiz, Ayten

    2014-01-01

    Obstructive sleep apnea (OSA) is common in adult population and may cause many adverse clinical results. We aimed to investigate possible changes in cardiopulmonary exercise capacity in OSA patients after positive airway pressure treatment. Patients who were admitted to Gaziantep University Pulmonary Diseases Sleep Center and diagnosed OSA were included. Studies carried out between May 2010 and July 2011. Sixty-five consecutive patients were included in this prospective study. Sixty-five adult sleep clinic patients diagnosed with OSA by polysomnography and in whom continuous positive airway pressure (CPAP) ventilation therapy was indicated were included. Cardiopulmonary exercise capacity was assessed by bicycle ergometry during diagnostic workup and at least 4 weeks later. There were 57 (87.7%) males. The mean age was 45.29 (10.57) years, apnea-hypopnea index 38.02 (23.19 events/h, body mass index 31.72 (4.87) kg/m2. Patients were grouped with respect to compliance with CPAP. The peak oxygen consumption (VO2) did not change in the CPAP compliant group (n=33) (22.52 [6.62] mL/[min.kg] to 21.32 [5.26] mL/[min.kg]; P=.111), and decreased from 21.31 (5.66) mL/(min.kg) to 19.92 (5.40) mL/(min.kg) (P=.05) in the CPAP noncompliant group. Work rate increased from 84.0% to 85.0% in the CPAP compliant group and decreased from 79.6% to 77.1% in the noncompliant group (P=.041). In the group that used the device, ventilation (VE)/VCO2 at anaerobic threshold (AT) declined from 28.42 to 27.36; however, it increased from 27.41 to 27.81 in the group that did not use the device (P=.033). Decline in the exercise capacity was prevented in patients with OSA after 4 weeks of CPAP therapy. The changes in VE/VCO2 at AT suggest the reversal of pathophysiologic changes in OSA with the CPAP therapy that may improve cardiac function and cause more efficient ventilation.

  3. [Improvement of lasting effects in outpatient pulmonary rehabilitation with special regard to exercise therapy and sports].

    Science.gov (United States)

    Dalichau, S; Demedts, A; im Sande, A; Möller, T

    2010-02-01

    The aim of this study was to evaluate the effects of outpatient medical rehabilitation (OMR) mainly composed of exercise therapy and sports for patients with asbestosis. Following the Hamburg model, the OMR focuses on keeping up lasting effects. In the frame of a pre-experimental study, 113 male asbestosis patients aged 66.1+/-5.8 years participated 6 hrs. a day five times a week over a period of three weeks in phase 1 of the OMR consisting of evidence-based contents of the pulmonary rehabilitation. Directly after that further therapeutic applications with the main focus on exercise therapy and sports were applied for 3 hrs. once a week over a period of twelve weeks (phase 2). After phase 2 the rehabilitation centre led the patients into sports groups near their places of residence (phase 3). The effects of the OMR were evaluated at the beginning (T1), at the end of phase 1 (T2) and phase 2 (T3) as well as 6 (T4) and 18 months (T5) after T3 by means of a suitable assessment. Compared to T1 physical fitness (6-minute Walk Test, Hand-Force Test) as well as health-related quality of life (SF-36), dyspnea (BDI/TDI) and oxygen partial pressure (pO2) were significantly improved in T2. These positive effects could be confirmed in T3. 89 patients (79%) were doing health-related sports regularly 6 and 18 months after T3 and could preserve their health outcome in T4 and T5, while the effects of rehabilitation of the 24 patients breaking off any sporting activities wore off again down to and even below the starting condition at T1. In spite of a restrictive pulmonary disease, specific exercise therapy and sports are able to mobilize physical reserves of performance and induce an increasing quality of life as well as a higher resilience in activities of daily living. These positive effects could be stabilized persistently by a regular training once a week. Thus, the results emphasize the necessity to include strategies of aftercare in the concept of rehabilitation. Georg

  4. Cost-effectiveness of spinal manipulative therapy, supervised exercise, and home exercise for older adults with chronic neck pain.

    Science.gov (United States)

    Leininger, Brent; McDonough, Christine; Evans, Roni; Tosteson, Tor; Tosteson, Anna N A; Bronfort, Gert

    2016-11-01

    Chronic neck pain is a prevalent and disabling condition among older adults. Despite the large burden of neck pain, little is known regarding the cost-effectiveness of commonly used treatments. This study aimed to estimate the cost-effectiveness of home exercise and advice (HEA), spinal manipulative therapy (SMT) plus HEA, and supervised rehabilitative exercise (SRE) plus HEA. Cost-effectiveness analysis conducted alongside a randomized clinical trial (RCT) was performed. A total of 241 older adults (≥65 years) with chronic mechanical neck pain comprised the patient sample. The outcome measures were direct and indirect costs, neck pain, neck disability, SF-6D-derived quality-adjusted life years (QALYs), and incremental cost-effectiveness ratios (ICERs) over a 1-year time horizon. This work was supported by grants from the National Center for Complementary and Integrative Health (#F32AT007507), National Institute of Arthritis and Musculoskeletal and Skin Diseases (#P60AR062799), and Health Resources and Services Administration (#R18HP01425). The RCT is registered at ClinicalTrials.gov (#NCT00269308). A societal perspective was adopted for the primary analysis. A healthcare perspective was adopted as a sensitivity analysis. Cost-effectivenesswas a secondary aim of the RCT which was not powered for differences in costs or QALYs. Differences in costs and clinical outcomes were estimated using generalized estimating equations and linear mixed models, respectively. Cost-effectiveness acceptability curves were calculated to assess the uncertainty surrounding cost-effectiveness estimates. Total costs for SMT+HEA were 5% lower than HEA (mean difference: -$111; 95% confidence interval [CI] -$1,354 to $899) and 47% lower than SRE+HEA (mean difference: -$1,932; 95% CI -$2,796 to -$1,097). SMT+HEA also resulted in a greater reduction of neck pain over the year relative to HEA (0.57; 95% CI 0.23 to 0.92) and SRE+HEA (0.41; 95% CI 0.05 to 0.76). Differences in disability and

  5. Method to observe hemodynamic and metabolic changes during hemodiafiltration therapy with exercise.

    Science.gov (United States)

    Cadena, Miguel; Pérez-Grovas, Héctor; Flores, Pedro; Azpiroz, Joaquín; Borja, Gisella; Medel, Humberto; Rodriguez, Fausto; Flores, Francisco

    2010-01-01

    Intradyalitic exercise programas are important to improve patient's hemodynamic stability. Blood pressure and metabolic changes are correlated when heat accumulation is due to increment of the body core temperature (+1.0 °C). However, increase in temperature could be controlled by lowering dialysate's temperature using two main modalities techniques (isothermic and thermoneural) with different patient's thermal balance consequences, not yet well studied. In this work, a new method to observe the main physiological parameters (hearth rate variability (HRV), blood pressure, BTM dialysate temperature control and substrate utilization by indirect calorimtery) which are involved in hemodiafitration (HDF), are displayd. An experiment was carried out in a group of 5 patients waiting kidney transplant. In each patient, EE was assessed as well as the HRV during isothermic and thermoneutral modalities as a manner of cross and prospective study (a) at before therapy, (b) during therapy and (c) at the end of the HDF therapy. Power extraction was also measured by a BTM (Blood Temperature Monitor from Fresenius Inc), in order to determine how the dialysate temperature was controlled. The results showed important method's advantages which place the BTM performance as unstable control system with the possibility to produce undesirable HRV changes as the vagotonical response. However more patient cases are needed in order to identify the real advantage of this new method.

  6. A Pilot Study to Assess the Feasibility of Group Exercise and Animal-Assisted Therapy in Older Adults.

    Science.gov (United States)

    Grubbs, Brandon; Artese, Ashley; Schmitt, Karla; Cormier, Eileen; Panton, Lynn

    2016-04-01

    This pilot study assessed the feasibility of incorporating animal-assisted therapy teams (ATT) into a 6-week group exercise program for older adults (77 ± 6 years). Fifteen participants were randomly assigned to an exercise with ATT (E+ATT; n = 8) or exercise only (E; n = 7) group. Groups exercised 3x/week for 45 min. Feasibility was assessed by three objectives: (1) ATT will not need extensive preparation beyond their original therapy training; (2) the study will require minimal cost; and (3) ATT must not impair the effectiveness of the exercise program. By the study conclusion, all objectives were met. Time and cost were minimal for ATT, and adherence was 93% and 90% for E+ATT and E, respectively. There were significant improvements in both groups (p ≤ .05) for arm curls, get-up and go, and 6-min walk. The results of this pilot study suggest that it is feasible to incorporate ATT into group exercise programming for older adults.

  7. Comparison between effectiveness of Mechanical and Manual Traction combined with mobilization and exercise therapy in Patients with Cervical Radiculopathy

    OpenAIRE

    Bukhari, Syed Rehan Iftikhar; Shakil-ur-Rehman, Syed; Ahmad, Shakeel; Naeem, Aamer

    2016-01-01

    Background and Objective: Cervical radiculopathy is a common neuro-musculo-skeletal disorder causing pain and disability. Traction is part of the evidence based manual physical therapy management due to its mechanical nature, type of traction and parameters related to its applicability and are still to be explored more through research. Our objective was to determine the Effects of Mechanical versus Manual Traction in Manual Physical Therapy combined with segmental mobilization and exercise t...

  8. From apelin to exercise: emerging therapies for management of hypertension in pregnancy.

    Science.gov (United States)

    Gilbert, Jeffrey S

    2017-06-01

    Studies over the last couple of decades have provided exciting new insights into mechanisms underlying the pathogenesis of preeclampsia. In addition, several novel and innovative molecules and ideas for management of the syndrome have also come forth. While our basic understanding of the initiating events of preeclampsia continues to be placental ischemia/hypoxia stimulating the release of a variety of factors from the placenta that act on the cardiovascular and renal systems, the number of candidate pathways for intervention continues to increase. Recent studies have identified apelin and its receptor, APJ, as an important contributor to the regulation of cardiovascular and fluid balance that is found to be disrupted in preeclampsia. Likewise, continued studies have revealed a critical role for the complement arm of the innate immune system in placental ischemia induced hypertension and in preeclampsia. Finally, the recent increase in animal models for studying hypertensive disorders of pregnancy has provided opportunities to evaluate the potential role for physical activity and exercise in a more mechanistic fashion. While the exact quantitative importance of the various endothelial and humoral factors that mediate vasoconstriction and elevation of arterial pressure during preeclampsia remains unclear, significant progress has been made. Thus, the goal of this review is to discuss recent efforts towards identifying therapies for hypertension during pregnancy that derive from work exploring the apelinergic system, the complement system as well as the role that exercise and physical activity may play to that end.

  9. Contrast water therapy and exercise induced muscle damage: a systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    François Bieuzen

    Full Text Available The aim of this systematic review was to examine the effect of Contrast Water Therapy (CWT on recovery following exercise induced muscle damage. Controlled trials were identified from computerized literature searching and citation tracking performed up to February 2013. Eighteen trials met the inclusion criteria; all had a high risk of bias. Pooled data from 13 studies showed that CWT resulted in significantly greater improvements in muscle soreness at the five follow-up time points (<6, 24, 48, 72 and 96 hours in comparison to passive recovery. Pooled data also showed that CWT significantly reduced muscle strength loss at each follow-up time (<6, 24, 48, 72 and 96 hours in comparison to passive recovery. Despite comparing CWT to a large number of other recovery interventions, including cold water immersion, warm water immersion, compression, active recovery and stretching, there was little evidence for a superior treatment intervention. The current evidence base shows that CWT is superior to using passive recovery or rest after exercise; the magnitudes of these effects may be most relevant to an elite sporting population. There seems to be little difference in recovery outcome between CWT and other popular recovery interventions.

  10. Parkinson's disease and intensive exercise therapy--a systematic review and meta-analysis of randomized controlled trials

    DEFF Research Database (Denmark)

    Uhrbrand, Anders; Stenager, Egon; Pedersen, Martin Sloth

    2015-01-01

    Objective To evaluate and compare the effect of 3 intensive exercise therapy modalities - Resistance Training (RT), Endurance Training (ET) and Other Intensive Training Modalities (OITM) - in Parkinson's Disease (PD). Design A systematic review and meta-analysis of randomized controlled trials......, ET and OITM may have beneficial effects on balance, walking performance, Unified Parkinson's Disease Rating Scale-III (UPDRS-III) score and quality of life in PD, but findings are inconsistent. No studies find deterioration in any outcomes following exercise therapy. Conclusion RT, ET and OITM all....... Methods A systematic literature search was conducted (Embase, Pubmed, Cinahl, SPORTDiscus, Cochrane, PEDro), which identified 15 studies that were categorized as RT, ET or OITM. The different exercise modalities were reviewed and a meta-analysis evaluating the effect of RT on muscle strength was made...

  11. When is Supervised Exercise Therapy Considered Useful in Peripheral Arterial Occlusive Disease? A Nationwide Survey among Vascular Surgeons

    NARCIS (Netherlands)

    Lauret, G. J.; van Dalen, H. C.; Hendriks, H. J.; van Sterkenburg, S. M.; Koelemay, M. J.; Zeebregts, C. J.; Peters, R. J.; Teijink, J. A.

    Objectives: Although international guidelines state that supervised exercise therapy (SET) should be offered to all patients with intermittent claudication (IC), SET appears to be underutilised in clinical practice. The aim of this study was to document current opinions of Dutch vascular surgeons on

  12. When is Supervised Exercise Therapy Considered Useful in Peripheral Arterial Occlusive Disease? A Nationwide Survey among Vascular Surgeons

    NARCIS (Netherlands)

    Lauret, G. J.; van Dalen, H. C.; Hendriks, H. J.; van Sterkenburg, S. M.; Koelemay, M. J.; Zeebregts, C. J.; Peters, R. J.; Teijink, J. A.

    2012-01-01

    Objectives: Although international guidelines state that supervised exercise therapy (SET) should be offered to all patients with intermittent claudication (IC), SET appears to be underutilised in clinical practice. The aim of this study was to document current opinions of Dutch vascular surgeons on

  13. Cognitive-behavioural therapies and exercise programmes for patients with fibromyalgia: state of the art and future directions.

    NARCIS (Netherlands)

    Koulil, S. van; Effting, M.; Kraaimaat, F.W.; Lankveld, W.G.J.M. van; Helmond, T. van; Cats, H.; Riel, P.L.C.M. van; Jong, A.J.L. de; Haverman, J.F.; Evers, A.W.M.

    2007-01-01

    This review provides an overview of the effects of non-pharmacological treatments for patients with fibromyalgia (FM), including cognitive-behavioural therapy, exercise training programmes, or a combination of the two. After summarising and discussing preliminary evidence of the rationale of

  14. Long-term effectiveness of exercise therapy in patients with osteoarthritis of hip or knee: a systematic review.

    NARCIS (Netherlands)

    Pisters, M.F.; Veenhof, C.; Meeteren, N.L.U. van; Ostelo, R.W.; Bakker, D. de; Schellevis, F.G.; Dekker, J.

    2007-01-01

    PURPOSE: To determine the long-term effectiveness (= 6 months after treatment) of exercise therapy on pain, physical function and patient global assessment of effectiveness in patients with osteoarthritis (OA) of the hip and/or knee. METHODS: An extensive literature search in PubMed, Embase, CINAHL,

  15. Long-term effectiveness of exercise therapy in patients with osteoarthritis of hip or knee: a systematic review.

    NARCIS (Netherlands)

    Pisters, M.F.; Veenhof, C.; Meeteren, N.L.U. van; Ostelo, R.W.; Bakker, D.H. de; Schellevis, F.G.; Dekker, J.

    2007-01-01

    OBJECTIVE: To determine the long-term effectiveness (>/=6 months after treatment) of exercise therapy on pain, physical function, and patient global assessment of effectiveness in patients with osteoarthritis (OA) of the hip and/or knee. METHODS: We conducted an extensive literature search in

  16. The effectiveness of exercise therapy in patients with osteoarthritis of the hip or knee: a randomized clinical trial.

    NARCIS (Netherlands)

    Baar, M.E. van; Dekker, J.; Oostendorp, R.A.B.; Bijl, D.; Voorn, T.B.; Lemmens, J.A.M.; Bijlsma, J.W.J.

    1998-01-01

    Objective: To determine the effectiveness of exercise therapy in patients with osteoarthritis (OA) of the hip or knee. Methods: A randomized single blind, clinical trial was conducted in a primary care setting. Patients with hip or knee OA by American College of Rheumatology criteria were

  17. Integrating acupuncture with exercise-based physical therapy for knee osteoarthritis: a randomized controlled trial.

    Science.gov (United States)

    Chen, Lan X; Mao, Jun J; Fernandes, Shawn; Galantino, Mary Lou; Guo, Wensheng; Lariccia, Patrick; Teal, Valerie L; Bowman, Marjorie A; Schumacher, H Ralph; Farrar, John T

    2013-09-01

    Knee osteoarthritis is a chronic disease associated with significant morbidity and economic cost. The efficacy of acupuncture in addition to traditional physical therapy has received little study. The objective of this study was to compare the efficacy and safety of integrating a standardized true acupuncture protocol versus nonpenetrating acupuncture into exercise-based physical therapy (EPT). This was a randomized, double-blind, controlled trial at 3 physical therapy centers in Philadelphia, PA. We studied 214 patients (66% African Americans) with at least 6 months of chronic knee pain and x-ray-confirmed Kellgren scores of 2 or 3. Patients received 12 sessions of acupuncture directly following EPT over 6 to 12 weeks. Acupuncture was performed at the same 9 points dictated by the traditional Chinese "Bi" syndrome approach to knee pain, using either standard needles or Streitberger non-skin-puncturing needles. The primary outcome was the proportion of patients with at least a 36% improvement in Western Ontario and McMaster Universities Osteoarthritis Index score at 12 weeks. Both treatment groups showed improvement from combined therapy with no difference between true (31.6%) and nonpenetrating acupuncture (30.3%) in Western Ontario and McMaster Universities Osteoarthritis Index response rate (P = 0.5) or report of minor adverse events. A multivariable logistic regression prediction model identified an association between a positive expectation of relief from acupuncture and reported improvement. No differences were noted by race, sex, or age. Puncturing acupuncture needles did not perform any better than nonpuncturing needles integrated with EPT. Whether EPT, acupuncture, or other factors accounted for any improvement noted in both groups could not be determined in this study. Expectation for relief was a predictor of reported benefit.

  18. Preconditioning by light-load eccentric exercise is equally effective as low-level laser therapy in attenuating exercise-induced muscle damage in collegiate men

    Directory of Open Access Journals (Sweden)

    Nausheen S

    2017-09-01

    Full Text Available Samar Nausheen,1 Jamal Ali Moiz,1 Shahid Raza,1 Mohammad Yakub Shareef,2 Shahnawaz Anwer,3,4 Ahmad H Alghadir3 1Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia, New Delhi, India; 2Faculty of Dentistry, Jamia Millia Islamia, New Delhi, India; 3Rehabilitation Research Chair, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia; 4Dr. D. Y. Patil College of Physiotherapy, Dr. D. Y. Patil Vidyapeeth, Pune, India Background/objective: Previous studies have already reported an independent effect of light-load eccentric exercise (10% eccentric exercise contraction [EEC] and low-level laser therapy (LLLT as a protective measure against more strenuous eccentric exercise. However, the difference between these two interventions is largely unknown. Therefore, the present study aimed to compare the preconditioning effect of 10% EEC vs. LLLT on subjective, physiological, and biochemical markers of muscle damage in elbow flexors in collegiate men.Methods: All 36 enrolled subjects were randomly assigned to either 10% EEC or LLLT group. Subjects in 10% EEC group performed 30 repetitions of an eccentric exercise with 10% maximal voluntary contraction strength 2 days prior to maximal eccentric exercise bout, whereas subjects in LLLT group were given LLLT. All the indirect markers of muscle damage were measured pre-exercise and at 24, 48, and 72 hours after the exercise-induced muscle damage protocol.Results: The muscle soreness was reduced in both groups (p = 0.024; however, soreness was attenuated more in LLLT group at 48 hours (33.5 vs. 42.7, p = 0.004. There was no significant difference between the effect of 10% EEC and LLLT groups on other markers of muscle damage like a maximum voluntary isometric contraction (p = 0.47, range of motion (p = 0.16, upper arm circumference (p = 0.70, creatine kinase (p = 0.42, and lactate dehydrogenase (p = 0.08. Within-group analysis showed both interventions provided

  19. Individual nutrition therapy and exercise regime: a controlled trial of injured, vulnerable elderly (INTERACTIVE trial).

    Science.gov (United States)

    Thomas, Susie K; Humphreys, Karen J; Miller, Michelle D; Cameron, Ian D; Whitehead, Craig; Kurrle, Susan; Mackintosh, Shylie; Crotty, Maria

    2008-02-26

    Proximal femoral fractures are amongst the most devastating consequences of osteoporosis and injurious accidental falls with 25-35% of patients dying in the first year post-fracture. Effective rehabilitation strategies are evolving however, despite established associations between nutrition, mobility, strength and strength-related functional outcomes; there has been only one small study with older adults immediately following fragility fracture where a combination of both exercise and nutrition have been provided. The aim of the INTERACTIVE trial is to establish whether a six month, individualised exercise and nutrition program commencing within fourteen days of surgery for proximal femur fracture, results in clinically and statistically significant improvements in physical function, body composition and quality of life at an acceptable level of cost and resource use and without increasing the burden of caregivers. This randomised controlled trial will be performed across two sites, a 500 bed acute hospital in Adelaide, South Australia and a 250 bed acute hospital in Sydney, New South Wales. Four hundred and sixty community-dwelling older adults aged > 70 will be recruited after suffering a proximal femoral fracture and followed into the community over a 12-month period. Participants allocated to the intervention group will receive a six month individualised care plan combining resistance training and nutrition therapy commencing within 14 days post-surgery. Outcomes will be assessed by an individual masked to treatment allocation at six and 12 months. To determine differences between the groups at the primary end-point (six months), ANCOVA or logistic regression will be used with models adjusted according to potential confounders. The INTERACTIVE trial is among the first to combine nutrition and exercise therapy as an early intervention to address the serious consequence of rapid deconditioning and weight loss and subsequent ability to regain pre-morbid function

  20. Individual nutrition therapy and exercise regime: A controlled trial of injured, vulnerable elderly (INTERACTIVE trial

    Directory of Open Access Journals (Sweden)

    Whitehead Craig

    2008-02-01

    Full Text Available Abstract Background Proximal femoral fractures are amongst the most devastating consequences of osteoporosis and injurious accidental falls with 25–35% of patients dying in the first year post-fracture. Effective rehabilitation strategies are evolving however, despite established associations between nutrition, mobility, strength and strength-related functional outcomes; there has been only one small study with older adults immediately following fragility fracture where a combination of both exercise and nutrition have been provided. The aim of the INTERACTIVE trial is to establish whether a six month, individualised exercise and nutrition program commencing within fourteen days of surgery for proximal femur fracture, results in clinically and statistically significant improvements in physical function, body composition and quality of life at an acceptable level of cost and resource use and without increasing the burden of caregivers. Methods and Design This randomised controlled trial will be performed across two sites, a 500 bed acute hospital in Adelaide, South Australia and a 250 bed acute hospital in Sydney, New South Wales. Four hundred and sixty community-dwelling older adults aged > 70 will be recruited after suffering a proximal femoral fracture and followed into the community over a 12-month period. Participants allocated to the intervention group will receive a six month individualised care plan combining resistance training and nutrition therapy commencing within 14 days post-surgery. Outcomes will be assessed by an individual masked to treatment allocation at six and 12 months. To determine differences between the groups at the primary end-point (six months, ANCOVA or logistic regression will be used with models adjusted according to potential confounders. Discussion The INTERACTIVE trial is among the first to combine nutrition and exercise therapy as an early intervention to address the serious consequence of rapid deconditioning

  1. Exercise, manual therapy, and use of booster sessions in physical therapy for knee osteoarthritis: a multi-center, factorial randomized clinical trial.

    Science.gov (United States)

    Fitzgerald, G K; Fritz, J M; Childs, J D; Brennan, G P; Talisa, V; Gil, A B; Neilson, B D; Abbott, J H

    2016-08-01

    (1) Do treatment effects differ between participants receiving manual therapy (MT) with exercise compared to subjects who don't, (2) are treatment effects sustained better when participants receive booster sessions compared to those who don't over a one year period in subjects with knee osteoarthritis (KOA)? Multi-center, 2 × 2 factorial randomized clinical trial. 300 participants with knee OA were randomized to four groups: exercise-no boosters (Ex), exercise-with boosters (Ex+B), manual therapy+exercise-no boosters (MT+Ex), manual therapy+exercise-with boosters (MT+Ex+B). The primary outcome was the Western Ontario and McMaster osteoarthritis index (WOMAC) at 1 year. Secondary outcomes included knee pain, physical performance tests, and proportions of participants meeting treatment responder criteria. There were no differences between groups on the WOMAC at 1 year or on any performance-based measures. Secondary analyses indicated a) better scores on the WOMAC and greater odds of being a treatment responder at 9 weeks for participants receiving MT, b) greater odds of being a treatment responder at 1 year for participants receiving boosters. Exploratory interaction analysis suggested knee pain decreases for participants receiving boosters and increases for participants not receiving boosters from 9 weeks to 1 year. MT or use of boosters with exercise did not result in additive improvement in the primary outcome at 1 year. Secondary outcomes suggest MT may have some short term benefit, and booster sessions may improve responder status and knee pain at 1 year. However, the role of booster sessions remains unclear in sustaining treatment effects and warrants further study. gov (NCT01314183). Copyright © 2016 Osteoarthritis Research Society International. All rights reserved.

  2. Extracorporeal shockwave therapy and therapeutic exercise for supraspinatus and biceps tendinopathies in 29 dogs.

    Science.gov (United States)

    Leeman, J J; Shaw, K K; Mison, M B; Perry, J A; Carr, A; Shultz, R

    2016-10-15

    Supraspinatus tendinopathy (ST) and biceps tendinopathy (BT) are common causes of forelimb lameness in large-breed dogs and have historically been treated with conservative management or surgery. Extracorporeal shockwave therapy (ESWT) and therapeutic exercise (TE) are thought to be treatment options for these conditions. The objectives of this study were to report the clinical presentations of dogs treated with ESWT for shoulder tendinopathies, to determine the association between shoulder lesion severity identified on ultrasonography or MRI and outcome, and to compare the outcomes of dogs treated with ESWT with and without TE. Medical records of 29 dogs diagnosed with shoulder tendinopathies and treated with ESWT were reviewed, and 24 dogs were diagnosed with either unilateral BT or BT and ST. None were found to have unilateral ST. Five dogs were diagnosed with bilateral disease. Eighty-five per cent of dogs had good or excellent outcomes determined by owner assessment 11-220 weeks after therapy. Outcomes were found to be better as tendon lesion severity increased (P=0.0497), regardless if ESWT was performed with or without TE (P=0.92). ESWT should be considered a safe primary therapeutic option for canine shoulder tendinopathies. Larger controlled prospective studies are needed to adequately assess these findings. British Veterinary Association.

  3. Diabetic foot and exercise therapy: step by step the role of rigid posture and biomechanics treatment.

    Science.gov (United States)

    Francia, Piergiorgio; Gulisano, Massimo; Anichini, Roberto; Seghieri, Giuseppe

    2014-03-01

    Lower extremity ulcers represent a serious and costly complication of diabetes mellitus. Many factors contribute to the development of diabetic foot. Peripheral neuropathy and peripheral vascular disease are the main causes of foot ulceration and contribute in turn to the growth of additional risk factors such as limited joint mobility, muscular alterations and foot deformities. Moreover, a deficit of balance, posture and biomechanics can be present, in particular in patients at high risk for ulceration. The result of this process may be the development of a vicious cycle which leads to abnormal distribution of the foot's plantar pressures in static and dynamic postural conditions. This review shows that some of these risk factors significantly improve after a few weeks of exercise therapy (ET) intervention. Accordingly it has been suggested that ET can be an important weapon in the prevention of foot ulcer. The aim of ET can relate to one or more alterations typically found in diabetic patients, although greater attention should be paid to the evaluation and possible correction of body balance, rigid posture and biomechanics. Some of the most important limitations of ET are difficult access to therapy, patient compliance and the transitoriness of the results if the training stops. Many proposals have been made to overcome such limitations. In particular, it is important that specialized centers offer the opportunity to participate in ET and during the treatment the team should work to change the patient's lifestyle by improving the execution of appropriate daily physical activity.

  4. Voiding dysfunction in children. Pelvic-floor exercises or biofeedback therapy: a randomized study.

    Science.gov (United States)

    Vasconcelos, Mônica; Lima, Eleonora; Caiafa, Letícia; Noronha, Alessandra; Cangussu, Renata; Gomes, Suzely; Freire, Raquel; Filgueiras, Maria Teresa; Araújo, Junia; Magnus, Gisele; Cunha, Cláudia; Colozimo, Enrico

    2006-12-01

    Fifty-six patients 5.9-15.2 years old with dysfunctional elimination syndrome (DES) unimproved by previous therapies were randomly distributed into two voiding training programs: group 1 contained 26 patients submitted to 24 training sessions over a 3-month period; group 2 contained 30 patients submitted to 16 sessions over a 2-month period. Both groups adhered to a voiding and drinking schedule, received instruction on adequate toilet posture, were reinforced through the maintenance of voiding diaries, and went through proprioceptive and pelvic floor muscle training (Kegel exercises). Group 2 patients also received biofeedback therapy. Clinical evaluation was carried out before each program's initiation and 1, 6, and 12 months after each program's termination. All patients were submitted to renal ultrasonography and dynamic ultrasonography before and 6 months after each program's conclusion. Millivoltage recordings of pelvic floor muscles were compared before and after training. Urinary continence was improved after completion of either training program. Only those patients who received biofeedback training showed a significant decrease in postvoiding residual (PVR) urine as detected by dynamic ultrasonography. Our results show that either training regime can reduce episodic urinary incontinence and urinary tract infection but that further study is required to identify the optimal training duration.

  5. The influence of dosing on effect size of exercise therapy for musculoskeletal foot and ankle disorders: a systematic review.

    Science.gov (United States)

    Young, Jodi L; Rhon, Daniel I; de Zoete, Rutger M J; Cleland, Joshua A; Snodgrass, Suzanne J

    2017-11-04

    The purpose of this review was to identify doses of exercise therapy associated with greater treatment effect sizes in individuals with common musculoskeletal disorders of the foot and ankle, namely, achilles tendinopathy, ankle sprains and plantar heel pain. AMED, EMBASE and MEDLINE were searched from 2005 to August 2017 for randomized controlled trials related to exercise for these three diagnoses. The Physiotherapy Evidence Database scale was used for methodological quality assessment. Exercise dosing variables and outcome measures related to pain and function were extracted from the studies, and standardized mean differences were calculated for the exercise groups. Fourteen studies met the final inclusion. A majority of the studies showed large effects and two small trends were identified. Patients with plantar heel pain may benefit more from a daily home exercise program than two supervised visits per week (SMD=3.82), but this recommendation is based on weak evidence. In achilles tendinopathy, a relationship was also seen when sets and repetitions of eccentric exercise were performed as tolerated (SMD=1.08 for function, -1.29 for pain). Session duration, frequency, total number of visits, and overall length of care may all be dosing variables with limited value for determining effective exercise prescription. However, the limited number of studies prevents any definitive conclusions. Further investigation is warranted to improve our understanding of the influence exercise dosing has on treatment effect sizes. Future randomized controlled trials comparing specific exercise dose variables should be conducted to clarify the impact of these variables. Copyright © 2017 Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia. All rights reserved.

  6. Effects of exercise and manual therapy on pain associated with hip osteoarthritis: a systematic review and meta-analysis.

    Science.gov (United States)

    Beumer, Lucy; Wong, Jennie; Warden, Stuart J; Kemp, Joanne L; Foster, Paul; Crossley, Kay M

    2016-04-01

    To explore the effects of exercise (water-based or land-based) and/or manual therapies on pain in adults with clinically and/or radiographically diagnosed hip osteoarthritis (OA). A systematic review and meta-analysis was performed, with patient reported pain assessed using a visual analogue scale (VAS) or the Western Ontario and McMaster Universities Arthritis Index (WOMAC) pain subscale. Data were grouped by follow-up time (0-3 months=short term; 4-12 months=medium term and; >12 months=long term), and standardised mean differences (SMD) with 95% CIs were used to establish intervention effect sizes. Study quality was assessed using modified PEDro scores. 19 trials were included. Four studies showed short-term benefits favouring water-based exercise over minimal control using the WOMAC pain subscale (SMD -0.53, 95% CI -0.96 to -0.10). Six studies supported a short-term benefit of land-based exercise compared to minimal control on VAS assessed pain (SMD -0.49, 95% CI -0.70 to -0.29). There were no medium (SMD -0.23, 95% CI -0.48 to 0.03) or long (SMD -0.22, 95% CI -0.51 to 0.06) term benefits of exercise therapy, or benefit of combining exercise therapy with manual therapy (SMD -0.38, 95% CI -0.88 to 0.13) when compared to minimal control. Best available evidence indicates that exercise therapy (whether land-based or water-based) is more effective than minimal control in managing pain associated with hip OA in the short term. Larger high-quality RCTs are needed to establish the effectiveness of exercise and manual therapies in the medium and long term. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  7. A systematic review of the literature on the effectiveness of exercise therapy for groin pain in athletes

    Directory of Open Access Journals (Sweden)

    Machotka Zuzana

    2009-03-01

    Full Text Available Abstract Background Athletes competing in sports that require running, changes in direction, repetitive kicking and physical contact are at a relatively higher risk of experiencing episodes of athletic groin pain. To date, there has been no systematic review that aims to inform clinicians about the best available evidence on features of exercise interventions for groin pain in athletes. The primary aim of this systematic review was to evaluate the available evidence on the effectiveness of exercise therapy for groin pain in athletes. The secondary aim of this review was to identify the key features of exercise interventions used in the management of groin pain in an athletic population. Methods MEDLINE, CINAHL, PubMed, SPORTSDiscus, Embase, AMED, Ovid, PEDro, Cochrane Controlled Trials Register and Google Scholar databases were electronically searched. Data relating to research design, sample population, type of sport and exercise intervention was extracted. The methodological evaluation of included studies was conducted by using a modified quantitative critical appraisal tool. Results The search strategy identified 468 studies, 12 of which were potentially relevant. Ultimately five studies were included in this review. Overall the quality of primary research literature was moderate, with only one randomised controlled trial identified. All included studies provided evidence that an exercise intervention may lead to favourable outcomes in terms of return to sport. Four of the five studies reviewed included a strengthening component and most utilised functional, standing positions similar to those required by their sport. No study appropriately reported the intensity of their exercise interventions. Duration of intervention ranged from 3.8 weeks to 16 weeks. All five studies reported the use of one or more co-intervention. Conclusion Best available evidence to date, with its limitations, continues to support common clinical practice of exercise

  8. Randomized, blinded, controlled trial on effectiveness of photobiomodulation therapy and exercise training in the fibromyalgia treatment.

    Science.gov (United States)

    da Silva, Mariana Moreira; Albertini, Regiane; de Tarso Camillo de Carvalho, Paulo; Leal-Junior, Ernesto Cesar Pinto; Bussadori, Sandra Kalil; Vieira, Stella Sousa; Bocalini, Danilo Sales; de Oliveira, Luis Vicente Franco; Grandinetti, Vanessa; Silva, José Antonio; Serra, Andrey Jorge

    2018-02-01

    This study evaluated the role of the phototherapy and exercise training (EXT) as well as the combined treatment in general symptoms, pain, and quality of life in women suffering from fibromyalgia (FM). A total of 160 women were enrolled and measures were carried out in two sets: it was sought to identify the acute effect for a single phototherapy and EXT session (Set 1); long-term effect (10 weeks) of the interventions (Set 2). Phototherapy irradiation was performed at 11 locations in their bodies, employing a cluster with nine diodes (one super-pulsed infrared 905 nm, four light-emitting diodes [LEDs] of 640 nm, and four LEDs of 875 nm, 39.3 J per location). Algometry and VAS instrument were applied to evaluate pain. The FM symptoms were evaluated with Fibromyalgia Impact Questionnaire (FIQ) and Research Diagnostic Criteria (RDC) instruments. Quality of life was assessed through SF-36 survey. Set 1: pain threshold was improved with the phototherapy, and EXT improved the pain threshold for temporomandibular joint (right and left body side) and occipital site (right body side). Set 2: there was improved pain threshold in several tender points with the phototherapy and EXT. There was an overlap of therapies to reduce the tender point numbers, anxiety, depression, fatigue, sleep, and difficulty sleeping on FIQ/RDC scores. Moreover, quality of life was improved with both therapies. The phototherapy and EXT improved the pain threshold in FM women. A more substantial effect was noticed for the combined therapy, in which pain relief was accomplished by improving VAS and FIQ scores as well as quality of life.

  9. Qigong versus exercise therapy for chronic low back pain in adults--a randomized controlled non-inferiority trial.

    Science.gov (United States)

    Blödt, S; Pach, D; Kaster, T; Lüdtke, R; Icke, K; Reisshauer, A; Witt, C M

    2015-01-01

    The value of qigong in the treatment of chronic low back pain is unclear. In a randomized controlled trial, we evaluated whether qigong is non-inferior to exercise therapy in patients with chronic low back pain. German outpatients (aged 46.7 ± 10.4) with chronic low back pain [mean visual analogue scale (VAS), 53.9 ± 12.5 mm] were enrolled and randomly allocated in a 1:1 ratio to receive either qigong (64 patients, 12 sessions with 1 × 90 min/week over 3 months) or exercise therapy (63 patients, 12 sessions 1 × 60 min/week). The primary outcome measure was the average pain intensity over the last 7 days on a VAS (0-100 mm, 0 = no pain, 100 = worst imaginable pain, non-inferiority margin = 5 mm) after 3 months. Follow-up was measured after 6 and 12 months. The mean adjusted low back pain intensity after 3 months was 34.8 mm [95% confidence interval (CI) 29.5; 40.2] in the qigong group and 33.1 mm (95% CI 27.7; 38.4) in the exercise group. Non-inferiority of the qigong group compared with the exercise group failed to show statistical significance (p = 0.204). In both groups, 10 patients reported suspected adverse reactions (e.g., muscle soreness, dizziness, pain) the total number was comparable in both groups (qigong n = 40, exercise n = 44). Qigong was not proven to be non-inferior to exercise therapy in the treatment of chronic low back pain. Its role in the prevention of chronic low back pain might be addressed in further studies. © 2014 European Pain Federation - EFIC®

  10. Efficacy of Tailored Exercise Therapy on Physical Functioning in Patients With Knee Osteoarthritis and Comorbidity: A Randomized Controlled Trial.

    Science.gov (United States)

    de Rooij, Mariëtte; van der Leeden, Marike; Cheung, John; van der Esch, Martin; Häkkinen, Arja; Haverkamp, Daniël; Roorda, Leo D; Twisk, Jos; Vollebregt, Joke; Lems, Willem F; Dekker, Joost

    2017-06-01

    To evaluate the efficacy on physical functioning and safety of tailored exercise therapy in patients with knee osteoarthritis (OA) and comorbidities. In a randomized controlled trial, 126 participants were included with a clinical diagnosis of knee OA and at least 1 of the following target comorbidities: coronary disease, heart failure, type 2 diabetes mellitus, chronic obstructive pulmonary disease, or obesity (body mass index ≥30 kg/m(2) ), with severity score ≥2 on the Cumulative Illness Rating Scale. The intervention group received a 20-week, individualized, comorbidity-adapted exercise program consisting of aerobic and strength training and training of daily activities. The control group received their current medical care for knee OA and were placed on a waiting list for exercise therapy. Primary outcome measures were the Western Ontario and McMaster Universities Osteoarthritis Index, subscale physical functioning (WOMAC-pf), and the 6-minute walk test (6MWT). Measurements were performed at baseline, after 20 weeks (directly posttreatment), and at 3 months posttreatment. Statistically significant physical functioning differences over time were found between the intervention and control group (WOMAC: B = -7.43 [95% confidence interval (95% CI) -9.99, -4.87], P exercise therapy is efficacious in improving physical functioning and safe in patients with knee OA and severe comorbidities. © 2016, American College of Rheumatology.

  11. Exercise therapy for functional capacity in chronic diseases: an overview of meta-analyses of randomised controlled trials.

    Science.gov (United States)

    Pasanen, Tero; Tolvanen, Samppa; Heinonen, Ari; Kujala, Urho M

    2017-10-01

    To summarise all meta-analyses of randomised controlled trials that have evaluated the effects of exercise therapy on functional capacity in patients with chronic diseases. Umbrella review of meta-analyses of randomised controlled trials. We systematically searched the CENTRAL, CINAHL, DARE, Medline, OTSeeker, PEDro, SPORTDiscus, ProQuest Nursing & Allied Health Database, Web of Science, Scopus, OpenGrey and BMC Proceedings from database inception to 1 September 2016. We included meta-analyses that compared the effects of exercise therapy with no treatment or usual care in adults with non-communicable chronic diseases and included outcomes related to functional capacity. We excluded meta-analyses with less than 100 patients. Eighty-five meta-analyses with 22 different chronic diseases were included. The exercise interventions resulted in statistically significant (pmeta-analyses. Exercise therapy appears to be a safe way to improve functional capacity and reduce disability in individuals with chronic disease. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  12. Effect of low-impact aerobic exercise combined with music therapy on patients with fibromyalgia. A pilot study.

    Science.gov (United States)

    Espí-López, Gemma V; Inglés, Marta; Ruescas-Nicolau, María-Arántzazu; Moreno-Segura, Noemí

    2016-10-01

    Fibromyalgia is a pathological entity characterized by chronic widespread musculoskeletal pain and the presence of "tender points". It constitutes a significant health problem because of its prevalence and economic impact. The aim of the present study was to determine the therapeutic benefits of low impact aerobic exercise alone or in combination with music therapy in patients with fibromyalgia. A single-blind randomized controlled pilot trial was performed. Thirty-five individuals with fibromyalgia were divided into three groups: (G1) therapeutic aerobic exercise with music therapy (n=13); (G2) therapeutic aerobic exercise at any rhythm (n=13) and (CG) control (n=9). The intervention period lasted eight weeks. Depression, quality of life, general discomfort and balance were assessed before and after intervention. At post-intervention, group G1 improved in all variables (depression (p=0.002), quality of life (p=0.017), general discomfort (p=0.001), and balance (p=0.000)), while group G2 improved in general discomfort (p=0.002). The change observed in balance was statistically different between groups (p=0.01). Therapeutic aerobic exercise is effective in improving depression and general discomfort in individuals with fibromyalgia. However, effectiveness is higher when combined with music therapy, which brings about further improvements in quality of life and balance. Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. The electroconvulsive therapy and anesthesia exercise (ECTAE): the creation of an interdisciplinary learning activity for medical students.

