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Sample records for vestibular rehabilitation exercises

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

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    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

  2. Quantification of Head Acceleration during Vestibular Rehabilitation Exercises.

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    Hogan, Anne E; Spindel, Jonathan H; Gray, Lincoln C

    2018-01-01

    Vestibular rehabilitation exercises have been proven to reduce symptoms and diminish the risk of falls in those with dizziness and balance impairments. The first purpose of this study is to investigate a new method of measuring head movements during habituation vestibular rehabilitation exercises. The second is to explore the relationship between head acceleration measurements during select traditional vestibular rehabilitation exercises and the variables of age, dizziness, and poor balance confidence. A descriptive, cross-sectional study, in a university setting. Fifty-two participants, ranging in age from 20 to 96 yr. All were volunteers, with the majority (34) reporting no history of dizziness or balance confidence. Head accelerations were calculated from linear and angular displacements as measured by magnetometry. Head accelerations decreased with increasing age, dizziness, and low balance confidence during four habituation exercises. Head acceleration varies as a function of age, dizziness, and low balance confidence during head movement-based vestibular and balance rehabilitation therapy (habituation) exercises. The magnetometry measurement method used could be applied across the course of treatment to establish predictive measures based on change in acceleration over time. More diverse participant sampling is needed to create normative data.

  3. Balance rehabilitation by moving platform and exercises in patients with neuropathy or vestibular deficit.

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    Nardone, Antonio; Godi, Marco; Artuso, Alessia; Schieppati, Marco

    2010-12-01

    To assess the efficacy of a balance rehabilitation treatment by using both a powered platform on which subjects stand and specific physical exercises (EXs). Crossover trial. Physical and rehabilitation medicine department in Italy. Patients (N=33) with balance disorders (14 vestibular origin, 19 peripheral neuropathy origin). Patients underwent powered platform then EX treatment (n=17); the other 16 received the same treatments in reverse order. powered platform consisted of balancing on a sinusoidally oscillating powered platform (in anteroposterior and laterolateral directions in separate trials) with eyes open and closed. A physical therapist administered Cawthorne-Cooksey EXs for patients with vestibular disorders and modified Frenkel EXs for patients with neuropathy. Treatment lasted 1 hour a day for 10 consecutive days, except for the weekend. Body sway area, subjective score of stability, balance and gait scores, and amplitude of head displacement while balancing on the oscillating powered platform were recorded before, (t0) after the first (t1), and after the second treatment (t2), regardless of the powered platform or EX order. On average, all participants improved balance regardless of the order of treatments, and more so at t2 than t1. Improvement was observed by using instrumental evaluations and balance and gait scales. In both patient groups, powered platform treatment proved to be as effective as EX in improving balance. This effect was stronger in patients with vestibular disorders, independently of order of treatment. Balance rehabilitation with either EX or powered platform is effective in patients with balance disorders of vestibular or neuropathic origin. These findings point to the value of either or both physical EXs and powered platform in increasing stability and potentially decrease the risk of falling in patients with neuropathy, for whom few results are documented in the literature. Copyright © 2010 American Congress of Rehabilitation

  4. Effectiveness of conventional versus virtual reality-based balance exercises in vestibular rehabilitation for unilateral peripheral vestibular loss: results of a randomized controlled trial.

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    Meldrum, Dara; Herdman, Susan; Vance, Roisin; Murray, Deirdre; Malone, Kareena; Duffy, Douglas; Glennon, Aine; McConn-Walsh, Rory

    2015-07-01

    To compare the effectiveness of virtual reality-based balance exercises to conventional balance exercises during vestibular rehabilitation in patients with unilateral peripheral vestibular loss (UVL). Assessor-blind, randomized controlled trial. Two acute care university teaching hospitals. Patients with UVL (N=71) who had dizziness/vertigo, and gait and balance impairment. Patients with UVL were randomly assigned to receive 6 weeks of either conventional (n=36) or virtual reality-based (n=35) balance exercises during vestibular rehabilitation. The virtual reality-based group received an off-the-shelf virtual reality gaming system for home exercise, and the conventional group received a foam balance mat. Treatment comprised weekly visits to a physiotherapist and a daily home exercise program. The primary outcome was self-preferred gait speed. Secondary outcomes included other gait parameters and tasks, Sensory Organization Test (SOT), dynamic visual acuity, Hospital Anxiety and Depression Scale, Vestibular Rehabilitation Benefits Questionnaire, and Activities Balance Confidence Questionnaire. The subjective experience of vestibular rehabilitation was measured with a questionnaire. Both groups improved, but there were no significant differences in gait speed between the groups postintervention (mean difference, -.03m/s; 95% confidence interval [CI], -.09 to .02m/s). There were also no significant differences between the groups in SOT scores (mean difference, .82%; 95% CI, -5.00% to 6.63%) or on any of the other secondary outcomes (P>.05). In both groups, adherence to exercise was high (∼77%), but the virtual reality-based group reported significantly more enjoyment (P=.001), less difficulty with (P=.009) and less tiredness after (P=.03) balance exercises. At 6 months, there were no significant between-group differences in physical outcomes. Virtual reality-based balance exercises performed during vestibular rehabilitation were not superior to conventional balance

  5. The effect of vestibular rehabilitation supplemented by training of the breathing rhythm or proprioception exercises, in patients with chronic peripheral vestibular disease.

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    Jáuregui-Renaud, Kathrine; Villanueva Padrón, Laura Alejandra; Cruz Gómez, Nora Silvia

    2007-01-01

    To assess the effect of performing vestibular rehabilitation using the Cawthorne & Cooksey exercises supplemented by training of the breathing rhythm or proprioception exercises on self-reported disability and postural control, in patients with chronic, peripheral, vestibular disease. Fifty one patients with peripheral vestibular disease and abnormal caloric test participated in the study (mean age 43 +/- S.D. 9 years). They were assigned to one of 3 treatment groups: I. Cawthorne &} Cooksey exercises with training of the breathing rhythm (n=17); II. Cawthorne & Cooksey exercises with proprioception exercises (n=17) and III. Cawthorne & Cooksey exercises with no additional intervention (n=17). The Dizziness Handicap Inventory and static posturography were evaluated prior to treatment and at week 8 of follow-up. Prior to treatment, composite scores on the Dizziness Handicap Inventory and static posturography were similar in the 3 groups. After treatment, a decrease of the composite score of at least 18 points was observed more frequently in patients of the respiration group (94%), compared to the proprioception group (53%) and the Cawthorne & Cooksey group (70%) (p=0.03); while the proprioception group showed a significant decrease of oscillation during all sensory conditions of static posturography (p< 0.05). The results suggest that regulation of the breathing pattern may have an influence on disability related to chronic vestibular disease, while proprioception exercises may improve postural control. However, further studies are needed to evaluate if training of the breathing rhythm could be an additional tool for vestibular rehabilitation.

  6. Rehabilitation exercise for treatment of vestibular disorder: A case study

    Directory of Open Access Journals (Sweden)

    Avraham Feazadeh

    2006-01-01

    Full Text Available Vertigo and dizziness are common symptoms in the general population. While the clinical picture is well known and widely described, there are different interpretations of Benign Paroxysmal Positional Vertigo. The purpose of this case report was to describe the treatment of a 56 year old woman with complains of positional vertigo for 35 consecutive years. She suffered from a sudden onset of rotatory, unilateral horizontal canal type benign paroxysmal positional vertigo (BPPV. The symtoms started a day after falling from a bus, where she injured her head. Otherwise her medical history was unremarkable. She was treated with an individualized home exercise program of eye movement exercises, Brandt/Daroff exercises, and general conditioning exercises (i.e., laying on the left side from sitting on the bed, while the head rotated 45 degrees to the right, waiting for about one minue; twice a day on gradual basis, not laying on the side all the way, but to use enough pillows to lay about at 60 degrees. Four weeks from the start of physical therapy, the patient was free of symptoms, even when her neck was in the extended position.

  7. Vestibular rehabilitation for unilateral peripheral vestibular dysfunction.

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    Hillier, Susan L; McDonnell, Michelle

    2011-02-16

    This is an update of a Cochrane Review first published in The Cochrane Library in Issue 4, 2007.Unilateral peripheral vestibular dysfunction (UPVD) can occur as a result of disease, trauma or postoperatively. The dysfunction is characterised by complaints of dizziness, visual or gaze disturbances and balance impairment. Current management includes medication, physical manoeuvres and exercise regimes, the latter known collectively as vestibular rehabilitation (VR). To assess the effectiveness of vestibular rehabilitation in the adult, community-dwelling population of people with symptomatic unilateral peripheral vestibular dysfunction. We searched the Cochrane Ear, Nose and Throat Disorders Group Trials Register; the Cochrane Central Register of Controlled Trials (CENTRAL); PubMed; EMBASE; CINAHL; Web of Science; BIOSIS Previews; Cambridge Scientific Abstracts; ISRCTN and additional sources for published and unpublished trials. The most recent search was 1 July 2010, following a previous search in March 2007. Randomised trials of adults living in the community, diagnosed with symptomatic unilateral peripheral vestibular dysfunction. We sought comparisons of VR versus control (placebo etc.), other treatment (non-VR, e.g. pharmacological) or another form of VR. We considered the outcome measures of frequency and severity of dizziness or visual disturbance; changes in balance impairment, function or quality of life; and measure/s of physiological status with known functional correlation. Both authors independently extracted data and assessed trials for risk of bias. We included 27 trials, involving 1668 participants, in the review. Trials addressed the effectiveness of VR against control/sham interventions, medical interventions or other forms of VR. Individual and pooled data showed a statistically significant effect in favour of VR over control or no intervention. The exception to this was when movement-based VR was compared to physical manoeuvres for benign

  8. The value of close monitoring in vestibular rehabilitation therapy.

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    Itani, M; Koaik, Y; Sabri, A

    2017-03-01

    Vestibular rehabilitation therapy is a well-established treatment modality for patients with vestibular problems. Performing vestibular rehabilitation therapy in a closely monitored setting may result in a better outcome than a home exercise programme. A retrospective study was conducted of patients undergoing vestibular rehabilitation therapy between June 2005 and November 2012 in a tertiary university hospital. The Dynamic Gait Index, the main outcome measure, was utilised before and after the rehabilitation programme. The magnitude of improvement for all patients was analysed, mainly to compare the home exercise group with the closely monitored therapy group. Only 32 patients underwent the vestibular rehabilitation therapy programme. In all patients, there was significant improvement in the mean Dynamic Gait Index score (from 11.75 to 17.38; p rehabilitation therapy resulted in improved performance status. More studies are needed to establish the efficiency of vestibular rehabilitation therapy and compare closely monitored therapy with tailored home exercise rehabilitation.

  9. Vestibular rehabilitation outcomes in the elderly with chronic vestibular dysfunction.

    Science.gov (United States)

    Bayat, Arash; Pourbakht, Akram; Saki, Nader; Zainun, Zuraida; Nikakhlagh, Soheila; Mirmomeni, Golshan

    2012-11-01

    Chronic vestibular dysfunction is a frustrating problem in the elderly and can have a tremendous impact on their life, but only a few studies are available. Vestibular rehabilitation therapy (VRT) is an important therapeutic option for the neuro-otologist in treating patients with significant balance deficits. The purpose of this study was to assess the effect of vestibular rehabilitation on dizziness in elderly patients with chronic vestibular dysfunction. A total of 33 patients older than 60 years with chronic vestibular dysfunction were studied. Clinical and objective vestibular tests including videonystagmography (VNG) and dizziness handicap inventory (DHI) were carried out at their first visit, 2 weeks, and 8 weeks post-VRT. The VRT exercises were performed according to Cawthorne and Cooksey protocols. Oculomotor assessments were within normal limits in all patients. Nineteen patients (57.57%) showed abnormal canal paralysis on caloric testing which at follow-up sessions; CP values were decreased remarkably after VRT exercises. We found a significant improvement between pre-VRT and post-VRT total DHI scores (P < 0.001). This improvement was most prominent in functional subscore. Our study demonstrated that VRT is an effective therapeutic method for elderly patients with chronic vestibular dysfunction.

  10. Effectiveness of Otolith Repositioning Maneuvers and Vestibular Rehabilitation exercises in elderly people with Benign Paroxysmal Positional Vertigo: a systematic review.

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    Ribeiro, Karyna Figueiredo; Oliveira, Bruna Steffeni; Freitas, Raysa V; Ferreira, Lidiane M; Deshpande, Nandini; Guerra, Ricardo O

    2017-06-29

    Benign Paroxysmal Positional Vertigo is highly prevalent in elderly people. This condition is related to vertigo, hearing loss, tinnitus, poor balance, gait disturbance, and an increase in risk of falls, leading to postural changes and quality of life decreasing. To evaluate the outcomes obtained by clinical trials on the effectiveness of Otolith Repositioning Maneuver and Vestibular Rehabilitation exercises in the treatment of Benign Paroxysmal Positional Vertigo in elderly. The literature research was performed using PubMed, Scopus, Web of Science and PEDro databases, and included randomized controlled clinical trials in English, Spanish and Portuguese, published during January 2000 to August 2016. The methodological quality of the studies was assessed by PEDro score and the outcomes analysis was done by critical revision of content. Six studies were fully reviewed. The average age of participants ranged between 67.2 and 74.5 years. The articles were classified from 2 to 7/10 through the PEDro score. The main outcome measures analyzed were vertigo, positional nystagmus and postural balance. Additionally, the number of maneuvers necessary for remission of the symptoms, the quality of life, and the functionality were also assessed. The majority of the clinical trials used Otolith Repositioning Maneuver (n=5) and 3 articles performed Vestibular Rehabilitation exercises in addition to Otolith Repositioning Maneuver or pharmacotherapy. One study showed that the addition of movement restrictions after maneuver did not influence the outcomes. There was a trend of improvement in Benign Paroxysmal Positional Vertigo symptomatology in elderly patients who underwent Otolith Repositioning Maneuver. There is sparse evidence from methodologically robust clinical trials that examined the effects of Otolith Repositioning Maneuver and Vestibular Rehabilitation exercises for treating Benign Paroxysmal Positional Vertigo in the elderly. Randomized controlled clinical trials with

  11. Vestibular rehabilitation with visual stimuli in peripheral vestibular disorders.

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    Manso, Andréa; Ganança, Mauricio Malavasi; Caovilla, Heloisa Helena

    2016-01-01

    Visual stimuli can induce vestibular adaptation and recovery of body balance. To verify the effect of visual stimuli by digital images on vestibular and body balance rehabilitation of peripheral vestibular disorders. Clinical, randomized, prospective study. Forty patients aged between 23 and 63 years with chronic peripheral vestibular disorders underwent 12 sessions of rehabilitation with visual stimuli using digital video disk (DVD) (experimental group) or Cawthorne-Cooksey exercises (control group). The Dizziness Handicap Inventory (DHI), dizziness analog scale, and the sensitized Romberg static balance and one-leg stance tests were applied before and after the intervention. Before and after the intervention, there was no difference between the experimental and control groups (p>0.005) regarding the findings of DHI, dizziness analog scale, and static balance tests. After the intervention, the experimental and control groups showed lower values (p<0.05) in the DHI and the dizziness analog scale, and higher values (p<0.05) in the static balance tests in some of the assessed conditions. The inclusion of visual stimuli by digital images on vestibular and body balance rehabilitation is effective in reducing dizziness and improving quality of life and postural control in individuals with peripheral vestibular disorders. Copyright © 2015 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  12. Vestibular rehabilitation with visual stimuli in peripheral vestibular disorders

    Directory of Open Access Journals (Sweden)

    Andréa Manso

    2016-04-01

    Full Text Available ABSTRACT INTRODUCTION: Visual stimuli can induce vestibular adaptation and recovery of body balance. OBJECTIVE: To verify the effect of visual stimuli by digital images on vestibular and body balance rehabilitation of peripheral vestibular disorders. METHODS: Clinical, randomized, prospective study. Forty patients aged between 23 and 63 years with chronic peripheral vestibular disorders underwent 12 sessions of rehabilitation with visual stimuli using digital video disk (DVD (experimental group or Cawthorne-Cooksey exercises (control group. The Dizziness Handicap Inventory (DHI, dizziness analog scale, and the sensitized Romberg static balance and one-leg stance tests were applied before and after the intervention. RESULTS: Before and after the intervention, there was no difference between the experimental and control groups (p > 0.005 regarding the findings of DHI, dizziness analog scale, and static balance tests. After the intervention, the experimental and control groups showed lower values (p < 0.05 in the DHI and the dizziness analog scale, and higher values (p < 0.05 in the static balance tests in some of the assessed conditions. CONCLUSION: The inclusion of visual stimuli by digital images on vestibular and body balance rehabilitation is effective in reducing dizziness and improving quality of life and postural control in individuals with peripheral vestibular disorders.

  13. Comparison of different exercise programs in the rehabilitation of patients with chronic peripheral vestibular dysfunction.

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    Szturm, T; Ireland, D J; Lessing-Turner, M

    1994-01-01

    The purpose of this study was to evaluate the effects of two exercise programs on balance performance in patients with chronic peripheral vestibular dysfunction and to assess whether these exercise programs induce adaptive modifications of the vestibulo-ocular reflex (VOR). Patients were randomly assigned to one of two groups. (1) Those in the Rehab (Reh) group (n = 11) received a comprehensive exercise program that consisted of balance retraining and goal-directed eye-head exercises under combinations of varied visual and somatosensory sensory conditions. Patients received 45-minute training sessions, three times per week for 12 weeks, and were instructed on a custom home exercise program. (2) Those in the Home group (n = 12) were instructed to perform the Cooksey-Cawthorne eye-head exercises at home, on a daily basis, for 12 weeks. In addition, after completion of the exercise program and a follow-up period, 7 of the participants in the Home group (here defined as the A group) chose to enter the Reh program (here defined as the B group). Balance performance was assessed by measuring the peak-to-peak magnitude and total amount of anterior-posterior body sway, and of horizontal (shear) ground reaction force during six test conditions, in which visual and somatosensory orientation cues were reduced or altered by rotation of the visual surround or support surface in proportion to the subject's sway, and in which vision was eliminated (eyes closed). The VOR response to step chair rotations of 60 degrees/s and 120 degrees/s, and the optokinetic reflex (OKN) response to 60 degrees/s constant velocity optokinetic stimuli were recorded. Left-right difference in VOR gain, VOR time constant, and OKN gain were determined. These tests were performed 1 day prior to start of treatment (TD 1), 6 weeks after start of treatment (TD 2), at the end of the 12-week treatment period (TD 3), and 5 months after end of treatment (TD 4). The findings revealed a significant improvement in

  14. [Vestibular rehabilitation in elderly patients with dizziness].

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    Zanardini, Francisco Halilla; Zeigelboim, Bianca Simone; Jurkiewicz, Ari Leon; Marques, Jair Mendes; Martins-Bassetto, Jackeline

    2007-01-01

    The aging of the population is a natural process and is manifested by a decline in the functions of several organs. Vestibular rehabilitation (VR) is a therapeutic process that seeks to promote a significant reduction in the symptoms of the labyrinth. To verify the benefits of VR exercises through the application of the Dizziness Handicap Inventory (DHI) questionnaire--Brazilian version--pre and post rehabilitation. Participants of this study were eight elderly patients with dizziness, ages between 63 and 82 years, three male and five female. The following procedures were carried out: medical history, otologic inspection, vestibular evaluation with vectoelectronystagmography (VENG), application of the DHI questionnaire and of the Cawthorne (1944) and Cooksey (1946) VR exercises. Regarding the auditory and vestibular complaints which were referred to in the medical history, the following was observed: presence of tinnitus, hearing loss, postural vertigo and of unbalance. In the evaluation of the vestibular function alterations were observed for all of the participants, mainly in the caloric test, with a prevalence of unilateral and bilateral hypofunction. In the vestibular exam the following was observed: three cases of unilateral peripheral vestibular deficit syndrome, three cases of bilateral peripheral vestibular deficit syndrome, one case of bilateral central vestibular deficit syndrome and one case of irritating bilateral central vestibular syndrome. There was a statistically significant improvement of the following aspects after VR: physical (p=0.00413), functional (p=0.00006) and emotional (p=0.03268). The VR protocol favored the improvement of life quality of the participants and was of assistance in the process of vestibular compensation.

  15. Efficacy of vestibular rehabilitation on chronic unilateral vestibular dysfunction.

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    Topuz, Oya; Topuz, Bülent; Ardiç, F Necdet; Sarhuş, Merih; Ogmen, Gülsen; Ardiç, Füsun

    2004-02-01

    To assess the efficacy of vestibular rehabilitation exercises on patients with chronic unilateral vestibular dysfunction. Prospective study. Physical Medicine and Rehabilitation Clinic and Otolaryngology Clinic of a tertiary referral hospital. One-hundred and twenty-five patients with unilateral chronic vestibular dysfunction were included in the study. Eight-week, two-staged (clinic and home) vestibular rehabilitation programme with components of Cawthorne-Cooksey and Norre exercises was applied. Dizziness Handicap Inventory (DHI) and visual analogue scale (VAS) were completed three times (at the beginning, end of the second week and end of the treatment). Data for 112 patients in the first stage and 93 patients in the second stage were evaluated because of insufficient compliance of the other patients. The mean DHI score was decreased from 50.42 +/- 24.12 points to 21.21 +/- 15.97 points (p < 0.001) at the end of first two weeks, and to 19.93 +/- 19.33 points at the end of the whole treatment. The mean VAS score was decreased from 5.87 +/- 2.27 to 2.02 +/- 1.75 (p < 0.001) at the end of second week, and to 1.51 +/- 1.29 at the end of eighth week. In respect to both VAS and DHI scores, improvement was noted in 67 patients (77.4%). Age, gender and disability level had no predictive value about therapy outcome. There was a fast recovery in the supervised exercise session, whereas there was no significant difference in the home exercise session. These findings suggest that either supervised exercise is better than home exercise or that 10 supervised sessions are sufficient to get the end result.

  16. [Effectiveness of Self-efficacy Promoting Vestibular Rehabilitation Program for Patients with Vestibular Hypofunction].

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    Lee, Hyun Jung; Choi-Kwon, Smi

    2016-10-01

    In this study an examination was done of the effect of self-efficacy promoting vestibular rehabilitation (S-VR) on dizziness, exercise selfefficacy, adherence to vestibular rehabilitation (VR), subjective and objective vestibular function, vestibular compensation and the recurrence of dizziness in patients with vestibular hypofunction. This was a randomized controlled study. Data were collected 3 times at baseline, 4 and 8 weeks after beginning the intervention. Outcome measures were level of dizziness, exercise self-efficacy, and level of adherence to VR. Subjective and objective vestibular function, vestibular compensation and the recurrence of dizziness were also obtained. Data were analyzed using Windows SPSS 21.0 program. After 4 weeks of S-VR, there was no difference between the groups for dizziness, subjective and objective vestibular functions. However, exercise self-efficacy and adherence to VR were higher in the experimental group than in the control group. After 8 weeks of S-VR, dizziness (p=.018) exercise self-efficacy (pVR (pVR is effective in reducing dizziness, and improving exercise self-efficacy, subjective vestibular function and adherence to VR. Objective vestibular function and vestibular compensation were also improved in the experimental group at the end of 8 weeks of S-VR.

  17. Vestibular rehabilitation following mild traumatic brain injury.

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    Gurley, James M; Hujsak, Bryan D; Kelly, Jennifer L

    2013-01-01

    Vertigo, dizziness, and imbalance are a symptom complex that is commonly found following concussion. Early metabolic changes following concussion may lead to worsening of the injury and symptoms in individuals not properly managed from the outset. When symptoms do not recover spontaneously, skilled vestibular rehabilitation can be an effective modality in an attempt to normalize the individual's vestibular responses. The purpose of this review is to appraise the current and accepted methods available to the skilled clinician in quantifying and treating vestibular dysfunction following concussion. Incidence and prognostic indicators will be reviewed along with common barriers to recovery. Vestibular Rehabilitation following concussion utilizes similar tools and techniques employed when treating those solely with peripheral pathology. The clinician must not only have a solid understanding of when and why certain exercises are required, but also be willing to accept that less exercise may be indicated in this population. As injury to the system following mild traumatic brain injury can include both peripheral and central structures, the duration of therapy and the time to recovery may be prolonged. Co-morbidities including cognitive and behavioral issues, visual-perceptual dysfunction, metabolic dysfunction, and autonomic dysfunction may hamper the effectiveness of the traditional Vestibular Rehabilitation approach. As successful treatment does not occur in a vacuum, working closely with other disciplines well versed in treating these co-morbid issues will help the individual to obtain optimal recovery. Vestibular Rehabilitation is an effective modality for managing dizziness, vertigo, and imbalance following concussion. Careful consideration of the acuity of the injury, along with effective management of co-morbid conditions will optimize the result.

  18. Vestibular rehabilitation with visual stimuli in peripheral vestibular disorders

    OpenAIRE

    Manso, Andréa; Ganança, Mauricio Malavasi; Caovilla, Heloisa Helena

    2016-01-01

    ABSTRACT INTRODUCTION: Visual stimuli can induce vestibular adaptation and recovery of body balance. OBJECTIVE: To verify the effect of visual stimuli by digital images on vestibular and body balance rehabilitation of peripheral vestibular disorders. METHODS: Clinical, randomized, prospective study. Forty patients aged between 23 and 63 years with chronic peripheral vestibular disorders underwent 12 sessions of rehabilitation with visual stimuli using digital video disk (DVD) (experimental...

  19. Can vestibular rehabilitation exercises help patients with concussion? A systematic review of efficacy, prescription and progression patterns.

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    Murray, Drew A; Meldrum, Dara; Lennon, Olive

    2017-03-01

    Concussion symptoms normally resolve within 7-10 days but vertigo, dizziness and balance dysfunction persist in 10-30% of cases causing significant morbidity. This study systematically evaluated the evidence supporting the efficacy, prescription and progression patterns of vestibular rehabilitation therapy (VRT) in patients with concussion. Systematic Review, guided by PRISMA guidelines and presenting a best evidence synthesis. Electronic databases PubMed (1949 to May 2015), CINAHL (1982 to May 2015), EMBASE (1947 to May 2015), SPORTDiscus (1985 to May 2015), Web of Science (1945 to May 2015) and PEDRO (1999 to May 2015), supplemented by manual searches and grey literature. Article or abstract of original research, population of patients with concussion/mild traumatic brain injury (mTBI) with vestibular symptoms, interventions detailing VRT, measurement of outcomes pre-VRT/post-VRT. Study type was not specified. Following a double review of abstract and full-text articles, 10 studies met the inclusion criteria: randomised controlled trial (n=2), uncontrolled studies (n=3) and case studies (n=5). 4 studies evaluated VRT as a single intervention. 6 studies incorporated VRT in multimodal interventions (including manual therapy, strength training, occupational tasks, counselling or medication). 9 studies reported improvement in outcomes but level I evidence from only 1 study was found that demonstrated increased rates (OR 3.91; 95% CI 1.34 to 11.34; p=0.002) of medical clearance for return to sport within 8 weeks, when VRT (combined with cervical therapy) was compared with usual care. Heterogeneity in study type and outcomes precluded meta-analysis. Habituation and adaptation exercises were employed in 8 studies and balance exercises in 9 studies. Prescription and progression patterns lacked standardisation. Current evidence for optimal prescription and efficacy of VRT in patients with mTBI/concussion is limited. Available evidence, although weak, shows promise in

  20. Effects of Vestibular Rehabilitation Interventions in the Elderly with Chronic Unilateral Vestibular Hypofunction

    OpenAIRE

    Arash Bayat; Nader Saki

    2017-01-01

    Introduction: Although vestibular rehabilitation therapy (VRT) methods are relatively popular in treating patients with body balance deficits of vestibular origin, only limited studies have been conducted into customized exercises for unilateral vestibular hypofunction (UVH). Furthermore, very little evidence is available on the outcomes of VRT in the elderly population with chronic UVH. Materials and Methods: A total of 21 patients, aged 61 to 74 years, with UVH participated in this study. T...

  1. An adaptive vestibular rehabilitation technique.

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    Crane, Benjamin T; Schubert, Michael C

    2017-05-23

    There is a large variation in vestibular rehabilitation (VR) results depending on type of therapy, adherence, and the appropriateness for the patient's level of function. A novel adaptive vestibular rehabilitation (AVR) program was developed and evaluated. Technology and procedure development, and prospective multicenter trial. Those with complete unilateral vestibular hypofunction and symptomatic at least 3 months with a Dizziness Handicap Inventory (DHI) >30 were eligible. Patients were given a device to use with their own computer. They were instructed to use the program daily, with each session lasting about 10 minutes. The task consisted of reporting orientation of the letter C, which appeared when their angular head velocity exceeded a threshold. The letter size and head velocity required were adjusted based on prior performance. Performance on the task was remotely collected by the investigator as well as a weekly DHI score. Four patients aged 31 to 74 years (mean = 51 years) were enrolled in this feasibility study to demonstrate efficacy. Two had treated vestibular schwannomas and two had vestibular neuritis. Starting DHI was 32 to 56 (mean = 42), which was reduced to 0 to 16 (mean = 11.5) after a month of therapy, a clinically and statistically significant (P VR in terms of cost and customization for patient ability and obtained a major improvement in symptoms. This study demonstrated a clinically and statistically significant decrease in symptoms after 4 weeks of therapy. 2b Laryngoscope, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

  2. [Semont maneuver and vestibular rehabilitation exercises in the treatment of benign paroxysmal postural vertigo. A comparative study].

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    Toledo, H; Cortés, M L; Pane, C; Trujillo, V

    2000-04-01

    Benign paraoxysmal postural vertigo (BPPV) is one of the most frequent causes of peripheral dizziness. Treatment based on vestibular rehabilitation exercises (VRE) is effective in 90% of the cases in an interval of 3 to 4 weeks. This treatment however is often abandoned by the patient. The only therapeutic maneuvers (based on otolyte release) are equally effective but present a high medium term recurrence. To compare the efficacy of the Semont maneuver (SM), the VRE and the combination of both in the treatment of BPPV at three months of follow up. Forty patients with the clinical and electronystagmographic diagnosis of BPPV were divided into three groups: 1. SM, 2. VRE and 3. SM + VRE. The results were compared in regard to the signs and symptoms observed in the three groups of patients at 15 days, one month and at three months of treatment. The SM was effective in 80% of the patients at 15 days of treatment versus 45% of those receiving only VRE. The third group of patients, receiving the combined treatment, demonstrated a cure in 100% of the cases when evaluated at three months while only 66% of the SM group were found to be asymptomatic at the same time period (p < 0.05). The SM is easy to perform, rapid and effective in the short term, however has high recurrence. The VRE are effective in the long term based on the patient persistence. Combination of the two treatment leads to symptom remission in 100% of the patients at three months of treatment.

  3. Vestibular rehabilitation: clinical benefits to patients with Parkinson's disease

    OpenAIRE

    Zeigelboim, Bianca Simone [UNIFESP; Klagenberg, Karlin Fabianne; TEIVE, HÉLIO A. GHIZONI; Munhoz,Renato Puppi; Martins-Bassetto,Jackeline

    2009-01-01

    OBJECTIVE: To evaluate the effectiveness of the vestibular rehabilitation (VR) exercises by means of an assessment before and after the application of the Brazilian version of the Dizziness Handicap Inventory (DHI) questionnaire. METHOD: Twelve patients were studied, the following procedures were carried out: anamnesis, otorhinolaryngological and vestibular evaluation, and the application of the DHI before and after the VR. RESULTS: Clinically resting tremors and subjective postural instabili...

  4. Is the Headache in Patients with Vestibular Migraine Attenuated by Vestibular Rehabilitation?

    OpenAIRE

    Sugaya, Nagisa; ARAI, Miki; Goto, Fumiyuki

    2017-01-01

    Background Vestibular rehabilitation is the most effective treatment for dizziness due to vestibular dysfunction. Given the biological relationship between vestibular symptoms and headache, headache in patients with vestibular migraine (VM) could be improved by vestibular rehabilitation that leads to the improvement of dizziness. This study aimed to compare the effects of vestibular rehabilitation on headache and other outcomes relating to dizziness, and the psychological factors in patien...

  5. Interactive 3-dimensional virtual reality rehabilitation for patients with chronic imbalance and vestibular dysfunction.

    Science.gov (United States)

    Yeh, Shih-Ching; Chen, Shuya; Wang, Pa-Chun; Su, Mu-Chun; Chang, Chia-Huang; Tsai, Po-Yi

    2014-01-01

    Chronic imbalance is common in patients with vestibular dysfunction. Vestibular rehabilitation is effective in improving upright balance control. Vestibular rehabilitation exercises, such as Cawthorne-Cooksey exercises, include simple repetitive movements and have limited feedback and adaptive training protocols. Interactive systems based on virtual reality (VR) technology may improve vestibular rehabilitation. The objective of this study was to examine the effectiveness of an interactive 3-dimensional VR system for vestibular rehabilitation. In 49 subjects with vestibular dysfunction, VR rehabilitation exercises were performed in 6 sessions. Before and after rehabilitation, subjects were evaluated for performance of the training exercises; the center of pressure was measured for 20 seconds and balance indices were determined. Five training scores (total 6) showed a significant improvement. For balance indices in condition of non-stimulation, all of them (total 5) showed a trend of improvement, in which there was a significant improvement in mean mediolateral. For balance indices in condition of post-stimulation, there was a significant improvement in statokinesigram and maximum mediolateral. The VR rehabilitation exercises were effective in improving upright balance control in patients with vestibular dysfunction.

  6. Vestibular rehabilitation: clinical benefits to patients with Parkinson's disease.

    Science.gov (United States)

    Zeigelboim, Bianca Simone; Klagenberg, Karlin Fabianne; Teive, Hélio A Ghizoni; Munhoz, Renato Puppi; Martins-Bassetto, Jackeline

    2009-06-01

    To evaluate the effectiveness of the vestibular rehabilitation (VR) exercises by means of an assessment before and after the application of the Brazilian version of the Dizziness Handicap Inventory (DHI) questionnaire. Twelve patients were studied, the following procedures were carried out: anamnesis, otorhinolaryngological and vestibular evaluation, and the application of the DHI before and after the VR. Clinically resting tremors and subjective postural instability were the motor complaints most frequently associated with complaints of vertigo in 12 cases (100%); in the vestibular exam, all the patients presented abnormalities, frequently from the uni and bilateral peripheral vestibular deficiency syndromes in 10 cases (83.3%); there was significant improvement in the physical, functional and emotional aspects of the DHI after the completion of the VR. The VR following the Cawthorne and Cooksey protocol were shown to be useful in managing subjective complaints of several aspects evaluated in this protocol.

  7. Vestibular rehabilitation strategies and factors that affect the outcome.

    Science.gov (United States)

    Eleftheriadou, Anna; Skalidi, Nikoleta; Velegrakis, Georgios A

    2012-11-01

    Ever since the introduction of Cawthorne-Cooksey exercises, vestibular rehabilitation (VR) has been gaining popularity in the treatment of the dizzy patient. Numerous studies support the effectiveness of VR in improving balance/walking skills, eye-head coordination and the quality of life of the patient. Different rehabilitation protocols have been used to treat patients with peripheral and central vestibular disorders. Assessment of the patients' progress is based on the patients' selfperception of dizziness and their functional skills. Factors such as age, medication, time of onset of vertigo and home based VR have been evaluated on their effect on the rehabilitation's outcome. The aim of this review is to evaluate rehabilitation strategies and discuss the factors that affect the outcome.

  8. [Vestibular rehabilitation in patients with relapsing-remitting multiple sclerosis].

    Science.gov (United States)

    Pavan, Karina; Marangoni, Bruna E M; Schmidt, Kizi B; Cobe, Fernanda A; Matuti, Gabriela S; Nishino, Lúcia K; Thomaz, Rodrigo B; Mendes, Maria Fernanda; Lianza, Sérgio; Tilbery, Charles Peter

    2007-06-01

    Multiple sclerosis (MS) is a demyelinating, inflammatory illness, that attack the white matter of the central nervous system, and abnormal vestibular sensations (vertigo, disequilibrium) are frequent. The vestibular rehabilitation (VR) is determined by mechanisms of adaptations, neural substitutions and compensations. This study evaluated the improvement of the central or peripheral vertigo in patients with relapsing-remitting MS submitted to the VR (exercises of Cawthorne-Cooksey), through the scale of Berg and Dizziness Handicap Inventory (DHI). In this sample of 4 cases the VR, carried through in a period of 2 months, demonstrated the improvement in 3 patients according to the Berg scale and in 2 patients considering that of the DHI.

  9. Vestibular rehabilitation ameliorates chronic dizziness through the SIRT1 axis

    Directory of Open Access Journals (Sweden)

    Chung-Lan eKao

    2014-03-01

    Full Text Available Dizziness is a common clinical symptom frequently referred to general neurologists and practitioners. Exercise intervention, in the form of vestibular rehabilitation, is known as an effective clinical management for dizziness. This intervention is reported to have a functional role in correcting dizziness, improving gaze stability, retraining balance and gait and enhancing physical fitness. Dizziness is known to be highly related to inflammation and oxidative stress. SIRT1 is a major molecule for regulation of inflammation and mitigation of oxidative stress in chronic diseases such as atherosclerosis and chronic obstructive pulmonary disease. However, the bio-molecular roles of SIRT1 involved in the pathogenesis of dizziness are still largely unclear. In this study, a total of 30 subjects were recruited (15 patients with chronic dizziness, and 15 age/gender matched non-dizzy control subjects. The dizzy subjects group received 18 sessions of 30-minutes vestibular training. We found that the mRNA and protein expression levels of SIRT1 in the blood samples of chronic dizzy patients were repressed compared with those of healthy controls. After vestibular training, the dizzy patients had significant symptomatic improvements. The SIRT1 expression and its downstream genes (PPAR-γ and PGC-1α were upregulated after vestibular exercises in dizzy subjects. Notably, the catalytic activity of SIRT1, NADPH and antioxidant enzyme activities were also activated in dizzy patients after vestibular training. Furthermore, vestibular exercise training reduced oxidative events and p53 expression in patients with dizziness. This study demonstrated that vestibular exercise training improved dizziness symptoms, and mechanisms for alleviation of chronic dizziness may partly involve the activation of the SIRT1 axis and the repression of redox status.

  10. Vestibular rehabilitation: useful but not universally so.

    Science.gov (United States)

    Krebs, David E; Gill-Body, Kathleen M; Parker, Stephen W; Ramirez, Jose V; Wernick-Robinson, Mara

    2003-02-01

    Although vestibular rehabilitation (VR) is gaining popularity, few data support its utility in improving locomotor stability, and no good predictors exist of whom will benefit most. A double-blind, placebo-controlled randomized trial of vestibular rehabilitation was conducted at a large tertiary care hospital on 124 patients (59 +/- 18 years old) with unilateral (n = 51) or bilateral (n = 73) vestibular hypofunction, of whom 86 completed a 12-week intervention. Of these 86, 27 returned for long-term (1-year) follow-up testing. The primary outcome measure was locomotor stability. Group A (6 weeks of VR) significantly (P VR; there were no group differences at 1 year. Of the 86 who completed the intervention, 52 (61%) had clear locomotor gains. VR is helpful for most patients in providing locomotor stability, but further work is needed to determine the factors that prevent VR from being effective for all patients with vestibulopathy.

  11. Effects of Vestibular Rehabilitation Interventions in the Elderly with Chronic Unilateral Vestibular Hypofunction

    Science.gov (United States)

    Bayat, Arash; Saki, Nader

    2017-01-01

    Introduction: Although vestibular rehabilitation therapy (VRT) methods are relatively popular in treating patients with body balance deficits of vestibular origin, only limited studies have been conducted into customized exercises for unilateral vestibular hypofunction (UVH). Furthermore, very little evidence is available on the outcomes of VRT in the elderly population with chronic UVH. Materials and Methods: A total of 21 patients, aged 61 to 74 years, with UVH participated in this study. The dizziness handicap inventory (DHI) was performed immediately before, and 2 and 8 weeks after treatment. Results: All patients showed a reduction in DHI scores during the study. The average decrease in DHI score was 25.98 points after 2 weeks’ intervention (P0.05). There were no relationships between the scores and gender. Conclusion: Our study demonstrates that VRT is an effective method for the management of elderly patients with UVH, and shows maximal effect on functional aspects. PMID:28819615

  12. Does betahistine treatment have additional benefits to vestibular rehabilitation?

    Science.gov (United States)

    Karapolat, Hale; Celebisoy, Nese; Kirazli, Yesim; Bilgen, Cem; Eyigor, Sibel; Gode, Sercan; Akyuz, Aycan; Kirazli, Tayfun

    2010-08-01

    The aim of this study was to investigate the effect of high-dose betahistine treatment added to vestibular rehabilitation (VR) on the disability, balance and postural stability in patients with unilateral vestibular disorder. The VR group (group 1, n = 24) and the VR + betahistine group (group 2, n = 23) were analyzed retrospectively. All patients were evaluated before and after an 8-week customized VR in terms of disability (Dizziness Handicap Inventory, DHI), dynamic balance [Dynamic Gait Index (DGI)] and postural stability (static posturography). In group 1 and group 2, differences between DHI, DGI and falling index score on static posturography before and after the exercise program were significant (p VR and betahistine + VR have a positive effect on disability and balance in patients with unilateral vestibular disorder. Betahistine treatment added to VR was effective in increasing postural stability.

  13. Presbivértigo: ejercicios vestibulares Presbivertigo: vestibular exercises

    Directory of Open Access Journals (Sweden)

    Esther Bernal Valls

    2006-12-01

    Full Text Available El uso de ejercicios en el tratamiento de pacientes con déficit vestibular crónico está incrementándose de forma notable, lo que evidencia que se trata de un procedimiento que resulta beneficioso para este tipo de pacientes. Los buenos resultados que se obtienen sugieren que los ejercicios vestibulares dan lugar a una estabilidad postural y a una disminución de la sensación de desequilibrio.The use of exercises in the treatment of patients with vestibular deficits is increasing in a representative way, what evidences this is a profitable process for this kind of patients. The good results suggest that vestibular exercises permit a postural stability and a decrease in the perception of disequilibrium.

  14. Presbivértigo: ejercicios vestibulares Presbivertigo: vestibular exercises

    OpenAIRE

    Esther Bernal Valls; Víctor Faus Cuñat; Raquel Bernal Valls

    2006-01-01

    El uso de ejercicios en el tratamiento de pacientes con déficit vestibular crónico está incrementándose de forma notable, lo que evidencia que se trata de un procedimiento que resulta beneficioso para este tipo de pacientes. Los buenos resultados que se obtienen sugieren que los ejercicios vestibulares dan lugar a una estabilidad postural y a una disminución de la sensación de desequilibrio.The use of exercises in the treatment of patients with vestibular deficits is increasing in a represent...

  15. The Use of Computer-Assisted Home Exercises to Preserve Physical Function after a Vestibular Rehabilitation Program: A Randomized Controlled Study

    DEFF Research Database (Denmark)

    Brandt, Michael Smærup; Læssøe, Uffe; Grönvall, Erik

    2016-01-01

    Objective. The purpose of this study was to evaluate whether elderly patients with vestibular dysfunction are able to preserve physical functional level, reduction in dizziness, and the patient's quality of life when assistive computer technology is used in comparison with printed instructions...... their high functional level indicating that the elderly should not necessarily exercise for the first three months after termination of the training in the outpatient clinic. Conclusion. Elderly vestibular dysfunction patients exercising at home seem to maintain their functional level, level of dizziness...

  16. Interaction between Vestibular Compensation Mechanisms and Vestibular Rehabilitation Therapy: 10 Recommendations for Optimal Functional Recovery

    OpenAIRE

    Lacour, Michel; Bernard-Demanze, Laurence

    2015-01-01

    This review questions the relationships between the plastic events responsible for the recovery of vestibular function after a unilateral vestibular loss (vestibular compensation), which has been well described in animal models in the last decades, and the vestibular rehabilitation (VR) therapy elaborated on a more empirical basis for vestibular loss patients. The main objective is not to propose a catalog of results but to provide clinicians with an understandable view on when and how to per...

  17. Interaction between vestibular compensation mechanisms and vestibular rehabilitation therapy: ten recommendations for optimal functional recovery

    OpenAIRE

    LACOUR eMichel; BERNARD DEMANZE eLaurence

    2015-01-01

    This review questions the relationships between the plastic events responsible for the recovery of vestibular function after a unilateral vestibular loss (vestibular compensation), which has been well described in animal models in the last decades, and the vestibular rehabilitation (VR) therapy elaborated on a more empirical basis for vestibular loss patients. The main objective is not to propose a catalogue of results but to provide clinicians with an understandable view on when and how to p...

  18. Interactive Healthcare Systems in the Home: Vestibular Rehabilitation

    DEFF Research Database (Denmark)

    Aarhus, Rikke; Grönvall, Erik; Larsen, Simon Bo

    2010-01-01

    Vestibular dysfunction is a balance disorder, causing dizziness that provokes discomfort and fall situations. This paper discusses early results from a project that aims to develop assistive technologies to support home-based rehabilitation for elderly affected by Vestibular dysfunction.......Vestibular dysfunction is a balance disorder, causing dizziness that provokes discomfort and fall situations. This paper discusses early results from a project that aims to develop assistive technologies to support home-based rehabilitation for elderly affected by Vestibular dysfunction....

  19. The Effect of Vestibular Rehabilitation Therapy Program on Sensory Organization of Deaf Children With Bilateral Vestibular Dysfunction

    Directory of Open Access Journals (Sweden)

    Amir Abbas Ebrahimi

    2018-01-01

    Full Text Available The purpose of this study was to determine the effect of vestibular rehabilitation therapy program on the sensory organization of deaf children with bilateral vestibular dysfunction. This cross-sectional and analytic study was conducted on 24 students between the age of 7 and 12 years (6 girls and 18 boys with the profound sensorineural hearing loss (PTA>90 dB. They were assessed through the balance subtest in Bruininks-Oseretsky test of motor proficiency (BOTMP. For children which the total score of the balance subtest was 3 standard deviation lower than their peers with typical development, vestibular function testing was completed pre-intervention. Posturography Sensory organization testing (SOT was completed pre- and post-intervention with SPS (Synapsys, Marseille, France. Children with bilateral vestibular impairment were randomly assigned to either the exercise or control group. Exercise intervention consisted of compensatory training, emphasizing enhancement of visual and somatosensory function, and balance training. The exercise group entered in vestibular rehabilitation therapy program for 8 weeks. The children initially participating in the control group were provided the exercise intervention following the post-test. Based on the results there was significant difference in condition 5 and 6, areas of limits of stability (LOS, vestibular ratio and global score in posturography at the end of the intervention, but there was no significant difference in the control group in posturography (P<0.05. The results indicated that testing of vestibular, and postural control function, as well as intervention for deficiencies identified, should be included in deaf children rehabilitation program.

  20. The Effect of Vestibular Rehabilitation Therapy Program on Sensory Organization of Deaf Children With Bilateral Vestibular Dysfunction.

    Science.gov (United States)

    Ebrahimi, Amir Abbas; Jamshidi, Ali Ashraf; Movallali, Guita; Rahgozar, Mehdi; Haghgoo, Hojjat Allah

    2017-11-01

    The purpose of this study was to determine the effect of vestibular rehabilitation therapy program on the sensory organization of deaf children with bilateral vestibular dysfunction. This cross-sectional and analytic study was conducted on 24 students between the age of 7 and 12 years (6 girls and 18 boys) with the profound sensorineural hearing loss (PTA>90 dB). They were assessed through the balance subtest in Bruininks-Oseretsky test of motor proficiency (BOTMP). For children which the total score of the balance subtest was 3 standard deviation lower than their peers with typical development, vestibular function testing was completed pre-intervention. Posturography Sensory organization testing (SOT) was completed pre- and post-intervention with SPS (Synapsys, Marseille, France). Children with bilateral vestibular impairment were randomly assigned to either the exercise or control group. Exercise intervention consisted of compensatory training, emphasizing enhancement of visual and somatosensory function, and balance training. The exercise group entered in vestibular rehabilitation therapy program for 8 weeks. The children initially participating in the control group were provided the exercise intervention following the post-test. Based on the results there was significant difference in condition 5 and 6, areas of limits of stability (LOS), vestibular ratio and global score in posturography at the end of the intervention, but there was no significant difference in the control group in posturography (P<0.05). The results indicated that testing of vestibular, and postural control function, as well as intervention for deficiencies identified, should be included in deaf children rehabilitation program.

  1. Effects of vibrotactile vestibular substitution on vestibular rehabilitation - preliminary study,

    Directory of Open Access Journals (Sweden)

    Cibele Brugnera

    2015-12-01

    Full Text Available ABSTRACT INTRODUCTION: Some patients with severe impairment of body balance do not obtain adequate improvement from vestibular rehabilitation (VR. OBJECTIVE: To evaluate the effectiveness of Vertiguard(tm biofeedback equipment as a sensory substitution (SS of the vestibular system in patients who did not obtain sufficient improvement from VR. METHODS: This was a randomized prospective clinical study. Thirteen patients without satisfactory response to conventional VR were randomized into a study group (SG, which received the vibrotactile stimulus from Vertiguard(tm for ten days, and a control group (CG, which used equipment without the stimulus. For pre- and post-treatment assessment, the Sensory Organization Test (SOT protocol of the Computerized Dynamic Posturography (CDP and two scales of balance self-perception, Activities-specific Balance Confidence (ABC and Dizziness Handicap Inventory (DHI, were used. RESULTS: After treatment, only the SG showed statistically significant improvement in C5 (p = 0.007 and C6 (p = 0.01. On the ABC scale, there was a significant difference in the SG (p= 0.04. The DHI showed a significant difference in CG and SG with regard to the physical aspect, and only in the SG for the functional aspect (p = 0.04. CONCLUSION: The present findings show that sensory substitution using the vibrotactile stimulus of the Vertiguard(tm system helped with the integration of neural networks involved in maintaining posture, improving the strategies used in the recovery of body balance.

  2. Effects of vibrotactile vestibular substitution on vestibular rehabilitation - preliminary study.

    Science.gov (United States)

    Brugnera, Cibele; Bittar, Roseli Saraiva Moreira; Greters, Mário Edvin; Basta, Dietmar

    2015-01-01

    Some patients with severe impairment of body balance do not obtain adequate improvement from vestibular rehabilitation (VR). To evaluate the effectiveness of Vertiguard™ biofeedback equipment as a sensory substitution (SS) of the vestibular system in patients who did not obtain sufficient improvement from VR. This was a randomized prospective clinical study. Thirteen patients without satisfactory response to conventional VR were randomized into a study group (SG), which received the vibrotactile stimulus from Vertiguard™ for ten days, and a control group (CG), which used equipment without the stimulus. For pre- and post-treatment assessment, the Sensory Organization Test (SOT) protocol of the Computerized Dynamic Posturography (CDP) and two scales of balance self-perception, Activities-specific Balance Confidence (ABC) and Dizziness Handicap Inventory (DHI), were used. After treatment, only the SG showed statistically significant improvement in C5 (p=0.007) and C6 (p=0.01). On the ABC scale, there was a significant difference in the SG (p=0.04). The DHI showed a significant difference in CG and SG with regard to the physical aspect, and only in the SG for the functional aspect (p=0.04). The present findings show that sensory substitution using the vibrotactile stimulus of the Vertiguard™ system helped with the integration of neural networks involved in maintaining posture, improving the strategies used in the recovery of body balance. Copyright © 2015 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  3. Galvanic vestibular stimulation improves the results of vestibular rehabilitation.

    Science.gov (United States)

    Carmona, Sergio; Ferrero, Antonela; Pianetti, Guillermina; Escolá, Natalia; Arteaga, María Victoria; Frankel, Lilian

    2011-09-01

    Here, we present findings from a three-step investigation of the effect of galvanic vestibular stimulation (GVS) in normal subjects and in subjects undergoing vestibular rehabilitation (VR). In an initial study, we examined the body sway of 10 normal subjects after one minute of 2 mA GVS. The effect of the stimulation lasted for at least 20 minutes in all subjects and up to two hours in 70% of the subjects. We then compared a group of patients who received conventional VR (40 patients) with a group that received a combination of VR and GVS. Results suggest a significant improvement in the second group. Finally, we attempted to establish the optimal number of GVS sessions and to rule out a placebo effect. Fifteen patients received "systematic" GVS: five sessions, once a week. Five patients received "nonsystematic" galvanic stimulation in a sham protocol, which included two stimulations of the clavicle. These data were analyzed with Fisher's exact test and indicated that the best results were obtained after three sessions of GVS and no placebo effect was observed. © 2011 New York Academy of Sciences.

  4. Outcomes after vestibular rehabilitation and Wii® therapy in patients with chronic unilateral vestibular hypofunction.

    Science.gov (United States)

    Verdecchia, Daniel H; Mendoza, Marcela; Sanguineti, Florencia; Binetti, Ana C

    2014-01-01

    Vestibular rehabilitation therapy is an exercise-based programme designed to promote central nervous system compensation for inner ear deficit. The objective of the present study was to analyse the differences in the perception of handicap, the risk of falls, and gaze stability in patients diagnosed with chronic unilateral vestibular hypofunction before and after vestibular rehabilitation treatment with complementary Wii® therapy. A review was performed on the clinical histories of patients in the vestibular rehabilitation area of a university hospital between April 2009 and May 2011. The variables studied were the Dizziness Handicap Inventory, the Dynamic Gait Index and dynamic visual acuity. All subjects received complementary Wii® therapy. There were 69 cases (41 woman and 28 men), with a median age of 64 years. The initial median Dizziness Handicap Inventory score was 40 points (range 0-84, percentile 25-75=20-59) and the final, 24 points (range 0-76, percentile 25-75=10.40), P<.0001. The initial median for the Dynamic Gait Index score was 21 points (range 8-24, percentile 25-75=17.5-2.3) and the final, 23 (range 12-24, percentile 25-75=21-23), P<.0001. The initial median for dynamic visual acuity was 2 (range 0-6, percentile 25-75=1-4) and the final, 1 (range 0-3, percentile 25-75=0-2), P<.0001. A reduction was observed in the Dizziness Handicap Inventory Values. Values for the Dynamic Gait Index increased and dynamic visual acuity improved. All these variations were statistically significant. Copyright © 2013 Elsevier España, S.L.U. y Sociedad Española de Otorrinolaringología y Patología Cérvico-Facial. All rights reserved.