    Science.gov (United States)

    Li, Descartes; Hall, Stephen E; Tong, Lowell D; Rollins, Mark D

    2013-09-01

    Demonstration of the effectiveness for medical student teaching of the electroconvulsive therapy (ECT)-anesthesia exercise (ECTAE). The ECTAE is a self-directed, interdisciplinary (psychiatry and anesthesia) learning exercise. Students are taught the assessment of mood and cognition using structured interviewing methods (psychiatry), basic airway and pharmacologic management (anesthesia), and informed consent and interdisciplinary communication (both). There are online pre-exercise and postexercise assessments. Third-year medical students reviewed educational reference materials, participated in ECT clinical encounters with both psychiatry and anesthesia, and debriefed after completion of the interdisciplinary exercise. The impact of the exercise was evaluated through online pre- and postexercise assessments. Quantitative and qualitative results for 3 student cohorts (2007 through 2010) were analyzed. Thirty-eight students participated the study over 3 years. Mean scores for 21 true-false questions increased from 14.3 to 17.5 (n = 30) with P self-directed exercises, online assessments, and actual clinical experience of ECT. It improves student knowledge of both psychiatry and anesthesia learning objectives, as well as increasing comfort about ECT. Further research could determine if this activity is easily transportable to other academic settings.

  14. Normalization of aberrant resting state functional connectivity in fibromyalgia patients following a three month physical exercise therapy.

    Science.gov (United States)

    Flodin, P; Martinsen, S; Mannerkorpi, K; Löfgren, M; Bileviciute-Ljungar, I; Kosek, E; Fransson, P

    2015-01-01

    Physical exercise is one of the most efficient interventions to mitigate chronic pain symptoms in fibromyalgia (FM). However, little is known about the neurophysiological mechanisms mediating these effects. In this study we investigated resting-state connectivity using functional magnetic resonance imaging (fMRI) before and after a 15 week standardized exercise program supervised by physical therapists. Our aim was to gain an understanding of how physical exercise influences previously shown aberrant patterns of intrinsic brain activity in FM. Fourteen FM patients and eleven healthy controls successfully completed the physical exercise treatment. We investigated post- versus pre-treatment changes of brain connectivity, as well as changes in clinical symptoms in the patient group. FM patients reported improvements in symptom severity. Although several brain regions showed a treatment-related change in connectivity, only the connectivity between the right anterior insula and the left primary sensorimotor area was significantly more affected by the physical exercise among the fibromyalgia patients compared to healthy controls. Our results suggest that previously observed aberrant intrinsic brain connectivity patterns in FM are partly normalized by the physical exercise therapy. However, none of the observed normalizations in intrinsic brain connectivity were significantly correlated with symptom changes. Further studies conducted in larger cohorts are warranted to investigate the precise relationship between improvements in fibromyalgia symptoms and changes in intrinsic brain activity.

  15. Normalization of aberrant resting state functional connectivity in fibromyalgia patients following a three month physical exercise therapy

    Directory of Open Access Journals (Sweden)

    P. Flodin

    2015-01-01

    Full Text Available Physical exercise is one of the most efficient interventions to mitigate chronic pain symptoms in fibromyalgia (FM. However, little is known about the neurophysiological mechanisms mediating these effects. In this study we investigated resting-state connectivity using functional magnetic resonance imaging (fMRI before and after a 15 week standardized exercise program supervised by physical therapists. Our aim was to gain an understanding of how physical exercise influences previously shown aberrant patterns of intrinsic brain activity in FM. Fourteen FM patients and eleven healthy controls successfully completed the physical exercise treatment. We investigated post- versus pre-treatment changes of brain connectivity, as well as changes in clinical symptoms in the patient group. FM patients reported improvements in symptom severity. Although several brain regions showed a treatment-related change in connectivity, only the connectivity between the right anterior insula and the left primary sensorimotor area was significantly more affected by the physical exercise among the fibromyalgia patients compared to healthy controls. Our results suggest that previously observed aberrant intrinsic brain connectivity patterns in FM are partly normalized by the physical exercise therapy. However, none of the observed normalizations in intrinsic brain connectivity were significantly correlated with symptom changes. Further studies conducted in larger cohorts are warranted to investigate the precise relationship between improvements in fibromyalgia symptoms and changes in intrinsic brain activity.

  16. Effects of a physical therapy home-based exercise program for Parkinson's disease

    Directory of Open Access Journals (Sweden)

    Viviane Vieira Santos

    Full Text Available INTRODUCTION: Parkinson's disease (PD is a neurological disorder that causes loss of functional abilities and independence. The aim of this study was to evaluate the effects of a physical therapist-supervised home-based exercise program in patients with PD using the UPDRS scale. MATERIALS AND METHODS: Thirty-three PD patients in the 1.5 to 3 Hoehn and Yahr stages participated in the trial. The patients and their relatives received a booklet with a 12-week home program, with a series of strengthening, stretching and flexibility exercises. The patients were trained by a physical therapist, and each session took 60 minutes, three times a week. RESULTS: We classified our patients in four groups: Group 1 - patients under 60 years of age and less than five years of PD; Group 2 - patients under 60 years of age and more than five years of PD; Group 3 - patients over 60 years of age and less than five years of the disease; and Group 4 - patients over 60 years of age and more than five years of PD. Significant improvement was found in group 1 in mentation, activities of daily living and motor function (p > 0.05. Group 3 presented statistically significant differences in motor function subscale (p > 0.05 and Group 4 showed no worsening in mentation subscale (p > 0.05. Group 2, however, presented no difference in all subscales (p < 0.05. CONCLUSION: Although not all patients improved their UPDRS scores, our data support the use of a home program as an alternative method of physical therapy treatment for PD patients.

  17. Tailored cognitive-behavioral therapy and exercise training for high-risk patients with fibromyalgia.

    Science.gov (United States)

    van Koulil, Saskia; van Lankveld, Wim; Kraaimaat, Floris W; van Helmond, Toon; Vedder, Annemieke; van Hoorn, Hanneke; Donders, Rogier; de Jong, Alphons J L; Haverman, Joost F; Korff, Kurt-Jan; van Riel, Piet L C M; Cats, Hans A; Evers, Andrea W M

    2010-10-01

    The treatment of patients with fibromyalgia (FM), a high-prevalence chronic pain condition with a high impact on both patients and society, poses a great challenge to clinicians due to a lack of effective treatments. In view of the large individual variability in outcome, selecting patients at risk of long-term dysfunction and offering tailored treatment may be promising for beneficial treatment effects. High-risk patients were selected and classified into 2 groups (pain-persistence and pain-avoidance groups) and subsequently randomized in groups to either a treatment condition (TC) or a waiting list control condition (WLC). Treatment consisted of 16 sessions of cognitive-behavioral therapy (CBT) and exercise training in groups, tailored to the patient's specific cognitive-behavioral pattern, delivered within 10 weeks. Physical and psychological functioning and impact of FM were assessed at baseline, posttreatment, and 6-month followup. Treatment effects were evaluated using a linear mixed model. The treatment effects were significant for all primary outcomes, showing significant differences in physical (pain, fatigue, and functional disability) and psychological (negative mood and anxiety) functioning, and impact of FM for the TC in comparison with the WLC. Effect sizes in the TC were overall large, and reliable change indices indicated a clinically relevant improvement among the TC. The presented results demonstrate for the first time that tailored CBT and exercise training for high-risk patients with FM is effective in improving short- and long-term physical and psychological functioning, indicating that tailoring treatment is likely to promote beneficial outcomes in FM and reduce the burden for patients and society.

  18. Comparison between effectiveness of Mechanical and Manual Traction combined with mobilization and exercise therapy in Patients with Cervical Radiculopathy.

    Science.gov (United States)

    Bukhari, Syed Rehan Iftikhar; Shakil-Ur-Rehman, Syed; Ahmad, Shakeel; Naeem, Aamer

    2016-01-01

    Cervical radiculopathy is a common neuro-musculo-skeletal disorder causing pain and disability. Traction is part of the evidence based manual physical therapy management due to its mechanical nature, type of traction and parameters related to its applicability and are still to be explored more through research. Our objective was to determine the Effects of Mechanical versus Manual Traction in Manual Physical Therapy combined with segmental mobilization and exercise therapy in the physical therapy management of Patients with Cervical Radiculopathy. This randomized control trial was conducted at department of physical therapy and rehabilitation, Rathore Hospital Faisalabad, from February to July 2015. Inclusion criteria were both male and female patients with evident symptoms of cervical spine radiculopathy and age ranged between 20-70 years. The exclusion criteria were Patients with history of trauma, neck pain without radiculopathy, aged less than 20 and more than 70. A total of 72 patients with cervical radiculopathy were screened out as per the inclusion criteria, 42 patients were randomly selected and placed into two groups by toss and trial method, and only 36 patients completed the study, while 6 dropped out. The mechanical traction was applied in group A and manual traction in group B along with common intervention of segmental mobilization and exercise therapy in both groups for 6 weeks. The patient's outcomes were assessed by self reported NPRS and NDI at the baseline and after completion of 06 weeks exercise program at 3 days per week. The data was analyzed through SPSS version-21, and paired T test was applied at 95% level significance to determine the statistical deference between two groups. Clinically the group of patients treated with mechanical traction managed pain (mean pre 6.26, mean post 1.43), and disability (mean pre 24.43 and mean post 7.26) more effectively as compared with the group of patients treated with manual traction (Pain mean pre 6

  19. Effect of combining music media therapy with lower extremity exercise on elderly patients with diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Li Ji

    2015-09-01

    Conclusion: Music media treatment combined with lower extremity exercise can both significantly increase the extent of exercise compliance of elderly patients suffering from diabetes mellitus, as well as improve blood circulation in their feet.

  20. EFFECT OF ADDING AN EXERCISE REGIMEN TO DIET THERAPY IN DECREASING BODY FAT PERCENTAGE AND BODY MASS INDEX AMONG OBESE FEMALES

    Directory of Open Access Journals (Sweden)

    Rajeena Haneefa

    2017-10-01

    Full Text Available BACKGROUND Obesity is one among the leading health problems in many developing countries including India. Lifestyle modifications, which include diet therapy and regular exercises are considered as the mainstay in the management of this health issue. Brisk walking is the preferred socially and economically acceptable mode of exercise. This randomised controlled trial tries to evaluate the efficacy of adding an exercise regimen to diet therapy in reducing body fat percentage and Body Mass Index (BMI among obese females. MATERIALS AND METHODS One hundred female patients aged between 20 and 60 years with BMI greater than 25 were recruited for this study of 6 months duration. Participants were randomised into either diet therapy alone group or diet therapy with exercise group. All participants were prescribed a low-calorie diet of 1500 kcal per day. The exercise intervention group was subjected to a home-based exercise regimen; walking for 30 minutes 5 days a week. Outcomes were measured by BMI and body fat percentage, documented every month. RESULTS Both groups showed significant reduction in body fat percentage and BMI, but the reduction was more in the exercise with diet therapy group (p value <0.001. CONCLUSION Adding a simple exercise like walking to other lifestyle modification measures can more efficiently bring down BMI and body fat percentage in turn significantly reducing the cardiovascular risk, morbidity and mortality in women.

  1. Functional and physiological outcomes from an exercise-based dysphagia therapy: a pilot investigation of the McNeill Dysphagia Therapy Program.

    Science.gov (United States)

    Crary, Michael A; Carnaby, Giselle D; LaGorio, Lisa A; Carvajal, Pamela J

    2012-07-01

    To investigate functional and physiological changes in swallowing performance of adults with chronic dysphagia after an exercise-based dysphagia therapy. Intervention study: before-after trial with 3-month follow-up evaluation. Outpatient clinic within a tertiary care academic health science center. Adults (N=9) with chronic (>12 mo) dysphagia after unsuccessful prior therapies. Subjects were identified from among patients referred to an outpatient dysphagia clinic. Subjects had dysphagia secondary to prior treatment for head/neck cancer or from neurologic injury. All subjects demonstrated clinical and fluoroscopic evidence of oropharyngeal dysphagia. No subject withdrew during the course of this study. All subjects completed 3 weeks of an intensive, exercise-based dysphagia therapy. Therapy was conducted daily for 1h/d, with additional activities completed by subjects each night between therapy sessions. Primary outcomes were clinical and functional change in swallowing performance with maintenance at 3 months after intervention. Secondary, exploratory outcomes included physiological change in swallow performance measured by hyolaryngeal elevation, lingual-palatal and pharyngeal manometric pressure, and surface electromyographic amplitude. Clinical and functional swallowing performances improved significantly and were maintained at the 3-month follow-up examination. Subject perspective (visual analog scale) on functional swallowing also improved. Four of 7 subjects who were initially feeding tube dependent progressed to total oral intake after 3 weeks of intervention. Physiological indices demonstrated increased swallowing effort after intervention. Significant clinical and functional improvement in swallowing performance followed a time-limited (3 wk) exercise-based intervention in a sample of subjects with chronic dysphagia. Physiological changes after therapy implicate improved neuromuscular functioning within the swallow mechanism. Copyright © 2012 American

  2. Exercise-induced left bundle branch block and subsequent mechanical left ventricular dyssynchrony -resolved with pharmacological therapy

    Science.gov (United States)

    2011-01-01

    A 53-year-old man with depressed ejection fraction (EF) of 35% and QRS width of 88 ms at rest was admitted to our institution with a complaint of exertional chest discomfort and dyspnea. During treadmill exercise, left bundle-branch block (LBBB) with a QRS width of 152 ms occurred at a heart rate of 100 bpm. During LBBB, the patient showed significant mechanical dyssynchrony as evidenced by a two-dimensional speckle tracking radial strain of 260 ms (≥130 ms), defined as the time difference between anterior-septum and posterior wall. Five-month after carvedilol and candesartan administration, EF had improved to 49% and LBBB did not occur until a heart rate of 126 bpm was attained during treadmill exercise. It appears that pharmacological therapy may be useful for patients with heart failure and exercise-induced LBBB. PMID:21294925

  3. Exercise-induced left bundle branch block and subsequent mechanical left ventricular dyssynchrony -resolved with pharmacological therapy

    Directory of Open Access Journals (Sweden)

    Tatsumi Kazuhiro

    2011-02-01

    Full Text Available Abstract A 53-year-old man with depressed ejection fraction (EF of 35% and QRS width of 88 ms at rest was admitted to our institution with a complaint of exertional chest discomfort and dyspnea. During treadmill exercise, left bundle-branch block (LBBB with a QRS width of 152 ms occurred at a heart rate of 100 bpm. During LBBB, the patient showed significant mechanical dyssynchrony as evidenced by a two-dimensional speckle tracking radial strain of 260 ms (≥130 ms, defined as the time difference between anterior-septum and posterior wall. Five-month after carvedilol and candesartan administration, EF had improved to 49% and LBBB did not occur until a heart rate of 126 bpm was attained during treadmill exercise. It appears that pharmacological therapy may be useful for patients with heart failure and exercise-induced LBBB.

  4. Role of low-level laser therapy added to facial expression exercises in patients with idiopathic facial (Bell's) palsy.

    Science.gov (United States)

    Ordahan, Banu; Karahan, Ali Yavuz

    2017-05-01

    The aim of the present study was to investigate the efficacy of low-level laser therapy in conjunction with conventional facial exercise treatment on functional outcomes during the early recovery period in patients with facial paralysis. Forty-six patients (mean age 41 ± 9.7 years; 40 women and 6 men) were randomized into two groups. Patients in the first group received low-level laser treatment as well as facial exercise treatment, while patients in the second group participated in facial exercise intervention alone. Laser treatment was administered at a wavelength of 830 nm, output power of 100 Mw, and frequency of 1 KHz using a gallium-aluminum-arsenide (GaAIAs, infrared laser) diode laser. A mean energy density of 10 J/cm 2 was administered to eight points of the affected side of the face three times per week, for a total of 6 weeks. The rate of facial improvement was evaluated using the facial disability index (FDI) before, 3 weeks after, and 6 weeks after treatment. Friedman analysis of variance was performed to compare the data from the parameters repeatedly measured in the inner-group analysis. Bonferroni correction was performed to compare between groups as a post hoc test if the variance analysis test result was significant. To detect the group differences, the Bonferroni Student t test was used. The Mann-Whitney U test was used to compare numeric data between the groups. In the exercise group, although no significant difference in FDI scores was noted between the start of treatment and week 3 (p laser group, significant improvement in FDI scores relative to baseline was observed at 3 and 6 weeks (p laser group than those in the exercise group (p laser therapy (LLLT) and exercise therapy is associated with significant improvements in FDI when compared with exercise therapy alone.

  5. A randomized controlled trial of exercise therapy for dizziness and vertigo in primary care.

    Science.gov (United States)

    Yardley, L; Beech, S; Zander, L; Evans, T; Weinman, J

    1998-04-01

    'Vestibular rehabilitation' (VR) is an increasingly popular treatment option for patients with persistent dizziness. Previous clinical trials have only evaluated the effects of specialist therapy programmes in small, selective, or uncontrolled patient samples. To determine the benefits of VR compared with standard medical care, using a brief intervention for dizzy patients in primary care. Adults consulting their general practitioner (GP) with dizziness or vertigo were randomly assigned to treatment or control groups. Patients in both groups received the same evaluation at baseline, six-week follow-up, and six-month follow-up, comprising examination of nystagmus, postural control, and movement-provoked dizziness, and a questionnaire assessment of subjective status, symptoms, handicap, anxiety, and depression. At baseline and six weeks later, the treatment group also received an individualized 30-minute therapy session, in which they were taught head, eye, and body exercises designed to promote vestibular compensation and enhance skill and confidence in balance. The treatment group (n = 67) improved on all measures, whereas the control group (n = 76) showed no improvement, resulting in a significant difference between the two groups on physical indices of balance and subjective indices of symptoms and distress. Odds ratios for improvement in treated patients relative to untreated patients were 3.1:1 at six weeks (95% CI = 1.4-6.8) and 3.8:1 at six months (95% CI = 1.6-8.7). VR is a simple, inexpensive, and beneficial treatment, and may be an appropriate first stage of management for many dizzy patients in primary care.

  6. A phase III clinical trial of exercise modalities on treatment side-effects in men receiving therapy for prostate cancer

    Directory of Open Access Journals (Sweden)

    Wall Bradley

    2009-06-01

    Full Text Available Abstract Background Androgen deprivation therapy (ADT is accompanied by a number of adverse side effects including reduced bone mass and increased risk for fracture, reduced lean mass and muscle strength, mood disturbance and increased fat mass compromising physical functioning, independence, and quality of life. The purpose of this investigation is to examine the effects of long term exercise on reversing musculoskeletal-related side effects, and cardiovascular and diabetes risk factors in men receiving androgen deprivation for their prostate cancer. Specifically, we aim to investigate the effects of a 12-month exercise program designed to load the musculoskeletal system and reduce cardiovascular and diabetes disease progression on the following primary endpoints: 1 bone mineral density; 2 cardiorespiratory function and maximal oxygen capacity; 3 body composition (lean mass and fat mass; 4 blood pressure and cardiovascular function; 5 lipids and glycemic control; and 6 quality of life and psychological distress. Methods/Design Multi-site randomized controlled trial of 195 men (65 subjects per arm undergoing treatment for prostate cancer involving ADT in the cities of Perth and Brisbane in Australia. Participants will be randomized to (1 resistance/impact loading exercise, (2 resistance/cardiovascular exercise groups and (3 usual care/delayed exercise. Participants will then undergo progressive training for 12 months. Measurements for primary and secondary endpoints will take place at baseline, 6 and 12 months (end of the intervention. Discussion The principal outcome of this project will be the determination of the strength of effect of exercise on the well established musculoskeletal, cardiovascular and insulin metabolism side effects of androgen deprivation in prostate cancer patients. As this project is much longer term than previous investigations in the area of exercise and cancer, we will gain knowledge as to the continuing effects of

  7. A crossover study of short burst oxygen therapy (SBOT for the relief of exercise-induced breathlessness in severe COPD

    Directory of Open Access Journals (Sweden)

    Pulakal Siddiq

    2011-05-01

    Full Text Available Abstract Background Previous small studies suggested SBOT may be ineffective in relieving breathlessness after exercise in COPD. Methods 34 COPD patients with FEV1 Results Average oxygen saturation fell from 95.0% to 91.3% after exercise. The mean time to subjective recovery was 3.3 minutes with no difference between treatments. The mean Borg breathlessness score was 1.5/10 at rest, rising to 5.1/10 at the end of exercise (No breathlessness = 0, worst possible breathlessness = 10. Oxygen therapy had no discernable effect on Borg scores even for 14 patients who desaturated below 90%. 15 patients had no preferred treatment, 7 preferred oxygen, 6 preferred the fan, 3 preferred air via a mask and 3 preferred room air. Conclusions This study provides no support for the idea that COPD patients who are not hypoxaemic at rest derive noticeable benefit from oxygen therapy after exercise. Use of air from a mask or from a fan had no apparent physiological or placebo effect.

  8. A 12-week supervised exercise therapy program for young adults with a meniscal tear: Program development and feasibility study

    DEFF Research Database (Denmark)

    Skou, Søren T.; Thorlund, Jonas B.

    2018-01-01

    interview. Feedback from patients was included to finalize the exercise therapy program. Median improvements (Range) in KOOS subscales were 15 (0–33) for Pain, 11 (−11 to 50) for Symptoms, 16 (3–37) for Function in daily living, 23 (10–45) for Function in sport and recreation, and 9 (−6 to 31) for Quality...... on clinical expertise and available evidence. Six patients (age range 22–39 years) considered eligible for meniscal surgery by an orthopedic surgeon underwent the program. Patients completed the Knee Injury and Osteoarthritis Outcome Score (KOOS) and evaluated the program during a semi-structured qualitative...... of life. The patients found the program relevant and effective with only a few short-lasting adverse events and important clinical improvements after four to ten weeks. Physical therapist supervision was considered important. No patients wanted surgery up to 6 month after the exercise therapy program...

  9. Evaluation of the benefit of corticosteroid injection before exercise therapy in patients with osteoarthritis of the knee

    DEFF Research Database (Denmark)

    Henriksen, Marius; Christensen, Robin; Klokker, Louise

    2015-01-01

    IMPORTANCE: Osteoarthritis (OA) of the knee is the most frequent form of arthritis and a cause of pain and disability. Combined nonpharmacologic and pharmacologic treatments are recommended as the optimal treatment approach, but no evidence supports the recommendation. OBJECTIVE: To assess...... the clinical benefits of an intra-articular corticosteroid injection given before exercise therapy in patients with OA of the knee. DESIGN, SETTING, AND PARTICIPANTS: We performed a randomized, blinded, placebo-controlled clinical trial evaluating the benefit of intra-articular corticosteroid injection vs...... placebo injection given before exercise therapy at an OA outpatient clinic from October 1, 2012, through April 2, 2014. The participants had radiographic confirmation of clinical OA of the knee, clinical signs of localized inflammation in the knee, and knee pain during walking (score >4 on a scale of 0...

  10. Study protocol to investigate the effects of testosterone therapy as an adjunct to exercise rehabilitation in hypogonadal males with chronic heart failure

    Directory of Open Access Journals (Sweden)

    Mathur Atish

    2006-11-01

    Full Text Available Abstract Background Testosterone deficiency is a common occurrence in men with chronic heart failure (CHF and may underpin features of advanced disease, including reduced skeletal muscle mass and fatigue. It is positively correlated with cardiac output and exercise capacity in patients with CHF, whereas a significant improvement in both these parameters has been observed following testosterone replacement therapy. Testosterone therapy has also been shown to reduce circulating levels of inflammatory markers, (TNF-α, sICAM-1 and sVCAM-1 in patients with established coronary artery disease and testosterone deficiency. This pilot study will assess the feasibility of a combined exercise rehabilitation and adjunctive testosterone therapy intervention for evoking improvements in exercise capacity, circulating inflammatory markers, cardiac and skeletal muscle function, indices of psychological health status and quality of life in hypogonadal males with chronic heart failure. Methods/design Following ethical approval, 36 patients will be randomly allocated to one of two groups: testosterone or placebo therapy during exercise rehabilitation. A combined programme of moderate intensity aerobic exercise and resistance (strength training will be used. The primary outcome measure is exercise capacity, assessed using an incremental shuttle walk test. Secondary outcome measures include measures of peak oxygen uptake, cardiac function, lower-limb skeletal muscle contractile function and oxygenation during exercise, circulating inflammatory markers, psychological health status and quality of life. Discussion Exercise rehabilitation can safely increase exercise capacity in stable CHF patients but there is a need for studies which are aimed at evaluating the long-term effects of physical training on functional status, morbidity and mortality. This pilot study will provide valuable preliminary data on the efficacy of testosterone therapy as an adjunct to exercise

  11. Insulin therapy and dietary adjustments to normalize glycemia and prevent nocturnal hypoglycemia after evening exercise in type 1 diabetes: a randomized controlled trial

    OpenAIRE

    Campbell, MD; Walker, M; Bracken, RM; Turner, D; Stevenson, EJ; Gonzalez, JT; Shaw, JA; West, DJ

    2015-01-01

    INTRODUCTION: Evening-time exercise is a frequent cause of severe hypoglycemia in type 1 diabetes, fear of which deters participation in regular exercise. Recommendations for normalizing glycemia around exercise consist of prandial adjustments to bolus insulin therapy and food composition, but this carries only short-lasting protection from hypoglycemia. Therefore, this study aimed to examine the impact of a combined basal-bolus insulin dose reduction and carbohydrate feeding strategy on glyc...

  12. Insulin therapy and dietary adjustments to normalize glycaemia and prevent nocturnal hypoglycaemia after evening exercise in type 1 diabetes: a randomized controlled trial

    OpenAIRE

    Campbell, MD; Walker, M; Trenell, MI; Stevenson, EJ; Turner, D; Bracken, RM; Shaw, JA; West, DJ

    2015-01-01

    Introduction Evening-time exercise is a frequent cause of severe hypoglycemia in type 1 diabetes, fear of which deters participation in regular exercise. Recommendations for normalizing glycemia around exercise consist of prandial adjustments to bolus insulin therapy and food composition, but this carries only short-lasting protection from hypoglycemia. Therefore, this study aimed to examine the impact of a combined basal-bolus insulin dose reduction and carbohydrate feeding strategy on glyce...

  13. A Progressive 5-Week Exercise Therapy Program Leads to Significant Improvement in Knee Function Early After Anterior Cruciate Ligament Injury

    Science.gov (United States)

    EITZEN, INGRID; MOKSNES, HÅVARD; SNYDER-MACKLER, LYNN; RISBERG, MAY ARNA

    2011-01-01

    STUDY DESIGN Prospective cohort study without a control group. OBJECTIVES Firstly, to present our 5-week progressive exercise therapy program in the early stage after anterior cruciate ligament (ACL) injury. Secondly, to evaluate changes in knee function after completion of the program for patients with ACL injury in general and also when classified as potential copers or noncopers, and, finally, to examine potential adverse events. BACKGROUND Few studies concerning early-stage ACL rehabilitation protocols exist. Consequently, little is known about the tolerance for, and outcomes from, short-term exercise therapy programs in the early stage after injury. METHODS One-hundred patients were included in a 5-week progressive exercise therapy program, within 3 months after injury. Knee function before and after completion of the program was evaluated from isokinetic quadriceps and hamstrings muscle strength tests, 4 single-leg hop tests, 2 different self-assessment questionnaires, and a global rating of knee function. A 2-way mixed-model analysis of variance was conducted to evaluate changes from pretest to posttest for the limb symmetry index for muscle strength and single-leg hop tests, and the change in scores for the patient-reported questionnaires. In addition, absolute values and the standardized response mean for muscle strength and single-leg hop tests were calculated at pretest and posttest for the injured and uninjured limb. Adverse events during the 5-week period were recorded. RESULTS The progressive 5-week exercise therapy program led to significant improvements (Ptherapy programs are well tolerated and should be incorporated in early-stage ACL rehabilitation, either to improve knee function before ACL reconstruction or as a first step in further nonoperative management. PMID:20710097

  14. Trauma-focused cognitive behaviour therapy and exercise for chronic whiplash: protocol of a randomised, controlled trial

    Directory of Open Access Journals (Sweden)

    Letitia Campbell

    2015-10-01

    Discussion: This study will provide a definitive evaluation of the effects of adding trauma-focused cognitive behaviour therapy to physiotherapy exercise for individuals with chronic WAD and PTSD. This study is likely to influence the clinical management of whiplash injury and will have immediate clinical applicability in Australia, Denmark and the wider international community. The study will also have implications for both health and insurance policy makers in their decision-making regarding treatment options and funding.

  15. Does targeting manual therapy and/or exercise improve patient outcomes in nonspecific low back pain? A systematic review

    OpenAIRE

    Kent, Peter; Mjøsund, Hanne L; Petersen, Ditte HD

    2010-01-01

    Abstract Background A central element in the current debate about best practice management of non-specific low back pain (NSLBP) is the efficacy of targeted versus generic (non-targeted) treatment. Many clinicians and researchers believe that tailoring treatment to NSLBP subgroups positively impacts on patient outcomes. Despite this, there are no systematic reviews comparing the efficacy of targeted versus non-targeted manual therapy and/or exercise. This systematic review was undertaken in o...

  16. Comparison of the Effect of Massage Therapy and Isometric Exercises on Primary Dysmenorrhea: A Randomized Controlled Clinical Trial.

    Science.gov (United States)

    Azima, Sara; Bakhshayesh, Hajar Rajaei; Kaviani, Maasumeh; Abbasnia, Keramatallah; Sayadi, Mehrab

    2015-12-01

    Dysmenorrhea is the most common cyclic pelvic pain, and it affects the quality of life of many women. We sought to compare the effects of massage and isometric exercises on primary dysmenorrhea. We conducted a randomized controlled trial at the dormitories of Shiraz University among 102 students with primary dysmenorrheal. The student groups were randomly divided into massage, isometric exercises, and control groups. The first group received 2 consecutive cycles of effleurage massage with lavender oil. The second group had 8 weeks of isometric exercises. No intervention was performed for the control group. Pain intensity was measured and recorded by using a visual analog scale. In addition, the duration of pain was measured in hours, and Spielberger's questionnaire was used to measure the anxiety level. Pain intensity had significantly reduced in the massage and exercises groups; the reduction was more significant in the massage group (P massage group after the third cycle (P = .017). Based on the present findings, it seems that massage therapy and isometric exercises were effective in reducing some symptoms of dysmenorrhea. Copyright © 2015 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  17. Effect of exercise and strength training on cardiovascular status in HIV-infected patients receiving highly active antiretroviral therapy.

    Science.gov (United States)

    Scevola, Daniele; Di Matteo, Angela; Lanzarini, Paolo; Uberti, Filippo; Scevola, Silvia; Bernini, Verginia; Spoladore, Greta; Faga, Angela

    2003-04-01

    A routine evaluation of lipid metabolism and body fat distribution along with a careful cardiovascular risk stratification according to international guidelines are required for HIV-infected patients receiving highly active antiretroviral therapy. Intervention includes evaluation of patients for both epidemiological and clinical factors, and for anthropometric and biochemical parameters. Diet counseling, prescription of antihyperlipidemic drugs and exercise training are the cornerstones of programs devoted to protecting patients from side effects of therapies that compromise quality of life and the functions of organs like the pancreas and heart that are involved in lipid disorders.

  18. Effect of theophylline on exercise capacity in COPD patients treated with combination long-acting bronchodilator therapy: a pilot study

    Science.gov (United States)

    Voduc, Nha; Alvarez, Gonzalo G; Amjadi, Kayvan; Tessier, Caroline; Sabri, Elham; Aaron, Shawn D

    2012-01-01

    Background Many patients with chronic obstructive pulmonary disease continue to experience significant functional limitation despite the use of both long-acting anticholinergic and beta-agonist inhalers. Theophylline is a widely available medication which may further improve lung function and exercise performance. Previous studies evaluating the effects of theophylline on exercise capacity in chronic obstructive pulmonary disease (COPD) have demonstrated heterogeneous results. Methods We performed a randomized placebo-controlled double-blind pilot study assessing the effects of theophylline on constant load exercise duration and lung function, involving 24 COPD patients already treated with long-acting inhaled beta-agonist and long-acting anti-cholinergic bronchodilator therapy. Results Analyzable data was available in 10 of 12 subjects in the treatment arm and 11 of 12 subjects in the control arm. Theophylline was associated with a 26.1% (95% confidence interval [CI]: −17.3–69.5) improvement in exercise duration compared to placebo. Four of 10 treated patients demonstrated an improvement in exercise duration exceeding the minimum clinically important difference of 33%, compared to 1 of 11 controls (P = 0.15). Furthermore, peak ventilation was reduced by 11.1%, (95% CI: 0.77–21.5) which may suggest improvements in gas exchange. There were no significant observed differences in resting lung function nor measures of dyspnea between the two treatment groups. Conclusions Our study demonstrated a trend, but not a statistically significant improvement in exercise duration and a reduction in peak ventilation with theophylline. Based on the observed mean differences and standard deviations in this pilot study, a randomized controlled trial would require 45 subjects in each arm to detect a significant change in exercise duration. PMID:22563244

  19. Resistance Exercise and Inflammation in Breast Cancer Patients Undergoing Adjuvant Radiation Therapy: Mediation Analysis From a Randomized, Controlled Intervention Trial

    Energy Technology Data Exchange (ETDEWEB)

    Schmidt, Martina E., E-mail: m.schmidt@dkfz.de [Division of Preventive Oncology, National Center for Tumor Diseases and German Cancer Research Center, Heidelberg (Germany); Meynköhn, Anna; Habermann, Nina [Division of Preventive Oncology, National Center for Tumor Diseases and German Cancer Research Center, Heidelberg (Germany); Wiskemann, Joachim [Division of Medical Oncology, National Center for Tumor Diseases and University Hospital, Heidelberg (Germany); Oelmann, Jan; Hof, Holger; Wessels, Sabine [Department of Radiation Oncology, National Center for Tumor Diseases and University Hospital, Heidelberg (Germany); Klassen, Oliver [Division of Preventive Oncology, National Center for Tumor Diseases and German Cancer Research Center, Heidelberg (Germany); Debus, Jürgen; Potthoff, Karin [Department of Radiation Oncology, National Center for Tumor Diseases and University Hospital, Heidelberg (Germany); Steindorf, Karen; Ulrich, Cornelia M. [Division of Preventive Oncology, National Center for Tumor Diseases and German Cancer Research Center, Heidelberg (Germany)

    2016-02-01

    Purpose: To explore the mediating role of inflammatory parameters in the development of fatigue, pain, and potentially related depressive symptoms during radiation therapy for breast cancer and its mitigation by resistance exercise. Methods and Materials: Breast cancer patients scheduled for adjuvant radiation therapy were randomized to 12-week progressive resistance exercise training (EX) or a relaxation control group. Interleukin-6 (IL-6) and interleukin-1 receptor antagonist (IL-1ra) were measured in serum samples collected before, at the end, and 6 weeks after radiation therapy from 103 chemotherapy-naïve participants. Fatigue was assessed with the multidimensional Fatigue Assessment Questionnaire, pain with the European Organization for Research and Treatment of Cancer QLQ-C30, and depressive symptoms with the Center for Epidemiologic Studies Depression Scale. Analysis of covariance models, partial correlations, Freedman-Schatzkin tests, and R{sup 2} effect-size measures for mediation were calculated. Results: The analysis of covariance models revealed a significant intervention effect on IL-6 (P=.010) and the IL-6/IL-1ra ratio (P=.018), characterized by a marked increase during radiation therapy among controls, but no significant change in EX. Interleukin-1 receptor antagonist did not change significantly in either group (P=.88). Increased IL-6 and IL-6/IL-1ra levels at the end of radiation therapy were significantly associated with increased physical fatigue and pain 6 weeks after radiation. We observed significant partial mediation by IL-6 and IL-6/IL-1ra of the effect of resistance exercise on physical fatigue (Freedman-Schatzkin P=.023 and P<.001) and pain (both P<.001). Hereby IL-6 and IL-6/IL-1ra mediated between 15% and 24% of the variance of physical fatigue and pain explained by the intervention. Conclusions: This randomized, controlled trial showed a significantly increased proinflammatory cytokine level after adjuvant radiation therapy in breast

  20. Quality of Life and Breast Cancer: How Can Mind–Body Exercise Therapies Help? An Overview Study

    Directory of Open Access Journals (Sweden)

    Anne Marie Lunde Husebø

    2017-10-01

    Full Text Available Breast cancer survivors experience extensive treatments, threatening their quality of life. Complementary therapies used as a supplement to cancer treatment may control symptoms, enhance quality of life, and contribute to overall patient care. Mind–body exercise therapies might motivate cancer survivors to exercise, and assist them in regaining health. The purpose of this overview study is to study benefits from mind–body exercise of yoga, tai chi chuan and qigong upon quality of life in breast cancer populations. A systematic overview of reviews was applied. Literature search in five electronic databases and in reference lists was performed during April 2017. In addition, experts in the field were consulted. Of 38 identified titles, 11 review articles, including six meta-analyses were found eligible for review. Methodological quality was high for the majority of quality domains. Yoga, the most studied mind–body therapy, was found to benefit breast cancer patients’ psychological quality of life, while less support was established concerning physical quality of life elements. The evidence of improvements of quality of life from tai chi chuan and qigong remains unclear. Breast cancer survivors’ experiences of psychological and social well-being may be enhanced by practicing yoga.

  1. Perceived value of spinal manipulative therapy and exercise among seniors with chronic neck pain: a mixed methods study.

    Science.gov (United States)

    Maiers, Michele; Vihstadt, Corrie; Hanson, Linda; Evans, Roni

    2014-11-01

    To explore perceptions of spinal manipulative therapy and exercise among adults aged 65 years and older with chronic neck pain. Mixed methods study embedded within a randomized clinical trial. Interviews were conducted with 222 of 241 randomized clinical trial participants. They had a mean age of 72.2 years and they had neck pain of moderate severity and of 6 years mean duration. Semi-structured interviews were conducted at the completion of the 12 week intervention phase, during which participants received spinal manipulative therapy and exercise interventions. Interviews explored determinants of satisfaction with care, whether or not therapy was worthwhile, and what was liked and disliked about treatment. Interviews were recorded and transcribed; content analysis was used to identify themes within responses. Participants placed high value on their relationships with health care team members, supervision, individualized care, and the exercises and information provided as treatment. Change in symptoms did not figure as prominently as social and process-related themes. Percpetions of age, activities, and co-morbities influenced some seniors' expectations of treatment results, and comorbidities impacted perceptions of their ability to participate in active care. Relationship dynamics should be leveraged in clinical encounters to enhance patient satisfaction and perceived value of care.

  2. Modulation of skeletal muscle performance and SERCA by exercise and adiponectin gene therapy in insulin-resistant rat.

    Science.gov (United States)

    Safwat, Yasmeen; Yassin, Nadia; Gamal El Din, Maha; Kassem, Lobna

    2013-07-01

    This study addresses the potential application of adiponectin gene therapy and exercise in protection against skeletal muscle dysfunction in type 2 diabetes mellitus (T2DM) while focusing on the role of sarco and endoplasmic reticulum Ca(+2) ATPase (SERCA) and Glut4. 50 rats were divided into five groups: control, T2DM, T2DM treated with either adiponectin gene or exercise or a combination of both. Serum glucose, insulin, HOMA index, triglycerides, and cholesterol were measured. Weight gain%, muscle contractile parameters {(peak twitch tension (Pt), peak tetanic tension (PTT), half relaxation time (HRT)}, and gene expression of SERCA, Glut4, and adiponectin were assessed in gastrocnemius muscle. Diabetic rats treated with either adiponectin gene or exercise showed significant reduction in all serum parameters and wt gain%. There was significant elevation in Pt and PTT with shortening in HRT. Furthermore, a significant increase in SERCA, Glut4, and adiponectin gene expression was noticed in both groups. Combination therapy caused marked gene expression of SERCA, GLUT4, and greater improvement in muscle contractility than either of the monotherapies. Skeletal muscle dysfunction in T2DM is mediated via impaired SERCA and Glut 4. Combination therapy offered best protection against muscle dysfunction and provides a novel promising strategy for a complete cure of muscle dysfunction in T2DM.

  3. Compliance to Standard Equipment Requirements by Exercise Therapy/Fitness Outfits in The South-South Geopolitical Zone of Nigeria

    Directory of Open Access Journals (Sweden)

    Oluwaseun S. Kubeyinje

    2016-08-01

    Full Text Available The purpose of this study was to assess the compliance of exercise therapy/fitness outfits in the south-south geopolitical zone of Nigeria to standard equipment requirements. Descriptive survey design was adopted for the conduct of the study using a sample size of 51centres/managers purposively selected from a population of 102 managers of fitness outfits in the six states of the south-south geopolitical zone of Nigeria. A self- developed structured questionnaire and a facility checklist were used to collect the data. Data collected were analysed using frequency counts and percentages. The study revealed in this analysis that only treadmills (66.7%, bicycle ergometers (66.7%, dumbbells (84.3% and weight racks (57.0% met the benchmark minimum in more than 50% of the exercise therapy/fitness outfits surveyed in six states of the south-south geopolitical zone of Nigeria. Most of the equipment surveyed were functional with the highest non-functionality occurring in treadmill machines in 9.8% of the surveyed centres followed by sit-up benches (5.9% and bicycle ergometers (3.9%. In conclusion, it could be deduced from the results that there’s gross inadequacy of equipment and low level of compliance to established standard in the exercise therapy/fitness outfits evaluated in the south-south geopolitical zone of Nigeria.

  4. Effects of Stretching and Strengthening Exercises, With and Without Manual Therapy, on Scapular Kinematics, Function, and Pain in Individuals With Shoulder Impingement: A Randomized Controlled Trial.

    Science.gov (United States)

    Camargo, Paula R; Alburquerque-Sendín, Francisco; Avila, Mariana A; Haik, Melina N; Vieira, Amilton; Salvini, Tania F

    2015-12-01

    Randomized controlled trial. To evaluate the effects of an exercise protocol, with and without manual therapy, on scapular kinematics, function, pain, and mechanical sensitivity in individuals with shoulder impingement syndrome. Stretching and strengthening exercises have been shown to effectively decrease pain and disability in individuals with shoulder impingement syndrome. There is still conflicting evidence regarding the efficacy of adding manual therapy to an exercise therapy regimen. Forty-six patients were assigned to 1 of 2 groups, one of which received a 4-week intervention of stretching and strengthening exercises (exercise alone) and the other the same intervention, supplemented by manual therapy targeting the shoulder and cervical spine (exercise plus manual therapy). All outcomes were measured preintervention and postintervention at 4 weeks. Outcome measures were scapular kinematics in the scapular and sagittal planes during arm elevation, function as determined through the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, pain as assessed with a visual analog scale, and mechanical sensitivity as assessed with pressure pain threshold. Independent of the intervention group, small, clinically irrelevant changes in scapular kinematics were observed postintervention. A significant group-by-time interaction effect (P = .001) was found for scapular anterior tilt during elevation in the sagittal plane, with a 3.0° increase (95% confidence interval [CI]: -1.5°, 7.5°) relative to baseline in the exercise-plus-manual therapy group compared to a decrease of 0.3° (95% CI: -4.2°, 4.8°) in the exercise-alone group. Pain, mechanical sensitivity, and the DASH score improved similarly for both groups by the end of the intervention period. Adding manual therapy to an exercise protocol did not enhance improvements in scapular kinematics, function, and pain in individuals with shoulder impingement syndrome. The noted improvements in pain and function

  5. SUPERvised Exercise Therapy or Immediate PTA for Intermittent Claudication in Patients with an Iliac Artery Obstruction - A Multicentre Randomised Controlled Trial; SUPER Study Design and Rationale

    NARCIS (Netherlands)

    Frans, F. A.; Bipat, S.; Reekers, J. A.; Legemate, D. A.; Koelemay, M. J. W.; Engelbert, R. H. H.