  5. The effect of vestibular rehabilitation on adults with bilateral vestibular hypofunction: a systematic review.

    Science.gov (United States)

    Porciuncula, Franchino; Johnson, Connie C; Glickman, Leslie B

    2012-01-01

    Adults with bilateral vestibular hypofunction (BVH) experience significant disability. A systematic review assessed evidence for vestibular rehabilitation (VR). NUMBER OF STUDIES: 14 studies. Search identification of studies based on inclusion criteria: (a) population: adults with BVH of peripheral origin; (b) interventions: vestibular exercises, balance training, education, or sensory prosthetics; (c) comparison: single interventions or compared to another psychophysical intervention, placebo, or healthy population; (d) outcomes: based on International Classification of Functioning, Disability and Health (ICF) Body Functions and Structure, Activity, and Participation; (e) study designs: prospective and interventional, Levels of Evidence I to III per Centre of Evidence-based Medicine grading. Coding and appraisal based on ICF framework and strength of evidence synthesis. Five Level II studies and nine Level III studies: All had outcomes on gaze and postural stability, five with outcomes on gait speed and perceptions of oscillopsia and disequilibrium. (a) Moderate evidence strength on improved gaze and postural stability (ICF-Body Functions) following exercise-based VR; (b) Inadequate number of studies supporting benefit of VR on ICF-Participation outcomes; (c) Sensory prosthetics in early phase of development. Moderate evidence strength in support of VR from an impairment level; clinical practice and research needed to explore interventions extending to ICF-Activity and Participation.

  6. Effects of vestibular rehabilitation and social reinforcement on recovery following ablative vestibular surgery.

    Science.gov (United States)

    Mruzek, M; Barin, K; Nichols, D S; Burnett, C N; Welling, D B

    1995-07-01

    This study investigated the relative effects of vestibular rehabilitation (VR) and social reinforcement (SR) on recovery following ablative vestibular surgery. Twenty-four subjects were randomly assigned to three treatment groups of either VR with SR, VR without SR, or general range of motion (ROM) exercises with SR. Outcome measures included equilibrium scores in dynamic posturography, asymmetry index in rotation testing, motion sensitivity quotient (MSQ), and dizziness handicap inventory (DHI). A multiple comparison of the overall outcome measures showed no significant differences in group performance over an 8-week period. When individual outcome measures were compared, MSQ and DHI results at the end of the 8-week treatment period revealed less motion sensitivity and dizziness handicap in groups who received VR, with or without SR, as compared with the group who received ROM exercises. These results suggest that after a vestibular injury most patients can effectively utilize central compensation mechanisms to recover from such an injury, regardless of the type of therapeutic intervention used. On the other hand, the reduction in motion sensitivity and dizziness handicap for patients who received VR could indicate a more rapid and complete recovery for these patients. This investigation is continuing as a long-term follow-up study to determine whether there are any long-term benefits in participating in a VR program.

  7. Manual therapy with and without vestibular rehabilitation for cervicogenic dizziness: a systematic review

    Directory of Open Access Journals (Sweden)

    Lystad Reidar P

    2011-09-01

    Full Text Available Abstract Background Manual therapy is an intervention commonly advocated in the management of dizziness of a suspected cervical origin. Vestibular rehabilitation exercises have been shown to be effective in the treatment of unilateral peripheral vestibular disorders, and have also been suggested in the literature as an adjunct in the treatment of cervicogenic dizziness. The purpose of this systematic review is to evaluate the evidence for manual therapy, in conjunction with or without vestibular rehabilitation, in the management of cervicogenic dizziness. Methods A comprehensive search was conducted in the databases Scopus, Mantis, CINHAL and the Cochrane Library for terms related to manual therapy, vestibular rehabilitation and cervicogenic dizziness. Included studies were assessed using the Maastricht-Amsterdam criteria. Results A total of fifteen articles reporting findings from thirteen unique investigations, including five randomised controlled trials and eight prospective, non-controlled cohort studies were included in this review. The methodological quality of the included studies was generally poor to moderate. All but one study reported improvement in dizziness following either unimodal or multimodal manual therapy interventions. Some studies reported improvements in postural stability, joint positioning, range of motion, muscle tenderness, neck pain and vertebrobasilar artery blood flow velocity. Discussion Although it has been argued that manual therapy combined with vestibular rehabilitation may be superior in the treatment of cervicogenic dizziness, there are currently no observational and experimental studies demonstrating such effects. A rationale for combining manual therapy and vestibular rehabilitation in the management of cervicogenic dizziness is presented. Conclusion There is moderate evidence to support the use of manual therapy, in particular spinal mobilisation and manipulation, for cervicogenic dizziness. The evidence

  8. Vestibular Rehabilitation for Peripheral Vestibular Hypofunction: An Evidence-Based Clinical Practice Guideline: FROM THE AMERICAN PHYSICAL THERAPY ASSOCIATION NEUROLOGY SECTION.

    Science.gov (United States)

    Hall, Courtney D; Herdman, Susan J; Whitney, Susan L; Cass, Stephen P; Clendaniel, Richard A; Fife, Terry D; Furman, Joseph M; Getchius, Thomas S D; Goebel, Joel A; Shepard, Neil T; Woodhouse, Sheelah N

    2016-04-01

    Uncompensated vestibular hypofunction results in postural instability, visual blurring with head movement, and subjective complaints of dizziness and/or imbalance. We sought to answer the question, "Is vestibular exercise effective at enhancing recovery of function in people with peripheral (unilateral or bilateral) vestibular hypofunction?" A systematic review of the literature was performed in 5 databases published after 1985 and 5 additional sources for relevant publications were searched. Article types included meta-analyses, systematic reviews, randomized controlled trials, cohort studies, case control series, and case series for human subjects, published in English. One hundred thirty-five articles were identified as relevant to this clinical practice guideline. Based on strong evidence and a preponderance of benefit over harm, clinicians should offer vestibular rehabilitation to persons with unilateral and bilateral vestibular hypofunction with impairments and functional limitations related to the vestibular deficit. Based on strong evidence and a preponderance of harm over benefit, clinicians should not include voluntary saccadic or smooth-pursuit eye movements in isolation (ie, without head movement) as specific exercises for gaze stability. Based on moderate evidence, clinicians may offer specific exercise techniques to target identified impairments or functional limitations. Based on moderate evidence and in consideration of patient preference, clinicians may provide supervised vestibular rehabilitation. Based on expert opinion extrapolated from the evidence, clinicians may prescribe a minimum of 3 times per day for the performance of gaze stability exercises as 1 component of a home exercise program. Based on expert opinion extrapolated from the evidence (range of supervised visits: 2-38 weeks, mean = 10 weeks), clinicians may consider providing adequate supervised vestibular rehabilitation sessions for the patient to understand the goals of the program

  9. Clinical benefits to vestibular rehabilitation in multiple sclerosis. Report of 4 cases.

    Science.gov (United States)

    Zeigelboim, Bianca; Liberalesso, Paulo; Jurkiewicz, Ari; Klagenberg, Karlin

    2010-01-01

    Balance difficulties are common among multiple sclerosis patients. To evaluate the effectiveness of the Cawthorne and Cooksey protocol of vestibular rehabilitation (VR) exercises in reducing the physical, functional and emotional impact of multiple sclerosis among individuals who complained of vertigo. Four patients with remittent-recurrent multiple sclerosis underwent an interview, otorhinolaryngological and vestibular evaluation, VR exercises and the Dizziness Handicap Inventory pre- and post-intervention. There was significant improvement in the physical, functional and emotional aspects of the DHI after the completion of the VR. The VR exercises appeared useful in reducing subjective complaints of the study participants.

  10. Top-down approach to vestibular compensation: translational lessons from vestibular rehabilitation

    Science.gov (United States)

    Balaban, Carey D.; Hoffer, Michael E.; Gottshall, Kim R.

    2012-01-01

    This review examines vestibular compensation and vestibular rehabilitation from a unified translational research perspective. Laboratory studies illustrate neurobiological principles of vestibular compensation at the molecular, cellular and systems levels in animal models that inform vestibular rehabilitation practice. However, basic research has been hampered by an emphasis on ‘naturalistic’ recovery, with time after insult and drug interventions as primary dependent variables. The vestibular rehabilitation literature, on the other hand, provides information on how the degree of compensation can be shaped by specific activity regimens. The milestones of the early spontaneous static compensation mark the re-establishment of static gaze stability, which provides a common coordinate frame for the brain to interpret residual vestibular information in the context of visual, somatosensory and visceral signals that convey gravitoinertial information. Stabilization of the head orientation and the eye orientation (suppression of spontaneous nystagmus) appear to be necessary by not sufficient conditions for successful rehabilitation, and define a baseline for initiating retraining. The lessons from vestibular rehabilitation in animal models offer the possibility of shaping the recovery trajectory to identify molecular and genetic factors that can improve vestibular compensation. PMID:22981400

  11. Recent Evidence About the Effectiveness of Vestibular Rehabilitation.

    Science.gov (United States)

    Whitney, Susan L; Alghadir, Ahmad H; Anwer, Shahnawaz

    2016-03-01

    Vestibular rehabilitation of persons with peripheral and central vestibular disorders requires a thorough evaluation and a customized plan of care. Collaboration of the various members of the treatment team optimizes outcomes. Early intervention appears to be better than referring patients who have developed chronic symptoms of balance loss, dizziness, anxiety, and depression. There is a body of emerging evidence that supports that the central nervous system has the capability to reweigh sensory inputs in order to improve function. There continues to be a dearth of knowledge related to how to treat persons with otolithic dysfunction as compared to those with semicircular canal damage. With the use of vestibular rehabilitation, patients are less likely to fall, are less dizzy, balance and gait improve, and quality of life is enhanced. Recent Cochrane reviews and a clinical practice guideline support the use of vestibular rehabilitation for persons with vestibular dysfunction. Typical symptoms and their management including dysregulated gait, falling, fear of falling, increased sway in standing, visual blurring, symptoms with complex visual scenes in the periphery, and weakness are all discussed with ideas for intervention. Any patient with a vestibular disorder may benefit from a trial of vestibular rehabilitation. A discussion of recent evidence and innovations related to vestibular rehabilitation is also included.

  12. Vestibular Rehabilitation in a Patient with Whiplash-associated Disorders

    Directory of Open Access Journals (Sweden)

    Kwo-Shieng Tuo

    2006-12-01

    Full Text Available Whiplash-associated disorders are characterized by multiple physical complaints after a flexion-extension trauma to the neck. They are difficult to treat, and they often result in great impact on the patient's quality of life. In this paper, the comprehensive treatment of a patient with whiplash-associated disorders is presented. The purpose is to highlight the importance of accurate diagnosis and appropriate treatment plans to improve patients' quality of life. This 23-year-old woman experienced a traffic accident which caused severely painful neck disability, numbness over bilateral upper limbs, dizziness, double vision and loss of balance. Among these symptoms, dizziness was the problem that bothered the patient most. She received a comprehensive rehabilitation program including physical modalities, trigger point injections for relief of pain, as well as a vestibular rehabilitation program, which included exercises challenging and improving her balance function, head-eye coordination exercise, visual-ocular control exercise and sensory substitution-promoting exercises. She resumed her previous full-time work after 3 weeks of treatment. This successfully treated case illustrates the importance of correct diagnosis and appropriate treatment for patients who suffer from whiplash-associated disorders.

  13. [Guided home-based vestibular rehabilitation assisted by audiovisual media].

    Science.gov (United States)

    Trinidad Ruiz, Gabriel; Domínguez Pedroso, Mónica; Cruz de la Piedad, Eduardo; Solís Vázquez, Raquel; Samaniego Regalado, Beatriz; Rejas Ugena, Eladio

    2010-01-01

    To describe the creation and validation process of a new audiovisual support model for the design of guided home-based vestibular rehabilitation programs (GHVR), we introduce a prospective experimental study. 89 patients who underwent vestibular rehabilitation (VR) were evaluated throughout 2009. For the model design, we built a video library with VR exercises that can be combined using DVD creation software to tailor VR protocols. Treatment incidents, adherence, need to convert to a posturography-based program and variations in the Dizziness Handicap Inventory (DHI) score and dynamic visual acuity (DVA) were assessed. A good response was found, not only with respect to adherence (5.6% abandonment), but also in the clinical parameters, with a mean DHI score variation of 33.14 points, and a decrease in lines lost in the DVA test from 4.24 to 1.52 lines at the end of the treatment. Our study results show the possibility of building an audiovisual aid for creating GHVR programs. Copyright © 2010 Elsevier España, S.L. All rights reserved.

  14. Humanoid assessing rehabilitative exercises.

    Science.gov (United States)

    Simonov, M; Delconte, G

    2015-01-01

    This article is part of the Focus Theme of Methods of Information in Medicine on "New Methodologies for Patients Rehabilitation". The article presents the approach in which the rehabilitative exercise prepared by healthcare professional is encoded as formal knowledge and used by humanoid robot to assist patients without involving other care actors. The main objective is the use of humanoids in rehabilitative care. An example is pulmonary rehabilitation in COPD patients. Another goal is the automated judgment functionality to determine how the rehabilitation exercise matches the pre-programmed correct sequence. We use the Aldebaran Robotics' NAO humanoid to set up artificial cognitive application. Pre-programmed NAO induces elderly patient to undertake humanoid-driven rehabilitation exercise, but needs to evaluate the human actions against the correct template. Patient is observed using NAO's eyes. We use the Microsoft Kinect SDK to extract motion path from the humanoid's recorded video. We compare human- and humanoid-operated process sequences by using the Dynamic Time Warping (DTW) and test the prototype. This artificial cognitive software showcases the use of DTW algorithm to enable humanoids to judge in near real-time about the correctness of rehabilitative exercises performed by patients following the robot's indications. One could enable better sustainable rehabilitative care services in remote residential settings by combining intelligent applications piloting humanoids with the DTW pattern matching algorithm applied at run time to compare humanoid- and human-operated process sequences. In turn, it will lower the need of human care.

  15. Guided and unguided internet based vestibular rehabilitation versus usual care for dizzy adults of 50 years and older: a protocol for a three armed randomised trial

    OpenAIRE

    van Vugt, V; van der Wouden, C; Bosmans, J; Smallbrugge, M; van Diest, W; Essery, Rosie; Yardley, Lucy; H Horst; Maarsingh, O

    2017-01-01

    Introduction Dizziness is a common symptom in general practice with a high prevalence among older adults. The most common cause of dizziness in general practice is peripheral vestibular disease. Vestibular rehabilitation (VR) is a safe and effective treatment for peripheral vestibular disease that entails specific exercises to maximise the central nervous system compensation for the effects of vestibular pathology. An internet-based VR intervention has recently been shown to be safe and effec...

  16. Vestibular rehabilitation using a wide field of view virtual environment.

    Science.gov (United States)

    Sparto, P J; Furman, J M; Whitney, S L; Hodges, L F; Redfern, M S

    2004-01-01

    This paper presents a theoretical justification for using a wide field of view (FOV) virtual reality display system for use in vestibular rehabilitation. A wide FOV environment offers some unique features that may be beneficial to vestibular rehabilitation. Primarily, optic flow information extracted from the periphery may be critical for recalibrating the sensory processes used by people with vestibular disorders. If this hypothesis is correct, then wide FOV systems will have an advantage over narrow field of view input devices such as head mounted or desktop displays. Devices that we have incorporated into our system that are critical for monitoring improvement in this clinical population will also be described.

  17. Vestibular rehabilitation: clinical benefits to patients with Parkinson's disease Reabilitação vestibular: utilidade clínica em pacientes com doença de Parkinson

    National Research Council Canada - National Science Library

    Bianca Simone Zeigelboim; Karlin Fabianne Klagenberg; Hélio A. Ghizoni Teive; Renato Puppi Munhoz; Jackeline Martins-Bassetto

    2009-01-01

    OBJECTIVE: To evaluate the effectiveness of the vestibular rehabilitation (VR) exercises by means of an assessment before and after the application of the Brazilian version of the Dizziness Handicap Inventory (DHI) questionnaire. METHOD...

  18. [Presbyastasis and application of vestibular rehabilitation in geriatrics].

    Science.gov (United States)

    Costa de Araujo, P; Demanez, L; Lechien, J; Bauvir, P; Petermans, J

    2011-03-01

    Balance disorders can have a major functional impact among the elderly. The main risk is falling. Three elements are implicated in the loss of balance: vision, proprioception and the vestibular system. This article will discuss mainly vestibular damage and its implications. The assessment of balance disorders, particularly in geriatric patients, is based on validated scales composed of several items. These provide scores and are based on the results of chronometric measurements. They can be useful for the application of Vestibular Rehabilitation (VR), a technique improving the adaptation and autonomy of these patients. Vestibular rehabilitation is therefore part of an overall support, the goal of therapy being to improve daily life and to reduce the risk of falls.

  19. Treating vertigo with vestibular rehabilitation: results in 155 patients.

    Science.gov (United States)

    Bittar, R S M; Pedalini, M E B; Lorenzi, M C; Formigoni, L G

    2002-01-01

    Balance is fundamental to our daily activities and the vestibular system, together with vision and proprioceptive functions, are the main structures involved in this process. Dizziness is the main clinical manifestation of malfunction of these systems. The mechanisms of vestibular compensation are one of the most studied aspects since they play an important role in the patient's everyday activities. In this retrospective description of a series of cases the authors present their results in 155 patients that underwent a program of vestibular rehabilitation (VR). The program, first described by Cawthorne and Coosey, is based on mechanisms of potentiation of the cervico-ocular reflex and substitution of the lost vestibular cues for visual and somatosensory cues. The results were satisfactory (remission or partial cure) in 75.5% of the patients, with an average treatment time of up to 2 months and 5 or fewer sessions performed in most of the cases. The results were somewhat inferior in those cases in which a central vestibular lesion or more than one etiologic factor was present. The results of a subgroup of elderly patients (age > 65 years) were similar to those of the total number of studied subjects. Vestibular rehabilitation, associated to the specific etiological treatment, appears to be a very useful tool in the management of patients suffering from dizziness of all ages, although different clinical responses to the therapy may vary according to the presence of a central or a peripheral vestibular lesion or multiple etiological factors.

  20. Effects of vestibular rehabilitation in the elderly: a systematic review.

    Science.gov (United States)

    Martins E Silva, Diandra Caroline; Bastos, Victor Hugo; de Oliveira Sanchez, Mariana; Nunes, Monara Kedma Gomes; Orsini, Marco; Ribeiro, Pedro; Velasques, Bruna; Teixeira, Silmar Silva

    2016-08-01

    Aging is characterized by gradual physiological changes in body systems. Changes in the vestibular system can occur and cause dizziness, vertigo and imbalance, symptoms that are common in the elderly. Vestibular rehabilitation is a therapeutic resource that has been widely used to improve this condition. To complete a systematic review of the effects of vestibular rehabilitation on the elderly. A search for relevant publications was conducted in SCIELO, PUBMED, MEDLINE, COCHRANE and LILACS databases. Clinical trials and cohort studies that were written in the English language and published over the course of the last 10 years were selected. The methodological quality of the studies was assessed using the PEDro scale. A critical analysis of the studies was composed. Eight studies that involved subjects who were over the age of 60 were selected for inclusion in the systematic review. The most common vestibular dysfunction identified was complaints about dizziness and imbalance. The Dizziness Handicap Inventory was the most frequently used assessment instrument, and the treatment protocol that prevailed was that suggested by Cawthorne and Cooksey. The PEDro scale showed that only one article was of an acceptable methodological quality and presented satisfactory outcome measures. This was due, in part, to a lack of a hidden randomization, masking of the subject, evaluators and therapists, and lack of outcome measures, which can reduce the quality of the evidence presented in this study. Clinical trials indicate that vestibular rehabilitation represents an effective means of treating elderly patients with vestibular disorders; however, evidence of its effectiveness remains lacking.

  1. Vestibular telemedicine and rehabilitation. Applications for virtual reality.

    Science.gov (United States)

    Viirre, E

    1996-01-01

    This paper will discuss the use of Virtual Reality (VR) technologies in the rehabilitation of patients with vestibular disorders and in the provision of remote medical consultations for those patients. Patients with a vestibular problem are very common (vertigo is the second most common neurological complaint after headache) and yet there are very few vestibular neurotologists: specialists in their diagnosis and treatment. New treatments for various disorders causing vertigo now exist. This means that appropriate diagnosis can significantly improve patients' well-being. Remote medical diagnosis and treatment facilities could make the few vestibular disorder specialists much more available to patients. An analysis of the technological and economic factors influencing the provision of this service is necessary. The main long term effect of many vestibular disorders is damage to the sensing apparatus of the inner ear. The damage can lead to inappropriate interaction between visually driven orientation sensing and sensing of orientation by the inner ear. The consequence for the patient is vertigo (a sensation of turning), motion sickness and imbalance. Current rehabilitation efforts are intended to drive the nervous system to adapt to the disordered vestibular input. Adaptation appears to occur slowly in many subjects, even those within rehabilitation programs. An appropriately designed VR experience could greatly increase the rate of adaptation in these patients.

  2. Preliminary evidence of improved cognitive performance following vestibular rehabilitation in children with combined ADHD (cADHD) and concurrent vestibular impairment.

    Science.gov (United States)

    Lotfi, Younes; Rezazadeh, Nima; Moossavi, Abdollah; Haghgoo, Hojjat Allah; Rostami, Reza; Bakhshi, Enayatollah; Badfar, Faride; Moghadam, Sedigheh Farokhi; Sadeghi-Firoozabadi, Vahid; Khodabandelou, Yousef

    2017-12-01

    Balance function has been reported to be worse in ADHD children than in their normal peers. The present study hypothesized that an improvement in balance could result in better cognitive performance in children with ADHD and concurrent vestibular impairment. This study was designed to evaluate the effects of comprehensive vestibular rehabilitation therapy on the cognitive performance of children with combined ADHD and concurrent vestibular impairment. Subject were 54 children with combined ADHD. Those with severe vestibular impairment (n=33) were randomly assigned to two groups that were matched for age. A rehabilitation program comprising overall balance and gate, postural stability, and eye movement exercises was assigned to the intervention group. Subjects in the control group received no intervention for the same time period. Intervention was administered twice weekly for 12 weeks. Choice reaction time (CRT) and spatial working memory (SWM) subtypes of the Cambridge Neuropsychological Test Automated Battery (CANTAB) were completed pre- and post-intervention to determine the effects of vestibular rehabilitation on the cognitive performance of the subjects with ADHD and concurrent vestibular impairment. ANCOVA was used to compare the test results of the intervention and control group post-test. The percentage of correct trial scores for the CRT achieved by the intervention group post-test increased significantly compared to those of the control group (p=0.029). The CRT mean latency scores were significantly prolonged in the intervention group following intervention (p=0.007) compared to the control group. No significant change was found in spatial functioning of the subjects with ADHD following 12 weeks of intervention (p>0.05). The study highlights the effect of vestibular rehabilitation on the cognitive performance of children with combined ADHD and concurrent vestibular disorder. The findings indicate that attention can be affected by early vestibular

  3. Effects of vestibular rehabilitation in the elderly complaining of dizziness

    Directory of Open Access Journals (Sweden)

    Andréa Paz-Oliveira

    2014-08-01

    Full Text Available Changes of body balance are among the most common complaints of the elderly. Vestibular rehabilitation is one of the most effective methods in the recovery of the body balance. The objective to investigate the effects of vestibular rehabilitation in body balance of a group of elderly people with dizziness complain through dizziness handicap inventory. The sample was comprised of 10 seniors (6 women and 4 men with mean age of 68.9 years. The elderly complaining of dizziness showed high score in the DHI in the physical, functional and emotional aspects in the condition pre-VR and these values decreased after vestibular rehabilitation program. Complaints of dizziness also decreased after the implementation of the programmee.  

  4. Vestibular rehabilitation in a university hospital

    OpenAIRE

    Flávia da Silva Tavares; Maria Francisca Colella dos Santos; Keila Alessandra Baraldi Knobel

    2008-01-01

    A Reabilitação Vestibular visa melhorar o equilíbrio global, a qualidade de vida e orientação espacial dos pacientes com tontura. OBJETIVOS: Traçar o perfil dos pacientes atendidos no Ambulatório de Reabilitação Vestibular do Setor de Otoneurologia de um hospital universitário e verificar os resultados obtidos no período de novembro/2000 a dezembro/2004. MATERIAL E MÉTODO: Levantamento de dados contidos nas fichas dos 93 pacientes submetidos à Reabilitação Vestibular no período. FORMA DE ESTU...

  5. Effectiveness of Vestibular Rehabilitation in Hemodialysis Patients With Dizziness.

    Science.gov (United States)

    Dai, Chin-Ying; Lin, Su-Chun; Peng, Hui-Ling; Chung, Yueh-Chin; Chen, Shu-Wen; Feng, Ying-Feng; Tung, Yi-Chen; Liu, Wen-Miao

    This study evaluated the effectiveness of vestibular rehabilitation (VR) for hemodialysis (HD) patients with chronic dizziness. A single-blind, randomized controlled study was performed. Cluster-randomized sampling was used to select the experimental group from two outpatient dialysis clinics. A total of 26 patients participated in the study. Dizziness Handicap Inventory (DHI) and falls were used as outcome measures. Data were collected at baseline (T1), 3 months (T2), and 6 months (T3). Two-way repeated-measures ANOVA of DHI revealed a statistically significant group and time interaction. Dizziness handicap outcome was significantly reduced over time in the experimental group (DHI total score, T1 = 35.29, T2 = 32.86, T3 = 27.86, p = .001). VR exercise instructed by nurses can be effective in alleviating handicap imposed by dizziness in dialysis patients. Nurses are encouraged to learn VR as a simple exercise to improve well-being in dialysis patients with chronic dizziness.

  6. Gaze stabilization exercises derive sensory reweighting of vestibular for postural control.

    Science.gov (United States)

    Ueta, Yusuke; Matsugi, Akiyoshi; Oku, Kosuke; Okuno, Kojiro; Tamaru, Yoshiki; Nomura, Shohei; Tanaka, Hiroaki; Douchi, Shinya; Mori, Nobuhiko

    2017-09-01

    [Purpose] The aim of this study was to investigate whether gaze stabilization exercise derives sensory reweighting of vestibular for upright postural control. [Subjects and Methods] Twenty-three healthy volunteers participated in this study. The center of pressure of the total trajectory length was measured before (pre), immediately after (post), and 10 min after (post10) gaze stabilization exercise, in the static standing position, with the eyes open or closed, on the floor or on foam rubber. The sensory contribution values of the visual, somatosensory, and vestibular systems were calculated using center of pressure of the total trajectory length value in these measuring conditions. [Results] The center of pressure of the total trajectory length on foam rubber in post and post10 were significantly lower than that in the pre. The sensory contribution values of vestibular in post10 stages were significantly higher than that in pre-stage. [Conclusion] Gaze stabilization exercise can improve the static body balance in a condition that particularly requires vestibular function. The possible mechanism involves increasing sensory contribution of the vestibular system for postural control by the gaze stabilization exercise, which may be useful to derive sensory reweighting of the vestibular system for rehabilitation.

  7. Gaze stabilization exercises derive sensory reweighting of vestibular for postural control

    Science.gov (United States)

    Ueta, Yusuke; Matsugi, Akiyoshi; Oku, Kosuke; Okuno, Kojiro; Tamaru, Yoshiki; Nomura, Shohei; Tanaka, Hiroaki; Douchi, Shinya; Mori, Nobuhiko

    2017-01-01

    [Purpose] The aim of this study was to investigate whether gaze stabilization exercise derives sensory reweighting of vestibular for upright postural control. [Subjects and Methods] Twenty-three healthy volunteers participated in this study. The center of pressure of the total trajectory length was measured before (pre), immediately after (post), and 10 min after (post10) gaze stabilization exercise, in the static standing position, with the eyes open or closed, on the floor or on foam rubber. The sensory contribution values of the visual, somatosensory, and vestibular systems were calculated using center of pressure of the total trajectory length value in these measuring conditions. [Results] The center of pressure of the total trajectory length on foam rubber in post and post10 were significantly lower than that in the pre. The sensory contribution values of vestibular in post10 stages were significantly higher than that in pre-stage. [Conclusion] Gaze stabilization exercise can improve the static body balance in a condition that particularly requires vestibular function. The possible mechanism involves increasing sensory contribution of the vestibular system for postural control by the gaze stabilization exercise, which may be useful to derive sensory reweighting of the vestibular system for rehabilitation. PMID:28931974

  8. Effects of vestibular rehabilitation therapy on emotional aspects in chronic vestibular patients.

    Science.gov (United States)

    Meli, Annalisa; Zimatore, Giovanna; Badaracco, Carlo; De Angelis, Ezio; Tufarelli, Davide

    2007-08-01

    A strong relationship exists between vestibular dysfunction and anxiety disorders. The aim of this study was to assess the anxiety and depression levels in patients with chronic dizziness and to assess the effects of vestibular rehabilitation (VR) therapy, on the anxiety and depression levels, without a behavioural or pharmacological therapy. Two groups of 40 patients, each affected by chronic vestibular deficit, were studied. The first one underwent VR, and the latter did not. The psychometric tests used were the State-Trait Anxiety Inventory (STAI) and the Centre for Epidemiological Studies Depression Scale (CES-D). Psychological factors influence the level of handicap experienced by chronic dizziness patients, and disequilibrium influences the anxiety and depression levels. STAI and CES-D scales significantly decrease after VR therapy (PVR therapy positively influences the emotional condition of chronic vestibular deficit patients without pharmacological or psychotherapy treatments.

  9. Vestibulary rehabilitation--election treatment method for compensating vestibular impairment.

    Science.gov (United States)

    Georgescu, Mădălina; Stoian, Sorina; Mogoantă, Carmen Aurelia; Ciubotaru, Gh V

    2012-01-01

    This paper aims to reveal the actual benefit of vestibular rehabilitation (VR) in patients with unilateral vestibular loss. Case report of a young female patient with acute unilateral vestibular loss due to facial nerve schwannoma developed above the internal auditory canal (IAC) from where it seems to have entered the IAC. Betahistine associated to VR treatment was recommended due to persisting imbalance after tumor removal. The benefit of the combined therapy was evaluated objectively (sensory organization test) and subjectively (questionnaires regarding self-perception of the deficit in quality of life). Both evaluations revealed great improvement in stability (SOT scores) as well as in health-related quality of life (HRQoL)--improvement of self-perception scores of disequilibrium in all questionnaires used. Combined recommended treatment (betahistine and VR) improves HRQoL after acute unilateral vestibular loss. It reduces self-perceived disability and intensity of symptoms during usual activities.

  10. Reabilitação vestibular no tratamento da tontura e do zumbido Vestibular rehabilitation in the treatment of dizziness and tinnitus

    Directory of Open Access Journals (Sweden)

    Bianca Simone Zeigelboim

    2008-01-01

    Full Text Available OBJETIVO: Verificar a efetividade dos exercícios de reabilitação vestibular na melhora do zumbido e da tontura por meio de avaliação pré e pós-aplicação do questionário Dizziness Handicap Inventory (DHI e Tinnitus Handicap Inventory (THI, ambos adaptados à população brasileira. MÉTODOS: Avaliaram-se seis pacientes (dois do sexo masculino e quatro do sexo feminino, na faixa etária de 43 a 70 anos. Os pacientes foram submetidos aos seguintes procedimentos: anamnese, inspeção otológica, avaliação vestibular por meio da vectoeletronistagmografia e aplicação dos questionários pré e pós-reabilitação vestibular, utilizando-se o protocolo de Cawthorne e Cooksey. RESULTADOS: a com relação às queixas mais referidas, observou-se desequilíbrio à marcha (83,3%, dor de cabeça (66,6% e depressão (66,6%; b no exame vestibular todos os pacientes apresentaram alteração na prova calórica, sendo a maior freqüência das síndromes vestibulares periféricas irritativas (83,3%; c constataram-se no exame vestibular dois casos de síndrome vestibular periférica irritativa, dois casos de síndrome vestibular periférica irritativa unilateral; um caso de síndrome vestibular periférica irritativa bilateral e um caso de síndrome vestibular periférica deficitária unilateral; d na aplicação do DHI, observou-se melhora nos aspectos: funcional e emocional, mantendo-se inalterado o aspecto físico; e na aplicação do THI, observou-se melhora em todos os aspectos avaliados. CONCLUSÃO: O protocolo utilizado de reabilitação vestibular promoveu diminuição do zumbido e da tontura, melhorando a qualidade de vida dos pacientes.PURPOSE: To verify the effectiveness of vestibular rehabilitation exercises in the improvement of tinnitus and dizziness through an evaluation carried out before and after the administration of the Dizziness Handicap Inventory (DHI and the Tinnitus Handicap Inventory (DHI questionnaires, both adapted to the

  11. Vestibular rehabilitation with visual stimuli in peripheral vestibular disorders

    National Research Council Canada - National Science Library

    Manso, Andréa; Ganança, Mauricio Malavasi; Caovilla, Heloisa Helena

    2016-01-01

    ...) or Cawthorne-Cooksey exercises (control group). The Dizziness Handicap Inventory (DHI), dizziness analog scale, and the sensitized Romberg static balance and one-leg stance tests were applied before and after...

  12. [Clinical value of dynamic posturography in the evaluation and rehabilitation of vestibular function of patients with benign paroxysmal positional vertigo].

    Science.gov (United States)

    Zhang, Dao-gong; Fan, Zhao-min; Han, Yue-chen; Yu, Gang; Wang, Hai-bo

    2010-09-01

    To explore the clinical value of dynamic posturography in the evaluation and rehabilitation of vestibular function of patients with benign paroxysmal positional vertigo (BPPV). A total of 48 patients with BPPV of posterior semicircular canal in vertigo clinic of our hospital from May 2007 to December 2008 were retrospectively analyzed in this study. All patients underwent the inspection of caloric test, static posturography, and dynamic posturography. The vestibular tests were performed at two different time points: at onset when patients had typical nystagmus provoked by the Dix-Hallpike maneuver before treatment with the Epley maneuver (canalith repositioning maneuver, CRM), and at one week after treatment with CRM as their nystagmus disappeared. And results at theses two time points were compared. Eight patients whose dynamic balances were still abnormal after CRM accepted vestibular rehabilitation exercise using dynamic posturography, and re-examined 3 weeks later with dynamic posturography. Among 48 cases of BPPV, the abnormal rates of caloric test, static posturography, and dynamic posturography before CRM were 25.0%, 33.3% and 70.8%, respectively. The abnormal rate of dynamic posturography was much higher than that of caloric test or static posturography, and the differences were statistically significant (χ² = 4.84, 7.88; P 0.05). Eight patients whose dynamic balances were still abnormal after CRM, accepted vestibular rehabilitation exercise lasting 3 weeks using dynamic posturography. The dynamic balances were all improved to normal after vestibular rehabilitation. Dynamic posturography can quantitatively analyze postural balance, and is helpful in comprehensive evaluation of the vestibular function of BPPV patients. Impaired balance often presents in patients with BPPV. Treatment of BPPV using the canalith repositioning maneuver results in improved postural stability in static and dynamic posturography. However, not all patients have normal dynamic

  13. Vestibular Rehabilitation After Traumatic Brain Injury: Case Series.

    Science.gov (United States)

    Kleffelgaard, Ingerid; Soberg, Helene Lundgaard; Bruusgaard, Kari A; Tamber, Anne L; Langhammer, Birgitta

    2016-06-01

    There has been an increasing focus on vestibular rehabilitation (VR) after traumatic brain injury (TBI) in recent years. However, detailed descriptions of the content of and patient responses to VR after TBI are limited. The purposes of this case series are (1) to describe a modified, group-based VR intervention and (2) to examine changes in self-reported and performance-based outcome measures. Two women and 2 men (aged 24-45 years) with mild TBI, dizziness, and balance problems participated in an 8-week intervention consisting of group sessions with guidance, individually modified VR exercises, a home exercise program, and an exercise diary. Self-reported and performance-based outcome measures were applied to assess the impact of dizziness and balance problems on functions related to activity and participation. The intervention caused no adverse effects. Three of the 4 patients reported reduced self-perceived disability because of dizziness, diminished frequency and severity of dizziness, improved health-related quality of life, reduced psychological distress, and improved performance-based balance. The change scores exceeded the minimal detectable change, indicating a clinically significant change or improvement in the direction of age-related norms. The fourth patient did not change or improve in most outcome measures. A modified, group-based VR intervention was safe and appeared to be viable and beneficial when addressing dizziness and balance problems after TBI. However, concurrent physical and psychological symptoms, other neurological deficits, and musculoskeletal problems might influence the course of central nervous system compensation and recovery. The present case series may be useful for tailoring VR interventions to patients with TBI. Future randomized controlled trials are warranted to evaluate the short- and long-term effects of VR after TBI. © 2016 American Physical Therapy Association.

  14. Exercise rehabilitation for smartphone addiction

    National Research Council Canada - National Science Library

    Hyunna Kim

    2013-01-01

    Internet addiction after launching smartphone is becoming serious. Therefore this paper has attempted to sketch out the diverse addiction treatment and then check the feasibility of exercise rehabilitation...

  15. Interaction between vestibular compensation mechanisms and vestibular rehabilitation therapy: ten recommendations for optimal functional recovery

    Directory of Open Access Journals (Sweden)

    LACOUR eMichel

    2015-01-01

    Full Text Available This review questions the relationships between the plastic events responsible for the recovery of vestibular function after a unilateral vestibular loss (vestibular compensation, which has been well described in animal models in the last decades, and the vestibular rehabilitation (VR therapy elaborated on a more empirical basis for vestibular loss patients. The main objective is not to propose a catalogue of results but to provide clinicians with an understandable view on when and how to perform VR therapy, and why VR may benefit from basic knowledge and may influence the recovery process. With this perspective, 10 major recommendations are proposed as ways to identify an optimal functional recovery. Among them are the crucial role of active and early VR therapy, coincidental with a post-lesion sensitive period for neuronal network remodelling, the instructive role that VR therapy may play in this functional reorganisation, the need for progression in the VR therapy protocol, which is based mainly on adaptation processes, the necessity to take into account the sensorimotor, cognitive and emotional profile of the patient to propose individual or à la carte VR therapies, and the importance of motivational and ecologic contexts. More than 10 general principles are very likely, but these principles seem crucial for the fast recovery of vestibular loss patients to ensure good quality of life.

  16. Interaction between Vestibular Compensation Mechanisms and Vestibular Rehabilitation Therapy: 10 Recommendations for Optimal Functional Recovery.

    Science.gov (United States)

    Lacour, Michel; Bernard-Demanze, Laurence

    2014-01-01

    This review questions the relationships between the plastic events responsible for the recovery of vestibular function after a unilateral vestibular loss (vestibular compensation), which has been well described in animal models in the last decades, and the vestibular rehabilitation (VR) therapy elaborated on a more empirical basis for vestibular loss patients. The main objective is not to propose a catalog of results but to provide clinicians with an understandable view on when and how to perform VR therapy, and why VR may benefit from basic knowledge and may influence the recovery process. With this perspective, 10 major recommendations are proposed as ways to identify an optimal functional recovery. Among them are the crucial role of active and early VR therapy, coincidental with a post-lesion sensitive period for neuronal network remodeling, the instructive role that VR therapy may play in this functional reorganization, the need for progression in the VR therapy protocol, which is based mainly on adaptation processes, the necessity to take into account the sensorimotor, cognitive, and emotional profile of the patient to propose individual or "à la carte" VR therapies, and the importance of motivational and ecologic contexts. More than 10 general principles are very likely, but these principles seem crucial for the fast recovery of vestibular loss patients to ensure good quality of life.

  17. Exercise gaming – a motivational approach for older adults with vestibular dysfunction

    DEFF Research Database (Denmark)

    Brandt, Michael Smærup; Grönvall, Erik; Larsen, Simon Bo

    2016-01-01

    , but their knowledge and understanding of the training programme were insufficient. The participants asked for a greater variation in the exercises and asked for closer contact with the physiotherapist. When Mitii is used for vestibular rehabilitation, the system has some limitations. Conclusions The modest level......Purpose The purpose of the study was to identify possible reasons for a modest level of exercise compliance during computer-assisted training for vestibular rehabilitation. Method Qualitative design and analysis of 14 semi-structured interviews with seven participants before and after a period...... with computer-assisted home training. The interviews evolved around themes, such as the elderly participants' self-efficacy, motivation and acceptance of the technology. Results Age was not an excuse for the modest exercise compliance. The participants were basically self-efficient and accepted the technology...

  18. Vestibular rehabilitation following surgical repair for Superior Canal Dehiscence Syndrome: A complicated case report.

    Science.gov (United States)

    Carender, Wendy J; Grzesiak, Melissa

    2018-02-01

    Superior Canal Dehiscence Syndrome (SCDS) causes auditory and vestibular symptoms. Following surgical repair of the dehiscence, patients often experience dizziness and imbalance. This case report describes a postoperative vestibular exercise program, focusing on the principles of central compensation and habituation, and how it was modified for a patient with delayed progress secondary to strabismus and visual vertigo. A 63-year-old male with history of strabismus eye surgery, right hearing loss, aural fullness, and sensitivity to loud sounds was referred for vestibular rehabilitation (VR). He was seen for one preoperative and six postoperative PT visits over eight months. Outcome measures two weeks postoperative were as follows: Dizziness Handicap Inventory (DHI) 38/100; Timed Up & Go (TUG) 9.92 seconds; Dynamic Gait Index (DGI) 16/24; and a 3-line difference in Dynamic Visual Acuity (DVA). Improved outcomes at discharge included: DHI 18/100; TUG 6.87 seconds; DGI 23/24; and 1-line difference in DVA. He was able to return to work and previously enjoyed recreational activities. Postoperative vestibular rehabilitation programs are functionally and symptomatically beneficial following surgical repair for SCDS. Deviations from expected recovery should be addressed to achieve optimal outcomes as demonstrated in this complicated case report.

  19. Effects of conventional versus multimodal vestibular rehabilitation on functional capacity and balance control in older people with chronic dizziness from vestibular disorders: design of a randomized clinical trial.

    Science.gov (United States)

    Aquaroni Ricci, Natalia; Aratani, Mayra Cristina; Caovilla, Heloisa Helena; Freitas Ganança, Fernando

    2012-12-31

    There are several protocols designed to treat vestibular disorders that focus on habituation, substitution, adaptation, and compensation exercises. However, protocols that contemplate not only vestibular stimulation but also other components that are essential to the body balance control in older people are rare. This study aims to compare the effectiveness of two vestibular rehabilitation protocols (conventional versus multimodal) on the functional capacity and body balance control of older people with chronic dizziness due to vestibular disorders. A randomized, single-blind, controlled clinical trial with a 3 months follow-up period will be performed. The sample will be composed of older individuals with a clinical diagnosis of chronic dizziness resulting from vestibular disorders. The subjects will be evaluated at baseline, post-treatment and follow-up. Primary outcomes will be determined in accordance with the Dizziness Handicap Inventory (functional capacity) and the Dynamic Gait Index (body balance). Secondary outcomes include dizziness features, functional records, body balance control tests, and psychological information. The older individuals (minimum sample n = 68) will be randomized to either the conventional or multimodal Cawthorne&Cooksey protocols. The protocols will be performed during individual 50-minute sessions, twice a week, for 2 months (a total of 16 sessions). The outcomes of both protocols will be compared according to the intention-to-treat analysis. Vestibular rehabilitation through the Cawthorne&Cooksey protocol has already proved to be effective. However, the addition of other components related to body balance control has been proposed to improve the rehabilitation of older people with chronic dizziness from vestibular disorders. ACTRN12610000018011.

  20. Effects of conventional versus multimodal vestibular rehabilitation on functional capacity and balance control in older people with chronic dizziness from vestibular disorders: design of a randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Ricci Natalia

    2012-12-01

    Full Text Available Abstract Background There are several protocols designed to treat vestibular disorders that focus on habituation, substitution, adaptation, and compensation exercises. However, protocols that contemplate not only vestibular stimulation but also other components that are essential to the body balance control in older people are rare. This study aims to compare the effectiveness of two vestibular rehabilitation protocols (conventional versus multimodal on the functional capacity and body balance control of older people with chronic dizziness due to vestibular disorders. Methods/design A randomized, single-blind, controlled clinical trial with a 3 months follow-up period will be performed. The sample will be composed of older individuals with a clinical diagnosis of chronic dizziness resulting from vestibular disorders. The subjects will be evaluated at baseline, post-treatment and follow-up. Primary outcomes will be determined in accordance with the Dizziness Handicap Inventory (functional capacity and the Dynamic Gait Index (body balance. Secondary outcomes include dizziness features, functional records, body balance control tests, and psychological information. The older individuals (minimum sample n = 68 will be randomized to either the conventional or multimodal Cawthorne&Cooksey protocols. The protocols will be performed during individual 50-minute sessions, twice a week, for 2 months (a total of 16 sessions. The outcomes of both protocols will be compared according to the intention-to-treat analysis. Discussion Vestibular rehabilitation through the Cawthorne&Cooksey protocol has already proved to be effective. However, the addition of other components related to body balance control has been proposed to improve the rehabilitation of older people with chronic dizziness from vestibular disorders. Trial registration ACTRN12610000018011

  1. Exercise gaming - a motivational approach for older adults with vestibular dysfunction.

    Science.gov (United States)

    Smaerup, M; Grönvall, E; Larsen, S B; Laessoe, U; Henriksen, J J; Damsgaard, E M

    2017-02-01

    Purpose The purpose of the study was to identify possible reasons for a modest level of exercise compliance during computer-assisted training for vestibular rehabilitation. Method Qualitative design and analysis of 14 semi-structured interviews with seven participants before and after a period with computer-assisted home training. The interviews evolved around themes, such as the elderly participants' self-efficacy, motivation and acceptance of the technology. Results Age was not an excuse for the modest exercise compliance. The participants were basically self-efficient and accepted the technology, but their knowledge and understanding of the training programme were insufficient. The participants asked for a greater variation in the exercises and asked for closer contact with the physiotherapist. When Mitii is used for vestibular rehabilitation, the system has some limitations. Conclusions The modest level of exercise compliance can be explained by (1) missing variety of exercise speed and duration and lack of introducing new exercises, (2) insufficient interaction with the physiotherapist regarding the participants' performance and lack of social contact with other patients and (3) desire for a deeper understanding of the training programme with supplying information on the parts of the vestibular system addressed by the training. Implications for Rehabilitation Computer-assisted technologies should generate feedback on the quality of user performance and inform the patient of the relevance of the exercise. The technology should support social contact among patients with the same diagnosis and establish contact with the physiotherapist at the hospital advice and feedback. Varity and adjustments to exercises are necessary to maintain motivation and exercise compliance.

  2. Vestibular rehabilitation in elderly patients with dizziness

    OpenAIRE

    Zanardini, Francisco Halilla; Zeigelboim, Bianca Simone [UNIFESP; Jurkiewicz, Ari Leon; Marques, Jair Mendes; Martins-Bassetto,Jackeline

    2007-01-01

    TEMA: o envelhecimento populacional é um processo natural, manifesta-se por um declínio das funções de diversos órgãos. A reabilitação vestibular (RV) é um processo terapêutico que visa promover a redução significativa dos sintomas labirínticos. OBJETIVO: verificar os benefícios dos exercícios de RV por meio da avaliação pré e pós-aplicação do questionário Dizziness Handicap Inventory (DHI) - adaptação brasileira. MÉTODO: participaram deste estudo oito idosos com queixa de tontura, na faixa e...

  3. Interactive wiimote gaze stabilization exercise training system for patients with vestibular hypofunction.

    Science.gov (United States)

    Chen, Po-Yin; Hsieh, Wan-Ling; Wei, Shun-Hwa; Kao, Chung-Lan

    2012-10-09

    Peripheral vestibular hypofunction is a major cause of dizziness. When complicated with postural imbalance, this condition can lead to an increased incidence of falls. In traditional clinical practice, gaze stabilization exercise is commonly used to rehabilitate patients. In this study, we established a computer-aided vestibular rehabilitation system by coupling infrared LEDs to an infrared receiver. This system enabled the subjects' head-turning actions to be quantified, and the training was performed using vestibular exercise combined with computer games and interactive video games that simulate daily life activities. Three unilateral and one bilateral vestibular hypofunction patients volunteered to participate in this study. The participants received 30 minutes of computer-aided vestibular rehabilitation training 2 days per week for 6 weeks. Pre-training and post-training assessments were completed, and a follow-up assessment was completed 1 month after the end of the training period. After 6 weeks of training, significant improvements in balance and dynamic visual acuity (DVA) were observed in the four participants. Self-reports of dizziness, anxiety and depressed mood all decreased significantly. Significant improvements in self-confidence and physical performance were also observed. The effectiveness of this training was maintained for at least 1 month after the end of the training period. Real-time monitoring of training performance can be achieved using this rehabilitation platform. Patients demonstrated a reduction in dizziness symptoms after 6 weeks of training with this short-term interactive game approach. This treatment paradigm also improved the patients' balance function. This system could provide a convenient, safe and affordable treatment option for clinical practitioners.

  4. Double-blind, placebo-controlled trial of rehabilitation for bilateral vestibular hypofunction: preliminary report.

    Science.gov (United States)

    Krebs, D E; Gill-Body, K M; Riley, P O; Parker, S W

    1993-10-01

    Vestibular rehabilitation (VR) is increasingly popular, but few data exist to support enthusiasts' claims of efficacy in improving functional abilities of patients with bilateral vestibular hypofunction (BVH). A double-blind, controlled study of eight subjects (mean, 64 +/- 12 years; seven females, one male) with bilateral vestibular hypofunction was conducted. Subjects in group A received 8 weeks of VR followed by 8 weeks of home VR exercises, whereas those in group B received 8 weeks of control treatment (isometric strengthening exercises) followed by 8 weeks of VR. At the end of 8 weeks, group A walked 8% faster and, during paced gait and stair-climbing, with greater stability, evidenced by a 10% larger maximum moment arm and a 17% decreased double-support duration during gait and stair stance. Group B improved less than 1% during the control treatment. Self-reported Dizziness Handicap Inventory scores did not differ significantly between control and active VR. All subjects improved compared with baseline tests at the 16-week post-test on both functional testing and on the Self-reported Dizziness Handicap Inventory scale. We conclude that in this small sample, VR effectively improved functional, dynamic stability during locomotion, but even strengthening exercises result in self-reported symptomatic improvement.

  5. Reabilitação vestibular: utilidade clínica em pacientes com esclerose múltipla Vestibular rehabilitation: clinical benefits to patients with multiple sclerosis

    Directory of Open Access Journals (Sweden)

    Bianca Simone Zeigelboim

    2010-01-01

    Full Text Available O objetivo desse estudo foi analisar a eficácia do exercício de reabilitação vestibular em dois casos de esclerose múltipla remitente-recorrente. Ambos os casos foram encaminhados do Hospital de Clínicas para o Laboratório de Otoneurologia de uma instituição de ensino e foram submetidos aos seguintes procedimentos: anamnese, inspeção otológica, avaliação vestibular e aplicação do Dizziness Handicap Inventory pré e pós reabilitação vestibular utilizando-se o protocolo de Cawthorne e Cooksey. No primeiro caso, gênero feminino, 35 anos, tempo de doença de seis anos, referiu tontura há três anos, de intensidade moderada de ocorrência frequente, cefaléia, quedas, desvio de marcha à direita e sensação de desmaio (sic. Apresentou no exame labiríntico, síndrome vestibular periférica deficitária bilateral. No segundo caso, gênero feminino, 49 anos, tempo de doença de dois anos, referiu desvio de marcha à direita, dificuldade e/ou dor ao movimento do pescoço, formigamento de extremidade e alteração vocal. Apresentou no exame labiríntico, síndrome vestibular periférica deficitária à direita. Houve melhora significativa em ambos os casos dos aspectos físico, funcional e emocional do Dizziness Handicap Inventory após a realização da reabilitação vestibular. O protocolo utilizado promoveu melhora na qualidade de vida e auxiliou no processo de compensação vestibular.The aim of the present study was to analyze the effectiveness of vestibular rehabilitation exercises in two cases of remittent-recurrent multiple sclerosis. Both cases were referred from the Clinics Hospital to the Laboratory of Otoneurology of the same institution and were submitted to the following procedures: anamnesis, otological inspection, vestibular evaluation, and application of the Dizziness Handicap Inventory before and after vestibular rehabilitation using the Cawthorne and Cooksey protocol. The first case was a 35-year-old female

  6. Computer-assisted training as a complement in rehabilitation of patients with chronic vestibular dizziness

    DEFF Research Database (Denmark)

    Smaerup, Michael; Grönvall, Erik; Larsen, Simon B.

    2015-01-01

    Objective To compare a computer exercise program with conservative home-training following printed instructions in the rehabilitation of elderly patients with vestibular dysfunction. Design Single-blind, randomized, controlled trial. Setting Geriatric Department, Aarhus University Hospital...... instructions (control group: n=31). Intervention Patients in the intervention group received assisted rehabilitation by a computer program. Main outcome measures Measurements at baseline, 8 and 16 weeks were compared. These included the One Leg Stand Test, Dynamic Gait Index, Chair Stand Test, Motion...... Sensitivity Test, Short Form-12, Dizziness Handicap Inventory and Visual Analog Scale. Results Both groups improved significantly during 16 weeks of rehabilitation. However, neither t-tests nor repeated measurement ANOVA demonstrated any significant differences between the two groups. The overall compliance...