    2012-01-01

    Introduction: Treatment of intermittent claudication (IC) due to peripheral arterial disease (PAD) is aimed at improving walking distance and includes secondary prevention of cardiovascular disease. Both supervised exercise therapy (SET) and percutaneous transluminal angioplasty (PTA) have proven to

  6. Exercise and Physical Activity in the Therapy of Substance Use Disorders

    Directory of Open Access Journals (Sweden)

    Elisabeth Zschucke

    2012-01-01

    Full Text Available Exercise and physical activity are constantly gaining attention as adjuvant treatment for substance use disorders, supplementing classical pharmacological and psychotherapeutic approaches. The present work reviews studies addressing the therapeutic effects of exercise in alcohol abuse/dependence, nicotine abuse/dependence, and illicit drug abuse/dependence. In the field of smoking cessation, evidence is strong for exercise as an effective adjuvant treatment, whereas no generalizable and methodologically strong studies have been published for alcohol and drug treatment so far, allowing only preliminary conclusions about the effectiveness of exercise in these disorders. A couple of potential mechanisms are discussed, by which exercise may act as an effective treatment, as well as future directions for studies investigating exercise as a treatment strategy for substance use disorders.

  7. Self-reported physical activity behavior of breast cancer survivors during and after adjuvant therapy: 12 months follow-up of two randomized exercise intervention trials.

    Science.gov (United States)

    Schmidt, Martina E; Wiskemann, Joachim; Ulrich, Cornelia M; Schneeweiss, Andreas; Steindorf, Karen

    2017-04-01

    Exercise during and after breast cancer treatment has shown several health benefits. However, little is known about the courses, patterns, and determinants of physical activity of breast cancer patients, and the role of exercise interventions on their physical activity behavior in the long run. Self-reported physical activity was assessed in 227 breast cancer survivors before, during, and three, six, and 12 months post-intervention within two randomized resistance exercise trials performed during adjuvant chemo- or radiotherapy, respectively, with similar designs. Multiple ordinal logistic regression analyses were performed to identify determinants of physical activity at these time points. While the intervention group exercised a median 1.8 h/week during adjuvant therapy (interquartile range 1.4-2.5), 68% of controls did not engage in any exercise. At 12-months follow-up 32% of patients did not engage in any exercise irrespective of the intervention. Of the patients who cycled for transportation pre-diagnosis about half stopped cycling in the long term in both groups. In contrast, walking was maintained over time. Major determinants of low levels of exercise at 12-months follow-up were low pre-diagnosis levels of exercise, lower education, being postmenopausal, and having breast problems or depressive symptoms. Further, the intervention appeared to influence the type of sports performed, with strength exercise being the most common type of exercise at follow-up in the exercise group, more frequently compared to the control group. The exercise intervention effectively countervailed the decrease in physical activity during cancer therapy and boosted strength exercise in the months following the intervention, but in the longer term many survivors were insufficiently active. Breast cancer survivors may need continued motivation and practical support tailored to their individual characteristics and physical activity history to incorporate exercise in everyday routine

  8. Effects of Relaxation Exercises and Music Therapy on the Psychological Symptoms and Depression Levels of Patients with Schizophrenia.

    Science.gov (United States)

    Kavak, Funda; Ünal, Süheyla; Yılmaz, Emine

    2016-10-01

    This study aims to identify the effects of relaxation exercises and music therapy on the psychological symptoms and depression levels of patients with chronic schizophrenia. This semi-experimental study was conducted using pre- and post-tests with a control group. The study population consists of patients with schizophrenia who regularly attended community mental health centers in the Malatya and Elazığ provinces of Turkey between May 2015 and September 2015. The study's sample consists of 70 patients with schizophrenia (n=35 in the control group; n=35 in the experimental group) who were selected randomly based on power analysis. The "Patient Information Form," the "Brief Psychiatric Rating Scale (BPRS)" and the "Calgary Depression Scale for Schizophrenia (CDSS)" were used for data collection. Patients in the experimental group participated in relaxation exercises and music therapy 5 times a week for 4 weeks. The experimental group of 35 persons was divided into three groups of approximately 10-12 individuals in order to enable all participants to attend the program. No intervention was applied to the patients in the control group. The data were evaluated using percentage distribution, arithmetic means, standard deviations, Chi-square and independent samples t-tests. The study found that patients in the experimental group showed a decrease in total mean scores on the BPRS and CDSS; the difference between the post-test scores of the experimental group and the post-test scores of the control group was statistically significant (pmusic therapy was proven to be effective in reducing schizophrenic patients' psychological symptoms and levels of depression. Relaxation exercises and music therapy can be used as a complementary therapy in the medical treatment of patients with chronic schizophrenia. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. A rice diet is associated with less fat synthesis/accumulation than a bread diet before exercise therapy.

    Science.gov (United States)

    Ishii, Kojiro; Takizawa, Kazuki; Okabe, Tetsuko; Yamaguchi, Taichi; Sakuma, Ichiro

    2005-10-01

    For effective exercise therapy after waking up, we focused on the staple food in diet therapy, and compared rice and bread diets. The subjects were 10 healthy college male students. After fasting for 12 h or more from the previous day, the subjects had breakfast consisting of rice (protein, 6.3 g; fat, 0.9 g: CHO, 79.3 g; energy, 368 kcal) or bread (protein, 15.7 g; fat, 5.8 g; CHO, 79.2 g; and energy, 450 kcal) containing the same amount of carbohydrates and the same side dishes (protein, 7.0 g; fat, 9.5 g; CHO, 21.3 g; energy, 199 kcal) in the morning 30 min before the initiation of exercise on a bicycle ergometer at an intensity of about 50% VO2max for 60 min. Measurements of the heart rate and expired gas were initiated 15 min before the start of exercise and continued until 10 min after exercise. Blood was collected before the meal, immediately before and 15, 30, and 45 min after the initiation of exercise, and immediately, 15, and 30 min after its termination. After breakfast containing carbohydrates, decreases were observed in the levels of free fatty acid and noradrenalin. Blood insulin (mealxtime, p<0.05 ANOVA) and triglyceride (meal x time, p<0.01, ANOVA) changed at higher levels in the bread diet than in the rice diet. Blood triglyceride is a resource of fat synthesis/accumulation, and insulin promotes its action. Therefore, the bread diet may promote fat synthesis/accumulation compared with the rice diet.

  10. Both aerobic exercise and cognitive-behavioral therapy reduce chronic fatigue in FSHD: an RCT.

    Science.gov (United States)

    Voet, Nicoline; Bleijenberg, Gijs; Hendriks, Jan; de Groot, Imelda; Padberg, George; van Engelen, Baziel; Geurts, Alexander

    2014-11-18

    To investigate the effect of aerobic exercise training (AET) and cognitive-behavioral therapy (CBT) on chronic fatigue in patients with facioscapulohumeral muscular dystrophy (FSHD). We performed a multicenter, assessor-blinded, randomized clinical trial (RCT). Fifty-seven patients with FSHD type 1 with severe chronic fatigue were randomly allocated to AET, CBT, or usual care (UC). Outcomes were assessed before treatment, following 16 weeks of intervention, and after a 12-week follow-up. A linear mixed model for repeated measurements was used to study the estimated group differences. Following treatment, both the AET (28 participants) and CBT (25 participants) intervention groups had less fatigue relative to the UC group (24 participants), with a difference of -9.1 for AET (95% confidence interval [CI] -12.4 to -5.8) and -13.3 for CBT (95% CI -16.5 to -10.2). These beneficial effects lasted through follow-up, with a difference of -8.2 for AET (95% CI -12.4 to -5.8) and -10.2 for CBT (95% CI -14.0 to -6.3). The patients who received CBT had an increase in registered and experienced physical activity, sleep quality, and social participation. The patients who received AET had an increase in registered physical activity only. The increase in registered physical activity in both groups and the improvement in social participation following CBT were still present at follow-up. This RCT shows that AET and CBT can ameliorate chronic fatigue in patients with FSHD. This study provides Class III evidence that, in patients with FSHD type 1 and severe chronic fatigue, AET or CBT reduces the severity of chronic fatigue. © 2014 American Academy of Neurology.

  11. [Inpatient multimodal pain therapy : Additive value of neuromuscular core stability exercises for chronic back pain].

    Science.gov (United States)

    Giesche, F; Streicher, H; Maiwald, M; Wagner, P

    2017-04-01

    The medical and healthcare economic burden caused by chronic lumbar back pain (CLBP) requires the use of interdisciplinary treatment approaches. The present study aimed to evaluate whether the effectiveness of inpatient multimodal pain therapy (MPT, operations and procedures (OPS) coding 8-918.02), can be increased by implementing additional neuromuscular core stability exercises (NCSE). As part of a prospective controlled study, subjects with CLBP (n = 48, 17 males, 58.2 ± 11.7 years) were allocated to one of two groups. One group received standard care (SC, n =23) encompassing manual, pharmacological and psychological therapy in addition to passive physiotherapeutic applications. The intervention group (IG, n =25) additionally completed NCSE. On the day of admission and on discharge as well as 1 and 6 weeks after inpatient care, pain intensity (numeric rating scale), pain-related routine daily functions (Oswestry disability index), well-being (SF-12 Health Survey) and motor function parameters (trunk strength, endurance and postural control) were assessed. Data analysis was performed using statistical inference methods. In addition, effect sizes (Cohen's d) of intergroup differences were calculated. Both groups showed significant reductions in pain intensity (p  0.6) at all measurement points (MP). Physical well-being and disability (p  0.6) were improved 1 week after discharge in the intervention group only. Overall, no systematic differences between groups were detected (p > 0.05). In relation to the motor outcomes, no significant changes over time nor between groups were verified (p > 0.05). Despite the use of an additional NCSE, no significant added value in individuals with CLBP could be detected, although a systematic pre-post effect in daily functions and physical well-being (one week after discharge) was observed for the IG only. Therefore, on the basis of the study results, the implementation of additional NCSE into the inpatient MPT cannot

  12. Effects of photobiomodulation therapy, pharmacological therapy, and physical exercise as single and/or combined treatment on the inflammatory response induced by experimental osteoarthritis.

    Science.gov (United States)

    Tomazoni, Shaiane Silva; Leal-Junior, Ernesto Cesar Pinto; Pallotta, Rodney Capp; Teixeira, Simone; de Almeida, Patricia; Lopes-Martins, Rodrigo Álvaro Brandão

    2017-01-01

    Osteoarthritis (OA) triggers increased levels of inflammatory markers, including prostaglandin (PG) E2 and proinflammatory cytokines. The elevation of cytokine levels is closely associated with increased articular tissue degeneration. Thus, the use of combination therapies may presumably be able to enhance the effects on the modulation of inflammatory markers. The present study aimed to evaluate and compare the effects of photobiomodulation therapy (PBMT), physical exercise, and topical nonsteroidal anti-inflammatory drug (NSAID) use on the inflammatory process after they were applied either alone or in different combinations. OA was induced by intra-articular papain injection in the knee of rats. After 21 days, the animals began treatment with a topical NSAID and/or with physical exercise and/or PBMT. Treatments were performed three times a week for eight consecutive weeks, totaling 24 therapy sessions. Analysis of real-time polymerase chain reaction (RT-PCR) gene expression; interleukin (IL)-1β, IL-6, and tumor necrosis factor alpha (TNF-α) protein expression; and PGE2 levels by enzyme-linked immunosorbent assay (ELISA) was conducted. Our results showed that PBMT alone and Exerc + PBMT significantly reduced IL-1β gene expression (p treatment changed both IL-6 and TNF-α gene expression. Treatment with NSAID alone, PBMT alone, Exerc + PBMT, and NSAID + PBMT reduced IL-1β protein expression (p therapies significantly reduced IL-6 and TNF-α protein expression (p therapies, except Exerc, reduced the levels of PGE2 (p treatment with PBMT is more effective in modulating the inflammatory process underlying OA when compared with the other therapies tested.

  13. Theoretical and practical outline of the Copenhagen PACT narrative-based exercise counselling manual to promote physical activity in post-therapy cancer survivors

    DEFF Research Database (Denmark)

    Midtgaard, Julie

    2013-01-01

    of regular physical activity in post-therapy cancer survivors is briefly presented including a brief review of the theoretical rationale behind the psychological component of the intervention, i.e. a narrative-based exercise counselling programme. Subsequently, particular attention is given to the core......BACKGROUND: Sedentary behaviour and reduced exercise capacity are potential persisting effects of anti-cancer therapy that may predispose to serious health conditions. It is well-established that physical exercise may prevent some of these problems. However, the extent to which cancer survivors...

  14. Comparison of 2 manual therapy and exercise protocols for cervical radiculopathy: a randomized clinical trial evaluating short-term effects.

    Science.gov (United States)

    Langevin, Pierre; Desmeules, François; Lamothe, Mélanie; Robitaille, Simon; Roy, Jean-Sébastien

    2015-01-01

    Participant- and assessor-blinded randomized clinical trial. To compare a rehabilitation program thought to increase the size of the intervertebral foramen (IVF) of the affected nerve root to a rehabilitation program that doesn't include any specific techniques thought to increase the size of the IVF in patients presenting with cervical radiculopathy (CR). Clinical approaches for the treatment of CR commonly include exercises and manual therapy techniques thought to increase the size of the IVF, but evidence regarding the effectiveness of these specific manual therapy techniques is scarce. Thirty-six participants with CR were randomly assigned either to a group that received a manual therapy and exercise program aimed at increasing the size of the IVF of the affected nerve root (experimental group, n=18) or to a group that received a manual therapy and exercise program without the specific goal of increasing the size of the IVF of the affected level and side (comparison group, n=18). Primary (Neck Disability Index) and secondary (shortened version of the Disabilities of the Arm, Shoulder and Hand questionnaire [QuickDASH] and numeric pain-rating scale) outcomes were evaluated at baseline, at the end of the 4-week program (week 4), and 4 weeks later (week 8). A mixed-model, 2-way analysis of variance was used to analyze treatment effects. No significant group-by-time interaction or group effect was observed for Neck Disability Index, QuickDASH, and numeric pain-rating scale scores (P≥.14) following the intervention. However, both groups showed statistically and clinically significant improvement from baseline to week 4 and to week 8 in Neck Disability Index, QuickDASH, and numeric pain-rating scale scores (Pmanual therapy and exercises are effective in reducing pain and functional limitations related to CR. The addition of techniques thought to increase the size of the IVF of the affected nerve root yielded no significant additional benefits. Given the absence of

  15. Effect of thrombolytic therapy on exercise response during early recovery from acute myocardial infarction

    DEFF Research Database (Denmark)

    Svendsen, J H; Madsen, J K; Saunamäki, K I

    1992-01-01

    Several studies have shown that infarct size is reduced following thrombolytic treatment in patients with acute myocardial infarction. Exercise test variables, such as an impaired heart rate response during exercise, are known to be related to left ventricular function and patient prognosis follo...

  16. The role of muscle strengthening in exercise therapy for knee osteoarthritis

    DEFF Research Database (Denmark)

    Bartholdy, Cecilie; Juhl, Carsten; Christensen, Robin

    2017-01-01

    OBJECTIVES: To analyze if exercise interventions for patients with knee osteoarthritis (OA) following the American College of Sports Medicine (ACSM) definition of muscle strength training differs from other types of exercise, and to analyze associations between changes in muscle strength, pain...

  17. A Comparative Study of the Efficacy of Cognitive Group Therapy and Aerobic Exercise in the Treatment of Depression among the Students.

    Science.gov (United States)

    Sadeghi, Khirollah; Ahmadi, Seyed Majid; Ahmadi, Seyed Mojtaba; Rezaei, Mansour; Miri, Javad; Abdi, Alireza; Khamoushi, Firoozeh; Salehi, Mahin; Jamshidi, Khadijeh

    2016-10-01

    Depression is one of the most common mental disorders. Finding effective treatments for such a disorder with higher efficiency lower side effects and affordability is an active area of research in psychiatry. This study aimed to comparatively analyze the effects of the cognitive group therapy and aerobic exercises on depression, automatic negative thoughts and dysfunctional attitudes of students at Kermanshah University of Medical Science. In this clinical trial, 46 associate and undergraduate students at Kermanshah University of Medical Science were randomly divided into three groups: cognitive therapy, aerobic exercise, and control. The data was gathered both before and 8 weeks after the intervention. Beck Depression Inventory (BDI-II), automatic negative thoughts (ATQ), and the Dysfunctional Attitude Scale (DAS) were used as the data collection instruments. The data were analyzed with SPSS version 15 using paired samples T-test, chi-square test, Kruskal-Wallis test, and analysis of variance (ANOVA). Cognitive therapy caused a significant decrease in depression, belief in automatic negative thoughts, and dysfunctional attitudes in comparison to the control group (pCognitive therapy also reduced the variables more than the aerobic exercise, but the decrease was not statistically significant. Cognitive group therapy and aerobic exercise are effective in treating depression. For treating depression, aerobic exercise can be used as a therapy itself or along with cognitive-behavioral therapy and pharmacotherapy.

  18. The Effects of the Disturbance of the Vestibular System on the Dynamic Balance of Idiopathic Scoliotic Subjects with and Without Exercise Therapy Compared to Healthy Subjects

    Directory of Open Access Journals (Sweden)

    N. Farahpour

    2004-01-01

    Full Text Available The mechanism of the neuromuscular system’s disorders in Adolescent Idiopathic Scoliosis (AIS are not well known. The objectives of this study were to assess the dynamic balance of the AIS patients and the influence of exercise therapy on patients' dynamic balance. Eleven teenager scoliotic subjects after three months exercise therapy, nine similar patients without therapy and 13 healthy age matched subjects as control group were studied. Using dynamic stability platform, the deviation of COG of subjects in different positions, including up right standing, standing with head flexion and standing with head hyper extension were measured. The tests were repeated in both lose and stable condition of the foot platform. Results showed that the stability of the foot platform resulted in COG's deviation by 1.13 0.08 in all subjects. Dynamic balance of scoliotic patients without treatment was similar to that of the normal subjects. While, exercised patients had less COG deviation than the other groups. The change in head position increased the COG deviation by 2.5 times in control and non-exercised patients and 1.5 times in exercised patients. The dynamic balance in scoliosis was not affected. Exercise improved the dynamic balance in scoliotic subjects. Exercise therapy is recommended to improve the proprioceptives function.

  19. Effect of low-level laser therapy (808 nm) in skeletal muscle after resistance exercise training in rats.

    Science.gov (United States)

    Patrocinio, Tatiane; Sardim, Andre Cabral; Assis, Livia; Fernandes, Kelly Rossetti; Rodrigues, Natalia; Renno, Ana Claudia Muniz

    2013-10-01

    The aim of this study was to evaluate the effects of 808 nm laser applied after a resistance training protocol, on biochemical markers and the morphology of skeletal muscle in rats. Strenuous physical activity results in fatigue and decreased muscle strength, impaired motor control, and muscle pain. Many biochemical and biophysical interventions have been studied in an attempt to accelerate the recovery process of muscle fatigue. Among these, low-level laser therapy (LLLT) has been demonstrated to be effective in increasing skeletal muscle performance in in vivo studies and in clinical trials. However, little is known about the effects of LLLT on muscle performance after resistance training. Thirty Wistar rats were randomly divided into three groups: control group (CG), trained group (TG), and trained and laser-irradiated group (TGL). The resistance training program was performed three times per week for 5 weeks, and consisted of a climbing exercise, with weights attached to the tail of the animal. Furthermore, laser irradiation was performed in the middle region of tibialis anterior (TA) muscle of both legs, after the exercise protocol. Analysis demonstrated that TGL demonstrated significantly reduced resting lactate level and decreased muscle glycogen depletion than the animals that were exercised only, and significantly increased the cross-section area of TA muscle fibers compared with thoseo in the other groups. These results suggest that LLLT could be an effective therapeutic approach in increasing muscle performance during a resistance exercise protocol.

  20. Effectiveness of Aerobic Exercise as an Augmentation Therapy for Inpatients with Major Depressive Disorder: A Preliminary Randomized Controlled Trial.

    Science.gov (United States)

    Shachar-Malach, Tal; Cooper Kazaz, Rena; Constantini, Naama; Lifschytz, Tzuri; Lerer, Bernard

    2015-01-01

    Physical exercise has been shown to reduce depressive symptoms when used in combination with antidepressant medication. We report a randomized controlled trial of aerobic exercise compared to stretching as an augmentation strategy for hospitalized patients with major depression. Male or female patients, 18-80 years, diagnosed with a Major Depressive Episode, were randomly assigned to three weeks of augmentation therapy with aerobic (n=6) or stretching exercise (n=6). Depression was rated, at several time points using the 21-item Hamilton Depression Scale (HAM-D), Beck Depression Inventory (BDI) and other scales. According to the HAM-D, there were four (out of six) responders in the aerobic group, two of whom achieved remission, and none in the stretching group. According to the BDI, there were two responders in the aerobic group who were also remitters and none in the stretching group. The results of this small study suggest that aerobic exercise significantly improves treatment outcome when added to antidepressant medication. However, due to the small sample size the results must be regarded as preliminary and further studies are needed to confirm the findings.

  1. [Effects of different interference orders of acupuncture and exercise therapy on the amplitude of somatosensory evoked potential (SEP) in the patient of hemiplegia after stroke].

    Science.gov (United States)

    Huang, Dong-E; Wu, Qiang; Lin, Zhong-Rong; Lin, Dong; Shen, Fang-Fang; Liu, Jian-Zhong

    2006-12-01

    To observe effects of different interference orders of acupuncture and exercise therapy on the therapeutic effect. The patients of hemiplegia after stroke in the stage of recovery were randomly divided into two groups: raising handclasp of Bobath after electroacupuncture at Quchi (LI 11) and Hegu (LI 4) on the affected side or electroacupuncture at Quchi (LI 11) and Hegu (LI 4) on the affected side after raising handclasp of Bobath. The changes of SEP on the affected side were recorded and compared. SEP on the affected side significantly increased in the patients after treatment of simple electroacupuncture or exercise therapy (P 0.05). There was a very significant difference in SEP on the affected side between the group of exercise treatment after electroacupuncture and the group of electroacupuncture after exercise therapy (P Bobath after electroacupuncture is better for improvement in cerebral function of the patient.

  2. Effects of Music Therapy on Endothelial Function in Patients With Coronary Artery Disease Participating in Aerobic Exercise Therapy.

    Science.gov (United States)

    Deljanin Ilic, Marina; Pavlovic, Radmila F; Kocic, Gordana; Simonovic, Dejan; Lazarevic, Gordana

    2017-05-01

    Context • Pleasant music that evokes a positive emotional response may activate brain pathways of the insular cortex, central nucleus of the amygdala, and lateral hypothalamus, which are involved in the integration of emotional and ambient sensory input, with corresponding autonomic responses. Exercise training can improve endothelium-dependent vasodilatation, both in epicardial coronary vessels and in resistance vessels, for patients with coronary heart disease. Objective • The aim of the present study was to evaluate the effects on endothelial function when patients with stable coronary artery disease (CAD) listened to their favorite music. Design • The study was a randomized controlled trial. Setting • The study occurred at the Institute of Cardiology, Niska Banja, Faculty of Medicine, University of Nis (Nis, Serbia). Participants • Participants were 74 patients with stable CAD. Intervention • Participants were randomly assigned to 1 of 3 groups: (1) exercise training only (T) group (n = 33), (2) listening to music and exercise training (MT) group (n = 31), and listening to music only (M) group (n = 10). Participants in the T and MT groups received usual medical care and underwent 3 wk of supervised aerobic exercise training. In addition to the exercise training, participants in the MT group listened to their favorite music for 1.5 h every day. Participants in the M group received the usual medical care and listened to their favorite music for 1.5 h every day. Outcome Measures • At baseline and postintervention, outcomes were assessed through measurement of the changes in circulating blood markers of endothelial function-the stable end product of nitric oxide (NOx), asymmetric dimethylarginine, symmetric dimethylarginine, and xanthine oxidase-and through the results of submaximal or symptom-limited exercise test. Results • After 3 wk, the NOx significantly increased in both in MT and T groups, with P favorite music in addition to participating in

  3. The use of manual therapy post-hip arthroscopy when an exercise-based therapy approach has failed: a case report.

    Science.gov (United States)

    LeBeau, Robert T; Nho, Shane J

    2014-09-01

    Case report. Although there is a growing body of literature on both surgical intervention and postsurgical rehabilitation of acetabular labral repairs and femoroacetabular impingement, there is a paucity of information on how to manage individuals who show a lack of progress postsurgery. A 30-year-old woman underwent surgical labral repair with femoroacetabular impingement osteochondroplasty. Postsurgery, she was initially treated with an exercise-based approach, but experienced an increase in hip pain and further decline in function. Her primary functional deficits were difficulty standing and pain (6/10) with ambulation. A combination of soft tissue mobilization and trigger point dry needling was used to address perceived muscle dysfunction, and nonthrust manipulation was used to address perceived hip joint hypomobility. Following 12 therapy sessions over 120 days, the patient returned to her demanding occupation with minimal residual symptoms. By the end of the period of care, the patient's Harris hip score had improved from 56 to 96 and her Lower Extremity Functional Scale score had improved from 26 to 70. This case describes a multimodal manual therapy approach and the health outcomes of a patient following labral repair with femoroacetabular impingement decompression who did not respond to an initial exercise-based postsurgical rehabilitation approach. Level of Evidence Therapy, level 4.

  4. EFFECTS OF A 12-WEEK AEROBIC EXERCISE PROGRAM COMBINED WITH MUSIC THERAPY AND MEMORY EXERCISES ON COGNITIVE AND FUNCTIONAL ABILITY IN PEOPLE WITH MIDDLE TYPE OF ALZHEIMER'S DISEASE

    Directory of Open Access Journals (Sweden)

    Christina Kampragkou

    2017-10-01

    Full Text Available Background: The Alzheimer's disease is the most common form of dementia and represents 60% of its cases. The disease is characterized by cognitive, non-cognitive and functional deficits and it’s incurable. The main of this study was to examine the effects of the aerobic exercise in combination with the music therapy and memory exercises in functional and cognitive ability on a patient with that have been affected by middle type (Second stage of Alzheimer's disease. Methods: Thirty patients from Chronic Diseases Center, with Alzheimer's disease, divided between an intervention and a control group, participated in this randomized controlled study. (Thirty patients with Alzheimer's were chosen from chronic disease center, and are divided into an intervention and a control group. The intervention requires 30 minutes of aerobic exercise, 10 minutes of memory games and music therapy, three times a week, for the duration of 12 weeks. The outcome measures the “Mini Mental State Examination” (MMSE scale and the “Alzheimer's Disease Assessment Scale cognitive test” (ADAS for the cognitive ability, “Katz Index Independence in Activities of Daily Living” (ADL, “Get up and Go test” and “One leg standing balance test” (OLST for the functionality. A three-way analysis of variance designs was applied to compare changes in each outcome measure before and after the intervention between the groups. Results: The MMSE score decrease significantly for the control group (males: 16.00 ± 4.04 to 15.14 ± 4.01 and for females: 16.00 ± 1.85 to 15.25 ± 1.98 before and after intervention but not for the intervention group (p > 0.05 (males: 16.25 ± 2.71 to 16.12 ± 2.94 and females: 12.85 ± 2.67 to 12.57 ± 2.93. The ADAS score on intervention experimental therapy group was significantly low (males: 39.00 ± 7.98 to 37.50 ± 8.12 and females: 49.85 ± 6.54 to 48.28 ± 6.79. In the Get up and Go test (males: 18.87 ± 5.24 to 17.87 ± 4.15 and

  5. Relation of Exercise Capacity to Risk of Development of Diabetes in Patients on Statin Therapy (the Henry Ford Exercise Testing Project).

    Science.gov (United States)

    Shaya, Gabriel E; Juraschek, Stephen P; Feldman, David I; Brawner, Clinton A; Ehrman, Jonathan K; Keteyian, Steven J; Al-Mallah, Mouaz H; Blaha, Michael J

    2017-09-01

    High exercise capacity (EC) has been associated with a lower risk of incident diabetes, whereas statin therapy has been associated with a higher risk. We sought to investigate whether the association between EC and diabetes risk is modified by statin therapy. This retrospective cohort study included 47,337 patients without diabetes or coronary artery disease at baseline (age 53 ± 13 years, 48% women, 66% white) who underwent clinical treadmill stress testing within the Henry Ford Health System from January 1, 1991, to May 31, 2009. The patients were stratified by baseline statin use and estimated peak METs achieved during exercise testing. Hazard ratios for incident diabetes were calculated using Cox proportional hazards models adjusted for demographic characteristics, co-morbidities, pertinent medications, and stress test indication. We observed 6,921 new diabetes cases (14.6%) over a median follow-up period of 5.1 years (interquartile interval of 2.6 to 8.2 years). Compared with the statin group, the no-statin group achieved higher mean METs (8.9 ± 2.7 vs 9.6 ± 3.0, respectively; p <0.001). After adjustment for covariates, a higher EC was associated with a lower risk of incident diabetes, irrespective of statin use (p-interaction = 0.15). Each 1-MET increment was associated with an 8%, 8%, and 6% relative risk reduction in the total cohort, the no-statin, and the statin groups, respectively (95% confidence interval, 0.91 to 0.93, 0.91 to 0.93, and 0.91 to 0.96, respectively; p <0.001 for all). We conclude that a higher EC is associated with a lower risk of incident diabetes regardless of statin use. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. Exercise-induced pulmonary artery hypertension in a patient with compensated cardiac disease: hemodynamic and functional response to sildenafil therapy.

    Science.gov (United States)

    Nikolaidis, Lazaros; Memon, Nabeel; O'Murchu, Brian

    2015-02-01

    We describe the case of a 54-year-old man who presented with exertional dyspnea and fatigue that had worsened over the preceding 2 years, despite a normally functioning bioprosthetic aortic valve and stable, mild left ventricular dysfunction (left ventricular ejection fraction, 0.45). His symptoms could not be explained by physical examination, an extensive biochemical profile, or multiple cardiac and pulmonary investigations. However, abnormal cardiopulmonary exercise test results and a right heart catheterization-combined with the use of a symptom-limited, bedside bicycle ergometer-revealed that the patient's exercise-induced pulmonary artery hypertension was out of proportion to his compensated left heart disease. A trial of sildenafil therapy resulted in objective improvements in hemodynamic values and functional class.

  7. Exercise as an anti-inflammatory therapy for rheumatic diseases—myokine regulation

    DEFF Research Database (Denmark)

    Benatti, Fabiana B; Pedersen, Bente K

    2015-01-01

    Persistent systemic inflammation, a typical feature of inflammatory rheumatic diseases, is associated with a high cardiovascular risk and predisposes to metabolic disorders and muscle wasting. These disorders can lead to disability and decreased physical activity, exacerbating inflammation...... muscle communicates with other organs by secreting proteins called myokines. Some myokines are thought to induce anti-inflammatory responses with each bout of exercise and mediate long-term exercise-induced improvements in cardiovascular risk factors, having an indirect anti-inflammatory effect...... of exercise, and indirectly, by improving comorbidities and cardiovascular risk factors. We also discuss the mechanisms by which some myokines have anti-inflammatory functions in inflammatory rheumatic diseases....

  8. The PEX study – Exercise therapy for patellofemoral pain syndrome: design of a randomized clinical trial in general practice and sports medicine [ISRCTN83938749

    Science.gov (United States)

    van Linschoten, Robbart; van Middelkoop, Marienke; Berger, Marjolein Y; Heintjes, Edith M; Koopmanschap, Mark A; Verhaar, Jan AN; Koes, Bart W; Bierma-Zeinstra, Sita MA

    2006-01-01

    Background Patellofemoral complaints are frequently seen in younger and active patients. Clinical strategy is usually based on decreasing provoking activities as sports and demanding knee activities during work and leisure and reassuring the patient on the presumed good outcome. Exercise therapy is also often prescribed although evidence on effectiveness is lacking. The objective of this article is to present the design of a randomized clinical trial that examines the outcome of exercise therapy supervised by a physical therapist versus a clinically accepted "wait and see" approach (information and advice about the complaints only). The research will address to both effectiveness and cost effectiveness of supervised exercise therapy in patients with patellofemoral pain syndrome (PFPS). Methods/design 136 patients (adolescents and young adults) with patellofemoral pain syndrome are recruited in general practices and sport medicine centers. They will be randomly allocated receiving either 3 months of exercise therapy (or usual care. The primary outcome measures are pain, knee function and perception of recovery after 3 months and 12 months of follow up and will be measured by self reporting. Measurements will take place at baseline, 6 weeks, and 3 monthly until 1 year after inclusion in the study. Secondary outcome measurements include an economic evaluation. A cost-utility analysis will be performed that expresses health improvements in Quality Adjusted Life Years (QALYs) and incorporates direct medical costs and productivity costs Discussion This study has been designed after reviewing the literature on exercise therapy for patellofemoral pain syndrome. It was concluded that to merit the effect of exercise therapy a trial based on correct methodological concept needed to be executed. The PEX study is a randomized clinical trial where exercise therapy is compared to usual care. This trial started in April 2005 and will finish in June 2007. The first results will be

  9. The PEX study - Exercise therapy for patellofemoral pain syndrome: design of a randomized clinical trial in general practice and sports medicine [ISRCTN83938749].

    Science.gov (United States)

    van Linschoten, Robbart; van Middelkoop, Marienke; Berger, Marjolein Y; Heintjes, Edith M; Koopmanschap, Mark A; Verhaar, Jan A N; Koes, Bart W; Bierma-Zeinstra, Sita M A

    2006-03-17

    Patellofemoral complaints are frequently seen in younger and active patients. Clinical strategy is usually based on decreasing provoking activities as sports and demanding knee activities during work and leisure and reassuring the patient on the presumed good outcome. Exercise therapy is also often prescribed although evidence on effectiveness is lacking. The objective of this article is to present the design of a randomized clinical trial that examines the outcome of exercise therapy supervised by a physical therapist versus a clinically accepted "wait and see" approach (information and advice about the complaints only). The research will address to both effectiveness and cost effectiveness of supervised exercise therapy in patients with patellofemoral pain syndrome (PFPS). 136 patients (adolescents and young adults) with patellofemoral pain syndrome are recruited in general practices and sport medicine centers. They will be randomly allocated receiving either 3 months of exercise therapy (or usual care. The primary outcome measures are pain, knee function and perception of recovery after 3 months and 12 months of follow up and will be measured by self reporting. Measurements will take place at baseline, 6 weeks, and 3 monthly until 1 year after inclusion in the study. Secondary outcome measurements include an economic evaluation.A cost-utility analysis will be performed that expresses health improvements in Quality Adjusted Life Years (QALYs) and incorporates direct medical costs and productivity costs This study has been designed after reviewing the literature on exercise therapy for patellofemoral pain syndrome. It was concluded that to merit the effect of exercise therapy a trial based on correct methodological concept needed to be executed. The PEX study is a randomized clinical trial where exercise therapy is compared to usual care. This trial started in April 2005 and will finish in June 2007. The first results will be available around December 2007.

  10. The PEX study – Exercise therapy for patellofemoral pain syndrome: design of a randomized clinical trial in general practice and sports medicine [ISRCTN83938749

    Directory of Open Access Journals (Sweden)

    Verhaar Jan AN

    2006-03-01

    Full Text Available Abstract Background Patellofemoral complaints are frequently seen in younger and active patients. Clinical strategy is usually based on decreasing provoking activities as sports and demanding knee activities during work and leisure and reassuring the patient on the presumed good outcome. Exercise therapy is also often prescribed although evidence on effectiveness is lacking. The objective of this article is to present the design of a randomized clinical trial that examines the outcome of exercise therapy supervised by a physical therapist versus a clinically accepted "wait and see" approach (information and advice about the complaints only. The research will address to both effectiveness and cost effectiveness of supervised exercise therapy in patients with patellofemoral pain syndrome (PFPS. Methods/design 136 patients (adolescents and young adults with patellofemoral pain syndrome are recruited in general practices and sport medicine centers. They will be randomly allocated receiving either 3 months of exercise therapy (or usual care. The primary outcome measures are pain, knee function and perception of recovery after 3 months and 12 months of follow up and will be measured by self reporting. Measurements will take place at baseline, 6 weeks, and 3 monthly until 1 year after inclusion in the study. Secondary outcome measurements include an economic evaluation. A cost-utility analysis will be performed that expresses health improvements in Quality Adjusted Life Years (QALYs and incorporates direct medical costs and productivity costs Discussion This study has been designed after reviewing the literature on exercise therapy for patellofemoral pain syndrome. It was concluded that to merit the effect of exercise therapy a trial based on correct methodological concept needed to be executed. The PEX study is a randomized clinical trial where exercise therapy is compared to usual care. This trial started in April 2005 and will finish in June 2007

  11. Melatonin therapy for blunt trauma and strenuous exercise: A mechanism involving cytokines, NFκB, Akt, MAFBXand MURF-1.

    Science.gov (United States)

    Maarman, Gerald J; Reiter, Russel J

    2018-01-09

    Muscle injury occurs due to trauma, strenuous exercise or sports activities; most people affected are athletes. Ineffectively treated muscle injury can negatively affect sports careers and quality of life after retirement from sports. Reports have indicated that the current therapeutic management of muscle injury, particularly anti-inflammatory drugs, are not necessarily effective. Therefore, better therapies are required. Accumulating evidence has demonstrated melatonin's potent antioxidant and anti-inflammatory actions against muscle pathology in sarcopenia or atrophy in systemic disease. However, the underlying mechanisms for the protective effect of melatonin in the context of trauma/strenuous exercise are multifactorial and not well described. This paper reviews data on melatonin's impact on muscle injury and findings that points toward the mechanisms through which melatonin achieves muscle protection. The general concept described in this review is that melatonin inhibits NFκB, reduces cytokine expression, increases Akt that downregulates the ratio of MAF BX and MURF-1 in order to limit the extent of muscle injury and promote muscle recovery post-injury. The work discussed in this review supports the notion that melatonin may be considered a possible therapy against trauma/sports related muscle injury. Inclusion of melatonin as a therapy in sports medicine could therefore provide a better treatment option for injured athletes and sports individuals.

  12. Effect of Beta-Blocker Therapy, Maximal Heart Rate, and Exercise Capacity During Stress Testing on Long-Term Survival (from The Henry Ford Exercise Testing Project).

    Science.gov (United States)

    Hung, Rupert K; Al-Mallah, Mouaz H; Whelton, Seamus P; Michos, Erin D; Blumenthal, Roger S; Ehrman, Jonathan K; Brawner, Clinton A; Keteyian, Steven J; Blaha, Michael J

    2016-12-01

    Whether lower heart rate thresholds (defined as the percentage of age-predicted maximal heart rate achieved, or ppMHR) should be used to determine chronotropic incompetence in patients on beta-blocker therapy (BBT) remains unclear. In this retrospective cohort study, we analyzed 64,549 adults without congestive heart failure or atrial fibrillation (54 ± 13 years old, 46% women, 29% black) who underwent clinician-referred exercise stress testing at a single health care system in Detroit, Michigan from 1991 to 2009, with median follow-up of 10.6 years for all-cause mortality (interquartile range 7.7 to 14.7 years). Using Cox regression models, we assessed the effect of BBT, ppMHR, and estimated exercise capacity on mortality, with adjustment for demographic data, medical history, pertinent medications, and propensity to be on BBT. There were 9,259 deaths during follow-up. BBT was associated with an 8% lower adjusted achieved ppMHR (91% in no BBT vs 83% in BBT). ppMHR was inversely associated with all-cause mortality but with significant attenuation by BBT (per 10% ppMHR HR: no BBT: 0.80 [0.78 to 0.82] vs BBT: 0.89 [0.87 to 0.92]). Patients on BBT who achieved 65% ppMHR had a similar adjusted mortality rate as those not on BBT who achieved 85% ppMHR (p >0.05). Estimated exercise capacity further attenuated the prognostic value of ppMHR (per-10%-ppMHR HR: no BBT: 0.88 [0.86 to 0.90] vs BBT: 0.95 [0.93 to 0.98]). In conclusion, the prognostic value of ppMHR was significantly attenuated by BBT. For patients on BBT, a lower threshold of 65% ppMHR may be considered for determining worsened prognosis. Estimated exercise capacity further diminished the prognostic value of ppMHR particularly in patients on BBT. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Prevention: Exercise

    Medline Plus

    Full Text Available ... Physical Therapy Postural Training Traction Watchful Waiting and Education Injection Treatments for Spinal Pain Epidural Steroid Injections ... martial arts all provide well-rounded core strengthening programs. Simple exercises can be done at home as ...

  14. Exercise improves quality of life in androgen deprivation therapy-treated prostate cancer: systematic review of randomised controlled trials.

    Science.gov (United States)

    Teleni, Laisa; Chan, Raymond J; Chan, Alexandre; Isenring, Elisabeth A; Vela, Ian; Inder, Warrick J; McCarthy, Alexandra L

    2016-02-01

    Men receiving androgen deprivation therapy (ADT) for prostate cancer (PCa) are likely to develop metabolic conditions such as diabetes, cardiovascular disease, abdominal obesity and osteoporosis. Other treatment-related side effects adversely influence quality of life (QoL) including vasomotor distress, depression, anxiety, mood swings, poor sleep quality and compromised sexual function. The objective of this study was to systematically review the nature and effects of dietary and exercise interventions on QoL, androgen deprivation symptoms and metabolic risk factors in men with PCa undergoing ADT. An electronic search of CINAHL, CENTRAL, Medline, PsychINFO and reference lists was performed to identify peer-reviewed articles published between January 2004 and December 2014 in English. Eligible study designs included randomised controlled trials (RCTs) with pre- and post-intervention data. Data extraction and assessment of methodological quality with the Cochrane approach was conducted by two independent reviewers. Seven exercise studies were identified. Exercise significantly improved QoL, but showed no effect on metabolic risk factors (weight, waist circumference, lean or fat mass, blood pressure and lipid profile). Two dietary studies were identified, both of which tested soy supplements. Soy supplementation did not improve any outcomes. No dietary counselling studies were identified. No studies evaluated androgen-deficiency symptoms (libido, erectile function, sleep quality, mood swings, depression, anxiety and bone mineral density). Evidence from RCTs indicates that exercise enhances health- and disease-specific QoL in men with PCa undergoing ADT. Further studies are required to evaluate the effect of exercise and dietary interventions on QoL, androgen deprivation symptoms and metabolic risk factors in this cohort. © 2016 Society for Endocrinology.

  15. Changes in pain-free walking based on time in accommodating pain-free exercise therapy for peripheral arterial disease.