  7. Reabilitação vestibular em idosos com Parkinson Vestibular rehabilitation in elderly patients with Parkinson

    Directory of Open Access Journals (Sweden)

    Jackeline Martins-Bassetto

    2007-06-01

    Full Text Available OBJETIVO: verificar a efetividade dos exercícios de reabilitação vestibular (RV por meio de avaliação pré e pós-aplicação do questionário Dizziness Handicap Inventory (DHI - adaptação brasileira. MÉTODOS: avaliaram-se oito pacientes (três do sexo feminino e cinco do sexo masculino, na faixa etária de 48 a 71 anos, encaminhados da Associação Paranaense de Parkinson para o Laboratório de Otoneurologia da Universidade Tuiuti do Paraná. Os pacientes foram divididos em dois grupos e submetidos aos seguintes procedimentos: anamnese, avaliação otorrinolaringológica, avaliação vestibular por meio da vectoeletronistagmografia (VENG e aplicação do questionário DHI - adaptação brasileira pré e pós RV utilizando-se os protocolos de Cawthorne e Cooksey (grupo A e Herdman (grupo B. RESULTADOS: a conforme as queixas otoneurológicas referidas na anamnese, observou-se a prevalência da tontura (100,0%, tremor (100,0% e desvio de marcha (75,0&; b no exame vestibular, todos os pacientes (100,0% apresentaram alteração, sendo a maior freqüência das síndromes vestibulares periféricas deficitárias (62,5%; c houve melhora significativa dos aspectos funcional (p = 0,020470 e emocional (p = 0,013631 após a realização dos exercícios de RV utilizando-se o protocolo de Cawthorne e Cooksey e do aspecto emocional (p=0,007316 utilizando-se o protocolo de Herdman. CONCLUSÃO: comparando-se os dois protocolos utilizados, verificou-se uma melhora significativa dos pacientes do grupo A, submetidos ao protocolo de Cawthorne e Cooksey (p=0.0231.PURPOSE: to check the effectiveness of vestibular rehabilitation exercises (RV by means of an evaluation of a pre and post application of the Dizziness Handicap Inventory (DHI questionnaire (Brazilian version. METHODS: eight patients were evaluated (three female and five male, in the age group varying from 48 to 71, referred from the Paraná Association of Parkinson to the Otoneurological Laboratory

  8. Use of canalith repositioning manoeuvres and vestibular rehabilitation: a GP survey.

    Science.gov (United States)

    van Vugt, Vincent A; Diaz Nerio, Patria M; van der Wouden, Johannes C; van der Horst, Henriëtte E; Maarsingh, Otto R

    2017-03-01

    To investigate the use of canalith repositioning manoeuvres and vestibular rehabilitation (VR) by GPs and to assess reasons for not using these techniques in patients with vertigo. Online survey. GPs in the western and central part of the Netherlands. Of GPs, 1169 were approached to participate in the survey. A sample of 426 GPs filled out the questionnaire (36.4% response rate). The 22-item questionnaire contained both multiple choice and free-text questions on the Epley manoeuvre, the Brandt-Daroff exercises and VR. Results of the survey were descriptively analyzed. The use of the Epley manoeuvre, the Brandt-Daroff exercises and VR by GPs; reasons that deter GPs from using these techniques. The repositioning manoeuvres (Epley manoeuvre and Brandt-Daroff exercises) were used by approximately half of all GPs (57.3 and 50.2%), while only a small group of GPs applied VR (6.8%). The most important reason for GPs not to use the Epley manoeuvre, Brandt-Daroff exercises and VR was that they did not know how to perform the technique (49.5, 89.6 and 92.4%). Despite the proven effectiveness, repositioning manoeuvres and VR are remarkably underused by Dutch GPs. Not knowing how to perform the technique is the most important reason for GPs not to use these techniques. Efforts should be made to increase the knowledge and skills of GPs regarding canalith repositioning manoeuvres and VR. Key points Dizziness is a common symptom with limited therapeutic options.   • Canalith repositioning manoeuvres and vestibular rehabilitation represent the best treatment options currently available for vertigo.   • Canalith repositioning manoeuvres and vestibular rehabilitation are still widely underused by GPs.   • The most important reason for GPs not to use these techniques is that they do not know how to perform them.   • Efforts should be made to increase the knowledge and skills of GPs regarding canalith repositioning manoeuvres and vestibular

  9. Three-dimensional, virtual reality vestibular rehabilitation for chronic imbalance problem caused by Ménière's disease: a pilot study.

    Science.gov (United States)

    Hsu, Su-Yi; Fang, Te-Yung; Yeh, Shih-Ching; Su, Mu-Chun; Wang, Pa-Chun; Wang, Victoria Y

    2017-08-01

    The purpose of this study was to evaluate a three-dimensional, virtual reality system for vestibular rehabilitation in patients with intractable Ménière's disease and chronic vestibular dysfunction. We included 70 patients (36 for study, 34 as control) with a chronic imbalance problem caused by uncompensated Ménière's disease. The virtual reality vestibular rehabilitation comprised four training tasks (modified Cawthorne-Cooksey exercises: eye, head, extension, and coordination exercises) performed in six training sessions (in 4 weeks). Measurements of the task scores and balance parameters obtained at the baseline and after final training sessions were compared. A significant improvement was observed in extension and coordination scores. Patients in the early stages of Ménière's disease had a significantly greater improvement in the center of gravity sway and trajectory excursion in the mediolateral direction than did patients in the late stages of Ménière's disease. Mild functional disability attributable to Ménière's disease was a predictor of improvement in the statokinesigram and maximum trajectory excursion in the anteroposterior direction after rehabilitation. The control group showed no significant improvement in almost all parameters. Virtual reality vestibular rehabilitation may be useful in patients with Ménière's disease, particular those in the early stages or having mild functional disability. Implication for rehabilitation Chronic imbalance caused by uncompensated Ménière's disease is an indication for vestibular rehabilitation. The interactive virtual reality video game, when integrated into vestibular rehabilitation exercise protocol, may assist patients who have mild disability Ménière's disease and who cannot benefit from treatment with drugs or surgery. The initial data from this study support the applicability of three-dimensional virtual reality technology in vestibular rehabilitation programs. The technology gives

  10. Effectiveness of conventional versus virtual reality based vestibular rehabilitation in the treatment of dizziness, gait and balance impairment in adults with unilateral peripheral vestibular loss: a randomised controlled trial.

    Science.gov (United States)

    Meldrum, Dara; Herdman, Susan; Moloney, Roisin; Murray, Deirdre; Duffy, Douglas; Malone, Kareena; French, Helen; Hone, Stephen; Conroy, Ronan; McConn-Walsh, Rory

    2012-03-26

    Unilateral peripheral vestibular loss results in gait and balance impairment, dizziness and oscillopsia. Vestibular rehabilitation benefits patients but optimal treatment remains unknown. Virtual reality is an emerging tool in rehabilitation and provides opportunities to improve both outcomes and patient satisfaction with treatment. The Nintendo Wii Fit Plus® (NWFP) is a low cost virtual reality system that challenges balance and provides visual and auditory feedback. It may augment the motor learning that is required to improve balance and gait, but no trials to date have investigated efficacy. In a single (assessor) blind, two centre randomised controlled superiority trial, 80 patients with unilateral peripheral vestibular loss will be randomised to either conventional or virtual reality based (NWFP) vestibular rehabilitation for 6 weeks. The primary outcome measure is gait speed (measured with three dimensional gait analysis). Secondary outcomes include computerised posturography, dynamic visual acuity, and validated questionnaires on dizziness, confidence and anxiety/depression. Outcome will be assessed post treatment (8 weeks) and at 6 months. Advances in the gaming industry have allowed mass production of highly sophisticated low cost virtual reality systems that incorporate technology previously not accessible to most therapists and patients. Importantly, they are not confined to rehabilitation departments, can be used at home and provide an accurate record of adherence to exercise. The benefits of providing augmented feedback, increasing intensity of exercise and accurately measuring adherence may improve conventional vestibular rehabilitation but efficacy must first be demonstrated. Clinical trials.gov identifier: NCT01442623.

  11. Effects of electrotactile vestibular substitution on rehabilitation of patients with bilateral vestibular loss.

    Science.gov (United States)

    Barros, Camila Giacomo Carneiro; Bittar, Roseli Saraiva Moreira; Danilov, Yuri

    2010-06-07

    The present study evaluated the effectiveness of electrotactile tongue biofeedback (BrainPort((R))) as a sensory substitute for the vestibular apparatus in patients with bilateral vestibular loss (BVL) who did not have a good response to conventional vestibular rehabilitation (VR). Seven patients with BVL were trained to use the device. Stimulation on the surface of the tongue was created by a dynamic pattern of electrical pulses and the patient was able to adjust the intensity of stimulation and spatially centralize the stimulus on the electrode array. Patients were directed to continuously adjust head orientation and to maintain the stimulus pattern at the center of the array. Postural tasks that present progressive difficulties were given during the use of the device. Pre- and post-treatment distribution of the sensory organization test (SOT) composite score showed an average value of 38.3+/-8.7 and 59.9+/-11.3, respectively, indicating a statistically significant improvement (p=0.01). Electrotactile tongue biofeedback significantly improved the postural control of the study group, even if they had not improved with conventional VR. The electrotactile tongue biofeedback system was able to supply additional information about head position with respect to gravitational vertical orientation in the absence of vestibular input, improving postural control. Patients with BVL can integrate electrotactile information in their postural control in order to improve stability after conventional VR. These results were obtained and verified not only by the subjective questionnaire but also by the SOT composite score. The limitations of the study are the small sample size and short duration of the follow-up. The current findings show that the sensory substitution mediated by electrotactile tongue biofeedback may contribute to the improved balance experienced by these patients compared to VR. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

  12. Aerobic exercise in pulmonary rehabilitation

    Directory of Open Access Journals (Sweden)

    Thiago Brasileiro de Vasconcelos

    2013-01-01

    Full Text Available The aim of this study was to conduct a literature review on the usefulness of aerobic exercise in pulmonary rehabilitation. This is an exploratory study of literature through the electronic databases Medline, Lilacs, Scielo, Pubmed and Google Scholar, published between 1996 and 2012, conducted during the period February to May 2012 with the following keywords: COPD, pulmonary rehabilitation, aerobic exercises, physical training, quality of life. The change in pulmonary function and dysfunction of skeletal muscles that result in exercise intolerance and reduced fitness and may cause social isolation, depression, anxiety and addiction. The training exercise is the most important component of the program of pulmonary rehabilitation where the aerobic training provides consistent results in clinical improvement in levels of exercise tolerance and decreased dyspnea generating more benefits to the body, reducing the chance of cardiovascular disease and improves quality and expectation of life. We demonstrated that the use of aerobic exercise in pulmonary rehabilitation program, allows an improvement of motor skills, decreased muscle fatigue and deconditioning, reducing sedentary lifestyle; however, has little or no effect on the reduction of strength and atrophy muscle.

  13. AEROBIC EXERCISE IN PULMONARY REHABILITATION

    Directory of Open Access Journals (Sweden)

    Thiago Brasileiro de Vasconcelos

    2013-05-01

    Full Text Available The aim of this study was to conduct a literature review on the usefulness of aerobic exercise in pulmonary rehabilitation. This is an exploratory study of literature through the electronic databases Medline, Lilacs, Scielo, Pubmed and Google Scholar, published between 1996 and 2012, conducted during the period February to May 2012 with the following keywords: COPD, pulmonary rehabilitation, aerobic exercises, physical training, quality of life. The change in pulmonary function and dysfunction of skeletal muscles that result in exercise intolerance and reduced fitness and may cause social isolation, depression, anxiety and addiction. The training exercise is the most important component of the program of pulmonary rehabilitation where the aerobic training provides consistent results in clinical improvement in levels of exercise tolerance and decreased dyspnea generating more benefits to the body, reducing the chance of cardiovascular disease and improves quality and expectation of life. We demonstrated that the use of aerobic exercise in pulmonary rehabilitation program, allows an improvement of motor skills, decreased muscle fatigue and deconditioning, reducing sedentary lifestyle; however, has little or no effect on the reduction of strength and atrophy muscle.

  14. Drug therapy for peripheral vestibular vertigo

    Directory of Open Access Journals (Sweden)

    L. M. Antonenko

    2017-01-01

    Full Text Available The choice of effective treatments for vestibular vertigo is one of the important problems, by taking into account the high prevalence of peripheral vestibular diseases. Different drugs, such as vestibular suppressants for the relief of acute vertigo attacks and vestibular compensation stimulants for rehabilitation treatment, are used to treat vestibular vertigo. Drug therapy in combination with vestibular exercises is effective in patients with vestibular neuronitis, Meniere's disease, so is that with therapeutic maneuvers in patients with benign paroxysmal positional vertigo. The high therapeutic efficacy and safety of betahistines permit their extensive use for the treatment of various vestibular disorders.

  15. Use of Virtual Reality Tools for Vestibular Disorders Rehabilitation: A Comprehensive Analysis

    OpenAIRE

    Mathieu Bergeron; Lortie, Catherine L.; Guitton, Matthieu J.

    2015-01-01

    Classical peripheral vestibular disorders rehabilitation is a long and costly process. While virtual reality settings have been repeatedly suggested to represent possible tools to help the rehabilitation process, no systematic study had been conducted so far. We systematically reviewed the current literature to analyze the published protocols documenting the use of virtual reality settings for peripheral vestibular disorders rehabilitation. There is an important diversity of settings and prot...

  16. Exercise rehabilitation for smartphone addiction.

    Science.gov (United States)

    Kim, Hyunna

    2013-12-31

    Internet addiction after launching smartphone is becoming serious. Therefore this paper has attempted to sketch out the diverse addiction treatment and then check the feasibility of exercise rehabilitation. The reason to addict the internet or smartphone is personalized individual characters related personal psychological and emotional factors and social environmental factors around them. We have shown that 2 discernible approaches due to 2 different addiction causes: that is behavioral treatment and complementary treatment. In the behavioral treatment, cognitive behavioral approach (CBT) is representative methods for changing additive thoughts and behaviors. Motivational interviewing (MI) is also the brief approach for persons not ready to change their behavior. Mindfulness behavioral cognitive treatment (MBCT) also the adapted treatment based on CBT. There are different types following the emphatic point, mindfulness-based relapse prevention (MBRP) or mindfulness oriented recovery enhancement (MORE). It is apparent that therapeutic recreation, music therapy using drumming activity, and art therapy are useful complementary treatment. Exercise rehabilitation contained the systematic procedures and comprehensive activities compared to previous addiction treatments by contents and techniques. Exercise rehabilitation can treat both physical symptoms at first and mental problems in the next step. So more evidence-based exercise rehabilitation researches need to do, but it is highly probable that exercise rehab can apply for smartphone addiction.

  17. Effect of exercise intervention on vestibular related impairments in ...

    African Journals Online (AJOL)

    2011-02-07

    ... the efficacy of exercise interventions in the treatment of vestibular-related deficits in hearing-impaired children. Sources: Extensive search of computerized bibliographic databases (MEDLINE, CINHAL, EMBASE, SCOPUS, ISI of web science, Cochrane Library, and AMED) was performed from earliest to February 7, 2011.

  18. Randomized trial of supervised versus unsupervised optokinetic exercise in persons with peripheral vestibular disorders.

    Science.gov (United States)

    Pavlou, Marousa; Bronstein, Adolfo M; Davies, Rosalyn A

    2013-01-01

    Visual vertigo (VV) symptoms improve only when customized vestibular rehabilitation (VR) integrates exposure to optokinetic stimuli (OK). However, equipment is expensive, biweekly sessions are not standard practice, and therapy is often unsupervised. A controlled, parallel-group comparison was made of patients' responses to an 8-week customized program incorporating OK training via a full-field visual environment rotator (group OKF) or DVD (an optokinetic disc or drum rotating at 40° or 60° s(-1)), supervised (group OKS) or unsupervised (group OKU). A total of 60 participants with chronic peripheral vestibular symptoms were randomly allocated to 1 of 3 treatment groups: group OKF (n = 20) or OKS (n = 20), in which participants attended weekly sessions and were prescribed customized home exercises incorporating the DVD, or group OKU (n = 20) who practiced customized exercises and the DVD unsupervised. Treatment response was assessed at baseline and at 8 weeks with dynamic posturography, Functional Gait Assessment (FGA), and questionnaires for symptoms, symptom triggers, and psychological state. No significant between-group differences were present at baseline or at post interventions. All groups showed significant within-group improvements for vestibular (ie, lightheadedness), VV, and autonomic symptoms (P VR. However, rehabilitation should be supervised for greater compliance and improvements, particularly for postural stability and psychological state.

  19. [Treatment failures in benign paroxysmal positional vertigo. Role of vestibular rehabilitation].

    Science.gov (United States)

    Vaz Garcia, F

    2005-01-01

    The objective of this study is to evaluate the efficacy of therapeutic maneuvers performed for BPPV patients. The study will also evaluate the efficacy of complementary exercises for vestibular rehabilitation (VR) in BPPV, presenting with persistent vertigo or disequilibrium after performing therapeutic maneuvers. 175 patients from both sexes, were included in this analysis. All suffered from BPPV and were treated with therapeutic maneuvers, preferably that described by Semont (SM). One week after SM, 79% of patients were cured; 13% complained of disequilibrium or vertigo without BPPV, 3%, presented with a persistent positional vertigo without nystagmus during the Hallpike manoeuvre and 5% of the patients still complained from BPPV which in some cases got worse. For patients still complaining of imbalance or non-positional vertigo, customized VR programs were applied (optokinetic stimulations, rotatory chair, proprioceptive training and/or platform). The final results, evaluated by posturography and by DHI, were good. VR exercises can achieve improvement or cure in 16% of these patients.

  20. Reabilitação vestibular na criança: estudo preliminar Vestibular rehabilitation in children: preliminary study

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    Roseli S. M. Bittar

    2002-08-01

    Full Text Available Forma de estudo: Clínico prospectivo. Objetivo: O estudo analisa prospectivamente os resultados da Reabilitação Vestibular pelo método de Cawtorne & Cooksey em 22 crianças, portadoras de vestibulopatia periférica, associada ou não a sintomas centrais, com idade média de 8,6 anos. Material e método: Os exames quantitativos da função vestibular utilizados para quantificar a vestibulopatia foram a eletronistagmografia e a prova rotatória pendular decrescente (PRPD, mas a história clínica altamente sugestiva de processo vestibular foi considerada diagnóstica mesmo na presença de exames normais. Resultado: Os resultados apontam a Reabilitação Vestibular como uma opção válida no tratamento das vestibulopatias na infância, uma vez que não houve casos não responsivos ao tratamento.Study design: Clinical prospective. Aim: The authors analyze prospectively 22 children (mean age 8,6 years with vestibulopathy treated with Vestibular Rehabilitation in order to verify its results. Material and methody: Twenty two children with peripheral vestibular disorders associated or not to central symptoms were submitted to vestibular stimulation by the method of Cawthorne & Cooksey. The methods used to quantify the vestibular abnormalities were the electronystagmography and rotational chair testing, but a suggestive history of vestibular disorder was accepted even the exams were normal. Results: All the patients improved and our results suggest that VR is a therapeutic alternative for the treatment of vestibular disorders in the children.

  1. Critical analysis of vestibular rehabilitation outcome according to dizziness etiology.

    Science.gov (United States)

    Bittar, Roseli Saraiva Moreira; Pedalini, Maria Elisabete Bovino; Ramalho, Jeanne Oiticica; Yoshimura, Ricardo

    2007-01-01

    Vestibular rehabilitation (VR) is an excellent therapy for dizziness patients. However, despite well managed, sometimes results are not suitable. evaluate VR outcome between patients according to dizziness etiology. Retrospective review of medical records. Patients records were analyzed between January 2002 and December 2004. As for inclusion criteria, patients should have had finished VR therapy and an established diagnosis. Patients were included in three VR outcome groups and compared according to etiology. according to VR outcome 13 patients had no improvement, 24 had partial improvement and 22 complete improvement. The main etiologies were cervical syndrome, trauma, metabolic disorders, central nervous system disorders, anxiety and mood disorders, autoimmune disease and orthostatic intolerance. Patients with metabolic disorders showed better VR outcome than the others. VR therapy combined with clinical etiology treatment is an excellent approach for dizziness patients.

  2. Manual therapy with and without vestibular rehabilitation for cervicogenic dizziness: a systematic review

    National Research Council Canada - National Science Library

    Lystad, Reidar P; Bell, Gregory; Bonnevie-Svendsen, Martin; Carter, Catherine V

    2011-01-01

    ... in the treatment of cervicogenic dizziness. The purpose of this systematic review is to evaluate the evidence for manual therapy, in conjunction with or without vestibular rehabilitation, in the management of cervicogenic dizziness...

  3. Exercise rehabilitation for smartphone addiction

    OpenAIRE

    Kim, Hyunna

    2013-01-01

    Internet addiction after launching smartphone is becoming serious. Therefore this paper has attempted to sketch out the diverse addiction treatment and then check the feasibility of exercise rehabilitation. The reason to addict the internet or smartphone is personalized individual characters related personal psychological and emotional factors and social environmental factors around them. We have shown that 2 discernible approaches due to 2 different addiction causes: that is behavioral treat...

  4. Outcomes Following a Vestibular Rehabilitation and Aerobic Training Program to Address Persistent Post-Concussion Symptoms.

    Science.gov (United States)

    Moore, Brian M; Adams, Joseph T; Barakatt, Edward

    2016-01-01

    To describe changes in adults with persistent symptoms and disability following a concussion after completing a supervised home exercise vestibular rehabilitation (VR) program combined with aerobic training. Participants included 14 consecutive individuals referred for VR within the context of a comprehensive concussion center. Outcome measures were administered at initial evaluation, 3 mos, and 6 mos. Outcome measures included: Rivermead Post-Concussion Questionnaire symptom (RPQ-3) and function (RPQ-13) subcategories, Dizziness Handicap Inventory (DHI), Activities-specific Balance Confidence Scale (ABC), functional gait assessment (FGA), return to work/study (RTW), and return to activity (RTA). At 6 months, all clinical outcome measures were found to be statistically significant or approaching statistical significance: RPQ-3 (pVR program with aerobic training, significant improvements were observed in participants' report of concussion-related symptoms, function, and return to meaningful activities.

  5. Vestibular rehabilitation in benign paroxysmal positional vertigo: Reality or fiction?

    Science.gov (United States)

    Bressi, Federica; Vella, Paola; Casale, Manuele; Moffa, Antonio; Sabatino, Lorenzo; Lopez, Michele Antonio; Carinci, Francesco; Papalia, Rocco; Salvinelli, Fabrizio; Sterzi, Silvia

    2017-06-01

    The objective of this article is to systematically review the evidence on the effectiveness of vestibular rehabilitation (VR) in patients with benign paroxysmal positional vertigo (BPPV). Relevant published studies about VR in BPPV were searched in PubMed, Google Scholar and Ovid using various keywords. We included trials that were available in the English language and did not apply publication year or publication status restrictions. Studies based on the VR in other peripheral and/or central balance disorders are excluded. Primary outcome was the effect on vertigo attacks and balance. Of 42 identified trials, only 12 trials fulfilled our inclusion criteria and were included in this review. Three of them investigated the role of VR in patients with BPPV comparing with no treatment, two of them evaluated the efficacy of VR versus medications, seven of them have highlighted the benefits of the VR alone or in combination with canalith repositioning procedure (CRP) compared to CRP alone. The studies differed in type of intervention, type of outcome and follow-up time. VR improves balance control, promoting visual stabilization with head movements, improving vestibular-visual interaction during head movement and expanding static and dynamic posture stability. CRP and VR seem to have a synergic effect in patients with BPPV, especially in elderly patients. VR does not reduce the recurrence rate, but it seems to reduce the unpleasantness. So VR can substitute CRP when spine comorbidities contraindicate CRP and can reduce the uptake of anti-vertigo drugs post CRP. Further studies are needed to confirm these encouraging results.

  6. Antivertiginous drug therapy does not hinder the efficacy of individualized vibrotactile neurofeedback training for vestibular rehabilitation - a randomized trial.

    Science.gov (United States)

    Basta, Dietmar; Borsellino, Liliana; Ernst, Arne

    2017-12-01

    Vestibular rehabilitation using individualized vibrotactile neurofeedback training (IVNT) can lead to significant improvement in the postural stability of patients with vestibular symptoms of different origins. However, some of these patients have complex, severe dizziness, meaning that a pharmacological pretreatment or parallel (to vestibular rehabilitation) treatment can help them perform the rehabilitation exercises. Hence, the present study investigated the influence of a pharmacological treatment on the efficacy of vibrotactile neurofeedback training in patients with chronic, noncompensated vestibulopathies. All participants performed IVNT for ∼10 min each day for 2 weeks. In addition, every second participant was selected randomly to receive oral medication (20 mg cinnarizine and 40 mg dimenhydrinate per tablet), taking three tables per day. Trunk and ankle sway and postural stability were measured. In addition, the dizziness handicap inventory was evaluated immediately before training on the last day of training and 6 months after training. After the 10-day period of IVNT, both groups showed a statistically significant improvement in all parameters tested. A follow-up analysis after 6 months showed a long-term efficacy for the IVNT, that is, the patients remained significantly improved in their postural stability. The antivertiginous therapy did not hinder the efficacy of the IVNT. The present results indicate that IVNT even in combination with an antivertiginous drug therapy is an effective treatment regime for patients with disabling vertigo of different origins.

  7. Effectiveness of conventional versus virtual reality based vestibular rehabilitation in the treatment of dizziness, gait and balance impairment in adults with unilateral peripheral vestibular loss: a randomised controlled trial

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    Dara Meldrum

    2012-03-01

    Full Text Available Abstract Background Unilateral peripheral vestibular loss results in gait and balance impairment, dizziness and oscillopsia. Vestibular rehabilitation benefits patients but optimal treatment remains unkown. Virtual reality is an emerging tool in rehabilitation and provides opportunities to improve both outcomes and patient satisfaction with treatment. The Nintendo Wii Fit Plus® (NWFP is a low cost virtual reality system that challenges balance and provides visual and auditory feedback. It may augment the motor learning that is required to improve balance and gait, but no trials to date have investigated efficacy. Methods/Design In a single (assessor blind, two centre randomised controlled superiority trial, 80 patients with unilateral peripheral vestibular loss will be randomised to either conventional or virtual reality based (NWFP vestibular rehabilitation for 6 weeks. The primary outcome measure is gait speed (measured with three dimensional gait analysis. Secondary outcomes include computerised posturography, dynamic visual acuity, and validated questionnaires on dizziness, confidence and anxiety/depression. Outcome will be assessed post treatment (8 weeks and at 6 months. Discussion Advances in the gaming industry have allowed mass production of highly sophisticated low cost virtual reality systems that incorporate technology previously not accessible to most therapists and patients. Importantly, they are not confined to rehabilitation departments, can be used at home and provide an accurate record of adherence to exercise. The benefits of providing augmented feedback, increasing intensity of exercise and accurately measuring adherence may improve conventional vestibular rehabilitation but efficacy must first be demonstrated. Trial registration Clinical trials.gov identifier: NCT01442623

  8. Vestibular rehabilitation outcomes: velocity trajectory analysis of repeated bench stepping.

    Science.gov (United States)

    Goldvasser, D; McGibbon, C A; Krebs, D E

    2000-10-01

    To quantify vestibular rehabilitation (VR) outcomes in patients with vestibulospinal reflex pathology (VSP) using a new technique, high curvature analysis (HCA), that measures space trajectory stability. Twelve patients with VSP and 10 healthy controls performed a repeated stepping task in a motion analysis laboratory. Patients with VSP were tested before and after a 12 week VR program. Three dimensional whole body center of gravity (CG) was captured during repeated bench stepping trials (step up forward/step down backward), and the resulting horizontal plane CG velocity trajectories were analyzed using HCA. VSP patients were significantly less stable than healthy subjects prior to VR (P=0.022), but these differences disappeared following VR (P=0.148). The stability of the VSP patients during the stepping task at 3 months increased significantly from baseline values (P=0.013). Evaluating the efficacy of VR requires analysis techniques that are sensitive to changes in stability. We conclude that HCA can be used for assessing improvements in CG stability of VSP patients while performing a repeated bench stepping activity.

  9. Quality of life of individuals submitted to vestibular rehabilitation Qualidade de vida de indivíduos submetidos à reabilitação vestibular

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    Olívia Helena Gomes Patatas

    2009-06-01

    Full Text Available Balance disorders affect social, family and professional activities. Vestibular rehabilitation can reduce the impact of these disorders on the quality of life of individuals with vertigo. AIM: to study the influence of vestibular rehabilitation on the quality of life of individuals, correlating it with gender, age, results from computerized vectoelectronystagmography and vertigo. Study type: Retrospective. MATERIALS AND METHODS:Twenty-two individuals were submitted to customized vestibular rehabilitation and the Brazilian Dizziness Handicap Inventory - DHI before and after vestibular rehabilitation. Results from this questionnaire were correlated with gender, age, vestibular assessment and the presence of vertigo. RESULTS: all the DHI scores reduced significantly after vestibular rehabilitation. There were no differences among genders; adults and elderly patients; irritative peripheral vestibular syndromes; deficiency syndromes and normal exams; the presence or absence of vertigo. CONCLUSION: all the individuals had improvements in their quality of life after customized vestibular rehabilitation.Desordens do equilíbrio comprometem atividades sociais, familiares e profissionais. A reabilitação vestibular pode reduzir o impacto dessas desordens na qualidade de vida dos indivíduos vertiginosos. OBJETIVO: Verificar a influência da reabilitação vestibular sobre a qualidade de vida dos indivíduos, correlacionando-a com gênero, idade, resultado da vectoeletronistagmografia computadorizada e presença de vertigem. Forma de Estudo: Retrospectivo. MATERIAL E MÉTODO: Vinte e dois indivíduos foram submetidos à reabilitação vestibular personalizada e ao Dizziness Handicap Inventory - DHI brasileiro - pré e pós-reabilitação vestibular. Os resultados desse questionário foram correlacionados com as variáveis gênero, idade, avaliação vestibular e presença de tontura do tipo vertigem. RESULTADOS: Todos os escores do DHI diminu

  10. A controlled trial of cognitive-behavior therapy combined with vestibular rehabilitation in the treatment of dizziness.

    Science.gov (United States)

    Andersson, Gerhard; Asmundson, Gordon J G; Denev, Johanna; Nilsson, Johanna; Larsen, Hans Christian

    2006-09-01

    Dizziness is a common and often untreated symptom in the general population. The aim of this study was to investigate the effects of a combined cognitive-behavioral/vestibular rehabilitation (VR) program, using a randomized control design. A total of 29 participants were randomized to treatment consisting of psychoeducation, vestibular exercises, relaxation and cognitive interventions, or to serve as waiting list controls. Measures of dizziness-related handicap, dizziness-provoking movements, and daily diary registrations of dizziness symptoms at pre- and post-treatment showed statistically significant improvements in many domains, which translated to moderate effect sizes. These findings provide preliminary support for the combination of Cognitive-behavioral therapy (CBT) and VR methods in the treatment of dizziness.

  11. Exercise-based oncology rehabilitation: leveraging the cardiac rehabilitation model.

    Science.gov (United States)

    Dittus, Kim L; Lakoski, Susan G; Savage, Patrick D; Kokinda, Nathan; Toth, Michael; Stevens, Diane; Woods, Kimberly; OʼBrien, Patricia; Ades, Philip A

    2015-01-01

    The value of exercise and rehabilitative interventions for cancer survivors is increasingly clear, and oncology rehabilitation programs could provide these important interventions. However, a pathway to create oncology rehabilitation has not been delineated. Community-based cardiac rehabilitation (CR) programs staffed by health care professionals with experience in providing rehabilitation and secondary prevention services to individuals with coronary heart disease are widely available and provide a potential model and location for oncology rehabilitation programs. Our purpose was to outline the rehabilitative needs of cancer survivors and demonstrate how oncology rehabilitation can be created using a CR model. We identify the impairments associated with cancer and its therapy that respond to rehabilitative interventions. Components of the CR model that would benefit cancer survivors are described. An example of an oncology rehabilitation program using a CR model is presented. Cancer survivors have impairments associated with cancer and its therapy that improve with rehabilitation. Our experience demonstrates that effective rehabilitation services can be provided utilizing an existing CR infrastructure. Few adjustments to current CR models would be needed to provide oncology rehabilitation. Preliminary evidence suggests that cancer survivors participating in an oncology rehabilitation program experience improvements in psychological and physiologic parameters. Utilizing the CR model of rehabilitative services and disease management provides a much needed mechanism to bring oncology rehabilitation to larger numbers of cancer survivors.

  12. Symptoms, disability and handicap in unilateral peripheral vestibular disorders. Effects of early presentation and initiation of balance exercises.

    Science.gov (United States)

    Bamiou, D E; Davies, R A; McKee, M; Luxon, L M

    2000-01-01

    The aim of this study was to obtain a profile of disability and handicap in patients with unilateral peripheral vestibular disorders presenting to a specialist tertiary care unit. Two validated questionnaires were sent to patients who had a unilateral peripheral vestibular disorder as defined by strict criteria. Some patients still suffered moderate handicap and disability 5 years after the initial symptoms related to a unilateral vestibular disorder, although the duration of symptoms (onset to questionnaire completion) did not correlate with severity of disability and handicap, as judged by questionnaire scores. However, patients presenting to the unit within 6 months of onset of vertigo commenced balance exercises significantly earlier and had significantly lower disability scores than patients presenting later. A high proportion of non-compliance with, and delay in initiation of, vestibular rehabilitation exercises was noted in the total patient sample, while compliance with, and early initiation of, Cooksey Cawthorne exercises were significantly correlated with low disability and questionnaire scores. These findings suggest that early referral to a specialist balance unit for patients with persistent dizziness is associated with better outcome.

  13. Reabilitação vestibular em pacientes com esclerose múltipla remitente-recorrente Vestibular rehabilitation in patients with relapsing- remitting multiple sclerosis

    Directory of Open Access Journals (Sweden)

    Karina Pavan

    2007-06-01

    Full Text Available A esclerose múltipla (EM é doença desmielinizante, inflamatória, que acomete a substância branca do sistema nervoso central, e sensações vestibulares anormais (vertigem, desequilíbrio são freqüentes. A reabilitação vestibular (RV é determinada por mecanismos de adaptações, substituições e compensações neurais. Este estudo avaliou a melhora da vertigem central ou periférica em pacientes com EM remitente-recorrente submetidos à RV (exercícios de Cawthorne-Cooksey, através da escala de Berg e Dizziness Handicap Inventory (DHI. Nesta amostra de 4 casos a RV, realizada em um período de 2 meses, demonstrou a melhora em 3 pacientes avaliados pela escala de Berg e em 2 pacientes quando avaliados pela DHI.Multiple sclerosis (MS is a demyelinating, inflammatory illness, that attack the white matter of the central nervous system, and abnormal vestibular sensations (vertigo, disequilibrium are frequent. The vestibular rehabilitation (VR is determined by mechanisms of adaptations, neural substitutions and compensations. This study evaluated the improvement of the central or peripheral vertigo in patients with relapsing-remitting MS submitted to the VR (exercises of Cawthorne-Cooksey, through the scale of Berg and Dizziness Handicap Inventory (DHI. In this sample of 4 cases the VR, carried through in a period of 2 months, demonstrated the improvement in 3 patients according to the Berg scale and in 2 patients considering that of the DHI.

  14. The role of sensory augmentation for people with vestibular deficits: Real-time balance aid and/or rehabilitation device?

    Science.gov (United States)

    Sienko, K H; Whitney, S L; Carender, W J; Wall, C

    2017-01-01

    This narrative review highlights findings from the sensory augmentation field for people with vestibular deficits and addresses the outstanding questions that are critical to the translation of this technology into clinical and/or personal use. Prior research has demonstrated that the real-time use of visual, vibrotactile, auditory, and multimodal sensory augmentation technologies can improve balance during static and dynamic stance tasks within a laboratory setting. However, its application in improving gait requires additional investigation, as does its efficacy as a rehabilitation device for people with vestibular deficits. In some locomotor studies involving sensory augmentation, gait velocity decreased and secondary task performance worsened, and subjects negatively altered their segmental control strategies when cues were provided following short training sessions. A further question is whether the retention and/or carry-over effects of training with a sensory augmentation technology exceed the retention and/or carry-over effects of training alone, thereby supporting its use as a rehabilitation device. Preliminary results suggest that there are short-term improvements in balance performance following a small number of training sessions with a sensory augmentation device. Long-term clinical and home-based controlled training studies are needed. It is hypothesized that sensory augmentation provides people with vestibular deficits with additional sensory input to promote central compensation during a specific exercise/activity; however, research is needed to substantiate this theory. Major obstacles standing in the way of its use for these critical applications include determining exercise/activity specific feedback parameters and dosage strategies. This paper summarizes the reported findings that support sensory augmentation as a balance aid and rehabilitation device, but does not critically examine efficacy or the quality of the research methods used in the

  15. Tai Chi and vestibular rehabilitation improve vestibulopathic gait via different neuromuscular mechanisms: preliminary report.

    Science.gov (United States)

    McGibbon, Chris A; Krebs, David E; Parker, Stephen W; Scarborough, Donna M; Wayne, Peter M; Wolf, Steven L

    2005-02-18

    Vestibular rehabilitation (VR) is a well-accepted exercise program intended to remedy balance impairment caused by damage to the peripheral vestibular system. Alternative therapies, such as Tai Chi (TC), have recently gained popularity as a treatment for balance impairment. Although VR and TC can benefit people with vestibulopathy, the degree to which gait improvements may be related to neuromuscular adaptations of the lower extremities for the two different therapies are unknown. We examined the relationship between lower extremity neuromuscular function and trunk control in 36 older adults with vestibulopathy, randomized to 10 weeks of either VR or TC exercise. Time-distance measures (gait speed, step length, stance duration and step width), lower extremity sagittal plane mechanical energy expenditures (MEE), and trunk sagittal and frontal plane kinematics (peak and range of linear and angular velocity), were measured. Although gait time-distance measures were improved in both groups following treatment, no significant between-groups differences were observed for the MEE and trunk kinematic measures. Significant within groups changes, however, were observed. The TC group significantly increased ankle MEE contribution and decreased hip MEE contribution to total leg MEE, while no significant changes were found within the VR group. The TC group exhibited a positive relationship between change in leg MEE and change in trunk velocity peak and range, while the VR group exhibited a negative relationship. Gait function improved in both groups consistent with expectations of the interventions. Differences in each group's response to therapy appear to suggest that improved gait function may be due to different neuromuscular adaptations resulting from the different interventions. The TC group's improvements were associated with reorganized lower extremity neuromuscular patterns, which appear to promote a faster gait and reduced excessive hip compensation. The VR group

  16. Tai Chi and vestibular rehabilitation improve vestibulopathic gait via different neuromuscular mechanisms: Preliminary report

    Directory of Open Access Journals (Sweden)

    Parker Stephen W

    2005-02-01

    Full Text Available Abstract Background Vestibular rehabilitation (VR is a well-accepted exercise program intended to remedy balance impairment caused by damage to the peripheral vestibular system. Alternative therapies, such as Tai Chi (TC, have recently gained popularity as a treatment for balance impairment. Although VR and TC can benefit people with vestibulopathy, the degree to which gait improvements may be related to neuromuscular adaptations of the lower extremities for the two different therapies are unknown. Methods We examined the relationship between lower extremity neuromuscular function and trunk control in 36 older adults with vestibulopathy, randomized to 10 weeks of either VR or TC exercise. Time-distance measures (gait speed, step length, stance duration and step width, lower extremity sagittal plane mechanical energy expenditures (MEE, and trunk sagittal and frontal plane kinematics (peak and range of linear and angular velocity, were measured. Results Although gait time-distance measures were improved in both groups following treatment, no significant between-groups differences were observed for the MEE and trunk kinematic measures. Significant within groups changes, however, were observed. The TC group significantly increased ankle MEE contribution and decreased hip MEE contribution to total leg MEE, while no significant changes were found within the VR group. The TC group exhibited a positive relationship between change in leg MEE and change in trunk velocity peak and range, while the VR group exhibited a negative relationship. Conclusion Gait function improved in both groups consistent with expectations of the interventions. Differences in each group's response to therapy appear to suggest that improved gait function may be due to different neuromuscular adaptations resulting from the different interventions. The TC group's improvements were associated with reorganized lower extremity neuromuscular patterns, which appear to promote a faster

  17. Machine learning-based assessment tool for imbalance and vestibular dysfunction with virtual reality rehabilitation system.

    Science.gov (United States)

    Yeh, Shih-Ching; Huang, Ming-Chun; Wang, Pa-Chun; Fang, Te-Yung; Su, Mu-Chun; Tsai, Po-Yi; Rizzo, Albert

    2014-10-01

    Dizziness is a major consequence of imbalance and vestibular dysfunction. Compared to surgery and drug treatments, balance training is non-invasive and more desired. However, training exercises are usually tedious and the assessment tool is insufficient to diagnose patient's severity rapidly. An interactive virtual reality (VR) game-based rehabilitation program that adopted Cawthorne-Cooksey exercises, and a sensor-based measuring system were introduced. To verify the therapeutic effect, a clinical experiment with 48 patients and 36 normal subjects was conducted. Quantified balance indices were measured and analyzed by statistical tools and a Support Vector Machine (SVM) classifier. In terms of balance indices, patients who completed the training process are progressed and the difference between normal subjects and patients is obvious. Further analysis by SVM classifier show that the accuracy of recognizing the differences between patients and normal subject is feasible, and these results can be used to evaluate patients' severity and make rapid assessment. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  18. Reabilitação vestibular em um hospital universitário Vestibular rehabilitation in a university hospital

    Directory of Open Access Journals (Sweden)

    Flávia da Silva Tavares

    2008-04-01

    Full Text Available A Reabilitação Vestibular visa melhorar o equilíbrio global, a qualidade de vida e orientação espacial dos pacientes com tontura. OBJETIVOS: Traçar o perfil dos pacientes atendidos no Ambulatório de Reabilitação Vestibular do Setor de Otoneurologia de um hospital universitário e verificar os resultados obtidos no período de novembro/2000 a dezembro/2004. MATERIAL E MÉTODO: Levantamento de dados contidos nas fichas dos 93 pacientes submetidos à Reabilitação Vestibular no período. FORMA DE ESTUDO: Clínico retrospectivo. RESULTADOS: A média etária dos pacientes foi de 52,82 anos, 56 do sexo feminino e 37 do sexo masculino. O número médio de atendimentos foi 4,3, sendo maior para os pacientes com distúrbios otoneurológicos centrais (média de 5,9. Dentre os pacientes que concluíram o tratamento proposto, 37 (60,7% obtiveram melhora significativa, 14 (22,9% tiveram melhora parcial e 10 (16,4% não referiram benefícios significativos. Os pacientes que mais se beneficiaram com a Reabilitação Vestibular tinham distúrbios otoneurológicos periféricos. CONCLUSÃO: A maior parte dos pacientes era do sexo feminino, com idade média de 52,8 anos. Cinqüenta e um pacientes (83,6% tiveram benefício com a terapia confirmando a eficácia do tratamento.The aim of vestibular rehabilitation is to improve total balance, quality of life and spatial orientation of patients with dizziness. AIMS: To determine the characteristics of the patients who underwent the Vestibular Rehabilitation program of the Neurotology Ward of a University Hospital, and to verify the results obtained between November/2000 and December/2004. MATERIALS AND METHODS: analysis of 93 files from patients under Vestibular Rehabilitation during the studied period. STUDY DESIGN: Retrospective clinical. RESULTS: the mean age of patients was 52.82 years, 56 females and 37 males. The average number of therapy sessions was 4.3, higher for patients with central neurotological

  19. Does otolith organ dysfunction influence outcomes after a customized program of vestibular rehabilitation?

    Science.gov (United States)

    Murray, Katherine J; Hill, Keith; Phillips, Bev; Waterston, John

    2010-06-01

    Vestibular rehabilitation (VR) is a successful approach to the treatment of vestibular dysfunction. The purpose of this study was to investigate the influence of otolith dysfunction on the response to VR in individuals with a peripheral vestibular disorder. Eighteen participants with loss of semicircular canal function only, and 29 participants with combined loss of semicircular canal and otolith organ function were recruited. All participants received a comprehensive clinical assessment before and after an 8-week customized program of VR. Both groups achieved significant improvements on most measures at the end of the 8-week VR program. However, no significant differences were identified between participants with versus without otolith dysfunction with respect to change in symptom severity (P = .81), self-perceived handicap (P = .92), functional limitations (P = .93), or balance performance after VR. Otolith dysfunction does not significantly influence the response to rehabilitation of individuals with a peripheral vestibular disorder. Vestibular rehabilitation is associated improvements in symptom severity, self-perceived handicap, and balance function in individuals with otolith dysfunction.

  20. Vestibular rehabilitation's effect over the quality of life of geriatric patients with labyrinth disease.

    Science.gov (United States)

    Mantello, Erika Barioni; Moriguti, Julio Cesar; Rodrigues-Júnior, Antonio Luiz; Ferrioli, Eduardo

    2008-01-01

    Dizziness is a symptom that affects the population world over, being more prevalent in the elderly due to the process of functional deterioration of the hearing and vestibular systems with aging. The objective of this study was to evaluate prospectively the effect of Vestibular Rehabilitation (VR) as treatment for labyrinth disease of vascular and metabolic origin in the quality of life of geriatric patients. The study was outlined as clinical-prospective, longitudinal, and observed, with the participation of 40 elder citizens of both genders, divided in 2 groups, dizziness of vascular or metabolic origin. The patients were evaluated and underwent VR - based on Cawthorne and Cooksey's protocol. The statistical analysis from the data was done through the t-Student test, the coefficients of Pearson and Spearman. based on quality of life scales showed that the individuals treated and assessed improved after Vestibular Rehabilitation. we concluded that VR, based on the protocols of Cawthorne and Cooksey, could be beneficial to this population.

  1. Three-dimensional head-mounted gaming task procedure maximizes effects of vestibular rehabilitation in unilateral vestibular hypofunction: a randomized controlled pilot trial.

    Science.gov (United States)

    Micarelli, Alessandro; Viziano, Andrea; Augimeri, Ivan; Micarelli, Domenico; Alessandrini, Marco

    2017-12-01

    Considering the emerging advantages related to virtual reality implementation in clinical rehabilitation, the aim of the present study was to discover possible (i) improvements achievable in unilateral vestibular hypofunction patients using a self-assessed head-mounted device (HMD)-based gaming procedure when combined with a classical vestibular rehabilitation protocol (HMD group) as compared with a group undergoing only vestibular rehabilitation and (ii) HMD procedure-related side effects. Therefore, 24 vestibular rehabilitation and 23-matched HMD unilateral vestibular hypofunction individuals simultaneously underwent a 4-week rehabilitation protocol. Both otoneurological measures (vestibulo-ocular reflex gain and postural arrangement by studying both posturography parameters and spectral values of body oscillation) and performance and self-report measures (Italian Dizziness Handicap Inventory; Activities-specific Balance Confidence scale; Zung Instrument for Anxiety Disorders, Dynamic Gait Index; and Simulator Sickness Questionnaire) were analyzed by means of a between-group/within-subject analysis of variance model. A significant post-treatment between-effect was found, and the HMD group demonstrated an overall improvement in vestibulo-ocular reflex gain on the lesional side, in posturography parameters, in low-frequency spectral domain, as well as in Italian Dizziness Handicap Inventory and Activities-specific Balance Confidence scale scores. Meanwhile, Simulator Sickness Questionnaire scores demonstrated a significant reduction in symptoms related to experimental home-based gaming tasks during the HMD procedure. Our findings revealed the possible advantages of HMD implementation in vestibular rehabilitation, suggesting it as an innovative, self-assessed, low-cost, and compliant tool useful in maximizing vestibular rehabilitation outcomes.

  2. Vestibular rehabilitation in elderly patients with benign paroxysmal positional vertigo

    OpenAIRE

    Resende Carolina R.; Taguchi Carlos K.; Almeida Juliane G. de; Fujita Reginaldo R.

    2003-01-01

    A Vertigem Posicional Paroxística Benigna (VPPB) é um distúrbio vestibular no qual os pacientes relatam breves momentos de vertigem e/ou leve instabilidade postural, ocasionados por uma mudança brusca na movimentação cefálica ou corporal. OBJETIVO: Verificar o benefício da reabilitação vestibular, realizada em grupo, em pacientes idosos portadores de VPPB. FORMA DE ESTUDO: Clínico prospectivo. MATERIAL E MÉTODO: Foram selecionados aleatoriamente 16 pacientes portadores de VPPB, todos medicado...

  3. Is customized vestibular rehabilitation effective in patients with multiple sclerosis? A randomized controlled trial.

    Science.gov (United States)

    Ozgen, Gulnur; Karapolat, Hale; Akkoc, Yesim; Yuceyar, Nur

    2016-08-01

    Balance disorders are among the most common problems encountered by patients diagnosed with multiple sclerosis (MS). The purpose of this randomized, controlled trial was to investigate the effects of customized vestibular rehabilitation (VR) on balance, functional capacity, quality of life, and depression in patients with MS. This study was designed as a prospective, randomized, controlled trial. The study was carried out in a single tertiary referral center. Forty consecutive patients referred with a diagnosis of MS were randomized into two groups: an exercise group (N.=20) and a control group (N.=20). The experimental group underwent customized VR and the wait-listed control group received the usual medical care. All of the patients were assessed with objective balance tests (Romberg Test, Tandem Romberg Test, Foam Romberg Test, Static Posturography, Six-Meter Walk Test, Five Times Sit-to-Stand Test, Berg Balance Scale, Timed Up and Go Test, Functional Gait Assessment, and Dynamic Gait Index), subjective balance parameters (Activities-Specific Balance Confidence Scale and Dizziness Handicap Inventory), and functional capacity (Six-Minute Walking Test), quality of life (Multiple Sclerosis Quality of Life-54), and depression (Beck Depression Inventory) scales. At the end of the trial, the exercise group exhibited significant changes in most of the evaluated parameters compared to the control group [except the Tandem Romberg with eyes closed and the Foam Romberg, standing with eyes open (P0.05). The intergroup comparisons of differences indicated significant recoveries in favor of the exercise group in all of the evaluated parameters (P<0.05). This study confirms the effects of customized VR programs on balance, quality of life, and functional capacity in patients with MS. Customized VR is an effective method for treating balance disorders in patients with MS.

  4. Challenges in conducting a randomized clinical trial of older people with chronic dizziness: before, during and after vestibular rehabilitation.

    Science.gov (United States)

    Ricci, Natalia A; Aratani, Mayra C; Caovilla, Heloísa H; Ganança, Fernando F

    2015-01-01

    This study aims to describe the process of conducting a randomized clinical trial of elderly with chronic dizziness subjected to vestibular rehabilitation (VR) and to verify its effectiveness on dizziness intensity. Older adults (≥65 years) with chronic dizziness from vestibular disorders referred to VR were enrolled to the trial. The control group (n=40) was submitted to the Cawthorne & Cooksey protocol and the experimental group (n=42) to the modified Cawthorne & Cooksey protocol which included multiple components. Protocols were performed during individual 50-minute sessions, twice-weekly, for eight weeks. Main measures were: recruitment data (refusal and eligibility), baseline characteristics, dropout rate, session attendance, protocol adherence, adverse effects, exercise adaptation and follow-up events. The Visual Analog Scale (VAS) was used to measure dizziness intensity. 144 elderly were referred to VR, 26.4% declined to participate and 16.7% were ineligible. There were 51 session non-attendances, with disease being the most frequent reason. Regardless of VR protocol, VAS dizziness intensity diminished along sessions (pVR protocols on recruitment, dropout, session's attendance, adherence to protocol and treatment effects. Our results revealed many challenges in conducting a rehabilitation trial with an elderly sample. The VR protocols showed to be feasible and suitable to reduce dizziness in older adults. Copyright © 2014 Elsevier Inc. All rights reserved.

  5. Vestibular Assessment and Rehabilitation: Ten-Year Survey Trends of Audiologists' Opinions and Practice.

    Science.gov (United States)

    Nelson, M Dawn; Akin, Faith W; Riska, Kristal M; Andresen, Kimberly; Mondelli, Stephanie Stamps

    2016-02-01

    The past decade has yielded changes in the education and training of audiologists and technological advancements that have become widely available for clinical balance function testing. It is unclear if recent advancements in vestibular instrumentation or the transition to an AuD degree have affected audiologists' vestibular clinical practice or opinions. The purpose of this study was to examine predominant opinions and practices for vestibular assessment (VA) and vestibular rehabilitation (VR) over the past decade and between master's- and AuD-level audiologists. A 31-question survey was administered to audiologists via U.S. mail in 2003 (N = 7,500) and electronically in 2014 (N = 9,984) with a response rate of 12% and 10%, respectively. There was an increase in the number of audiologists providing vestibular services in the past decade. Most respondents agreed that audiologists were the most qualified professionals to conduct VA. Less than half of the surveyed audiologists felt that graduate training was adequate for VA. AuD-level audiologists were more satisfied with graduate training and felt more comfortable performing VA compared to master's-level audiologists. Few respondents agreed that audiologists were the most qualified professionals to conduct VR or that graduate training prepared them to conduct VR. The basic vestibular test battery was unchanged across surveys and included: calorics, smooth pursuit, saccades, search for spontaneous, positional, gaze and optokinetic nystagmus, Dix-Hallpike, case history, and hearing evaluation. There was a trend toward greater use of air (versus water) calorics, videonystagmography (versus electronystagmography), and additional tests of vestibular and balance function. VA is a growing specialty area in the field of audiology. Better training opportunities are needed to increase audiologists' knowledge and skills for providing vestibular services. The basic tests performed during VA have remained relatively unchanged

  6. Comparison of Cawthorne-Cooksey exercises and sinusoidal support surface translations to improve balance in patients with unilateral vestibular deficit.

    Science.gov (United States)

    Corna, Stefano; Nardone, Antonio; Prestinari, Alessandro; Galante, Massimo; Grasso, Margherita; Schieppati, Marco

    2003-08-01

    To compare the effectiveness of vestibular rehabilitation by using Cawthorne-Cooksey exercises with that of instrumental rehabilitation. The main study (n=32) used a pre-post rehabilitation (A-B) design; the ancillary studies used a subset of 11 patients 1 month before rehabilitation versus pre-post rehabilitation (A-A-B design) and 9 patients pre-post rehabilitation versus 1 month after (A-B-B design). Division of physical therapy and rehabilitation at a scientific institute in Italy. Patients (Cawthorne-Cooksey, n=17; instrumental rehabilitation, n=15) with a complete or incomplete unilateral vestibular lesion due to ischemic, inflammatory, cranial nerve VIII sectioning, or unknown cause. Cawthorne-Cooksey exercises or instrumental rehabilitation training consisting of standing with eyes open (EO) or closed (EC) on a platform moving, relative to the subjects, in the anteroposterior (AP) or mediolateral direction, at a sinusoidal translation frequency of 0.2 or 0.6Hz; training sessions for both interventions were twice daily, 30 minutes per session, for 5 days. Body sway and subjective score of sway during quiet stance with EO or EC, with feet 10cm apart (FA) or together (FT); the standard deviation of the AP displacement of the malleolus, hip, and head during AP platform translations; the Dizziness Handicap Inventory (DHI); and performance-oriented evaluation of balance and gait (according to Tinetti). Both interventions improved patients' balance. Under each postural and visual condition, both groups showed reduction in body sway, and the post rehabilitation sway values approached those observed in normal subjects; improvement was significantly better for instrumental rehabilitation under FA EO, FA EC, and FT EC conditions. All patients reported a subjective feeling of increased steadiness. Sway recorded 1 month before treatment did not differ from that at the start of treatment. The follow-up evaluation showed persistence of effect. Parallel to the improved

  7. PREHAB vs. REHAB - presurgical treatment in vestibular schwannoma surgery enhances recovery of postural control better than postoperative rehabilitation: Retrospective case series.

    Science.gov (United States)

    Tjernström, Fredrik; Fransson, Per-Anders; Kahlon, Babar; Karlberg, Mikael; Lindberg, Sven; Siesjö, Peter; Magnusson, Måns

    2018-01-01

    To evaluate post-surgical postural stability when treating patients with remaining vestibular function with intratympanic gentamicin (PREHAB) prior to schwannoma surgery. 44 consecutive patients with some form remaining vestibular function scheduled for vestibular schwannoma surgery. 20 were medically deafferented with intratympanic gentamicin before surgery and 24 were not. Both groups were of the same age, had the same tumor size, same type of surgery, and same perioperative sensory rehabilitation (training exercises), and no surgical complications. Postural stability measured as energy expenditure while standing on a force platform during vibratory stimulation of the calf muscles, performed prior to surgery (or gentamicin treatment) and 6 months after surgery. Patients pretreated with gentamicin had significantly better postural stability at the time for follow-up (p learning as the vestibular function slowly attenuates; no concomitant central nervous dysfunction due to effects from neurosurgery, thus allowing time for a separate unimpeded recovery process with more limited challenges and objectives; and the initiation and certain progression of sensory reweighting processes allowed prior to surgery. In contrast, worse compensation could be due to; immobilization from nausea after surgery, harmful amount of stress and cognitive dysfunction from the combination of surgical and sensory trauma and an abrupt vestibular deafferentation and its consequences on sensory reweighting.

  8. Critical analysis of vestibular rehabilitation outcome according to dizziness etiology

    OpenAIRE

    Roseli Saraiva Moreira Bittar; Maria Elisabete Bovino Pedalini; Jeanne Oiticica Ramalho; Ricardo Yoshimura

    2007-01-01

    A reabilitação vestibular (RV) é uma ótima opção terapêutica para tratamento dos pacientes vestibulopatas. Contudo, mesmo quando bem conduzida, algumas vezes não surte os efeitos propostos. OBJETIVO: Avaliar a resposta de pacientes submetidos à RV em relação às etiologias apresentadas. Forma de Estudo: Retrospectivo descritivo. PACIENTES E MÉTODO: Analisamos pacientes que concluíram a RV e tinham diagnóstico entre janeiro de 2002 e dezembro de 2004. Dividimos os pacientes em três grupos, de a...

  9. Vestibular rehabilitation in the treatment of dizziness and tinnitus

    OpenAIRE

    Bianca Simone Zeigelboim; Marine Raquel Diniz da Rosa; Karlin Fabianne Klagenberg; Ari Leon Jurkiewicz

    2008-01-01

    OBJETIVO: Verificar a efetividade dos exercícios de reabilitação vestibular na melhora do zumbido e da tontura por meio de avaliação pré e pós-aplicação do questionário Dizziness Handicap Inventory (DHI) e Tinnitus Handicap Inventory (THI), ambos adaptados à população brasileira. MÉTODOS: Avaliaram-se seis pacientes (dois do sexo masculino e quatro do sexo feminino), na faixa etária de 43 a 70 anos. Os pacientes foram submetidos aos seguintes procedimentos: anamnese, inspeção otológica, avali...

  10. Use of canalith repositioning manoeuvres and vestibular rehabilitation: a GP survey

    OpenAIRE

    van Vugt, Vincent A; Diaz Nerio, Patria M.; van der Wouden, Johannes C.; Horst, Henri?tte E van der; Maarsingh, Otto R

    2017-01-01

    Objective To investigate the use of canalith repositioning manoeuvres and vestibular rehabilitation (VR) by GPs and to assess reasons for not using these techniques in patients with vertigo. Design Online survey. Setting GPs in the western and central part of the Netherlands. Subjects and method Of GPs, 1169 were approached to participate in the survey. A sample of 426 GPs filled out the questionnaire (36.4% response rate). The 22-item questionnaire contained both multiple choice and free-tex...

  11. Effectiveness of conventional versus virtual reality based vestibular rehabilitation in the treatment of dizziness, gait and balance impairment in adults with unilateral peripheral vestibular loss: a randomised controlled trial

    National Research Council Canada - National Science Library

    Meldrum, Dara; Herdman, Susan; Moloney, Roisin; Murray, Deirdre; Duffy, Douglas; Malone, Kareena; French, Helen; Hone, Stephen; Conroy, Ronan; McConn-Walsh, Rory

    2012-01-01

    .... Vestibular rehabilitation benefits patients but optimal treatment remains unknown. Virtual reality is an emerging tool in rehabilitation and provides opportunities to improve both outcomes and patient satisfaction with treatment...

  12. Parallel Robot for Lower Limb Rehabilitation Exercises

    OpenAIRE

    Alireza Rastegarpanah; Mozafar Saadat; Alberto Borboni

    2016-01-01

    The aim of this study is to investigate the capability of a 6-DoF parallel robot to perform various rehabilitation exercises. The foot trajectories of twenty healthy participants have been measured by a Vicon system during the performing of four different exercises. Based on the kinematics and dynamics of a parallel robot, a MATLAB program was developed in order to calculate the length of the actuators, the actuators’ forces, workspace, and singularity locus of the robot during the performing...

  13. Proprioception exercises in medical rehabilitation.

    Science.gov (United States)

    Stryła, Wanda; Pogorzała, Adam M; Stępień, Justyna

    2013-01-03

    Proprioception, or kinesthesia, is the sense of orientation responsible for perception of body and relative position of its parts. Kinaesthesia is received by receptors located in muscles and tendons. In this study a set of proprioception developing exercises was presented. Proprioception should be restored in case of musculoskeletal and neurological disorders. Proprioception training can also be used as a prophylaxis before starting various sporting activities. Proprioception developing exercises have significant meaning for the elderly, who are at risk of balance disorders. These exercises help developing motor memory and at the same time protect from falls.

  14. Rehabilitation outcome in home-based versus supervised exercise programs for chronically dizzy patients.

    Science.gov (United States)

    Kao, Chung-Lan; Chen, Liang-Kung; Chern, Chang-Ming; Hsu, Li-Chi; Chen, Chih-Chun; Hwang, Shinn-Jang

    2010-01-01

    We aimed to evaluate the effectiveness of vestibular rehabilitation (VR) exercise between supervised and home-based programs in young and senior age groups of patients with chronic dizziness. Dizziness Handicap Inventory (DHI), Dynamic gait index (DGI), Tinetti fall risk performance scales and Timed "Up and Go" test (TUG) were administered to patients on their initial and follow-up visits for forty-one patients suffering from chronic dizziness. Twenty-eight patients received three 30-min vestibular training exercise sessions per week. Thirteen patients who could not visit our clinic on regular basis were instructed to do the same set of exercises at home, with the same duration and frequency. All scales were evaluated again on their follow-up visits 2 months later. Patients in both groups showed statistically significant improvement in DHI and Tinetti scales. A higher percentage of patients in the supervised-exercise-program (SP) group showed clinically significant outcome improvements. Age was not a predictive factor for rehabilitation outcome. We concluded that for all ages of chronically dizzy patients, 2 months of VR can reduce handicap, improve balance function and a consequent improvement of life quality. Health care professionals need to be educated about the importance of rehabilitation program for treatment of chronic dizziness. Copyright © 2009 Elsevier Ireland Ltd. All rights reserved.

  15. Use of Virtual Reality Tools for Vestibular Disorders Rehabilitation: A Comprehensive Analysis

    Directory of Open Access Journals (Sweden)

    Mathieu Bergeron

    2015-01-01

    Full Text Available Classical peripheral vestibular disorders rehabilitation is a long and costly process. While virtual reality settings have been repeatedly suggested to represent possible tools to help the rehabilitation process, no systematic study had been conducted so far. We systematically reviewed the current literature to analyze the published protocols documenting the use of virtual reality settings for peripheral vestibular disorders rehabilitation. There is an important diversity of settings and protocols involving virtual reality settings for the treatment of this pathology. Evaluation of the symptoms is often not standardized. However, our results unveil a clear effect of virtual reality settings-based rehabilitation of the patients’ symptoms, assessed by objectives tools such as the DHI (mean decrease of 27 points, changing symptoms handicap perception from moderate to mild impact on life. Furthermore, we detected a relationship between the duration of the exposure to virtual reality environments and the magnitude of the therapeutic effects, suggesting that virtual reality treatments should last at least 150 minutes of cumulated exposure to ensure positive outcomes. Virtual reality offers a pleasant and safe environment for the patient. Future studies should standardize evaluation tools, document putative side effects further, compare virtual reality to conventional physical therapy, and evaluate economical costs/benefits of such strategies.

  16. Use of Virtual Reality Tools for Vestibular Disorders Rehabilitation: A Comprehensive Analysis.

    Science.gov (United States)

    Bergeron, Mathieu; Lortie, Catherine L; Guitton, Matthieu J

    2015-01-01

    Classical peripheral vestibular disorders rehabilitation is a long and costly process. While virtual reality settings have been repeatedly suggested to represent possible tools to help the rehabilitation process, no systematic study had been conducted so far. We systematically reviewed the current literature to analyze the published protocols documenting the use of virtual reality settings for peripheral vestibular disorders rehabilitation. There is an important diversity of settings and protocols involving virtual reality settings for the treatment of this pathology. Evaluation of the symptoms is often not standardized. However, our results unveil a clear effect of virtual reality settings-based rehabilitation of the patients' symptoms, assessed by objectives tools such as the DHI (mean decrease of 27 points), changing symptoms handicap perception from moderate to mild impact on life. Furthermore, we detected a relationship between the duration of the exposure to virtual reality environments and the magnitude of the therapeutic effects, suggesting that virtual reality treatments should last at least 150 minutes of cumulated exposure to ensure positive outcomes. Virtual reality offers a pleasant and safe environment for the patient. Future studies should standardize evaluation tools, document putative side effects further, compare virtual reality to conventional physical therapy, and evaluate economical costs/benefits of such strategies.

  17. Vestibular rehabilitation: clinical benefits to patients with Parkinson's disease Reabilitação vestibular: utilidade clínica em pacientes com doença de Parkinson

    Directory of Open Access Journals (Sweden)

    Bianca Simone Zeigelboim

    2009-06-01

    Full Text Available OBJECTIVE: To evaluate the effectiveness of the vestibular rehabilitation (VR exercises by means of an assessment before and after the application of the Brazilian version of the Dizziness Handicap Inventory (DHI questionnaire. METHOD: Twelve patients were studied, the following procedures were carried out: anamnesis, otorhinolaryngological and vestibular evaluation, and the application of the DHI before and after the VR. RESULTS: Clinically resting tremors and subjective postural instability were the motor complaints most frequently associated with complaints of vertigo in 12 cases (100%; in the vestibular exam, all the patients presented abnormalities, frequently from the uni and bilateral peripheral vestibular deficiency syndromes in 10 cases (83.3%; there was significant improvement in the physical, functional and emotional aspects of the DHI after the completion of the VR. CONCLUSION: The VR following the Cawthorne and Cooksey protocol were shown to be useful in managing subjective complaints of several aspects evaluated in this protocol.OBJETIVO: Avaliar a eficácia dos exercícios de reabilitação vestibular (RV por meio de avaliação pré e pós-aplicação da versão brasileira do questionário Dizziness Handicap Inventory (DHI. MÉTODO: Estudou-se 12 pacientes e realizaram-se os seguintes procedimentos: anamnese, avaliação otorrinolaringológica, vestibular e aplicação do DHI pré e pós RV. RESULTADOS: Do ponto de vista clínico, o tremor de repouso e a instabilidade postural subjetiva foram às queixas motoras mais freqüentes associadas às queixas de vertigem em 12 casos (100%; no exame vestibular, todos os pacientes apresentaram anormalidades, com freqüência das síndromes vestibulares periféricas deficitárias uni e bilaterais em 10 casos (83,3%; houve melhora significativa dos aspectos físico, funcional e emocional do DHI após a realização da RV. CONCLUSÃO: A RV seguindo o protocolo de Cawthorne e Cooksey mostrou

  18. Shoulder-elbow exoskeleton as rehabilitation exerciser

    Science.gov (United States)

    Ianoşi, A.; Dimitrova, A.; Noveanu, S.; Tătar, O. M.; Mândru, D. S.

    2016-08-01

    This paper presents a 2 degree of freedom exoskeleton designed for the rehabilitation of the shoulder and elbow movement in the sagittal plane; a semi-portable design strategy was chosen, which enables an easy attachment to a standard medical chair as well as the patient upper limb. A dedicated driver enables the control from a graphical user interface, which also provides the option of customized rehabilitation exercises. The potential of future improvements is assessed, and recommendations of research direction are made in order to broaden the usability of the proposed device.

  19. Preliminary evidence of improved gaze stability following exercise in two children with vestibular hypofunction.

    Science.gov (United States)

    Braswell, Jennifer; Rine, Rose Marie

    2006-11-01

    Despite impaired gaze stability and reading in children with sensorineural hearing loss (SNHL) and vestibular hypofunction (VH), there are no reports of intervention. We examined the effect of visual-vestibular exercises in two children on dynamic visual acuity (DVA), critical print size (CPS) and reading acuity (RA) using an ABA design. Improvement in CPS and RA was seen in both subjects. DVA improved only in the subject with acquired versus congenital VH. These results suggest that although exercise improves reading acuity, age at the time of lesion affects the improvement of DVA in children with SNHL and BVH.

  20. Internet-Based Vestibular Rehabilitation for Older Adults With Chronic Dizziness: A Randomized Controlled Trial in Primary Care

    OpenAIRE

    Geraghty, Adam W.A.; Essery, Rosie; Kirby, Sarah; Stuart, Beth; Turner, David; Little, Paul; Bronstein, Adolfo; Andersson, Gerhard; Carlbring, Per; Yardley, Lucy

    2017-01-01

    Purpose: Vestibular Rehabilitation (VR) is an effective intervention for dizziness due to vestibular dysfunction, but is seldom provided. We aimed to determine the effectiveness of internet-based VR for older adults experiencing dizziness in primary care. Methods: A single centre, single blind randomised controlled trial comparing an internet-based VR intervention with usual primary care was conducted with patients from 54 primary care practices in southern England (ISRCTN: 86912968). Pati...

  1. A Conceptual Framework for the Progression of Balance Exercises in Persons with Balance and Vestibular Disorders.

    Science.gov (United States)

    Klatt, B N; Carender, W J; Lin, C C; Alsubaie, S F; Kinnaird, C R; Sienko, K H; Whitney, S L

    There is little information in peer-reviewed literature to specifically guide the choice of exercise for persons with balance and vestibular disorders. The purpose of this study is to provide a rationale for the establishment of a progression framework and propose a logical sequence in progressing balance exercises for persons with vestibular disorders. Our preliminary conceptual framework was developed by a multidisciplinary team of physical therapists and engineers with extensive experience with people with vestibular disorders. Balance exercises are grouped into six different categories: static standing, compliant surface, weight shifting, modified center of gravity, gait, and vestibulo-ocular reflex (VOR). Through a systematized literature review, interviews and focus group discussions with physical therapists and postural control experts, and pilot studies involving repeated trials of each exercise, exercise progressions for each category were developed and ranked in order of degree of difficulty. Clinical expertise and experience guided decision making for the exercise progressions. Hundreds of exercise combinations were discussed and research is ongoing to validate the hypothesized rankings. The six exercise categories can be incorporated into a balance training program and the framework for exercise progression can be used to guide less experienced practitioners in the development of a balance program. It may also assist clinicians and researchers to design, develop, and progress interventions within a treatment plan of care, or within clinical trials. A structured exercise framework has the potential to maximize postural control, decrease symptoms of dizziness/visual vertigo, and provide "rules" for exercise progression for persons with vestibular disorders. The conceptual framework may also be applicable to persons with other balance-related issues.

  2. Exercise rehabilitation in patients with cancer

    Science.gov (United States)

    Lakoski, Susan G.; Eves, Neil D.; Douglas, Pamela S.; Jones, Lee W.

    2013-01-01

    Emerging evidence indicates that patients with cancer have considerable impairments in cardiorespiratory fitness, which is likely to be a result of the direct toxic effects of anticancer therapy as well as the indirect consequences secondary to therapy (for example, deconditioning). This reduced cardiorespiratory fitness is associated with heightened symptoms, functional dependence, and possibly with an increased risk of cardiovascular morbidity and mortality. Current understanding of the complex interaction between the effects of the tumour and cancer-associated therapies on the organ components that govern cardiorespiratory fitness, and the effects of exercise training on these parameters is limited; further research will be critical for further progress of exercise-based rehabilitation in the oncology setting. We assess the current evidence regarding the level, mechanisms, and clinical importance of diminished cardiorespiratory fitness in patients with cancer. The efficacy and adaptations to exercise training to prevent and/or mitigate dysfunction in conjunction with exercise prescription considerations for clinical use are also discussed. PMID:22392097

  3. The Effect of Vestibular Rehabilitation in the Treatment of Elderly Patients with Benign Paroxysmal Positional Vertigo

    Directory of Open Access Journals (Sweden)

    N. Saki

    2011-04-01

    Full Text Available Introduction & Objective: Vertigo in the elderly is relatively common, but only a few studies are available. Vestibular rehabilitation (VR therapy is an important therapeutic option in treating patients with significant balance deficits. The purpose of this study was to analyze the effect of vestibular rehabilitation on vertigo symptoms in elderly patients with benign paroxysmal positional vertigo (BPPV. Materials & Methods: In a cross sectional analytic design, 46 patients older than 60 years (aged 61 to 72 years with BPPV who referred to the ENT center of Imam Khomeini Hospital, Ahwaz, were studied. After an otologic evaluation, videonystagmography and dizziness handicap inventory (DHI evaluations were performed for each case. Then, vestibular rehabilitation (VR therapy was carried out by means of Epley maneuver. Efficacy of a VRT was tested by comparing pre-treatment with post-treatment VNG and DHI assessments. The data were analyzed by SPSS 16 software. Results: The average age of the patients was 67.28 ± 4.5 years. VR caused normal Hallpike findings in 31 (67.4 % and noticeable reduction in nystagmus amplitudes in 9 patients. We found a significant correlation between nystagmus amplitudes and DHI scores (r=0.77. The mean DHI scores decreased from 53.26±16.12 points to 15.36±9.23 points (p<0.001 at the end of the treatment course. Conclusion: Our investigation revealed that VR plays an important role in reducing vertigo in at-risk elderly patients. Lack of appropriate treatment in this population may cause a serious balance problem (such as bone fracture and long-term handicap that may interfere with their daily activities. (Sci J Hamadan Univ Med Sci 2011;18(1:33-36

  4. Vestibular physical therapy intervention: utilizing a computer assisted rehabilitation environment in lieu of traditional physical therapy.

    Science.gov (United States)

    Gottshall, Kim R; Sessoms, Pinata H; Bartlett, Jamie L

    2012-01-01

    Advanced technology such as virtual reality or immersive environments increases the complexities and challenges therapists can impose on their patients. In this study, four patients with mild traumatic brain injury utilized a Computer Assisted Rehabilitation Environment (CAREN) in place of traditional vestibular physical therapy. Patients visited the CAREN twice weekly for 6 weeks. Therapy sessions included a variety of applications that tasked the cognitive and physical capabilities of individual patients. After the 6 weeks, all patients showed improvement on balance, gait and visual measures. Virtual reality based therapy is an engaging and effective tool to treat patients with deficiencies related to a prior brain injury.

  5. Parallel Robot for Lower Limb Rehabilitation Exercises

    Directory of Open Access Journals (Sweden)

    Alireza Rastegarpanah

    2016-01-01

    Full Text Available The aim of this study is to investigate the capability of a 6-DoF parallel robot to perform various rehabilitation exercises. The foot trajectories of twenty healthy participants have been measured by a Vicon system during the performing of four different exercises. Based on the kinematics and dynamics of a parallel robot, a MATLAB program was developed in order to calculate the length of the actuators, the actuators’ forces, workspace, and singularity locus of the robot during the performing of the exercises. The calculated length of the actuators and the actuators’ forces were used by motion analysis in SolidWorks in order to simulate different foot trajectories by the CAD model of the robot. A physical parallel robot prototype was built in order to simulate and execute the foot trajectories of the participants. Kinect camera was used to track the motion of the leg’s model placed on the robot. The results demonstrate the robot’s capability to perform a full range of various rehabilitation exercises.

  6. Parallel Robot for Lower Limb Rehabilitation Exercises.

    Science.gov (United States)

    Rastegarpanah, Alireza; Saadat, Mozafar; Borboni, Alberto

    2016-01-01

    The aim of this study is to investigate the capability of a 6-DoF parallel robot to perform various rehabilitation exercises. The foot trajectories of twenty healthy participants have been measured by a Vicon system during the performing of four different exercises. Based on the kinematics and dynamics of a parallel robot, a MATLAB program was developed in order to calculate the length of the actuators, the actuators' forces, workspace, and singularity locus of the robot during the performing of the exercises. The calculated length of the actuators and the actuators' forces were used by motion analysis in SolidWorks in order to simulate different foot trajectories by the CAD model of the robot. A physical parallel robot prototype was built in order to simulate and execute the foot trajectories of the participants. Kinect camera was used to track the motion of the leg's model placed on the robot. The results demonstrate the robot's capability to perform a full range of various rehabilitation exercises.

  7. Gaze stabilization exercises derive sensory reweighting of vestibular for postural control

    OpenAIRE

    Ueta, Yusuke; Matsugi, Akiyoshi; Oku, Kosuke; Okuno, Kojiro; Tamaru, Yoshiki; Nomura, Shohei; Tanaka, Hiroaki; Douchi, Shinya; Mori, Nobuhiko

    2017-01-01

    [Purpose] The aim of this study was to investigate whether gaze stabilization exercise derives sensory reweighting of vestibular for upright postural control. [Subjects and Methods] Twenty-three healthy volunteers participated in this study. The center of pressure of the total trajectory length was measured before (pre), immediately after (post), and 10?min after (post10) gaze stabilization exercise, in the static standing position, with the eyes open or closed, on the floor or on foam rubber...

  8. Effectiveness of conventional versus virtual reality based vestibular rehabilitation in the treatment of dizziness, gait and balance impairment in adults with unilateral peripheral vestibular loss: a randomised controlled trial.

    OpenAIRE

    Dara Meldrum; Susan Herdman; Roisin Moloney; Deirdre Murray; Douglas Duffy; Kareena Malone; Helen French; Stephen Hone; Ronan Conroy; Rory McConn-Walsh

    2012-01-01

    Abstract Background Unilateral peripheral vestibular loss results in gait and balance impairment, dizziness and oscillopsia. Vestibular rehabilitation benefits patients but optimal treatment remains unkown. Virtual reality is an emerging tool in rehabilitation and provides opportunities to improve both outcomes and patient satisfaction with treatment. The Nintendo Wii Fit Plus® (NWFP) is a low cost virtual reality system that challenges balance and provides visual and auditory feedback. It ma...

  9. 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.

  10. Tai Chi and vestibular rehabilitation effects on gaze and whole-body stability.

    Science.gov (United States)

    McGibbon, Chris A; Krebs, David E; Wolf, Steven L; Wayne, Peter M; Scarborough, Donna Moxley; Parker, Stephen W

    2004-01-01

    Tai Chi (TC) is a comparatively new intervention for peripheral vestibular hypofunction, which is often treated with vestibular rehabilitation (VR). We compared gaze stability (GZS), whole-body stability (WBS) and footfall stability (FFS) during locomotion among 26 people with vestibulopathy (VSP), randomized into two treatment arms (13 TC and 13 VR). Each intervention program was offered for 10 weeks. GZS improved more for VR than for TC, but WBS (and FFS) improved more for TC than for VR. There was a significant relationship between changes in GZS and WBS for the VR subjects (r=0.60, p=0.01), but not for TC subjects. There was a significant relationship between changes in WBS and FFS for both VR (r=0.65, p VR but not the TC group when controlling for GZS. These findings suggest that VR and TC both benefit patients with VSP but via differing mechanisms. Moreover, these data are the first to test the assumption that improving gaze control among patients with VSP perforce improves postural stability: it does not. We conclude that GZS is most improved in those who receive VR, but that TC improves WBS and FFS without improving GZS, suggesting patients with VSP can rely on non-gaze related mechanisms to improve postural control.

  11. Vestibuler rehabilitation in bilateral vestibulopaty

    Directory of Open Access Journals (Sweden)

    Onur Armağan

    2017-04-01

    Full Text Available Bilateral vestibulopathy is a heterogeneous chronic condition characterized by a bilateral reduced or absent function of the vestibular organs, the vestibular nerves or a combination of both. The vestibular system plays a crucial role in the multisensory control of balance. When vestibular function is lost, essential tasks such as postural control, gaze stabilization, and balance deteriorate and the quality of life of patients is significantly impaired. Nowadays the widely available treatment of bilateral vestibulopathy is vestibular rehabilitation. The aim of the vestibular rehabiltation is to use adaptive mechanisms of brain and to activate compensation mechanisms. In this review, applications of vestibular rehabilitation, different exercise programs and techniques are presented by reviewing recent literature results.

  12. Internet-based vestibular rehabilitation for adults aged 50 years and over: a protocol for a randomised controlled trial.

    Science.gov (United States)

    Geraghty, Adam W A; Kirby, Sarah; Essery, Rosie; Little, Paul; Bronstein, Adolfo; Turner, David; Stuart, Beth; Andersson, Gerhard; Carlbring, Per; Yardley, Lucy

    2014-07-22

    Dizziness is highly prevalent in older adults and can lead to falls, fear of falling, loss of confidence, anxiety and depression. Vestibular rehabilitation (VR) exercises are effective in reducing dizziness due to vestibular dysfunction, but access to trained therapists is limited. Providing dizzy patients with booklets teaching them how to carry out VR exercises has been shown to be a cost-effective way of managing dizziness in primary care. Internet-based intervention delivery has many advantages over paper-based methods, including the provision of video instructions, automated tailoring and symptom-related feedback. This trial will examine whether an internet-based VR intervention is (1) effective in reducing dizziness and (2) a cost-effective primary care treatment option. This will be a single blind, randomised controlled trial carried out in UK primary care. A stand-alone internet-based VR intervention will be compared with routine care in 262 dizzy patients aged 50 years and over. Measures will be taken at baseline, 3 and 6 months. Our primary outcome measure will be the effectiveness of the intervention in reducing dizziness symptoms compared with routine care at 6 months. Cost-effectiveness will be examined along with the effect of the intervention on dizziness-related disability and symptoms of depression and anxiety. Psychological process variables including expectancy, self-efficacy and acceptance will be explored in relation to adherence and symptom reduction. This trial has undergone ethical scrutiny and been approved by an NHS Research Ethics Committee, Southampton A REC Reference: 13/SC/0119. The findings of this trial will be disseminated to the scientific community through presentations at national and international conferences, and by publishing in peer review journals. Findings will be disseminated to the public through targeted press releases. This trial will provide valuable information on the role of internet interventions in facilitating

  13. Influence of vestibular rehabilitation on neck pain and cervical range of motion among patients with whiplash-associated disorder: a randomized controlled trial

    National Research Council Canada - National Science Library

    Hansson, Eva Ekvall; Persson, Liselott; Malmström, Eva Maj

    2013-01-01

    To describe how vestibular rehabilitation influences pain and range of motion among patients with whiplash-associated disorder and dizziness, and to describe whether pain or range of motion correlated...

  14. Reabilitação vestibular na criança: estudo preliminar Vestibular rehabilitation in children: preliminary study

    OpenAIRE

    Bittar Roseli S.M.; Pedalini Maria E. B; Medeiros Ítalo R.T.; Bottino Marco A.; Bento Ricardo F.

    2002-01-01

    Forma de estudo: Clínico prospectivo. Objetivo: O estudo analisa prospectivamente os resultados da Reabilitação Vestibular pelo método de Cawtorne & Cooksey em 22 crianças, portadoras de vestibulopatia periférica, associada ou não a sintomas centrais, com idade média de 8,6 anos. Material e método: Os exames quantitativos da função vestibular utilizados para quantificar a vestibulopatia foram a eletronistagmografia e a prova rotatória pendular decrescente (PRPD), mas a história clínica altame...

  15. A systematic review about the effects of the vestibular rehabilitation in middle-age and older adults.

    Science.gov (United States)

    Ricci, Natalia A; Aratani, Mayra C; Doná, Flávia; Macedo, Camila; Caovilla, Heloísa H; Ganança, Fernando F

    2010-01-01

    to summarize the results of clinical trials on vestibular rehabilitation (VR) in middle-aged and elderly people with vestibular disorders. a search for relevant trials was performed in the databases LILACS, EMBASE, MEDLINE, SciELO, Cochrane, ISI Web of Knowledge and virtual libraries of theses and dissertations. Randomized controlled trials published in the last 10 years and written in English, Portuguese or Spanish were included. The methodological quality of the studies was assessed by the PEDro scale. Results from the included studies were analyzed through a critical review of content. nine studies were included in the review. Four studies reported on participants aged over 40 years (middle-aged and elderly) and five studies consisted exclusively of elderly subjects (over 60 years). Findings of vestibular dysfunction were diverse and the most common complaints were body imbalance or postural instability (3 studies), and vertigo or dizziness (3 studies). The Visual Analogue Scale (VAS) was the most commonly used instrument to assess subjective perception of symptoms of vestibular dysfunction (4 studies). According to the PEDro scale, four studies were considered to be of good quality. The most common experimental intervention was the Cawthorne & Cooksey protocol (4 studies). For most outcome measures, the studies comparing VR with another type of intervention showed no differences between the groups after the therapy. the studies included in this review provide evidence for the positive effects of VR in elderly and middle-aged adults with vestibular disturbances.

  16. Controlling Motion Sickness and Spatial Disorientation and Enhancing Vestibular Rehabilitation with a User-Worn See-Through Display

    Science.gov (United States)

    Krueger, Wesley W.O.

    2010-01-01

    Objectives/Hypotheses An eyewear mounted visual display (“User-worn see-through display”) projecting an artificial horizon aligned with the user's head and body position in space can prevent or lessen motion sickness in susceptible individuals when in a motion provocative environment as well as aid patients undergoing vestibular rehabilitation. In this project, a wearable display device, including software technology and hardware, was developed and a phase I feasibility study and phase II clinical trial for safety and efficacy were performed. Study Design Both phase I and phase II were prospective studies funded by the NIH. The phase II study used repeated measures for motion intolerant subjects and a randomized control group (display device/no display device) pre-post test design for patients in vestibular rehabilitation. Methods Following technology and display device development, 75 patients were evaluated by test and rating scales in the phase II study; 25 subjects with motion intolerance used the technology in the display device in provocative environments and completed subjective rating scales while 50 patients were evaluated before and after vestibular rehabilitation (25 using the display device and 25 in a control group) using established test measures. Results All patients with motion intolerance rated the technology as helpful for nine symptoms assessed, and 96% rated the display device as simple and easy to use. Duration of symptoms significantly decreased with use of the technology displayed. In patients undergoing vestibular rehabilitation, there were no significant differences in amount of change from pre- to post-therapy on objective balance tests between display device users and controls. However, those using the technology required significantly fewer rehabilitation sessions to achieve those outcomes than the control group. Conclusions A user-worn see-through display, utilizing a visual fixation target coupled with a stable artificial horizon

  17. Rehabilitation Effect of Exercise with Soft Tissue Manipulation in ...

    African Journals Online (AJOL)

    2017-05-22

    , et al. Rehabilitation effect of exercise with soft tissue manipulation in patients with lumbar muscle strain. Niger J Clin Pract 2017;20:629-33. This is an open access article distributed under the terms of the Creative Commons.

  18. REHABILITATION OF LUMBAR HYPERLORDOSIS THROUGH SWIMMING-SPECIFIC EXERCISES

    OpenAIRE

    Petrea Renato-Gabriel; Rusu Diana-Elena

    2014-01-01

    The purpose of this paper is to show the importance and utility of swimming within rehabilitation and therapeutic programs for posture deficiencies, in our context for the rehabilitation of lumbar hyperlordosis. We consider that, by using exercises specific to swimming and means specific to acquiring swimming procedures, we will reduce the range of lumbar hyperlordosis. More precisely, we believe that, through exercises specific to swimming, we will reduce the range of lumbar hyperlordosis by...

  19. Measuring outcome from Vestibular Rehabilitation, Part I: Qualitative development of a new self-report measure.

    Science.gov (United States)

    Morris, Anna E; Lutman, Mark E; Yardley, Lucy

    2008-04-01

    Research suggests that Vestibular Rehabilitation (VR) is an effective treatment for dizziness, but there is currently no measure specifically designed to assess treatment outcome. A review of existing self-report measures of dizziness indicates that no measure has been designed for longitudinal application and all suffer from limitations which restrict their usefulness in measuring VR outcome. A need for a psychometrically robust patient-oriented measure of quality of life benefit from VR is identified. The aim of the present study was to explore dimensions relevant to VR with a view to developing a measure of outcome. Eighteen adults receiving VR participated in interviews about the quality of life impact of dizziness. Qualitative analysis revealed 64 themes describing self-perceived quality of life impact. Themes were developed into potential questionnaire items and 35 were selected to represent the quality of life impact of dizziness in a prototype questionnaire. A quarter of items in the prototype questionnaire refer to issues not addressed by existing measures; the remaining items draw together issues covered by the range of questionnaires currently in use.

  20. Exercise-based cardiac rehabilitation for adults with atrial fibrillation

    DEFF Research Database (Denmark)

    Risom, Signe Stelling; Zwisler, Anne Dorthe; Palm Johansen, Pernille

    2014-01-01

    This is the protocol for a review and there is no abstract. The objectives are as follows: The aim of this review is to assess the benefits and harms of rehabilitation programmes consisting of a physical exercise component that focuses on increasing exercise capacity, and may include...

  1. Exercise training programs in Dutch cardiac rehabilitation centres

    NARCIS (Netherlands)

    Vromen, T.; Spee, R. F.; Kraal, J. J.; Peek, N.; van Engen-Verheul, M. M.; Kraaijenhagen, R. A.; Gijsbers, H. J. H.; Kemps, H. M. C.

    2013-01-01

    To assess methods for determination of exercise intensity, and to investigate practice variation with respect to the contents, volume and intensity of exercise training programs in Dutch cardiac rehabilitation (CR) centres. A paper questionnaire was sent to all Dutch CR centres, consisting of 85

  2. Exercise-related cardiac cardiac rehabilitation arrest In

    African Journals Online (AJOL)

    most important being myocardial infarction and cardiac arrest. (CA).1,2. 'Normal' ... myocardial infarction and CA in cardiac rehabilitation pro- ..... The acute risk of. Strenuous exercise.JAMA 1980; 244: 1799-1801. 5. Siscovick DS, Weiss NS, Fletcber RH et al. The incidence of primary cardiac arrest during vigorous exercise.

  3. Exercise-based cardiac rehabilitation in heart transplant recipients

    DEFF Research Database (Denmark)

    Anderson, Lindsey; Dall, Christian H.; Nguyen, Tricia T.

    2016-01-01

    This is the protocol for a review and there is no abstract. The objectives are as follows: To determine the effectiveness and safety of exercise-based rehabilitation on the mortality, hospital admissions, morbidity, exercise capacity, health-related quality of life, and return to work of people a...... after heart transplantation....

  4. Cancer survivors' experience of exercise-based cancer rehabilitation

    DEFF Research Database (Denmark)

    Midtgaard, Julie; Hammer, Nanna Maria; Andersen, Christina

    2015-01-01

    BACKGROUND: Evidence for the safety and benefits of exercise training as a therapeutic and rehabilitative intervention for cancer survivors is accumulating. However, whereas the evidence for the efficacy of exercise training has been established in several meta-analyses, synthesis of qualitative...... research is lacking. In order to extend healthcare professionals' understanding of the meaningfulness of exercise in cancer survivorship care, this paper aims to identify, appraise and synthesize qualitative studies on cancer survivors' experience of participation in exercise-based rehabilitation. MATERIAL......-based rehabilitation according to cancer survivors. Accordingly, the potential of rebuilding structure in everyday life, creating a normal context and enabling the individual to re-establish confidentiality and trust in their own body and physical potential constitute substantial qualities fundamental...

  5. The rationale and technique of head exercises in the treatment of vertigo.

    Science.gov (United States)

    Dix, M R

    1979-01-01

    The central compensation mechanisms for vertigo resulting from vestibular lesions are described together with the scientific basis for head exercises in vestibular rehabilitation. The indications and contra-indications for head exercises are discussed and the Cawthorne-Cooksey regime of exercises illustrated.

  6. CURRENT CONCEPTS IN MUSCLE STRETCHING FOR EXERCISE AND REHABILITATION

    Science.gov (United States)

    2012-01-01

    Stretching is a common activity used by athletes, older adults, rehabilitation patients, and anyone participating in a fitness program. While the benefits of stretching are known, controversy remains about the best type of stretching for a particular goal or outcome. The purpose of this clinical commentary is to discuss the current concepts of muscle stretching interventions and summarize the evidence related to stretching as used in both exercise and rehabilitation. PMID:22319684

  7. Proposta de um protocolo para reabilitação vestibular em vestibulopatias periféricas

    OpenAIRE

    Rogatto, Adriana Roberta Degressi; Pedroso, Laira; Almeida, Sara Regina Meira; Oberg, Telma Dagmar

    2010-01-01

    INTRODUCTION: Vestibular rehabilitation has been recognized as a treatment of choice for patients with persistent vertigo due to peripheral vestibular dysfunction, providing significant improvements in quality of life. Among the treatments listed have been exercises Cawthorne and Cooksey, sensory integration and body-moving platforms. OBJECTIVE: The research objective was to invent the protocol of exercises in balance with the exercises of Cawthorne and Cooksey associated to the Sensory Integ...

  8. Exercise suppresses COX-2 pro-inflammatory pathway in vestibular migraine.

    Science.gov (United States)

    Lee, Yi-Yen; Yang, Yi-Ping; Huang, Pin-I; Li, Wen-Cheng; Huang, Ming-Chao; Kao, Chung-Lan; Chen, Yann-Jang; Chen, Ming-Teh

    2015-07-01

    Migraine and dizziness are relatively common disorders. Patients with dizziness have a higher incidence of migraines than the general population. The discomfort experienced by these patients is often poorly controlled by medication. However, the pathophysiology of vestibular migraine (VM) remains unclear. We hypothesized that patients with VM would experience remission from symptoms after exercise training and that this effect may be mediated through the suppression of cyclooxygenase-2 (COX-2)-mediated inflammation. Thus, the aim of the present study was to investigate the efficacy and possible anti-inflammatory benefits of exercise in patients with VM. We assessed the level of soluble inflammatory mediators in plasma from VM patients and control subjects. Our analysis of cytokine expression in the patients with VM undergoing exercise treatment revealed a significant reduction in pro-inflammatory cytokines and/or cytotoxic factors, such as tumor necrosis factor-α, interleukins, nitric oxide (NO), inducible NO synthase, and reactive oxygen species. In contrast, we found an increase in the level of anti-inflammatory cytokines after exercise. Moreover, the group undergoing exercise training showed significant symptomatic improvement and demonstrated suppressed antioxidant enzyme activity. To summarize, our data suggest that exercise significantly inhibits COX-2 activity, leading to the suppression of pro-inflammatory cytokines and changes in redox status. These results suggest that there is a molecular link between the central nervous system and the immune system. Furthermore, elucidation of the neurobiological mechanisms underlying VM could potentially lead to the development of novel therapeutic interventions for these patients. Copyright © 2015 Elsevier Inc. All rights reserved.

  9. Rehabilitation effect of exercise with soft tissue manipulation in ...

    African Journals Online (AJOL)

    Objective: To study the rehabilitation effect of exercise with soft tissue manipulation therapy for patients with lumbar muscle strain. Methods: Patients with lumbar muscle strain who met the inclusion criteria for study were randomly divided into control and experimental groups. Conventional therapy (i.e., triple therapy of ...

  10. Exercise and rehabilitation for individuals with multiple sclerosis.

    Science.gov (United States)

    Brown, Theodore R; Kraft, George H

    2005-05-01

    It is the coexistence of physical and cognitive impairments, together with emotional and social issues in a disease with an uncertain course, that makes MS rehabilitation unique and challenging. Inpatient rehabilitation improves functional independence but has only limited success improving the level of neurologic impairment. Benefits are usually not long lasting. Severely disabled people derive equal or more benefit than those who are less disabled, but cognitive problems and ataxia tend to be refractory. There is now good evidence that exercise can improve fitness and function for those with mild MS and helps to maintain function for those with moderate to severe disability. Therapy can be performed over 6 to 15 weeks in outpatient or home-based settings or as a weekly day program lasting several months. Several different forms of exercise have been investigated. For most individuals, aerobic exercise that incorporates a degree of balance training and socialization is recommended. Time constraints, access, impairment level, personal preferences, motivations, and funding sources influence the prescription for exercise and other components of rehabilitation. Just as immunomodulatory drugs must be taken on a continual basis and be adjusted as the disease progresses, so should rehabilitation be viewed as an ongoing process to maintain and restore maximum function and QOL.

  11. Exercise and Rehabilitation Delivered through Exergames in Older Adults

    DEFF Research Database (Denmark)

    Skjæret, Nina; Nawaz, Ather; Morat, Tobias

    2016-01-01

    Background: There has been a rapid increase in research on the use of virtual reality (VR) and gaming technology as a complementary tool in exercise and rehabilitation in the elderly population. Although a few recent studies have evaluated their efficacy, there is currently no in-depth description...

  12. Exercise-Based Cardiac Rehabilitation for Coronary Heart Disease

    DEFF Research Database (Denmark)

    Anderson, Lindsey; Oldridge, Neil; Thompson, David R

    2016-01-01

    BACKGROUND: Although recommended in guidelines for the management of coronary heart disease (CHD), concerns have been raised about the applicability of evidence from existing meta-analyses of exercise-based cardiac rehabilitation (CR). OBJECTIVES: The goal of this study is to update the Cochrane...

  13. Disability and rehabilitation in the dizzy patient.

    Science.gov (United States)

    Cohen, Helen S

    2006-02-01

    This review focuses on prospective studies of vertigo and balance therapy in the past 3 years, including advances in vertigo-habituation exercises for adults, pediatric intervention, and virtual reality techniques, and, in more depth, the literature pertinent to driving motor vehicles. Increased support has been generated for the efficacy of a minimal, home-based vertigo-habituation program for adults with peripheral vestibular disorders. Vestibular rehabilitation has been shown to be associated with improvements in independence and dynamic visual acuity. Community-based vestibular rehabilitation has been shown to be efficacious for selected patients, after careful screening, when trained personnel provide intervention. Vestibular rehabilitation has been incorporated into the rehabilitation program for head-injured military personnel who will be returned to duty, and multifactorial balance rehabilitation has been shown to be useful for children with hearing and balance impairments. Virtual reality techniques have made significant advances, so immersive environments have potential for rehabilitation for patients with vestibular disorders and for developing training regimens for astronauts to ameliorate some effects of exposure to microgravity. Driving skill, in general, is affected by use of benzodiazepines. For many patients with vestibular impairments driving is a particularly problematic activity of daily living. Progress has been made in studies of acute care, community-based, and pediatric vestibular rehabilitation. Work on simulator-based paradigms has moved toward readiness for implementation. Studies of driving have provided some insight into the problems of these patients. More work remains to be done on all of these problems.

  14. Exercise-based cardiac rehabilitation in patients with heart failure

    DEFF Research Database (Denmark)

    Lewinter, Christian; Doherty, Patrick; Gale, Christopher P

    2015-01-01

    BACKGROUND: Guidelines recommend exercise-based cardiac rehabilitation (EBCR) for patients with heart failure (HF). However, established research has not investigated the longer-term outcomes including mortality and hospitalisation in light of the contemporary management of HF. METHODS......: This was a systematic review including a meta-analysis of EBCR on all-cause mortality, hospital admission, and standardised exercise capacity using four separate exercise tests in patients with heart failure over a minimum follow-up of six months from January 1999-January 2013. Electronic searches were performed...

  15. Paciente com cefaleia e síndrome vestibular periférica: relato de caso Patient with headache and peripheral vestibular dysfunction: case report

    Directory of Open Access Journals (Sweden)

    Tatiane Maria Rossi

    2009-01-01

    Full Text Available TEMA: a Reabilitação Vestibular constitui-se numa opção de tratamento para pacientes portadores de síndrome vestibular periférica e cefaleia. PROCEDIMENTOS: o paciente, do sexo feminino com 26 anos de idade apresentava síndrome vestibular periférica acompanhada de crises de cefaleia. Foi realizada avaliação e terapia fonoaudiológica com exercícios de habituação vestibular além de fisioterapia e dieta recomendada pelo nutricionista. RESULTADOS: no período de 3 meses com reabilitação vestibular realizada semanalmente observou-se melhora no quadro vertiginoso e da cefaleia da paciente. CONCLUSÕES: evidenciou-se boa eficácia clínica para o tratamento desta paciente através da reabilitação vestibular com exercícios de habituação vestibular. Salienta-se a eficácia da reabilitação para a melhora na qualidade de vida da paciente e minimização das crises de cefaleia.BACKGROUND: vestibular rehabilitation is an option for treating peripheral vestibular syndrome and headache patients. PROCEDURES: the patient is a 29-year old woman and has Peripheral Vestibular Syndrome along with headache attacks. Evaluation and Phonoaudiological therapy with exercises of habituation tests with physical and nutritional therapy were carried out. RESULTS: in 3 month period with weekly vestibular rehabilitation therapy, we observed an improvement in the condition of the patient's vertigo and migraine. CONCLUSIONS: it was evident that the patient's treatment through the rehabilitation test with habituation test exercises had good efficiency. Please note the effectiveness of the rehabilitation for the improvement in the patient's life quality and minimization of headache attacks.

  16. Optimal duration of therapy in the recovery period of vestibular diseases

    Directory of Open Access Journals (Sweden)

    M. V. Zamergrad

    2014-01-01

    Full Text Available Dizziness is a common symptom in neurological and general medical practice. In most cases it is caused by diseases of the central or peripheral vestibular system. The most common vestibular system diseases include benign paroxysmal postural vertigo, dizziness, Meniere's disease, vestibular neuronitis, and cerebrovascular diseases. One of the main treatments for the diseases accompanied by dizziness is vestibular rehabilitation that is a complex of exercises, the goal of which is to stimulate vestibular compensation. Adequate vestibular compensation allows a patient to get rid of dizziness and unsteadiness even though vestibular system injury is irreversible. Some medications are able to enhance the efficiency of vestibular rehabilitation. At the same time, the optimal duration of treatment for the most common vestibular disorders has not beenadequately explored. The paper gives the results of an observational program, whose purpose was to determine the optimal duration of vestibular rehabilitation in combination with the use of tanakan in patients with non-progressive unilateral peripheral vestibular disorder.Patients and methods. Data on 46 patients aged 19 to 70 years who underwent vestibular rehabilitation and took tanakan for vertigo caused by vestibular neuronitis (n = 44, labyrinthitis (n =1, or Ramsay Hunt syndrome (n = 1 were analyzed. All the patients were examined four times. The symptoms were recorded and the histories of disease were considered. The degree of vestibular disorders, including vertigo, was assessed when collecting complaints. The symptoms of vertigo were objectivized using its vertigo rating scale and five-point subjective rating scale for vertigo. All the patients underwent standard somatic and neurological examinations and videonystagmography. During the first visit after diagnosis, vestibular exercises were chosen for the patients and tanakan was used in a dose of 40 mg thrice daily to accelerate

  17. Which is better in the rehabilitation of stroke patients, core stability exercises or conventional exercises?

    OpenAIRE

    Sun, Xibo; Gao, Qian; Dou, Honglei; Tang, Shujie

    2016-01-01

    [Purpose] The aim of this study was to determine which is better in the rehabilitation of stroke patients, core stability exercises or conventional exercises. [Subjects and Methods] Forty participants with hemiplegia were recruited in the Department of Neurology of Yidu Central Hospital of Weifang between January 2014 and February 2015 and randomly divided into either an experimental or control group. The patients in the control group performed conventional exercises for six weeks, and those ...

  18. Exercise-based cardiac rehabilitation for adults with atrial fibrillation

    DEFF Research Database (Denmark)

    Risom, Signe S.; Zwisler, Ann-Dorthe; Johansen, Pernille P.

    2017-01-01

    Background: Exercise-based cardiac rehabilitation may benefit adults with atrial fibrillation or those who had been treated for atrial fibrillation. Atrial fibrillation is caused by multiple micro re-entry circuits within the atrial tissue, which result in chaotic rapid activity in the atria....... Objectives: To assess the benefits and harms of exercise-based rehabilitation programmes, alone or with another intervention, compared with no-exercise training controls in adults who currently have AF, or have been treated for AF. Search methods: We searched the following electronic databases; CENTRAL...... and the Database of Abstracts of Reviews of Effectiveness (DARE) in the Cochrane Library, MEDLINE Ovid, Embase Ovid, PsycINFO Ovid, Web of Science Core Collection Thomson Reuters, CINAHL EBSCO, LILACS Bireme, and three clinical trial registers on 14 July 2016. We also checked the bibliographies of relevant...

  19. Reabilitação Vestibular em portadores de Vertigem Posicional Paroxística Benigna Vestibular rehabilitation in patients with benign paroxysmal positional vertigo

    Directory of Open Access Journals (Sweden)

    João Simão de Melo Neto

    2012-01-01

    Full Text Available OBJETIVO: verificar, por meio do questionário handicap de tontura, o efeito de um protocolo de Reabilitação Vestibular (RV em portadores de Vertigem Posicional Paroxística Benigna (VPPB sete dias após primeira intervenção e seis meses após a segunda intervenção. MÉTODO: pacientes submetidos à confirmação diagnóstica de VPPB pela positividade da manobra Dix-Hallpike foram avaliados (coleta pelo questionário Dizziness Handicap Inventory - brasileiro (DHI-brasileiro, antes da primeira intervenção, após a segunda (intervalo de sete dias e seis meses após a segunda intervenção. As intervenções constavam de relaxamento cervical, manobra de Epley e restrições posturais e foram aplicadas logo após a primeira avaliação e antes da segunda avaliação, com intervalo de sete dias. Os resultados obtidos foram submetidos à análise estatística. RESULTADOS: nove mulheres com média de 63 anos (desvio padrão 4,6 fizeram parte da amostra. Foram encontradas as seguintes pontuações no DHI-brasileiro: Aspecto Físico - apresentou média na coleta 1 de 2,6a(±0,17; coleta 2 de 0,82b (±0,24; coleta 3 de 1,43b(±0,43 com pPURPOSE: to evaluate, by means of the dizziness handicap questionnaire, the effect of a Vestibular Rehabilitation (VR protocol in patients with benign paroxysmal positional vertigo (BPPV, seven days after the first intervention and six months after the second intervention. METHOD: patients undergoing BPPV diagnosis confirmation by a positive Dix-Hallpike maneuver were assessed (collection by the Dizziness Handicap Inventory - Brazilian (DHI-Brazilian before the first intervention, after the second (seven day interval and six months after the second one. The interventions consisted of cervical relaxation, Epley and postural restrictions were applied after the first assessment and before the second evaluation, with an interval of seven days. The results were statistically analyzed. RESULTS: nine women with an average

  20. HIV - implications for exercise in treatment and rehabilitation

    Directory of Open Access Journals (Sweden)

    M. Mars

    2004-02-01

    Full Text Available Exercise is an integral part of many forms of rehabilitationfollowing muscle injury or surgery. It is usual to advise patients with a viral infection to avoid exercise because of the risk of developing myocarditis. Should HIV+ patients should be encouraged to undertake exercise as part of rehabilitation and should they further be advised to participate in regular exercise? There is sufficient evidence to support the benefits of regular exercise in the HIV+ patient. They will experience a training effect dependent on the normal parameters of frequency, intensity, duration, and mode of exercise.  The disease does place potential limitations to exercise, as the HI virus directly affects pulmonary, cardiac, skeletal muscle and endocrine function.  The effects of these changes may be  exacerbated by secondary infection and other pathological changes may be induced by treatment.  The advent of highly active antiretroviral therapy has brought with it a range of metabolic changes that may also influence exercise  participation. The limitations to exercise imposed by HIV infection and its treatment are reviewed.