    Science.gov (United States)

    Martinez, Coleen Archer; Carmeli, Eli; Barak, Sharon; Stopka, Christine Boyd

    2009-03-01

    Symptoms of intermittent claudication (IC) can be relieved by lifestyle modification, medications, and walking exercises. The intensity of the walking exercise is still debatable. The goal of this study was to determine the effects of accommodating pain-free walking exercise therapy program length on pain-free walking. A descriptive, longitudinal study with repeated measures of exercise capacity was conducted. An IC questionnaire was administered to assess IC signs, symptoms, and lifestyle. Walking was performed on a treadmill for 30 to 50 minutes below the participant's individualized walking pain threshold. The study included patients diagnosed with IC due to peripheral arterial disease. All participants were randomly assigned to three groups. Group A (n = 28) participated in the walking program for 2-9 weeks, group B (n = 30) for 10-14 weeks, and group C (n = 26) for 15-94 weeks. The main outcome measure of the study was to determine changes in exercise capacity: walking distance (miles), walking duration (minutes), and walking speed (mph). Group A increased the amount of distance, duration, and speed walked from pretest to posttest by 80% (P < .001), 27% (P < .001), and 37% (P < .001), respectively. Group B increased the amount of distance, duration, and speed walked from pretest to posttest by 122% (P < .001), 56% (P < .001), and 43% (P < .001), respectively. Group C increased the amount of distance, duration, and speed walked from pretest to posttest by 26% (P = .002), 22% (P = .002), and 5% (P = .541) respectively. We reached the conclusion that a walking program of 10-14 weeks is optimal for achieving the best improvements in walking distance, duration, and speed.

  16. Chiropractic manipulative therapy of the thoracic spine in combination with stretch and strengthening exercises, in improving postural kyphosis in woman

    Directory of Open Access Journals (Sweden)

    Kim C. Branco

    2016-10-01

    Method: A randomised study design with thirty female participants between the ages of twenty and  thirty nine was selected. Group 1 (n = 10 received chiropractic spinal manipulative therapy to the thoracic spine. Group 2 (n = 10 received chiropractic spinal manipulative therapy to the thoracic spine as well as stretch and strengthening exercises i.e. stretching the pectoralis major muscles and strengthening the rhomboid, middle and inferior trapezius muscles. Group 3 (n = 10 received stretch and strengthening exercises. The stretch and strengthening exercises were performed in the consultation rooms to ensure that the participants were complying with the treatment and doing the exercises properly. The study consisted of seven consultations for Group 1 (they received treatment once a week for six weeks and for Groups 2 and 3 there were nineteen consultations (they received three treatments a week for six weeks. Objective data was recorded at the beginning of the first, fourth and seventh consultations for Group 1, and the first, tenth and nineteenth consultations for Groups 2 and 3. On the seventh consultation (for Group 1 and nineteenth consultation for Groups 2 and 3, only data collection was done. Objective data were obtained by using the Flexicurve® Ruler measurements for the angle of kyphosis. Visual analysis was done by taking lateral (sagittal view photographs at the beginning of the initial and final consultations. Results: Statistical analysis revealed significant statistical changes for the intragroup results for all three groups. No significant statistical difference was found between the groups for the inter-group analysis. Conclusion: The study showed that all three treatment protocols for Groups 1, 2, and 3 were effective. However, Group 1 had not shown a great improvement in their postural kyphosis, Group 3 had shown a relatively good improvement in their posture, while Group 2 had shown the best results with regards to improvement of the

  17. Virtual reality pain control during physical therapy range of motion exercises for a patient with multiple blunt force trauma injuries.

    Science.gov (United States)

    Hoffman, Hunter G; Patterson, David R; Soltani, Maryam; Teeley, Aubriana; Miller, William; Sharar, Sam R

    2009-02-01

    Patients with severe blunt force trauma injuries (e.g., multiple fractures and/or internal injuries) often experience severe to excruciating pain during medical procedures. We explored the adjunctive use of immersive virtual reality (VR) to distract a patient with multiple blunt trauma injuries from his procedural pain during physical therapy. The patient was a 32-year-old male hospitalized after suffering upper and lower extremity injuries when he was hit by a semi truck as a pedestrian. While a nurse assisted the patient's passive range of motion (ROM) leg exercises over two days, the patient spent a total of 10 minutes of physical therapy with no distraction and 10 minutes in VR (within-subjects design, order randomized). Three 0 to 10 graphic-rating-scale pain scores for each of the two treatment conditions served as the primary dependent variables. The patient reported a reduction in pain when distracted with VR. "Pain unpleasantness" ratings during physical therapy dropped from "severe" (mean = 8.5) to "mild/moderate" (4.5). The patient's ROM was 1 degree less during VR on day 1, but the patient achieved 15 degrees greater ROM during VR on day 2. The present study provides preliminary evidence that immersive VR can be an effective adjunctive, nonpharmacologic pain-reduction technique for a patient with multiple blunt trauma injuries experiencing severe pain during physical therapy. The potential utility of VR analgesia for movement or exercise therapy for patients with blunt force trauma injuries should be explored in controlled studies.

  18. Association of Exercise Therapy and Reduction of Pain Sensitivity in Patients With Knee Osteoarthritis

    DEFF Research Database (Denmark)

    Henriksen, Marius; Klokker, Louise; Graven-Nielsen, Thomas

    2014-01-01

    visual analog scale pain scores during constant pressure for 6 minutes at 125% of the PPT as a measure of temporal summation (TS) of pressure-pain. Secondary outcomes included self-reported pain using the Knee Injury and Osteoarthritis Outcome Score (KOOS) questionnaire. Analyses were based on the "per...... supervised exercise program compared to a no attention CG. These results demonstrate beneficial effects of exercise on basic pain mechanisms and further exploration may provide a basis for optimized treatment....

  19. Efficacy of exercise therapy in workers with rotator cuff tendinopathy: a systematic review.

    Science.gov (United States)

    Desmeules, François; Boudreault, Jennifer; Dionne, Clermont E; Frémont, Pierre; Lowry, Véronique; MacDermid, Joy C; Roy, Jean-Sébastien

    2016-09-30

    To perform a systematic review of randomized controlled trials (RCTs) on the efficacy of therapeutic exercises for workers suffering from rotator cuff (RC) tendinopathy. A literature search in four bibliographical databases (Pubmed, CINAHL, EMBASE, and PEDro) was conducted from inception up to February 2015. RCTs were included if participants were workers suffering from RC tendinopathy, the outcome measures included work-related outcomes, and at least one of the interventions under study included exercises. The methodological quality of the studies was evaluated with the Cochrane Risk of Bias Assessment tool. The mean methodological score of the ten included studies was 54.4%±17.2%. Types of workers included were often not defined, and work-related outcome measures were heterogeneous and often not validated. Three RCTs of moderate methodological quality concluded that exercises were superior to a placebo or no intervention in terms of function and return-to-work outcomes. No significant difference was found between surgery and exercises based on the results of two studies of low to moderate methodological quality. One study of low methodological quality, comparing a workplace-based exercise program focusing on the participants' work demands to an exercise program delivered in a clinical setting, concluded that the work-based intervention was superior in terms of function and return-to-work outcomes. There is low to moderate-grade evidence that therapeutic exercises provided in a clinical setting are an effective modality to treat workers suffering from RC tendinopathy and to promote return-to-work. Further high quality studies comparing different rehabilitation programs including exercises in different settings with defined workers populations are needed to draw firm conclusions on the optimal program to treat workers.

  20. Effects of exercise therapy on knee joint function and synovial fluid cytokine levels in patients with knee osteoarthritis.

    Science.gov (United States)

    Zhang, Shao-Lan; Liu, Hong-Qi; Xu, Xiao-Zu; Zhi, Juan; Geng, Jiao-Jiao; Chen, Jin

    2013-01-01

    The aims of this study were to observe the effect of exercise therapy on the function of the knee joint and the levels of cytokines and cytokine-related genes, specifically tumor necrosis factor-α (TNF-α), high sensitivity C-reactive protein (hs-CRP) and matrix metalloproteinase-3 (MMP-3), in the synovial joints of patients with knee osteoarthritis (KOA) and to explore its mechanism of action. A total of 100 KOA patients were divided into a treatment group (n=50) and a control group (n=50) according to the order of admission. The patients in the treatment group were treated with diclofenac sodium combined with exercise therapy and the patients in the control group were treated with diclofenac sodium only. The function of the knee joint and the therapeutic efficacy was evaluated and the TNF-α, hs-CRP and MMP-3 levels in the synovial fluid were measured following 4 weeks of treatment. The results revealed that the knee joint index score and the TNF-α, hs-CRP and MMP-3 levels in the synovial fluid decreased significantly in the KOA patients of the two groups following treatment (Pknee joint index score and the TNF-α, hs-CRP and MMP-3 levels in the synovial joints were lower and the therapeutic efficacy was increased in the patients of the treatment group (P<0.05). In brief, exercise therapy may decrease cytokine and cytokine-related gene levels in the synovial fluid and inhibit inflammatory factor-mediated cartilage degradation in KOA patients, thus, effectively improving the clinical symptoms of KOA.

  1. The Effect of Aquatic Exercise Therapy on Muscle Strength and Joint's Range of Motion in Hemophilia Patients.

    Science.gov (United States)

    Kargarfard, Mehdi; Dehghadani, Mehdi; Ghias, Reza

    2013-01-01

    This study was to evaluate the effect of a period of aquatic exercise therapy on muscle strength and joints range of motion in hemophilia patients. This was a semiexperimental, pretest, post-test study with a control group. This semi-experimental study comprised twenty men suffering moderate hemophilia were selected by convenience sampling method from patients of a referral hospital. They were randomly assigned to intervention and control groups of equal number. The hemophilia patients who were referred to Sayedo-Shohada Hospital enrolled in this study. Twenty men suffering moderate hemophilia were selected using convenience sampling method and then divided randomly into intervention and control groups (10 patients in each group). Subjects of aquatic exercise therapy group underwent activity in water in three sessions (45-60 minutes) per week for 8 weeks, while the control group was only under follow-up and during this period did not experience any effective physical activity. The patients' muscle strength and joint range of motion were evaluated through standard laboratory tools, using an isokinetic dynamometer (Biodex, Systems III) and a standard goniometer in the beginning and at end of the study. Finally, data was analyzed using analysis of covariance (ANCOVA). The strength of the muscles around the knee joint (to perform extension and flexion movements) increased significantly in the case group while the control group experienced a significant reduction of strength in left leg, but in right leg remarkable change was observed. Range of motion in all joints was improved in the case group, while the control group did not improve significantly. The results showed that aquatic exercise therapy can be a useful method to improve joints' strength and range of motion in hemophilia patients in order to improve their daily functioning and quality of life.

  2. Exercise therapy in oncology rehabilitation in Australia: A mixed-methods study.

    Science.gov (United States)

    Dennett, Amy M; Peiris, Casey L; Shields, Nora; Morgan, Delwyn; Taylor, Nicholas F

    2017-10-01

    Oncology rehabilitation improves outcomes for cancer survivors but little is known about program availability in Australia. The aims of this study were: to describe oncology rehabilitation programs in Australia: determine whether the exercise component of programs is consistent with guidelines: and to explore barriers and facilitators to program implementation. A sequential, explanatory mixed-methods study was completed in two phases: (1) a survey of Australian oncology rehabilitation programs; and (2) purposively sampled follow-up semistructured interviews with senior clinicians working in oncology rehabilitation who were involved with exercise prescription. Hospitals and/or cancer centers from 42 public hospital health networks (representing 163 hospitals) and 39 private hospitals were contacted to identify 31 oncology rehabilitation programs. All 31 surveys were returned (100% response rate). Programs were typically multidisciplinary, ran twice weekly, provided education and exercise and included self-management strategies. Exercise prescription and progression was patient centered and included a combination of resistance and aerobic training supplemented by balance, pelvic floor, and core stability exercises. Challenges to implementation included a lack of awareness of programs in the community and organizational barriers such as funding. Strong links with oncologists facilitated program referrals. Despite evidence to support oncology rehabilitation, there are few programs in Australia and there are challenges that limit it becoming part of standard practice. Programs that exist are multidisciplinary with a focus on exercise with the majority of programs following a cardiac rehabilitation model of care. © 2016 John Wiley & Sons Australia, Ltd.

  3. Skeletal Muscle Sorbitol Levels in Diabetic Rats with and without Insulin Therapy and Endurance Exercise Training

    Directory of Open Access Journals (Sweden)

    O. A. Sánchez

    2009-01-01

    Full Text Available Sorbitol accumulation is postulated to play a role in skeletal muscle dysfunction associated with diabetes. The purpose of this study was to determine the effects of insulin and of endurance exercise on skeletal muscle sorbitol levels in streptozotocin-induced diabetic rats. Rats were assigned to one of five experimental groups (control sedentary, control exercise, diabetic sedentary, diabetic exercise, diabetic sedentary no-insulin. Diabetic rats received daily subcutaneous insulin. The exercise-trained rats ran on a treadmill (1 hour, 5X/wk, for 12 weeks. Skeletal muscle sorbitol levels were the highest in the diabetic sedentary no-insulin group. Diabetic sedentary rats receiving insulin had similar sorbitol levels to control sedentary rats. Endurance exercise did not significantly affect sorbitol levels. These results indicate that insulin treatment lowers sorbitol in skeletal muscle; therefore sorbitol accumulation is probably not related to muscle dysfunction in insulin-treated diabetic individuals. Endurance exercise did not influence intramuscular sorbitol values as strongly as insulin.

  4. The efficacy of manual therapy and exercise for treating non-specific neck pain: A systematic review.

    Science.gov (United States)

    Hidalgo, Benjamin; Hall, Toby; Bossert, Jean; Dugeny, Axel; Cagnie, Barbara; Pitance, Laurent

    2017-11-06

    To review and update the evidence for different forms of manual therapy (MT) and exercise for patients with different stages of non-specific neck pain (NP). MEDLINE, Cochrane-Register-of-Controlled-Trials, PEDro, EMBASE. A qualitative systematic review covering a period from January 2000 to December 2015 was conducted according to updated-guidelines. Specific inclusion criteria only on RCTs were used; including differentiation according to stages of NP (acute - subacute [ASNP] or chronic [CNP]), as well as sub-classification based on type of MT interventions: MT1 (HVLA manipulation); MT2 (mobilization and/or soft-tissue-techniques); MT3 (MT1 + MT2); and MT4 (Mobilization-with-Movement). In each sub-category, MT could be combined or not with exercise and/or usual medical care. Initially 121 studies were identified for potential inclusion. Based on qualitative and quantitative evaluation criteria, 23 RCTs were identified for review. Evidence for ASNP: MODERATE-evidence: In favour of (i) MT1 to the cervical spine (Cx) combined with exercises when compared to MT1 to the thoracic spine (Tx) combined with exercises; (ii) MT3 to the Cx and Tx combined with exercise compared to MT2 to the Cx with exercise or compared to usual medical care for pain and satisfaction with care from short to long-term. Evidence for CNP: STRONG-evidence: Of no difference of efficacy between MT2 at the symptomatic Cx level(s) in comparison to MT2 on asymptomatic Cx level(s) for pain and function. MODERATE to STRONG-evidence: In favour of MT1 and MT3 on Cx and Tx with exercise in comparison to exercise or MT alone for pain, function, satisfaction with care and general-health from short to moderate-terms. MODERATE-evidence: In favour (i) of MT1 as compared to MT2 and MT4, all applied to the Cx, for neck mobility, and pain in the very short term; (ii) of MT2 using sof-tissue-techniques to the Cx and Tx or MT3 to the Cx and Tx in comparison to no-treatment in the short-term for pain and disability

  5. Efficacy of standardised manual therapy and home exercise programme for chronic rotator cuff disease: randomised placebo controlled trial.

    Science.gov (United States)

    Bennell, Kim; Wee, Elin; Coburn, Sally; Green, Sally; Harris, Anthony; Staples, Margaret; Forbes, Andrew; Buchbinder, Rachelle

    2010-06-08

    To investigate the efficacy of a programme of manual therapy and exercise treatment compared with placebo treatment delivered by physiotherapists for people with chronic rotator cuff disease. Randomised, participant and single assessor blinded, placebo controlled trial. Metropolitan region of Melbourne, Victoria, Australia. 120 participants with chronic (>3 months) rotator cuff disease recruited through medical practitioners and from the community. The active treatment comprised a manual therapy and home exercise programme; the placebo treatment comprised inactive ultrasound therapy and application of an inert gel. Participants in both groups received 10 sessions of individual standardised treatment over 10 weeks. For the following 12 weeks, the active group continued the home exercise programme and the placebo group received no treatment. The primary outcomes were pain and function measured by the shoulder pain and disability index, average pain on movement measured on an 11 point numerical rating scale, and participants' perceived global rating of overall change. 112 (93%) participants completed the 22 week trial. At 11 weeks no difference was found between groups for change in shoulder pain and disability index (3.6, 95% confidence interval -2.1 to 9.4) or change in pain (0.7, -0.1 to 1.5); both groups showed significant improvements. More participants in the active group reported a successful outcome (defined as "much better"), although the difference was not statistically significant: 42% (24/57) of active participants and 30% (18/61) of placebo participants (relative risk 1.43, 0.87 to 2.34). The active group showed a significantly greater improvement in shoulder pain and disability index than did the placebo group at 22 weeks (between group difference 7.1, 0.3 to 13.9), although no significant difference existed between groups for change in pain (0.9, -0.03 to 1.7) or for the percentage of participants reporting a successful treatment outcome (relative risk

  6. Does targeting manual therapy and/or exercise improve patient outcomes in nonspecific low back pain? A systematic review.

    Science.gov (United States)

    Kent, Peter; Mjøsund, Hanne L; Petersen, Ditte H D

    2010-04-08

    A central element in the current debate about best practice management of non-specific low back pain (NSLBP) is the efficacy of targeted versus generic (non-targeted) treatment. Many clinicians and researchers believe that tailoring treatment to NSLBP subgroups positively impacts on patient outcomes. Despite this, there are no systematic reviews comparing the efficacy of targeted versus non-targeted manual therapy and/or exercise. This systematic review was undertaken in order to determine the efficacy of such targeted treatment in adults with NSLBP. MEDLINE, EMBASE, Current Contents, AMED and the Cochrane Central Register of Controlled Trials were electronically searched, reference lists were examined and citation tracking performed. Inclusion criteria were randomized controlled trials of targeted manual therapy and/or exercise for NSLPB that used trial designs capable of providing robust information on targeted treatment (treatment effect modification) for the outcomes of activity limitation and pain. Included trials needed to be hypothesis-testing studies published in English, Danish or Norwegian. Method quality was assessed using the criteria recommended by the Cochrane Back Review Group. Four high-quality randomized controlled trials of targeted manual therapy and/or exercise for NSLBP met the inclusion criteria. One study showed statistically significant effects for short-term outcomes using McKenzie directional preference-based exercise. Research into subgroups requires much larger sample sizes than traditional two-group trials and other included studies showed effects that might be clinically important in size but were not statistically significant with their samples sizes. The clinical implications of these results are that they provide very cautious evidence supporting the notion that treatment targeted to subgroups of patients with NSLBP may improve patient outcomes. The results of the studies included in this review are too patchy, inconsistent and the

  7. Does targeting manual therapy and/or exercise improve patient outcomes in nonspecific low back pain? A systematic review

    DEFF Research Database (Denmark)

    Kent, Peter; Mjøsund, Hanne L; Petersen, Ditte H D

    2010-01-01

    A central element in the current debate about best practice management of non-specific low back pain (NSLBP) is the efficacy of targeted versus generic (non-targeted) treatment. Many clinicians and researchers believe that tailoring treatment to NSLBP subgroups positively impacts on patient...... outcomes. Despite this, there are no systematic reviews comparing the efficacy of targeted versus non-targeted manual therapy and/or exercise. This systematic review was undertaken in order to determine the efficacy of such targeted treatment in adults with NSLBP....

  8. Chiropractic manipulative therapy of the thoracic spine in combination with stretch and strengthening exercises, in improving postural kyphosis in woman

    Directory of Open Access Journals (Sweden)

    Kim Castello Branco

    2016-12-01

    Conclusion: The study showed that all three treatment protocols for Groups 1, 2, and 3 were effective. However, Group 1 had not shown a great improvement in their postural kyphosis, Group 3 had shown a relatively good improvement in their posture, while Group 2 had shown the best results with regards to improvement of the participants' posture. Therefore, in conclusion, Groups 2 and 3 treatment protocols can be used effectively to treat postural kyphosis but Group 2's treatment protocol, consisting of chiropractic spinal manipulative therapy to the thoracic spine in combination with stretch and strengthening exercises, will yield the best results.

  9. Does targeting manual therapy and/or exercise improve patient outcomes in nonspecific low back pain? A systematic review

    Directory of Open Access Journals (Sweden)

    Mjøsund Hanne L

    2010-04-01

    Full Text Available Abstract Background A central element in the current debate about best practice management of non-specific low back pain (NSLBP is the efficacy of targeted versus generic (non-targeted treatment. Many clinicians and researchers believe that tailoring treatment to NSLBP subgroups positively impacts on patient outcomes. Despite this, there are no systematic reviews comparing the efficacy of targeted versus non-targeted manual therapy and/or exercise. This systematic review was undertaken in order to determine the efficacy of such targeted treatment in adults with NSLBP. Method MEDLINE, EMBASE, Current Contents, AMED and the Cochrane Central Register of Controlled Trials were electronically searched, reference lists were examined and citation tracking performed. Inclusion criteria were randomized controlled trials of targeted manual therapy and/or exercise for NSLPB that used trial designs capable of providing robust information on targeted treatment (treatment effect modification for the outcomes of activity limitation and pain. Included trials needed to be hypothesis-testing studies published in English, Danish or Norwegian. Method quality was assessed using the criteria recommended by the Cochrane Back Review Group. Results Four high-quality randomized controlled trials of targeted manual therapy and/or exercise for NSLBP met the inclusion criteria. One study showed statistically significant effects for short-term outcomes using McKenzie directional preference-based exercise. Research into subgroups requires much larger sample sizes than traditional two-group trials and other included studies showed effects that might be clinically important in size but were not statistically significant with their samples sizes. Conclusions The clinical implications of these results are that they provide very cautious evidence supporting the notion that treatment targeted to subgroups of patients with NSLBP may improve patient outcomes. The results of the

  10. Exercise, education, manual-therapy and taping compared to education for patellofemoral osteoarthritis: a blinded, randomised clinical trial.

    Science.gov (United States)

    Crossley, K M; Vicenzino, B; Lentzos, J; Schache, A G; Pandy, M G; Ozturk, H; Hinman, R S

    2015-09-01

    Patellofemoral joint osteoarthritis (PFJ OA) contributes considerably to knee OA symptoms. This study aimed to determine the efficacy of a PFJ-targeted exercise, education manual-therapy and taping program compared to OA education alone, in participants with PFJ OA. A randomised, participant-blinded and assessor-blinded clinical trial was conducted in primary-care physiotherapy. 92 people aged ≥40 years with symptomatic and radiographic PFJ OA participated. Physiotherapists delivered the PFJ-targeted exercise, education, manual-therapy and taping program, or the OA-education (control condition) in eight sessions over 12 weeks. Primary outcomes at 3-month (primary) and 9-month follow-up: (1) patient-perceived global rating of change (2) pain visual analogue scale (VAS) (100 mm); and (3) activities of daily living (ADL) subscale of the Knee injury and Osteoarthritis Outcome Score (KOOS). 81 people (88%) completed the 3-month follow-up and data analysed on an intention-to-treat basis. Between-group baseline similarity for participant characteristics was observed. The exercise, education, manual-therapy and taping program resulted in more people reporting much improvement (20/44) than the OA-education group (5/48) (number needed to treat 3 (95% confidence interval (CI) 2 to 5)) and greater pain reduction (mean difference: -15.2 mm, 95% CI -27.0 to -3.4). No significant effects on ADL were observed (5.8; 95% CI -0.6 to 12.1). At 9 months there were no significant effects for self-report of improvement, pain (-10.5 mm, 95% CI -22.7 to 1.8) or ADL (3.0, 95% CI -3.7 to 9.7). Exercise, education, manual-therapy and taping can be recommended to improve short-term patient rating of change and pain severity. However over 9-months, both options were equivalent. Australian New Zealand Clinical Trials Registry (ACTRN12608000288325): https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=82878. Copyright © 2015 Osteoarthritis Research Society International. Published

  11. Exercise therapy for low back pain: a small-scale exploratory survey of current physiotherapy practice in the Republic of Ireland acute hospital setting.

    Science.gov (United States)

    Byrne, Karol; Doody, Catherine; Hurley, Deirdre A

    2006-11-01

    A small-scale exploratory cross-sectional survey investigated the current use of a range of exercise therapy approaches for low back pain (LBP) by outpatient physiotherapists in the acute hospital setting in the Republic of Ireland, where the majority of publicly funded treatment is delivered. Of the 120 postal questionnaires distributed to 24 physiotherapy departments, 87 were returned (72.5% response rate). The results showed specific spinal stabilization exercises were the most popular exercise therapy for acute (39%; n = 35) and chronic (51%; n = 48) LBP, followed by the McKenzie approach (acute LBP (ALBP) 35.6%; n = 32: chronic LBP (CLBP) 17%; n = 16), and abdominal exercise (ALBP 11.1%; n = 10: CLBP 9.6%; n = 9). The most popular forms of exercise therapy used by outpatient physiotherapists in acute hospital settings in Ireland lack support from evidence-based clinical guidelines, and further large-scale high quality randomized controlled trials of these approaches are warranted. Further research should also establish the use of exercise therapy and attitudes to clinical guidelines of physiotherapists in other countries and healthcare settings.

  12. Internet-Based Exercise Therapy Using Algorithms for Conservative Treatment of Anterior Knee Pain: A Pragmatic Randomized Controlled Trial.

    Science.gov (United States)

    Kim, Tae Won Benjamin; Gay, Nic; Khemka, Arpit; Garino, Jonathan

    2016-12-14

    Conservative treatment remains the first-line option, and there is significant medical evidence showing that home-based exercise therapy for the treatment of common causes of knee pain is effective. SimpleTherapy created an online platform that delivers Internet-based exercise therapy for common causes of knee pain. The system is driven by an algorithm that can process the user's feedback to provide an adaptive exercise regimen. This triple-armed, pragmatic randomized pilot was designed to evaluate if this telerehabilitation platform is safe and effective. We hypothesized that a home-based, algorithm-driven exercise therapy program can be safe for use and even improve compliance over the standard of care, the paper handout. After an independent internal review board review and approval, the website trial.simpletherapy.com was opened. Once the trial was open for enrollment, no changes to the functionality or user interaction features were performed until the trial had closed. User accrual to the website was done using website optimization and social media postings tied to existence of knee pain. Consent was obtained online through checkboxes with third-party signature confirmation. No fees were charged to any patient. Patients were recruited online from an open access website. Outcomes were self-assessed through questionnaires with no face-to-face clinician interaction. A triple-arm randomized controlled trial was used with arm 1 being a static handout of exercises, arm 2 being a video version of arm 1, and arm 3 being a video-based, algorithm-driven system that took patient feedback and changed the exercises based on the feedback. Patients used household items and were not supervised by a physical therapist or clinician. Patients were reminded at 48-hour intervals to complete an exercise session. A total of 860 users found the trial and initiated the registration process. These 860 were randomized, and the demographic distribution shows the randomization was

  13. The effects of manual therapy or exercise therapy or both in people with hip osteoarthritis: a systematic review and meta-analysis.

    Science.gov (United States)

    Sampath, Kesava Kovanur; Mani, Ramakrishnan; Miyamori, Takayuki; Tumilty, Steve

    2016-12-01

    To determine whether manual therapy or exercise therapy or both is beneficial for people with hip osteoarthritis in terms of reduced pain, improved physical function and improved quality of life. Databases such as Medline, AMED, EMBASE, CINAHL, SPORTSDiscus, PubMed, Cochrane Library, Web of Science, Physiotherapy Evidence Database, and SCOPUS were searched from their inception till September 2015. Two authors independently extracted and assessed the risk of bias in included studies. Standardised mean differences for outcome measures (pain, physical function and quality of life) were used to calculate effect sizes. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach was used for assessing the quality of the body of evidence for each outcome of interest. Seven trials (886 participants) that met the inclusion criteria were included in the meta-analysis. There was high quality evidence that exercise therapy was beneficial at post-treatment (pain-SMD-0.27,95%CI-0.5to-0.04;physical function-SMD-0.29,95%CI-0.47to-0.11) and follow-up (pain-SMD-0.24,95%CI- 0.41to-0.06; physical function-SMD-0.33,95%CI-0.5to-0.15). There was low quality evidence that manual therapy was beneficial at post-treatment (pain-SMD-0.71,95%CI-1.08to-0.33; physical function-SMD-0.71,95%CI-1.08to-0.33) and follow-up (pain-SMD-0.43,95%CI-0.8to-0.06; physical function-SMD-0.47,95%CI-0.84to-0.1). Low quality evidence indicated that combined treatment was beneficial at post-treatment (pain-SMD-0.43,95%CI-0.78to-0.08; physical function-SMD-0.38,95%CI-0.73to-0.04) but not at follow-up (pain-SMD0.25,95%CI-0.35to0.84; physical function-SMD0.09,95%CI-0.5to0.68). There was no effect of any interventions on quality of life. An Exercise therapy intervention provides short-term as well as long-term benefits in terms of reduction in pain, and improvement in physical function among people with hip osteoarthritis. The observed magnitude of the treatment effect would be considered

  14. The Interaction Between Statins and Exercise: Mechanisms and Strategies to Counter the Musculoskeletal Side Effects of This Combination Therapy

    Science.gov (United States)

    Deichmann, Richard E.; Lavie, Carl J.; Asher, Timothy; DiNicolantonio, James J.; O'Keefe, James H.; Thompson, Paul D.

    2015-01-01

    Background Broad indications for the use of statin medications are resulting in more patients using these therapies. Simultaneously, healthcare professionals are strongly advocating recommendations to increase exercise training (ET) as a means of decreasing cardiovascular disease (CVD) risk and improving other parameters of fitness. Methods We review the literature to explore mechanisms that may increase the risk of statin/ET interactions, examine the benefits and risks of combining ET and statin use, and offer strategies to minimize the hazards of this combination therapy. Results The combined use of statins and ET can result in health gains and decreased CVD risk; however, multiple factors may increase the risk of adverse events. Some of the events that have been reported with the combination of statins and ET include decreased athletic performance, muscle injury, myalgia, joint problems, decreased muscle strength, and fatigue. The type of statin, the dose, drug interactions, genetic variants, coenzyme Q10 deficiency, vitamin D deficiency, and underlying muscle diseases are among the factors that may predispose patients to intolerance of this combined therapy. Conclusion Effective strategies exist to help patients who may be intolerant of combined statin therapy and ET so they may benefit from this proven therapy. Careful attention to identifying high-risk groups and strategies to prevent or treat side effects that may occur should be employed. PMID:26730228

  15. Comparison of adaptive pacing therapy, cognitive behaviour therapy, graded exercise therapy, and specialist medical care for chronic fatigue syndrome (PACE): a randomised trial.

    Science.gov (United States)

    White, P D; Goldsmith, K A; Johnson, A L; Potts, L; Walwyn, R; DeCesare, J C; Baber, H L; Burgess, M; Clark, L V; Cox, D L; Bavinton, J; Angus, B J; Murphy, G; Murphy, M; O'Dowd, H; Wilks, D; McCrone, P; Chalder, T; Sharpe, M

    2011-03-05

    Trial findings show cognitive behaviour therapy (CBT) and graded exercise therapy (GET) can be effective treatments for chronic fatigue syndrome, but patients' organisations have reported that these treatments can be harmful and favour pacing and specialist health care. We aimed to assess effectiveness and safety of all four treatments. In our parallel-group randomised trial, patients meeting Oxford criteria for chronic fatigue syndrome were recruited from six secondary-care clinics in the UK and randomly allocated by computer-generated sequence to receive specialist medical care (SMC) alone or with adaptive pacing therapy (APT), CBT, or GET. Primary outcomes were fatigue (measured by Chalder fatigue questionnaire score) and physical function (measured by short form-36 subscale score) up to 52 weeks after randomisation, and safety was assessed primarily by recording all serious adverse events, including serious adverse reactions to trial treatments. Primary outcomes were rated by participants, who were necessarily unmasked to treatment assignment; the statistician was masked to treatment assignment for the analysis of primary outcomes. We used longitudinal regression models to compare SMC alone with other treatments, APT with CBT, and APT with GET. The final analysis included all participants for whom we had data for primary outcomes. This trial is registered at http://isrctn.org, number ISRCTN54285094. We recruited 641 eligible patients, of whom 160 were assigned to the APT group, 161 to the CBT group, 160 to the GET group, and 160 to the SMC-alone group. Compared with SMC alone, mean fatigue scores at 52 weeks were 3·4 (95% CI 1·8 to 5·0) points lower for CBT (p = 0·0001) and 3·2 (1·7 to 4·8) points lower for GET (p = 0·0003), but did not differ for APT (0·7 [-0·9 to 2·3] points lower; p = 0·38). Compared with SMC alone, mean physical function scores were 7·1 (2·0 to 12·1) points higher for CBT (p = 0·0068) and 9·4 (4·4 to 14·4) points higher

  16. Study protocol of the TIRED study : A randomised controlled trial comparing either graded exercise therapy for severe fatigue or cognitive behaviour therapy with usual care in patients with incurable cancer

    NARCIS (Netherlands)

    Poort, Hanneke; Verhagen, Constans A. H. H. V. M.; Peters, Marlies E. W. J.; Goedendorp, Martine M.; Donders, A. Rogier T.; Hopman, Maria T. E.; Nijhuis-van der Sanden, Maria W. G.; Berends, Thea; Bleijenberg, Gijs; Knoop, Hans

    2017-01-01

    Background: Fatigue is a common and debilitating symptom for patients with incurable cancer receiving systemic treatment with palliative intent. There is evidence that non-pharmacological interventions such as graded exercise therapy (GET) or cognitive behaviour therapy (CBT) reduce cancer-related

  17. Physical exercise and internet-based cognitive-behavioural therapy in the treatment of depression: randomised controlled trial.

    Science.gov (United States)

    Hallgren, Mats; Kraepelien, Martin; Öjehagen, Agneta; Lindefors, Nils; Zeebari, Zangin; Kaldo, Viktor; Forsell, Yvonne

    2015-09-01

    Depression is common and tends to be recurrent. Alternative treatments are needed that are non-stigmatising, accessible and can be prescribed by general medical practitioners. To compare the effectiveness of three interventions for depression: physical exercise, internet-based cognitive-behavioural therapy (ICBT) and treatment as usual (TAU). A secondary aim was to assess changes in self-rated work capacity. A total of 946 patients diagnosed with mild to moderate depression were recruited through primary healthcare centres across Sweden and randomly assigned to one of three 12-week interventions (trail registry: KCTR study ID: KT20110063). Patients were reassessed at 3 months (response rate 78%). Patients in the exercise and ICBT groups reported larger improvements in depressive symptoms compared with TAU. Work capacity improved over time in all three groups (no significant differences). Exercise and ICBT were more effective than TAU by a general medical practitioner, and both represent promising non-stigmatising treatment alternatives for patients with mild to moderate depression. © The Royal College of Psychiatrists 2015.

  18. A 9-week randomized trial comparing a chronotherapeutic intervention (wake and light therapy) to exercise in major depressive disorder patients treated with duloxetine.

    Science.gov (United States)

    Martiny, Klaus; Refsgaard, Else; Lund, Vibeke; Lunde, Marianne; Sørensen, Lene; Thougaard, Britta; Lindberg, Lone; Bech, Per

    2012-09-01

    The onset of action of antidepressants often takes 4 to 6 weeks. The antidepressant effect of wake therapy (sleep deprivation) comes within hours but carries a risk of relapse. The objective of this study was to investigate whether a new chronotherapeutic intervention combining wake therapy with bright light therapy and sleep time stabilization could induce a rapid and sustained augmentation of response and remission in major depressive disorder. 75 adult patients with DSM-IV major depressive disorder, recruited from psychiatric wards, psychiatric specialist practices, or general medical practices between September 2005 and August 2008, were randomly assigned to a 9-week chronotherapeutic intervention using wake therapy, bright light therapy, and sleep time stabilization (n = 37) or a 9-week intervention using daily exercise (n = 38). Patients were evaluated at a psychiatric research unit. The study period had a 1-week run-in phase in which all patients began treatment with duloxetine. This phase was followed by a 1-week intervention phase in which patients in the wake therapy group did 3 wake therapies in combination with daily morning light therapy and sleep time stabilization and patients in the exercise group began daily exercise. This phase was followed by a 7-week continuation phase with daily light therapy and sleep time stabilization or daily exercise. The 17-item Hamilton Depression Rating Scale was the primary outcome measure, and the assessors were blinded to patients' treatment allocation. Both groups responded well to treatment. Patients in the wake therapy group did, however, have immediate and clinically significantly better response and remission compared to the exercise group. Thus, immediately after the intervention phase (week 2), response was obtained in 41.4% of wake therapy patients versus 12.8% of exercise patients (odds ratio [OR] = 4.8; 95% CI, 1.7-13.4; P = .003), and remission was obtained in 23.9% of wake therapy patients versus 5.4% of

  19. Pilates exercise training vs. physical therapy for improving walking and balance in people with multiple sclerosis: a randomized controlled trial.

    Science.gov (United States)

    Kalron, Alon; Rosenblum, Uri; Frid, Lior; Achiron, Anat

    2017-03-01

    Evaluate the effects of a Pilates exercise programme on walking and balance in people with multiple sclerosis and compare this exercise approach to conventional physical therapy sessions. Randomized controlled trial. Multiple Sclerosis Center, Sheba Medical Center, Tel-Hashomer, Israel. Forty-five people with multiple sclerosis, 29 females, mean age (SD) was 43.2 (11.6) years; mean Expanded Disability Status Scale (S.D) was 4.3 (1.3). Participants received 12 weekly training sessions of either Pilates ( n=22) or standardized physical therapy ( n=23) in an outpatient basis. Spatio-temporal parameters of walking and posturography parameters during static stance. Functional tests included the Time Up and Go Test, 2 and 6-minute walk test, Functional Reach Test, Berg Balance Scale and the Four Square Step Test. In addition, the following self-report forms included the Multiple Sclerosis Walking Scale and Modified Fatigue Impact Scale. At the termination, both groups had significantly increased their walking speed ( P=0.021) and mean step length ( P=0.023). According to the 2-minute and 6-minute walking tests, both groups at the end of the intervention program had increased their walking speed. Mean (SD) increase in the Pilates and physical therapy groups were 39.1 (78.3) and 25.3 (67.2) meters, respectively. There was no effect of group X time in all instrumented and clinical balance and gait measures. Pilates is a possible treatment option for people with multiple sclerosis in order to improve their walking and balance capabilities. However, this approach does not have any significant advantage over standardized physical therapy.

  20. Management of pain induced by exercise and mobilization during physical therapy programs: views of patients and care providers

    Directory of Open Access Journals (Sweden)

    Rannou François

    2011-07-01

    Full Text Available Abstract Background The expectations of patients for managing pain induced by exercise and mobilization (PIEM have seldom been investigated. We identified the views of patients and care providers regarding pain management induced by exercise and mobilization during physical therapy programs. Methods We performed a qualitative study based on semi-structured interviews with a stratified sample of 12 patients (7 women and 14 care providers (6 women: 4 general practitioners [GPs], 1 rheumatologist, 1 physical medicine physician, 1 geriatrician, 2 orthopedic surgeons, and 5 physical therapists. Results Patients and care providers have differing views on PIEM in the overall management of the state of disease. Patients' descriptions of PIEM were polymorphic, and they experienced it as decreased health-related quality of life. The impact of PIEM was complex, and patient views were sometimes ambivalent, ranging from denial of symptoms to discontinuation of therapy. Care providers agreed that PIEM is generally not integrated in management strategies. Care providers more often emphasized the positive and less often the negative dimensions of PIEM than did patients. However, the consequences of PIEM cited included worsened patient clinical condition, fears about physical therapy, rejection of the physical therapist and refusal of care. PIEM follow-up is not optimal and is characterized by poor transmission of information. Patients expected education on how better to prevent stress and anxiety generated by pain, education on mobilization, and adaptations of physical therapy programs according to pain intensity. Conclusion PIEM management could be optimized by alerting care providers to the situation, improving communication among care providers, and providing education to patients and care providers.

  1. The Distribution of Body Weight Force on Toe and Heel before and after Exercise Therapy in Children with Spastic Diplegia Cerebral Palsy

    Directory of Open Access Journals (Sweden)

    Keyvan Sharif-Moradi

    2005-07-01

    Full Text Available Objective: The purpose of this study was to assess the distribution of body weight force on toe and heel before and after exercise therapy and its effects on relaxation of children with spastic diplegia cerebral palsy. Materials & Methods: Ten children with spastic diplegia cerebral palsy between 8 to15 years of age participated in this study. Their mean weight and height were (30.8kg ± 5.7kg and (1.35m±0.09m respectively. Subjects underwent a 12 weeks of exercise therapy. A dynamic stability platform system (BIODEX was used to measure the mean percentage of body weight pressure on toe and heal. The balance tests were repeated on stable, almost stable and unstable base of support as well as with and without shoes. Results: Showed that the mean percentage of body weight pressure on toe and heal after exercise therapy was not significant (p>0.05. The mean percentage of body weight pressure on toe and heal was significantly decrease after exercise therapy in both with and without shoes (p<0.05. The greatest improvement achieved on almost stable and unstable conditions. Wearing shoes resulted in a balance percentage of body weight pressure on toe and heal on stable situation of stability platform the percentage of body weight pressure on toe and heal has no difference before and after exercise therapy. After exercise therapy strengthening the muscle of the ankle joint balance the percentage of body weight pressure on toe and heal. Wearing shoes decrease the muscle stretch and therefore balance the percentage of body weight pressure on toe and heal. Conclusion: The flexibility of spastic muscle and strengthening of the relax muscle must be perform. This result provides good information for physician in recognizing and therapy impacts on cerebral palsy children.

  2. Low-Grade Inflammation and Spinal Cord Injury: Exercise as Therapy?

    Science.gov (United States)

    da Silva Alves, Eduardo; de Aquino Lemos, Valdir; Ruiz da Silva, Francieli; Lira, Fabio Santos; dos Santos, Ronaldo Vagner Thomathieli; Rosa, João Paulo Pereira; Caperuto, Erico; Tufik, Sergio; de Mello, Marco Tulio

    2013-01-01

    An increase in the prevalence of obesity in people with spinal cord injury can contribute to low-grade chronic inflammation and increase the risk of infection in this population. A decrease in sympathetic activity contributes to immunosuppression due to the lower activation of immune cells in the blood. The effects of physical exercise on inflammatory parameters in individuals with spinal cord injury have not been well described. We conducted a review of the literature published from 1974 to 2012. This review explored the relationships between low-grade inflammation, spinal cord injury, and exercise to discuss a novel mechanism that might explain the beneficial effects of exercise involving an increase in catecholamines and cytokines in people with spinal cord injury. PMID:23533315

  3. Low-Grade Inflammation and Spinal Cord Injury: Exercise as Therapy?

    Directory of Open Access Journals (Sweden)

    Eduardo da Silva Alves

    2013-01-01

    Full Text Available An increase in the prevalence of obesity in people with spinal cord injury can contribute to low-grade chronic inflammation and increase the risk of infection in this population. A decrease in sympathetic activity contributes to immunosuppression due to the lower activation of immune cells in the blood. The effects of physical exercise on inflammatory parameters in individuals with spinal cord injury have not been well described. We conducted a review of the literature published from 1974 to 2012. This review explored the relationships between low-grade inflammation, spinal cord injury, and exercise to discuss a novel mechanism that might explain the beneficial effects of exercise involving an increase in catecholamines and cytokines in people with spinal cord injury.