  1. Patients’ follow-up using biomechanical analysis of rehabilitation exercises

    Directory of Open Access Journals (Sweden)

    Bruno Bonnechère

    2017-03-01

    Full Text Available Thanks to the evolution of game controllers video games are becoming more and more popular in physical rehabilitation. The integration of serious games in rehabilitation has been tested for various pathologies. Parallel to this clinical research, a lot of studies have been done in order to validate the use of these game controllers for simple biomechanical evaluation. Currently, it is thus possible to record the motions performed by the patients during serious gaming exercises for later analysis. Therefore, data collected during the exercises could be used for monitoring the evolution of the patients during long term rehabilitation. Before using the parameters extracted from the games to assess patients’ evolution two important aspects must be verified: the reproducibility of measurement and a possible effect of learning of the task to be performed. Ten healthy adults played 9 sessions of specific games developed for rehabilitation over a 3-weeks period. Nineteen healthy children played 2 sessions to study the influence of age. Different parameters were extracted from the games: time, range of motion, reaching area. Results of this study indicates that it is possible to follow the evolution of the patients during the rehabilitation process. The majority of the learning effect occurred during the very first session. Therefore, in order to allow proper regular monitoring, the results of this first session should not be included in the follow-up of the patient.

  2. Predictors of exercise capacity following exercise-based rehabilitation in patients with coronary heart disease and heart failure

    DEFF Research Database (Denmark)

    Uddin, Jamal; Zwisler, Ann-Dorthe; Lewinter, Christian

    2016-01-01

    BACKGROUND: The aim of this study was to undertake a comprehensive assessment of the patient, intervention and trial-level factors that may predict exercise capacity following exercise-based rehabilitation in patients with coronary heart disease and heart failure. DESIGN: Meta-analysis and meta...... of improvement in exercise capacity following exercise-based rehabilitation compared to control among patients with coronary heart disease or heart failure. Whilst higher exercise intensities were associated with a greater level of post-rehabilitation exercise capacity, there was no strong evidence to support...

  3. Exercise-based cardiac rehabilitation in heart transplant recipients.

    Science.gov (United States)

    Anderson, Lindsey; Nguyen, Tricia T; Dall, Christian H; Burgess, Laura; Bridges, Charlene; Taylor, Rod S

    2017-04-04

    Heart transplantation is considered to be the gold standard treatment for selected patients with end-stage heart disease when medical therapy has been unable to halt progression of the underlying pathology. Evidence suggests that aerobic exercise training may be effective in reversing the pathophysiological consequences associated with cardiac denervation and prevent immunosuppression-induced adverse effects in heart transplant recipients. To determine the effectiveness and safety of exercise-based rehabilitation on the mortality, hospital admissions, adverse events, exercise capacity, health-related quality of life, return to work and costs for people after heart transplantation. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library, MEDLINE (Ovid), Embase (Ovid), CINAHL (EBSCO) and Web of Science Core Collection (Thomson Reuters) to June 2016. We also searched two clinical trials registers and handsearched the reference lists of included studies. We included randomised controlled trials (RCTs) of parallel group, cross-over or cluster design, which compared exercise-based interventions with (i) no exercise control (ii) a different dose of exercise training (e.g. low- versus high-intensity exercise training); or (iii) an active intervention (i.e. education, psychological intervention). The study population comprised adults aged 18 years or over who had received a heart transplant. Two review authors independently screened all identified references for inclusion based on pre-specified inclusion criteria. Disagreements were resolved by consensus or by involving a third person. Two review authors extracted outcome data from the included trials and assessed their risk of bias. One review author extracted study characteristics from included studies and a second author checked them against the trial report for accuracy. We included 10 RCTs that involved a total of 300 participants whose mean age was 54.4 years. Women accounted

  4. Effects of primary caregiver participation in vestibular rehabilitation for unilateral neglect patients with right hemispheric stroke: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Dai CY

    2013-04-01

    Full Text Available Chin-Ying Dai,1,2 Yu-Hui Huang,3,4 Li-Wei Chou,5,6 Shiao-Chi Wu,7 Ray-Yau Wang,8 Li-Chan Lin9 1School of Nursing, National Yang Ming University, Taipei, Taiwan; 2Department of Nursing, Central Taiwan University of Science and Technology, Taichung, Taiwan; 3Department of Physical Medicine and Rehabilitation, Chung Shan Medical University Hospital, Taichung, Taiwan; 4School of Medicine, Chung Shan Medical University, Taichung, Taiwan; 5Department of Physical Medicine and Rehabilitation, China Medical University Hospital, Taichung, Taiwan; 6School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan; 7Institute of Health and Welfare Policy, National Yang-Ming University, Taipei, Taiwan; 8Department of Physical Therapy and Assistive Technology, National Yang-Ming University, Taipei, Taiwan; 9Institute of Clinical and Community Health Nursing, National Yang-Ming University, Taipei, Taiwan, Republic of China Introduction: The current study aims to investigate the effects of primary caregiver participation in vestibular rehabilitation (VR on improving the measures of neglect, activities of daily living (ADL, balance, and falls of unilateral neglect (UN patients. Methods: This study is a single-blind randomized controlled trial. Both experimental (n = 24 and control groups (n = 24 received conventional rehabilitation. The experimental group undertook VR for a month. During the first and second weeks, a registered nurse trained the experimental group in VR. The primary caregivers in the experimental group supervised and guided their patients in VR during the third and fourth weeks. The outcome measures were neglect, ADL, balance, and falls. Results: The two groups of UN patients showed a significant improvement in neglect, ADL, and balance over time. Based on the generalized estimating equations model, an interaction was observed between groups and times. Significant interactions were observed between the VR group

  5. Vestibular compensation following vestibular neurotomy.

    Science.gov (United States)

    Devèze, A; Montava, M; Lopez, C; Lacour, M; Magnan, J; Borel, L

    2015-09-01

    Four studies assessing vestibular compensation in Menière's disease patients undergoing unilateral vestibular neurotomy, using different analysis methods, are reviewed, with a focus on the different strategies used by patients according to their preoperative sensory preference. Four prospective studies performed in a university tertiary referral center were reviewed, measuring the pattern of vestibular compensation in Menière's disease patients before and after unilateral vestibular neurotomy on various assessment protocols: postural syndrome assessed on static posturography and gait analysis; perceptual syndrome assessed on subjective visual vertical perception; and oculomotor syndrome assessed on ocular cyclotorsion. Vestibular compensation occurred at variable intervals depending on the parameter investigated. Open-eye postural control and gait/walking returned to normal one month after neurotomy. Fine balance analysis found that visual perception of the vertical and ocular cyclotorsion impairment persisted at long-term follow-up. Clinical postural disturbance persisted only when visual afferents were cut off (eyes closed). These impairments were the expression of a postoperative change in postural strategy related to the new use of visual and non-visual references. Understanding pre-operative interindividual variation in balance strategy is critical to screening for postural instability and tailoring vestibular rehabilitation. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  6. Contribution Of Vestibular Rehabilitation In Tinnitus Recovery: A Surprising Result [contribu̧ão Da Reabilitação Vestibular Na Melhora Do Zumbido: Um Resultado Inesperado

    OpenAIRE

    Knobel K.A.B.; Pfeilsticker L.N.; Stoler G.; Sanchez T.G.

    2003-01-01

    Introduction: Dizziness and tinnitus are common symptoms on clinical practice that can occur simultaneous or independently. Both can have multiple or unknown etiology, and can be worsen by emotional factors and limit day-by-day activities. Aim: evaluate the results of vestibular rehabilitation (VR) focusing on tinnitus recovery. Study design: Longitudinal cohorte. Method: after the clinical observation of the non-intentional tinnitus recovery with the VR we studied the patients' files with di...

  7. Effects of Vestibular Rehabilitation on Balance Control in Older People with Chronic Dizziness: A Randomized Clinical Trial.

    Science.gov (United States)

    Ricci, Natalia Aquaroni; Aratani, Mayra Cristina; Caovilla, Heloísa Helena; Ganança, Fernando Freitas

    2016-04-01

    The aim of this study was to compare the effects of vestibular rehabilitation protocols on balance control in elderly with dizziness. This is a randomized clinical trial with 3-mo follow-up period. The sample was composed of 82 older individuals with chronic dizziness from vestibular disorders. The control group was treated according to the Conventional Cawthorne & Cooksey protocol (n = 40), and the experimental group was submitted to a Multimodal Cawthorne & Cooksey protocol (n = 42). Measures included Dynamic Gait Index, fall history, hand grip strength, Time Up-and-Go Test, sit-to-stand test, multidirectional reach, and static balance tests. With the exception of history of falls, Forward Functional Reach, Unipedal Right and Left Leg Eyes Closed, and Sensorial Romberg Eyes Open, all outcomes improved after treatments. Such results persisted at follow-up period, with the exception of the Tandem Eyes Open and the Timed Up-and-Go manual. The between-group differences for Sensorial Romberg Eyes Closed (4.27 secs) and Unipedal Left Leg Eyes Open (4.08 secs) were significant after treatment, favoring the Multimodal protocol. Both protocols resulted in improvement on elderly's balance control, which was maintained during a short-term period. The multimodal protocol presented better performance on specific static balance tests.

  8. The treatment of diseases related to balance disorders in the elderly and the effectiveness of vestibular rehabilitation.

    Science.gov (United States)

    Moreira Bittar, Roseli Saraiva; Simoceli, Lucinda; Bovino Pedalini, Maria Elisabete; Bottino, Marco Aurélio

    2007-01-01

    The aim of this study was to assess the impact of adequate treatment of concomitant diseases in the elderly undergoing Vestibular Rehabilitation (VR). 52 elderly patients with complaints of vertigo and/or imbalance requiring VR participated in this prospective study. The trial was designed as an open clinical assay at the Ear Nose and Throat Department Geriatric Otoneurology Clinic, and was done between 2003 and 2005. Patients were compared with the total group of elderly individuals treated with VR during the same period. 65 diseases were diagnosed in the study group, an average 1.25 diseases per patient. After the treatment of these diseases, patients underwent VR. The effectiveness of VR (remission and partial improvement rates) was 84.5% in the study group against 81.8% in the control group, which was not significant. Remission of symptoms, however, was present in 69.2% of the study group against 43.18% of the control group, which was statistically significant. The difference in the effectiveness of VR in both groups highlights the importance of the etiological treatment of concomitant diseases in patients with vestibular disorders.

  9. The role of eccentric exercise in sport injuries rehabilitation.

    Science.gov (United States)

    Frizziero, Antonio; Trainito, Sabina; Oliva, Francesco; Nicoli Aldini, Nicolò; Masiero, Stefano; Maffulli, Nicola

    2014-06-01

    Sports injuries frequently involve tendons, muscles and ligaments. The variable outcome of surgery and medical treatment support early functional treatments. Eccentric exercise (EE) showed effectiveness in the management of Achilles tendinopathy (AT), patellar tendinopathy (PT) and lateral epicondyle tendinopathy (LET). Preliminary results of EE in other tendinopathies and sports injuries suggest its wide prescription in the sport rehabilitation field. A comprehensive search of PubMed, Web of Science, the Cochrane Collaboration Database, Physiotherapy Evidence Database (PEDro), Evidence Based Medicine (EBM) Search review, National Guidelines, Scopus and Google Scholar was performed using keywords such as 'eccentric exercise', 'sports injuries rehabilitation', 'tendinopathy', 'hamstrings strain' 'adductor injuries' and 'ACL reconstruction rehabilitation'. EE, alone or associated with other therapies, represents a feasible, cost-effective and successful tool in the treatment of well-known targets and might be promising in shoulder tendinopathy, adductor-related groin pain, hamstring strains, and ACL rehabilitation. The lack of standardization of protocols, the variable amount, quality and follow-up of studies, the different anatomy and pathophysiology of the therapeutic targets limit the evidence of applicability of EE to sports injuries. The role of pathology and biomechanics in the response to EE should be further investigated. New randomized controlled trials should test the effectiveness of standardized EE regimens to various sites of sports injuries. © The Author 2014. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  10. Exercise Prescriptions for Training and Rehabilitation in Patients with Heart and Lung Disease.

    Science.gov (United States)

    Palermo, Pietro; Corrà, Ugo

    2017-07-01

    Rehabilitation in patients with advanced cardiac and pulmonary disease has been shown to increase survival and improve quality of life, among many other benefits. Exercise training is the fundamental ingredient in these rehabilitation programs. However, determining the amount of exercise is not straightforward or uniform. Most rehabilitation and training programs fix the time of exercise and set the exercise intensity to the goals of the rehabilitation program and the exercise-related hurdles of the individual. The exercise training intensity prescription must balance the desired gain in conditioning with safety. Symptom-limited cardiopulmonary exercise testing is the fundamental tool to identify the exercise intensity and define the appropriate training. In addition, cardiopulmonary exercise testing provides an understanding of the systems involved in oxygen transport and utilization, making it possible to identify the factors limiting exercise capacity in individual patients.

  11. [Factors influencing the participation of post coronary artery bypass patients in cardiac rehabilitation exercise].

    Science.gov (United States)

    Tang, Hsin-Ju; Tsai, Shiau-Ting; Chou, Fan-Hao

    2013-12-01

    Studies have shown that cardiovascular rehabilitation exercise improves quality of life in post-coronary-bypass-surgery patients. However, the rate of participation in this exercise by this patient group in Taiwan has increased only 8.2% during the past 13 years (from 61.9% in 1996 to 70.1% in 2009). Little is known about the factors that influence patient motivation to participate in cardiovascular rehabilitation exercise. This study explores the factors that influence patient participation in rehabilitation exercise following coronary bypass surgery. This cross-sectional, correlational study recruited a convenience sample of 253 patients who had undergone coronary bypass surgery at a medical center in southern Taiwan. Structured questionnaires, including a patient rehabilitation exercise experience questionnaire, Short Form-36 Health Survey-Taiwan Form, and cardiac rehabilitation exercise design factors questionnaire were used for data collection. SPSS19.0 was used to analyze data. The variables "healthcare provider recommendation of rehabilitation exercise", "exercise program accessibility", "physical health status", and "patient post-surgical exercise patterns" each had a significant influence on participant participation in post-surgical rehabilitation exercise. Binary logistic regression analyses identified "receiving information on rehabilitation exercise", "level of patient-perceived importance of rehabilitation exercise", and "having post-surgical exercise patterns" as important predictors of participation in a rehabilitation exercise program, with OR ratios of 112, 7.86, and 3.23 times respectively. These 3 factors accounted for 90.1% of the total variance. Patient education on coronary bypass post-surgical rehabilitation exercise programs should be emphasized during pre-surgical consultation and care in order to facilitate the recovery of normal life functions following coronary bypass surgery.

  12. Improvements in gait speed and weight shift of persons with traumatic brain injury and vestibular dysfunction using a virtual reality computer-assisted rehabilitation environment.

    Science.gov (United States)

    Sessoms, Pinata H; Gottshall, Kim R; Collins, John-David; Markham, Amanda E; Service, Kathrine A; Reini, Seth A

    2015-03-01

    Many people sustaining a traumatic brain injury experience vestibular pathology requiring physical therapy for treatment. This study measured improvements in gait speed and weight shift for subjects receiving vestibular physical therapy using a Computer-Assisted Rehabilitation Environment (CAREN). A 6-session CAREN, 6-session traditional vestibular therapy group was compared with a 12-session CAREN only (0 traditional sessions) therapy group. These two groups were compared to each other and with data from healthy controls performing similar tasks on the CAREN. Those participating in 12 CAREN sessions had greater improvements in gait speed (p=0.014) and weight shift scores (p<0.001) and demonstrated similar values achieved by a healthy control population. Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.

  13. [Physical activity and exercise recommendations for cancer patients during rehabilitation].

    Science.gov (United States)

    Zopf, E M; Baumann, F T; Pfeifer, K

    2014-02-01

    Cancer and its commonly required continuous and intensive medical treatment have a profound and lasting effect on patients' physical, functional, emotional and social wellbeing. In this context the positive comprehensive effects of physical exercise interventions increasingly prove to be promising. The aim of this review is to derive physical exercise recommendations for patients with cancer, especially concerning aerobic and resistance training during rehabilitation, based on the current literature. In a second step the 3 main cancer types breast cancer, prostate cancer and colon cancer and their distinctive features will be addressed briefly. A hierarchic literature research was conducted using the medical information portal Medpilot. The evaluation system of the "European Society of Cardiology" was applied in order to evaluate the evidence and compile evidence-based exercise recommendations for patients with cancer. When summing up the current data, physical exercise proves to be efficient, safe and feasible for patients with cancer. Both aerobic and resistance training have a positive influence on a patient's physical, psychological and social level and should therefore be included in every exercise program. While the evidence for breast cancer and increasingly also for prostate cancer is strong, research in colon cancer, for example, is still sparse. In order to create precise recommendations regarding the ideal exercise type and dose for the different cancer types during various treatment phases further high quality studies are necessary. © Georg Thieme Verlag KG Stuttgart · New York.

  14. Effects of primary caregiver participation in vestibular rehabilitation for unilateral neglect patients with right hemispheric stroke: a randomized controlled trial.

    Science.gov (United States)

    Dai, Chin-Ying; Huang, Yu-Hui; Chou, Li-Wei; Wu, Shiao-Chi; Wang, Ray-Yau; Lin, Li-Chan

    2013-01-01

    The current study aims to investigate the effects of primary caregiver participation in vestibular rehabilitation (VR) on improving the measures of neglect, activities of daily living (ADL), balance, and falls of unilateral neglect (UN) patients. This study is a single-blind randomized controlled trial. Both experimental (n = 24) and control groups (n = 24) received conventional rehabilitation. The experimental group undertook VR for a month. During the first and second weeks, a registered nurse trained the experimental group in VR. The primary caregivers in the experimental group supervised and guided their patients in VR during the third and fourth weeks. The outcome measures were neglect, ADL, balance, and falls. The two groups of UN patients showed a significant improvement in neglect, ADL, and balance over time. Based on the generalized estimating equations model, an interaction was observed between groups and times. Significant interactions were observed between the VR group at days 14 and 28 in the areas of neglect, ADL, and balance. No significant difference was observed between the two groups in the number of falls. Neglect, ADL, and balance among UN patients with right hemispheric stroke can be improved through the participation of primary caregivers in VR. Trained informal caregivers were recommended to provide VR guidance and supervision to patients who suffer from UN.

  15. Simulator sickness when performing gaze shifts within a wide field of view optic flow environment: preliminary evidence for using virtual reality in vestibular rehabilitation

    Directory of Open Access Journals (Sweden)

    Whitney Susan L

    2004-12-01

    Full Text Available Abstract Background Wide field of view virtual environments offer some unique features that may be beneficial for use in vestibular rehabilitation. For one, optic flow information extracted from the periphery may be critical for recalibrating the sensory processes used by people with vestibular disorders. However, wide FOV devices also have been found to result in greater simulator sickness. Before a wide FOV device can be used in a clinical setting, its safety must be demonstrated. Methods Symptoms of simulator sickness were recorded by 9 healthy adult subjects after they performed gaze shifting tasks to locate targets superimposed on an optic flow background. Subjects performed 8 trials of gaze shifting on each of the six separate visits. Results The incidence of symptoms of simulator sickness while subjects performed gaze shifts in an optic flow environment was lower than the average reported incidence for flight simulators. The incidence was greater during the first visit compared with subsequent visits. Furthermore, the incidence showed an increasing trend over the 8 trials. Conclusion The performance of head unrestrained gaze shifts in a wide FOV optic flow environment is tolerated well by healthy subjects. This finding provides rationale for testing these environments in people with vestibular disorders, and supports the concept of using wide FOV virtual reality for vestibular rehabilitation.

  16. Simulator sickness when performing gaze shifts within a wide field of view optic flow environment: preliminary evidence for using virtual reality in vestibular rehabilitation.

    Science.gov (United States)

    Sparto, Patrick J; Whitney, Susan L; Hodges, Larry F; Furman, Joseph M; Redfern, Mark S

    2004-12-23

    BACKGROUND: Wide field of view virtual environments offer some unique features that may be beneficial for use in vestibular rehabilitation. For one, optic flow information extracted from the periphery may be critical for recalibrating the sensory processes used by people with vestibular disorders. However, wide FOV devices also have been found to result in greater simulator sickness. Before a wide FOV device can be used in a clinical setting, its safety must be demonstrated. METHODS: Symptoms of simulator sickness were recorded by 9 healthy adult subjects after they performed gaze shifting tasks to locate targets superimposed on an optic flow background. Subjects performed 8 trials of gaze shifting on each of the six separate visits. RESULTS: The incidence of symptoms of simulator sickness while subjects performed gaze shifts in an optic flow environment was lower than the average reported incidence for flight simulators. The incidence was greater during the first visit compared with subsequent visits. Furthermore, the incidence showed an increasing trend over the 8 trials. CONCLUSION: The performance of head unrestrained gaze shifts in a wide FOV optic flow environment is tolerated well by healthy subjects. This finding provides rationale for testing these environments in people with vestibular disorders, and supports the concept of using wide FOV virtual reality for vestibular rehabilitation.

  17. Vestibular rehabilitation with virtual reality in Ménière's disease

    OpenAIRE

    Garcia, Adriana Pontin [UNIFESP; Ganança, Mauricio Malavasi; Cusin, Flávia Salvaterra [UNIFESP; Tomaz,Andreza; Ganança,Fernando Freitas; Caovilla,Heloisa Helena

    2013-01-01

    A tecnologia de realidade virtual fornece uma grande variedade de estímulos que geram conflitos sensoriais em diferentes níveis de dificuldades e em ambiente seguro. OBJETIVO: Verificar o efeito de um programa de reabilitação vestibular do equilíbrio corporal com estímulos de realidade virtual em pacientes com doença de Ménière. Forma de estudo: Estudo clínico observacional. MÉTODO: Quarenta e quatro pacientes, com idade entre 18 e 60 anos e doença de Ménière definida, distribuídos em dois gr...

  18. Phasic exercises for cervical rehabilitation after "whiplash" trauma.

    Science.gov (United States)

    Fitz-Ritson, D

    1995-01-01

    To assess whether "phasic" exercises, including rapid eye-head-neck-arm movements, can benefit patients with chronic cervical injuries. A randomized, controlled, double blind study involving 30 chronic patients, who were allocated to either group 1 or group 2. The study period was for 8 wk. The study was conducted in a private practice. Thirty chronic motor vehicle accident patients who continued to experience increased pain/soreness/stiffness of the cervical musculature with sports/activities requiring rapid head neck movements were selected for the study. Group 1 patients (n = 15) had standard exercises (stretching/isometric/isokinetic) and chiropractic therapy. Group 2 patients (n = 15) had "phasic" exercises and chiropractic therapy. Patients in both groups exercised for a minimum of four times weekly, for 8 wk. Pre and Post Pain and Disability Index was administered to both groups. Group 1, which had standard exercises and chiropractic therapy, improved by 7.4% (p > .05). Group 2, which had "phasic" exercises and chiropractic therapy, improved by 48.3% (p > .001). Confounders were identified, which explains the minimal improvement of group 1 and the remarkable results of group 2. It would appear that any rehabilitation program for chronic neck-injured patients should involve exercises that address the following: eye-head-neck-arm coordinated movements, coordination of the entire vertebral column,/ and return the "phasic" component of the musculature to functional levels. Additional studies will address the effect of these exercises on the strength, range of motion and pain improvement of the cervical spine in normal, acute and chronic patients.

  19. Vestibular rehabilitation with virtual reality in Ménière's disease.

    Science.gov (United States)

    Garcia, Adriana Pontin; Ganança, Mauricio Malavasi; Cusin, Flávia Salvaterra; Tomaz, Andreza; Ganança, Fernando Freitas; Caovilla, Heloisa Helena

    2013-01-01

    Virtual reality technology can provide a wide range of sensory stimuli to generate conflicts of varying degrees of complexity in a safe environment. To verify the effect of a virtual realitybased balance rehabilitation program for patients with Menière's disease. This observational clinical study included 44 patients aged between 18 and 60 years diagnosed with Menière's disease submitted to a controlled randomized therapeutic intervention. The case and control groups took betahistine and followed a diet. Case group subjects underwent 12 rehabilitation sessions with virtual reality stimuli in a Balance Rehabilitation Unit (BRU TM). Patients were assessed based on DHI scores, the dizziness visual analogue scale, and underwent posturography with virtual reality before and after the intervention. After the intervention, the case group showed significantly lower scores in DHI (p Virtual reality-based balance rehabilitation effectively improved dizziness, quality of life, and limit of stability of patients with Menière's disease.

  20. Influence of vestibular rehabilitation on neck pain and cervical range of motion among patients with whiplash-associated disorder: a randomized controlled trial.

    Science.gov (United States)

    Hansson, Eva Ekvall; Persson, Liselott; Malmström, Eva Maj

    2013-09-01

    To describe how vestibular rehabilitation influences pain and range of motion among patients with whiplash-associated disorder and dizziness, and to describe whether pain or range of motion correlated with balance performance or self-perceived dizziness handicap. A total of 29 patients, 20 women and 9 men, age range 22-76 years. Patients with whiplash-associated disorder and dizziness were randomized to either intervention (vestibular rehabilitation) or control. Neck pain intensity, cervical range of motion (CROM), balance and self-perceived dizziness handicap were measured at baseline, 6 weeks and 3 months. There were no differences in neck pain intensity or CROM between the 2 groups either at baseline, 6 weeks or 3 months (p = 0.10-0.89). At baseline, neck pain intensity correlated with CROM (-0.406) and self-perceived dizziness handicap (0.492). CROM correlated with self-perceived dizziness handicap and with 1 balance measure (-0.432). Neck pain intensity did not correlate with balance performance (-0.188-0.049). Neck pain intensity and CROM was not influenced by vestibular rehabilitation. Importantly, the programme did not appear to increase pain or decrease neck motion, as initially thought. Neck pain intensity and CROM correlated with self-perceived dizziness handicap. CROM also correlated with 1 balance measure.

  1. Physiotherapy and rehabilitative interventions in patients with chronic respiratory diseases: exercise and non-exercise treatment.

    Science.gov (United States)

    Nellessen, A; Hernandes, N A; Pitta, F

    2013-06-01

    The aim of this literature review was to describe and discuss the available evidence about different modalities of physical therapy treatment and pulmonary rehabilitation (PR) involving exercise training in patients with chronic obstructive pulmonary disease (COPD), asthma, bronchiectasis and interstitial lung disease (ILD). The search was performed by using the Cochrane Library and PubMed databases. We selected studies published between 2001 and 2012 which involved physiotherapy treatment and included patients with COPD, asthma, bronchiectasis or ILD, aged 18 years or more, in stable or unstable disease condition. PR involving exercise training was effective in improving exercise capacity, muscle force, quality of life and reducing symptoms in patients with COPD and asthma. Although there are few studies published about exercise training in patients with bronchiectasis, improvement in exercise capacity and quality of life in those patients was also observed. Patients with ILD also respond to exercise training; however, the response is less pronounced than in COPD and they lose the gains more quickly. Non-exercise-based interventions, such as bronchial hygiene techniques and inspiratory muscle training, also present positive results when applied to patients with COPD, asthma and bronchiectasis. In some cases it is recommended that these interventions are combined with exercise training. Studies about non-exercise based interventions applied to patients with ILD are still necessary.

  2. Vestibular rehabilitation with biofeedback in patients with central imbalance Reabilitação vestibular por biofeedback no desequilíbrio corporal de origem central

    Directory of Open Access Journals (Sweden)

    Roseli Saraiva Moreira Bittar

    2011-06-01

    Full Text Available Central Nervous System disorders may cause important functional unbalance in the maintenance of balance and posture. There is no effective rehabilitation for these symptoms until now. OBJECTIVE: The aim of this paper is to evaluate the use of tongue electrotactile stimulation on patients with central imbalance using BrainPort. MATERIALS AND METHODS: This is a prospective case series study. We evaluated 8 patients with central imbalance, 6 men and 2 women, with mean age of 67.75 years. The patients were submitted to Computed Dynamic Posturography (CDP and then received 18 sessions of electrotactile stimulation by BrainPort® device for 20 minutes, twice a day. Then they were submitted to a new CDP test and to a self-perception scale to assess symptom remission, partial improvement and no improvement at all. RESULTS: 75% of the patients reported being more stable. There was no improvement in the balance control of the mass center in these patients. CONCLUSION: The patients were able to use the electrotactile stimulus to improve their balance control.As lesões do Sistema Nervoso Central (SNC determinam importantes prejuízos funcionais na manutenção do equilíbrio e da postura. A reabilitação vestibular e a fisioterapia oferecem benefícios limitados nesses casos. OBJETIVO: Avaliar a resposta de pacientes portadores de desequilíbrio de origem central à estimulação eletrotáctil da língua por meio do BrainPort®. CASUÍSTICA E MÉTODO: O estudo é prospectivo e configura uma série de casos. Foram avaliados 8 pacientes portadores de desequilíbrio de origem central, 6 homens e 2 mulheres com média de idade de 67,75 anos. Os pacientes foram submetidos à posturografia dinâmica computadorizada (PDC e submetidos ao treinamento pelo BrainPort®. em duas sessões diárias de 20 minutos, perfazendo um total de 18 sessões. Foram então reavaliados pela PDC e a uma escala análogo visual, que compreendeu remissão dos sintomas, melhora parcial

  3. Efeito da reabilitação vestibular sobre a qualidade de vida de idosos labirintopatas Vestibular rehabilitation's effect over the quality of life of geriatric patients with labyrinth disease

    Directory of Open Access Journals (Sweden)

    Erika Barioni Mantello

    2008-04-01

    Full Text Available A tontura é um sintoma que acomete a população mundial, sendo observado maior prevalência em idosos devido ao processo de deterioração funcional dos sistemas auditivo e vestibular com o envelhecimento. OBJETIVO: O objetivo deste trabalho foi avaliar prospectivamente o efeito da Reabilitação Vestibular (RV como tratamento das labirintopatias de origem vascular e metabólica sobre a qualidade de vida de idosos. MATERIAL E MÉTODO: O estudo foi delineado como um ensaio clínico prospectivo, longitudinal, com a participação de 40 idosos de ambos os gêneros, divididos em 2 grupos, tontura de origem vascular ou metabólica. Os pacientes passaram por avaliações, orientações e a RV, que se baseou no protocolo de Cawthorne e Cooksey. A análise estatística dos dados foi feita através do teste t-Student e dos coeficientes de Pearson e Spearman. RESULTADOS: Pelas escalas de qualidade de vida utilizadas podemos observar que os aspectos avaliados melhoraram após a Reabilitação Vestibular. CONCLUSÃO: Conclui-se que a RV baseada nos protocolos de Cawthorne e Cooksey pode ser utilizada de modo benéfico nesta população.Dizziness is a symptom that affects the population world over, being more prevalent in the elderly due to the process of functional deterioration of the hearing and vestibular systems with aging. AIM: The objective of this study was to evaluate prospectively the effect of Vestibular Rehabilitation (VR as treatment for labyrinth disease of vascular and metabolic origin in the quality of life of geriatric patients. METHODS: The study was outlined as clinical-prospective, longitudinal, and observed, with the participation of 40 elder citizens of both genders, divided in 2 groups, dizziness of vascular or metabolic origin. The patients were evaluated and underwent VR - based on Cawthorne and Cooksey's protocol. The statistical analysis from the data was done through the t-Student test, the coefficients of Pearson and Spearman

  4. [Vibrational physical exercises as the rehabilitation in gerontology].

    Science.gov (United States)

    Piatin, V F; Shirolapov, I V; Nikitin, O L

    2009-01-01

    Vibration biomechanical stimulation as the physiological basis of vibration physical exercises (whole body vibration) causes reflecting muscle contractions like tonic vibration reflex. This type of intervention leads to high intensive stimulation of proprioceptors as called muscle spindles which result in alteration in parameters of activity and developments of human physiological functions. This type of training has broad positive influence on organism. Acceleration physical exercises improve muscle performance, flexibility, nervous function, significantly increase bone mineral density, physiological secretion of anabolic hormones, growth and anti-aging factors; normalize/decrease cortisol as anti-stress effect and are beneficial for balance and mobility as well. It is showed acceleration training caused by vibration stimulus is beneficial for people suffering from osteoporosis and obesity, for rehabilitation of nervous and motor function in patients with Parkinson's disease, multiple sclerosis and stroke.

  5. Exercise-based cardiac rehabilitation for coronary heart disease

    DEFF Research Database (Denmark)

    Anderson, Lindsey; Thompson, David R; Oldridge, Neil

    2016-01-01

    BACKGROUND: Coronary heart disease (CHD) is the single most common cause of death globally. However, with falling CHD mortality rates, an increasing number of people live with CHD and may need support to manage their symptoms and prognosis. Exercise-based cardiac rehabilitation (CR) aims to improve......-based interventions with at least six months' follow-up, compared with a no exercise control. The study population comprised men and women of all ages who have had a myocardial infarction (MI), coronary artery bypass graft (CABG) or percutaneous coronary intervention (PCI), or who have angina pectoris, or coronary...... artery disease. We included RCTs that reported at least one of the following outcomes: mortality, MI, revascularisations, hospitalisations, health-related quality of life (HRQL), or costs. DATA COLLECTION AND ANALYSIS: Two review authors independently screened all identified references for inclusion...

  6. Guided and unguided internet-based vestibular rehabilitation versus usual care for dizzy adults of 50 years and older: a protocol for a three-armed randomised trial.

    Science.gov (United States)

    van Vugt, Vincent A; van der Wouden, Johannes C; Bosmans, Judith E; Smalbrugge, Martin; van Diest, Willianne; Essery, Rosie; Yardley, Lucy; van der Horst, Henriëtte E; Maarsingh, Otto R

    2017-01-20

    Dizziness is a common symptom in general practice with a high prevalence among older adults. The most common cause of dizziness in general practice is peripheral vestibular disease. Vestibular rehabilitation (VR) is a safe and effective treatment for peripheral vestibular disease that entails specific exercises to maximise the central nervous system compensation for the effects of vestibular pathology. An internet-based VR intervention has recently been shown to be safe and effective. Online interventions are low cost and easily accessible, but prone to attrition and non-adherence. A combination of online and face-to-face therapy, known as blended care, may balance these advantages and disadvantages. A single-blind, three-arm, randomised controlled trial among patients aged 50 years and over presenting with dizziness of vestibular origin in general practice will be performed. In this study, we will compare the clinical and cost-effectiveness of stand-alone internet-based VR and internet-based VR with physiotherapeutic support ('blended care') with usual care during 6 months of follow-up. We will use a translated Dutch version of a British online VR intervention. Randomisation will be stratified by dizziness severity. The primary outcome measure is the Vertigo Symptoms Scale-Short Form. Intention-to-treat analysis will be performed, adjusting for confounders. The economic evaluation will be conducted from a societal perspective. We will perform an additional analysis on the data to identify predictors of successful treatment in the same population to develop a clinical decision rule for general practitioners. The ethical committee of the VU University Medical Center approved ethics and dissemination of the study protocol. The insights and results of this study will be widely disseminated through international peer-reviewed journals and conference presentations. Pre-results, NTR5712. Published by the BMJ Publishing Group Limited. For permission to use (where not

  7. Reduction of falls in older people by improving balance with vestibular rehabilitation (ReFOVeRe study): design and methods.

    Science.gov (United States)

    Soto-Varela, Andrés; Gayoso-Diz, Pilar; Rossi-Izquierdo, Marcos; Faraldo-García, Ana; Vaamonde-Sánchez-Andrade, Isabel; del-Río-Valeiras, María; Lirola-Delgado, Antonio; Santos-Pérez, Sofía

    2015-12-01

    Evaluate the effectiveness of vestibular rehabilitation (VR) to improve the balance in older people, assessed immediately afterwards. (a) To verify the maintenance of improvement of the balance achieved in the medium term (6-12 months). (b) To consider whether this improvement results in a reduction in the number of falls. (c) To compare among themselves the effectiveness of three different methods of VR in improving balance and to explore whether there are differences to achieve a reduction in the number of falls. Experimental study, single-centre, open, randomised (balanced blocks of patients) in four branches in parallel, in 220 elderly patients (over 64 years) with high risk of falls and a follow-up period of 12 months. Department of Otolaryngology of the University Hospital of Santiago. People over 64 years, fulfilling one of the following requirements: (a) At least one fall in the last year. (b) Take at least 16 s or require some support in perform the test "timed up and go". (c) A percentage of average balance in the sensory organisation test (SOT) in the dynamic posturography (CDP) VR. The percentage of average balance in the SOT in CDP. Secondary measures: time and supports in the test of "timed up and go", scores of the dynamic posturography and SwayStar system, and rate of falls.

  8. Prescribing exercise training in pulmonary rehabilitation: A clinical experience

    Directory of Open Access Journals (Sweden)

    S. Bernard

    2014-03-01

    Full Text Available Built around exercise training, pulmonary rehabilitation (PR is a multidisciplinary, evidence‐based, comprehensive approach to working with the patient as a whole and not just the pulmonary component of the disease. Integrated into the individualized treatment, this intervention aims to reduce symptoms, optimize functional status, increase participation in daily life, and reduce health care costs through stabilizing or reversing systemic manifestations of the disease. Although there are many other components that should be considered to manage the impairment and symptom burden, supervised exercise training is considered the cornerstone of effective pulmonary rehabilitation. This paper addresses our clinical experience at Institut universitaire de cardiologie et de pneumologie de Québec to assess and manage exercise training in line with the current recommendations and guidelines surrounding PR. Resumo: Construída com base no exercício físico, a reabilitação pulmonar (RP é uma abordagem multidisciplinar, fundamentada e abrangente para trabalhar com o doente como um todo, e não apenas com a componente pulmonar da doença. Integrado no tratamento individual, esta intervenção visa reduzir os sintomas, optimizar o estado funcional, aumentar a participação na vida diária e reduzir os custos do tratamento de saúde, através da estabilização ou inversão das manifestações sistémicas da doença. Embora existam muitos outros componentes que devem ser tidos em consideração para gerir o peso da incapacidade e dos sintomas, o exercício físico supervisionado é considerado o fundamento da reabilitação pulmonar eficiente. Este documento trata da nossa experiência clínica no Institut universitaire de cardiologie et de pneumologie de Québec para avaliar e gerir o exercício físico em linha com as recomendações e orientações actuais envolvendo a RP

  9. Strength-training exercise in dysphagia rehabilitation: principles, procedures, and directions for future research.

    Science.gov (United States)

    Burkhead, Lori M; Sapienza, Christine M; Rosenbek, John C

    2007-07-01

    Dysphagia rehabilitation, historically, has focused a great deal on various compensations during swallowing to prevent aspiration and/or improve safety and efficiency. Exercise, in general, has been a part of the dysphagia rehabilitation landscape. However, heightened discussions in the field regarding best practices for exercise training, particularly strengthening, raise more questions than answers. The intent of this paper is to (1) explore the overriding principles of neuromuscular plasticity with regard to strength training, (2) evaluate how current exercise-training interventions in dysphagia rehabilitation correspond to these principles, and (3) postulate directions for future study of normal and disordered swallowing and determine how to incorporate these principles into dysphagia rehabilitation.

  10. Do supervised weekly exercise programs maintain functional exercise capacity and quality of life, twelve months after pulmonary rehabilitation in COPD?

    Directory of Open Access Journals (Sweden)

    Alison Jennifer A

    2007-05-01

    Full Text Available Abstract Background Pulmonary rehabilitation programs have been shown to increase functional exercise capacity and quality of life in COPD patients. However, following the completion of pulmonary rehabilitation the benefits begin to decline unless the program is of longer duration or ongoing maintenance exercise is followed. Therefore, the aim of this study is to determine if supervised, weekly, hospital-based exercise compared to home exercise will maintain the benefits gained from an eight-week pulmonary rehabilitation program in COPD subjects to twelve months. Methods Following completion of an eight-week pulmonary rehabilitation program, COPD subjects will be recruited and randomised (using concealed allocation in numbered envelopes into either the maintenance exercise group (supervised, weekly, hospital-based exercise or the control group (unsupervised home exercise and followed for twelve months. Measurements will be taken at baseline (post an eight-week pulmonary rehabilitation program, three, six and twelve months. The exercise measurements will include two six-minute walk tests, two incremental shuttle walk tests, and two endurance shuttle walk tests. Oxygen saturation, heart rate and dyspnoea will be monitored during all these tests. Quality of life will be measured using the St George's Respiratory Questionnaire and the Hospital Anxiety and Depression Scale. Participants will be excluded if they require supplemental oxygen or have neurological or musculoskeletal co-morbidities that will prevent them from exercising independently. Discussion Pulmonary rehabilitation plays an important part in the management of COPD and the results from this study will help determine if supervised, weekly, hospital-based exercise can successfully maintain functional exercise capacity and quality of life following an eight-week pulmonary rehabilitation program in COPD subjects in Australia.

  11. Effects of balance Vestibular Rehabilitation Therapy in elderly with Benign Paroxysmal Positional Vertigo: a randomized controlled trial.

    Science.gov (United States)

    Ribeiro, Karyna Myrelly Oliveira Bezerra de Figueiredo; Freitas, Raysa Vanessa de Medeiros; Ferreira, Lidiane Maria de Brito Macedo; Deshpande, Nandini; Guerra, Ricardo Oliveira

    2017-06-01

    To evaluate short-term effects of balance Vestibular Rehabilitation Therapy (VRT) on balance, dizziness symptoms and quality of life of the elderly with chronic Benign Paroxysmal Positional Vertigo (BPPV). In this randomized, single-blind and controlled trial, older adults with chronic BPPV were randomized into two groups, the experimental group (n = 7, age: 69 (65-78) years) and the control group (n = 7, age: 73 (65-76) years). Patients in the experimental group underwent balance VRT (50 min per session, two times a week) and Canalith Repositioning Maneuver (CRM) as required, for 13 weeks. The control group was treated using only CRM as required. Standing and dynamic balance, dizziness symptoms and quality of life were measured at the baseline, and at one, five, nine and thirteen weeks. There were no between-group differences in dizziness, quality of life and standing balance over the 13 weeks. Significant differences were observed in dynamic balance measures between groups (p <  0.05 for most tests) through assessments. In intragroup analysis, both groups showed improvements in all measurements except no improvement was found in majority of the dynamic balance tests in the control group. The patients who received additional balance VRT demonstrated better results in dynamic balance than those who received only CRM. Implications for Rehabilitation The findings that balance VRT in addition to CRM improves dynamic balance in elderly people with BPPV should be useful in guiding rehabilitation professionals' clinical decision making to design interventions for seniors suffering from BPPV; Improvements in tests of dynamic balance suggest that the risk of adverse consequences of BPPV in the elderly such as falls and fractures can be potentially reduced through implementation of CRM in conjunction with balance VRT; Lack of additional improvement in Visual Analogue Scale of dizziness and Dizziness Handicap Index suggests that addition of balance VRT does

  12. Efeito da reabilitação vestibular em idosos: quanto ao equilíbrio, qualidade de vida e percepção Effect of vestibular rehabilitation in elder people: regarding balance, quality of life and perception

    Directory of Open Access Journals (Sweden)

    Magali Peres

    2010-09-01

    Full Text Available As atuais preocupações com qualidade de vida (QV, envelhecimento da população, limitações impostas pelos distúrbios do equilíbrio na população idosa e a alternativa de tratamento por meio da reabilitação vestibular (RV justificaram este estudo. Nele, objetivou-se analisar, perspectivamente, os resultados da aplicação do protocolo de Cawtome & Cooksey para RV, em idosos institucionalizados, com queixas de alterações de equilíbrio e probabilidade de queda (PQ, visando à melhoria da QV e à percepção desses idosos sobre as limitações impostas pelos distúrbios do equilíbrio. Utilizou-se uma metodologia híbrida, buscando a integração de dados quantitativos e qualitativos, associando-se o estudo experimental ao fenomenológico, em uma população de trinta idosos asilados com queixas de alterações do equilíbrio. Os instrumentos de avaliação foram a Escala de Berg, Dizziness Handicap Inventory (DHI e análise de conteúdo. Como conclusão do estudo, constatou-se que, na população estudada, a RV foi efetiva quanto à melhora dos sintomas de alteração do equilíbrio em relação à QV, à PQ e aos sentimentos de segurança e independência dos idosos.The current concerns with quality of life, population aging, limitations imposed by balance disturbance in the elder population and the alternative treatment through the vestibular rehabilitation had justified this study. The objective was to analyze in perspective the application of the Cawtome & Cooksey protocol for vestibular rehabilitation results in aged institutionalized people with complains of balance alterations and probability of fall, aiming the improvement of quality of life and that elders could perceive the limitations imposed by the balance disturbance. A hybrid methodology was used, searching an integration of quantitative and qualitative data associating the experimental to the phenomenological in a population of 30 elders with complains of balance

  13. Development of an efficient rehabilitation exercise program for functional recovery in chronic ankle instability

    OpenAIRE

    Kim, Kewwan; Jeon, Kyoungkyu

    2016-01-01

    [Purpose] The aim of the present study was to construct an integrated rehabilitation exercise program to prevent chronic pain and improve motor ability in cases of ankle injury and re-injury. [Subjects and Methods] Twenty-six male soccer players who required functional strength exercises due to repeated ankle injury were the subjects. A 12-week rehabilitation exercise program was constructed with the aim of improving muscle strength in the ankle and dynamic coordination of the lower limb. Mus...

  14. A study on the operation of rehabilitation interfaces in active rehabilitation exercises for upper limb hemiplegic patients: Interfaces for lateral and bilateral exercises.

    Science.gov (United States)

    Eom, Su-Hong; Lee, Eung-Hyuk

    2016-04-29

    For implementing autonomous rehabilitation exercises for upper limb hemiplegic patients, interfaces and a rehabilitation scenario that allow lateral and bilateral motions in a rehabilitation exercise robot are proposed. The proposed method measures the motion information generated from the unaffected part and projects it to an affected part in which the affected part expresses motions of the unaffected part. Both the accelerometer and gyro data were merged for estimating the motion information of the unaffected part. Also, HDR and complementary filters were applied to improve measurement errors in a data merging process. For verifying the proposed method, a device, which is similar to a human body joint, was fabricated. Then, the angular values estimated by using an inertial sensor and the encoder values from the device were compared. In addition, a camera analysis was used to verify the proposed rehabilitation scenario by applying the rehabilitation interface proposed in this study to an exo-skeleton robot arm. It is possible to apply the method proposed in this study to the control variables in different upper limb rehabilitation exercise robots. Thus, it is expected that patient centered active lateral/bilateral rehabilitation exercises can be performed through this interface method.

  15. Which is better in the rehabilitation of stroke patients, core stability exercises or conventional exercises?

    Science.gov (United States)

    Sun, Xibo; Gao, Qian; Dou, Honglei; Tang, Shujie

    2016-04-01

    [Purpose] The aim of this study was to determine which is better in the rehabilitation of stroke patients, core stability exercises or conventional exercises. [Subjects and Methods] Forty participants with hemiplegia were recruited in the Department of Neurology of Yidu Central Hospital of Weifang between January 2014 and February 2015 and randomly divided into either an experimental or control group. The patients in the control group performed conventional exercises for six weeks, and those in the experiment group performed core stability exercises for six weeks. The outcomes were evaluated using Modified Barthel Index and Berg Balance Scale. [Results] After treatment, the Modified Barthel Index and Berg Balance Scale were significantly increased in both groups when compared with the baseline. The Modified Barthel Index was significantly lower in the control group compared with the experimental group. The Berg Balance Scale scores in the control group were relatively lower than those in the experimental group, but there was no significant difference between the two groups. [Conclusion] Core stability exercises have a better effect on patients with hemiplegia than conventional exercises.

  16. Exercise-based cardiac rehabilitation after heart valve surgery

    DEFF Research Database (Denmark)

    Hansen, T B; Zwisler, Ann-Dorthe; Berg, S K

    2015-01-01

    BACKGROUND: Owing to a lack of evidence, patients undergoing heart valve surgery have been offered exercise-based cardiac rehabilitation (CR) since 2009 based on recommendations for patients with ischaemic heart disease in Denmark. The aim of this study was to investigate the impact of CR...... on the costs of healthcare use and sick leave among heart valve surgery patients over 12 months post surgery. METHODS: We conducted a nationwide survey on the CR participation of all patients having undergone valve surgery between 1 January 2011 and 30 June 2011 (n=667). Among the responders (n=500, 75...... expensive outpatient visits. Further studies should investigate the benefits of CR to heart valve surgery patients as part of a formal cost-utility analysis....

  17. Reabilitação vestibular: utilidade clínica em pacientes com doença de Parkinson

    OpenAIRE

    Bianca Simone Zeigelboim; Karlin Fabianne Klagenberg; Hélio A. Ghizoni Teive; Renato Puppi Munhoz; Jackeline Martins-Bassetto

    2009-01-01

    OBJECTIVE: To evaluate the effectiveness of the vestibular rehabilitation (VR) exercises by means of an assessment before and after the application of the Brazilian version of the Dizziness Handicap Inventory (DHI) questionnaire. METHOD: Twelve patients were studied, the following procedures were carried out: anamnesis, otorhinolaryngological and vestibular evaluation, and the application of the DHI before and after the VR. RESULTS: Clinically resting tremors and subjective postural instabili...

  18. The effect of virtual reality on visual vertigo symptoms in patients with peripheral vestibular dysfunction: a pilot study

    OpenAIRE

    Pavlou, M.; Kanegaonkar, R. G.; Swapp, D.; Bamiou, D. E.; Slater, Mel; Luxon. L. M.

    2012-01-01

    Individuals with vestibular dysfunction may experience visual vertigo (VV), in which symptoms are provoked or exacerbated by excessive or disorientating visual stimuli (e.g. supermarkets). VV can significantly improve when customized vestibular rehabilitation exercises are combined with exposure to optokinetic stimuli. Virtual reality (VR), which immerses patients in realistic, visually challenging environments, has also been suggested as an adjunct to VR to improve VV symptoms. This pilot st...

  19. Role of physical exercise in low back pain rehabilitation: a randomized controlled trial of a three-month exercise program in patients who have completed multidisciplinary rehabilitation.

    Science.gov (United States)

    Henchoz, Yves; de Goumoëns, Pierre; Norberg, Michael; Paillex, Roland; So, Alexander K L

    2010-05-20

    Randomized controlled trial with 1-year follow-up. To analyze the effects of an exercise program or routine follow-up on patients with chronic low back pain who have completed functional multidisciplinary rehabilitation. The short- and long-term outcome in terms of symptoms and physical and social functioning was compared. Systematic reviews have shown that functional multidisciplinary rehabilitation improves physical function and reduces pain in patients with chronic low back pain. However, long-term maintenance of these improvements is inconsistent and the role of exercise in achieving this goal is unclear. One hundred five chronic patients with low back pain who had completed a 3-week functional multidisciplinary rehabilitation program were randomized to either a 3-month exercise program (n = 56) or routine follow-up (n = 49). The exercise program consisted of 24 training sessions during 12 weeks. Patients underwent evaluations of trunk muscle endurance, cardiovascular endurance, lumbar spine mobility (flexion and extension range-of-motion, fingertip-to-floor distance), pain and perceived functional ability at the beginning and the end of functional multidisciplinary rehabilitation, at the end of the exercise program (3 months) and at 1-year follow-up. Disability was also assessed at the same time points except at the beginning of functional multidisciplinary rehabilitation. At the end of the functional multidisciplinary rehabilitation, both groups improved significantly in all physical parameters except flexion and extension range-of-motion. At the 3 month and 1 year follow-up, both groups maintained improvements in all parameters except for cardiovascular endurance. Only the exercise program group improved in disability score and trunk muscle endurance. No differences between groups were found. A favorable long-term outcome was observed after functional multidisciplinary rehabilitation in both patient groups. Patients who participated in an exercise program

  20. A review of guidelines for cardiac rehabilitation exercise programmes: Is there an international consensus?

    Science.gov (United States)

    Price, Kym Joanne; Gordon, Brett Ashley; Bird, Stephen Richard; Benson, Amanda Clare

    2016-11-01

    Cardiac rehabilitation is an important component in the continuum of care for individuals with cardiovascular disease, providing a multidisciplinary education and exercise programme to improve morbidity and mortality risk. Internationally, cardiac rehabilitation programmes are implemented through various models. This review compared cardiac rehabilitation guidelines in order to identify any differences and/or consensus in exercise testing, prescription and monitoring. Guidelines, position statements and policy documents for cardiac rehabilitation, available internationally in the English language, were identified through a search of electronic databases and government and cardiology society websites. Information about programme delivery, exercise testing, prescription and monitoring were extracted and compared. Leading cardiac rehabilitation societies in North America and Europe recommend that patients progress from moderate- to vigorous-intensity aerobic endurance exercise over the course of the programme, with resistance training included as an important adjunct, for maintaining independence and quality of life. North American and European guidelines also recommend electrocardiograph-monitored exercise stress tests. Guidelines for South America and individual European nations typically include similar recommendations; however, those in the United Kingdom, Australia and New Zealand specify lower-intensity exercise and less technical assessment of functional capacity. Higher-intensity aerobic training programmes, supplemented by resistance training, have been recommended and deemed safe for cardiac rehabilitation patients by many authorities. Based on research evidence, this may also provide superior outcomes for patients and should therefore be considered when developing an international consensus for exercise prescription in cardiac rehabilitation. © The European Society of Cardiology 2016.

  1. Exercises commonly used in rehabilitation of patients with chronic obstructive pulmonary disease: cardiopulmonary responses and effect over time

    NARCIS (Netherlands)

    Helvoort, H.A.C. van; Boer, R.C. de; Broek, L. van den; Dekhuijzen, R.; Heijdra, Y.F.

    2011-01-01

    OBJECTIVES: To compare conventional exercise-based assessment of pulmonary rehabilitation (PR) with improvement in training exercises employed during a PR program, and to describe the cardiopulmonary response of different training exercises during PR of patients with chronic obstructive pulmonary

  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. [Therapy of vestibular vertigo].

    Science.gov (United States)

    Hamann, K F

    1993-05-01

    The non-surgical treatment of vestibular disorders must be based on current knowledge of vestibular pathophysiology. It is generally accepted that after vestibular lesions a self-repair mechanism exists that allows a more or less complete recovery. In cases of persisting vestibular complaints the physician's duty consists in stimulation of these pre-existing mechanisms. This can be done by physical exercises, as has been recommended since the work of Cawthorne and Cooksey in 1946. This concept is meanwhile supported by modern neurophysiological research. This article describes a short training program consisting of exercises for fixation during rotations, smooth pursuit, optokinetic nystagmus and motor learning mechanisms. Physical exercises can be reinforced by nootropic drugs.