  4. The results of "exercise therapy in coronary prone individuals and coronary patients".

    Science.gov (United States)

    Plavsic, C; Turkulin, K; Perman, Z; Steinel, S; Oreskovic, A; Dimnik, R; Martic, P; Fischer, F; Puharic, M; Bruketa, I; Martic, M; Stojanovic, D; Ljubetic, L

    1976-01-01

    The authors followed for at least two years 483 patients (430 coronary prone patients and 53 with proved coronary heart disease), to determine whether physical training could decrease coronary risk factors and improve exercise tolerance in the trained group as compared with the conventionally treated group (way of life, diet, drugs). There was no significant difference among the two groups for blood lipid profile, blood pressure (at rest and during exercise), functional capacity and mortality. In the authors' opinion this could be explained by the inadequate training program (45 minutes twice a week) and by a possible overlapping of the groups.

  5. Exercise, sleep quality, and mediators of sleep in breast and prostate cancer patients receiving radiation therapy

    OpenAIRE

    Sprod, Lisa K.; Palesh, Oxana G.; Janelsins, Michelle C.; Peppone, Luke J.; Heckler, Charles E.; Adams, M. Jacob; Morrow, Gary R.; Mustian, Karen M.

    2010-01-01

    Cancer patients often report impaired sleep quality. Impaired sleep quality may be due to increased levels of sleep-mediating cytokines resulting from cancer treatment. Exercise may have a positive influence on sleep-mediating cytokines, such as interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), and soluble tumor necrosis factor-alpha receptor (sTNF-R), which may improve sleep quality. This two-arm pilot study compared the influence of a home-based exercise intervention with standard ...

  6. Effects of Exercise Therapy on Balance Capacity in Chronic Stroke: Systematic Review and Meta-Analysis

    NARCIS (Netherlands)

    Duijnhoven, H.J.R. van; Heeren, A.; Peters, M.A.; Veerbeek, J.M.; Kwakkel, G.; Geurts, A.C.H.; Weerdesteyn, V.

    2016-01-01

    BACKGROUND AND PURPOSE: The purpose of this systematic review and meta-analysis was to investigate the effects of exercise training on balance capacity in people in the chronic phase after stroke. Furthermore, we aimed to identify which training regimen was most effective. METHODS: Electronic

  7. The Interacting-Reflecting Training Exercise: Addressing the Therapist's Inner Conversation in Family Therapy Training

    Science.gov (United States)

    Rober, Peter

    2010-01-01

    In recent years several authors have made a beginning in describing therapeutic conversations from a dialogical perspective. Training and supervision, however, have not yet been addressed from a dialogical perspective. In this article, an experiential training exercise is described that is focused on the basic dialogical skills of the trainee:…

  8. Aerobic exercise and cognitive behavioral therapy in facioscapulohumeral muscular dystrophy: a model based approach

    NARCIS (Netherlands)

    Voet, N.B.M.

    2016-01-01

    People with facioscapulohumeral muscular dystrophy (FSHD), a muscular dystrophy, often experience severe chronic fatigue. For them, daily life is top sport. One would expect that being active leads to a higher level of fatigue. The opposite is true. Both aerobic exercise and cognitive behavioral

  9. Exercise therapy for Stress-related mental disorder, a randomised controlled trial in primary care

    NARCIS (Netherlands)

    Quartero, A. Otto; Burger, Huib; Donker, Marieke; de Wit, Niek J.

    2011-01-01

    Background: to investigate whether a structured physical exercise programme (PEP) improves the recovery of general health in patients suffering from Stress-related Mental Disorder (SMD). Method: Study design: randomised open trial in general practice. Patients from two regions in the Netherlands

  10. TNF-α and TNFR1 responses to recovery therapies following acute resistance exercise

    Directory of Open Access Journals (Sweden)

    Jeremy R. Townsend

    2015-02-01

    Full Text Available The purpose of this investigation was to compare the effect of two commonly used therapeutic modalities a. neuromuscular electrical stimulation (NMES and b. cold water immersion (CWI on circulating tumor necrosis factor alpha (TNF-α and monocyte TNF-α receptor (TNFR1 expression following intense acute resistance exercise and subsequent recovery. Thirty (n=30 resistance trained men (22.5 ± 2.7 y performed an acute heavy resistance exercise protocol on three consecutive days followed by one of three recovery methods (CON, NMES, and CWI. Circulating TNF-α levels were assayed and TNFR1 expression on CD14+ monocytes was measured by flow cytometry measured PRE, immediately post (IP, 30-minutes post (30M, 24 hours post (24H, and 48 hours post (48H exercise. Circulating TNF-α was elevated at IP (p = 0.001 and 30M (p = 0.005 and decreased at 24H and 48H recovery from IP in CON (p = 0.015 and CWI (p = 0.011. TNF-α did not significantly decrease from IP during recovery in NMES. TNFR1 expression was elevated (p < 0.001 at 30M compared to PRE and all other time points. No significant differences between groups were observed in TNFR1 expression. During recovery (24H, 48H from muscle damaging exercise, NMES treatment appears to prevent the decline in circulating TNF-α observed during recovery in those receiving no treatment or CWI.

  11. Exercise therapy for Stress-related mental disorder, a randomised controlled trial in primary care

    Directory of Open Access Journals (Sweden)

    Donker Marieke

    2011-07-01

    Full Text Available Abstract Background to investigate whether a structured physical exercise programme (PEP improves the recovery of general health in patients suffering from Stress-related Mental Disorder (SMD. Method Study design: randomised open trial in general practice. Patients from two regions in the Netherlands were included between September 2003 and December 2005, and followed up for 12 weeks. Intervention: the patients were referred to a physical therapist for instruction in and monitoring of physical exercise of an intermediate intensity. Following the Dutch Guidelines for Healthy Physical Exercise, the patients were instructed to exercise at least five times a week, for at least 30 minutes per day. Control group: usual care from the GP Outcome Primary: improvement of general health after 6 weeks according to the 'general health' dimension of the Short-Form 36. Secondary: total days off work, percentage that resumed work after 6 and 12 weeks, change in distress score and change in remaining SF36 dimensions after 6 and 12 weeks. Results out of 102 randomised patients (mean age 43, 60 (59% female, 70 (68% completed the trial, of whom 31 were in the intervention group. After 6 weeks, the mean (SD general health score was 54.6 (22.1 for the intervention group and 57.5 (19.2 for the controls. The corresponding effect size (Cohen's d with 95% confidence interval from analysis of covariance was -0.06 (-0.41, 0.30 indicating no effect on general health. No significant effects of the intervention were detected for any secondary outcome parameter either. Conclusion Notwithstanding the relatively high drop-out rate, our results suggest that referral to a physical therapist for structured physical exercise is not likely to be very effective in improving recovery from SMD. Trial registry Current Controlled Trials ISRCTN15609105

  12. Dual AAV therapy ameliorates exercise-induced muscle injury and functional ischemia in murine models of Duchenne muscular dystrophy.

    Science.gov (United States)

    Zhang, Yadong; Yue, Yongping; Li, Liang; Hakim, Chady H; Zhang, Keqing; Thomas, Gail D; Duan, Dongsheng

    2013-09-15

    Neuronal nitric oxide synthase (nNOS) membrane delocalization contributes to the pathogenesis of Duchenne muscular dystrophy (DMD) by promoting functional muscle ischemia and exacerbating muscle injury during exercise. We have previously shown that supra-physiological expression of nNOS-binding mini-dystrophin restores normal blood flow regulation and prevents functional ischemia in transgenic mdx mice, a DMD model. A critical next issue is whether systemic dual adeno-associated virus (AAV) gene therapy can restore nNOS-binding mini-dystrophin expression and mitigate muscle activity-related functional ischemia and injury. Here, we performed systemic gene transfer in mdx and mdx4cv mice using a pair of dual AAV vectors that expressed a 6 kb nNOS-binding mini-dystrophin gene. Vectors were packaged in tyrosine mutant AAV-9 and co-injected (5 × 10(12) viral genome particles/vector/mouse) via the tail vein to 1-month-old dystrophin-null mice. Four months later, we observed 30-50% mini-dystrophin positive myofibers in limb muscles. Treatment ameliorated histopathology, increased muscle force and protected against eccentric contraction-induced injury. Importantly, dual AAV therapy successfully prevented chronic exercise-induced muscle force drop. Doppler hemodynamic assay further showed that therapy attenuated adrenergic vasoconstriction in contracting muscle. Our results suggest that partial transduction can still ameliorate nNOS delocalization-associated functional deficiency. Further evaluation of nNOS binding mini-dystrophin dual AAV vectors is warranted in dystrophic dogs and eventually in human patients.

  13. Effectiveness of Standardized Physical Therapy Exercises for Patients With Difficulty Returning to Usual Activities After Decompression Surgery for Subacromial Impingement Syndrome: Randomized Controlled Trial.

    Science.gov (United States)

    Christiansen, David Høyrup; Frost, Poul; Falla, Deborah; Haahr, Jens Peder; Frich, Lars Henrik; Andrea, Linda Christie; Svendsen, Susanne Wulff

    2016-06-01

    Little is known about the effectiveness of exercise programs after decompression surgery for subacromial impingement syndrome. For patients with difficulty returning to usual activities, special efforts may be needed to improve shoulder function. The purpose of this study was to evaluate the effectiveness at 3 and 12 months of a standardized physical therapy exercise intervention compared with usual care in patients with difficulty returning to usual activities after subacromial decompression surgery. A multicenter randomized controlled trial was conducted. The study was conducted in 6 public departments of orthopedic surgery, 2 departments of occupational medicine, and 2 physical therapy training centers in Central Denmark Region. One hundred twenty-six patients reporting difficulty returning to usual activities at the postoperative clinical follow-up 8 to 12 weeks after subacromial decompression surgery participated. A standardized exercise program consisting of physical therapist-supervised individual training sessions and home training was used. The primary outcome measure was the Oxford Shoulder Score. Secondary outcome measures were the Constant Score and the Fear-Avoidance Beliefs Questionnaire. At 3 and 12 months, follow-up data were obtained for 92% and 83% of the patients, respectively. Intention-to-treat analyses suggested a between-group difference on the Oxford Shoulder Score favoring the exercise group at 3 months, with an adjusted mean difference of 2.0 (95% confidence interval=-0.5, 4.6), and at 12 months, with an adjusted mean difference of 5.8 (95% confidence interval=2.8, 8.9). Significantly larger improvements for the exercise group were observed for most secondary and supplementary outcome measures. The nature of the exercise intervention did not allow blinding of patients and care providers. The standardized physical therapy exercise intervention resulted in statistically significant and clinically relevant improvement in shoulder pain and

  14. Trauma-focused cognitive behaviour therapy and exercise for chronic whiplash: protocol of a randomised, controlled trial.

    Science.gov (United States)

    Campbell, Letitia; Kenardy, Justin; Andersen, Tonny; McGregor, Leanne; Maujean, Annick; Sterling, Michele

    2015-10-01

    As a consequence of a road traffic crash, persistent pain and disability following whiplash injury are common and incur substantial personal and economic costs. Up to 50% of people who experience a whiplash injury will never fully recover and up to 30% will remain moderately to severely disabled by the condition. The reason as to why symptoms persist past the acute to sub-acute stage and become chronic is unclear, but likely results from complex interactions between structural injury, physical impairments, and psychological and psychosocial factors. Psychological responses related to the traumatic event itself are becoming an increasingly recognised factor in the whiplash condition. Despite this recognition, there is limited knowledge regarding the effectiveness of psychological interventions, either delivered alone or in combination with physiotherapy, in reducing the physical and pain-related psychological factors of chronic whiplash. Pilot study results have shown positive results for the use of trauma-focused cognitive behaviour therapy to treat psychological factors, pain and disability in individuals with chronic whiplash. The results have indicated that a combined approach could not only reduce psychological symptoms, but also pain and disability. The primary aim of this randomised, controlled trial is to investigate the effectiveness of combined trauma-focused cognitive behavioural therapy, delivered by a psychologist, and physiotherapy exercise to decrease pain and disability of individuals with chronic whiplash and post-traumatic stress disorder (PTSD). The trial also aims to investigate the effectiveness of the combined therapy in decreasing post-traumatic stress symptoms, anxiety and depression. A total of 108 participants with chronic whiplash-associated disorder (WAD) grade II of > 3 months and Psychological therapy will be delivered once a week over 10 weeks, with participants randomly assigned to either trauma-focused cognitive behavioural therapy

  15. The health benefits and constraints of exercise therapy for wheelchair users: A clinical commentary

    Directory of Open Access Journals (Sweden)

    Terry J. Ellapen

    2017-01-01

    Full Text Available Background: There are approximately 1 billion people living with chronic lower limb disability, many of whom are wheelchair users.Objectives: Review cardiometabolic and neuromuscular risk profiles of wheelchair users, benefits of regular exercise and the causes of neuromuscular upper limb and hip injuries that hinder regular adherence.Method: Literature published between 2013 and 2017 was adopted according to the standard practices for systematic reviews (PRISMA through Crossref Metadata and Google Scholar searches. Individual paper quality was evaluated using a modified Downs and Black Appraisal Scale.Results: The literature search identified 16 600 papers which were excluded if they were non-English, non-peer-reviewed or published before 2013. Finally, 25 papers were accepted, indicating that sedentary wheelchair users have poor cardiometabolic risk profiles (PCMRP because of a lack of physical activity, limiting their quality of life, characterised by low self-esteem, social isolation and depression. Their predominant mode of physical activity is through upper limb exercises, which not only improves their cardiometabolic risk profiles but also precipitates neuromuscular upper limb overuse injuries. The primary cause of upper limb injuries was attributed to poor wheelchair propulsion related to incorrect chair setup and poor cardiorespiratory fitness.Conclusion: Wheelchair users have a high body mass index, body fat percentage and serum lipid, cholesterol and blood glucose concentrations. Empirical investigations illustrate exercise improves their PCMRP and cardiorespiratory fitness levels. Although literature encourages regular exercise, none discusses the need to individualise chair setup in order to eliminate wheelchair pathomechanics and upper limb neuromuscular injuries. Wheelchair users must be encouraged to consult a biokineticist or physiotherapist to review their wheelchair setup so as to eliminate possible incorrect manual wheelchair

  16. Efficacy of exercise therapy in workers with rotator cuff tendinopathy: a systematic review

    OpenAIRE

    Desmeules, Fran?ois; Boudreault, Jennifer; Dionne, Clermont E; Fr?mont, Pierre; Lowry, V?ronique; MacDermid, Joy C.; Roy, Jean-S?bastien

    2016-01-01

    Objective: To perform a systematic review of randomized controlled trials (RCTs) on the efficacy of therapeutic exercises for workers suffering from rotator cuff (RC) tendinopathy. Methods: A literature search in four bibliographical databases (Pubmed, CINAHL, EMBASE, and PEDro) was conducted from inception up to February 2015. RCTs were included if participants were workers suffering from RC tendinopathy, the outcome measures included work-related outcomes, and at least one of the interventi...

  17. Evidence for the benefit of exercise therapy in patients with type 2 diabetes

    OpenAIRE

    Madden KM

    2013-01-01

    Kenneth M Madden VITALiTY (Vancouver Initiative to Add Life to Years) Research Laboratory, Division of Geriatric Medicine, Department of Medicine, University of British Columbia, Vancouver, BC, Canada Abstract: Exercise interventions are recommended in most guidelines for the treatment of type 2 diabetes. Although most guidelines suggest a combination of both aerobic and resistance training, the exact benefits of these interventions remain unclear. Although either modality alone or in combin...

  18. No effects of a 12-week supervised exercise therapy program on gait in patients with mild to moderate osteoarthritis: a secondary analysis of a randomized trial.

    Science.gov (United States)

    Eitzen, Ingrid; Fernandes, Linda; Nordsletten, Lars; Risberg, May Arna

    2015-03-05

    It is unknown whether gait biomechanics in hip osteoarthritis patients with mild to moderate symptoms change following exercise therapy interventions. The aim of the present study was to compare stance phase gait characteristics in hip osteoarthritis patients with mild to moderate symptoms participating in a randomized trial with two different interventions; patient education only or patient education followed by a 12-week supervised exercise therapy program. The study was conducted as a secondary analysis of a single-blinded randomized controlled trial. Patients aged 40 to 80 years, with hip osteoarthritis verified from self-reported pain and radiographic changes, were included. The final material comprised 23 patients (10 males/13 females, mean (SD) age 58.2 (10.02) years) in the patient education only group, and 22 patients (9 males/13 females, mean (SD) age 60.2 (9.49) years) in the patient education + exercise therapy group. Three-dimensional gait analysis was conducted at baseline and at four month follow-up. Sagittal and frontal plane joint angle displacement and external joint moments of the hip, knee and ankle were compared from a one-way analysis of covariance between the groups at follow-up, with baseline values as covariates (p gait velocity, joint angle displacement, or moments. As the compliance in the exercise therapy group was inadequate, we calculated possible associations between the number of completed exercise sessions and change in each of the kinematic or kinetic variables. Associations were weak to neglible. Thus, the negative findings in this study cannot be explained from inadequate compliance alone, but most likely also suggest the exercise therapy program itself to be insufficient to engender gait alterations. Adding a 12-week supervised exercise therapy program to patient education did not induce changes in our selected biomechanical variables during the stance phase of gait, even when adjusting for poor compliance. Thus, we did not find

  19. The perspectives of older women with chronic neck pain on perceived effects of qigong and exercise therapy on aging: a qualitative interview study

    Directory of Open Access Journals (Sweden)

    Holmberg C

    2014-03-01

    Full Text Available Christine Holmberg,1,2 Julia Rappenecker,1 Julia J Karner,1 Claudia M Witt1,3 1Institute for Social Medicine, Epidemiology, and Health Economics, 2Berlin School of Public Health, Charité – Universitätsmedizin Berlin, Berlin, Germany; 3Center for Complementary and Integrative Medicine, University Hospital Zurich, Zurich, Switzerland Abstract: Chronic pain is prevalent in elderly populations. The goals of this study were 1 to understand the results of a randomized clinical trial – Qigong and Exercise Therapy for Elderly Patients with Chronic Neck Pain (QIBANE – that showed no difference between qigong, exercise therapy, and no-treatment on quality of life, and 2 to understand how elderly individuals with chronic pain experience interventions of qigong and exercise therapy. A qualitative interview study was conducted with 20 QIBANE participants. Interviews asked about motivation for and expectations of trial participation, experiences with the exercise classes (qigong or exercise therapy, and changes in pain experience. Interviews were transcribed, entered into the software program ATLAS.ti, and coded thematically by two coders. Content analysis was performed. All interviewees reflected positively on their QIBANE experience and described their participation in QIBANE as helpful. However, what was discussed in both groups when they talked about “positive experiences” in the study differed between the two groups. For example, themes that emerged in the exercise-therapy group related to difficulties associated with aging and staying physically active. In the interviews with qigong group members, emergent themes related to qigong as a method that improved bodily experiences and influenced daily activities. The effects that exercise therapy and qigong have on an elderly population cannot be captured by health-related quality-of-life measurements, such as the Short Form (36 Health Survey. Broader concepts of quality of life that include the

  20. Flecainide Therapy Reduces Exercise-Induced Ventricular Arrhythmias in Patients With Catecholaminergic Polymorphic Ventricular Tachycardia

    NARCIS (Netherlands)

    van der Werf, Christian; Kannankeril, Prince J.; Sacher, Frederic; Krahn, Andrew D.; Viskin, Sami; Leenhardt, Antoine; Shimizu, Wataru; Sumitomo, Naokata; Fish, Frank A.; Bhuiyan, Zahurul A.; Willems, Albert R.; van der Veen, Maurits J.; Watanabe, Hiroshi; Laborderie, Julien; Haïssaguerre, Michel; Knollmann, Björn C.; Wilde, Arthur A. M.

    2011-01-01

    Objectives This study evaluated the efficacy and safety of flecainide in addition to conventional drug therapy in patients with catecholaminergic polymorphic ventricular tachycardia (CPVT). Background CPVT is an inherited arrhythmia syndrome caused by gene mutations that destabilize cardiac

  1. Manual therapy, exercise therapy or combined treatment in the management of adult neck pain - A systematic review and meta-analysis.

    Science.gov (United States)

    Fredin, Ken; Lorås, Håvard

    2017-10-01

    Neck pain is a common and often disabling musculoskeletal condition. Two therapies frequently prescribed for its management are manual therapy (MT) and exercise therapy (ET), and combining these treatment approaches are common. To assess whether or not combined treatment consisting of MT and ET is more effective than either therapy alone in relieving pain and improving function in adult patients with grade I-II neck pain. Systematic review with meta-analysis. A systematic search on EMBASE, MEDLINE, AMED, CENTRAL and PEDro were performed until June 2017. Randomized controlled trials with adult grade I-II neck pain patients were included if they investigated the combined effect of MT and ET to the same ET or MT alone, and reported pain intensity or disability on numerical scales. Quality of life was assessed as a secondary outcome. Quality of the included trials was assessed with the PEDro scale, and the quality of evidence was assessed with GRADE. 1169 articles were screened, and 7 studies were included, all of which investigated the addition of ET to MT. Only very small and non-significant between group differences was found on pain intensity at rest, neck disability, and quality of life at immediate post-treatment, 6 months, and 12 months follow-up. The quality of evidence was moderate for pain-at-rest outcomes and moderate too low for neck disability and quality of life outcomes. Combined treatment consisting of MT and ET does not seem to be more effective in reducing neck pain intensity at rest, neck disability or improving quality of life in adult patients with grade I-II neck pain, than ET alone. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. Monitoring Resistance Exercise Intensity via RPE in Previously Untrained Patients with Prostate Cancer undergoing Androgen Deprivation Therapy.

    Science.gov (United States)

    Fairman, C M; LaFountain, R L; Lucas, A R; Focht, B C

    2017-05-23

    Exercise has been shown to be safe and effective for prostate cancer (PrCa) patients. The monitoring of resistance exercise (RE) intensity is an emerging area of interest in RE prescription. Rating of perceived exertion (RPE) is one of the most commonly used methods, but has not yet been validated in this population. Thus, the purpose of this study was to examine the relationship between RPE and RE intensity in PrCa. Data for this study were abstracted from baseline upper and lower body strength assessments from two previous trials (IDEA-P; Livestrong) in our laboratory investigating functional outcomes in PrCa patients undergoing androgen deprivation therapy (ADT). A total of 75 participants from both trials were included in this study. RPE's corresponding to 50%, 70% and 90% 1RM were extracted from the results of participants' upper and lower body 1RM strength tests. The changes in RPE across increasing intensities were assessed using separate univariate analysis of variance (ANOVA). For each ANOVA, RPE was used as the dependent variable and intensity (50%, 70%, 90%) used as the fixed factor. A univariate ANOVA revealed a significant difference (pRPE values for each intensity for both upper and lower body lifts. The results of our analyses suggest that RPE values rise linearly in response to increases in exercise intensity. Our study supports the concept that RPE may be a practical training tool to accurately estimate RE intensity in PrCa survivors undergoing ADT. Practitioners may consider employing RPE to monitor and adjust RE intensity in this population.

  3. Experiences of Older Adults With Mobile Phone Text Messaging as Reminders of Home Exercises After Specialized Manual Therapy for Recurrent Low Back Pain: A Qualitative Study

    Science.gov (United States)

    2017-01-01

    Background Clinical experience of manual therapy for musculoskeletal pain is that patients often suffer from recurrent pain and disorders, but that they do not continue to perform their physical home exercises when they are free from symptoms. The chance of positive long-term effects of manual therapy would probably increase if patients were reminded that they are to continue to perform their exercises. Mobile phone text messaging (short messaging service, SMS) is increasingly used as an innovative intervention to remind patient to exercise. However, there are only a few studies on such interventions in the field of low back pain (LBP). Qualitative studies of patients’ experiences of receiving text messages as reminders of home exercises after manual treatment for recurrent LBP have to the best of our knowledge never been published. Objectives The aim of this study was to explore older persons’ common experiences of receiving reminders of home exercises through mobile phone text messaging after specialized manual therapy for recurrent LBP. Methods A total of 7 men and 8 women (67-86 years), who had sought specialized manual therapy (Naprapathic manual therapy) for recurrent LBP were included in the study. Individual one-way text messages as reminders of home exercises (to be performed on a daily basis) were sent to each patient every third day for 3 weeks, then once a week for another 2 weeks. Semistructured interviews with 2 broad, open-ended questions were held and data were analyzed with systematic text condensation, based on Giorgi’s principles of psychological phenomenological analysis. Results The participants appreciated the messages, which were perceived as timely and usable, and also stimulated memorizing. The messages made the participants reflect on the aim of the exercise, value of being reminded, and on their improvement in pain. During the interviews, the participants created their own routines for continued adherence to the exercises

  4. Effect of diabetes mellitus on walking distance parameters after supervised exercise therapy for intermittent claudication: A systematic review.

    Science.gov (United States)

    Hageman, David; Gommans, Lindy Nm; Scheltinga, Marc Rm; Teijink, Joep Aw

    2017-02-01

    Some believe that certain patients with intermittent claudication may be unsuitable for supervised exercise therapy (SET), based on the presence of comorbidities and the possibly increased risks. We conducted a systematic review (MEDLINE, EMBASE and CENTRAL) to summarize evidence on the potential influence of diabetes mellitus (DM) on the response to SET. Randomized and nonrandomized studies that investigated the effect of DM on walking distance after SET in patients with IC were included. Considered outcome measures were maximal, pain-free and functional walking distance (MWD, PFWD and FWD). Three articles met the inclusion criteria ( n = 845). In one study, MWD was 111 meters (128%) longer in the non-DM group compared to the DM group after 3 months of follow-up ( p = 0.056). In a second study, the non-DM group demonstrated a significant increase in PFWD (114 meters, p ⩽ 0.05) after 3 months of follow-up, whereas there was no statistically significant increase for the DM group (54 meters). On the contrary, the largest study of this review did not demonstrate any adverse effect of DM on MWD and FWD after SET. In conclusion, the data evaluating the effects of DM on SET were inadequate to determine if DM impairs the exercise response. While trends in the data do not suggest an impairment, they are not conclusive. Practitioners should consider this limitation when making clinical decisions.

  5. Education, progressive muscle relaxation therapy, and exercise for the treatment of night eating syndrome. A pilot study.

    Science.gov (United States)

    Vander Wal, Jillon S; Maraldo, Toni M; Vercellone, Allison C; Gagne, Danielle A

    2015-06-01

    Night eating syndrome (NES) is a circadian rhythm disorder in which food intake is shifted toward the end of the day, interfering with sleep. According to the biobehavioral model of NES, the disorder is the result of a genetic predisposition that, coupled with stress, leads to enhanced reuptake of serotonin, thereby dysregulating circadian rhythms and decreasing satiety. Using the biobehavioral model as a guide, we developed a brief behavioral intervention using education, relaxation strategies, and exercise to address the core symptoms of NES. In this pilot randomized controlled clinical trial, 44 participants with NES were randomly assigned to an educational group (E; n = 14), E plus progressive muscle relaxation therapy (PMR; n = 15); or PMR plus exercise (PMR Plus, n = 15). Participants received a baseline intervention with 1- and 3-week follow-up sessions. Effectiveness analyses showed that participants in all three groups evidenced significant reductions on measures of NES symptoms (p relaxation in the behavioral treatment of NES. Copyright © 2015 Elsevier Ltd. All rights reserved.

  6. Effect of Home Exercise Program Performance in Patients with Osteoarthritis of the Knee or the Spine on the Visual Analog Scale after Discharge from Physical Therapy

    Science.gov (United States)

    Chen, Hamilton; Onishi, Kentaro

    2012-01-01

    The aim of our study was to assess the effect of the frequency of home exercise program (HEP) performance on pain [10-point visual analog scale (VAS)] in patients with osteoarthritis of the spine or knee after more than 6 months discharge from physical therapy (PT). We performed a retrospective chart review of 48 adult patients with a clinical…

  7. Effects of the Fitkids Exercise Therapy Program on Health-Related Fitness, Walking Capacity, and Health-Related Quality of Life.

    NARCIS (Netherlands)

    Kotte, E.M.W.; Groot, J.F. de; Winkler, A.M.F.; Huijgen, B.C.H.; Sanders, L.; Takken, T.

    2014-01-01

    Background: Children with disabilities have an increased risk for reduced fitness and reduced health-related quality of life (HRQoL). Fitkids, a nationwide exercise therapy program in the Netherlands, was developed to improve fitness and HRQoL in children with disabilities. Objective: The study

  8. Effects of the Fitkids Exercise Therapy Program on Health-Related Fitness, Walking Capacity, and Health-Related Quality of Life

    NARCIS (Netherlands)

    Kotte, Elles M. W.; de Groot, Janke F.; Winkler, Alexander M. F.; Huijgen, Barbara C. H.; Takken, Tim

    Background. Children with disabilities have an increased risk for reduced fitness and reduced health-related quality of life (HRQoL). Fitkids, a nationwide exercise therapy program in the Netherlands, was developed to improve fitness and HRQoL in children with disabilities. Objective. The study

  9. Short- and long-term clinical outcomes following a standardized protocol of orthopedic manual physical therapy and exercise in individuals with osteoarthritis of the hip: a case series

    Science.gov (United States)

    Hando, Ben R; Gill, Norman W; Walker, Michael J; Garber, Mathew

    2012-01-01

    Objectives: Describe short- and long-term outcomes observed in individuals with hip osteoarthritis (OA) treated with a pre-selected, standardized set of best-evidence manual therapy and therapeutic exercise interventions. Methods: Fifteen consecutive subjects (9 males, 6 females; mean age: 52±7.5 years) with unilateral hip OA received an identical protocol of manual therapy and therapeutic exercise interventions. Subjects attended 10 treatment sessions over an 8-week period for manual therapy interventions and performed the therapeutic exercise as a home program. Results: Baseline to 8-week follow-up outcomes were as follows: Harris Hip Scale (HHS) scores improved from 60.3(±10.4) to 80.7(±10.5), Numerical Pain Rating Scale (NPRS) scores improved from 4.3(±1.9) to 2.0(±1.9), hip flexion range of motion (ROM) improved from 99 degrees (±10.6) to 127 degrees (±6.3) and hip internal rotation ROM improved from 19 degrees (±9.1) to 31 degrees (±11.5). Improvements in HHS, NPRS, and hip ROM measures reached statistical significance (Ptreatment protocol were similar to those observed in previous studies involving impairment-based manual therapy and therapeutic exercise for hip OA. Future studies might directly compare the two approaches. Discussion: PMID:24179327

  10. Case report of exercise and statin-fibrate combination therapy-caused myopathy in a patient with metabolic syndrome: contradictions between the two main therapeutic pathways

    Directory of Open Access Journals (Sweden)

    László Andrea

    2013-02-01

    Full Text Available Abstract Background Lifestyle modifications including exercise are beneficial and fundamentally part of the therapy of metabolic syndrome, although in most of the cases medical interventions are also required to reach the target values in the laboratory parameters. Statin and fibrate combination therapy is considered to be safe and effective in dyslipidaemia and metabolic syndrome. However, increased physical activity can enhance the statin and fibrate-associated myopathy. Myositis and the rare but life-threatening rhabdomyolysis are causing a conflict between exercise and statin-fibrate therapy, which is yet to be resolved. Case presentation We present a case of a 43-year-old Caucasian man with metabolic syndrome who had the side-effect of exercise and drug-associated myositis. The patient had only transient moderate complaints and rhabdomyolysis could be avoided with the one-month creatine kinase control, a test which is not recommended routinely by the new guidelines. Conclusions We would like to turn the spotlight on the possible complications of statin-fibrate therapy and exercise, when strict follow-up is recommended. In this condition high number of patients can be affected and the responsibility of general practitioners is accentuated.

  11. Group-based exercise in daily clinical practice to improve physical fitness in men with prostate cancer undergoing androgen deprivation therapy

    DEFF Research Database (Denmark)

    Østergren, Peter; Ragle, Anne-Mette; Jakobsen, Henrik

    2016-01-01

    INTRODUCTION: Level 1 evidence supports the use of supervised exercise to mitigate the adverse effects of androgen deprivation therapy (ADT) in men with prostate cancer. The data, however, have been generated in controlled research settings and might not be transferable to daily clinical practice...

  12. Manual therapy in joint and nerve structures combined with exercises in the treatment of recurrent ankle sprains: A randomized, controlled trial.

    Science.gov (United States)

    Plaza-Manzano, Gustavo; Vergara-Vila, Marta; Val-Otero, Sandra; Rivera-Prieto, Cristina; Pecos-Martin, Daniel; Gallego-Izquierdo, Tomás; Ferragut-Garcías, Alejandro; Romero-Franco, Natalia

    2016-12-01

    Recurrent ankle sprains often involve residual symptoms for which subjects often perform proprioceptive or/and strengthening exercises. However, the effectiveness of mobilization to influence important nerve structures due to its anatomical distribution like tibial and peroneal nerves is unclear. To analyze the effects of proprioceptive/strengthening exercises versus the same exercises and manual therapy including mobilizations to influence joint and nerve structures in the management of recurrent ankle sprains. A randomized single-blind controlled clinical trial. Fifty-six patients with recurrent ankle sprains and regular sports practice were randomly assigned to experimental or control group. The control group performed 4 weeks of proprioceptive/strengthening exercises; the experimental group performed 4 weeks of the same exercises combined with manual therapy (mobilizations to influence joint and nerve structures). Pain, self-reported functional ankle instability, pressure pain threshold (PPT), ankle muscle strength, and active range of motion (ROM) were evaluated in the ankle joint before, just after and one month after the interventions. The within-group differences revealed improvements in all of the variables in both groups throughout the time. Between-group differences revealed that the experimental group exhibited lower pain levels and self-reported functional ankle instability and higher PPT, ankle muscle strength and ROM values compared to the control group immediately after the interventions and one month later. A protocol involving proprioceptive and strengthening exercises and manual therapy (mobilizations to influence joint and nerve structures) resulted in greater improvements in pain, self-reported functional joint stability, strength and ROM compared to exercises alone. Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. Participant recruitment into a randomised controlled trial of exercise therapy for people with multiple sclerosis.

    Science.gov (United States)

    Carter, Anouska; Humphreys, Liam; Snowdon, Nicky; Sharrack, Basil; Daley, Amanda; Petty, Jane; Woodroofe, Nicola; Saxton, John

    2015-10-15

    The success of a clinical trial is often dependant on whether recruitment targets can be met in the required time frame. Despite an increase in research into the benefits of exercise in people with multiple sclerosis (PwMS), no trial has reported detailed data on effective recruitment strategies for large-scale randomised controlled trials. The main purpose of this report is to provide a detailed outline of recruitment strategies, rates and estimated costs in the Exercise Intervention for Multiple Sclerosis (ExIMS) trial to identify best practices for future trials involving multiple sclerosis (MS) patient recruitment. The ExIMS researchers recruited 120 PwMS to participate in a 12-week exercise intervention. Participants were randomly allocated to either exercise or usual-care control groups. Participants were sedentary, aged 18-65 years and had Expanded Disability Status Scale scores of 1.0-6.5. Recruitment strategies included attendance at MS outpatient clinics, consultant mail-out and trial awareness-raising activities. A total of 120 participants were recruited over the course of 34 months. To achieve this target, 369 potentially eligible and interested participants were identified. A total of 60 % of participants were recruited via MS clinics, 29.2 % from consultant mail-outs and 10.8 % through trial awareness. The randomisation yields were 33.2 %, 31.0 % and 68.4 % for MS clinic, consultant mail-outs and trial awareness strategies, respectively. The main reason for ineligibility was being too active (69.2 %), whilst for eligible participants the most common reason for non-participation was the need to travel to the study site (15.8 %). Recruitment via consultant mail-out was the most cost-effective strategy, with MS clinics being the most time-consuming and most costly. To reach recruitment targets in a timely fashion, a variety of methods were employed. Although consultant mail-outs were the most cost-effective recruitment strategy, use of this

  14. Heart rate recovery improvement in patients following acute myocardial infarction: exercise training, β-blocker therapy or both.

    Science.gov (United States)

    Medeiros, Wladimir M; de Luca, Fabio A; de Figueredo Júnior, Alcides R; Mendes, Felipe A R; Gun, Carlos

    2017-04-12

    Heart rate recovery (HRR) is a strong mortality predictor. Exercise training (ET) and β-blocker therapy have significant impact on the HRR of patients following myocardial infarction (MI). However, the combination of ET and β-blocker therapy, as well as its effectiveness in patients with a more compromised HRR (≤12 bpm), has been under-studied. Male patients (n = 64) post-MI were divided: Training + β-blocker (n = 19), Training (n = 15), β-blocker (n = 11) and Control (n = 19). Participants performed an ergometric test before and after 3 months of intervention. HRR was obtained during 5 min of recovery and corrected by the cardiac reserve (HRRcorrCR ). Compared to pre-intervention, HRRcorrCR was significantly increased during the 1st and 2nd minutes of recovery in the Training + β-blocker group (70·5% and 37·5%, respectively; Pblocker group showed a reduction in HRRcorrCR during the 2nd and 3rd minutes of recovery (-21·2% and -16·3%, respectively; P 12 bpm. Combination of β-blocker therapy with ET does not compromise the effect of training and instead promotes HRR and aerobic capacity improvement. In addition, this combination is particularly beneficial for individuals presenting with a more compromised HRR. However, chronic administration of β-blocker therapy alone did not promote improvement in HRR or aerobic capacity. © 2017 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.

  15. Assessment-driven selection and adaptation of exercise difficulty in robot-assisted therapy: a pilot study with a hand rehabilitation robot.

    Science.gov (United States)

    Metzger, Jean-Claude; Lambercy, Olivier; Califfi, Antonella; Dinacci, Daria; Petrillo, Claudio; Rossi, Paolo; Conti, Fabio M; Gassert, Roger

    2014-11-15

    Selecting and maintaining an engaging and challenging training difficulty level in robot-assisted stroke rehabilitation remains an open challenge. Despite the ability of robotic systems to provide objective and accurate measures of function and performance, the selection and adaptation of exercise difficulty levels is typically left to the experience of the supervising therapist. We introduce a patient-tailored and adaptive robot-assisted therapy concept to optimally challenge patients from the very first session and throughout therapy progress. The concept is evaluated within a four-week pilot study in six subacute stroke patients performing robot-assisted rehabilitation of hand function. Robotic assessments of both motor and sensory impairments of hand function conducted prior to the therapy are used to adjust exercise parameters and customize difficulty levels. During therapy progression, an automated routine adapts difficulty levels from session to session to maintain patients' performance around a target level of 70%, to optimally balance motivation and challenge. Robotic assessments suggested large differences in patients' sensorimotor abilities that are not captured by clinical assessments. Exercise customization based on these assessments resulted in an average initial exercise performance around 70% (62% ± 20%, mean ± std), which was maintained throughout the course of the therapy (64% ± 21%). Patients showed reduction in both motor and sensory impairments compared to baseline as measured by clinical and robotic assessments. The progress in difficulty levels correlated with improvements in a clinical impairment scale (Fugl-Meyer Assessment) (r s = 0.70), suggesting that the proposed therapy was effective at reducing sensorimotor impairment. Initial robotic assessments combined with progressive difficulty adaptation have the potential to automatically tailor robot-assisted rehabilitation to the individual patient. This results in optimal challenge and

  16. [Clinical effect of pulmonary rehabilitation therapy including respiratory exercise and vibration expectoration on patients with pulmonary infection after abdominal surgery].

    Science.gov (United States)

    Zhou, Zhou; Han, Xiaotong; Ning, Fengling; Wen, Hui; Fan, Maiying; Yuan, Xia; Luo, Jieying; Zhang, Yi

    2017-03-01

    To investigate the clinical effect of pulmonary rehabilitation therapy including respiratory exercise and vibration expectoration on patients with pulmonary infection after abdominal surgery. A retrospective case control study was conducted. Seventy-six patients with pulmonary infection after abdominal surgery admitted to the First Affiliated Hospital of Hunan Normal University from September 2015 to September 2016 were enrolled. According to whether accept the pulmonary rehabilitation therapy or not, the patients were divided into two groups. In the control group (n = 35), the conventional expectoration method was adopted. The patients in pulmonary rehabilitation group (n = 41) received both methods of the control group and pulmonary rehabilitation treatment, including respiratory exercise (effective cough, lip reduction breathing), respiratory exercise device (respiratory exerciser tri-ball), and vibrated expectoration. The 24-hour sputum volume, degree of comfort, inflammatory and pulmonary function parameters, and recovery situation were recorded in the two groups. (1) There were no significant differences in the parameters of inflammation and pulmonary function before treatment between the two groups. After treatment, the white blood cell (WBC) and C-reactive protein (CRP) in both groups were significantly decreased, and the forced expiratory volume in 1 second (FEV1) and FEV1/forced vital capacity (FVC) were significantly increased. The above changes in pulmonary rehabilitation group were more significant than those of the control group [WBC (×109/L): 11.12±2.88 vs. 13.42±2.62 at 3 days, 8.22±1.48 vs. 9.27±1.92 at 5 days; CRP (mg/L): 13.47±4.77 vs. 16.03±4.94 at 3 days, 9.69±1.56 vs. 11.77±1.41 at 5 days; FEV1 (L): 2.48±0.14 vs. 2.29±0.16 at 3 days, FEV1/FVC: 0.78±0.04 vs. 0.75±0.04 at 3 days; all P rehabilitation group were significantly higher than that of the control group (mL: 30.51±4.15 vs. 18.30±3.64 at 1 day, 31.08±3.22 vs. 20.37±3

  17. Evaluating the Training Effects of Two Swallowing Rehabilitation Therapies Using Surface Electromyography--Chin Tuck Against Resistance (CTAR) Exercise and the Shaker Exercise.

    Science.gov (United States)

    Sze, Wei Ping; Yoon, Wai Lam; Escoffier, Nicolas; Rickard Liow, Susan J

    2016-04-01

    In this study, the efficacy of two dysphagia interventions, the Chin Tuck against Resistance (CTAR) and Shaker exercises, were evaluated based on two principles in exercise science-muscle-specificity and training intensity. Both exercises were developed to strengthen the suprahyoid muscles, whose contractions facilitate the opening of the upper esophageal sphincter, thereby improving bolus transfer. Thirty-nine healthy adults performed two trials of both exercises in counter-balanced order. Surface electromyography (sEMG) recordings were simultaneously collected from suprahyoid muscle group and sternocleidomastoid muscle during the exercises. Converging results using sEMG amplitude analyses suggested that the CTAR was more specific in targeting the suprahyoid muscles than the Shaker exercise. Fatigue analyses on sEMG signals further indicated that the suprahyoid muscle group were equally or significantly fatigued (depending on metric), when participants carried out CTAR compared to the Shaker exercise. Importantly, unlike during Shaker exercise, the sternocleidomastoid muscles were significantly less activated and fatigued during CTAR. Lowering the chin against resistance is therefore sufficiently specific and intense to fatigue the suprahyoid muscles.

  18. Improvement in upper leg muscle strength underlies beneficial effects of exercise therapy in knee osteoarthritis: secondary analysis from a randomised controlled trial.