  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. The dynamics of somatic indicators of basketball players under the influence of the special exercises which are directed to the increase of stability of the vestibular analyzer

    Directory of Open Access Journals (Sweden)

    Yevhen Kharchenko

    2016-06-01

    Full Text Available Purpose: to determine stability of the vestibular analyzer of basketball players of the team of KhSAPC by indicators of somatic displacements after the standard vestibular irritations on the Barany chair, after the introduction of the special exercises in the educational – training process, which are directed on the increase of stability of the vestibular sensor-based system. Material & Methods: the analysis of references, methods of definition of a functional condition of the vestibular analyzer on indicators of somatic displacements before and after the irritation on the Barany chair, methods of mathematical statistics. 12 boys – basketball players of the men's national team of KhSAPC took part in the researches. Results: somatic indicators of a functional condition of the vestibular analyzer of students – basketball players of the team of KhSAPC, and, their changes under the influence of rotary loadings before the pedagogical experiment are given in the article. Conclusions: the analysis of the results which were received after the experiment showed the considerable improvement of indicators, according to the testing of the motive test (4x9 m (s, hand dynamometry of 100% of a maximum and 50% of a maximum of the right and left hands (р0,05.

  6. The Activity of Surface Electromyographic Signal of Selected Muscles during Classic Rehabilitation Exercise

    OpenAIRE

    Jinzhuang Xiao; Jinli Sun; Junmin Gao; Hongrui Wang; Xincai Yang

    2016-01-01

    Objectives. Prone bridge, unilateral bridge, supine bridge, and bird-dog are classic rehabilitation exercises, which have been advocated as effective ways to improve core stability among healthy individuals and patients with low back pain. The aim of this study was to investigate the activity of seven selected muscles during rehabilitation exercises through the signal of surface electromyographic. Approaches. We measured the surface electromyographic signals of four lower limb muscles, two ab...

  7. Computational Architecture of a Robot Coach for Physical Exercises in Kinesthetic Rehabilitation

    OpenAIRE

    Nguyen, Sao Mai; Tanguy, Philippe; Rémy-Néris, Olivier

    2016-01-01

    International audience; The rising number of the elderly incurs growing concern about healthcare, and in particular rehabilitation healthcare. Assistive technology and and assistive robotics in particular may help to improve this process. We develop a robot coach capable of demonstrating rehabilitation exercises to patients, watch a patient carry out the exercises and give him feedback so as to improve his performance and encourage him. We propose a general software architecture for our robot...

  8. Rehabilitative exercise in a rat model of doxorubicin cardiotoxicity.

    Science.gov (United States)

    Hydock, David S; Lien, Chia-Ying; Jensen, Brock T; Parry, Traci L; Schneider, Carole M; Hayward, Reid

    2012-12-01

    The use of exercise to minimize doxorubicin (DOX)-induced cardiotoxicity is gaining attention. However, very few clinically relevant reports exist investigating the effects of exercise performed during and following DOX treatments. The purpose of this study, therefore, was to examine the effects of voluntary wheel running during and following DOX treatment using two models of late-onset DOX cardiotoxicity in the rat. Female Sprague-Dawley rats received either DOX or saline injections using one of two separate treatment regimens. These regimens involved either daily or weekly DOX injections with cumulative doses for both protocols totaling 15 mg/kg. Daily DOX injections were 1 mg/kg and lasted for 15 consecutive days while weekly DOX injections were 2.5 mg/kg and lasted for six consecutive weeks with control animals receiving matched saline injection regimens. Immediately following the initial DOX/saline injection, animals were randomly housed in cages with voluntary running wheels or standard rat cages throughout DOX/saline treatments and continued until reaching 10 weeks. Cardiac function was then assessed using echocardiography and an isolated working heart model, and myosin heavy chain (MHC) isoform distribution was assessed using sodium dodecyl sulfate-polyacrylamide gel electrophoresis. When compared wth controls, daily DOX treatment resulted in reduced running wheel distances at weeks 2-10 (P running wheel distances at weeks 2, 6 and 10 (P running during and following daily and weekly DOX dosing protected against DOX-induced cardiotoxicity by preserving maximal mitral and aortic blood flow velocities, left ventricular developed pressure and MHC isoform expression. In conclusion, the overall reduced volume of activity during and following daily and weekly DOX treatments attenuated DOX-induced cardiac dysfunction suggesting that low-volume endurance training may be an effective rehabilitative approach in minimizing DOX cardiotoxicity in cancer patients.

  9. Pulmonary rehabilitation for COPD improves exercise time rather than exercise tolerance: effects and mechanisms

    Directory of Open Access Journals (Sweden)

    Miki K

    2017-04-01

    Full Text Available Keisuke Miki,1 Ryoji Maekura,1 Seigo Kitada,1 Mari Miki,1 Kenji Yoshimura,1 Hiroshi Yamamoto,2 Toshiko Kawabe,2 Hiroyuki Kagawa,1 Yohei Oshitani,1 Akitoshi Satomi,1 Kohei Nishida,1 Nobuhiko Sawa,1 Kimiko Inoue2 1Department of Respiratory Medicine, 2Department of Rehabilitation Medicine, National Hospital Organization, Toneyama National Hospital, Toyonaka, Japan Background: COPD patients undergoing pulmonary rehabilitation (PR show various responses. The purpose of this study was to investigate the possible mechanisms and predictors of the response to PR in COPD patients.Methods: Thirty-six stable COPD patients underwent PR including a 4-week high-intensity exercise training program, and they were evaluated by cardiopulmonary exercise testing. All patients (mean age 69 years, severe and very severe COPD 94% were classified into four groups by whether the exercise time (Tex or the peak oxygen uptake (VO2 increased after PR: two factors increased (both the Tex and the peak VO2 increased; two factors decreased; time only increased (the Tex increased, but the peak VO2 economized; and VO2 only increased (the Tex decreased, but the peak VO2 increased. Within all patients, the relationships between baseline variables and the post-to-pre-change ratio of the time–slope, Tex/(peak minus resting VO2, were investigated.Results: Compared with the two factors increased group (n=11, in the time only increased group (n=18, the mean differences from pre-PR at peak exercise in 1 minute ventilation (VE (P=0.004, VO2 (P<0.0001, and carbon dioxide output (VCO2 (P<0.0001 were lower, 2 VE/VO2 (P=0.034 and VE/VCO2 (P=0.006 were higher, and 3 the dead space/tidal volume ratio (VD/VT and the dyspnea level were similar. After PR, there was no significant difference in the ratio of the observed peak heart rate (HR to the predicted peak HR (220 – age [years] between the two groups. A significant negative correlation with the baseline time–slope (r=-0.496, P=0.002 and a

  10. Understanding patient experiences of self-managing chronic dizziness: a qualitative study of booklet-based vestibular rehabilitation, with or without remote support.

    Science.gov (United States)

    Muller, Ingrid; Kirby, Sarah; Yardley, Lucy

    2015-05-18

    This study explores participants' experience of self-management of dizziness using booklet-based vestibular rehabilitation (VR), with or without expert telephone support. Semistructured qualitative interviews were conducted. Participants were recruited from primary care practices as part of a large RCT. Interviews were carried out with 33 people (10 men and 23 women; age 27-84) self-managing chronic dizziness using booklet-based vestibular rehabilitation, with or without expert telephone support. Data were analysed using inductive thematic analysis. The majority of participants in both groups reported a positive experience of VR therapy, with many participants reporting an improvement in their dizziness symptoms since undertaking the therapy. Participants in the telephone support group felt that a genuine relationship developed between them and their therapist within three short sessions, and described their therapy sessions as reassuring, encouraging and motivational. The VR treatment booklet appears to be a valued tool for self-managing chronic dizziness and people appreciate receiving remote telephone support. NCT00732797. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  11. Effects of scapular stability exercise on shoulder stability and rehabilitative ultrasound images in office workers

    Science.gov (United States)

    Go, Seong-Uk; Lee, Byoung-Hee

    2016-01-01

    [Purpose] To examine the clinical effectiveness of scapular stability exercise on shoulder stability and rehabilitative ultrasound images in office workers. [Subjects and Methods] Thirty-eight subjects were randomly divided into a scapular stability exercise group (n=19) and a manual therapy group (n=19). Subjects in the scapular stability exercise group performed a scapular stability exercise designed to correct the abnormal location of the scapula, at 40 minutes per session, two times per week, for 6 weeks. Forward head horizontal distance, rounded shoulder posture, stability of the upper limb for the shoulder, and rehabilitative ultrasound images were evaluated before and after 6 weeks. [Results] After the intervention, both groups showed significantly decreased forward head horizontal distance and rounded shoulder posture, with significantly improved stability of the upper limb and rehabilitative ultrasound images. Forward head horizontal distance, rounded shoulder posture, stability of the upper limb, and rehabilitative ultrasound images showed greater improvements in the shoulder stability exercise group than in the manual therapy group. [Conclusion] Scapular stability exercise can improve shoulder stability and the thickness of the lower trapezius in rehabilitative ultrasound images of office workers, and could be useful in clinical rehabilitation. PMID:27942108

  12. Effects of scapular stability exercise on shoulder stability and rehabilitative ultrasound images in office workers.

    Science.gov (United States)

    Go, Seong-Uk; Lee, Byoung-Hee

    2016-11-01

    [Purpose] To examine the clinical effectiveness of scapular stability exercise on shoulder stability and rehabilitative ultrasound images in office workers. [Subjects and Methods] Thirty-eight subjects were randomly divided into a scapular stability exercise group (n=19) and a manual therapy group (n=19). Subjects in the scapular stability exercise group performed a scapular stability exercise designed to correct the abnormal location of the scapula, at 40 minutes per session, two times per week, for 6 weeks. Forward head horizontal distance, rounded shoulder posture, stability of the upper limb for the shoulder, and rehabilitative ultrasound images were evaluated before and after 6 weeks. [Results] After the intervention, both groups showed significantly decreased forward head horizontal distance and rounded shoulder posture, with significantly improved stability of the upper limb and rehabilitative ultrasound images. Forward head horizontal distance, rounded shoulder posture, stability of the upper limb, and rehabilitative ultrasound images showed greater improvements in the shoulder stability exercise group than in the manual therapy group. [Conclusion] Scapular stability exercise can improve shoulder stability and the thickness of the lower trapezius in rehabilitative ultrasound images of office workers, and could be useful in clinical rehabilitation.

  13. Exercise-based cardiac rehabilitation after heart valve surgery

    DEFF Research Database (Denmark)

    Hansen, T B; Zwisler, Ann-Dorthe; Berg, S K

    2015-01-01

    BACKGROUND: Owing to a lack of evidence, patients undergoing heart valve surgery have been offered exercise-based cardiac rehabilitation (CR) since 2009 based on recommendations for patients with ischaemic heart disease in Denmark. The aim of this study was to investigate the impact of CR on the ...... expensive outpatient visits. Further studies should investigate the benefits of CR to heart valve surgery patients as part of a formal cost-utility analysis....... on the costs of healthcare use and sick leave among heart valve surgery patients over 12 months post surgery. METHODS: We conducted a nationwide survey on the CR participation of all patients having undergone valve surgery between 1 January 2011 and 30 June 2011 (n=667). Among the responders (n=500, 75......%), the resource use categories of primary and secondary healthcare, prescription medication and sick leave were analysed for CR participants (n=277) and non-participants (n=223) over 12 months. A difference-in-difference analysis was undertaken. All estimates were presented as the means per patient (95% CI) based...

  14. Diabetic polyneuropathy may increase the handicap related to vestibular disease.

    Science.gov (United States)

    Aranda, Catalina; Meza, Anabel; Rodríguez, Raymundo; Mantilla, María Teresa; Jáuregui-Renaud, Kathrine

    2009-04-01

    We undertook this study to assess the influence of diabetic peripheral neuropathy on self-reported disability and postural control during quiet stance of patients with peripheral vestibular disease, before and after a standardized program of vestibular rehabilitation (Cawthorne & Cooksey exercises). Twenty patients with peripheral vestibular disease participated in the study (mean age 56+/-7.8 years), 10 with and 10 without peripheral neuropathy (age matched). The Dizziness Handicap Inventory and static posturography (eyes open/closed and firm/soft surface) were evaluated prior to rehabilitation and at week 7 of follow-up. Compared to patients without neuropathy, patients with neuropathy had more time elapsed since the diabetes was diagnosed, higher glycemia and HbAc level and higher composite scores on the Dizziness Handicap Inventory, but similar results on static posturography. After rehabilitation, although scores on the Dizziness Handicap Inventory decreased in the two groups, the difference between them persisted. In patients with neuropathy, static posturography showed improvement of postural control only with the eyes closed and soft surface, whereas in patients without neuropathy the postural control improved during all sensory conditions (eyes open/closed and firm/soft surface). In diabetic patients with peripheral vestibular disease, peripheral neuropathy contributes to self-reported disability and may interfere with complete balance recovery.

  15. Muscle activation and perceived loading during rehabilitation exercises: comparison of dumbbells and elastic resistance

    DEFF Research Database (Denmark)

    Andersen, Lars L; Andersen, Christoffer H; Mortensen, Ole S

    2010-01-01

    High-intensity resistance training plays an essential role in the prevention and rehabilitation of musculoskeletal injuries and disorders. Although resistance exercises with heavy weights yield high levels of muscle activation, the efficacy of more user-friendly forms of exercise needs to be exam...

  16. Physiologic benefits of exercise training in rehabilitation of patients with severe chronic obstructive pulmonary disease.

    Science.gov (United States)

    Casaburi, R; Porszasz, J; Burns, M R; Carithers, E R; Chang, R S; Cooper, C B

    1997-05-01

    We determined the effect on exercise tolerance and physiological exercise responses of rigorous rehabilitative exercise training in chronic obstructive pulmonary disease (COPD). Fifteen men and 10 women (mean age, 68 +/- 6 yr; FEV1, 0.93 +/- 0.27 L) participated in a rehabilitation program with an exercise component of three per week 45-min sessions of cycle ergometer training for 6 wk with exercise intensity kept near maximal targets. Before and after rehabilitation, patients performed an incremental test and a constant work rate (CWR) test at 80% of the peak work rate in the preprogram incremental test. Ventilation (V(E)) and gas exchange were measured breath by breath; arterialized venous blood was analyzed for blood gas determinations and lactate. Rehabilitation yielded an average increase in peak work rate in the incremental test of 36% (p effect. Further, for identical CWR tasks, V(E) was 10% lower (p exercise training for patients with severe COPD yields more efficient exercise breathing pattern and lower V(E); this is associated with improved exercise tolerance.

  17. Integrating Shoulder and Core Exercises When Rehabilitating Athletes Performing Overhead Activities

    OpenAIRE

    Brumitt, Jason; Dale, R. Barry

    2009-01-01

    Athletes performing overhead activities are at risk of sustaining both overuse and traumatic shoulder injuries. Research studies utilizing electromyography have identified therapeutic exercises that are effective in the muscular activation of the rotator cuff and the scapular stabilizers. Sports medicine professionals routinely prescribe these traditional therapeutic exercises when rehabilitating athletes. Failing to identify and address contributing musculoskeletal dysfunctions may delay an ...

  18. Muscle activation and perceived loading during rehabilitation exercises: comparison of dumbbells and elastic resistance

    DEFF Research Database (Denmark)

    Andersen, Lars L; Andersen, Christoffer H; Mortensen, Ole S

    2010-01-01

    High-intensity resistance training plays an essential role in the prevention and rehabilitation of musculoskeletal injuries and disorders. Although resistance exercises with heavy weights yield high levels of muscle activation, the efficacy of more user-friendly forms of exercise needs...

  19. Unsupervised Rehabilitation: effects of Exercise Training over the Long Run

    Directory of Open Access Journals (Sweden)

    Japy Angelini Oliveira Filho

    2002-09-01

    Full Text Available OBJECTIVE: To assess the safety and efficacy of unsupervised rehabilitation (USR in the long run in low-risk patients with coronary artery disease. METHODS: We carried out a retrospective study with 30 patients divided into: group I (GI - 15 patients from private clinics undergoing unsupervised rehabilitation; group II (GII - control group, 15 patients from ambulatory clinic basis, paired by age, sex, and clinical findings. GI was stimulated to exercise under indirect supervision (jogging, treadmill, and sports. GII received the usual clinical treatment. RESULTS: The pre- and postobservation values in GI were, respectively: VO2peak (mL/kg/min, 24±5 and 31± 9; VO2 peak/peak HR: 0.18±0.05 and 0.28±0.13; peak double product (DP peak:26,800±7,000 and 29,000 ± 6,500; % peak HR/predicted HRmax: 89.5±9 and 89.3±9. The pre- and post- values in GII were: VO2 peak (mL/kg/min, 27± 7 and 28±5; VO2 peak/peak HR: 0.2±0.06 and 0.2± 0.05; DP peak: 24,900±8,000 and 25,600± 8,000, and % peak HR/predicted HRmax: 91.3±9 and 91.1± 11. The following values were significant: preobservation VO2peak versus postobservation VO2peak in GI (p=0.0 063; postobservation VO2peak in GI versus postobservation VO2peak in GII (p=0.0045; postobservation VO2 peak/peak HR GI versus postobservation peak VO2/peak HR in GII (p=0.0000. The follow-up periods in GI and GII were, respectively, 41.33± 20.19 months and 20.60±8.16 months (p<0.05. No difference between the groups was observed in coronary risk factors, therapeutic management, or evolution of ischemia. No cardiovascular events secondary to USR were observed in 620 patient-months. CONCLUSION: USR was safe and efficient, in low-risk patients with coronary artery disease and provided benefits at the peripheral level.

  20. Cancer survivors' experience of exercise-based cancer rehabilitation - a meta-synthesis of qualitative research.

    Science.gov (United States)

    Midtgaard, Julie; Hammer, Nanna Maria; Andersen, Christina; Larsen, Anders; Bruun, Ditte-Marie; Jarden, Mary

    2015-05-01

    Evidence for the safety and benefits of exercise training as a therapeutic and rehabilitative intervention for cancer survivors is accumulating. However, whereas the evidence for the efficacy of exercise training has been established in several meta-analyses, synthesis of qualitative research is lacking. In order to extend healthcare professionals' understanding of the meaningfulness of exercise in cancer survivorship care, this paper aims to identify, appraise and synthesize qualitative studies on cancer survivors' experience of participation in exercise-based rehabilitation. Five electronic databases (PubMed, PsychINFO, EMBASE, Cinahl and Scopus) were searched systematically for articles published up to May 2014 using keywords and MeSH terms. To be included, studies had to contain primary data pertaining to patient experiences from participation in supervised, structured moderate to vigorous-intensity exercise. In total 2447 abstracts were screened and 37 papers were read in full. Of these, 19 studies (n = 390) were selected for inclusion and critically appraised. Synthesis of data extracted from eight studies including in total 174 patients (77% women, age 28-76 years) exclusively reporting experiences of participation in structured, supervised exercise training resulted in nine themes condensed into three categories: 1) emergence of continuity; 2) preservation of health; and 3) reclaiming the body reflecting the benefits of exercise-based rehabilitation according to cancer survivors. Accordingly, the potential of rebuilding structure in everyday life, creating a normal context and enabling the individual to re-establish confidentiality and trust in their own body and physical potential constitute substantial qualities fundamental to the understanding of the meaningfulness of exercise-based rehabilitation from the perspective of patients. In addition to the accumulating evidence for the efficacy of exercise training in cancer rehabilitation, it is incumbent upon

  1. Effect of Orofacial Myofunctional Exercise Using an Oral Rehabilitation Tool on Labial Closure Strength, Tongue Elevation Strength and Skin Elasticity

    National Research Council Canada - National Science Library

    Ibrahim, Fatimah; Arifin, Nooranida; Rahim, Zubaidah H A

    2013-01-01

    [Purpose] This paper reports the effects of orofacial myofunctional exercise using an oral cavity rehabilitation device on physiological parameters that include labial closure strength, tongue elevation...

  2. Vestibular migraine

    DEFF Research Database (Denmark)

    Lempert, Thomas; Olesen, Jes; Furman, Joseph

    2012-01-01

    This paper presents diagnostic criteria for vestibular migraine, jointly formulated by the Committee for Classification of Vestibular Disorders of the Bárány Society and the Migraine Classification Subcommittee of the International Headache Society (IHS). The classification includes vestibular...... migraine and probable vestibular migraine. Vestibular migraine will appear in an appendix of the third edition of the International Classification of Headache Disorders (ICHD) as a first step for new entities, in accordance with the usual IHS procedures. Probable vestibular migraine may be included...... in a later version of the ICHD, when further evidence has been accumulated. The diagnosis of vestibular migraine is based on recurrent vestibular symptoms, a history of migraine, a temporal association between vestibular symptoms and migraine symptoms and exclusion of other causes of vestibular symptoms...

  3. Aerobic exercise intensity assessment and prescription in cardiac rehabilitation: a joint position statement of the European Association for Cardiovascular Prevention and Rehabilitation, the American Association of Cardiovascular and Pulmonary Rehabilitation, and the Canadian Association of Cardiac Rehabilitation.

    Science.gov (United States)

    Mezzani, Alessandro; Hamm, Larry F; Jones, Andrew M; McBride, Patrick E; Moholdt, Trine; Stone, James A; Urhausen, Axel; Williams, Mark A

    2012-01-01

    Aerobic exercise intensity prescription is a key issue in cardiac rehabilitation, being directly linked to both the amount of improvement in exercise capacity and the risk of adverse events during exercise. This joint position statement aims to provide professionals with up-to-date information regarding the identification of different exercise intensity domains, the methods of direct and indirect determination of exercise intensity for both continuous and interval aerobic training, the effects of the use of different exercise protocols on exercise intensity prescription and the indications for recommended exercise training prescription in specific cardiac patients' groups. The importance of functional evaluation through exercise testing prior to starting an aerobic training program is strongly emphasized, and ramp incremental cardiopulmonary exercise test, when available, is proposed as the gold standard for a physiologically comprehensive exercise intensity assessment and prescription. This may allow a shift from a 'range-based' to a 'threshold-based' aerobic exercise intensity prescription, which, combined with thorough clinical evaluation and exercise-related risk assessment, could maximize the benefits obtainable by the use of aerobic exercise training in cardiac rehabilitation.

  4. Current and Future Management of Bilateral Loss of Vestibular Sensation – An update on the Johns Hopkins Multichannel Vestibular Prosthesis Project

    Science.gov (United States)

    Della Santina, Charles C.; Migliaccio, Americo A.; Hayden, Russell; Melvin, Thuy-Anh; Fridman, Gene Y.; Chiang, Bryce; Davidovics, Natan S.; Dai, Chenkai; Carey, John P.; Minor, Lloyd B.; Anderson, Iee-Ching; Park, HongJu; Lyford-Pike, Sofia; Tang, Shan

    2012-01-01

    Bilateral loss of vestibular sensation can disable individuals whose vestibular hair cells are injured by ototoxic medications, infection, Ménière’s disease or other insults to the labyrinth including surgical trauma during cochlear implantation. Without input to vestibulo-ocular and vestibulo-spinal reflexes that normally stabilize the eyes and body, affected patients suffer blurred vision during head movement, postural instability, and chronic disequilibrium. While individuals with some residual sensation often compensate for their loss through rehabilitation exercises, those who fail to do so are left with no adequate treatment options. An implantable neuroelectronic vestibular prosthesis that emulates the normal labyrinth by sensing head movement and modulating activity on appropriate branches of the vestibular nerve could significantly improve quality of life for these otherwise chronically dizzy patients. This brief review describes the impact and current management of bilateral loss of vestibular sensation, animal studies supporting the feasibility of prosthetic vestibular stimulation, and a vestibular prosthesis designed to restore sensation of head rotation in all directions. Similar to a cochlear implant in concept and size, the Johns Hopkins Multichannel Vestibular Prosthesis (MVP) includes miniature gyroscopes to sense head rotation, a microcontroller to process inputs and control stimulus timing, and current sources switched between pairs of electrodes implanted within the vestibular labyrinth. In rodents and rhesus monkeys rendered bilaterally vestibular-deficient via treatment with gentamicin and/or plugging of semicircular canals, the MVP partially restores the vestibulo-ocular reflex for head rotations about any axis of rotation in 3-dimensional space. Our efforts now focus on addressing issues prerequisite to human implantation, including refinement of electrode designs and surgical technique to enhance stimulus selectivity and preserve

  5. The Activity of Surface Electromyographic Signal of Selected Muscles during Classic Rehabilitation Exercise

    Directory of Open Access Journals (Sweden)

    Jinzhuang Xiao

    2016-01-01

    Full Text Available Objectives. Prone bridge, unilateral bridge, supine bridge, and bird-dog are classic rehabilitation exercises, which have been advocated as effective ways to improve core stability among healthy individuals and patients with low back pain. The aim of this study was to investigate the activity of seven selected muscles during rehabilitation exercises through the signal of surface electromyographic. Approaches. We measured the surface electromyographic signals of four lower limb muscles, two abdominal muscles, and one back muscle during rehabilitation exercises of 30 healthy students and then analyzed its activity level using the median frequency method. Results. Different levels of muscle activity during the four rehabilitation exercises were observed. The prone bridge and unilateral bridge caused the greatest muscle fatigue; however, the supine bridge generated the lowest muscle activity. There was no significant difference (P>0.05 between left and right body side muscles in the median frequency slope during the four rehabilitation exercises of seven muscles. Conclusions. The prone bridge can affect the low back and lower limb muscles of most people. The unilateral bridge was found to stimulate muscles much more active than the supine bridge. The bird-dog does not cause much fatigue to muscles but can make most selected muscles active.

  6. The Activity of Surface Electromyographic Signal of Selected Muscles during Classic Rehabilitation Exercise.

    Science.gov (United States)

    Xiao, Jinzhuang; Sun, Jinli; Gao, Junmin; Wang, Hongrui; Yang, Xincai

    2016-01-01

    Objectives. Prone bridge, unilateral bridge, supine bridge, and bird-dog are classic rehabilitation exercises, which have been advocated as effective ways to improve core stability among healthy individuals and patients with low back pain. The aim of this study was to investigate the activity of seven selected muscles during rehabilitation exercises through the signal of surface electromyographic. Approaches. We measured the surface electromyographic signals of four lower limb muscles, two abdominal muscles, and one back muscle during rehabilitation exercises of 30 healthy students and then analyzed its activity level using the median frequency method. Results. Different levels of muscle activity during the four rehabilitation exercises were observed. The prone bridge and unilateral bridge caused the greatest muscle fatigue; however, the supine bridge generated the lowest muscle activity. There was no significant difference (P > 0.05) between left and right body side muscles in the median frequency slope during the four rehabilitation exercises of seven muscles. Conclusions. The prone bridge can affect the low back and lower limb muscles of most people. The unilateral bridge was found to stimulate muscles much more active than the supine bridge. The bird-dog does not cause much fatigue to muscles but can make most selected muscles active.

  7. Evaluation of the Effectiveness of a Novel Brain and Vestibular Rehabilitation Treatment Modality in PTSD Patients Who have Suffered Combat-Related Traumatic Brain Injuries.

    Science.gov (United States)

    Carrick, Frederick R; McLellan, Kate; Brock, J Brandon; Randall, Cagan; Oggero, Elena

    2015-01-01

    Blast-related head injuries are among the most prevalent injuries suffered by military personnel deployed in combat and mild traumatic brain injury (mTBI) or concussion on the battlefield in Iraq/Afghanistan has resulted in its designation as a "signature injury." Vestibular complaints are the most frequent sequelae of mTBI, and vestibular rehabilitation (VR) has been established as the most important treatment modality for this group of patients. We studied the effectiveness of a novel brain and VR treatment post-traumatic stress disorder (PTSD) in subjects who had suffered combat-related traumatic brain injuries in terms of PTSD symptom reduction. The trial was registered as ClinicalTrials.gov Identifier: NCT02003352. (http://clinicaltrials.gov/ct2/show/NCT02003352?term=carrick&rank=6). We analyzed the difference in the Clinician Administered DSM-IV PTSD Scale (CAPS) scores pre- and post-treatment using our subjects as their own matched controls. The study population consisted of 98 combat veterans maintaining an alpha of VR with a potential decrease in suffering of patients, family, and society.

  8. Exercise-related cardiac arrest in cardiac rehabilitation - The ...

    African Journals Online (AJOL)

    ... to establish the safety of cardiac rehabilitation as a medical intervention at the Johannesburg Cardiac Rehabilitation Centre from its inception in September 1982 to July 1988, and analyses the medical status of patients who suffered a cardiac arrest (CA) in order to determine possible factors predictive of sudden death.

  9. Exercise rehabilitation on home-dwelling patients with Alzheimer's disease - a randomized, controlled trial. Study protocol

    Directory of Open Access Journals (Sweden)

    Tilvis Reijo S

    2010-10-01

    Full Text Available Abstract Background Besides cognitive decline, Alzheimer's disease (AD leads to physical disability, need for help and permanent institutional care. The trials investigating effects of exercise rehabilitation on physical functioning of home-dwelling older dementia patients are still scarce. The aim of this study is to investigate the effectiveness of intensive exercise rehabilitation lasting for one year on mobility and physical functioning of home-dwelling patients with AD. Methods During years 2008-2010, patients with AD (n = 210 living with their spousal caregiver in community are recruited using central AD registers in Finland, and they are offered exercise rehabilitation lasting for one year. The patients are randomized into three arms: 1 tailored home-based exercise twice weekly 2 group-based exercise twice weekly in rehabilitation center 3 control group with usual care and information of exercise and nutrition. Main outcome measures will be Guralnik's mobility and balance tests and FIM-test to assess physical functioning. Secondary measures will be cognition, neuropsychiatric symptoms according to the Neuropsychiatric Inventory, caregivers' burden, depression and health-related quality of life (RAND-36. Data concerning admissions to institutional care and the use and costs of health and social services will be collected during a two year follow-up. Discussion To our knowledge this is the first large scale trial exploring whether home-dwelling patients with AD will benefit from intense and long-lasting exercise rehabilitation in respect to their mobility and physical functioning. It will also provide data on cost-effectiveness of the intervention. Trial registration ACTRN12608000037303

  10. Paralysis: Rehabilitation

    Science.gov (United States)

    ... Forum About Us Donate Living with Paralysis > Rehabilitation Rehabilitation Rehabilitation and exercise are key to enhancing your health and quality of life. Find a rehabilitation center near you and become familiar with different ...

  11. Rotator-cuff muscle-recruitment strategies during shoulder rehabilitation exercises.

    Science.gov (United States)

    Swanik, Kathleen A; Huxel Bliven, Kellie; Swanik, Charles Buz

    2011-11-01

    There are contradictory data on optimal muscle-activation strategies for restoring shoulder stability. Further investigation of neuromuscular-control strategies for glenohumeral-joint stability will guide clinicians in decisions regarding appropriate rehabilitation exercises. To determine whether subscapularis, infraspinatus, and teres minor (anteroposterior force couple) muscle activation differ between 4 shoulder exercises and describe coactivation ratios and individual muscle-recruitment characteristics of rotator-cuff muscles throughout each shoulder exercise. Crossover. Laboratory. healthy, physically active men, age 20.55 ± 2.0 y. 4 rehabilitation exercises: pitchback, PNF D2 pattern with tubing, push-up plus, and slide board. Mean coactivation level, coactivation-ratio patterns, and level (area) of muscle-activation patterns of the subscapularis, infraspinatus, and teres minor throughout each exercise. Coactivation levels varied throughout each exercise. Subscapularis activity was consistently higher than that of the infraspinatus and teres minor combined at the start of each exercise and in end ranges of motion. Individual muscle-recruitment levels in the subscapularis were also different between exercises. Results provide descriptive data for determining normative coactivation-ratio values for muscle recruitment for the functional exercises studied. Differences in subscapularis activation suggest a reliance to resist anteriorly directed forces.

  12. Reabilitação vestibular com realidade virtual na doença de Ménière Vestibular rehabilitation with virtual reality in Ménière's disease

    Directory of Open Access Journals (Sweden)

    Adriana Pontin Garcia

    2013-06-01

    Full Text Available A tecnologia de realidade virtual fornece uma grande variedade de estímulos que geram conflitos sensoriais em diferentes níveis de dificuldades e em ambiente seguro. OBJETIVO: Verificar o efeito de um programa de reabilitação vestibular do equilíbrio corporal com estímulos de realidade virtual em pacientes com doença de Ménière. Forma de estudo: Estudo clínico observacional. MÉTODO: Quarenta e quatro pacientes, com idade entre 18 e 60 anos e doença de Ménière definida, distribuídos em dois grupos - experimental (GE e controle (GC - fizeram uso de betaistina e dieta alimentar; o grupo experimental foi submetido adicionalmente a 12 sessões de reabilitação com realidade virtual da BRU TM. Os pacientes responderam ao Dizziness Handicap Inventory (DHI, à escala analógica de tontura e realizaram a posturografia com realidade virtual antes e após a intervenção. RESULTADOS: Após a intervenção, o GE apresentou valores significantemente menores do DHI (p Virtual reality technology can provide a wide range of sensory stimuli to generate conflicts of varying degrees of complexity in a safe environment. OBJECTIVE: To verify the effect of a virtual realitybased balance rehabilitation program for patients with Menière's disease. METHOD: This observational clinical study included 44 patients aged between 18 and 60 years diagnosed with Menière's disease submitted to a controlled randomized therapeutic intervention. The case and control groups took betahistine and followed a diet. Case group subjects underwent 12 rehabilitation sessions with virtual reality stimuli in a Balance Rehabilitation Unit (BRU TM. Patients were assessed based on DHI scores, the dizziness visual analogue scale, and underwent posturography with virtual reality before and after the intervention. RESULTS: After the intervention, the case group showed significantly lower scores in DHI (p < 0,001 and in the dizziness visual analog scale (p = 0.012, and had

  13. Efficacy of a respiratory rehabilitation exercise training package in hospitalized elderly patients with acute exacerbation of COPD: a randomized control trial

    National Research Council Canada - National Science Library

    Liao, Lin-Yu; Chen, Kuei-Min; Chung, Wei-Sheng; Chien, Jung-Yien

    2015-01-01

    .... To evaluate the effects of a respiratory rehabilitation exercise training package on dyspnea, cough, exercise tolerance, and sputum expectoration among hospitalized elderly patients with AECOPD...

  14. Baseline Systolic Blood Pressure Response to Exercise Stress Test Can Predict Exercise Indices following Cardiac Rehabilitation Program

    Directory of Open Access Journals (Sweden)

    Akram Sardari

    2010-11-01

    Full Text Available Background: Systolic blood pressure recovery (rSBP is of prognostic value for predicting the survival and co-morbidity rate in patients with coronary artery disease (CAD. This study investigated the association between rSBP and exercise indices after complete cardiac rehabilitation program (CR in a population-based sample of patients undergoing coronary artery bypass grafting (CABG.Methods: The sample population consisted of 352 patients who underwent pure CABG. The patients underwent standard symptom-limited exercise testing immediately before and also after the completion of the CR sessions. rSBP was defined as the ratio of the systolic blood pressure at 3 minutes in recovery to the systolic blood pressure at peak exercise.Results: An abnormal baseline rSBP after exercise was a strong predictor of exercise parameters in the last session, including metabolic equivalents (β = -0.617, SE = 0.127, p value < 0.001 and peak O2 consumption (β = -1.950, SE = 0.363, p value < 0.001 measured in the last session adjusted for baseline exercise characteristics, demographics, function class, and left ventricular ejection fraction.Conclusion: The current study strongly emphasizes the predictive role of baseline rSBP after exercise in evaluating exercise parameters following CR. This baseline index can predict abnormal METs value, peak O2 consumption, post-exercise heart rate, and heart rate recovery after a 24-session CR program.

  15. Exercise may cause myocardial ischemia at the anaerobic threshold in cardiac rehabilitation programs.

    Science.gov (United States)

    Fuchs, A R C N; Meneghelo, R S; Stefanini, E; De Paola, A V; Smanio, P E P; Mastrocolla, L E; Ferraz, A S; Buglia, S; Piegas, L S; Carvalho, A A C

    2009-03-01

    Myocardial ischemia may occur during an exercise session in cardiac rehabilitation programs. However, it has not been established whether it is elicited when exercise prescription is based on heart rate corresponding to the anaerobic threshold as measured by cardiopulmonary exercise testing. Our objective was to determine the incidence of myocardial ischemia in cardiac rehabilitation programs according to myocardial perfusion SPECT in exercise programs based on the anaerobic threshold. Thirty-nine patients (35 men and 4 women) diagnosed with coronary artery disease by coronary angiography and stress technetium-99m-sestamibi gated SPECT associated with a baseline cardiopulmonary exercise test were assessed. Ages ranged from 45 to 75 years. A second cardiopulmonary exercise test determined training intensity at the anaerobic threshold. Repeat gated-SPECT was obtained after a third cardiopulmonary exercise test at the prescribed workload and heart rate. Myocardial perfusion images were analyzed using a score system of 6.4 at rest, 13.9 at peak stress, and 10.7 during the prescribed exercise (P exercise was defined as a difference > or = 2 between the summed stress score and summed rest score. Accordingly, 25 (64%) patients were classified as ischemic and 14 (36%) as nonischemic. MIBI-SPECT showed myocardial ischemia during exercise within the anaerobic threshold. The 64% prevalence of ischemia observed in the study should not be looked on as representative of the whole population of patients undergoing exercise programs. Changes in patient care and exercise programs were implemented as a result of our finding of ischemia during the prescribed exercise.

  16. Exercise Training and Cardiac Rehabilitation in Primary and Secondary Prevention of Coronary Heart Disease

    OpenAIRE

    Lavie, Carl J.; Thomas, Randal J.; Squires, Ray W.; Allison, Thomas G.; Milani, Richard V.

    2009-01-01

    Substantial data have established a sedentary lifestyle as a major modifiable risk factor for coronary heart disease (CHD). Increased levels of physical activity, exercise training, and overall cardiorespiratory fitness have provided protection in the primary and secondary prevention of CHD. This review surveys data from observational studies supporting the benefits of physical activity, exercise training, and overall cardiorespiratory fitness in primary prevention. Clearly, cardiac rehabilit...

  17. Randomized controlled trial of postoperative exercise rehabilitation program after lumbar spine fusion: study protocol

    Directory of Open Access Journals (Sweden)

    Tarnanen Sami

    2012-07-01

    Full Text Available Abstract Background Lumbar spine fusion (LSF effectively decreases pain and disability in specific spinal disorders; however, the disability rate following surgery remains high. This, combined with the fact that in Western countries the number of LSF surgeries is increasing rapidly it is important to develop rehabilitation interventions that improve outcomes. Methods/design In the present RCT-study we aim to assess the effectiveness of a combined back-specific and aerobic exercise intervention for patients after LSF surgery. One hundred patients will be randomly allocated to a 12-month exercise intervention arm or a usual care arm. The exercise intervention will start three months after surgery and consist of six individual guidance sessions with a physiotherapist and a home-based exercise program. The primary outcome measures are low back pain, lower extremity pain, disability and quality of life. Secondary outcomes are back function and kinesiophobia. Exercise adherence will also be evaluated. The outcome measurements will be assessed at baseline (3 months postoperatively, at the end of the exercise intervention period (15 months postoperatively, and after a 1-year follow-up. Discussion The present RCT will evaluate the effectiveness of a long-term rehabilitation program after LSF. To our knowledge this will be the first study to evaluate a combination of strength training, control of the neutral lumbar spine position and aerobic training principles in rehabilitation after LSF. Trial registration ClinicalTrials.gov Identifier NCT00834015

  18. Common Vestibular Disorders

    Directory of Open Access Journals (Sweden)

    Dimitrios G. Balatsouras

    2017-01-01

    /vomiting. Vestibular rehabilitation hastens the recovery. The efficacy of topical and systemic steroids requires further validation.

  19. Effects of a renal rehabilitation exercise program in patients with CKD: a randomized, controlled trial.

    Science.gov (United States)

    Rossi, Ana P; Burris, Debra D; Lucas, F Leslie; Crocker, Gail A; Wasserman, James C

    2014-12-05

    Patients with CKD have a high prevalence of cardiovascular disease associated with or exacerbated by inactivity. This randomized, controlled study investigated whether a renal rehabilitation exercise program for patients with stages 3 or 4 CKD would improve their physical function and quality of life. In total, 119 adults with CKD stages 3 and 4 were randomized, and 107 of these patients proceeded to usual care or the renal rehabilitation exercise intervention consisting of usual care plus guided exercise two times per week for 12 weeks (24 sessions). Physical function was determined by three well established performance-based tests: 6-minute walk test, sit-to-stand test, and gait-speed test. Health-related quality of life was assessed by the RAND 36-Item Short Form Health Survey. At baseline, no differences in self-reported level of activity, 6-minute walk test, and sit-to-stand test scores were observed between the usual care (n=48) and renal rehabilitation exercise (n=59) groups, although baseline gait-speed test score was higher in the renal rehabilitation exercise group (Pexercise group but not the usual care group showed significant improvements in the 6-minute walk test (+210.4±266.0 ft [19% improvement] versus -10±219.9 ft; Page prediction [29% improvement] versus +0.7±12.1% of age prediction; Pexercise regimen was generally well tolerated. A 12-week/24-session renal rehabilitation exercise program improved physical capacity and quality of life in patients with CKD stages 3 and 4. Longer follow-up is needed to determine if these findings will translate into decreased mortality rates. Copyright © 2014 by the American Society of Nephrology.

  20. A better response in exercise capacity after pulmonary rehabilitation in more severe COPD patients

    NARCIS (Netherlands)

    Altenburg, Wytske A.; de Greef, Mathieu H. G.; ten Hacken, Nick H. T.; Wempe, Johan B.

    Purpose: Pulmonary rehabilitation (PR) has positive effects on exercise capacity in Chronic Obstructive Pulmonary Disease (COPD). However, not all COPD patients benefit from PR to the same extent. We investigated whether there is a patient profile, which is associated with the improvement in

  1. Time to adapt exercise training regimens in pulmonary rehabilitation – a review of the literature

    Directory of Open Access Journals (Sweden)

    Lee AL

    2014-11-01

    Full Text Available Annemarie L Lee,1–4 Anne E Holland1–3 1Physiotherapy, Alfred Health, Melbourne, VIC, Australia; 2Institute for Breathing and Sleep, Austin Health, Melbourne, VIC, Australia; 3Physiotherapy, La Trobe University, Melbourne, VIC, Australia; 4Westpark Healthcare Centre, ON, Canada Abstract: Exercise intolerance, exertional dyspnea, reduced health-related quality of life, and acute exacerbations are features characteristic of chronic obstructive pulmonary disease (COPD. Patients with a primary diagnosis of COPD often report comorbidities and other secondary manifestations, which diversifies the clinical presentation. Pulmonary rehabilitation that includes whole body exercise training is a critical part of management, and core programs involve endurance and resistance training for the upper and lower limbs. Improvement in maximal and submaximal exercise capacity, dyspnea, fatigue, health-related quality of life, and psychological symptoms are outcomes associated with exercise training in pulmonary rehabilitation, irrespective of the clinical state in which it is commenced. There may be benefits for the health care system as well as the individual patient, with fewer exacerbations and subsequent hospitalization reported with exercise training. The varying clinical profile of COPD may direct the need for modification to traditional training strategies for some patients. Interval training, one-legged cycling (partitioning and non-linear periodized training appear to be equally or more effective than continuous training. Inspiratory muscle training may have a role as an adjunct to whole body training in selected patients. The benefits of balance training are also emerging. Strategies to ensure that health enhancing behaviors are adopted and maintained are essential. These may include training for an extended duration, alternative environments to undertake the initial program, maintenance programs following initial exercise training, program repetition

  2. Dealing with existential anxiety in exercise-based cardiac rehabilitation

    DEFF Research Database (Denmark)

    Simonÿ, Charlotte; Pedersen, Birthe D; Dreyer, Pia

    2015-01-01

    rehabilitation. Focus group interviews were conducted at the programme end, and individual interviews were performed one to two months later. The interpretation comprised three methodological steps: naïve reading, structural analysis, and comprehensive interpretation and discussion. Findings Although both...

  3. Contribuição da reabilitação vestibular na melhora do zumbido: um resultado inesperado Contribution of vestibular rehabilitation in tinnitus recovery: a surprising result

    Directory of Open Access Journals (Sweden)

    Keila A. B. Knobel

    2003-12-01

    Full Text Available INTRODUÇÃO: A tontura e o zumbido são sintomas comuns na prática clínica que podem ocorrer simultânea ou independentemente. Ambos podem ter etiologia indefinida ou múltipla, ser agravados por fatores emocionais e limitar as atividades rotineiras do indivíduo. OBJETIVO: avaliar os resultados da reabilitação vestibular (RV enfocando a melhora dos acúfenos. FORMA DE ESTUDO: Coorte longitudinal. MÉTODO: após a observação clínica da melhora (não intencional do zumbido com a RV realizamos o levantamento dos prontuários dos pacientes submetidos à terapia. RESULTADOS: Após a RV 100% dos sujeitos relataram melhora da tontura, 58% tiveram redução do zumbido e 75% relataram melhora da hipersensibilidade auditiva. A comparação da diferença entre os valores pós e pré-tratamento dos índices da escala análogo visual (0 a 5 de cada paciente evidenciou melhora da tontura (2,42, do zumbido (1,17 e da hipersensibilidade auditiva (1,00. CONCLUSÕES: A RV pode interferir positivamente no zumbido em alguns casos. Tais resultados abrem discussões a respeito das correlações e interferências entre os dois sintomas.INTRODUCTION: Dizziness and tinnitus are common symptoms on clinical practice that can occur simultaneous or independently. Both can have multiple or unknown etiology, and can be worsen by emotional factors and limit day-by-day activities. AIM: evaluate the results of vestibular rehabilitation (VR focusing on tinnitus recovery. STUDY DESIGN: Longitudinal cohorte. METHOD: after the clinical observation of the non-intentional tinnitus recovery with the VR we studied the patients' files with dizziness and tinnitus that underwent the therapy. RESULTS: After VR 100% of the subjects recovered from dizziness, 58% had tinnitus reduction and 75% had reduction on hypersensitivity to sound. The comparison of the difference between post and pre treatment values of the analog visual scale (0 a 5 of each patient showed the following: 2

  4. Análise crítica dos resultados da reabilitação vestibular em relação à etiologia da tontura Critical analysis of vestibular rehabilitation outcome according to dizziness etiology

    Directory of Open Access Journals (Sweden)

    Roseli Saraiva Moreira Bittar

    2007-12-01

    Full Text Available A reabilitação vestibular (RV é uma ótima opção terapêutica para tratamento dos pacientes vestibulopatas. Contudo, mesmo quando bem conduzida, algumas vezes não surte os efeitos propostos. OBJETIVO: Avaliar a resposta de pacientes submetidos à RV em relação às etiologias apresentadas. Forma de Estudo: Retrospectivo descritivo. PACIENTES E MÉTODO: Analisamos pacientes que concluíram a RV e tinham diagnóstico entre janeiro de 2002 e dezembro de 2004. Dividimos os pacientes em três grupos, de acordo com a resposta à RV e os comparamos em relação às etiologias. RESULTADOS: Observamos 13 casos sem melhora com a RV, 24 com melhora parcial e 22 com remissão dos sintomas. As etiologias encontradas foram cervical, trauma, metabólica, central, transtornos da ansiedade e do humor, doença auto-imune, intolerância ortostática. A etiologia metabólica apresentou evolução significativamente melhor do que as demais. CONCLUSÃO: Quando associada à adequada correção etiológica, a RV é uma ótima opção no tratamento das vestibulopatias.Vestibular rehabilitation (VR is an excellent therapy for dizziness patients. However, despite well managed, sometimes results are not suitable. AIM: evaluate VR outcome between patients according to dizziness etiology. Study design: Retrospective review of medical records. METHOD: Patients’ records were analyzed between January 2002 and December 2004. As for inclusion criteria, patients should have had finished VR therapy and an established diagnosis. Patients were included in three VR outcome groups and compared according to etiology. RESULTS: according to VR outcome 13 patients had no improvement, 24 had partial improvement and 22 complete improvement. The main etiologies were cervical syndrome, trauma, metabolic disorders, central nervous system disorders, anxiety and mood disorders, autoimmune disease and orthostatic intolerance. Patients with metabolic disorders showed better VR outcome than

  5. Evaluation of the effectiveness of a novel brain and vestibular rehabilitation treatment modality in PTSD patients who have suffered combat related traumatic brain injuries

    Directory of Open Access Journals (Sweden)

    Frederick Robert Carrick

    2015-02-01

    Full Text Available Introduction: Blast-related head injuries are among the most prevalent injuries suffered by military personnel deployed in combat and mild traumatic brain injury (mTBI or concussion on the battlefield in Iraq/Afghanistan has resulted in its designation as a signature injury. Vestibular complaints are the most frequent sequelae of mTBI and vestibular rehabilitation (VR has been established as the most important treatment modality for this group of patients. Material and Methods:We studied the effectiveness of a novel brain and VR treatment PTSD in subjects who had suffered combat related traumatic brain injuries in terms of PTSD symptom reduction. The trial was registered as ClinicalTrials.gov Identifier: NCT02003352. (http://clinicaltrials.gov/ct2/show/NCT02003352?term=carrick&rank=6. We analyzed the difference in the Clinician Administered DSM-IV PTSD Scale (CAPS scores pre and post treatment using our subjects as their own matched controls. The study population consisted of 98 combat veterans maintaining an alpha of <0.05 and power of 80%. Results:Prior to treatment, 75 subjects representing 76.53 % of the sample were classified in the 2 most severe categories of PTSD. 41 subjects, representing 41.80 % of the total sample, were classified in the extreme category of PTSD and 34 subjects, representing 34.70 % of the total sample, were classified in the severe category of PTSD. After treatment we observed a large reduction in CAPS severity scores with both statistical and substantive significance. Discussion:Treatment of PTSD as a physical injury rather than a psychiatric disorder is associated with strong statistical and substantive significant outcomes associated with a decrease of PTSD classification. The stigma associated with neuropsychiatric disorders may be lessened when PTSD is treated with brain and VR with a potential decrease in suffering of patients, family and society.

  6. Exercise-based cardiac rehabilitation for adults after Heart valve surgery (protocol)

    DEFF Research Database (Denmark)

    Lærum Sibilitz, Kristine; Berg, Selina Kikkenborg; Tang, Lars Hermann

    2013-01-01

    This is the protocol for a review and there is no abstract. The objectives are as follows: To assess the benefits and harms of exercise-based intervention programmes (exercise-based interventions alone or in combination with psycho-educational components), compared to no intervention, or treatmen...... as usual, in adults who have had heart valve surgery. In this review we will focus on programmes that include an exercise-based intervention with, or without, another rehabilitation component (such as a psycho-educational component)....

  7. Pulmonary rehabilitation improves exercise capacity in subjects with kyphoscoliosis and severe respiratory impairment.

    Science.gov (United States)

    Fuschillo, Salvatore; De Felice, Alberto; Martucci, Michele; Gaudiosi, Carlo; Pisano, Viviana; Vitale, Dino; Balzano, Giovanni

    2015-01-01

    Patients with kyphoscoliosis and severe respiratory impairment frequently experience reduction in exercise tolerance, limitation in daily life activities, and deterioration in health-related quality of life (HRQOL). Noninvasive ventilation (NIV) as an add-on treatment to long-term oxygen therapy (LTOT) was shown to improve symptoms and HRQOL in these patients. Pulmonary rehabilitation can increase exercise capacity and HRQOL in patients with COPD, but its role in patients with restrictive thoracic disease, such as kyphoscoliosis, is uncertain. The aim of this study was to analyze the effects of combining pulmonary rehabilitation with LTOT and NIV treatments on arterial blood gases and the 6-min walk test (6MWT) in a homogeneous group of subjects with kyphoscoliosis. Twenty-three subjects with kyphoscoliosis and respiratory failure who were being treated with both LTOT and NIV and who had been referred to a pulmonary rehabilitation program were retrospectively analyzed. Eighteen subjects were included, and there was no control group. Pulmonary rehabilitation involved educational and physical training sessions and was carried out daily for 4-6 weeks. Exercise intensity was personalized based on individual tolerance, physiologic parameters, or physiotherapist judgment. Upon completion of pulmonary rehabilitation, a significant improvement in 6-min walk distance was observed (P = .04). The dyspnea score at the end of the 6MWT improved as well, although the improvement did not reach statistical significance (P = .06). These changes were not confirmed at a 12-month follow-up visit. No significant effects of pulmonary rehabilitation on arterial blood gases were observed. A combined intervention including a tailored pulmonary rehabilitation program together with LTOT and NIV seems to be of short-term benefit in subjects with kyphoscoliosis and severe respiratory impairment. Copyright © 2015 by Daedalus Enterprises.

  8. Rehabilitation and development after childhood cancer: can the need for physical exercise be met?

    Science.gov (United States)

    Robertson, Ann R R; Johnson, David A

    2002-01-01

    Clinical and experimental evidence attests to the neurological and psychological benefits of physical exercise. Prescribing exercise for children after cancer has the potential to facilitate recovery, performance and development, with consequent improvement in quality of life and long-term outcome. However, could a school take up the prescription for a child's individual exercise programme? As a preliminary to an intervention study, all primary and secondary schools in two Scottish regions were surveyed. The aim was to evaluate the utility of prescribing exercise as part of a child's individual rehabilitation plan and to investigate awareness in schools of the potential benefits of exercise for cognition and behaviour. Approximately half the respondents indicated that extra physical exercise sessions could be incorporated into the school day. The main difficulties preventing such inclusion were identified as a lack of staff for supervision and timetabling problems. However, there was also a high level (>70%) of lack of information about what a child could be expected to do after cancer. Further, more respondents (approximately 60%) anticipated benefits of exercise for social development than for academic progress (approximately 35%). These results emphasize the necessity of clear and specific liaison with a school when planning and implementing a child's long-term rehabilitation programme.

  9. Magnetic resonance imaging evaluation of muscle usage associated with three exercises for rotator cuff rehabilitation.