    Science.gov (United States)

    Knoop, J; Steultjens, M P M; Roorda, L D; Lems, W F; van der Esch, M; Thorstensson, C A; Twisk, J W R; Bierma-Zeinstra, S M A; van der Leeden, M; Dekker, J

    2015-06-01

    Although exercise therapy is effective for reducing pain and activity limitations in patients with knee osteoarthritis (OA), the underlying mechanisms are unclear. This study aimed to evaluate if improvements in neuromuscular factors (i.e. upper leg muscle strength and knee proprioception) underlie the beneficial effects of exercise therapy in patients with knee OA. Secondary analyses from a randomised controlled trial, with measurements at baseline, 6 weeks, 12 weeks and 38 weeks. Rehabilitation centre. One hundred and fifty-nine patients diagnosed with knee OA. Exercise therapy. Changes in pain [numeric rating scale (NRS)] and activity limitations [Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) physical function subscale and get-up-and-go test] during the study period. Independent variables were changes in upper leg muscle strength and knee joint proprioception (i.e. motion sense) during the study period. Longitudinal regression analyses (generalised estimating equation) were performed to analyse associations between changes in upper leg muscle strength and knee proprioception with changes in pain and activity limitations. Improved muscle strength was significantly associated with reductions in NRS pain {B coefficient -2.5 [95% confidence interval (CI) -3.7 to -1.4], meaning that every change of 1 unit of strength was linked to a change of -2.5 units of pain}, WOMAC physical function (-8.8, 95% CI -13.4 to -4.2) and get-up-and-go test (-1.7, 95% CI -2.4 to -1.0). Improved proprioception was not significantly associated with better outcomes of exercise therapy (P>0.05). Upper leg muscle strengthening is one of the mechanisms underlying the beneficial effects of exercise therapy in patients with knee OA. Copyright © 2014 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

  19. Competency-Based Training: Objective Structured Clinical Exercises (OSCE) in Marriage and Family Therapy

    Science.gov (United States)

    Miller, John K.

    2010-01-01

    The field of marriage and family therapy (MFT) has recently engaged in the process of defining core competencies for the profession. Many MFT training programs are adapting their curriculum to develop more competency-based training strategies. The Objective Structured Clinical "Examination" (OSCE) is widely used in the medical profession to assess…

  20. Preference for Progressive Delays and Concurrent Physical Therapy Exercise in an Adult with Acquired Brain Injury

    Science.gov (United States)

    Dixon, Mark R.; Falcomata, Terry S.

    2004-01-01

    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…

  1. Effects of aerobic exercise and drug therapy on blood pressure and ...

    African Journals Online (AJOL)

    EB

    reducing effect on antihypertensive drug therapy seems to have been investigated in only laboratory animals. Objectives: This study investigated the effects of .... pregnant or diabetic or had a history of coronary or valvular heart, renal, cerebral vascular, ... Participants with recent history of smoking and alcohol abuse (<6 ...

  2. Comprehensive impairment-based exercise and manual therapy intervention for patients with subacromial impingement syndrome: a case series.

    Science.gov (United States)

    Tate, Angela R; McClure, Philip W; Young, Ian A; Salvatori, Renata; Michener, Lori A

    2010-08-01

    Case series. Few studies have defined the dosage and specific techniques of manual therapy and exercise for rehabilitation for patients with subacromial impingement syndrome. This case series describes a standardized treatment program for subacromial impingement syndrome and the time course and outcomes over a 12-week period. Ten patients (age range, 19-70 years) with subacromial impingement syndrome defined by inclusion and exclusion criteria were treated with a standardized protocol for 10 visits over 6 to 8 weeks. The protocol included a 3-phase progressive strengthening program, manual stretching, thrust and nonthrust manipulation to the shoulder and spine, patient education, activity modification, and a daily home exercise program of stretching and strengthening. Patients completed a history and measures of impairments and functional disability at 2, 4, 6, and 12 weeks. Treatment success was defined as both a 50% improvement on the Disabilities of the Arm, Shoulder, and Hand (DASH) score and a global rating of change of at least "moderately better." At 6 weeks, 6 of 10 patients had a successful (mean +/- SD) DASH outcome score (initial, 33.9 +/- 16.2; 6 weeks, 8.1 +/- 9.2). At 12 weeks, 8 of 10 patients had a successful DASH outcome score (initial, 33.1 +/- 14; 12 weeks, 8.3 +/- 6.4). As a group, the largest improvement was in the first 2 weeks. The most common impairments for all 10 patients were rotator cuff and trapezius muscle weakness (10 of 10 patients), limited shoulder internal rotation motion (8 of 10 patients), and reduced kyphosis of the midthoracic area (7 of 10 patients). A program aimed at strengthening rotator cuff and scapular muscles, with stretching and manual therapy aimed at thoracic spine and the posterior and inferior soft-tissue structures of the glenohumeral joint appeared to be successful in the majority of patients. This case series describes a comprehensive impairment-based treatment which resulted in symptomatic and functional

  3. The development and implementation of a regional network of physiotherapists for exercise therapy in patients with peripheral arterial disease, a preliminary report

    Directory of Open Access Journals (Sweden)

    Prins MH

    2005-07-01

    Full Text Available Abstract Background Exercise therapy (ET is the main conservative and proven effective treatment of patients with intermittent claudication. Currently, the most frequent exercise prescription is a single 'go home and walk' advise, without supervision or follow-up. There is no evidence to support the efficacy of this advise and compliance is known to be low. Therefore, a systematic approach was used to guarantee quality and standardisation of treatment, optimal guideline adherence and improved of inter-professional communication between vascular surgeons and physiotherapists. In this preliminary report we would like to outline the steps taken for the development and implementation of the Network Exercise Therapy Parkstad Methods In October 2003 all 59 regional physiotherapy practices were invited to attend a symposium regarding ET in a physiotherapeutic setting. Attending physiotherapists interested in providing ET and willing to follow a certified course on ET, were asked to register. Three tastkgroups were formed to accomplish the set targets: Exercise therapy education, Exercise therapy implementation and continuity, and Inter-professional communication in the Parkstad region. Results In total 27 physiotherapists, from 22 different practices followed the educational program and are now trained and accredited to provide ET according to the guideline of the Royal Dutch Society for Physiotherapy. A web-based database wasdesigned to contain information on disease specific items provided by the vascular surgery department, and aspects with respect to ET registered by the physiotherapist. The information is regularly updated and available online. Access tothe database is restricted to vascular surgeons and physiotherapists in the network. The secondary purpose of the database is to register essential benchmark data for future analysis of ET in a physiotherapeutic setting in the Netherlands and to enable physiotherapists continuous feedback on

  4. The effect of low-level laser therapy on oxidative stress and functional fitness in aged rats subjected to swimming: an aerobic exercise.

    Science.gov (United States)

    Guaraldo, Simone A; Serra, Andrey Jorge; Amadio, Eliane Martins; Antônio, Ednei Luis; Silva, Flávio; Portes, Leslie Andrews; Tucci, Paulo José Ferreira; Leal-Junior, Ernesto Cesar Pinto; de Carvalho, Paulo de Tarso Camillo

    2016-07-01

    The aim of the present study was to determine whether low-level laser therapy (LLLT) in conjunction with aerobic training interferes with oxidative stress, thereby influencing the performance of old rats participating in swimming. Thirty Wistar rats (Norvegicus albinus) (24 aged and six young) were tested. The older animals were randomly divided into aged-control, aged-exercise, aged-LLLT, aged-LLLT/exercise, and young-control. Aerobic capacity (VO2max(0.75)) was analyzed before and after the training period. The exercise groups were trained for 6 weeks, and the LLLT was applied at 808 nm and 4 J energy. The rats were euthanized, and muscle tissue was collected to analyze the index of lipid peroxidation thiobarbituric acid reactive substances (TBARS), glutathione (GSH), superoxide dismutase (SOD), and catalase (CAT) activities. VO2 (0.75)max values in the aged-LLLT/exercise group were significantly higher from those in the baseline older group (p  0.05). Laser therapy in conjunction with aerobic training may reduce oxidative stress, as well as increase VO2 (0.75)max, indicating that an aerobic exercise such as swimming increases speed and improves performance in aged animals treated with LLLT.

  5. Exercise therapy, quality of life, and activities of daily living in patients with Parkinson disease: a small scale quasi-randomised trial

    Directory of Open Access Journals (Sweden)

    Khoei Ali

    2009-08-01

    Full Text Available Abstract Background The purpose of this study was to examine the effect of a 10-week exercise therapy regimen on activities of daily living (ADL and perceived health status in patients with Parkinson disease. Methods Twenty-four Parkinson's disease patients entered into the study. Participants were allocated into the experimental (n = 12 or control group (n = 12. ADL was assessed using the Short Parkinson Evaluation Scale/Scale for Outcomes in Parkinson Disease (SPES/SCOPA and perceived health status was measured using the Parkinson's Disease Quality of Life (PDQL questionnaire. Patients in the experimental group received pharmacological therapy plus a 1-hour exercise therapy session 4 times a week, while patients in the control group received pharmacological therapy only. The Mann-Whitney U test was used for comparison. Results The mean age of participants was 59.8 (SD = 3.0 and 58.2 (SD = 3.4 years in the experimental and control groups, respectively. The median Hoehn and Yahr stage was 3.0 for both groups. There were no significant differences in all subscales and overall scores between two groups at baseline. However, after the intervention, except for the emotional functioning (P = 0.27, there were significant differences between the two groups for Parkinson symptoms, systemic symptoms, social functioning, and overall scores of the PDQL (all P values Conclusion The findings from this small scale quasi-randomised trial showed that exercise therapy was effective in improving activities of daily living and perceived health status in patients with Parkinson's disease. Indeed, exercise therapy could be offered to patients with Parkinson disease, considering that it is low in cost and usually has no negative side effects. Trial registration Current Controlled Trials ISRCTN98825027

  6. Exercise therapy, quality of life, and activities of daily living in patients with Parkinson disease: a small scale quasi-randomised trial.

    Science.gov (United States)

    Yousefi, Bahram; Tadibi, Vahid; Khoei, Ali Fathollahzadeh; Montazeri, Ali

    2009-08-11

    The purpose of this study was to examine the effect of a 10-week exercise therapy regimen on activities of daily living (ADL) and perceived health status in patients with Parkinson disease. Twenty-four Parkinson's disease patients entered into the study. Participants were allocated into the experimental (n = 12) or control group (n = 12). ADL was assessed using the Short Parkinson Evaluation Scale/Scale for Outcomes in Parkinson Disease (SPES/SCOPA) and perceived health status was measured using the Parkinson's Disease Quality of Life (PDQL) questionnaire. Patients in the experimental group received pharmacological therapy plus a 1-hour exercise therapy session 4 times a week, while patients in the control group received pharmacological therapy only. The Mann-Whitney U test was used for comparison. The mean age of participants was 59.8 (SD = 3.0) and 58.2 (SD = 3.4) years in the experimental and control groups, respectively. The median Hoehn and Yahr stage was 3.0 for both groups. There were no significant differences in all subscales and overall scores between two groups at baseline. However, after the intervention, except for the emotional functioning (P = 0.27), there were significant differences between the two groups for Parkinson symptoms, systemic symptoms, social functioning, and overall scores of the PDQL (all P values exercise therapy was effective in improving activities of daily living and perceived health status in patients with Parkinson's disease. Indeed, exercise therapy could be offered to patients with Parkinson disease, considering that it is low in cost and usually has no negative side effects. Current Controlled Trials ISRCTN98825027.

  7. Effectiveness of low-level laser therapy combined with an exercise program to reduce pain and increase function in adults with shoulder pain: a critically appraised topic.

    Science.gov (United States)

    Thornton, Aimee L; McCarty, Cailee W; Burgess, Mollie-Jean

    2013-02-01

    Shoulder pain is a common musculoskeletal condition that affects up to 25% of the general population. Shoulder pain can be caused by any number of underlying conditions including Subacromial impingement syndrome, rotator-cuff tendinitis, and biceps tendinitis. Regardless of the specific pathology, pain is generally the number 1 symptom associated with shoulder injuries and can severely affect daily activities and quality of life of patients with these conditions. Two of the primary goals in the treatment of these conditions are reducing pain and increasing shoulder range of motion (ROM). Conservative treatment has traditionally included a therapeutic exercise program targeted at increasing ROM, strengthening the muscles around the joint, proprioceptive training, or some combination of those activities. In addition, these exercise programs have been supplemented with other interventions including nonsteroidal anti-inflammatory drugs, corticosteroid injections, manual therapy, activity modification, and a wide array of therapeutic modalities (eg, cryotherapy, EMS, ultrasound). Recently, low-level laser therapy (LLLT) has been used as an additional modality in the conservative management of patients with shoulder pain. However, the true effectiveness of LLLT in decreasing pain and increasing function in patients with shoulder pain is unclear. Is low-level laser therapy combined with an exercise program more effective than an exercise program alone in the treatment of adults with shoulder pain?

  8. Exercise therapy in the complex of physical rehabilitation of patients with pulmonary tuberculosis.

    Directory of Open Access Journals (Sweden)

    Nogas A.O.

    2012-01-01

    Full Text Available The programs of physical rehabilitation, which are directed on proceeding in the broken function of the external breathing, are appraised. In research 68 patients took part with a diagnosis the first diagnosed white plague (40 - men and 28 - women, middle ages - 29 years. The complex program of physical rehabilitation included: morning hygienical gymnastics, medical gymnastics, massotherapy, physical therapy procedures, hydropathy, manipulation interferences and educational programs. A tendency is set to more hasty growth of indexes which characterize the level of violation of bronchial ability to travel the cross-country; frequencies of breathing, respiratory volume, minute volume of breathing. It is well-proven that over application of medical physical culture brings to rapid renewal of the broken function of the external breathing, improvement of the functional state of the respiratory and cardiovascular systems, strengthening of respiratory musculature, increase of efficiency of medicinal therapy, general physical health and diminishing of development of complications level.

  9. Exercise therapy in the complex of physical rehabilitation of patients with pulmonary tuberculosis.

    OpenAIRE

    Nogas A.O.

    2012-01-01

    The programs of physical rehabilitation, which are directed on proceeding in the broken function of the external breathing, are appraised. In research 68 patients took part with a diagnosis the first diagnosed white plague (40 - men and 28 - women, middle ages - 29 years). The complex program of physical rehabilitation included: morning hygienical gymnastics, medical gymnastics, massotherapy, physical therapy procedures, hydropathy, manipulation interferences and educational programs. A tende...

  10. Effects of aerobic exercise therapy and cognitive behavioural therapy on functioning and quality of life in amyotrophic lateral sclerosis: protocol of the FACTS-2-ALS trial

    Directory of Open Access Journals (Sweden)

    van de Weerd Margreet GH

    2011-06-01

    Full Text Available Abstract Background Amyotrophic lateral sclerosis (ALS is a fatal progressive neurodegenerative disorder affecting motor neurons in the spinal cord, brainstem and motor cortex, leading to muscle weakness. Muscle weakness may result in the avoidance of physical activity, which exacerbates disuse weakness and cardiovascular deconditioning. The impact of the grave prognosis may result in depressive symptoms and hopelessness. Since there is no cure for ALS, optimal treatment is based on symptom management and preservation of quality of life (QoL, provided in a multidisciplinary setting. Two distinctly different therapeutic interventions may be effective to improve or preserve daily functioning and QoL at the highest achievable level: aerobic exercise therapy (AET to maintain or enhance functional capacity and cognitive behavioural therapy (CBT to improve coping style and cognitions in patients with ALS. However, evidence to support either approach is still insufficient, and the underlying mechanisms of the approaches remain poorly understood. The primary aim of the FACTS-2-ALS trial is to study the effects of AET and CBT, in addition to usual care, compared to usual care alone, on functioning and QoL in patients with ALS. Methods / Design A multicentre, single-blinded, randomized controlled trial with a postponed information model will be conducted. A sample of 120 patients with ALS (1 month post diagnosis will be recruited from 3 university hospitals and 1 rehabilitation centre. Patients will be randomized to one of three groups i.e. (1 AET + usual care, (2 CBT + usual care, (3 Usual care. AET consists of a 16-week aerobic exercise programme, on 3 days a week. CBT consists of individual psychological support of patients in 5 to 10 sessions over a 16-week period. QoL, functioning and secondary outcome measures will be assessed at baseline, immediately post intervention and at 3- and 6-months follow-up. Discussion The FACTS-2-ALS study is the first

  11. Effectiveness of conservative interventions including exercise, manual therapy and medical management in adults with shoulder impingement: a systematic review and meta-analysis of RCTs.

    Science.gov (United States)

    Steuri, Ruedi; Sattelmayer, Martin; Elsig, Simone; Kolly, Chloé; Tal, Amir; Taeymans, Jan; Hilfiker, Roger

    2017-09-01

    To investigate the effectiveness of conservative interventions for pain, function and range of motion in adults with shoulder impingement. Systematic review and meta-analysis of randomised trials. Medline, CENTRAL, CINAHL, Embase and PEDro were searched from inception to January 2017. Randomised controlled trials including participants with shoulder impingement and evaluating at least one conservative intervention against sham or other treatments. For pain, exercise was superior to non-exercise control interventions (standardised mean difference (SMD) -0.94, 95% CI -1.69 to -0.19). Specific exercises were superior to generic exercises (SMD -0.65, 95% CI -0.99 to -0.32). Corticosteroid injections were superior to no treatment (SMD -0.65, 95% CI -1.04 to -0.26), and ultrasound guided injections were superior to non-guided injections (SMD -0.51, 95% CI -0.89 to -0.13). Nonsteroidal anti-inflammatory drugs (NSAIDS) had a small to moderate SMD of -0.29 (95% CI -0.53 to -0.05) compared with placebo. Manual therapy was superior to placebo (SMD -0.35, 95% CI -0.69 to -0.01). When combined with exercise, manual therapy was superior to exercise alone, but only at the shortest follow-up (SMD -0.32, 95% CI -0.62 to -0.01). Laser was superior to sham laser (SMD -0.88, 95% CI -1.48 to -0.27). Extracorporeal shockwave therapy (ECSWT) was superior to sham (-0.39, 95% CI -0.78 to -0.01) and tape was superior to sham (-0.64, 95% CI -1.16 to -0.12), with small to moderate SMDs. Although there was only very low quality evidence, exercise should be considered for patients with shoulder impingement symptoms and tape, ECSWT, laser or manual therapy might be added. NSAIDS and corticosteroids are superior to placebo, but it is unclear how these treatments compare to exercise. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  12. Cardiac output response to changes of the atrioventricular delay in different body positions and during exercise in patients receiving cardiac resynchronization therapy

    DEFF Research Database (Denmark)

    Ståhlberg, Marcus; Damgaard, Morten; Norsk, Peter

    2009-01-01

    AIMS: The aim of this study was to study the haemodynamic effect of atrioventricular delay (AVD) modifications within a narrow range in different body positions and during exercise in patients receiving cardiac resynchronization therapy (CRT). METHODS: The previously optimized AVD was shortened...... and prolonged by 40 ms in 27 CRT patients and 9 controls without heart failure. Cardiac output (CO) was measured by inert gas rebreathing (Innocor) as the average over different body positions (left-lateral, supine, sitting, standing, and exercise). In eight CRT patients with an implantable haemodynamic monitor.......61, Pnarrow range is larger in CRT patients than in normal...

  13. Protocol for: Sheffield Obesity Trial (SHOT: A randomised controlled trial of exercise therapy and mental health outcomes in obese adolescents [ISRCNT83888112

    Directory of Open Access Journals (Sweden)

    Wright Neil P

    2005-10-01

    Full Text Available Abstract Background While obesity is known to have many physiological consequences, the psychopathology of this condition has not featured prominently in the literature. Cross-sectional studies have indicated that obese children have increased odds of experiencing poor quality of life and mental health. However, very limited trial evidence has examined the efficacy of exercise therapy for enhancing mental health outcomes in obese children, and the Sheffield Obesity Trial (SHOT will provide evidence of the efficacy of supervised exercise therapy in obese young people aged 11–16 years versus usual care and an attention-control intervention. Method/design SHOT is a randomised controlled trial where obese young people are randomised to receive; (1 exercise therapy, (2 attention-control intervention (involving body-conditioning exercises and games that do not involve aerobic activity, or (3 usual care. The exercise therapy and attention-control sessions will take place three times per week for eight weeks and a six-week home programme will follow this. Ninety adolescents aged between 11–16 years referred from a children's hospital for evaluation of obesity or via community advertisements will need to complete the study. Participants will be recruited according to the following criteria: (1 clinically obese and aged 11–16 years (Body Mass Index Centile > 98th UK standard (2 no medical condition that would restrict ability to be active three times per week for eight weeks and (3 not diagnosed with insulin dependent diabetes or receiving oral steroids. Assessments of outcomes will take place at baseline, as well as four (intervention midpoint and eight weeks (end of intervention from baseline. Participants will be reassessed on outcome measures five and seven months from baseline. The primary endpoint is physical self-perceptions. Secondary outcomes include physical activity, self-perceptions, depression, affect, aerobic fitness and BMI.

  14. The PED-t trial protocol: The effect of physical exercise -and dietary therapy compared with cognitive behavior therapy in treatment of bulimia nervosa and binge eating disorder.

    Science.gov (United States)

    Mathisen, Therese Fostervold; Rosenvinge, Jan H; Pettersen, Gunn; Friborg, Oddgeir; Vrabel, KariAnne; Bratland-Sanda, Solfrid; Svendsen, Mette; Stensrud, Trine; Bakland, Maria; Wynn, Rolf; Sundgot-Borgen, Jorunn

    2017-05-12

    Sufferers from bulimia nervosa (BN) and binge eating disorder (BED) underestimate the severity risk of their illness and, therefore, postpone seeking professional help for years. Moreover, less than one in five actually seek professional help and only 50% respond to current treatments, such as cognitive behavioral therapy (CBT). The impetus for the present trial is to explore a novel combination treatment approach adapted from physical exercise- and dietary therapy (PED-t). The therapeutic underpinnings of these separate treatment components are well-known, but their combination to treat BN and BED have never been previously tested. The purpose of this paper is to provide the rationale for this new treatment approach and to outline the specific methods and procedures. The PED-t trial uses a prospective randomized controlled design. It allocates women between 18 and 40 years (BMI range 17.5-35.0) to groups consisting of 5-8 members who receive either CBT or PED-t for 16 weeks. Excess participants are allocated to a waiting list control group condition. All participants are assessed at baseline, post-treatment, 6, 12 and 24 months' post-follow-up, respectively, and monitored for changes in biological, psychological and therapy process variables. The primary outcome relates to the ED symptom severity, while secondary outcomes relates to treatment effects on physical health, treatment satisfaction, therapeutic alliance, and cost-effectiveness. We aim to disseminate the results in high-impact journals, preferable open access, and at international conferences. We expect that the new treatment will perform equal to CBT in terms of behavioral and psychological symptoms, but better in terms of reducing somatic symptoms and complications. We also expect that the new treatment will improve physical fitness and thereby, quality of life. Hence, the new treatment will add to the portfolio of evidence-based therapies and thereby provide a good treatment alternative for females

  15. Comparison of the Effect of Exercise Therapy with Transcutaneous Electrical Nerve Stimulation on Improvement of Pain and Function in Patients with Patellofemoral Pain Syndrome

    Directory of Open Access Journals (Sweden)

    A Akbari

    2008-04-01

    Full Text Available ABSTRACT: Introduction & Objective: One of the most common disorders of the knee joint in adult is patellofemoral pain syndrome. Sometimes it becomes chronic and causes activity limitation. This study aimed to compare the efficacy of exercise therapy with Transcutaneous Electrical Nerve Stimulation on improvement of pain intensity, knee function, muscle atrophy and range of knee flexion. Materials & Methods: This double-blind, randomized clinical trial was carried out in Zahedan Razmejo-Moghadam Physiotherapy Clinic, in 2007. Thirty-two patients with patellofemoral pain syndrome were recruited through simple non-probability sampling. Subjects were randomly assigned to one of the equal groups, exercise therapy (including hip, knee, and leg muscles strengthening and stretching exercises or electrical stimulation group. Before and after intervention, we assessed pain through Visual Analog Scale (VAS (ordinal, function (ordinal with Knee Injury and Osteoarthritis Outcome Score (KOOS, thigh circumference with tape measure (centimeter and range of knee flexion with goniometer (degree. A 10 session treatment program, three sessions per week and one hour per session was performed for both groups. Independent t-test or Mann-Whitney U and paired t-test or Wilcoxon were used for comparison between the pretreatment and post treatment results between groups and within groups, in SPSS software, respectively. Results: The mean total score of knee function increased from 100.53±19.25 to 130.87±18.25 in the electrical stimulation group and from 107.67±22.69 to 131.47±15.11 in the exercise therapy group (p=0.001. The mean score of knee function subscales including symptoms, pain, functional limitation, recreational activity, and life style improved in both groups (p<0.05. The pain score and range of knee flexion improved in both groups (p<0.05. After treatment, range of knee flexion significantly increased in the exercise group compared with the electrical

  16. A televideo exercise and nutrition program for children with acute lymphoblastic leukemia in maintenance therapy: design and methods

    Directory of Open Access Journals (Sweden)

    Gibson CA

    2015-07-01

    Full Text Available Cheryl A Gibson,1 Keith J August,2 Jerry L Greene,3 Stephen D Herrmann,4 Jaehoon Lee,5 Susan P Harvey,6 Kate Lambourne,3 Debra K Sullivan7 1Department of Internal Medicine, Division of General and Geriatric Medicine, University of Kansas Medical Center, KS, USA; 2Children's Mercy Hospital, MO, USA; 3Department of Health, Sport, and Exercise Sciences, University of Kansas, KS, USA; 4Children's Health Research Center, Sanford Research, SD, USA; 5Institute for Measurement, Methodology, Analysis and Policy, Texas Tech University, TX, USA; 6Center for Research on Learning, University of Kansas, KS, USA; 7Department of Dietetics and Nutrition, University of Kansas Medical Center, KS, USA Abstract: Changes in nutrient intake and decreased exercise resulting from cancer therapies as well as their side effects may be contributing factors in the increased body weight and differences in physical fitness observed in survivors of childhood acute lymphoblastic leukemia (ALL. This article will describe the study protocol for an intervention program designed to improve the physical activity and nutrition behaviors of ALL survivors. Twenty-four children aged between 4 years and 12 years with ALL will be randomized to a 6-month technology-based exercise and nutrition program (TLC4ALLKids or to enhanced usual care (eUC. The participants randomized to the TLC4ALLKids will participate in weekly, 1-hour coaching sessions on nutrition and physical activity and 1-hour physical activity classes delivered by group video conferencing. Participants will be provided with iPad tablets loaded with video conferencing software and the Healthy Lifestyle Tracking calendar to track daily nutrition and physical activity goals and weight. Both groups will be provided with Fitbit™ Zip to monitor physical activity. To assess feasibility, participant recruitment (achievement of proposed sample size, attendance (per weekly online sessions/assessment sessions, and adherence (number of

  17. The effect of combining manual therapy with exercise for mild chronic obstructive pulmonary disease: study protocol for a randomised controlled trial.

    Science.gov (United States)

    Engel, Roger M; Wearing, Jaxson; Gonski, Peter; Vemulpad, Subramanyam

    2017-06-17

    Chronic obstructive pulmonary disease (COPD) is a major cause of disability and hospital admission. Current management strategies have not been successful in altering the loss of lung function typically seen as the disease progresses. A recent systematic review into the use of spinal manipulative therapy (SMT) in the management of COPD concluded that there was low level evidence to support the view that a combination of SMT and exercise had the potential to improve lung function more than exercise alone in people with moderate to severe COPD. The aim of this study is to investigate whether the combination of exercise and manual therapy (MT) that includes SMT produces sustainable improvements in lung function and exercise capacity in people with mild COPD. The study is a randomised controlled trial of 202 people with stable mild COPD. The cohort will be divided into two equal groups matched at baseline. The first group will receive a standardised exercise program. The second group will receive MT that includes SMT plus the same standardised exercise program. Exercise will be administered a total of 36 times over an 18-week period, while MT will be administered in conjunction with exercise a total of 15 times over a 6-week period. The primary outcome measure is lung function (forced expiratory volume in the 1(st) second: FEV1 and forced vital capacity: FVC). The secondary outcome measures are the 6-minute walking test (6MWT), quality of life questionnaire (St George's Respiratory Questionnaire: SGRQ), anxiety and depression levels (Hospital Anxiety and Depression Scale: HADS), frequency of exacerbations, chest wall expansion measurements (tape measurements) and systemic inflammatory biomarker levels. Outcome measurements will be taken by blinded assessors on seven occasions over a 48-week period. Adverse event data will also be gathered at the beginning of each intervention session. This randomised controlled trial is designed to investigate whether the combination

  18. Exercise therapy improves aerobic capacity of inpatients with major depressive disorder.

    Science.gov (United States)

    Kerling, Arno; von Bohlen, Anne; Kück, Momme; Tegtbur, Uwe; Grams, Lena; Haufe, Sven; Gützlaff, Elke; Kahl, Kai G

    2016-06-01

    Unipolar depression is one of the most common diseases worldwide and is associated with a higher cardiovascular risk partly due to reduced aerobic capacity. Therefore, the aim of our study was to examine whether a structured aerobic training program can improve aerobic capacity in inpatients with MDD (major depressive disorder). Overall, 25 patients (13 women, 12 men) diagnosed with MDD were included in the study. Parameters of aerobic capacity, such as maximum performance, maximum oxygen consumption, and VAT (ventilatory anaerobic threshold), were assessed on a bicycle ergometer before and 6 weeks after a training period (three times per week for 45 min on two endurance machines). In addition, a constant load test was carried out at 50% of the maximum performance prior to and after the training period. The performance data were compared with 25 healthy controls matched for sex, age, and body mass index before and after the training period. Compared to controls, patients with MDD had significantly lower aerobic capacity. After training, there was a significant improvement in their performance data. A significant difference remained only for VAT between patients with MDD and healthy controls. With regard to the coincidence of MDD with cardiovascular and cardiometabolic disorders, a structured supervised exercise program carried out during hospitalization is a useful supplement for patients with MDD.

  19. The effect of exercise therapy on depressive and anxious symptoms in patients with ischemic heart disease: A systematic review

    NARCIS (Netherlands)

    Verschueren, Suzanne; Eskes, Anne M.; Maaskant, Jolanda M.; Roest, Annelieke M.; Latour, Corine H. M.; Scholte Op Reimer, Wilma

    2018-01-01

    Depressive and anxiety symptoms are associated with Ischemic Heart Disease (IHD). Exercise interventions might improve both depressive and anxiety symptoms, but an overview of the evidence is lacking. Therefore, we systematically reviewed the existing literature on the effectiveness of exercise

  20. Vibration Therapy Is No More Effective Than the Standard Practice of Massage and Stretching for Promoting Recovery From Muscle Damage After Eccentric Exercise.

    Science.gov (United States)

    Fuller, Joel T; Thomson, Rebecca L; Howe, Peter R C; Buckley, Jonathan D

    2015-07-01

    The purpose of this study was to determine if vibration therapy is more effective than the standard treatment of stretching and massage for improving recovery of muscle strength and reducing muscle soreness after muscle damage induced by eccentric exercise. A randomized, single-blinded parallel intervention trial design was used. Research laboratory. Fifty untrained men aged 18 to 30 years completed the study. Participants performed 100 maximal eccentric muscle actions (ECCmax) of the right knee extensor muscles. For the next 7 days, 25 participants applied cycloidal vibration therapy to the knee extensors twice daily and 25 participants performed stretching and sports massage (SSM) twice daily. Changes in markers of muscle damage [peak isometric torque (PIT), serum creatine kinase (CK), and serum myoglobin (Mb)], muscle soreness (visual analog scale), and inflammation [serum C-reactive protein (CRP)] were assessed. After ECCmax, there was no difference in recovery of PIT and muscle soreness or serum CK, Mb, and CRP levels between vibration and SSM groups (P > 0.28). Cycloidal vibration therapy is no more effective than the standard practice of stretching and massage to promote muscle recovery after the performance of muscle-damaging exercise. Prescription of vibration therapy after maximal exercise involving eccentric muscle damage did not alleviate signs and symptoms of muscle damage faster than the standard prescription of stretching and massage.

  1. No Reduction of Severe Fatigue in Patients With Postpolio Syndrome by Exercise Therapy or Cognitive Behavioral Therapy: Results of an RCT.

    Science.gov (United States)

    Koopman, Fieke S; Voorn, Eric L; Beelen, Anita; Bleijenberg, Gijs; de Visser, Marianne; Brehm, Merel A; Nollet, Frans

    2016-06-01

    People with postpolio syndrome (PPS) commonly experience severe fatigue that persists over time and negatively affects functioning and health-related quality of life (HRQoL). To study the efficacy of exercise therapy (ET) and cognitive behavioral therapy (CBT) on reducing fatigue and improving activities and HRQoL in patients with PPS. We conducted a multicenter, single-blinded, randomized controlled trial. Over 4 months, severely fatigued patients with PPS received ET, CBT, or usual care (UC). The primary end point (fatigue) was assessed using the subscale fatigue severity of the Checklist Individual Strength (CIS20-F). Secondary end points included activities and HRQoL, which were assessed with the Sickness Impact Profile and the 36-Item Short-Form, respectively. End points were measured at baseline and at 4, 7, and 10 months. A total of 68 patients were randomized. No differences were observed between the intervention groups and UC group for fatigue (mean differences in CIS20-F score = 1.47, 95%CI = -2.84 to 5.79, for ET versus UC; and 1.87, 95%CI = -2.24 to 5.98, for CBT versus UC), activities, or HRQoL. Our results demonstrate that neither ET nor CBT were superior to UC in reducing fatigue in severely fatigued PPS patients. Further research should investigate explanations for the lack of efficacy of these 2 currently advised approaches in clinical practice, which may provide clues to improving treatment aimed at reducing fatigue in PPS. © The Author(s) 2015.

  2. Exercise therapy and custom-made insoles are effective in patients with excessive pronation and chronic foot pain

    DEFF Research Database (Denmark)

    Andreasen, Jane; Mølgaard, Carsten; Christensen, Marianne

    2013-01-01

    and chronic pain conditions in the foot at short and long term follow-up. Methods: Single blinded Randomized Controlled Trial with 80 subjects randomized: (1) Standard Intervention, (2) Insole, (3) Exercise, and (4) Insole + Exercise. Exercise – 12 week supervised program. Insoles – individually molded...

  3. Adaptive pacing, cognitive behaviour therapy, graded exercise, and specialist medical care for chronic fatigue syndrome: a cost-effectiveness analysis.

    Directory of Open Access Journals (Sweden)

    Paul McCrone

    Full Text Available The PACE trial compared the effectiveness of adding adaptive pacing therapy (APT, cognitive behaviour therapy (CBT, or graded exercise therapy (GET, to specialist medical care (SMC for patients with chronic fatigue syndrome. This paper reports the relative cost-effectiveness of these treatments in terms of quality adjusted life years (QALYs and improvements in fatigue and physical function.Resource use was measured and costs calculated. Healthcare and societal costs (healthcare plus lost production and unpaid informal care were combined with QALYs gained, and changes in fatigue and disability; incremental cost-effectiveness ratios (ICERs were computed.SMC patients had significantly lower healthcare costs than those receiving APT, CBT and GET. If society is willing to value a QALY at £30,000 there is a 62.7% likelihood that CBT is the most cost-effective therapy, a 26.8% likelihood that GET is most cost effective, 2.6% that APT is most cost-effective and 7.9% that SMC alone is most cost-effective. Compared to SMC alone, the incremental healthcare cost per QALY was £18,374 for CBT, £23,615 for GET and £55,235 for APT. From a societal perspective CBT has a 59.5% likelihood of being the most cost-effective, GET 34.8%, APT 0.2% and SMC alone 5.5%. CBT and GET dominated SMC, while APT had a cost per QALY of £127,047. ICERs using reductions in fatigue and disability as outcomes largely mirrored these findings.Comparing the four treatments using a health care perspective, CBT had the greatest probability of being the most cost-effective followed by GET. APT had a lower probability of being the most cost-effective option than SMC alone. The relative cost-effectiveness was even greater from a societal perspective as additional cost savings due to reduced need for informal care were likely.

  4. Haemophilia & Exercise Project (HEP): the impact of 1-year sports therapy programme on physical performance in adult haemophilia patients.

    Science.gov (United States)

    Czepa, D; von Mackensen, S; Hilberg, T

    2013-03-01

    Episodes of bleeding in people with haemophilia (PWH) are associated with reduced activity and limitations in physical performance. Within the scope of the 'Haemophilia & Exercise Project' (HEP) PWH were trained in a sports therapy programme. Aim of this study was to investigate subjective and objective physical performance in HEP-participants after 1 year training. Physical performance of 48 adult PWH was compared before and after sports therapy subjectively (HEP-Test-Q) and objectively regarding mobility (range of motion), strength and coordination (one-leg-stand) and endurance (12-min walk test). Sports therapy included an independent home training that had previously been trained in several collective sports camps. Forty-three controls without haemophilia and without training were compared to PWH. Of 48 PWH, 13 performed a regular training (active PWH); 12 HEP-participants were constantly passive (passive PWH). Twenty-three PWH and 24 controls dropped out because of incomplete data. The activity level increased by 100% in active PWH and remained constant in passive PWH, and in controls (P ≤ 0.05). Only mobility of the right knee was significantly improved in active PWH (+5.8 ± 5.3°) compared to passive PWH (-1.3 ± 8.6°). The 12-min walk test proved a longer walking distance for active PWH (+217 ± 199 m) compared to controls (-32 ± 217 m). Active PWH reported a better subjective physical performance in the HEP-Test-Q domains 'strength & coordination', 'endurance' and in the total score (+9.4 ± 13.8) compared to passive PWH (-5.3 ± 13.5) and controls (+3.7 ± 7.5). The 'mobility'-scale and one-leg-stand remained unchanged. Sports therapy increases the activity level and physical performance of PWH, whereby objective effects do not always correspond with subjective assessments. © 2012 Blackwell Publishing Ltd.

  5. The effect of massage therapy and/or exercise therapy on subacute or long-lasting neck pain--the Stockholm neck trial (STONE): study protocol for a randomized controlled trial.

    Science.gov (United States)

    Skillgate, Eva; Bill, Anne-Sylvie; Côté, Pierre; Viklund, Peter; Peterson, Anna; Holm, Lena W

    2015-09-16

    Neck pain is a major health problem in populations worldwide and an economic burden in modern societies due to its high prevalence and costs in terms of health care expenditures and lost productivity. Massage and exercise therapy are widely used management options for neck pain. However, there is a lack of scientific evidence regarding their effectiveness for subacute and long-lasting neck pain. This study protocol describes a randomized controlled trial aiming to determine the effect of massage and/or exercise therapy on subacute and long-lasting neck pain over the course of 1 year. A randomized controlled trial in which at least 600 study participants with subacute or long-lasting nonspecific neck pain will be recruited and randomly allocated to one of four treatment arms: massage therapy (A), exercise therapy (B), exercise therapy plus massage therapy (C) and advice to stay active (D). The study has an E-health approach, and study participants are being recruited through advertising with a mix of traditional and online marketing channels. Web-based self-report questionnaires measure the main outcomes at 7, 12, 26 and 52 weeks after inclusion. The primary outcomes are a clinically important improvement in pain intensity and pain-related disability at follow-up, measured with a modified version of the Chronic Pain Questionnaire (CPQ). The secondary outcomes are global improvement, health-related quality of life (EQ-5D), sick leave, drug consumption and healthcare utilization. Adverse events are measured by questionnaires at return visits to the clinic, and automated text messages (SMSes) survey neck pain intensity and pain-related disability every week over one year. The results of this study will provide clinicians and stakeholders much needed knowledge to plan medical care for subacute and long-lasting neck pain disorders. Current Controlled Trials ISRCTN01453590. Date of registration: 3 July 2014.

  6. [Social participation and activities of daily living of patients with inflammatory rheumatic diseases : support by self-help, exercise therapy and new media].

    Science.gov (United States)

    Mattukat, K; Thyrolf, A

    2014-02-01

    Rheumatic patients are at risk of social isolation and physical inactivity which can have a significant impact on physical and mental health. Only every seventh patient is organized in a self-help group (SHG), most of them in the German League Against Rheumatism (GLAR). Members of a SHG are socially and physically more active and take part in exercise therapy (ET) more often. Depending on the study, the utilization of ET ranges from 25 % to 71 %. The functional training as the most attended offer of the GLAR showed positive effects at the physical and psychological levels. To motivate difficult to reach patients to engage in self-help and regular exercise, further development of exercise programs with individually tailored intensive strength and endurance elements as well as the increased use of new media seems promising. The Internet provides various opportunities for networking and social participation especially for severely impaired and temporally less flexible patients.

  7. Heart rate variability biofeedback therapy and graded exercise training in management of chronic fatigue syndrome: An exploratory pilot study.

    Science.gov (United States)

    Windthorst, Petra; Mazurak, Nazar; Kuske, Marvin; Hipp, Arno; Giel, Katrin E; Enck, Paul; Nieß, Andreas; Zipfel, Stephan; Teufel, Martin

    2017-02-01

    Chronic fatigue syndrome (CFS) is characterised by persistent fatigue, exhaustion, and several physical complaints. Research has shown cognitive behavioural therapy (CBT) and graded exercise training (GET) to be the most effective treatments. In a first step we aimed to assess the efficacy of heart rate variability biofeedback therapy (HRV-BF) as a treatment method comprising cognitive and behavioural strategies and GET in the pilot trial. In a second step we aimed to compare both interventions with regard to specific parameters. The study was conducted in an outpatient treatment setting. A total of 28 women with CFS (50.3±9.3years) were randomly assigned to receive either eight sessions of HRV-BF or GET. The primary outcome was fatigue severity. Secondary outcomes were mental and physical quality of life and depression. Data were collected before and after the intervention as well as at a 5-month follow-up. General fatigue improved significantly after both HRV-BF and GET. Specific cognitive components of fatigue, mental quality of life, and depression improved significantly after HRV-BF only. Physical quality of life improved significantly after GET. There were significant differences between groups regarding mental quality of life and depression favouring HRV-BF. Both interventions reduce fatigue. HRV-BF seems to have additional effects on components of mental health, including depression, whereas GET seems to emphasise components of physical health. These data offer implications for further research on combining HRV-BF and GET in patients with CFS. The described trial has been registered at the International Clinical Trials Registry Platform following the number DRKS00005445. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Effects of glucosamine sulfate and exercise therapy on serum leptin levels in patients with knee osteoarthritis: preliminary results of randomized controlled clinical trial.

    Science.gov (United States)

    Durmus, Dilek; Alayli, Gamze; Aliyazicioglu, Yuksel; Buyukakıncak, Ozlem; Canturk, Ferhan

    2013-03-01

    Osteoarthritis (OA) is a slow, chronic disease characterized by the focal deterioration and abrasion of articular cartilage. Leptin may play an important role in the pathophysiology of OA. Exercise and glucosamine sulfate therapy is one of the most commonly used in patients with knee OA. The goals of the present study are performed to investigate whether 12-week strength training program and glucosamine sulfate have an effect on serum leptin levels in knee OA and the relationship between leptin, clinical parameters, and radiographic severity of knee OA. Thirty-seven women with the diagnosis of knee OA were enrolled in the study. Patients were randomized into two groups. Group I (n = 19) received an exercise program, while group II (n = 18) received glucosamine sulfate (1,500 mg/day) in addition to the exercise therapy. Both groups were treated for 12 weeks. Leptin level was assessed at baseline and after 12 weeks. The concentration of leptin was measured by ELISA. The patients were evaluated regarding pain, disability, functional performance, and muscle strength. Both groups showed significant improvements in leptin levels, pain, disability, muscle strength, and functional performance with no statistically significant difference between the groups after the therapy. At basal time, plasma leptin levels were significantly correlated with body mass index and duration of disease, but no significant correlation was found with patient age, pain, disability, functional performance, muscle strength, and radiographic severity of knee OA. The results of this preliminary study revealed that exercise alone was adequate to prevent structural changes relieving the symptoms of OA. We also found that exercise alone could affect serum plasma levels of the leptin, important mediators of cartilage metabolism. Decreases in serum leptin may be one mechanism by which cartilage metabolism affects physical function and symptoms in OA patients.