    Science.gov (United States)

    Horrigan, J M; Shellock, F G; Mink, J H; Deutsch, A L

    1999-10-01

    Methods of determining muscle usage for exercises involving rotator cuff muscles are limited. Therefore, this investigation used magnetic resonance imaging (MRI) to evaluate the effect of three different exercises used for rehabilitation of the rotator cuff. Five normal volunteer subjects (3 men, 2 women, mean age 31.4 yr) were studied. The exercises were scaption with internal rotation (SIR), military press (MP), and side-lying 45 degrees abduction (SLA). MR imaging was performed immediately before and after exercise using a "fast" spin echo STIR sequence and oblique coronal plane imaging. Changes in signal intensity pre- and post-exercise were measured at comparable section locations for the MR images of the supraspinatus, infraspinatus, teres minor, subscapularis, deltoid, and trapezius. The SLA showed the greatest increase in signal intensity in all the muscles (percent change, P < 0.01) except for the trapezius, which was used more by the MP and SIR. None of the exercises activated the teres minor (percent change, P = not significant). These findings have important implications in efficacy of physical rehabilitation of the rotator cuff and avoidance of subacromial impingement exercise motions.

  10. Methodological aspects of practical training for students based on complexes of exercise rehabilitation orientation

    Directory of Open Access Journals (Sweden)

    Zaytsev Vjacheslav Petrovich

    2011-10-01

    Full Text Available The structure and content of practical training for students of specialty "Physical rehabilitation". It is proposed program of theoretical studies section. It is shown the following areas of special choice of exercise facilities for practical training section. The laid motor activity of patients after acute myocardial infarction in stationary conditions. Submitted physical rehabilitation patients in a hospital depending on the intended motor mode: strict bed, bed, ward and free. Shown approximate three week and five week program of physical rehabilitation patients in accordance with the recommendations of the World Health Organization. For each mode of the motor circuit is composed of physical rehabilitation patients: tasks, means of therapeutic physical culture, its forms and methods of training.

  11. Muscle and intensity based hamstring exercise classification in elite female track and field athletes: implications for exercise selection during rehabilitation

    Directory of Open Access Journals (Sweden)

    Tsaklis P

    2015-06-01

    Full Text Available Panagiotis Tsaklis,1,2 Nikos Malliaropoulos,3–5,10 Jurdan Mendiguchia,6 Vasileios Korakakis,7–9 Kyriakos Tsapralis,11 Debasish Pyne,5 Peter Malliaras101Department of Physiotherapy, Laboratory of Biomechanics and Ergonomics, Alexander Technological Educational Institute of Thessaloniki, Thessaloniki, Greece; 2Department of Mechanical Engineering, Bioengineering, Massachusetts Institute of Technology, Cambridge, MA, USA; 3National Track and Field Centre, Sports Injury Clinic, Sports Medicine Clinic of SEGAS, 4Thessaloniki Sports Medicine Clinic, Thessaloniki, Greece; 5Rheumatology Department, Sports Medicine Clinic, Mile End Hospital, London, UK; 6Department of Physical Therapy, Zentrum Rehabilitation and Performance Center, Pamplona, Spain; 7Aspetar, Orthopaedic and Sports Medicine Hospital, Doha, Qatar; 8Faculty of Physical Education and Sport Science, University of Thessaly, Trikala, 9Hellenic Orthopaedic Manipulative Therapy Diploma, Athens, Greece; 10Centre for Sports and Exercise Medicine, Queen Mary, University of London, London, UK; 11K Tsapralis Isokinetic Medical Group, Bologna, ItalyBackground: Hamstring injuries are common in many sports, including track and field. Strains occur in different parts of the hamstring muscle but very little is known about whether common hamstring loading exercises specifically load different hamstring components. The purpose of this study was to investigate muscle activation of different components of the hamstring muscle during common hamstring loading exercises.Methods: Twenty elite female track and field athletes were recruited into this study, which had a single-sample, repeated-measures design. Each athlete performed ten hamstring loading exercises, and an electromyogram (EMG was recorded from the biceps femoris and semitendinosus components of the hamstring. Hamstring EMG during maximal voluntary isometric contraction (MVIC was used to normalize the mean data across ten repetitions of each

  12. PATIENTS OVERCOME ANXIETY AND ARE ENCOURAGED TO BE PHYSICAL ACTIVETHROUGH EXERCISE-BASED CARDIAC REHABILITATION

    DEFF Research Database (Denmark)

    Simonÿ, Charlotte; Dreyer, Pia; Pedersen, Birthe D.

    2015-01-01

    other to begin exercising; and growing confidence in the heart, whereby the patients overcome anxiety and dare to be physically active. Conclusions. Exercise-based cardiac rehabilitation provides a comfort-giving setting that offers peer support and a positive physical perception leading to confidence...... interviews were performed 1-2 months later. A phenomenological hermeneutic interpretation was conducted, comprising three methodological steps: naïve reading, structural analysis and comprehensive interpretation. Results. The preliminary findings are that although physically and especially mentally...... into that the heart endures physical activity. In addition to serving as physical guidance, exercise-based cardiac rehabilitation offers valuable mental support. The patients find help to overcome an initial anxiety and move forward towards a physically active life featuring a feeling of improved health and new...

  13. Exercise-based cardiac rehabilitation for adults after heart valve surgery

    DEFF Research Database (Denmark)

    Sibilitz, Kirstine Lærum; Berg, Selina Kikkenborg; Tang, Lars Hermann

    2016-01-01

    = 148; studies = 2; quality of evidence: very low). Included trials did not report on health-related quality of life (HRQoL), and the secondary outcomes of New York Heart Association class, left ventricular ejection fraction and cost. We did find that, compared with control (no exercise), exercise......BACKGROUND: Exercise-based cardiac rehabilitation may benefit heart valve surgery patients. We conducted a systematic review to assess the evidence for the use of exercise-based intervention programmes following heart valve surgery. OBJECTIVES: To assess the benefits and harms of exercise......: the Cochrane Central Register of Controlled Trials (CENTRAL); the Database of Abstracts of Reviews of Effects (DARE); MEDLINE (Ovid); EMBASE (Ovid); CINAHL (EBSCO); PsycINFO (Ovid); LILACS (Bireme); and Conference Proceedings Citation Index-S (CPCI-S) on Web of Science (Thomson Reuters) on 23 March 2015. We...

  14. Cardiac rehabilitation: impact of graded exercise in the recovery period following myocardial infarction

    Directory of Open Access Journals (Sweden)

    White S

    2013-07-01

    Full Text Available Simon WhiteSchool of Pharmacy, Keele University, Staffordshire, UKAbstract: This paper reviews the impact of graded exercise undertaken as part of a cardiac rehabilitation (CR program in the recovery period following a myocardial infarction, focusing on how CR may be best provided and the evidence-base relating to exercise-based CR. Essential components of CR are considered here to include education about healthy behavior, lifestyle modification where necessary (especially in relation to smoking, diet, and physical exercise, medical risk factor management, use of cardioprotective medicines and implantable devices, and psychosocial health management. It is argued that the totality of the evidence continues to demonstrate benefits of exercise-based CR in terms of mortality and morbidity, despite the debate about the magnitude of that benefit. However, given the wide variance in the quality and nature of CR service provision, there is no guarantee that patients eligible for CR will benefit fully. In line with national and international standards, CR should be tailored to the patient's individual needs, but structured exercise is recommended for most patients. Exercise sessions, whether based in hospital, in the community, or at home, should be designed to vary the frequency, intensity, duration, and type of exercise. They must include an initial warm-up period, before a conditioning period, and finish with a cool-down period. Patients should be taught to self-monitor so that they can exercise safely on their own. In designing interventions to support patients to change health behavior, health professionals should recognize that patients may only make lifestyle modifications to aspects of lifestyle perceived as causes of their cardiovascular disease and so, for example, may not do the recommended amount of exercise if they do not perceive lack of exercise to be a cause of their cardiovascular disease.Keywords: cardiovascular disease, public health

  15. Core stabilization exercise prescription, part 2: a systematic review of motor control and general (global) exercise rehabilitation approaches for patients with low back pain.

    Science.gov (United States)

    Brumitt, Jason; Matheson, J W; Meira, Erik P

    2013-11-01

    Therapeutic exercises are frequently prescribed to patients with low back pain. Numerous exercise programs for patients with low back pain have been described. Many of these treatment programs are based on 1 of 2 popular rehabilitation strategies: a motor control exercise approach or a general exercise approach. PubMed clinical queries from 1966 to March 2013 for keyword combinations including motor control exercise, core stability exercise, therapeutic exercise, general exercise, global exercise, local exercise, transversus abdominis, segmental stabilization, and low back pain. Randomized controlled trials that assessed the effects of a motor control exercise approach, a general exercise approach, or both for patients with low back pain that were published in scientific peer-reviewed journals. Included studies underwent appraisal for exercise intervention and outcomes. Fifteen studies were identified (8, motor control exercise approach without general exercise comparison; 7, general exercise approach with or without motor control exercise approach comparison). Current evidence suggests that exercise interventions may be effective at reducing pain or disability in patients with low back pain. Stabilization exercises for patients with low back pain may help to decrease pain and disability. It may not be necessary to prescribe exercises purported to restore motor control of specific muscles.

  16. Now you feel both: Galvanic vestibular stimulation induces lasting improvements in the rehabilitation of chronic tactile extinction

    Directory of Open Access Journals (Sweden)

    Lena eSchmidt

    2013-03-01

    Full Text Available Tactile extinction is frequent, debilitating and often persistent after brain damage. Currently, there is no treatment available for this disorder. In two previous case studies we showed an influence of galvanic vestibular stimulation (GVS on tactile extinction. Here, we evaluated in further patients the immediate and lasting effects of GVS on tactile extinction. GVS is known to induce polarity-specific changes in cerebral excitability in the vestibular cortices and adjacent cortical areas. Tactile extinction was examined with the Quality Extinction Test (QET where subjects have to discriminate six different tactile fabrics in bilateral, double simultaneous stimulations (DSS on their dorsum of hands with identical or different tactile fabrics. Twelve patients with stable left-sided tactile extinction after unilateral right-hemisphere lesions were divided into two groups. The GVS group (N=6 performed the QET under six different experimental conditions (two Baselines, Sham-GVS, left-cathodal/right-anodal GVS, right-cathodal/left-anodal GVS, and a follow-up test. The second group of patients with left-sided extinction (N=6 performed the QET six times repetitively, but without receiving GVS (control group. Both right-cathodal/left-anodal as well as left-cathodal/right-anodal GVS (mean: 0.67 mA improved tactile identification of identical and different stimuli in the experimental group. These results show a generic effect of GVS on tactile extinction, but not in a polarity-specific way. These observed effects persisted at Follow-up. Sham-GVS had no significant effect on extinction. In the control group, no significant improvements were seen in the QET after the six measurements of the QET, thus ruling out test repetition effects. In conclusion, GVS improved bodily awareness permanently for the contralesional body side in patients with tactile extinction and thus offers a novel treatment option for these patients.

  17. Increasing patient engagement in rehabilitation exercises using computer-based citizen science.

    Directory of Open Access Journals (Sweden)

    Jeffrey Laut

    Full Text Available Patient motivation is an important factor to consider when developing rehabilitation programs. Here, we explore the effectiveness of active participation in web-based citizen science activities as a means of increasing participant engagement in rehabilitation exercises, through the use of a low-cost haptic joystick interfaced with a laptop computer. Using the joystick, patients navigate a virtual environment representing the site of a citizen science project situated in a polluted canal. Participants are tasked with following a path on a laptop screen representing the canal. The experiment consists of two conditions: in one condition, a citizen science component where participants classify images from the canal is included; and in the other, the citizen science component is absent. Both conditions are tested on a group of young patients undergoing rehabilitation treatments and a group of healthy subjects. A survey administered at the end of both tasks reveals that participants prefer performing the scientific task, and are more likely to choose to repeat it, even at the cost of increasing the time of their rehabilitation exercise. Furthermore, performance indices based on data collected from the joystick indicate significant differences in the trajectories created by patients and healthy subjects, suggesting that the low-cost device can be used in a rehabilitation setting for gauging patient recovery.

  18. Increasing patient engagement in rehabilitation exercises using computer-based citizen science.

    Science.gov (United States)

    Laut, Jeffrey; Cappa, Francesco; Nov, Oded; Porfiri, Maurizio

    2015-01-01

    Patient motivation is an important factor to consider when developing rehabilitation programs. Here, we explore the effectiveness of active participation in web-based citizen science activities as a means of increasing participant engagement in rehabilitation exercises, through the use of a low-cost haptic joystick interfaced with a laptop computer. Using the joystick, patients navigate a virtual environment representing the site of a citizen science project situated in a polluted canal. Participants are tasked with following a path on a laptop screen representing the canal. The experiment consists of two conditions: in one condition, a citizen science component where participants classify images from the canal is included; and in the other, the citizen science component is absent. Both conditions are tested on a group of young patients undergoing rehabilitation treatments and a group of healthy subjects. A survey administered at the end of both tasks reveals that participants prefer performing the scientific task, and are more likely to choose to repeat it, even at the cost of increasing the time of their rehabilitation exercise. Furthermore, performance indices based on data collected from the joystick indicate significant differences in the trajectories created by patients and healthy subjects, suggesting that the low-cost device can be used in a rehabilitation setting for gauging patient recovery.

  19. Exercise-based cardiac rehabilitation in twelve European countries results of the European cardiac rehabilitation registry

    DEFF Research Database (Denmark)

    Benzer, Werner; Rauch, Bernhard; Schmid, Jean-Paul

    2017-01-01

    AIM: Results from EuroCaReD study should serve as a benchmark to improve guideline adherence and treatment quality of cardiac rehabilitation (CR) in Europe. METHODS AND RESULTS: Data from 2.054 CR patients in 12 European countries were derived from 69 centres. 76% were male. Indication for CR...

  20. Electromyographic analysis of the rotator cuff in postoperative shoulder patients during passive rehabilitation exercises.

    Science.gov (United States)

    Murphy, Cynthia A; McDermott, William J; Petersen, Roger K; Johnson, Scott E; Baxter, Stephanie A

    2013-01-01

    Numerous rehabilitation protocols exist for postoperative rotator cuff repairs. Because the goal of early rehabilitation is to prevent postoperative adhesions while protecting the repaired tendons, it would be advantageous to know which range-of-motion exercises allow the rotator cuff to remain the most passive in a painful, guarded, postsurgical shoulder. Twenty-six subjects who had undergone subacromial decompression, distal clavicle resection, or a combination of both procedures volunteered to participate within the first 4 days after surgery. Fine-wire electrodes were inserted into the subject's supraspinatus (SS) and infraspinatus (IS). Muscle activity was recorded at resting baseline (BL) and during 14 exercises that have been found in the passive phase of rotator cuff protocols and tested in healthy subjects. Each exercise was compared with BL activity as well as with other exercises in the same movement group. The SS remained as passive as BL during therapist- and self-assisted external rotation, therapist-assisted elevation, pendulums, and isometric internal rotation and adduction. The IS was activated greater than BL for all 14 exercises studied. Of the 14 exercises studied, 6 allowed the SS and 0 allowed the IS to remain as passive as quiet-stance BL in postsurgical subacromial decompression/distal clavicle resection patients. Copyright © 2013 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.

  1. Validation of the Balance Board for Clinical Evaluation of Balance During Serious Gaming Rehabilitation Exercises.

    Science.gov (United States)

    Bonnechère, Bruno; Jansen, Bart; Omelina, Lubos; Sholukha, Victor; Van Sint Jan, Serge

    2016-09-01

    Balance and posture can be affected in various conditions or become decreased with aging. A diminution of balance control induces an increase of fall's risk. The Nintendo Wii Balance Board™ (WBB) is used in rehabilitation to perform balance exercises (using commercial video games). The WBB has also been validated to assess balance and posture in static conditions. However, there is currently no study investigating the use of WBB to assess balance during the realization of balance exercises using this device. The aim of this study was to validate the use of WBB, coupled with specially developed serious games, to assess dynamic balance during rehabilitation exercises. Thirty five subjects participated in this study. Subjects were asked to play two specially developed serious games. Center of pressure (CP) displacements were simultaneously recorded with a WBB and a gold standard force plate (FP). Nine parameters were derived from CP displacement. Bland and Altman plots, paired-sample t tests, intraclass correlation coefficient's, and Pearson's coefficient correlations were computed. Excellent correlation between both devices was found for each parameter for the two games (R = 0.95 and 0.96). Unlike previous work on the WBB, these excellent results were obtained without using any calibration procedure. Despite this, results were highly correlated between the WBB and the FP. The WBB could be used in clinics to assess balance during rehabilitation exercises and, thus, allows a more regular patient follow-up.

  2. The effect of virtual reality on visual vertigo symptoms in patients with peripheral vestibular dysfunction: a pilot study.

    Science.gov (United States)

    Pavlou, M; Kanegaonkar, R G; Swapp, D; Bamiou, D E; Slater, M; Luxon, L M

    2012-01-01

    Individuals with vestibular dysfunction may experience visual vertigo (VV), in which symptoms are provoked or exacerbated by excessive or disorientating visual stimuli (e.g. supermarkets). VV can significantly improve when customized vestibular rehabilitation exercises are combined with exposure to optokinetic stimuli. Virtual reality (VR), which immerses patients in realistic, visually challenging environments, has also been suggested as an adjunct to VR to improve VV symptoms. This pilot study compared the responses of sixteen patients with unilateral peripheral vestibular disorder randomly allocated to a VR regime incorporating exposure to a static (Group S) or dynamic (Group D) VR environment. Participants practiced vestibular exercises, twice weekly for four weeks, inside a static (Group S) or dynamic (Group D) virtual crowded square environment, presented in an immersive projection theatre (IPT), and received a vestibular exercise program to practice on days not attending clinic. A third Group D1 completed both the static and dynamic VR training. Treatment response was assessed with the Dynamic Gait Index and questionnaires concerning symptom triggers and psychological state. At final assessment, significant between-group differences were noted between Groups D (p=0.001) and D1 (p=0.03) compared to Group S for VV symptoms with the former two showing a significant 59.2% and 25.8% improvement respectively compared to 1.6% for the latter. Depression scores improved only for Group S (p=0.01) while a trend towards significance was noted for Group D regarding anxiety scores (p=0.07). Exposure to dynamic VR environments should be considered as a useful adjunct to vestibular rehabilitation programs for patients with peripheral vestibular disorders and VV symptoms.

  3. Feasibility of a Facebook Intervention for Exercise Motivation and Cardiac Rehabilitation Adherence: Study Protocol.

    Science.gov (United States)

    Siegmund, Lee Anne; Ahmed, Haitham M; Crawford, Michael Todd; Bena, James Frank

    2017-08-18

    While cardiac rehabilitation has been shown to be effective at improving coronary heart disease (CHD), participation is generally poor. Attempts to increase uptake and adherence often fail. Use of a Facebook intervention for this population may be a unique opportunity to support self-determined motivation and affect adherence. To evaluate the impact of a Facebook intervention on motivation for exercise and adherence to cardiac rehabilitation in patients with CHD during a 12-week, Phase II cardiac rehabilitation program. A prospective, randomized controlled pilot study, grounded in Self-Determination Theory, will be conducted. Participants will be recruited from inpatient, or the intake visit to outpatient, cardiac rehabilitation, and then randomly assigned to the intervention or comparison group. Participants in the intervention group will take part in a private Facebook group. Weekly posts will be designed to support self-determined motivation, measured at baseline and postcardiac rehabilitation by the Behavioral Regulation in Exercise Questionnaire-3 (BREQ-3). The Psychological Need Satisfaction for Exercise (PNSE) scale will measure fulfillment of needs that affect motivation. Participants in the comparison group will be given the same materials, but these will be supplied via handouts and email. The number of sessions attended will be tallied and analyzed using t tests. Overall motivation will be evaluated using analysis of covariance (ANCOVA) models. Multivariate analysis of variance models will be used to evaluate differences in the change across motivation subtypes. If significant, ANCOVA models for each subtype will be fit. ANCOVA models will be used to compare changes in needs satisfaction, overall and separately among the three subscales, between groups. Engagement in the Facebook group will be measured by number of "likes" and self-report of weekly visits to the group. This project was funded in July 2017 and recruitment is currently underway. The

  4. Case Series of a Knowledge Translation Intervention to Increase Upper Limb Exercise in Stroke Rehabilitation.

    Science.gov (United States)

    Connell, Louise A; McMahon, Naoimh E; Tyson, Sarah F; Watkins, Caroline L; Eng, Janice J

    2016-12-01

    Current approaches to upper limb rehabilitation are not sufficient to drive neural reorganization and maximize recovery after stroke. To address this evidence-practice gap, a knowledge translation intervention using the Behaviour Change Wheel was developed. The intervention involves collaboratively working with stroke therapy teams to change their practice and increase therapy intensity by therapists prescribing supplementary self-directed arm exercise. The purposes of this case series are: (1) to provide an illustrative example of how a research-informed process changed clinical practice and (2) to report on staff members' and patients' perceptions of the utility of the developed intervention. A participatory action research approach was used in 3 stroke rehabilitation units in the United Kingdom. The intervention aimed to change 4 therapist-level behaviors: (1) screening patients for suitability for supplementary self-directed arm exercise, (2) provision of exercises, (3) involving family and caregivers in assisting with exercises, and (4) monitoring and progressing exercises. Data on changes in practice were collected by therapy teams using a bespoke audit tool. Utility of the intervention was explored in qualitative interviews with patients and staff. Components of the intervention were successfully embedded in 2 of the 3 stroke units. At these sites, almost all admitted patients were screened for suitability for supplementary self-directed exercise. Exercises were provided to 77%, 70%, and 88% of suitable patients across the 3 sites. Involving family and caregivers and monitoring and progressing exercises were not performed consistently. This case series is an example of how a rigorous research-informed knowledge translation process resulted in practice change. Research is needed to demonstrate that these changes can translate into increased intensity of upper limb exercise and affect patient outcomes. © 2016 American Physical Therapy Association.

  5. Australian perspective regarding recommendations for physical activity and exercise rehabilitation in pulmonary arterial hypertension

    Directory of Open Access Journals (Sweden)

    Gabbay E

    2011-12-01

    Full Text Available Robin Fowler1–3, Sue Jenkins2,3,5, Andrew Maiorana2,4, Kevin Gain2,3,6,7, Gerry O'Driscoll7–9, Eli Gabbay1–3,7–91Advanced Lung Disease Program, Royal Perth Hospital, 2School of Physiotherapy and Curtin Health Innovation Research Institute, Curtin University, 3Lung Institute of Western Australia (LIWA, Centre for Asthma, Allergy and Respiratory Research, University of Western Australia, 4Advanced Heart Failure and Cardiac Transplant Service, Royal Perth Hospital, 5Physiotherapy Department, Sir Charles Gairdner Hospital, 6Respiratory Medicine Department, Royal Perth Hospital, 7School of Medicine, University of Western Australia, 8School of Medicine, University of Notre Dame, 9Heart and Lung Transplant Foundation of Western Australia, Perth, Western Australia, AustraliaAim: To determine the opinion of health care professionals within Australia, regarding acceptable levels of exertion and symptoms, and referral for exercise rehabilitation in patients with pulmonary arterial hypertension (PAH.Method: In 2010, 76 health care professionals at a specialist pulmonary hypertension meeting in Australia were surveyed using a self-administered questionnaire. The questionnaire included case studies of patients with PAH in World Health Organization (WHO functional classes II–IV. For each case study, respondents were asked to report their opinion regarding the acceptable level of exertion and symptoms during daily activities, and whether they would refer the patient for exercise rehabilitation. Three additional questions asked about advice in relation to four specific physical activities.Results: The response rate was 70% (n = 53. Overall, 58% of respondents recommended patients undertake daily activities 'as tolerated'. There was no consensus regarding acceptable levels of breathlessness or fatigue, but the majority of respondents considered patients should have no chest pain (73% and no more than mild light-headedness (92% during daily activities

  6. A review of the interrelationship between vestibular dysfunction ...

    African Journals Online (AJOL)

    problems and dyslexia were also associated with dysfunction of the vestibular system. Different tests evaluating vestibular loss were identified of which some can be used successfully by practitionars. Various programmes and activities were identified to successfully rehabilitate vestibular function. For better understanding ...

  7. Chronic disease self-management and exercise in COPD as pulmonary rehabilitation: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Cameron-Tucker HL

    2014-05-01

    Full Text Available Helen L Cameron-Tucker,1 Richard Wood-Baker,1 Christine Owen,2 Lyn Joseph,3 E Haydn Walters11Centre of Research Excellence for Chronic Respiratory Disease and Lung Aging, School of Medicine, University of Tasmania, Hobart, TAS, Australia; 2Faculty of Education, University of Tasmania, Hobart, TAS, Australia; 3Department of Respiratory Medicine, Royal Hobart Hospital, Hobart, TAS, AustraliaPurpose: Both exercise and self-management are advocated in pulmonary rehabilitation for people with chronic obstructive pulmonary disease (COPD. The widely used 6-week, group-based Chronic Disease Self-Management Program (CDSMP increases self-reported exercise, despite supervised exercise not being a program component. This has been little explored in COPD. Whether adding supervised exercise to the CDSMP would add benefit is unknown. We investigated the CDSMP in COPD, with and without a formal supervised exercise component, to address this question.Patients and methods: Adult outpatients with COPD were randomized to the CDSMP with or without one hour of weekly supervised exercise over 6 weeks. The primary outcome measure was 6-minute walk test distance (6MWD. Secondary outcomes included self-reported exercise, exercise stage of change, exercise self-efficacy, breathlessness, quality of life, and self-management behaviors. Within- and between-group differences were analyzed on an intention-to-treat basis.Results: Of 84 subjects recruited, 15 withdrew. 6MWD increased similarly in both groups: CDSMP-plus-exercise (intervention group by 18.6±46.2 m; CDSMP-alone (control group by 20.0±46.2 m. There was no significant difference for any secondary outcome.Conclusion: The CDSMP produced à small statistically significant increase in 6MWD. The addition of a single supervised exercise session did not further increase exercise capacity. Our findings confirm the efficacy of a behaviorally based intervention in COPD, but this would seem to be less than expected from

  8. Evaluation of quality of life pre- and post-vestibular rehabilitation in patients with benign paroxysmal positional vertigo associated with Meniere's disease.

    Science.gov (United States)

    Socher, Dayra Dill; Socher, Jan Alessandro; Azzi, Viviane Jacintha Bolfe

    2012-10-01

     Vertigo is a symptom that impacts the patients' quality of life and may force them to cease performing activities of daily living. Here, we discuss benign paroxysmal positional vertigo (BPPV) and Meniere's disease (MD), which show exacerbated symptoms when they appear in association. Vestibular rehabilitation (VR) is an effective treatment in reducing vertigo, especially in conjunction with other therapies.  To evaluate the quality of life of patients with BPPV and MD before and after VR.  We conducted a descriptive observational qualitative and quantitative case study with 12 patients aged 35 to 86 years. All patients diagnosed with BPPV and MD received treatment in the ENT clinic. The Brazilian DHI questionnaire, which assesses the quality of life with a focus on physical, emotional, and functional aspects, was used for data collection, and was completed by patients before the first session and after the fifth session of VR. Data were tested using the Shapiro-Wilk normality test, followed by Wilcoxon, Friedman, and Spearman correlation tests (p VR was an effective method for the treatment of patients with BPPV and MD; it improves quality of life and shows the maximal influence on physical aspect scores, regardless of age or gender.

  9. Evaluation of quality of life pre- and post-vestibular rehabilitation in patients with benign paroxysmal positional vertigo associated with Meniere's disease

    Directory of Open Access Journals (Sweden)

    Azzi, Viviane Jacintha Bolfe

    2012-01-01

    Full Text Available Introduction: Vertigo is a symptom that impacts the patients' quality of life and may force them to cease performing activities of daily living. Here, we discuss benign paroxysmal positional vertigo (BPPV and Meniere's disease (MD, which show exacerbated symptoms when they appear in association. Vestibular rehabilitation (VR is an effective treatment in reducing vertigo, especially in conjunction with other therapies. Aim: To evaluate the quality of life of patients with BPPV and MD before and after VR. Method: We conducted a descriptive observational qualitative and quantitative case study with 12 patients aged 35 to 86 years. All patients diagnosed with BPPV and MD received treatment in the ENT clinic. The Brazilian DHI questionnaire, which assesses the quality of life with a focus on physical, emotional, and functional aspects, was used for data collection, and was completed by patients before the first session and after the fifth session of VR. Data were tested using the Shapiro-Wilk normality test, followed by Wilcoxon, Friedman, and Spearman correlation tests (p < 0.05. Results: There were significant improvements in scores for all aspects, with median changes ranging from 12 to 0 in the physical, 6 to 1 in the emotional, and 11 to 1 in the functional aspect. There were no correlations between the scores and sample characteristics. Conclusion: VR was an effective method for the treatment of patients with BPPV and MD; it improves quality of life and shows the maximal influence on physical aspect scores, regardless of age or gender.

  10. Rehabilitation

    Science.gov (United States)

    ... doing things you did before. This process is rehabilitation. Rehabilitation often focuses on Physical therapy to help your ... who has had a stroke may simply want rehabilitation to be able to dress or bathe without ...

  11. The Association Between Insomnia Symptoms and Mood Changes During Exercise Among Patients Enrolled in Cardiac Rehabilitation.

    Science.gov (United States)

    Rouleau, Codie R; Horsley, Kristin J; Morse, Erin; Aggarwal, Sandeep; Bacon, Simon L; Campbell, Tavis S

    2015-01-01

    Insomnia symptoms (ie, difficulty falling asleep, difficulty staying asleep, and early awakenings) are common among patients with cardiovascular disease and may interfere with the beneficial impact of exercise on mood state. This study investigated the association of insomnia symptom severity with mood disturbance and with changes in mood state during exercise in a cardiac rehabilitation (CR) population. Insomnia symptom severity was measured using the Insomnia Severity Index upon admission to a 12-week CR program (n = 57). The Physical Activity Affect Scale was administered before and during a single bout of moderate intensity exercise to measure changes in mood state. Indices of mood disturbance included depressive symptoms (Hospital Anxiety and Depression Scale) and pre-exercise mood state (Physical Activity Affect Scale). Greater severity of insomnia symptoms was associated with less pleasant mood overall (r = -0.45, P positive affect (r = -0.39, P = .003), and worse fatigue (r = 0.36, P = .005); greater insomnia symptom severity also predicted greater improvements during exercise in both overall mood state (b = 0.26, standard error = 0.10, P = .009) and tranquility (b = 0.09, standard error = 0.04, P = .04), following statistical adjustment for demographic variables and pre-exercise mood state. Although CR patients reporting insomnia symptoms tend to experience daytime mood disturbance, they may benefit from mood-elevating properties of exercise. Future research is needed to help optimize mood during exercise, which may have implications for improving psychological distress and CR adherence.

  12. Improvement in self-reported exercise participation with the combination of tiotropium and rehabilitative exercise training in COPD patients

    Directory of Open Access Journals (Sweden)

    Steven Kesten

    2008-03-01

    Full Text Available Steven Kesten1, Richard Casaburi2, David Kukafka3, Christopher B Cooper41Boehringer Ingelheim GmbH, Ingelheim, Germany; 2Harbor-UCLA Medical Center, Torrance, CA, USA; 3Northern Colorado Pulmonary Consultants PC, Fort Collins, CO, USA; 4UCLA School of Medicine, Los Angeles, CA, USABackground: Improvements in ventilatory mechanics with tiotropium increases exercise tolerance during pulmonary rehabilitation. We wondered whether tiotropium also increased physical activities outside of pulmonary rehabilitation.Methods: COPD patients participating in 8 weeks of pulmonary rehabilitation were studied in a randomized, double-blind, placebo-controlled trial of tiotropium 18 µg daily (tiotropium = 47, placebo = 44. Study drug was administered for 5 weeks prior to, 8 weeks during, and 12 weeks following pulmonary rehabilitation. Patients completed a questionnaire documenting participation in pre-defined activities outside of pulmonary rehabilitation during the 2 weeks prior to each visit. Patients who submitted an activity questionnaire at week 4 and on at least one subsequent visit were included in the analysis. For each patient, the number of sessions was multiplied with the duration of each activity and then summed to give overall activity duration.Results: Patients (n = 46 had mean age of 67 years, mean baseline FEV1 of 0.84 L (33% predicted. Mean (SE increase in duration of activities (minutes during 2 weeks prior to each visit from week 4 (prior to PR to week 13 (end of PR was 145 (84 minutes with tiotropium and 66 (96 minutes with placebo. The increase from week 4 to week 25 (end of follow-up was 262 (96 and 60 (93 minutes for the respective groups. Increases in activity duration from week 4 to weeks 17, 21, and 25 were statistically significant with tiotropium. No statistical differences over time were observed within the placebo-treated group and differences between groups were not significant.Conclusions: Tiotropium appears to amplify the

  13. Time to adapt exercise training regimens in pulmonary rehabilitation--a review of the literature.

    Science.gov (United States)

    Lee, Annemarie L; Holland, Anne E

    2014-01-01

    Exercise intolerance, exertional dyspnea, reduced health-related quality of life, and acute exacerbations are features characteristic of chronic obstructive pulmonary disease (COPD). Patients with a primary diagnosis of COPD often report comorbidities and other secondary manifestations, which diversifies the clinical presentation. Pulmonary rehabilitation that includes whole body exercise training is a critical part of management, and core programs involve endurance and resistance training for the upper and lower limbs. Improvement in maximal and submaximal exercise capacity, dyspnea, fatigue, health-related quality of life, and psychological symptoms are outcomes associated with exercise training in pulmonary rehabilitation, irrespective of the clinical state in which it is commenced. There may be benefits for the health care system as well as the individual patient, with fewer exacerbations and subsequent hospitalization reported with exercise training. The varying clinical profile of COPD may direct the need for modification to traditional training strategies for some patients. Interval training, one-legged cycling (partitioning) and non-linear periodized training appear to be equally or more effective than continuous training. Inspiratory muscle training may have a role as an adjunct to whole body training in selected patients. The benefits of balance training are also emerging. Strategies to ensure that health enhancing behaviors are adopted and maintained are essential. These may include training for an extended duration, alternative environments to undertake the initial program, maintenance programs following initial exercise training, program repetition, and incorporation of approaches to address behavioral change. This may be complemented by methods designed to maximize uptake and completion of a pulmonary rehabilitation program.

  14. Usability Test of Exercise Games Designed for Rehabilitation of Elderly Patients After Hip Replacement Surgery: Pilot Study

    NARCIS (Netherlands)

    Y. Ling (Yun); L.P.D.M. ter Meer (Louis); Z. Yumak (Zerrin); R.C. Veltkamp (Remco)

    2017-01-01

    markdownabstractBACKGROUND: Patients who receive rehabilitation after hip replacement surgery are shown to have increased muscle strength and better functional performance. However, traditional physiotherapy is often tedious and leads to poor adherence. Exercise games, provide ways for increasing

  15. Effectiveness of Hamstring Knee Rehabilitation Exercise Performed in Training Machine vs. Elastic Resistance Electromyography Evaluation Study

    DEFF Research Database (Denmark)

    Jakobsen, M. D.; Sundstrup, E.; Andersen, C. H.

    2014-01-01

    Objective The aim of this study was to evaluate muscle activity during hamstring rehabilitation exercises performed in training machine compared with elastic resistance. Design Six women and 13 men aged 28-67 yrs participated in a crossover study. Electromyographic (EMG) activity was recorded in ...... extended knee angles and with higher perceived loading as hamstring curls using training machines.......Objective The aim of this study was to evaluate muscle activity during hamstring rehabilitation exercises performed in training machine compared with elastic resistance. Design Six women and 13 men aged 28-67 yrs participated in a crossover study. Electromyographic (EMG) activity was recorded...... in the biceps femoris and the semitendinosus during the concentric and the eccentric phase of hamstring curls performed with TheraBand elastic tubing and Technogym training machines and normalized to maximal voluntary isometric contraction-EMG (normalized EMG). Knee joint angle was measured using electronic...

  16. Pulmonary Rehabilitation Exercise Prescription in Chronic Obstructive Pulmonary Disease: Review of Selected Guidelines: AN OFFICIAL STATEMENT FROM THE AMERICAN ASSOCIATION OF CARDIOVASCULAR AND PULMONARY REHABILITATION.

    Science.gov (United States)

    Garvey, Chris; Bayles, Madeline Paternostro; Hamm, Larry F; Hill, Kylie; Holland, Anne; Limberg, Trina M; Spruit, Martijn A

    2016-01-01

    Chronic obstructive pulmonary disease (COPD) is associated with disabling dyspnea, skeletal muscle dysfunction, and significant morbidity and mortality. Current guidelines recommend pulmonary rehabilitation (PR) to improve dyspnea, functional capacity, and quality of life. Translating exercise science into safe and effective exercise training requires interpretation and use of multiple guidelines and recommendations. The purpose of this statement is to summarize for clinicians 3 current chronic obstructive pulmonary disease guidelines for exercise that may be used to develop exercise prescriptions in the PR setting. The 3 guidelines have been published by the American College of Sports Medicine, the American Thoracic Society/European Respiratory Society, and the American Association of Cardiovascular and Pulmonary Rehabilitation. In addition to summarizing these 3 guidelines, this statement describes clinical applications, explores areas of uncertainty, and suggests strategies for providing effective exercise training, given the diversity of guidelines and patient complexity.

  17. The importance of components of pulmonary rehabilitation, other than exercise training, in COPD

    Directory of Open Access Journals (Sweden)

    Kylie Hill

    2013-09-01

    Full Text Available Comprehensive pulmonary rehabilitation is an important component in the clinical management of people with chronic obstructive pulmonary disease (COPD. Although supervised exercise training is considered the cornerstone of effective pulmonary rehabilitation, there are many other components that should be considered to manage the impairments and symptom burden, as well as the psychosocial and lifestyle changes imposed by COPD. These include approaches designed to: 1 facilitate smoking cessation; 2 optimise pharmacotherapy; 3 assist with early identification and treatment of acute exacerbations; 4 manage acute dyspnoea; 5 increase physical activity; 6 improve body composition; 7 promote mental health; 8 facilitate advance care planning; and 9 establish social support networks. This article will describe these approaches, which may be incorporated within pulmonary rehabilitation, to optimise effective chronic disease self-management.

  18. The importance of components of pulmonary rehabilitation, other than exercise training, in COPD.

    Science.gov (United States)

    Hill, Kylie; Vogiatzis, Ioannis; Burtin, Chris

    2013-09-01

    Comprehensive pulmonary rehabilitation is an important component in the clinical management of people with chronic obstructive pulmonary disease (COPD). Although supervised exercise training is considered the cornerstone of effective pulmonary rehabilitation, there are many other components that should be considered to manage the impairments and symptom burden, as well as the psychosocial and lifestyle changes imposed by COPD. These include approaches designed to: 1) facilitate smoking cessation; 2) optimise pharmacotherapy; 3) assist with early identification and treatment of acute exacerbations; 4) manage acute dyspnoea; 5) increase physical activity; 6) improve body composition; 7) promote mental health; 8) facilitate advance care planning; and 9) establish social support networks. This article will describe these approaches, which may be incorporated within pulmonary rehabilitation, to optimise effective chronic disease self-management.

  19. Walking tests during the exercise training: Specific use for the cardiac rehabilitation

    OpenAIRE

    Casillas, J.-M.; Hannequin, A.; Besson, D.; Benaïm, S.; Krawcow, C.; Laurent, Y.; Gremeaux, V.

    2013-01-01

    International audience; Walk tests, principally the six-minute walk test (6mWT), constitute a safe, useful submaximal tool for exercise tolerance testing in cardiac rehabilitation (CR). The 6mWT result reflects functional status, walking autonomy and efficacy of CR on walking endurance, which is more pronounced in patients with low functional capacity (heart failure - cardiac surgery). The 6mWT result is a strong predictor of mortality. However, clinically significant changes and reliability ...

  20. Telerehabilitation Solution Conceptual Paper for Community-Based Exercise Rehabilitation of Patients Discharged After Critical Illness

    OpenAIRE

    TSAVOURELOU, APHRODITE; STYLIANIDES, NIKOLAS; PAPADOPOULOS, ANDREAS; DIKAIAKOS, MARIOS D.; NANAS, SERAFEIM; KYPRIANOY, THEODOROS; TOKMAKIDIS, SAVVAS P.

    2016-01-01

    A novel service oriented platform has been developed under the framework of the Telerehabilitation Service funded by the Cross Border Cooperation Programme Greece Cyprus 2007 – 2013 to support tele-supervised exercise rehabilitation for patients after hospitalization in intensive care units (ICU). The platform enables multiparty, interregional bidirectional audio/visual communication between clinical practitioners and post-ICU patients. It also enables patient group-based vital sign real time...

  1. Exercise and Life-Satisfactory-Fitness: Complementary Strategies in the Prevention and Rehabilitation of Illnesses

    OpenAIRE

    Christiane Jennen; Gerhard Uhlenbruck

    2004-01-01

    Moderate training of an endurance nature, but also other exercise activities, not only has a preventive effect on various illnesses and pre-illness states such as the metabolic syndrome and cancer, but is also effective in treating patients in the rehabilitation phase after illness, e.g. cardiovascular or cancer. Our investigation demonstrates that even low level physical activity has a very good preventive effect too, which is enhanced when it is accompanied by mental activity and psychologi...

  2. Shoulder muscle activity and function in common shoulder rehabilitation exercises.

    Science.gov (United States)

    Escamilla, Rafael F; Yamashiro, Kyle; Paulos, Lonnie; Andrews, James R

    2009-01-01

    The rotator cuff performs multiple functions during shoulder exercises, including glenohumeral abduction, external rotation (ER) and internal rotation (IR). The rotator cuff also stabilizes the glenohumeral joint and controls humeral head translations. The infraspinatus and subscapularis have significant roles in scapular plane abduction (scaption), generating forces that are two to three times greater than supraspinatus force. However, the supraspinatus still remains a more effective shoulder abductor because of its more effective moment arm. Both the deltoids and rotator cuff provide significant abduction torque, with an estimated contribution up to 35-65% by the middle deltoid, 30% by the subscapularis, 25% by the supraspinatus, 10% by the infraspinatus and 2% by the anterior deltoid. During abduction, middle deltoid force has been estimated to be 434 N, followed by 323 N from the anterior deltoid, 283 N from the subscapularis, 205 N from the infraspinatus, and 117 N from the supraspinatus. These forces are generated not only to abduct the shoulder but also to stabilize the joint and neutralize the antagonistic effects of undesirable actions. Relatively high force from the rotator cuff not only helps abduct the shoulder but also neutralizes the superior directed force generated by the deltoids at lower abduction angles. Even though anterior deltoid force is relatively high, its ability to abduct the shoulder is low due to a very small moment arm, especially at low abduction angles. The deltoids are more effective abductors at higher abduction angles while the rotator cuff muscles are more effective abductors at lower abduction angles. During maximum humeral elevation the scapula normally upwardly rotates 45-55 degrees, posterior tilts 20-40 degrees and externally rotates 15-35 degrees. The scapular muscles are important during humeral elevation because they cause these motions, especially the serratus anterior, which contributes to scapular upward rotation

  3. Auditory and Vestibular Issues Related to Human Spaceflight

    Science.gov (United States)

    Danielson, Richard W.; Wood, Scott J.

    2009-01-01

    Human spaceflight provides unique opportunities to study human vestibular and auditory systems. This session will discuss 1) vestibular adaptive processes reflected by pronounced perceptual and motor coordination problems during, and after, space missions; 2) vestibular diagnostic and rehabilitative techniques (used to promote recovery after living in altered gravity environments) that may be relevant to treatment of vestibular disorders on earth; and 3) unique acoustical challenges to hearing loss prevention and crew performance during spaceflight missions.

  4. A randomised study of the effects of supplemental exercise sessions after a 7-week chronic obstructive pulmonary disease rehabilitation program

    DEFF Research Database (Denmark)

    Linneberg, Allan René; Rasmussen, Mathilde; Buch, Tove Fedder

    2012-01-01

    Background: Several studies have suggested that the effects of chronic obstructive pulmonary disease (COPD) rehabilitation programs tend to attenuate with time. We aimed to investigate the effects of supplemental exercise sessions following an initial 7-week COPD rehabilitation program with regard...... to exercise capacity and disease-specific quality of life (QoL). Methods: We performed a 7-week COPD rehabilitation program in 140 COPD patients. Patients (n = 118) who completed the initial program were randomised for additional six supervised supplemental exercise sessions or three follow-up examinations...... without exercise. Both groups were followed for 12 months. Primary end-points were QoL as measured by the St. George's Respiratory Questionnaire total score and exercise capacity as measured by the endurance shuttle walking time (ESWT). Results: A marked increase in ESWT (from 193 to 921 s) and a moderate...

  5. Effects of exercise training on resting energy expenditure and lean mass during pediatric burn rehabilitation

    Science.gov (United States)

    Al-Mousawi, Ahmed M.; Williams, Felicia N.; Mlcak, Ronald P.; Jeschke, Marc G.; Herndon, David N.; Suman, Oscar E.

    2013-01-01

    Objective Severe burns cause profound hormonal and metabolic disturbances resulting in hypermetabolism, reflected in extreme elevation of resting energy expenditure (REE) and extensive skeletal muscle catabolism. Aerobic and resistive exercise programs during rehabilitation have shown substantial benefits, although whether such training potentially exacerbates basal metabolism is unknown. We therefore examined the effects of exercise training upon REE during the rehabilitation of severely burned pediatric patients. Methods Children with 40% total body surface area (TBSA) burns and greater were enrolled on admission to our burn intensive-care unit to participate in a twelve-week, hospital-based exercise program (EX), or a home-based standard of care program (SOC), commencing six months post-injury. Results Twenty-one patients (7–17 years) were enrolled and randomized to SOC (n=10) or EX (n=11). Age, gender, and TBSA burned were similar. Mean change (± sd) in REE, normalized to individual lean body mass (LBM), was almost negligible between SOC and EX group patients (0.03 ± 17.40%, SOC vs. 0.01 ± 26.38%, EX). A significant increase in LBM was found for EX patients (2.06 ± 3.17%, SOC vs. 8.75 ± 5.65%, EX; p=0.004), which persisted when normalized to height (0.70 ± 2.39%, SOC vs. 6.14 ± 6.46%, EX; p=0.02). Peak torque also improved significantly more in EX patients (12.29 ± 16.49%, SOC vs. 54.31 ± 44.25%, EX; p=0.02), reflecting improved strength. Conclusion Exercise training significantly enhanced lean mass and strength, without observed exacerbation of post-burn hypermetabolism. We therefore advocate use of exercise conditioning as a safe and effective component of pediatric burn rehabilitation. PMID:20354445

  6. Pulmonary rehabilitation improves exercise capacity and dyspnea in air pollution-related respiratory disease.

    Science.gov (United States)

    Miyamoto, Naomi; Senjyu, Hideaki; Tanaka, Takako; Asai, Masaharu; Yanagita, Yorihide; Yano, Yudai; Nishinakagawa, Tsuyoshi; Kotaki, Kenji; Kitagawa, Chika; Rikitomi, Naoto; Kozu, Ryo; Honda, Sumihisa

    2014-01-01

    Air pollution in Japan caused respiratory disease, such as chronic bronchitis and asthma, in many individuals in the 1960s. Although air pollution has decreased, many victims of air pollution-related respiratory disease are limited in their activities of daily living because of respiratory symptoms. The purpose of this study was to evaluate the efficacy of pulmonary rehabilitation in victims of air pollution-related chronic bronchitis or asthma. Subjects were enrolled in a 12-week (2-week inpatient followed by 10-week outpatient) pulmonary rehabilitation program. The program comprised conditioning, strength training, endurance training, and patient education. We assessed the Modified Medical Research Council (MMRC) dyspnea grade, pulmonary function, peripheral muscle force, incremental shuttle walk distance (ISWD), and physical activity at baseline and immediately after the program. Twenty-nine subjects (mean age 74.2 ± 10.1 years, 11 males) completed the program, including 11 subjects with COPD and 18 subjects with asthma. Following rehabilitation, the participants (n = 29) showed significant improvements in MMRC dyspnea grade, vital capacity % predicted, quadriceps force and ISWD (all P rehabilitation is an effective method of improving exercise capacity and dyspnea in officially acknowledged victims of air pollution-related asthma. In conclusion, we recommend that patients with chronic bronchitis or asthma, resulting from exposure to air pollution, are referred for pulmonary rehabilitation.

  7. An intensive exercise program improves motor performances in patients with dementia: translational model of geriatric rehabilitation.

    Science.gov (United States)

    Schwenk, Michael; Dutzi, Ilona; Englert, Stefan; Micol, William; Najafi, Bijan; Mohler, Jane; Hauer, Klaus

    2014-01-01

    Translation of intensive exercise programs developed specifically for patients with dementia into clinical settings is lacking. To determine if a progressive resistance and functional training program, previously evaluated in dementia outpatients, can be implemented in a geriatric inpatient setting in order to improve motor performances in patients with dementia. Eligible patients in one ward of a German geriatric hospital were assigned to the intervention group (IG, n = 74) and received intensive exercise training specifically designed for patients with dementia. Patients in the second ward were observed as a control group (CG, n = 74). All patients received usual care treatment. Primary endpoints were maximal lower extremity strength measured by a leg-press device and duration of the 5-chair-stand test for functional performance. Secondary outcomes included a number of parameters for strength and function. The rehabilitation period averaged 18.1 ± 6.8 days. The IG significantly improved in both primary endpoints (change: maximal strength, IG: +51.9 ± 42.3% versus CG: +13.5 ± 51.8%, p exercise program can be implemented in a geriatric rehabilitation setting to improve motor performances in patients with dementia. Results suggest that an intensification of training is feasible in the target group and substantially increases the benefits in comparison to receiving usual care exercise only.

  8. Specialized core stability exercise: a neglected component of anterior cruciate ligament rehabilitation programs.

    Science.gov (United States)

    Shi, Dong-liang; Li, Jing-long; Zhai, Hua; Wang, Hui-fang; Meng, Han; Wang, Yu-bin

    2012-01-01

    The incidence of anterior cruciate ligament injury has continued to increase over the last two decades. This injury is associated with abnormal gait patterns and osteoarthritis of the knee. In order to accelerate recovery, the introduction of core stability exercises into the rehabilitation program is proposed. The theory underlying the use of core stability exercise relates to the neuroplasticity that follows anterior cruciate ligament injury. Neuroplasticity in lumbar, thoracic, cervical and brain regions diminish activation in the contralateral thalamus, postparietal cortex, SM1, basal ganglia-external globus pallidus, SII, cingulated motor area, premotor cortex, and in the ipsilateral cerebellum and SM1 and increase activation in pre-SMA, SIIp, and pITG, indicating modifications of the CNS. In addition, the neuroplasticity can regulate the movement of trunk muscles, for example, sternocleidomastoid and lower trapezius muscles. Core stability also demonstrates a negative correlation with the incidence of anterior cruciate ligament injury. Therefore, we propose that core stability exercises may improve the rehabilitation of anterior cruciate ligament injuries by increasing core motor control. Specialized core stability exercises aimed at rectifying biomechanical problems associated with gait and core stability may play a key role in the management of anterior cruciate ligament injury.

  9. Exercise Is Medicine Initiative: Physical Activity as a Vital Sign and Prescription in Adult Rehabilitation Practice.

    Science.gov (United States)

    Cowan, Rachel E

    2016-09-01

    To support rehabilitation health care professionals' efforts to increase physical activity levels among their outpatient rehabilitation and postdischarge patients, we review the Exercise is Medicine (EIM) initiative. The EIM initiative was launched in 2007 jointly by the American College of Sports Medicine and American Medical Association. Three principles underlie the EIM initiative. First, physical activity should be monitored as a vital sign; second, physical activity is an effective medical modality and should be prescribed; and third, success of their vision requires top down and bottom up efforts by 3 key stakeholder groups: health care providers, exercise professionals, and the community. The target weekly physical activity level is 150 minutes of moderate-to-vigorous physical activity, as established by the Centers for Disease Control and Prevention and World Health Organization. Persons falling below the weekly target physical activity level should be prescribed physical activity and/or referred to an exercise professional for implementation support. Selection of an exercise professional for referral is based on the patient's risk stratification and need to participate in clinically supervised physical activity. Copyright © 2016. Published by Elsevier Inc.