  9. Assessment of Spasticity by a Pendulum Test in SCI Patients Who Exercise FES Cycling or Receive Only Conventional Therapy.

    Science.gov (United States)

    Popovic-Maneski, Lana; Aleksic, Antonina; Metani, Amine; Bergeron, Vance; Cobeljic, Radoje; Popovic, Dejan B

    2018-01-01

    Increased muscle tone and exaggerated tendon reflexes characterize most of the individuals after a spinal cord injury (SCI). We estimated seven parameters from the pendulum test and used them to compare with the Ashworth modified scale of spasticity grades in three populations (retrospective study) to assess their spasticity. Three ASIA B SCI patients who exercised on a stationary FES bicycle formed group F, six ASIA B SCI patients who received only conventional therapy were in the group C, and six healthy individuals constituted the group H. The parameters from the pendulum test were used to form a single measure, termed the PT score, for each subject. The pendulum test parameters show differences between the F and C groups, but not between the F and H groups, however, statistical significance was limited due to the small study size. Results show a small deviation from the mean for all parameters in the F group and substantial deviations from the mean for the parameters in the C group. PT scores show significant differences between the F and C groups and the C and H groups and no differences between the F and C groups. The correlation between the PT score and Ashworth score was 0.88.

  10. Beneficial Effects of Pre-operative Exercise Therapy in Patients with an Abdominal Aortic Aneurysm: A Systematic Review.

    Science.gov (United States)

    Pouwels, S; Willigendael, E M; van Sambeek, M R H M; Nienhuijs, S W; Cuypers, P W M; Teijink, J A W

    2015-01-01

    The impact of post-operative complications in abdominal aortic aneurysm (AAA) surgery is substantial, and increases with age and concomitant co-morbidities. This systematic review focuses on the possible effects of pre-operative exercise therapy (PET) in patients with AAA on post-operative complications,aerobic capacity, physical fitness, and recovery. A systematic search on PET prior to AAA surgery was conducted. The methodological quality of the included studies was rated using the Physiotherapy Evidence Database scale. The agreement between the reviewers was assessed with Cohen's kappa. Five studies were included, with a methodological quality ranging from moderate to good. Cohen's kappa was 0.79. Three studies focused on patients with an AAA (without indication for surgical repair) with physical fitness as the outcome measure. One study focused on PET in patients awaiting AAA surgery and one study focused on the effects of PET on post-operative complications, length of stay, and recovery. PET has beneficial effects on various physical fitness variables of patients with an AAA. Whether this leads to less complications or faster recovery remains unclear. In view of the large impact of post-operative complications, it is valuable to explore the possible benefits of a PET program in AAA surgery.

  11. Medical Exercise Therapy for Treating Musculoskeletal Pain: A Narrative Review of Results from Randomized Controlled Trials with a Theoretical Perspective.

    Science.gov (United States)

    Lorås, H; Østerås, B; Torstensen, T A; Østerås, H

    2015-09-01

    The purpose of this narrative review is to present an overview and theoretical rationale of medical exercise therapy (MET) as a physiotherapeutic rehabilitation treatment for musculoskeletal pain conditions. Results from randomized controlled trials (RCTs) conducted on MET are also presented. Computerized searches for any RCTs were conducted on the MET concept in the databases PubMed, Medline, Embase and ISI Web of science up to 2013. Overall findings from five included MET RCTs are long-term (≥1 year) reductions in pain and improved physical and functional capabilities. These results are interpreted in the context of the biopsychosocial model, advancing the view of a dynamic interaction among physiologic, psychological and social factors that influence pain modulation. MET is a biopsychosocial treatment that reduces pain and improves activities of daily living in patients with a musculoskeletal pain condition. Pain modulation is a key feature of MET, and an important area for further research is to elucidate the specific mechanisms behind the treatment effects. Copyright © 2015 John Wiley & Sons, Ltd.

  12. Sub-classification based specific movement control exercises are superior to general exercise in sub-acute low back pain when both are combined with manual therapy: A randomized controlled trial.

    Science.gov (United States)

    Lehtola, Vesa; Luomajoki, Hannu; Leinonen, Ville; Gibbons, Sean; Airaksinen, Olavi

    2016-03-22

    Clinical guidelines recommend research on sub-groups of patients with low back pain (LBP) but, to date, only few studies have been published. One sub-group of LBP is movement control impairment (MCI) and clinical tests to identify this sub-group have been developed. Also, exercises appear to be beneficial for the management of chronic LBP (CLBP), but very little is known about the management of sub-acute LBP. A randomized controlled trial (RCT) was conducted to compare the effects of general exercise versus specific movement control exercise (SMCE) on disability and function in patients with MCI within the recurrent sub-acute LBP group. Participants having a MCI attended five treatment sessions of either specific or general exercises. In both groups a short application of manual therapy was applied. The primary outcome was disability, assessed by the Roland-Morris Disability Questionnaire (RMDQ). The measurements were taken at baseline, immediately after the three months intervention and at twelve-month follow-up. Seventy patients met the inclusion criteria and were eligible for the trial. Measurements of 61 patients (SMCE n = 30 and general exercise n = 31) were completed at twelve months. (Drop-out rate 12.9 %). Patients in both groups reported significantly less disability (RMDQ) at twelve months follow-up. However, the mean change on the RMDQ between baseline and the twelve-month measurement showed statistically significantly superior improvement for the SMCE group -1.9 points (-3.9 to -0.5) 95 % (CI). The result did not reach the clinically significant three point difference. There was no statistical difference between the groups measured with Oswestry Disability Index (ODI). For subjects with non-specific recurrent sub-acute LBP and MCI an intervention consisting of SMCE and manual therapy combined may be superior to general exercise combined with manual therapy. The study protocol registration number is ISRCTN48684087 . It was registered

  13. Do subjects with whiplash-associated disorders respond differently in the short-term to manual therapy and exercise than those with mechanical neck pain?

    DEFF Research Database (Denmark)

    Castaldo, Matteo; Catena, Antonella; Chiarotto, Alessandro

    2017-01-01

    OBJECTIVE : To compare the short-term effects of manual therapy and exercise on pain, related disability, range of motion, and pressure pain thresholds between subjects with mechanical neck pain and whiplash-associated disorders. METHODS : Twenty-two subjects with mechanical neck pain and 28...... with whiplash-associated disorders participated. Clinical and physical outcomes including neck pain intensity, neck-related disability, and pain area, as well as cervical range of motion and pressure pain thresholds over the upper trapezius and tibialis anterior muscles, were obtained at baseline and after...... the intervention by a blinded assessor. Each subject received six sessions of manual therapy and specific neck exercises. Mixed-model repeated measures analyses of covariance (ANCOVAs) were used for the analyses. RESULTS : Subjects with whiplash-associated disorders exhibited higher neck-related disability (P = 0...

  14. Cost-effectiveness evaluation of an RCT in rehabilitation after lumbar spinal fusion: a low-cost, behavioural approach is cost-effective over individual exercise therapy

    DEFF Research Database (Denmark)

    Søgaard, Rikke; Laurberg, Ida; Christensen, Finn B

    2008-01-01

    Recently, Christensen et al. reported the clinical effects of a low-cost rehabilitation program equally efficient to a relatively intensive program of individual, physiotherapist-guided exercise therapy. Yet, the low-cost approach is not fully supported as an optimal strategy until a full...... with a behavioural element and (2) a regimen of individual exercise therapy, both in comparison with usual practice, from a health economic, societal perspective. Study design was a cost-effectiveness evaluation of an RCT with a 2-year follow-up. Ninety patients having had posterolateral or circumferential fusion...... (indicated by chronic low back pain and localized pathology) were randomized 3 months after their spinal fusion. Validated pain- and disability index scales were applied at baseline and at 2 years postoperative. Costs were measured in a full-scale societal perspective. The probability of the behavioural...

  15. Multidisciplinary approach to non-surgical management of inguinal disruption in a professional hockey player treated with platelet-rich plasma, manual therapy and exercise: a case report.

    Science.gov (United States)

    St-Onge, Eric; MacIntyre, Ian G; Galea, Anthony M

    2015-12-01

    To present the clinical management of inguinal disruption in a professional hockey player and highlight the importance of a multidisciplinary approach to diagnosis and management. A professional hockey player with recurrent groin pain presented to the clinic after an acute exacerbation of pain while playing hockey. The patient received a clinical diagnosis of inguinal disruption. Imaging revealed a tear in the rectus abdominis. Management included two platelet-rich plasma (PRP) injections to the injured tissue, and subsequent manual therapy and exercise. The patient returned to his prior level of performance in 3.5 weeks. This case demonstrated the importance of a multidisciplinary team and the need for advanced imaging in athletes with groin pain. Research quality concerning the non-surgical management of inguinal disruption remains low. This case adds evidence that PRP, with the addition of manual therapy and exercise may serve as a relatively quick and effective non-surgical management strategy.

  16. The effect of combining manual therapy with exercise for mild chronic obstructive pulmonary disease: study protocol for a randomised controlled trial

    OpenAIRE

    Engel, Roger M; Wearing, Jaxson; Gonski, Peter; Vemulpad, Subramanyam

    2017-01-01

    Background Chronic obstructive pulmonary disease (COPD) is a major cause of disability and hospital admission. Current management strategies have not been successful in altering the loss of lung function typically seen as the disease progresses. A recent systematic review into the use of spinal manipulative therapy (SMT) in the management of COPD concluded that there was low level evidence to support the view that a combination of SMT and exercise had the potential to improve lung function mo...

  17. Kinesio Taping Does Not Provide Additional Benefits in Patients With Chronic Low Back Pain Who Receive Exercise and Manual Therapy: A Randomized Controlled Trial.

    Science.gov (United States)

    Added, Marco Aurélio Nemitalla; Costa, Leonardo Oliveira Pena; de Freitas, Diego Galace; Fukuda, Thiago Yukio; Monteiro, Renan Lima; Salomão, Evelyn Cassia; de Medeiros, Flávia Cordeiro; Costa, Lucíola da Cunha Menezes

    2016-07-01

    Study Design Randomized controlled trial. Background Many clinical practice guidelines endorse both manual therapy and exercise as effective treatment options for patients with low back pain. To optimize the effects of the treatments recommended by the guidelines, a new intervention known as Kinesio Taping is being widely used in these patients. Objectives To determine the effectiveness of Kinesio Taping in patients with chronic nonspecific low back pain when added to a physical therapy program consisting of exercise and manual therapy. Methods One hundred forty-eight patients with chronic nonspecific low back pain were randomly allocated to receive 10 (twice weekly) sessions of physical therapy, consisting of exercise and manual therapy, or the same treatment with the addition of Kinesio Taping applied to the lower back. The primary outcomes were pain intensity and disability (5 weeks after randomization) and the secondary outcomes were pain intensity, disability (3 months and 6 months after randomization), global perceived effect, and satisfaction with care (5 weeks after treatment). Data were collected by a blinded assessor. Results No between-group differences were observed in the primary outcomes of pain intensity (mean difference, -0.01 points; 95% confidence interval [CI]: -0.88, 0.85) or disability (mean difference, 1.14 points; 95% CI: -0.85, 3.13) at 5 weeks' follow-up. In addition, no between-group differences were observed for any of the other outcomes evaluated, except for disability 6 months after randomization (mean difference, 2.01 points; 95% CI: 0.03, 4.00) in favor of the control group. Conclusion Patients who received a physical therapy program consisting of exercise and manual therapy did not get additional benefit from the use of Kinesio Taping. Level of Evidence Therapy, level 1b. Prospectively registered May 28, 2013 at www.ClinicalTrials.gov (NCT01866332). J Orthop Sports Phys Ther 2016;46(7):506-513. Epub 6 Jun 2016. doi:10.2519/jospt.2016.6590.

  18. Theoretical and practical outline of the Copenhagen PACT narrative-based exercise counselling manual to promote physical activity in post-therapy cancer survivors.

    Science.gov (United States)

    Midtgaard, Julie

    2013-02-01

    Sedentary behaviour and reduced exercise capacity are potential persisting effects of anti-cancer therapy that may predispose to serious health conditions. It is well-established that physical exercise may prevent some of these problems. However, the extent to which cancer survivors are able to adopt long-term physical activity habits depends largely on their motivation. This theoretical paper aims to outline how researchers and practitioners can draw from Antonovsky's salutogenetic theory and White & Epston's Narrative Therapy to develop and implement intervention efforts centered on promotion of long-term physical activity behaviour, while at the same time increasing the individual cancer survivor's sense of meaning and personal health resources. The Copenhagen PACT (Physical Activity after Cancer Treatment) Study targeting adoption and maintenance of regular physical activity in post-therapy cancer survivors is briefly presented including a brief review of the theoretical rationale behind the psychological component of the intervention, i.e. a narrative-based exercise counselling programme. Subsequently, particular attention is given to the core principles, different components and structure of the counselling manual including sample questions and examples of written documents that have emanated from the individual counselling sessions. The discussion includes consideration of some methodological challenges that arise when attempting to evaluate narrative-based interventions in the context of physical activity promotion in cancer rehabilitation and survivorship care.

  19. [Effects of music therapy and rhythmic exercise on quality of life, blood pressure and upper extremity muscle strength in institution-dwelling elderly women].

    Science.gov (United States)

    Jeon, Eun Young; Kim, Sook Young; Yoo, Hyun Suk

    2009-12-01

    The purpose of this study was to determine the effects of music therapy and rhythmic exercise on health related quality of life, blood pressure and upper extremity muscle strength in the institution-dwelling elderly women. The study was designed using a nonequivalent control group pretest-posttest design. The participants consisted of 35 elders (18 in the experimental group and 17 in the control group). The music therapy and rhythmic exercise were developed by the investigators. The experimental group took part in this program twice a week for 8 weeks. The Short Form 36 health survey questionnaire, blood pressure and grasp power scale were used as instruments. The data were analyzed using SPSS 14.0. Repeated measures ANOVA revealed that music therapy and rhythmic exercise had positive effects on quality of life, especially on vitality, general health and mental health. Also, there were statistically significant differences in diastolic blood pressure and upper extremity muscle strength between the pretest and posttest in the experimental group. The study suggests that this program can be applied for older women in long-term facilities to improve quality of life, blood pressure and upper extremity muscle strength.

  20. Exercise and cancer

    DEFF Research Database (Denmark)

    Idorn, Manja; thor Straten, Per

    2017-01-01

    Exercise improves functional capacity and patient-reported outcomes across a range of cancer diagnoses. The mechanisms behind this protection have been largely unknown, but exercise-mediated changes in body composition, sex hormone levels, systemic inflammation, and immune cell function have been...... hypothesize that this link between exercise and the immune system can be exploited in cancer therapy in particular in combination with immunotherapy. Thus, we believe that exercise may not just be “healthy” but may in fact be therapeutic....

  1. Effect of Combination Exercise Therapy on Walking Distance, Postural Balance, Fatigue and Quality of Life in Multiple Sclerosis Patients: A Clinical Trial Study

    Science.gov (United States)

    Sangelaji, Bahram; Nabavi, Seyed Massood; Estebsari, Fatemeh; Banshi, Mohammad Reza; Rashidian, Hamideh; Jamshidi, Ensiyeh; Dastoorpour, Maryam

    2014-01-01

    Background: Multiple Sclerosis (MS) is a demyelinating disease of the nervous system which has numerous disabling effects on patients. Objectives: This study aimed at investigating the short- and long-term effects of a period of combination exercise therapy on walking distance, balance, fatigue and quality of life in multiple sclerosis patients referred to the physiotherapy clinic of Iran's Multiple Sclerosis Society in 2013. Patients and Methods: This study was a randomized controlled clinical trial on 59 patients divided into the intervention (n = 39) and control groups (n = 20). The intervention group received 10 weeks of combination therapy including aerobic, strengthening, balancing and stretching exercises. A week before, a week later and a year after the beginning of the exercises, both groups of patients received BBSS, six minute walking, Family Support Services (FSS), Expanded Disability Status Scale (EDSS) and quality of life tests. The scores of two groups were then compared using statistical tests such as repeated measures ANOVA test. Results: The results indicated significant changes in the intervention group in comparison to the control group in the second phase of the study comparing to the first one for all tests except EDSS (Mean difference scores of EDSS: -0.13), P-value = 0.60; FSS: -6.9, P-value = 0.02, Mental Quality of Life (QOL): 16.36, P-value = 0.001; Physical QOL: 12.17, P-value = 0.001, six minute walking: 137.2, P-value multiple sclerosis, and cessation of exercise may cause recurrence of symptoms in the intervention group with a slope similar to that of the control group. Therefore, continuous rather than short period exercises have valuable symptomatic and supportive relief effects in patients. PMID:25068045

  2. Altered postural responses persist following physical therapy of general versus specific trunk exercises in people with low back pain.

    Science.gov (United States)

    Lomond, Karen V; Henry, Sharon M; Hitt, Juvena R; DeSarno, Michael J; Bunn, Janice Y

    2014-10-01

    Interventions that target trunk muscle impairments in people with LBP have been promoted; however, the treatment effects on muscle activation impairments during postural tasks remain unclear. Thus, our objective was to evaluate the effects trunk stabilization vs. general strength and conditioning exercises on the automatic postural response in persons with chronic low back pain (LBP). Fifty-eight subjects with chronic, recurrent LBP (n = 58) (i.e., longer than six months) were recruited and randomly assigned to one of two, 10-week physical therapy programs: stabilization (n = 29) or strength and conditioning (n = 29). Pain and function were measured at 11 weeks and 6 months post-treatment initiation. To quantify postural following support surface perturbations, surface electrodes recorded electromyography (EMG) of trunk and leg muscles and force plates recorded forces under the feet, to calculate the center of pressure. Both groups demonstrated significant improvements in pain and function out to 6 months. There were also changes in muscle activation patterns immediately post-treatment, but not at 6 months. However, changes in center of pressure (COP) responses were treatment specific. Following treatment, the stabilization group demonstrated later onset of COP displacement, while the onset of COP displacement in the strengthening group was significantly earlier following treatment. Despite two different treatments, clinical improvements and muscle activation patterns were similar for both groups, indicating that the stabilization treatment protocol does not preferentially improve treatment outcomes or inter-muscle postural coordination patterns for persons with LBP. NCT01611792. Copyright © 2014 Elsevier Ltd. All rights reserved.

  3. The effects of scapular stabilization based exercise therapy on pain, posture, flexibility and shoulder mobility in patients with shoulder impingement syndrome: a controlled randomized clinical trial.

    Science.gov (United States)

    Moezy, Azar; Sepehrifar, Saeed; Solaymani Dodaran, Masoud

    2014-01-01

    Dysfunction in the kinetic chain caused by poor scapula stabilization can contribute to shoulder injuries and Shoulder Impingement Syndrome (SIS). The purpose of this study was to compare the effectiveness of two treatment approaches scapular stabilization based exercise therapy and physical therapy in patients with SIS. The study is a randomized clinical trial in which 68 patients with SIS were randomly assigned in two groups of exercise therapy (ET) and physical therapy (PT) and received 18 sessions of treatment. Pain, shoulders' range of abduction and external rotation, shoulder protraction, scapular rotation and symmetry as well as postural assessment and Pectoralis minor length were evaluated pre and post intervention. The paired-sample t test and the independent sample t test were applied respectively to determine the differences in each group and between two groups. Our findings indicated significant differences in abduction and external rotation range, improvement of forward shoulder translation and increase in the flexibility of the involved shoulder between the two groups (respectively ; p=0.024, p=0.001, ppain reduction between the groups (p=0.576). Protraction of the shoulder (pshoulder range, decreasing forward head and shoulder postures and Pectoralis minor flexibility.

  4. Exercise and Manual therapy Arthritis Research Trial (EMPART) for osteoarthritis of the hip: A Multicentre Randomised Controlled trial.

    LENUS (Irish Health Repository)

    French, Helen P

    2012-10-16

    OBJECTIVE: To determine the effectiveness of exercise therapy (ET) compared to ET with adjunctive manual therapy (ET+MT) for people with hip osteoarthritis (OA). A secondary aim was to identify if immediate commencement of ET or ET+MT was more beneficial than a 9 week waiting period for either intervention. DESIGN: Assessor-blind randomised controlled trial with 9 and 18 week follow-ups. SETTING: Four academic teaching hospitals, Dublin, Ireland. PARTICIPANTS: 131 patients with hip OA recruited from general practitioners, rheumatologists, orthopaedic surgeons, and other hospital consultants were randomised to one of three groups: ET (n=45), ET+MT (n=43) and wait-list control (n=43). INTERVENTIONS: Participants in both ET and ET+ MT groups received up to 8 treatments over 8 weeks. Control group participants were re-randomised into either ET or ET+MT group after 9 week follow-up. Their data were pooled with original treatment group data: ET (n=66) and ET+MT (n=65). MAIN OUTCOME MEASURES: The primary outcome was the WOMAC physical function (PF) subscale. Secondary outcomes included physical performance, pain, hip range of motion (HROM), anxiety\\/depression, quality of life, medication usage, patient-perceived change and patient satisfaction. RESULTS: There was no significant difference in WOMAC PF between ET (n=66) and ET+MT (n=65) groups at 9 weeks (mean diff 0.09 (95% CI -4.41, 5.25)) or at 18 weeks (mean diff 0.42 (95% CI -3.98, 6.83)), or other outcomes, except \\'patient satisfaction with outcome\\' which was higher in the ET+MT group (p=0.02). Improvements in WOMAC, HROM and patient-perceived change occurred in both treatment groups compared with the control group. CONCLUSION: Self-reported function, HROM and patient-perceived improvement occurred after an 8 week programme of ET for patients with hip OA MT as an adjunct provided no further benefit, except for higher patient satisfaction.

  5. Cost-effectiveness of exercise as a therapy for behavioural and psychological symptoms of dementia within the EVIDEM-E randomised controlled trial.

    Science.gov (United States)

    D'Amico, Francesco; Rehill, Amritpal; Knapp, Martin; Lowery, David; Cerga-Pashoja, Arlinda; Griffin, Mark; Iliffe, Steve; Warner, James

    2016-06-01

    Although available evidence is modest, exercise could be beneficial in reducing behavioural and psychological symptoms of dementia. We aim to evaluate the cost-effectiveness of a dyadic exercise regimen for individuals with dementia and their main carer as therapy for behavioural and psychological symptoms of dementia. Cost-effectiveness analysis within a two-arm, pragmatic, randomised, controlled, single-blind, parallel-group trial of a dyadic exercise regimen (individually tailored, for 20-30 min at least five times per week). The study randomised 131 community-dwelling individuals with dementia and clinically significant behavioural and psychological symptoms with a carer willing and able to participate in the exercise regimen; 52 dyads provided sufficient cost data for analyses. Mean intervention cost was £284 per dyad. For the subsample of 52 dyads, the intervention group had significantly higher mean cost from a societal perspective (mean difference £2728.60, p = 0.05), but costs were not significantly different from a health and social care perspective. The exercise intervention was more cost-effective than treatment as usual from both societal and health and social care perspectives for the measure of behavioural and psychological symptoms (Neuropsychiatric Inventory). It does not appear cost-effective in terms of cost per quality-adjusted life year gain. The exercise intervention has the potential to be seen as cost-effective when considering behavioural and psychological symptoms but did not appear cost-effective when considering quality-adjusted life year gains. Copyright © 2015 John Wiley & Sons, Ltd.

  6. Effectiveness of an aquatic exercise program and low-level laser therapy on articular cartilage in an experimental model of osteoarthritis in rats.

    Science.gov (United States)

    Milares, Luiz Paulo; Assis, Lívia; Siqueira, Amanda; Claudino, Vitoria; Domingos, Heloisa; Almeida, Thais; Tim, Carla; Renno, Ana Claudia

    2016-09-01

    The aim of this study was to evaluate the effects of an aquatic exercise program and low-level laser therapy (LLLT) (associated or not) on degenerative modifications and inflammatory mediators on the articular cartilage using an experimental model of knee OA. Forty male Wistar rats were divided into 4 groups: knee OA - without treatment (OA); OA plus exercise program group (OAE); OA plus LLLT (OAL); OA plus exercise program associated with LLLT (OAEL). Trained rats performed a water-jumping program carrying a load equivalent to 50-80 % of their body mass strapped to their chest. The laser irradiation was used either as the only method or after the exercise training had been performed, at 2 points contact mode (medial and lateral side of the left joint). The treatments started 4 weeks after the surgery, 3 days/week for 8 weeks. The results revealed that all treated groups (irradiated or not) exhibited a better pattern of tissue organization, with less fibrillation and irregularities along the articular surface and improved chondrocytes organization. Also, a lower cellular density and structural damage (OARSI score) and higher thickness values were observed in all treated groups. Additionally, OAE and OAEL showed a reduced expression in IL-1β and caspase-3 as compared with OA. Furthermore, a statistically lower MMP-13 expression was only observed in OAEL as compared with OA. These results suggest that aquatic exercise program and LLLT were effective in preventing cartilage degeneration. Also, physical exercise program presented anti-inflammatory effects in the knees in OA rats.

  7. Effect of thrombolytic therapy on exercise response during early recovery from acute myocardial infarction: a placebo controlled study

    DEFF Research Database (Denmark)

    Svendsen, Jesper Hastrup; Madsen, J K; Saunamäki, K I

    1992-01-01

    Several studies have shown that infarct size is reduced following thrombolytic treatment in patients with acute myocardial infarction. Exercise test variables, such as an impaired heart rate response during exercise, are known to be related to left ventricular function and patient prognosis follo...

  8. Post-exercise heart rate recovery in HIV-positive individuals on highly active antiretroviral therapy. Early indicator of cardiovascular disease?

    Science.gov (United States)

    Cade, WT; Reeds, DN; Lassa-Claxton, S; Davila-Roman, VG; Waggoner, AD; Powderly, WG; Yarasheski, KE

    2015-01-01

    Background HIV infection and its treatment, specifically protease inhibitor (PI) therapy, have been associated with an increased risk for cardiovascular disease. Heart rate recovery (HRR) following peak exercise is predictive of future cardiovascular events and mortality in the general population. Nothing is known regarding HRR in individuals infected with HIV on highly active antiretroviral therapy (HAART). Subjects and methods HIV-positive subjects on HAART that included a PI (HIV 1 PI, n = 19), HIV-positive subjects on HAART that did not include a PI (HIV 1 noPI, n = 19) and HIV-seronegative age, gender and body mass index (BMI) matched controls (Cntl, n = 15) underwent a graded maximal exercise test on a cycle ergometer to volitional exhaustion. A continuous electrocardiogram was recorded and HRR was monitored every 30 s for 2 min post exercise. Results HRR at 1.5 and 2 min was significantly delayed in HIV-positive subjects both on and not on PI-based HAART compared with controls (P<0.01). Conclusion HRR is impaired in HIV-positive individuals on HAART, whether or not the HAART includes a PI, compared with age, gender, BMI, and activity level matched HIV-seronegative controls. Abnormal HRR may reflect cardio-autonomic dysfunction and may be an independent risk factor for future cardiac events in HIV-positive individuals that receive HAART. PMID:18093131

  9. Comparing physical exercise in groups to group cognitive behaviour therapy for the treatment of panic disorder in a randomized controlled trial.

    Science.gov (United States)

    Hovland, Anders; Nordhus, Inger Hilde; Sjøbø, Trond; Gjestad, Bente A; Birknes, Birthe; Martinsen, Egil W; Torsheim, Torbjørn; Pallesen, Ståle

    2013-07-01

    Previous studies have suggested that physical exercise can reduce symptoms for subjects suffering from panic disorder (PD). The efficacy of this intervention has so far not been compared to an established psychotherapy, such as cognitive behaviour therapy (CBT). Assessment of controlled long-term effects and the clinical significance of the treatment are also lacking. To compare physical exercise to CBT as treatment for PD, and assess controlled long-term and clinically significant effects. PD-patients were randomized to either three weekly sessions of physical exercise (n = 17), or one weekly session of CBT (n = 19). Both treatments ran for 12 weeks, were manualized and administered in groups. Patients were assessed twice before the start of treatment, at post-treatment and at 6 and 12 months thereafter. Primary outcome-measures consisted of the Mobility Inventory (MI), the Agoraphobia Cognitions Questionnaire (ACQ) and the Body Sensations Questionnaire (BSQ). A two-way repeated measures MANOVA of these measures demonstrated a significant effect of time, F(16, 544) = 7.28, p < .01, as well as a significant interaction effect, F(16, 544) = 1.71, p < .05, in favour of CBT. This finding was supported by the assessment of clinically significant changes of avoidant behaviour and of treatment-seeking one year later. Group CBT is more effective than group physical exercise as treatment of panic disorder, both immediately following treatment and at follow-up assessments.

  10. Physical Therapy Versus a General Exercise Programme in Patients with Hoehn Yahr Stage II Parkinson's Disease: A Randomized Controlled Trial.

    Science.gov (United States)

    Dipasquale, Savina; Meroni, Roberto; Sasanelli, Francesco; Messineo, Ivan; Piscitelli, Daniele; Perin, Cecilia; Cornaggia, Cesare Maria; Cerri, Cesare G

    2017-01-01

    Several studies suggest that general exercise (GE) and physical therapy programmes (PT) improve the outcomes of Parkinson's disease (PD) patients; however, the available data do not allow a determination of which treatment is more effective. Our study aims to compare the effects of physiotherapy and general exercise in Parkinson's disease. Design and setting: Randomized controlled trial -general hospital outpatient clinic. The participants were patients with Hoehn Yahr stage II PD. Two randomized groups: one receiving PT and one receiving GE. The outcome measures were the FIM, Hamilton Rating Scale, TUG test, and UPDRS. FIM median scores improved by 3 points in the PT group after treatment, and the improvements were maintained at follow-up. The GE FIM median scores were unchanged after treatment and were reduced by 1 point at follow-up (p Hoehn Yahr stage II PD.

  11. Cardiac resynchronization therapy for exercise-induced left ventricular dysfunction in the setting of left bundle branch block: A case report and review of the literature

    Directory of Open Access Journals (Sweden)

    JoEllyn M. Abraham, MD

    2014-12-01

    Full Text Available Exercise-induced dyspnea is one of the most common symptoms that cause a patient to see a physician and a broad differential diagnosis is required. In this case report, we describe a patient with this complaint who had a left bundle branch block and preserved left ventricular function at rest. On stress echocardiography, she had significant exercise-induced left ventricular dysfunction and associated mitral regurgitation but a coronary angiogram demonstrated normal coronary arteries. Both of the echocardiographic findings, as well as her symptoms, improved with the placement of a bi-ventricular pacemaker. A brief review of the literature on cardiac resynchronization therapy for indications beyond the current guidelines is also provided.

  12. A dynamic view of comorbid depression and generalized anxiety disorder symptom change in chronic heart failure: the discrete effects of cognitive behavioral therapy, exercise, and psychotropic medication.

    Science.gov (United States)

    Tully, Phillip J; Selkow, Terina; Bengel, Jürgen; Rafanelli, Chiara

    2015-01-01

    No previous study has reported upon comorbid depression and anxiety disorders and their treatment in heart failure (HF), which the current study has sought to document. Total 29 HF patients under psychiatric management underwent primary depression cognitive behavioral therapy (CBT; n = 15) or primary generalized anxiety disorder (GAD) CBT (n = 14), and participated in a community exercise program and standard physician care. Repeated measures analysis of variance assessed Patient Health Questionnaire (PHQ-9) and GAD-7 symptom change pre- and post-CBT treatment, and assessed the interaction effects of treatment type, exercise, anti-depressant and anxiolytic. There was a significant time and treatment interaction effect that favored the primary GAD CBT group for reduction in PHQ symptoms (F(1, 24) = 4.52, p = 0.04). Analysis of PHQ-somatic symptoms also showed a significant main effect for participation in the exercise program (F(1, 24) = 4.21, p = 0.05) and a significant time and anxiolytic interaction (F(1, 24) = 3.98, p = 0.05). The average number of cardiac hospital readmissions favored the primary GAD CBT group (p = 0.05). The findings support the use of multifaceted interventions in the rehabilitation of HF patients with comorbid psychiatric needs. Implications for Rehabilitation Comorbid depression and anxiety disorders are a clinical and research focus that deserves more attention in the treatment of heart failure patients. Cognitive behavioral therapy, exercise, and anxiolytic use was associated with significant changes in depression and anxiety though discrete effects were evident. Multifaceted interventions are most likely to be successful in the rehabilitation of HF patients with psychiatric needs.

  13. Effects of behavioural exercise therapy on the effectiveness of a multidisciplinary rehabilitation for chronic non-specific low back pain: study protocol for a randomised controlled trial.

    Science.gov (United States)

    Hofmann, Jana; Peters, Stefan; Geidl, Wolfgang; Hentschke, Christian; Pfeifer, Klaus

    2013-03-11

    In Germany, a multidisciplinary rehabilitation named "behavioural medical rehabilitation" (BMR) is available for treatment of chronic low back pain (clbp). A central component of BMR is standard exercise therapy (SET), which is directed mainly to improve physical fitness. There is a need to address psychosocial factors within SET and therefore to improve behavior change with a focus on the development of self-management skills in dealing with clbp. Furthermore, short-term effectiveness of BMR with a SET has been proven, but the impact of a behavioural exercise therapy (BET) for improvement of the long-term effectiveness of BMR is unclear. To compare the effectiveness of two exercise programs with different approaches within BMR on the effects of BMR a prospective randomized controlled trial (RCT) in two rehabilitation centres will be performed. 214 patients aged 18-65 with clbp will be, based on an "urn randomisation"-algorithm, randomly assigned to a BMR with SET (function-oriented, n=107) and BMR with BET (behaviour-oriented, n=107). Both exercise programs have a mean duration of 26 hours in three weeks and are delivered by a limited number of not-blinded study therapists in closed groups with six to twelve patients who will be masked regarding study group. The main differences of BET lie in its detailed manualised program with a theory-based, goal-orientated combination of exercise, education and behavioural elements, active participation of patients and consideration of their individual preferences and previous experiences with exercise. The primary outcome is functional ability assessed with the Hannover Functional Ability Questionnaire directly before and after the rehabilitation program, as well as a six and twelve-month follow-up. This RCT is designed to explore the effects of BET on the effectiveness of a BMR compared to a BMR with SET in the management of patients with clbp. Methodological challenges arise from conducting a RCT within routine health care

  14. Exercise and internet-based cognitive-behavioural therapy for depression: multicentre randomised controlled trial with 12-month follow-up.

    Science.gov (United States)

    Hallgren, Mats; Helgadóttir, Björg; Herring, Matthew P; Zeebari, Zangin; Lindefors, Nils; Kaldo, Viktor; Öjehagen, Agneta; Forsell, Yvonne

    2016-11-01

    Evidence-based treatment of depression continues to grow, but successful treatment and maintenance of treatment response remains limited. To compare the effectiveness of exercise, internet-based cognitive-behavioural therapy (ICBT) and usual care for depression. A multicentre, three-group parallel, randomised controlled trial was conducted with assessment at 3 months (post-treatment) and 12 months (primary end-point). Outcome assessors were masked to group allocation. Computer-generated allocation was performed externally in blocks of 36 and the ratio of participants per group was 1:1:1. In total, 945 adults with mild to moderate depression aged 18-71 years were recruited from primary healthcare centres located throughout Sweden. Participants were randomly assigned to one of three 12-week interventions: supervised group exercise, clinician-supported ICBT or usual care by a physician. The primary outcome was depression severity assessed by the Montgomery-Åsberg Depression Rating Scale (MADRS). The response rate at 12-month follow-up was 84%. Depression severity reduced significantly in all three treatment groups in a quadratic trend over time. Mean differences in MADRS score at 12 months were 12.1 (ICBT), 11.4 (exercise) and 9.7 (usual care). At the primary end-point the group × time interaction was significant for both exercise and ICBT. Effect sizes for both interventions were small to moderate. The long-term treatment effects reported here suggest that prescribed exercise and clinician-supported ICBT should be considered for the treatment of mild to moderate depression in adults. © The Royal College of Psychiatrists 2016.

  15. Exercise Therapy Downregulates the Overexpression of TLR4, TLR2, MyD88 and NF-κB after Cerebral Ischemia in Rats

    Directory of Open Access Journals (Sweden)

    Lin Qiang

    2013-02-01

    Full Text Available Toll-like receptor 2 (TLR2 and Toll-like receptor 4 (TLR4 are considered to mediate the inflammatory reaction of cerebral ischemia injury, and exercise can inhibit the activity of the Toll-like receptor signaling pathway in the peripheral blood of humans. Although physical exercise has been demonstrated to be neuroprotective in both clinical and laboratory settings, the underlying mechanism remains unclear. To clarify this critical issue, this study investigated the effects of treadmill training on the recovery of neurological function and the expression of TLR2 and TLR4 and their main downstream targets, nuclear factor-kappaB (NF-κB and myeloid differentiation factor 88 (MyD88, in the ischemic rat brain after middle cerebral artery occlusion-reperfusion (MCAo/R. Rats were divided into seven groups: sham control without MCAo/R and five, nine and 16 days post-ischemic exercise or non-exercise. The neurological function and infarct volume were measured, and reverse transcription polymerase chain reaction (RT-PCR and Western blotting were used to detect the expression of TLR2, TLR4, NF-κB and MyD88 in ischemic brain tissue. The results indicated that treadmill training promoted functional recovery and reduced the overexpression of TLR2, TLR4, NF-κB and MyD88 in rat brain tissue after ischemia, a finding that may have implications for understanding the mechanism of exercise therapy after brain ischemia and indicating new therapeutic strategies for the pharmacological modulation of TLR signaling.

  16. Effectiveness of Aquatic Exercise and Balneotherapy: A Summary of Systematic Reviews Based on Randomized Controlled Trials of Water Immersion Therapies

    National Research Council Canada - National Science Library

    Kamioka, Hiroharu; Tsutani, Kiichiro; Okuizumi, Hiroyasu; Mutoh, Yoshiteru; Ohta, Miho; Handa, Shuichi; Okada, Shinpei; Kitayuguchi, Jun; Kamada, Masamitsu; Shiozawa, Nobuyoshi; Honda, Takuya

    2010-01-01

    Background: The objective of this review was to summarize findings on aquatic exercise and balneotherapy and to assess the quality of systematic reviews based on randomized controlled trials.Methods...

  17. The effect of exercise therapy on depressive and anxious symptoms in patients with ischemic heart disease : A systematic review

    NARCIS (Netherlands)

    Verschueren, Suzanne; Eskes, Anne M; Maaskant, Jolanda M; Roest, Annelieke M; Latour, Corine H M; Op Reimer, Wilma Scholte

    OBJECTIVE: Depressive and anxiety symptoms are associated with Ischemic Heart Disease (IHD). Exercise interventions might improve both depressive and anxiety symptoms, but an overview of the evidence is lacking. Therefore, we systematically reviewed the existing literature on the effectiveness of

  18. How can we implement exercise therapy for patellofemoral pain if we don't know what was prescribed?

    DEFF Research Database (Denmark)

    Holden, Sinead; Rathleff, Michael Skovdal; Jensen, Martin Bach

    2017-01-01

    OBJECTIVE: To evaluate the completeness of exercise prescription in randomised controlled trials (RCTs) for patellofemoral pain (PFP), identify which elements are most frequently missing and supplement recommendations based on additional data from authors. DESIGN: Systematic review. DATA SOURCES:...

  19. Comparison among the Short-Term Effect of Massage Therapy, Central Stability Exercise and Combination Method on Limits of Stability in Patients with Chronic Non-Specific Low Back Pain

    Directory of Open Access Journals (Sweden)

    A. Shakeri

    2017-01-01

    Full Text Available Aims: Nowadays, balance and postural control index is assessed as one of the main parameters in the assessment of persons with neuromuscular and musculoskeletal disorders. The aim of the study was to investigate the short term effects of massage therapy, core stability exercises and combined stability exercises on the stability limits in patients with chronic non-specific low back pain. Materials & Methods: In the semi-experimental study, 30 male patients with chronic non-specific LBP, referred to the physiotherapy clinics of 1 and 3 districts of Tehran City, were studied in 2013. The subjects were selected via random sampling method, were randomly divided into three groups including massage therapy, core stability exercise, and combined stability exercises. 12-session treatment protocols (4 weeks were conducted in the groups under the therapist’s supervision. The force plate device was used to measure the reaction time (RT, movement velocity (MV, maximum excursion (ME, and end point of excursion (EPE in eight different directions. Data was analyzed by SPSS 16 software using ANCOVA test. Findings: After the treatment interventions, the combined exercises improved RT at directions 3 (right lateral and 8 (left anterior more than the stability exercises and massage therapy. In addition, more improvement in MV was recorded at the direction 2 (right anterior compared to the stability exercises. ME records of stability and combined exercises groups were significantly different at direction 7 (left lateral only (p<0.05. Conclusion: Despite the fact that each treatment intervention has short term effects on the stability limits of patients with chronic non-specific LBP, it seems that the combination of core stability exercises and massage therapy is more effective than each one solely.

  20. The effect of BEMER therapy on selected blood indicators in the process of biological restitution after exercise endurance. A case study.

    OpenAIRE

    Mrozkowiak, Mirosław; Posłuszny, Mariusz

    2017-01-01

    Mrozkowiak M., Posłuszny M.. The effect of BEMER therapy on selected blood indicators in the process of biological restitution after exercise endurance. A case study. Journal of Education, Health and Sport. 2017;7(7):703-722 eISSN 2391-8306. DOI http://dx.doi.org/10.5281/zenodo.841092 http://ojs.ukw.edu.pl/index.php/johs/article/view/4679 The journal has had 7 points in Ministry of Science and Higher Education parametric evaluation. Part B item 1223 (26.01.2017). ...

  1. The efficacy of manual therapy and exercise for different stages of non-specific low back pain: an update of systematic reviews.

    Science.gov (United States)

    Hidalgo, Benjamin; Detrembleur, Christine; Hall, Toby; Mahaudens, Philippe; Nielens, Henri

    2014-05-01

    to review and update the evidence for different forms of manual therapy (MT) for patients with different stages of non-specific low back pain (LBP). MEDLINE, Cochrane-Register-of-Controlled-Trials, PEDro, EMBASE. A systematic review of MT with a literature search covering the period of January 2000 to April 2013 was conducted by two independent reviewers according to Cochrane and PRISMA guidelines. A total of 360 studies were evaluated using qualitative criteria. Two stages of LBP were categorized; combined acute-subacute and chronic. Further sub-classification was made according to MT intervention: MT1 (manipulation); MT2 (mobilization and soft-tissue-techniques); and MT3 (MT1 combined with MT2). In each sub-category, MT could be combined or not with exercise or usual medical care (UMC). Consequently, quantitative evaluation criteria were applied to 56 eligible randomized controlled trials (RCTs), and hence 23 low-risk of bias RCTs were identified for review. Only studies providing new updated information (11/23 RCTs) are presented here. Acute-subacute LBP: STRONG-evidence in favour of MT1 when compared to sham for pain, function and health improvements in the short-term (1-3 months). MODERATE-evidence to support MT1 and MT3 combined with UMC in comparison to UMC alone for pain, function and health improvements in the short-term. Chronic LBP: MODERATE to STRONG-evidence in favour of MT1 in comparison to sham for pain, function and overall-health in the short-term. MODERATE-evidence in favour of MT3 combined with exercise or UMC in comparison to exercise and back-school was established for pain, function and quality-of-life in the short and long-term. LIMITED-evidence in favour of MT2 combined with exercise and UMC in comparison to UMC alone for pain and function from short to long-term. LIMITED-evidence of no effect for MT1 with extension-exercise compared to extension-exercise alone for pain in the short to long-term. This systematic review updates the evidence

  2. Using Exercise to Ward Off Depression.

    Science.gov (United States)

    Nicoloff, George; Schwenk, Thomas L.

    1995-01-01

    Exercise can be as effective as psychotherapy and antidepressant therapy in treating mild-to-moderate depression, and even more effective when used in conjunction with them. Exercise can also be preventive therapy for those not clinically depressed. The paper explains how best to work exercise into a depressed patient's therapy. (Author/SM)

  3. Rehabilitation, exercise therapy and music in patients with Parkinson's disease: a meta-analysis of the effects of music-based movement therapy on walking ability, balance and quality of life.

    Science.gov (United States)

    de Dreu, M J; van der Wilk, A S D; Poppe, E; Kwakkel, G; van Wegen, E E H

    2012-01-01

    Recent evidence suggests that music-based movement (MbM) therapy may be a promising intervention to improve gait and gait-related activities in Parkinson's disease (PD) patients, because it naturally combines cognitive movement strategies, cueing techniques, balance exercises and physical activity while focussing on the enjoyment of moving on music instead of the current mobility limitations of the patient. A meta-analysis of RCTs on the efficacy of MbM-therapy, including individual rhythmic music training and partnered dance classes, was performed. Identified studies (K = 6) were evaluated on methodological quality, and summary effect sizes (SES) were calculated. Studies were generally small (total N= 168). Significant homogeneous SESs were found for the Berg Balance Scale, Timed Up and Go test and stride length (SESs: 4.1,2.2,0.11; P-values <0.01; I(2) 0,0,7%, respectively). A sensitivity analysis on type of MbM-therapy (dance- or gait-related interventions) revealed a significant improvement in walking velocity for gait-related MbM-therapy, but not for dance-related MbM-therapy. No significant effects were found for UPDRS-motor score, Freezing of Gait and Quality of Life. Overall, MbM-therapy appears promising for the improvement of gait and gait-related activities in PD. Future studies should incorporate larger groups and focus on long-term compliance and follow-up. Copyright © 2011 Elsevier Ltd. All rights reserved.

  4. Exercise, Eating, Estrogen, and Osteoporosis.

    Science.gov (United States)

    Brown, Jim

    1986-01-01

    Osteoporosis affects millions of people, especially women. Three methods for preventing or managing osteoporosis are recommended: (1) exercise; (2) increased calcium intake; and (3) estrogen replacement therapy. (CB)

  5. Efficacy and safety of home-based exercises versus individualized supervised outpatient physical therapy programs after total knee arthroplasty: a systematic review and meta-analysis.

    Science.gov (United States)

    Florez-García, Mariano; García-Pérez, Fernando; Curbelo, Rafael; Pérez-Porta, Irene; Nishishinya, Betina; Rosario Lozano, Maria Piedad; Carmona, Loreto

    2017-11-01

    The aim of the present study was to evaluate the efficacy and safety of non-supervised home-based exercise versus individualized and supervised programs delivered in clinic-based settings for the functional recovery immediately after discharge from a primary TKA. Medline, Embase, Cochrane, and PEDro databases were screened, from inception to April 2015, in search for randomized clinical trials (RCT) of home-based exercise interventions versus individualized and supervised outpatient physical therapy after primary TKA. Target outcomes were: knee range of motion (ROM), patient-reported pain and function, functional performance, and safety. Risk of bias was assessed with the PEDro scale. After assessing homogeneity, data were combined using random effects meta-analysis and reported as standardized mean differences or mean differences. We set a non-inferiority margin of four points in mean differences. The search and selection process identified 11 RCT of moderate quality and small sample sizes. ROM active extension data suitable for meta-analysis was available from seven studies with 707 patients, and ROM active flexion from nine studies with 983 patients. Most studies showed no difference between groups. Pooled differences were within the non-inferiority margin. Most meta-analyses showed significant statistical heterogeneity. Short-term improvements in physical function and knee ROM do not clearly differ between outpatient physiotherapy and home-based exercise regimes in patients after primary TKA; however, this conclusion is based on a meta-analysis with high heterogeneity. I.

  6. Effects of exercise training and photobiomodulation therapy (EXTRAPHOTO) on pain in women with fibromyalgia and temporomandibular disorder: study protocol for a randomized controlled trial.

    Science.gov (United States)

    da Silva, Mariana Moreira; Albertini, Regiane; Leal-Junior, Ernesto Cesar Pinto; de Tarso Camillo de Carvalho, Paulo; Silva, José Antonio; Bussadori, Sandra Kalil; de Oliveira, Luis Vicente Franco; Casarin, Cezar Augusto Souza; Andrade, Erinaldo Luiz; Bocalini, Danilo Sales; Serra, Andrey Jorge

    2015-06-04

    Fibromyalgia (FM) is a syndrome most prevalent in women, in whom it is characterized mainly by chronic pain. An important issue is that many patients with FM are reported to have temporomandibular dysfunction (TMD), and the coexistence of these pathologies generates a clinical outcome of high complexity. The literature is unclear regarding an effective therapy for reducing pain in patients with both comorbidities. Exercise training and phototherapy (low-level laser therapy with light-emitting diode) are two of the approaches used to treat pain. Thus, the aim of this study is to assess the potential role of exercise training plus phototherapy in reducing chronic pain in women with FM and TMD. A further aim is to determine whether the interventions can improve quality of life and modulate endogenous serotonin. A randomized controlled clinical trial will be conducted. It will involve 60 women ≥ 35 years of age with a diagnosis of FM and TMD. After recruitment, patients will be randomly allocated to one of four groups: a control group (no intervention), a group that will receive a phototherapy intervention (PHO), a group that will be prescribed muscle-stretching, aerobic, and facial exercises (EXT), or a group that will receive phototherapy plus exercise interventions (PHO + EXT). The trial will last 10 weeks, and the following outcomes will be evaluated on two separate occasions (baseline and within 24 h after the last day of the protocol). Pain intensity will be analyzed using a visual analogue scale and the McGill Pain Questionnaire, and pain thresholds will be punctuated using a digital algometer. FM symptoms will be assessed using the Fibromyalgia Impact Questionnaire, and quality of life will be determined with the 36-item Short Form Health Survey. Serotonin levels will be evaluated in salivary samples using a competitive enzyme-linked immunosorbent assay. This is the first randomized controlled trial in which the role of phototherapy, exercise training, and a

  7. Identifying potential working mechanisms behind the positive effects of exercise therapy on pain and function in osteoarthritis; a systematic review.

    Science.gov (United States)

    Runhaar, J; Luijsterburg, P; Dekker, J; Bierma-Zeinstra, S M A

    2015-07-01

    Although physical exercise is the commonly recommended for osteoarthritis (OA) patients, the working mechanism behind the positive effects of physical exercise on pain and function is a black box phenomenon. In the present study we aimed to identify possible mediators in the relation between physical exercise and improvements of pain and function in OA patients. A systematic search for all studies evaluating the effects of physical exercise in OA patients and select those that additionally reported the change in any physiological factor from pre-to post-exercise. In total, 94 studies evaluating 112 intervention groups were included. Most included studies evaluated subjects with solely knee OA (96 out of 112 groups). Based on the measured physiological factors within the included studies, 12 categories of possible mediators were formed. Muscle strength and ROM/flexibility were the most measured categories of possible mediators with 61 and 21 intervention groups measuring one or more physiological factors within these categories, respectively. 60% (31 out of 52) of the studies showed a significant increase in knee extensor muscle strength and 71% (22 out of 31) in knee flexor muscle strength over the intervention period. All 5 studies evaluating extension impairments and 10 out of 12 studies (83%) measuring proprioception found a significant change from pre-to post-intervention. An increase of upper leg strength, a decrease of extension impairments and improvement in proprioception were identified as possible mediators in the positive association between physical exercise and OA symptoms. Copyright © 2015 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

  8. The effect of exercise therapy in head and neck cancer patients in the treatment of radiotherapy-induced trismus: A systematic review.

    Science.gov (United States)

    Scherpenhuizen, Anne; van Waes, Anne M A; Janssen, Luuk M; Van Cann, Ellen M; Stegeman, Inge

    2015-08-01

    Trismus is characterized by a reduced ability to open the mouth, directly affecting many aspects of daily life, such as chewing, swallowing, speaking and maintaining oral hygiene. Several studies have shown that trismus affects health related quality of life. Radiotherapy in the head and neck area is identified as one of the most frequent causes of trismus in head and neck cancer (HNC) patients. Currently, there is no standard treatment for trismus. Several stretching techniques and jaw mobilizing devices are available, but their effect in radiotherapy-induced trismus is still largely unknown. With this review we give an overview of the present relevant literature and compare the effect of exercise therapy versus no exercise therapy on jaw mobility, expressed in millimeters mouth opening, in HNC patients with radiotherapy-induced trismus. A systematic literature search in four electronic bibliographic databases was conducted in July 2014. Selected articles were critically appraised on relevance and validity. Best available evidence was analyzed and compared. Three of the four selected articles show a significant increase (p-valuetrismus. Copyright © 2015 Elsevier Ltd. All rights reserved.

  9. Insulin therapy and dietary adjustments to normalize glycemia and prevent nocturnal hypoglycemia after evening exercise in type 1 diabetes: a randomized controlled trial.

    Science.gov (United States)

    Campbell, Matthew D; Walker, Mark; Bracken, Richard M; Turner, Daniel; Stevenson, Emma J; Gonzalez, Javier T; Shaw, James A; West, Daniel J

    2015-01-01

    Evening-time exercise is a frequent cause of severe hypoglycemia in type 1 diabetes, fear of which deters participation in regular exercise. Recommendations for normalizing glycemia around exercise consist of prandial adjustments to bolus insulin therapy and food composition, but this carries only short-lasting protection from hypoglycemia. Therefore, this study aimed to examine the impact of a combined basal-bolus insulin dose reduction and carbohydrate feeding strategy on glycemia and metabolic parameters following evening exercise in type 1 diabetes. Ten male participants (glycated hemoglobin: 52.4±2.2 mmol/mol), treated with multiple daily injections, completed two randomized study-days, whereby administration of total daily basal insulin dose was unchanged (100%), or reduced by 20% (80%). Participants attended the laboratory at ∼08:00 h for a fasted blood sample, before returning in the evening. On arrival (∼17:00 h), participants consumed a carbohydrate meal and administered a 75% reduced rapid-acting insulin dose and 60 min later performed 45 min of treadmill running. At 60 min postexercise, participants consumed a low glycemic index (LGI) meal and administered a 50% reduced rapid-acting insulin dose, before returning home. At ∼23:00 h, participants consumed a LGI bedtime snack and returned to the laboratory the following morning (∼08:00 h) for a fasted blood sample. Venous blood samples were analyzed for glucose, glucoregulatory hormones, non-esterified fatty acids, β-hydroxybutyrate, interleukin 6, and tumor necrosis factor α. Interstitial glucose was monitored for 24 h pre-exercise and postexercise. Glycemia was similar until 6 h postexercise, with no hypoglycemic episodes. Beyond 6 h glucose levels fell during 100%, and nine participants experienced nocturnal hypoglycemia. Conversely, all participants during 80% were protected from nocturnal hypoglycemia, and remained protected for 24 h postexercise. All metabolic

  10. Mediators of the resistance and aerobic exercise intervention effect on physical and general health in men undergoing androgen deprivation therapy for prostate cancer.

    Science.gov (United States)

    Buffart, Laurien M; Galvão, Daniel A; Chinapaw, Mai J; Brug, Johannes; Taaffe, Dennis R; Spry, Nigel; Joseph, David; Newton, Robert U

    2014-01-15

    The objective of the current study was to identify mediators of the effects of a combined resistance and aerobic exercise program on perceived physical and general health in men undergoing androgen deprivation therapy for prostate cancer. In total, 57 patients with prostate cancer undergoing androgen deprivation therapy were randomly assigned to 12 weeks of resistance and aerobic exercise or usual care. The outcome measures of physical and general health were assessed by standardized questionnaires. Linear regression analyses were conducted on the residual change scores of the variables. The mediating effects of fatigue, muscle strength, and functional performance on the intervention's effect on physical and general health were examined using the product of coefficients method. Bootstrapping was used to calculate the 95% confidence intervals (95% CIs). The exercise intervention was found to significantly improve physical (beta, 5.03; 95% CI, 1.01-9.04) and general health (beta, 12.89; 95% CI, 2.24-23.54). Upper body muscle strength and walking speed significantly mediated the intervention effect on physical health (beta, 2.65; 95% CI, 0.64-5.54), accounting for 53% of the total effect. Walking speed and fatigue were found to be mediators in the intervention effect on general health (beta, 7.52; 95% CI, 2.16-16.92), accounting for 51% of the total effect. The intervention effects on physical and general health were explained by different mediating mechanisms. Walking speed mediated the intervention effect on both physical and general health. The intervention effect on physical health was further mediated by upper body strength, whereas the effect on general health was mediated by fatigue. © 2013 American Cancer Society.

  11. Enhanced function and quality of life following 5 months of exercise therapy for patients with irreparable rotator cuff tears - an intervention study.

    Science.gov (United States)

    Christensen, Birgitte Hede; Andersen, Kathrine Skov; Rasmussen, Sten; Andreasen, Elizabeth Lykholt; Nielsen, Lotte Mejlvig; Jensen, Steen Lund

    2016-06-08

    Rotator cuff rupture is associated with dysfunction, pain and muscular weakness related to the upper extremity. Some evidence exists to support the beneficial effect of exercises but there is lack of evidence of which exercises imply the best effect and how physiotherapy should be administered. Therefore, the purpose of this study was to examine the effect of a neuromuscular exercise program for patients with irreparable rotator cuff rupture. Based on sample-size calculations thirty patients with chronic irreparable rotator cuff tears (of at least m. supraspinatus and m. infraspinatus) was consecutively included. Twenty-four patients completed the five months training to restore function with focus on centering the humeral head in the glenoid cavity trough strengthening m. deltoideus anterior and m. teres minor. The primary outcome measure was Oxford Shoulder Score which was completed at baseline, 3 and 5 months follow-up. One-way, repeated-measure ANOVA was used if data was normally distributed. Secondary outcome measures included EQ-5D, range of motion, strength and muscle activity. Paired t-test and Wilcoxon Signed Ranks Test was used to the appropriate outcomes. Improvements was seen for both primary and secondary outcomes from baseline to follow-up. Oxford Shoulder Score improved from 25.6 (SD 8.1) at baseline to 33.8 (SD 8.7) at 3 months (p = 0.004) and 37.2 (SD 8.2) at five months (p rotator cuff tears showed increased function in their symptomatic shoulder, reduced pain and increased quality of life. This study therefore supports the use of exercise therapy in patients with irreparable rotator cuff rupture. This study is approved by The National Committee on Health Research Ethics (N-20120040) and registered retrospectively at ClinicalTrials.gov in April 2016 ( NCT02740946 ).

  12. Prevention: Exercise

    Medline Plus

    Full Text Available ... Smoking Weight Patient Safety Exercise Strengthening Strengthen Your Core! Stretching/Flexibility Aerobic Exercise Cervical Exercise Strength Training for the Elderly Other Back Pack Safety ...

  13. A randomized controlled trial comparing McKenzie therapy and motor control exercises on the recruitment of trunk muscles in people with chronic low back pain: a trial protocol.

    Science.gov (United States)

    Halliday, Mark H; Ferreira, Paulo H; Hancock, Mark J; Clare, Helen A

    2015-06-01

    To investigate if McKenzie exercises when applied to a cohort of patients with chronic LBP who have a directional preference demonstrate improved recruitment of the transversus abdominis compared to motor control exercises when measurements were assessed from ultrasound images. A randomized blinded trial with a 12-month follow-up. The Physiotherapy department of Concord Hospital a primary health care environment. 70-adults with greater than three-month history of LBP who have a directional preference. McKenzie techniques or motor control exercises for 12-sessions over eight weeks. Transversus abdominus thickness measured from real time ultrasound images, pain, global perceived effect and capacity to self-manage. This study will be the first to investigate the possible mechanism of action that McKenzie therapy and motor control exercises have on the recruitment of the transversus abdominus in a cohort of low back pain patients sub-classified with a directional preference. Patients receiving matched exercises according to their directional preference are believed to have better outcomes than those receiving unmatched exercises. A better understanding of the mechanism of action that specific treatments such as motor control exercises or McKenzie exercises have on patients classified with a directional preference will allow therapist to make a more informed choice about treatment options. Copyright © 2014 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

  14. Using Computers to Enable Self-Management of Aphasia Therapy Exercises for Word Finding: The Patient and Carer Perspective

    Science.gov (United States)

    Palmer, Rebecca; Enderby, Pam; Paterson, Gail

    2013-01-01

    Background: Speech and language therapy (SLT) for aphasia can be difficult to access in the later stages of stroke recovery, despite evidence of continued improvement with sufficient therapeutic intensity. Computerized aphasia therapy has been reported to be useful for independent language practice, providing new opportunities for continued…

  15. Physical therapy vs. internet-based exercise training (PATH-IN) for patients with knee osteoarthritis: study protocol of a randomized controlled trial.

    Science.gov (United States)

    Williams, Quinn I; Gunn, Alexander H; Beaulieu, John E; Benas, Bernadette C; Buley, Bruce; Callahan, Leigh F; Cantrell, John; Genova, Andrew P; Golightly, Yvonne M; Goode, Adam P; Gridley, Christopher I; Gross, Michael T; Heiderscheit, Bryan C; Hill, Carla H; Huffman, Kim M; Kline, Aaron; Schwartz, Todd A; Allen, Kelli D

    2015-09-28

    Physical activity improves pain and function among individuals with knee osteoarthritis (OA), but most people with this condition are inactive. Physical therapists play a key role in helping people with knee OA to increase appropriate physical activity. However, health care access issues, financial constraints, and other factors impede some patients from receiving physical therapy (PT) for knee OA. A need exists to develop and evaluate other methods to provide physical activity instruction and support to people with knee OA. This study is examining the effectiveness of an internet-based exercise training (IBET) program designed for knee OA, designed by physical therapists and other clinicians. This is a randomized controlled trial of 350 participants with symptomatic knee OA, allocated to three groups: IBET, standard PT, and a wait list (WL) control group (in a 2:2:1 ratio, respectively). The study was funded by the Patient Centered Outcomes Research Institute, which conducted a peer review of the proposal. The IBET program provides patients with a tailored exercise program (based on functional level, symptoms, and current activity), video demonstrations of exercises, and guidance for appropriate exercise progression. The PT group receives up to 8 individual visits with a physical therapist, mirroring standard practice for knee OA and with an emphasis on a home exercise program. Outcomes are assessed at baseline, 4 months (primary time point) and 12 months (to assess maintenance of treatment effects). The primary outcome is the Western Ontario and McMaster Universities Osteoarthritis Index, and secondary outcomes include objective physical function, satisfaction with physical function, physical activity, depressive symptoms and global assessment of change. Linear mixed models will be used to compare both the IBET and standard PT groups to the WL control group, examine whether IBET is non-inferior to PT (a treatment that has an established evidence base for knee

  16. Therapeutic patient education and exercise therapy in patients with cervicogenic dizziness: a prospective case series clinical study

    Science.gov (United States)

    Minguez-Zuazo, Ana; Grande-Alonso, Mónica; Saiz, Beatriz Moral; La Touche, Roy; Lara, Sergio Lerma

    2016-01-01

    The purpose of this study was to evaluate the effectiveness of a treatment for patients with cervicogenic dizziness that consisted of therapeutic education and exercises. The Dizziness Handicap Inventory and Neck Disability Index were used. Secondary outcomes included range of motion, postural control, and psychological variables. Seven patients (two males and five females) aged 38.43±14.10 with cervicogenic dizziness were included. All the participants received eight treatment sessions. The treatment was performed twice a week during a four weeks period. Outcome measures included a questionnaire (demographic data, body chart, and questions about pain) and self-reported disability, pain, and psychological variables. Subjects were examined for cervical range of motion and postural control. All of these variables were assessed pre- and postintervention. Participants received eight sessions of therapeutic education patient and therapeutic exercise. The majority of participants showed an improvement in catastrophism (mean change, 11.57±7.13; 95% confidence interval [CI], 4.96–18.17; d=1.60), neck disability (mean change, 5.14±2.27.28; 95% CI, 3.04–7.24; d=1.32), and dizziness disability (mean change, 9.71±6.96; 95% CI, 3.26–16.15; d=1.01). Patients also showed improved range of motion in the right and left side. Therapeutic patient education in combination with therapeutic exercise was an effective treatment. Future research should investigate the efficacy of therapeutic patient education and exercise with larger sample sizes of patients with cervicogenic dizziness. PMID:27419118

  17. Graded Exercise Therapy Guided Self-Help Trial for Patients with Chronic Fatigue Syndrome (GETSET): Protocol for a Randomized Controlled Trial and Interview Study.

    Science.gov (United States)

    Clark, Lucy V; McCrone, Paul; Ridge, Damien; Cheshire, Anna; Vergara-Williamson, Mario; Pesola, Francesca; White, Peter D

    2016-06-08

    Chronic fatigue syndrome, also known as myalgic encephalomyelitis (CFS/ME), is characterized by chronic disabling fatigue and other symptoms, which are not explained by an alternative diagnosis. Previous trials have suggested that graded exercise therapy (GET) is an effective and safe treatment. GET itself is therapist-intensive with limited availability. While guided self-help based on cognitive behavior therapy appears helpful to patients, Guided graded Exercise Self-help (GES) is yet to be tested. This pragmatic randomized controlled trial is set within 2 specialist CFS/ME services in the South of England. Adults attending secondary care clinics with National Institute for Health and Clinical Excellence (NICE)-defined CFS/ME (N=218) will be randomly allocated to specialist medical care (SMC) or SMC plus GES while on a waiting list for therapist-delivered rehabilitation. GES will consist of a structured booklet describing a 6-step graded exercise program, supported by up to 4 face-to-face/telephone/Skype™ consultations with a GES-trained physiotherapist (no more than 90 minutes in total) over 8 weeks. The primary outcomes at 12-weeks after randomization will be physical function (SF-36 physical functioning subscale) and fatigue (Chalder Fatigue Questionnaire). Secondary outcomes will include healthcare costs, adverse outcomes, and self-rated global impression change scores. We will follow up all participants until 1 year after randomization. We will also undertake qualitative interviews of a sample of participants who received GES, looking at perceptions and experiences of those who improved and worsened. The project was funded in 2011 and enrolment was completed in December 2014, with follow-up completed in March 2016. Data analysis is currently underway and the first results are expected to be submitted soon. This study will indicate whether adding GES to SMC will benefit patients who often spend many months waiting for rehabilitative therapy with little or

  18. Treating disability in knee osteoarthritis with exercise therapy: a central role for self-efficacy and pain.

    Science.gov (United States)

    Rejeski, W J; Ettinger, W H; Martin, K; Morgan, T

    1998-04-01

    To examine the effects of aerobic and resistance exercise on self-efficacy beliefs in older adults with knee osteoarthritis (OA) and to determine whether self-efficacy and knee pain mediated the effects of the treatments on stair time performance and health perceptions. Measures of self-efficacy, knee pain, stair climbing performance, and health perceptions were collected prior to randomization and again at an 18-month followup in older adults with knee OA who were assigned to 1 of 3 treatment conditions: aerobic exercise, resistance training, or health education control. All analyses were conducted on the intention-to-treat principle. Both exercise treatments increased self-efficacy for stair climbing in comparison to the health education control group. Both knee pain and self-efficacy mediated the effect of the treatments on stair climb time, whereas only knee pain mediated health perceptions. The findings suggest that control beliefs and changes in physical symptoms such as knee pain are important outcomes in physical activity programs with patients who have OA of the knee. Moreover, these variables mediate the effects that such programs have on disability and health perceptions.

  19. Long-term low-level laser therapy promotes an increase in maximal oxygen uptake and exercise performance in a dose-dependent manner in Wistar rats.

    Science.gov (United States)

    Perini, Júlia Luiza; Hentschke, Vítor Scotta; Sonza, Anelise; Dal Lago, Pedro

    2016-02-01

    The use of low-level laser therapy (LLLT) represents a new intervention modality that has been explored to enhance exercise performance. The aim of this study was to evaluate the influence of LLLT (GaAIAs-850 nm) at different doses on VO2max and on exercise performance in rats. Male Wistar rats were divided into three groups: "placebo" rats (P-LLLT, n = 10), rats at a dose of 0.315 J per treatment point of LLLT (8.7 J/cm(2)-LLLT, n = 10), and rats at a dose of 2.205 J per treatment point of LLLT (61.2 J/cm(2)-LLLT, n = 10). The LLLT was applied bilaterally at the biceps femoris, gluteus, lateral and medial gastrocnemius, iliopsoas, and adductor longus muscles. One spot in each muscle belly was applied, with a sum of 12 spots in each rat, once a day, for 10 days. All animals performed the maximal exercise test (ET) at a metabolic treadmill for rats, with simultaneous gas analysis. The distance covered was measured during ET, before and after the conclusion of the LLLT protocol. The data were compared by a repeated measures two-way ANOVA followed by the Student-Newman-Keuls post hoc tests (p muscle. No significant results were found comparing before and after conditions for the studied variables considering P-LLLT and 8.7 J/cm(2)-LLLT groups. The LLLT promoted in a dose-dependent manner an increase in oxygen consumption uptake and a performance increment of male Wistar rats.

  20. A Feasibility study on Combining Internet-Based Cognitive Behaviour Therapy with Physical Exercise as Treatment for Panic Disorder--Treatment Protocol and Preliminary Results.

    Science.gov (United States)

    Hovland, Anders; Johansen, Henning; Sjøbø, Trond; Vøllestad, Jon; Nordhus, Inger Hilde; Pallesen, Ståle; Havik, Odd E; Martinsen, Egil W; Nordgreen, Tine

    2015-01-01

    Internet-based cognitive behaviour therapy (ICBT) is a recommended, cost-effective and efficacious treatment for panic disorder (PD). However, treatment effects in psychiatric settings indicate that a substantial proportion fail to achieve remission. Physical exercise improves symptoms in patients with PD, and acts through mechanisms that can augment the effect of ICBT. The feasibility of combining these two interventions has not previously been investigated, and this was the aim of this study. The intervention comprised guided ICBT combined with one weekly session of supervised and two weekly sessions of unsupervised physical exercise for a total of 12 weeks. Treatment rationale, procedures and protocols are presented together with preliminary results for four patients with PD who have currently finished treatment. Quantitative and qualitative results are reported on the feasibility of adhering to the treatments, treatment outcome as assessed by clinician rating and estimation of reliable and clinically significant change for outcome measures, and participants' satisfactions with the combined treatment. The preliminary results indicate that the combined treatment is feasible to complete, and that the combination is perceived by the participants as beneficial.

  1. Whole-Body Vibration Exercise Therapy Improves Cardiac Autonomic Function and Blood Pressure in Obese Pre- and Stage 1 Hypertensive Postmenopausal Women.

    Science.gov (United States)

    Wong, Alexei; Alvarez-Alvarado, Stacey; Kinsey, Amber W; Figueroa, Arturo

    2016-12-01

    Whole-body vibration (WBV) is an unconventional exercise therapy that appears to provide the same benefits of resistance training in postmenopausal women while being more safe and gentle on the joints. This study evaluated the effect of an 8-week WBV exercise regimen on heart rate variability (HRV) and blood pressure (BP) in obese postmenopausal women. Randomized controlled study with two parallel groups. Twenty-five (age 50-65 years) obese (body-mass index >30 and vibration (25-40 Hz and low-high amplitude) progressed throughout the 8 weeks. Brachial systolic BP (SBP) and diastolic BP (DBP) and HRV: sympathovagal balance (natural logarithm of low frequency [LnLF]/natural logarithm of high frequency [LnHF]; normalized low frequency [nLF]/normalized high frequency [nHF]), parasympathetic tone (LnHF, nHF, natural logarithm of root mean square of successive differences [LnRMSSD]), sympathetic tone (LnLF, nLF), natural logarithm of total power, and heart rate (HR). There were significant group × time interactions (p obese postmenopausal women.

  2. Effects of low-level laser therapy (LLLT) in the development of exercise-induced skeletal muscle fatigue and changes in biochemical markers related to postexercise recovery.

    Science.gov (United States)

    Leal Junior, Ernesto Cesar Pinto; Lopes-Martins, Rodrigo Alvaro Brandão; Frigo, Lucio; De Marchi, Thiago; Rossi, Rafael Paolo; de Godoi, Vanessa; Tomazoni, Shaiane Silva; Silva, Daniela Perin; Basso, Maira; Filho, Pedro Lotti; de Valls Corsetti, Francisco; Iversen, Vegard V; Bjordal, Jan Magnus

    2010-08-01

    Randomized crossover double-blinded placebo-controlled trial. To investigate if low-level laser therapy (LLLT) can affect biceps muscle performance, fatigue development, and biochemical markers of postexercise recovery. Cell and animal studies have suggested that LLLT can reduce oxidative stress and inflammatory responses in muscle tissue. But it remains uncertain whether these findings can translate into humans in sport and exercise situations. Nine healthy male volleyball players participated in the study. They received either active LLLT (cluster probe with 5 laser diodes; lambda = 810 nm; 200 mW power output; 30 seconds of irradiation, applied in 2 locations over the biceps of the nondominant arm; 60 J of total energy) or placebo LLLT using an identical cluster probe. The intervention or placebo were applied 3 minutes before the performance of exercise. All subjects performed voluntary elbow flexion repetitions with a workload of 75% of their maximal voluntary contraction force until exhaustion. Active LLLT increased the number of repetitions by 14.5% (mean +/- SD, 39.6 +/- 4.3 versus 34.6 +/- 5.6; P = .037) and the elapsed time before exhaustion by 8.0% (P = .034), when compared to the placebo treatment. The biochemical markers also indicated that recovery may be positively affected by LLLT, as indicated by postexercise blood lactate levels (Pendurance for repeated elbow flexion against resistance and decreased postexercise levels of blood lactate, creatine kinase, and C-reactiveprotein. Performance enhancement, level 1b.

  3. Effects of photobiomodulation therapy (pulsed LASER 904 nm) on muscle oxygenation and performance in exercise-induced skeletal muscle fatigue in young women: a pilot study

    Science.gov (United States)

    Oliveira, Murilo X.; Toma, Renata L.; Jones, Brett J. L.; Cyprien, Thomas P.; Tier, Matthew R.; Wallace, Cameron A.; Renno, Ana C. M.; Sabapathy, Surendran; Laakso, E.-Liisa

    2017-02-01

    Photobiomodulation therapy (PBMt) has been used to increase muscle performance and improve recovery when applied before exercise. We aimed to evaluate the effects of PBMt using LASER on muscle oxygenation and performance. The study was a randomized, participant and assessor-blinded, within-subject crossover trial with placebo control to test the viability of the methods. Five physically active young women were randomly assigned to either placebo, or active PBMt (12 diode cluster probe; 904 nm; 60 mW; 250 Hz; 43.2 J per site, 129.6 J total) in contact over rectus femoris (RF) muscle of the dominant limb immediately before an isokinetic fatigue protocol. A one-week wash-out period preceded cross-over. Electromyography and isokinetic performance measures were evaluated. Absolute concentrations of deoxygenated haemoglobin and myoglobin (deoxy[Hb + Mb]) of the RF, an index of local microvascular fractional O2 extraction, was monitored continuously by near-infrared spectroscopy (NIRS). Total haemoglobin concentration as an indicator of microvascular haematocrit was calculated as the sum of the deoxy[Hb + Mb] and oxy[Hb + Mb] signals. PBMt pre-conditioning reduced time to peak torque when compared to placebo (P0.05). PBMt before exercise improves indicators of muscle performance, potentially by increasing local matching of bulk and microvascular O2 delivery relative to skeletal muscle O2 utilisation. Further work is required to understand the effect of PBMt on haemodynamic and metabolic characteristics of muscle.

  4. Australasian College of Sports Physicians-position statement: the place of mesenchymal stem/stromal cell therapies in sport and exercise medicine.

    Science.gov (United States)

    Osborne, Hamish; Anderson, Lynley; Burt, Peter; Young, Mark; Gerrard, David

    2016-10-01

    This Position Statement has been written expressly for members of the Australasian College of Sports Physicians (ACSP); however, it may also be of interest to the wider medical community, sporting organisations, athletes and the general community. It has been informed by a comprehensive review of the scientific literature and the opinions of kindred organisations. This statement outlines the use of mesenchymal stem cell (MSC) therapies in the broad context of Sport and Exercise Medicine, recognising that every medical practitioner should respect: (1) the evidence for the therapeutic use of MSCs and (2) the priority for patient health and welfare. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  5. Aerobic Exercise Prescription for Rheumatoid Arthritics.

    Science.gov (United States)

    Evans, Blanche W.; Williams, Hilda L.

    The use of exercise as a general treatment for rheumatoid arthritics (RA) has included range of motion, muscular strength, water exercise and rest therapy while virtually ignoring possible benefits of aerobic exercise. The purposes of this project were to examine the guidelines for exercise prescription in relation to this special population and…

  6. Effects of physical exercise therapy on mobility, physical functioning, physical activity and quality of life in community-dwelling older adults with impaired mobility, physical disability and/or multi-morbidity: a meta-analysis.

    NARCIS (Netherlands)

    Vries, N.M. de; Ravensberg, C.D. van; Hobbelen, J.S.; Olde Rikkert, M.G.; Staal, J.B.; Nijhuis-Van der Sanden, M.W.

    2012-01-01

    This is the first meta-analysis focusing on elderly patients with mobility problems, physical disability and/or multi-morbidity. The aim of this study is to assess the effect of physical exercise therapy on mobility, physical functioning, physical activity and quality of life. A broad systematic

  7. What "CAM" we learn about the level of evidence from 60 years of research into manipulative and body-based therapies in sports and exercise medicine?

    Science.gov (United States)

    Mącznik, Aleksandra K; Schneiders, Anthony G; Sullivan, S John; Athens, Josie

    2014-04-01

    Complementary and alternative medicine (CAM) is becoming increasingly accepted in modern western society, including amongst amateur and professional athletes, however, it has not yet been determined how CAM is reflected in scientific publications in sports and exercise medicine (SEM). The aim of this study was to identify trends in the levels of evidence for manipulative and body-based therapies within the SEM literature. The literature was systematically searched with no language restrictions in seven databases and retrieved articles were screened and classified according to their study design using the Oxford Centre for Evidence-Based Medicine system. From 6088 retrieved articles, 395 were retained for evaluation and these included 180 on massage, 96 on acupuncture and 95 on manipulation. The majority of the articles were published in English, with 88 in non-English languages. Level-1 evidence was available for acupuncture, manipulation, massage, and Pilates. From the nineteen-seventies onwards, a decreasing trend was observed for low evidence articles with a corresponding increasing trend for clinical trials. After the year 2000, over 50% of the published articles were clinical trials, RCTs or systematic reviews. This review revealed an increase in the quantity and quality of published manipulative and body-based therapy articles in SEM over the last 60 years with the evidence level varying considerably between therapies. The timeframe associated with the development of evidence in CAM may reflect the move to provide scientific support for therapies previously justified primarily by anecdotal evidence, or traditional and cultural use. Copyright © 2014. Published by Elsevier Ltd.

  8. Action Mechanism of Ginkgo biloba Leaf Extract Intervened by Exercise Therapy in Treatment of Benign Prostate Hyperplasia

    Directory of Open Access Journals (Sweden)

    Chiung-Chi Peng

    2013-01-01

    overexpression of stromal, and epithelial growth factors associated with chronic inflammation, has become an atypical direct cause of mortality of aged male diseases. Ginkgo possesses anti-inflammatory, blood flow-enhancing, and free radical scavenging effects. Considering strenuous exercise can reduce BPH risks, we hypothesize Ginkgo + exercise (Ginkgo + Ex could be beneficial to BPH. To verify this, rat BPH model was induced by s.c. 3.5 mg testosterone (T and 0.1 mg estradiol (E2 per head per day successively for 8 weeks, using mineral oil as placebo. Cerenin® 8.33 μL/100 g was applied s.c. from the 10th to the 13th week, and simultaneously, Ex was applied (30 m/min, 3 times/week. In BPH, Ginkgo alone had no effect on T, 5α-reductase, and dihydrotestosterone (DHT, but suppressed androgen receptor (AR, aromatase, E2 and estrogen receptor (ER, and the proliferating cell nuclear antigen (PCNA; Ex alone significantly reduced T, aromatase, E2, ER, AR, and PCNA, but highly raised DHT. While Ginkgo + Ex androgenically downregulated T, aromatase, E2, and ER, but upregulated DHT, AR, and PCNA, implying Ginkgo + Ex tended to worsen BPH. Conclusively, Ginkgo or Ex alone may be more beneficial than Ginkgo + Ex for treatment of BPH.

  9. Action Mechanism of Ginkgo biloba Leaf Extract Intervened by Exercise Therapy in Treatment of Benign Prostate Hyperplasia

    Science.gov (United States)

    Peng, Chiung-Chi; Liu, Jia-Hong; Chang, Chi-Huang; Chung, Jin-Yuan; Chen, Kuan-Chou

    2013-01-01

    Benign prostatic hyperplasia (BPH), an imbalance between androgen/estrogen, overexpression of stromal, and epithelial growth factors associated with chronic inflammation, has become an atypical direct cause of mortality of aged male diseases. Ginkgo possesses anti-inflammatory, blood flow-enhancing, and free radical scavenging effects. Considering strenuous exercise can reduce BPH risks, we hypothesize Ginkgo + exercise (Ginkgo + Ex) could be beneficial to BPH. To verify this, rat BPH model was induced by s.c. 3.5 mg testosterone (T) and 0.1 mg estradiol (E2) per head per day successively for 8 weeks, using mineral oil as placebo. Cerenin® 8.33 μL/100 g was applied s.c. from the 10th to the 13th week, and simultaneously, Ex was applied (30 m/min, 3 times/week). In BPH, Ginkgo alone had no effect on T, 5α-reductase, and dihydrotestosterone (DHT), but suppressed androgen receptor (AR), aromatase, E2 and estrogen receptor (ER), and the proliferating cell nuclear antigen (PCNA); Ex alone significantly reduced T, aromatase, E2, ER, AR, and PCNA, but highly raised DHT. While Ginkgo + Ex androgenically downregulated T, aromatase, E2, and ER, but upregulated DHT, AR, and PCNA, implying Ginkgo + Ex tended to worsen BPH. Conclusively, Ginkgo or Ex alone may be more beneficial than Ginkgo + Ex for treatment of BPH. PMID:23690843

  10. Video game play (Dance Dance Revolution) as a potential exercise therapy in Huntington's disease: a controlled clinical trial.

    Science.gov (United States)

    Kloos, Anne D; Fritz, Nora E; Kostyk, Sandra K; Young, Gregory S; Kegelmeyer, Deb A

    2013-11-01

    To investigate the feasibility, acceptability, and safety of a supervised video game exercise program administered via Dance Dance Revolution in individuals with Huntington's disease. A cross-over, controlled, single-blinded, six-week trial. Home-based. Eighteen ambulatory individuals with Huntington's disease (seven male, mean age 50.7 SD 14.7). Participants played the Dance Dance Revolution game with supervision and the handheld game without supervision for 45 minutes, two days per week for six weeks. Game play performance and adherence, participant perceptions of the game, safety (vital signs, adverse health changes), spatiotemporal gait measures, Four-Square Step Test, Tinetti Mobility Test, Activities-Specific Balance Confidence Scale, and World Health Organization Quality of Life - Bref, before and after each intervention. Most participants improved on game play, enjoyed playing the game, and wanted to continue playing after study completion. After playing Dance Dance Revolution, participants showed significant reductions in double support percentage (adjusted mean difference (95% confidence intervals): -2.54% (-4.75, -0.34) for forward walking and -4.18 (-6.89, -0.48) for backward walking) and those with less severe motor symptoms had reductions in heel-to-heel base of support during forward walking. The remaining measures were not significantly impacted by the intervention. Dance Dance Revolution appears to be a feasible, motivating, and safe exercise intervention for individuals with Huntington's disease.

  11. Exercise and Depression: Swapping Sweat for Serenity?

    Science.gov (United States)

    Monahan, Terry

    1986-01-01

    Individuals who engage in regular exercise of varying intensity report significant reduction in anxiety and depression. While most evidence is anecdotal, research has provided support for exercise in depression therapy. (Author/MT)

  12. Internet-based cognitive behaviour therapy and physical exercise - Effects studied by automated telephone assessments in mental ill-health patients; a randomized controlled trial.

    Science.gov (United States)

    Strid, Catharina; Andersson, Claes; Forsell, Yvonne; Öjehagen, Agneta; Lundh, Lars-Gunnar

    2016-11-01

    Mental ill-health has become a large health problem and it is important for caregivers to provide effective treatment alternatives. REGASSA is a randomized controlled study performed in primary care to study the effects of 12 weeks of Internet-based cognitive behaviour therapy (ICBT) and physical exercise (PE) compared with treatment as usual (TAU) in patients with mild-to-moderate mental ill-health. The present study aimed to examine the results of these treatment alternatives on psychological functioning, stress, and sleep disturbances. The study comprised 879 patients with mental ill-health taking part in the REGASSA study. Data were collected by Interactive Voice Response (IVR), a computerized, automated telephone technique. The treatments were compared at baseline, twice during treatment, at the end of treatment and at three follow-ups after treatment. Measures used were the Outcome Questionnaire-45, the short versions of the Perceived Stress Scale, and the Karolinska Sleep Questionnaire. Linear mixed models showed that the patients in ICBT and PE had better results than in TAU on psychological functioning and sleep disturbances, p effect sizes. On stress there were no differences; all groups made improvements. Women had stronger effects than men. More patients recovered on psychological functioning (OQ-45) in ICBT and PE than in TAU. Internet-based cognitive behaviour therapy and PE proved to be effective treatment alternatives for patients with mild-to-moderate mental ill-health in improving psychological functioning, stress, and sleep disturbances and could be useful alternatives in primary care. Internet-based cognitive behaviour therapy and physical exercise proved to be effective treatment alternatives for mental ill-health patients in primary care. Automated techniques (Interactive Voice Response) could be useful for following treatment course in large groups of patients in the health care. It is important to use measures that capture different

  13. Dichloroacetate therapy attenuates the blood lactate response to submaximal exercise in patients with defects in mitochondrial energy metabolism.

    Science.gov (United States)

    Duncan, G E; Perkins, L A; Theriaque, D W; Neiberger, R E; Stacpoole, P W

    20