  10. Revisão sistemática sobre os efeitos da reabilitação vestibular em adultos de meia-idade e idosos A systematic review about the effects of the vestibular rehabilitation in middle-age and older adults

    Directory of Open Access Journals (Sweden)

    Natalia A. Ricci

    2010-10-01

    Full Text Available OBJETIVO: Sistematizar os resultados de ensaios clínicos sobre reabilitação vestibular (RV em indivíduos de meia-idade e idosos com distúrbios vestibulares. MÉTODOS: A busca de publicações sobre a RV em indivíduos com distúrbios vestibulares foi realizada nas bases de dados LILACS, EMBASE, MEDLINE, SciELO, Cochrane, ISI Web of Knowledge e bibliotecas virtuais de teses e dissertações. Foram selecionados ensaios clínicos aleatórios e controlados dos últimos 10 anos em língua inglesa, portuguesa e espanhola. A qualidade metodológica dos estudos foi avaliada pela escala PEDro. A análise dos resultados dos estudos foi feita por meio de revisão crítica dos conteúdos. RESULTADOS: Nove estudos foram revisados na íntegra, sendo a faixa etária dos participantes acima de 40 anos (n=4 e composta exclusivamente por idosos (n=5. Os achados de disfunção vestibular foram diversificados, sendo os mais comuns queixa de desequilíbrio corporal ou instabilidade postural (n=3 e queixa de vertigem ou tontura (n=3. A Escala Visual Analógica (EVA foi o instrumento mais utilizado para avaliar a percepção subjetiva da sintomatologia da disfunção vestibular (n=4. A escala PEDro revelou que quatro dos artigos apresentaram delineamento de boa qualidade para a condução do estudo experimental. A proposta de intervenção mais utilizada foi o protocolo de Cawthorne & Cooksey (n=4. Os estudos que compararam a RV com outro tipo de intervenção não apresentaram, na maioria dos desfechos analisados, diferença entre os grupos após a terapia. CONCLUSÃO: Estudos aleatorizados controlados disponibilizaram evidências de efeitos positivos da RV em idosos e adultos de meia-idade com distúrbios vestibulares.OBJECTIVE: To summarize the results of clinical trials on vestibular rehabilitation (VR in middle-aged and elderly people with vestibular disorders. METHODS: A search for relevant trials was performed in the databases LILACS, EMBASE, MEDLINE, Sci

  11. The role of the vestibular assessment.

    Science.gov (United States)

    Phillips, J S; FitzGerald, J E; Bath, A P

    2009-11-01

    To evaluate the role of vestibular assessment in the management of the dizzy patient. A retrospective review of case notes and vestibular assessment reports of 100 consecutive patients referred for vestibular assessment. Sixty of the 100 patients had an abnormal vestibular assessment. Eleven patients had benign paroxysmal positional vertigo as the sole diagnosis, of whom nine had not had a Dix-Hallpike manoeuvre performed before referral. Of patients referred for vestibular rehabilitation, 76 per cent had an abnormal electrophysiological assessment. After vestibular assessment, 35 patients were discharged with no further follow-up appointments in the ENT department. All patients should have a Dix-Hallpike manoeuvre performed prior to referral for vestibular assessment. The majority of our patients undergoing vestibular rehabilitation had abnormal test results, although a significant number did not. Prior to referral, it is worth considering the implication of a 'normal' and 'abnormal' result for the management of the patient. Careful consideration should be given to the development of dedicated dizziness clinics run by practitioners with a specialist interest in balance disorders, in order to ensure appropriate requests for vestibular assessment.

  12. Impact of cardiac rehabilitation and exercise training programs in coronary heart disease.

    Science.gov (United States)

    Kachur, Sergey; Chongthammakun, Vasutakarn; Lavie, Carl J; De Schutter, Alban; Arena, Ross; Milani, Richard V; Franklin, Barry A

    Cardiovascular rehabilitation (CR) is the process of developing and maintaining an optimal level of physical, social, and psychological well-being in order to promote recovery from cardiovascular (CV) illness. It is a multi-disciplinary approach encompassing supervised exercise training, patient counseling, education and nutritional guidance that may also enhance quality of life. Beneficial CV effects may include improving coronary heart disease risk factors; particularly exercise capacity, reversing cardiac remodeling, and favorably modifying metabolism and systemic oxygen transport. We review the historical basis for contemporary CR, the indications and critical components of CR, as well as the potential salutary physiological and clinical effects of exercise-based CR. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. Adherence to a Maintenance Exercise Program 1 Year After Pulmonary Rehabilitation WHAT ARE THE PREDICTORS OF DROPOUT?

    NARCIS (Netherlands)

    Heerema-Poelman, Ankie; Stuive, Ilse; Wempe, Johan B.

    2013-01-01

    PURPOSE: To evaluate adherence to a maintenance exercise program in patients with chronic obstructive pulmonary disease (COPD) and explore predictors for adherence. METHODS: Seventy patients with COPD were referred to a home-care maintenance exercise program after completing pulmonary rehabilitation

  14. Restorative effects of exercise rehabilitation and bracing on females with lateral displacement of patella

    Directory of Open Access Journals (Sweden)

    Atiye Karimzadehfini

    2014-01-01

    Full Text Available Background: This investigation compared the effects of exercise rehabilitation and bracing on muscle flexibility and strength as well as knee proprioception and pain in female sufferers of lateral displacement of patella (LDP. Materials and Methods: Twenty-two females with unilateral LDP were randomly divided into two groups to receive exercises (n = 12 or patellar brace (n = 10. Both groups were evaluated before and after 8 weeks with isokinetic dynamometer (Biodex System 3 Pro for muscle strength and proprioception, with SLR, Active Knee Flexion, and Sit and Reach tests for flexibility assessment and with a visual analog scale for pain. Results: Muscle flexibility in both exercise and bracing groups improved (F(1,20≥5.99 and P ≤ 0.024, whereas improvement in bracing group was not significant. Significant interaction was observed in favor of exercise group in 2 strength tests of knee flexion and knee extension (F(1,20≥6.564 and P ≤ 0.019. For proprioception, a significant interaction was observed in favor of bracing group (F(1,20 =7.944 and P = 0.011. Also the results showed both exercise rehab and brace decreased significantly pain severity during stair ascending and descending. Conclusion: These results suggest that better flexibility and more strength in exercise group somehow reduced the stress on patellofemoral joint and it, in turn, alleviated the symptoms and pain. It is also likely that relieving effects of brace and improvement of proprioception by it allows patients to be more physically active and it could have, more or less, effects similar to exercise. Therefore both exercise and brace could be prescribed for patients with LDP. It seems application of the patellar brace combined with exercise might be a better treatment for these patients, because they could improve strength, flexibility and proprioception.

  15. The sustainability of exercise capacity changes in home versus center-based cardiac rehabilitation.

    Science.gov (United States)

    Ramadi, Ailar; Haennel, Robert G; Stone, James A; Arena, Ross; Threlfall, Tyler G; Hitt, Elizabeth; Aggarwal, Sandeep G; Haykowsky, Mark; Martin, Billie-Jean

    2015-01-01

    Although participation in either center- or home-based cardiac rehabilitation (CR) can improve exercise capacity, the sustainability of this improvement following completion of the CR program is challenging. The purpose of this study was to compare the immediate and 1-year effectiveness of center- versus home-based CR on exercise capacity in cardiac patients who were given the choice of participating in a center-based or home-based CR program. This was a retrospective study, which relied on the database from a large multidisciplinary CR program. A sample of 3488 cardiac patients participated either in center-based (n = 2803) or home-based (n = 685) CR. Participants underwent exercise testing at baseline, after 12 weeks of CR and again 1 year after completion of the CR programs. Following CR, exercise capacity (ie, peak metabolic equivalents [METs]) increased significantly in both groups (P < .05). From post-CR to the 1-year followup, exercise capacity remained unchanged in home-based CR participants (P = .183), whereas the center-based CR group demonstrated a decline in exercise capacity (P < .05). Although at the 1-year followup exercise capacity decreased in the center-based group, the observed decline did not seem to be clinically significant. The present findings indicate that when the patients were given a choice as to the delivery model (center- vs home-based) used for their CR program, they were relatively successful in retaining the improvement in exercise capacity 1 year post-CR irrespective of the exact location for their exercise training.

  16. Restorative effects of exercise rehabilitation and bracing on females with lateral displacement of patella

    Science.gov (United States)

    Karimzadehfini, Atiye; Zolaktaf, Vahid; Vahdatpour, Babak

    2014-01-01

    Background: This investigation compared the effects of exercise rehabilitation and bracing on muscle flexibility and strength as well as knee proprioception and pain in female sufferers of lateral displacement of patella (LDP). Materials and Methods: Twenty-two females with unilateral LDP were randomly divided into two groups to receive exercises (n = 12) or patellar brace (n = 10). Both groups were evaluated before and after 8 weeks with isokinetic dynamometer (Biodex System 3 Pro) for muscle strength and proprioception, with SLR, Active Knee Flexion, and Sit and Reach tests for flexibility assessment and with a visual analog scale for pain. Results: Muscle flexibility in both exercise and bracing groups improved (F(1,20)≥5.99 and P ≤ 0.024), whereas improvement in bracing group was not significant. Significant interaction was observed in favor of exercise group in 2 strength tests of knee flexion and knee extension (F(1,20)≥6.564 and P ≤ 0.019). For proprioception, a significant interaction was observed in favor of bracing group (F(1,20) =7.944 and P = 0.011). Also the results showed both exercise rehab and brace decreased significantly pain severity during stair ascending and descending. Conclusion: These results suggest that better flexibility and more strength in exercise group somehow reduced the stress on patellofemoral joint and it, in turn, alleviated the symptoms and pain. It is also likely that relieving effects of brace and improvement of proprioception by it allows patients to be more physically active and it could have, more or less, effects similar to exercise. Therefore both exercise and brace could be prescribed for patients with LDP. It seems application of the patellar brace combined with exercise might be a better treatment for these patients, because they could improve strength, flexibility and proprioception. PMID:25221768

  17. Designing And Implementation Of An Intelligent Monitoring System For Hand Rehabilitation Exercises

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    Parysa Rashidzadeh

    2017-02-01

    Full Text Available Background: intelligent hand rehabilitee exerciser provides direct supervising on therapeutic movements which patient with hemiplegia disorder have done during treatment sessions. This instrument improves hand functions without continuous present of therapist. Objectives: purpose of this study is indirect palpation control in hand rehabilitive exercises among hemiplegia patients. In that, encourage hemiplegia patients to repeat hand therapeutic movements without continuous present of therapist.Finally, intelligent hand  rehabilitee exerciser flourishes the quality and quantity hand functions. Methods: participants include 13 hemiplegia patients and 3 healthy persons who followed seventy therapeutic sessions. Functional movements and quality of life were assessed . moreover recorded captures were examined by specialists. Result: kinematic parameters (average and maximum velocity , maximum angular velocity , acceleration , accurate movements or ability to induce profit  motor pattern 3-5 and trunk movements pattern with final scoring the movements showed increasing the upper limb function with intelligent hand rehabilitee exerciser. Conclusion: Results depict intelligent  hand rehabilitee exerciser increased in accurate thera peutic exercises and quality of life in hemiplegia patients also , confidence  coefficient of specialists had improvement.

  18. A Qualitative Exploration of Exercise Among Pulmonary Rehabilitation Participants: Insight From Multiple Sources of Social Influence.

    Science.gov (United States)

    Witcher, Chad S G; McGannon, Kerry R; Hernandez, Paul; Dechman, Gail; Ferrier, Suzanne; Spence, John C; Rhodes, Ryan E; Blanchard, Chris M

    2015-11-01

    Exercise training within the pulmonary rehabilitation (PR) context is considered the most effective strategy to reduce COPD symptoms. However, participation in PR and continued exercise training following program completion are low. Previous research examined factors related to attendance and adherence, but the knowledge base to date has been limited to quantitative findings that focus solely on participants diagnosed with COPD. In addition to quantitative research, exploring multiple perspectives (eg, PR participants, significant others, staff, and stakeholders) using qualitative research methods opens a window of additional understanding. The goal of this study was to obtain multiple perspectives on PR to gain insight into factors that affect exercise participation among individuals diagnosed with COPD. A total of 26 participants were interviewed via telephone, including 8 individuals diagnosed with COPD (4 men and 4 women, mean age of 67 [range of 58-77] y), 4 family members, 11 PR staff, and 3 community stakeholders. Analysis revealed 3 themes: task self-efficacy for exercise, provision of support and encouragement, and perceptions of gender differences. Despite initial concerns, individuals diagnosed with COPD reported becoming more confident during PR and emphasized the importance of being supported by staff. PR staff perceived that men tended to approach exercise in a more eager and aggressive manner compared with women, who were more cautious and hesitant. In addition to enhancing task self-efficacy, findings suggest that exercise participation and adherence within the PR environment may be improved by adopting a gender-tailored approach. Copyright © 2015 by Daedalus Enterprises.

  19. Physical therapy for persons with vestibular disorders.

    Science.gov (United States)

    Whitney, Susan L; Alghwiri, Alia; Alghadir, Ahmad

    2015-02-01

    Persons with vestibular disorders experience symptoms of dizziness and balance dysfunction, resulting in falls, as well as impairments of daily life. Various interventions provided by physical therapists have been shown to decrease dizziness and improve postural control. In the present review, we will focus on the role of physical therapy in the management of vestibular symptoms in patients with peripheral and central vestibular disorders. Persons with both acute and chronic central and peripheral vestibular disorders improve with vestibular rehabilitation. New interventions during the past 5 years have been designed to enhance recovery from problems with balance and dizziness. Examples include the use of virtual reality, vibrotactile feedback, optokinetic flow, YouTube videos, and innovative methods to change the gain of the vestibulo-ocular reflex (VOR). Patients with central and peripheral vestibular disorders benefit from physical therapy interventions. Advances in physical therapy interventions include new methods to stimulate adaptation of the VOR and the vestibulospinal systems.

  20. Effects of a comprehensive cardiac rehabilitation program on quality of life and exercise tolerance in women: A retrospective analysis

    Directory of Open Access Journals (Sweden)

    Knapik Grant

    2003-04-01

    Full Text Available Abstract Background Currently, there are a lack of investigations that have examined the effect of participating in a comprehensive cardiac rehabilitation program on quality of life and physiological measures in women of different ages. The purpose of this investigation was to examine the effect of participating in a comprehensive cardiac rehabilitation program on quality of life, exercise tolerance, blood pressure and lipids in women between 33 and 82 years of age. Methods The 126 women participated in a 14-week cardiac rehabilitation program that consisted of 7 weeks of formal supervised exercise training and 7 weeks of unsupervised exercise and lifestyle modification. Physiologic and quality of life outcome measures obtained at the outset and after 14 weeks included: 1 exercise treadmill time; 2 resting and peak systolic and diastolic blood pressure; 3 total cholesterol, low-density lipoprotein cholesterol, high density lipoprotein cholesterol and Triglycerides; 4 Cardiac Quality of Life Index questionnaire. Results Significant improvements were found in the following quality of life measures after participating in the cardiac rehabilitation program: physical well being, psychosocial, worry, nutrition and symptoms. No significant differences were seen for any QOL variable between the different age groups. Significant improvements were seen in exercise tolerance (+21% and high density lipoprotein (+5%. Conclusion Cardiac rehabilitation may play an important role in improving quality of life, exercise tolerance and high density lipoprotein cholesterol levels in younger and older women with underlying cardiovascular disease.

  1. Aerobic capacity, orthostatic tolerance, and exercise perceptions at discharge from inpatient spinal cord injury rehabilitation.

    Science.gov (United States)

    Pelletier, Chelsea A; Jones, Graham; Latimer-Cheung, Amy E; Warburton, Darren E; Hicks, Audrey L

    2013-10-01

    To describe physical capacity, autonomic function, and perceptions of exercise among adults with subacute spinal cord injury (SCI). Cross-sectional. Two inpatient SCI rehabilitation programs in Canada. Participants (N=41; mean age ± SD, 38.9 ± 13.7y) with tetraplegia (TP; n=19), high paraplegia (HP; n=8), or low paraplegia (LP; n=14) completing inpatient SCI rehabilitation (mean ± SD, 112.9 ± 52.5d postinjury). Not applicable. Peak exercise capacity was determined by an arm ergometry test. As a measure of autonomic function, orthostatic tolerance was assessed by a passive sit-up test. Self-efficacy for exercise postdischarge was evaluated by a questionnaire. There was a significant difference in peak oxygen consumption and heart rate between participants with TP (11.2 ± 3.4;mL·kg(-1)·min(-1) 113.9 ± 19.7 beats/min) and LP (17.1 ± 7.5 mL·kg(-1)·min(-1); 142.8 ± 22.7 beats/min). Peak power output was also significantly lower in the TP group (30.0 ± 6.9W) compared with the HP (55.5 ± 7.56W) and LP groups (62.5 ± 12.2W). Systolic blood pressure responses to the postural challenge varied significantly between groups (-3.0 ± 33.5 mmHg in TP, 17.8 ± 14.7 mmHg in HP, 21.6 ± 18.7 mmHg in LP). Orthostatic hypotension was most prevalent among participants with motor complete TP (73%). Results from the questionnaire revealed that although participants value exercise and see benefits to regular participation, they have low confidence in their abilities to perform the task of either aerobic or strengthening exercise. Exercise is well tolerated in adults with subacute SCI. Exercise interventions at this stage should focus on improving task-specific self-efficacy, and attention should be made to blood pressure regulation, particularly in individuals with motor complete TP. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  2. Rote of adaptation exercises in clinical practice.

    Science.gov (United States)

    Kirtane, M V

    1999-04-01

    Adaptation, habitution and compensation are the mechanisms involved in rehabilitation of vertigo patients. In Vestibular Rehabilitation Therapy (VRT), patients are advised to perform a series of maneuvers involving head, eye and body movements which stimulate the in-built adaptive mechanisms. Cawthorne and Cooksey were the first to describe adaptation exercises, which are further modified. Norre has designed VRT test battery of specific exercises. Drug treatment used along with VRT should not interfere with the compensation mechanism. Anti-vertigo drug Betahistine has been shown to hasten the compensation and hence is suitable for use with VRT.

  3. Comparison of exercise training effect with different robotic devices for upper limb rehabilitation: a retrospective study.

    Science.gov (United States)

    Colombo, Roberto; Pisano, Fabrizio; Delconte, Carmen; Mazzone, Alessandra; Grioni, Giuseppe; Castagna, Marisa; Bazzini, Giacomo; Imarisio, Chiara; Maggioni, Giorgio; Pistarini, Caterina

    2017-04-01

    Several robotic devices have been proposed for upper limb rehabilitation, but they differ in terms of application fields and the technical solutions implemented. The aim of this study was to compare the effectiveness of three different robotic devices for shoulder-elbow rehabilitation in reducing motor impairment and improving motor performance in post-stroke patients. Retrospective multi-center study. Inpatient rehabilitation hospital. Eighty-seven chronic and subacute post-stroke patients, aged 48-85 years. Data were obtained through a retrospective analysis of patients who underwent a 3-week rehabilitation program including robot-assisted therapy of the upper limb and conventional physical therapy. Patients were divided into three groups according to the robot device used for exercise training: 'Braccio di Ferro" (BdF), InMotion2 (IMT), and MEchatronic system for MOtor recovery after Stroke (MEMOS). They were evaluated at the beginning and end of treatment using the Fugl-Meyer (FM) and Modified Ashworth (MAS) clinical scales and by a set of robot measured kinematic parameters. The three groups were homogeneous for age, level of impairment, time since the acute event, and spasticity level. A significant effect of time (Probot device used. Further, the ES ranged from moderate to large for the remaining kinematic parameters except for the movement accuracy (mean distance, MD), which exhibited a small ES in the BdF and MEMOS groups. The motor function gains obtained during robot-assisted therapy of stroke patients seem to be independent of the type of robot device used for the training program. All devices tested in this study were effective in improving the level of impairment and motor performance. This study could help rehabilitation professionals to set-up comparative studies involving rehabilitation technologies.

  4. Dealing with existential anxiety in exercise-based cardiac rehabilitation: a phenomenological-hermeneutic study of patients' lived experiences.

    Science.gov (United States)

    Simonÿ, Charlotte P; Pedersen, Birthe D; Dreyer, Pia; Birkelund, Regner

    2015-09-01

    To investigate patients' lived experiences of exercise-based cardiac rehabilitation. Exercise-based cardiac rehabilitation is used to enable patients with cardiac problems to move forward to lead satisfying lives. However, knowledge of patients' concerns while they follow the current programmes is sparse. This study, which included nine men and two women with unstable angina pectoris and non-ST-elevation myocardial infarction, used a phenomenological-hermeneutic approach. The patients were followed by field observations during exercise-based cardiac rehabilitation. Focus group interviews were conducted at the programme end, and individual interviews were performed one to two months later. The interpretation comprised three methodological steps: naïve reading, structural analysis, and comprehensive interpretation and discussion. Although both physically and psychologically challenged, the patients were encouraged to maintain an active lifestyle. Three themes were identified: anxiety regarding exercise, whereby the patients are initially insecure about how to behave with their diseased hearts; encouragement from training together, whereby the patients support each other in exercising; and growing confidence in the heart, whereby the patients enjoy being physically active. In exercise-based cardiac rehabilitation, patients' insecurity with respect to their heart disease is revealed as an existential anxiety. Through peer support and a positive physical perception, the patients gain renewed self-efficacy, helping them to continue their lives in an active and satisfying way. Knowing that patients are confronted with an existential anxiety during exercise-based cardiac rehabilitation is important because it requires specific care. Recognising this anxiety also highlights how participating in the programme can be very demanding, which can help us understand aspects of adherence problems. Of greatest importance is that exercise-based cardiac rehabilitation enables

  5. Exercise after spinal cord injury as an agent for neuroprotection, regeneration and rehabilitation.

    Science.gov (United States)

    Sandrow-Feinberg, Harra R; Houlé, John D

    2015-09-04

    Spinal cord injury (SCI) is a traumatic event from which there is limited recovery of function, despite the best efforts of many investigators to devise realistic therapeutic treatments. Partly this is due to the multifaceted nature of SCI, where there is considerable disarray and dysfunction secondary to the initial injury. Contributing to this secondary degeneration is neurotoxicity, vascular dysfunction, glial scarring, neuroinflammation, apoptosis and demyelination. It seems logical that addressing the need for neuroprotection, regeneration and rehabilitation will require different treatment strategies that may be applied at varied stages of the post-injury response. Here we focus on a single strategy, exercise/physical training, which appears to have multiple applications and benefits for an acute or chronic SCI. Exercise has been demonstrated to be advantageous at cellular and biochemical levels, as well as being of benefit for the whole animal or human subject. Data from our lab and others will be discussed to further elucidate the many positive aspects of implementing exercise following injury and to suggest that rehabilitation is not the sole target of a training regimen following SCI. This article is part of a Special Issue entitled SI: Spinal cord injury. Copyright © 2015 Elsevier B.V. All rights reserved.

  6. Vestibular mechanisms.

    Science.gov (United States)

    Precht, W

    1979-01-01

    It is apparent from this and other reviews of the subject that our knowledge of vestibular function is most complete for the primary canal and otolithic afferents. Relatively little progress has been made in the understanding of receptor mechanisms and the functional importance of the efferent vestibular system. Since most of it has been summarized previously the latter were not considered here. Considerably more knowledge has accumulated in the field of central vestibular mechanisms, particularly those related to eye movements. Recent advances in functional synaptology of direct and indirect vestibuloocular pathways are described. It appears that the indirect pathways are essential for the central integration of the peripheral head velocity into a central eye position signal. Candidates for the neural integrator are presented and discussed and their connectivity described both for the horizontal and the relatively poorly studied vertical eye movement system. This field will certainly be studied extensively during the next years. Another interesting field is the role of the cerebellum in the control the vestibuloocular reflex. Recent data and hypotheses, including the problem of cerebellar plasticity, are summarized and evaluated. That the vestibular nuclei are by no means a simple relay system for specific vestibular signals destined for other sensory or motor centers is evidenced in this review by the description of multiple canal-canal, canalotolith, and visual-vestibular convergence at the nuclear level. Canal-otolith and polysensory convergence in vestibular neurons enables them to correct for the inherent inadequacies of the peripheral canal system in the low frequency range. The mechanisms of polysensory interaction in the central vestibular system will undoubtedly be an important and interesting field for future research.

  7. Modulation of Synaptic Plasticity by Exercise Training as a Basis for Ischemic Stroke Rehabilitation.

    Science.gov (United States)

    Nie, Jingjing; Yang, Xiaosu

    2017-01-01

    In recent years, rehabilitation of ischemic stroke draws more and more attention in the world, and has been linked to changes of synaptic plasticity. Exercise training improves motor function of ischemia as well as cognition which is associated with formation of learning and memory. The molecular basis of learning and memory might be synaptic plasticity. Research has therefore been conducted in an attempt to relate effects of exercise training to neuroprotection and neurogenesis adjacent to the ischemic injury brain. The present paper reviews the current literature addressing this question and discusses the possible mechanisms involved in modulation of synaptic plasticity by exercise training. This review shows the pathological process of synaptic dysfunction in ischemic roughly and then discusses the effects of exercise training on scaffold proteins and regulatory protein expression. The expression of scaffold proteins generally increased after training, but the effects on regulatory proteins were mixed. Moreover, the compositions of postsynaptic receptors were changed and the strength of synaptic transmission was enhanced after training. Finally, the recovery of cognition is critically associated with synaptic remodeling in an injured brain, and the remodeling occurs through a number of local regulations including mRNA translation, remodeling of cytoskeleton, and receptor trafficking into and out of the synapse. We do provide a comprehensive knowledge of synaptic plasticity enhancement obtained by exercise training in this review.

  8. Developing interactive and simple electromyogram PONG game for foot dorsiflexion and plantarflexion rehabilitation exercise.

    Science.gov (United States)

    Cheok Lek Hee; Tune Hau Chong; Gouwanda, Darwin; Gopalai, Alpha A; Cheng Yee Low; Binti Hanapiah, Fazah Akhtar

    2017-07-01

    Gaming systems have been proven to be able to improve physical and cognitive skills. Several studies have integrated games to be part of rehabilitation program to improve functional ability of human limbs in performing activities of daily living. This paper presents the development of an interactive electromyogram (EMG) based PONG game for foot dorsifexion and plantarflexion exercise. PONG game is selected because it is a classical game that can be easily comprehended and can be played by young and old people. Two surface EMG sensors were used in this work to acquire muscle activity of tibialis anterior muscle and gastrocnemius muscle. An experimental study was carried out to examine the viability of this sensor as input to play the game. The results were satisfactory. This study further strengthens the viability of using muscle activity as an input for gaming system and as a mean to monitor patient rehabilitation progress.

  9. Clinicians' perceptions of rationales for rehabilitative exercise in a critical care setting: A cross-sectional study.

    Science.gov (United States)

    Nickels, Marc; Aitken, Leanne M; Walsham, James; Watson, Lisa; McPhail, Steven

    2017-03-01

    Rehabilitative exercise for critically ill patients may have many benefits; however, it is unknown what intensive care unit (ICU) clinicians perceive to be important rationale for the implementation of rehabilitative exercise in critical care settings. To identify which rationales for rehabilitative exercise interventions were perceived by ICU clinicians to be important and determine whether perceptions were consistent across nursing, medical and physiotherapy clinicians. A cross-sectional study was undertaken among clinicians (nursing, medical, physiotherapy) working in a mixed medical surgical ICU in an Australian metropolitan tertiary hospital. Participants completed a customised web-based questionnaire developed by a clinician working-group. The questionnaire consisted of 11 plausible rationales for commencing rehabilitative exercise in ICUs based on prior literature and their own clinical experiences grouped into 4 over-arching categories (musculoskeletal, respiratory, psychological and facilitation of discharge). Participants rated their perceived importance for each potential rationale on a 5-point Likert scale. Participants (n=76) with a median (interquartile range) 4.8 (1.5, 15.5) years of experience working in ICUs completed the questionnaire. Responses were consistent across professional disciplines. Clinicians rated rehabilitative exercise as either 'very much' or 'somewhat' important for facilitating discharge (n=76, 100%), reducing muscle atrophy (n=76, 100%), increasing muscle strength (n=76, 100%), prevention of contractures (n=73, 96%), reducing the incidence of ICU acquired weakness (n=62, 82%), increasing oxygenation (n=71, 93%), facilitating weaning (n=72, 97%), reducing anxiety (n=60, 80%), reducing depression (n=64, 84%), reducing delirium (n=53, 70%), and increasing mental alertness (n=65, 87%). Any shortcoming in implementation of rehabilitation exercise is unlikely attributable to a lack of perceived importance by nursing, medical or

  10. Reabilitação vestibular personalizada: levantamento de prontuários dos pacientes atendidos no ambulatório de otoneurologia da I.S.C.M.S.P. Personalized vestibular rehabilitation: medical chart survey with patients seen at the ambulatory of otoneurology of I.S.C.M.S.P.

    Directory of Open Access Journals (Sweden)

    Lucia Kazuko Nishino

    2005-08-01

    Full Text Available O OBJETIVO: o objetivo deste trabalho foi verificar a eficácia da reabilitação vestibular personalizada (RVP em diferentes quadros otoneurológicos. FORMA DE ESTUDO: clínico retrospectivo. MATERIAL E MÉTODO: Foi realizado um estudo retrospectivo que constou de uma descrição do programa de reabilitação vestibular de 37 pacientes, com idade entre 21 a 87 anos, vinte e seis do sexo feminino, onze do sexo masculino, com quadros otoneurológicos variados, atendidos no Ambulatório de Otoneurologia do Departamento de Otorrinolaringologia da Irmandade da Santa Casa de Misericórdia de São Paulo, no período de 2002 a 2003. Estes foram submetidos à avaliação otoneurológica e depois de realizado o diagnóstico pelo otorrinolaringologista, encaminhados para a reabilitação vestibular, realizada semanalmente no ambulatório, e em casa diariamente. Cada paciente seguiu programas específicos de exercícios, considerando-se os achados ao exame vestibular, o quadro clínico e, principalmente, os sintomas apresentados. Os exercícios foram baseados em diferentes protocolos descritos na literatura. Foi realizada uma análise individual da evolução clínica e em conjunto, a fim de verificar a eficácia da RVP em diferentes quadros clínicos. CONCLUSÃO: Pudemos concluir que o programa de RVP mostrou-se um recurso terapêutico efetivo na diminuição e extinção dos sintomas e conseqüente melhora na qualidade de vida de pacientes portadores de diferentes quadros clínicos.The objective of this research study was to verify the efficiency of the personalized vestibular rehabilitation (PVR in different otoneurologic clinical diseases, as well as set the best protocol option in each case. STUDY DESIGN: clinical retrospective. MATERIAL AND METHOD: A retrospective study was conducted based on the description of the vestibular rehabilitation program of 37 patients aged 21 to 87 years, twenty-six females and eleven males, with different clinical

  11. [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

  12. Laboratory-free measurement of gait rhythmicity in the assessment of the degree of impairment and the effectiveness of rehabilitation in patients with vertigo resulting from vestibular hypofunction.

    Science.gov (United States)

    Perring, S; Summers, T

    2007-06-01

    A portable system for measurement of stride time rhythmicity was developed using the technique of Hausdorff et al (2001a Arch. Phys. Med. Rehabil. 82 1050-6). Measurement was performed for an extended period of walking of 256 steps for each foot outside of the laboratory on 18 normal individuals and 20 patients referred with symptomatic vestibular impairment. Ten of the patients were reassessed following vestibular therapy. Gait rhythmicity measured by standard deviation (SD) stride time was found to be significantly higher in patients with vestibular impairment than in normal volunteers (mean +/- SD 60.3 +/- 39.8 ms versus 21.9 +/- 4.9 ms respectively, P measurement, specifically measurement of stride time variability, appears to be a powerful assessment tool for objective measurement of extent of impairment and response to therapy in patients with vestibular hypofunction.

  13. Telehealth exercise-based cardiac rehabilitation: a systematic review and meta-analysis.

    Science.gov (United States)

    Rawstorn, Jonathan C; Gant, Nicholas; Direito, Artur; Beckmann, Christina; Maddison, Ralph

    2016-08-01

    Despite proven effectiveness, participation in traditional supervised exercise-based cardiac rehabilitation (exCR) remains low. Telehealth interventions that use information and communication technologies to enable remote exCR programme delivery can overcome common access barriers while preserving clinical supervision and individualised exercise prescription. This meta-analysis aimed to determine the benefits of telehealth exCR on exercise capacity and other modifiable cardiovascular risk factors compared with traditional exCR and usual care, among patients with coronary heart disease (CHD). CINAHL, The Cochrane Library, Embase, MEDLINE, PubMed and PsycINFO were searched from inception through 31 May 2015 for randomised controlled trials comparing telehealth exCR with centre-based exCR or usual care among patients with CHD. Outcomes included maximal aerobic exercise capacity, modifiable cardiovascular risk factors and exercise adherence. 11 trials (n=1189) met eligibility criteria and were included in the review. Physical activity level was higher following telehealth exCR than after usual care. Compared with centre-based exCR, telehealth exCR was more effective for enhancing physical activity level, exercise adherence, diastolic blood pressure and low-density lipoprotein cholesterol. Telehealth and centre-based exCR were comparably effective for improving maximal aerobic exercise capacity and other modifiable cardiovascular risk factors. Telehealth exCR appears to be at least as effective as centre-based exCR for improving modifiable cardiovascular risk factors and functional capacity, and could enhance exCR utilisation by providing additional options for patients who cannot attend centre-based exCR. Telehealth exCR must now capitalise on technological advances to provide more comprehensive, responsive and interactive interventions. 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/

  14. The Feasibility of Financial Incentives to Increase Exercise Among Canadian Cardiac Rehabilitation Patients.

    Science.gov (United States)

    Mitchell, Marc S; Goodman, Jack M; Alter, David A; Oh, Paul I; Leahey, Tricia M; Faulkner, Guy E J

    2016-01-01

    To examine the feasibility of conducting a randomized controlled trial investigating the effectiveness of financial incentives for exercise self-monitoring in cardiac rehabilitation (CR). A 12-week, 2 parallel-arm, single-blind feasibility study design was employed. A volunteer sample of CR program graduates was randomly assigned to an exercise self-monitoring intervention only (control; n = 14; mean age ± SD, 62.7 ± 14.6 years), or an exercise self-monitoring plus incentives approach (incentive; n = 13; mean age ± SD, 63.6 ± 11.8 years). Control group participants received a "home-based" exercise self-monitoring program following CR program completion (exercise diaries could be submitted online or by mail). Incentive group participants received the "home-based" program, plus voucher-based incentives for exercise diary submissions ($2 per day). A range of feasibility outcomes is presented, including recruitment and retention rates, and intervention acceptability. Data for the proposed primary outcome of a definitive trial, aerobic fitness, are also reported. Seventy-four CR graduates were potentially eligible to participate, 27 were enrolled (36.5% recruitment rate; twice the expected rate), and 5 were lost to followup (80% retention). Intervention acceptability was high with three-quarters of participants indicating that they would likely sign up for an incentive program at baseline. While group differences in exercise self-monitoring (the incentive "target") were not observed, modest but nonsignificant changes in aerobic fitness were noted with fitness increasing by 0.23 mL·kg-·min- among incentive participants and decreasing by 0.68 mL·kg-·min- among controls. This preliminary study demonstrates the feasibility of studying incentives in a CR context, and the potential for incentives to be readily accepted in the broader context of the Canadian health care system.

  15. A rehabilitation exercise program to remediate skeletal muscle atrophy in an estrogen-deficient organism may be ineffective.

    Science.gov (United States)

    Brown, Marybeth; Ferreira, J Andries; Foley, Andrea M; Hemmann, Kaitlyn M

    2012-01-01

    To determine rehabilitation exercise program effects under hormone deficient (ovariectomy or OVX) and hormone supplemented [OVX + 17-beta estradiol (E2)] conditions. Mature female rats (n = 123) were assigned to OVX or OVX + E2-supplemented groups. OVX and OVX + E2 groups were allocated to one of four conditions: (1) control, (2) hindlimb unweighted (HLU) for 4 weeks to induce muscle atrophy, (3) cage Recovery for 2 weeks after HLU, and (4) Recovery with 2 weeks of rehabilitation exercise program after 4 weeks of HLU. Atrophy following HLU was comparable for OVX and OVX + E2-supplemented rats and was significant in all muscles examined (soleus, tibialis anterior, plantaris, gastrocnemius, quadriceps). Also significant with HLU was the decline in muscle force (P muscle mass in Recovery OVX and Recovery OVX + E2 groups but only the E2 supplemented OVX rats had return of muscle mass (4/5 muscles studied) with exercise. Peak tetanic tension (Po) returned to control values in the E2 supplemented Exercise rats but not in the unsupplemented Exercise group. For example, gastrocnemius Po for OVX HLU, OVX Recovery and OVX-Exercise groups was 82%*, 82%* and 76%* of control. Gastrocnemius Po for E2 supplemented HLU, Recovery and Exercise groups was 72%*, 95% and 106% of control (*P rehabilitation exercise program to remediate acute atrophy in females appears more effective if E2 is present.

  16. Perspectives on aging vestibular function

    Directory of Open Access Journals (Sweden)

    Eric eAnson

    2016-01-01

    Full Text Available Much is known about age related anatomical changes in the vestibular system. Knowledge regarding how vestibular anatomical changes impact behavior for older adults continues to grow, in line with advancements in diagnostic testing. However, despite advancements in clinical diagnostics, much remains unknown about the functional impact that an aging vestibular system has on daily life activities like standing and walking. Modern diagnostic tests are very good at characterizing neural activity of the isolated vestibular system, but the tests themselves are artificial and do not reflect the multi-sensory aspects of natural human behavior. Also, the majority of clinical diagnostic tests are passively applied because active behavior can enhance performance. In this perspective paper we review anatomical and behavioral changes associated with an aging vestibular system and highlight several areas where a more functionally relevant perspective can be taken. For postural control, a multi-sensory perturbation approach could be used to bring balance rehabilitation into the arena of precision medicine. For walking and complex gaze stability, this may result in less physiologically specific impairments, but the trade-off would be a greater understanding of how the aging vestibular system truly impacts the daily life of older adults.

  17. Perspectives on Aging Vestibular Function.

    Science.gov (United States)

    Anson, Eric; Jeka, John

    2015-01-01

    Much is known about age-related anatomical changes in the vestibular system. Knowledge regarding how vestibular anatomical changes impact behavior for older adults continues to grow, in line with advancements in diagnostic testing. However, despite advancements in clinical diagnostics, much remains unknown about the functional impact that an aging vestibular system has on daily life activities such as standing and walking. Modern diagnostic tests are very good at characterizing neural activity of the isolated vestibular system, but the tests themselves are artificial and do not reflect the multisensory aspects of natural human behavior. Also, the majority of clinical diagnostic tests are passively applied because active behavior can enhance performance. In this perspective paper, we review anatomical and behavioral changes associated with an aging vestibular system and highlight several areas where a more functionally relevant perspective can be taken. For postural control, a multisensory perturbation approach could be used to bring balance rehabilitation into the arena of precision medicine. For walking and complex gaze stability, this may result in less physiologically specific impairments, but the trade-off would be a greater understanding of how the aging vestibular system truly impacts the daily life of older adults.

  18. An m-Health system for education and motivation in cardiac rehabilitation: the experience of HeartCycle guided exercise.

    Science.gov (United States)

    Salvi, Dario; Ottaviano, Manuel; Muuraiskangas, Salla; Martínez-Romero, Alvaro; Vera-Muñoz, Cecilia; Triantafyllidis, Andreas; Cabrera Umpiérrez, Maria Fernanda; Arredondo Waldmeyer, Maria Teresa; Skobel, Erik; Knackstedt, Christian; Liedes, Hilkka; Honka, Anita; Luprano, Jean; Cleland, John Gf; Stut, Wim; Deighan, Carolyn

    2017-01-01

    Introduction Home-based programmes for cardiac rehabilitation play a key role in the recovery of patients with coronary artery disease. However, their necessary educational and motivational components have been rarely implemented with the help of modern mobile technologies. We developed a mobile health system designed for motivating patients to adhere to their rehabilitation programme by providing exercise monitoring, guidance, motivational feedback, and educational content. Methods Our multi-disciplinary approach is based on mapping "desired behaviours" into specific system's specifications, borrowing concepts from Fogg's Persuasive Systems Design principles. A randomised controlled trial was conducted to compare mobile-based rehabilitation (55 patients) versus standard care (63 patients). Results Some technical issues related to connectivity, usability and exercise sessions interrupted by safety algorithms affected the trial. For those who completed the rehabilitation (19 of 55), results show high levels of both user acceptance and perceived usefulness. Adherence in terms of started exercise sessions was high, but not in terms of total time of performed exercise or drop-outs. Educational level about heart-related health improved more in the intervention group than the control. Exercise habits at 6 months follow-up also improved, although without statistical significance. Discussion Results indicate that the adopted design methodology is promising for creating applications that help improve education and foster better exercise habits, but further studies would be needed to confirm these indications.

  19. Impact of exercise rehabilitation on cardiac neuronal function in heart failure. An iodine-123 metaiodobenzylguanidine scintigraphy study

    Energy Technology Data Exchange (ETDEWEB)

    Agostini, D.; Bouvard, G. [Service de Medecine Nucleaire, CHU Cote de Nacre, Caen (France); Lecluse, E.; Grollier, G.; Potier, J.C. [Service de Cardiologie, CHU Cote de Nacre, Caen (France); Belin, A. [Service de Readaptation Cardiaque, CHU Cote de Nacre, Caen (France); Babatasi, G. [Service de Chirurgie Cardio-Thoracique, CHU Cote de Nacre, Caen (France); Amar, M.H. [Centre Francois Baclesse, Caen (France). Service de Recherche Clinique

    1998-03-01

    Exercise training can induce important haemodynamic and metabolic adaptations in patients with chronic heart failure due to severe left ventricular dysfunction. This study examined the impact of exercise rehabilitation on cardiac neuronal function using iodine-123 metaiobodenzylguanidine (MIBG) scintigraphy. Fourteen patients (11 men, 3 women; mean age 48 years; range: 36-66 years) with stable chronic heart failure of NYHA class II-III and an initial resting radionuclide left ventricular ejection fraction (LVEF) <50% were enrolled in the study. Patients underwent progressive, supervised endurance training (treadmill test, Bruce protocol) during a 6-month period (60 sessions, 3 sessions per week) at a cardiac rehabilitation referral centre in order to measure exercise parameters. Planar {sup 123}I-MIBG scintigraphy provided measurements of cardiac neuronal uptake (heart-mediastinum ratio activity, 4 h after intravenous injection of 185 MBq of MIBG). Radionuclide LVEF was also assessed at the outset and after 6 months of exercise training. Workload (801{+-}428 vs 1229{+-}245 kpm.min{sup -1}, P=0.001), exercise duration (504{+-}190 vs 649{+-}125 s, P=0.02), and myocardial MIBG uptake (135%{+-}19% vs 156%{+-}25%, P=0.02) increased significantly after rehabilitation. However, LVEF did not change significantly (23%{+-}9% vs 21%{+-}10%, p=NS). It is concluded that exercise rehabilitation induces improvement of cardiac neuronal function without having negative effects on cardiac contractility in patients with stable chronic heart failure. (orig.)

  20. Participation in water-exercising long-term after breast cancer surgery: Experiences of significant factors for continuing exercising as a part of cancer rehabilitation.

    Science.gov (United States)

    Enblom, A; Lindquist, H; Bergmark, K

    2017-08-15

    Although physical exercising has great benefits, little is known regarding factors of significance for cancer survivors to continue exercising within their rehabilitation. The objective was to describe factors experienced to be of significance for cancer survivors to continue with water-exercising long-term after breast cancer surgery. Women (n = 29) who had undergone breast cancer surgery (mastectomy 79%, axillary surgery 86%, and radiotherapy 86%) for median (md) 13 (25th-75th percentile 3-21.5) was followed up regarding their rehabilitation, arm function Disabilities of Arm Shoulder and Hand (md 14, IQR 7-32), EQ-5D score (md 0.8, IQR 0.73-1.0) and quality of life EQ health barometer (md 80, IQR 64-95). We performed qualitative focus-group interviews regarding the women's views (n = 24). The women had participated in water-exercising 1-46 semesters, md 8 (25th-75th percentile 3-21.5) semesters. Nearly all, 97%, participated in the water-exercising group every week, and 21 (72%) had participated in the water-exercising group at least half of the time since their breast cancer surgery, without complications. The women experienced that factors of significance to continue with water-exercising were the convenience of easily modified weightless exercising in the water, social interaction, and access to a private dressing room. These factors would be important to consider to encourage continuing in exercising. © 2017 John Wiley & Sons Ltd.

  1. Competitive and cooperative arm rehabilitation games played by a patient and unimpaired person: effects on motivation and exercise intensity.

    Science.gov (United States)

    Goršič, Maja; Cikajlo, Imre; Novak, Domen

    2017-03-23

    People with chronic arm impairment should exercise intensely to regain their abilities, but frequently lack motivation, leading to poor rehabilitation outcome. One promising way to increase motivation is through interpersonal rehabilitation games, which allow patients to compete or cooperate together with other people. However, such games have mainly been evaluated with unimpaired subjects, and little is known about how they affect motivation and exercise intensity in people with chronic arm impairment. We designed four different arm rehabilitation games that are played by a person with arm impairment and their unimpaired friend, relative or occupational therapist. One is a competitive game (both people compete against each other), two are cooperative games (both people work together against the computer) and one is a single-player game (played only by the impaired person against the computer). The games were played by 29 participants with chronic arm impairment, of which 19 were accompanied by their friend or relative and 10 were accompanied by their occupational therapist. Each participant played all four games within a single session. Participants' subjective experience was quantified using the Intrinsic Motivation Inventory questionnaire after each game, as well as a final questionnaire about game preferences. Their exercise intensity was quantified using wearable inertial sensors that measured hand velocity in each game. Of the 29 impaired participants, 12 chose the competitive game as their favorite, 12 chose a cooperative game, and 5 preferred to exercise alone. Participants who chose the competitive game as their favorite showed increased motivation and exercise intensity in that game compared to other games. Participants who chose a cooperative game as their favorite also showed increased motivation in cooperative games, but not increased exercise intensity. Since both motivation and intensity are positively correlated with rehabilitation outcome

  2. Usability Test of Exercise Games Designed for Rehabilitation of Elderly Patients After Hip Replacement Surgery: Pilot Study.

    Science.gov (United States)

    Ling, Yun; Ter Meer, Louis P; Yumak, Zerrin; Veltkamp, Remco C

    2017-10-12

    Patients who receive rehabilitation after hip replacement surgery are shown to have increased muscle strength and better functional performance. However, traditional physiotherapy is often tedious and leads to poor adherence. Exercise games, provide ways for increasing the engagement of elderly patients and increase the uptake of rehabilitation exercises. The objective of this study was to evaluate Fietsgame (Dutch for cycling game), which translates existing rehabilitation exercises into fun exercise games. The system connects exercise games with a patient's personal record and a therapist interface by an Internet of Things server. Thus, both the patient and physiotherapist can monitor the patient's medical status. This paper describes a pilot study that evaluates the usability of the Fietsgame. The study was conducted in a rehabilitation center with 9 participants, including 2 physiotherapists and 7 patients. The patients were asked to play 6 exercise games, each lasting about 5 min, under the guidance of a physiotherapist. The mean age of the patients was 74.57 years (standard deviation [SD] 8.28); all the patients were in the recovery process after hip surgery. Surveys were developed to quantitatively measure the usability factors, including presence, enjoyment, pain, exertion, and technology acceptance. Comments on advantages and suggested improvements of our game system provided by the physiotherapists and patients were summarized and their implications were discussed. The results showed that after successfully playing the games, 75% to 100% of the patients experienced high levels of enjoyment in all the games except the squats game. Patients reported the highest level of exertion in squats when compared with other exercise games. Lunges resulted in the highest dropout rate (43%) due to interference with the Kinect v2 from support chairs. All the patients (100%) found the game system useful and easy to use, felt that it would be a useful tool in their further

  3. Knowledge and exercise behavior maintenance in cardiac rehabilitation patients receiving educational interventions.

    Science.gov (United States)

    Ghisi, Gabriela Lima de Melo; Grace, Sherry L; Thomas, Scott; Vieira, Ariany Marques; Costa, Isabel Ziesemer; Oh, Paul

    2015-01-01

    To test whether a theoretically-based education curriculum results in more sustained knowledge, higher scores on Health Action Process Approach (HAPA) constructs, and greater exercise behavior 6 months post-cardiac rehabilitation (CR) when compared to traditional CR education. Patient education is a core component of CR. No research has examined whether this education results in sustained improvements post-program. In this quasi-experimental study, participants exposed to the traditional vs HAPA-based education completed surveys pre, post-CR, and 6 months post-discharge assessing knowledge, HAPA constructs, and exercise. Ninety-three participants completed the final survey. Knowledge increases post-CR were sustained 6 months post-program, with no differences by curriculum. Many improvements in HAPA constructs observed post-CR were sustained, except for some decay in self-efficacy. Minutes of exercise per week were significantly greater in participants exposed to the HAPA-based curriculum 6 months post-program. HAPA-based education in CR has sustained effects on exercise. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. 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.

  5. Effects of proprioceptive exercises on pain and function in chronic neck- and low back pain rehabilitation: a systematic literature review

    OpenAIRE

    McCaskey, Michael A.; Schuster-Amft, Corinna; Wirth, Brigitte; Suica, Zorica; de Bruin, Eling D

    2014-01-01

    Background Proprioceptive training (PrT) is popularly applied as preventive or rehabilitative exercise method in various sports and rehabilitation settings. Its effect on pain and function is only poorly evaluated. The aim of this systematic review was to summarise and analyse the existing data on the effects of PrT on pain alleviation and functional restoration in patients with chronic (≥3 months) neck- or back pain. Methods Relevant electronic databases were searched from their respective i...

  6. [Pilates breathing exercise method as a form of pneumological rehabilitation in children and youths with bronchiale asthma].

    Science.gov (United States)

    Wroński, Waldemar; Nowak, Magdalena

    2008-01-01

    Asthma is a chronic and inflammatory disease of the respiratory tract, where its basis is of allergic origin. It is not only a severe health problem in Poland, but as well as in the whole world. Besides pharmacotherapy, which is the basic form of bronchial asthma treatment pneumological rehabilitation is also used. Innovative form of this rehabilitation is Pilates method, in which exercises are concentrated on rib-diaphragram way of breathing.

  7. Short- and Long-Term Effectiveness of a Subject's Specific Novel Brain and Vestibular Rehabilitation Treatment Modality in Combat Veterans Suffering from PTSD.

    Science.gov (United States)

    Carrick, Frederick Robert; Pagnacco, Guido; McLellan, Kate; Solis, Ross; Shores, Jacob; Fredieu, Andre; Brock, Joel Brandon; Randall, Cagan; Wright, Cameron; Oggero, Elena

    2015-01-01

    Treatment for post-traumatic stress disorder (PTSD) in combat veterans that have a long-term positive clinical effect has the potential to modify the treatment of PTSD. This outcome may result in changed and saved lives of our service personnel and their families. In a previous before-after-intervention study, we demonstrated high statistical and substantively significant short-term changes in the Clinician Administered DSM-IV PTSD Scale (CAPS) scores after a 2-week trial of a subject's particular novel brain and vestibular rehabilitation (VR) program. The long-term maintenance of PTSD severity reduction was the subject of this study. We studied the short- and long-term effectiveness of a subject's particular novel brain and VR treatment of PTSD in subjects who had suffered combat-related traumatic brain injuries in terms of PTSD symptom reduction. The trial was registered as ClinicalTrials.gov Identifier: NCT02003352. We analyzed the difference in the CAPS scores pre- and post-treatment (1 week and 3 months) using our subjects as their matched controls. The generalized least squares (GLS) technique demonstrated that with our 26 subjects in the 3 timed groups the R (2) within groups was 0.000, R (2) between groups was 0.000, and overall the R (2) was 0.000. The GLS regression was strongly statistically significant z = 21.29, p < 0.001, 95% CI [58.7, 70.63]. The linear predictive margins over time demonstrated strong statistical and substantive significance of decreasing PTSD severity scores for all timed CAPS tests. Our investigation has the promise of the development of superior outcomes of treatments in this area that will benefit a global society. The length of the treatment intervention involved (2 weeks) is less that other currently available treatments and has profound implications for cost, duration of disability, and outcomes in the treatment of PTSD in combat veterans.

  8. Short and long term effectiveness of a subject's specific novel brain and vestibular rehabilitation treatment modality in combat veterans suffering from PTSD

    Directory of Open Access Journals (Sweden)

    Frederick Robert Carrick

    2015-06-01

    Full Text Available AbstractIntroduction: Treatment for post-traumatic stress disorder (PTSD in combat veterans that have a long-term positive clinical effect has the potential to modify the treatment of PTSD. This outcome may result in changed and saved lives of our service personnel and their families. In a previous before-after-intervention study we demonstrated high statistical and substantively significant short-term changes in the Clinician Administered DSM-IV PTSD Scale (CAPS scores after a two week trial of a subject's particular novel brain and vestibular rehabilitation (VR program. The long-term maintenance of PTSD severity reduction was the subject of this study.Material and Methods:We studied the short and long term effectiveness of a subject's particular novel brain and VR treatment of PTSD in subjects who had suffered combat-related traumatic brain injuries in terms of PTSD symptom reduction. The trial was registered as ClinicalTrials.gov Identifier: NCT02003352. We analyzed the difference in the CAPS scores pre and post treatment (one week and three months using our subjects as their matched controls. Results:The generalized least squares (GLS technique demonstrated that with our 26 subjects in the 3 timed groups the R2 within groups was 0.000, R2 between groups was 0.000 and overall the R2 was 0.000. The GLS regression was strongly statistically significant z = 21.29, p < 0.001, 95% CI [58.7, 70.63]. The linear predictive margins over time demonstrated strong statistical and substantive significance of decreasing PTSD severity scores for all timed CAPS tests.Discussion:Our investigation has the promise of the development of superior outcomes of treatments in this area that will benefit a global society. The length of the treatment intervention involved (two weeks is less that other currently available treatments and has profound implications for cost, duration of disability and outcomes in the treatment of PTSD in combat veterans.

  9. Test and Validation of a Smart Exercise Bike for Motor Rehabilitation in Individuals With Parkinson's Disease.

    Science.gov (United States)

    Mohammadi-Abdar, Hassan; Ridgel, Angela L; Discenzo, Fred M; Phillips, Robert S; Walter, Benjamin L; Loparo, Kenneth A

    2016-11-01

    To assess and validate the Smart Exercise Bike designed for Parkinson's Disease (PD) rehabilitation, 47 individuals with PD were randomly assigned to either the static or dynamic cycling group, and completed three sessions of exercise. Heart rate, cadence and power data were captured and recorded for each patient during exercise. Motor function for each subject was assessed with the UPDRS Motor III test before and after the three exercise sessions to evaluate the effect of exercise on functional abilities. Individuals who completed three sessions of dynamic cycling showed an average of 13.8% improvement in the UPDRS, while individuals in the static cycling group worsened by 1.6% in UPDRS. To distinguish the static and dynamic cycling groups by biomechanical and physiological features, the complexity of the recorded signals (cadence, power, and heart rate) was examined using approximate entropy (ApEn), sample entropy (SaEn) and spectral entropy (SpEn) as measures of variability. A multiple linear regression (MLR) model was used to relate these features to changes in motor function as measured by the UPDRS Motor III scale. Pattern variability in cadence was greater in the dynamic group when compared to the static group. In contrast, variability in power was greater for the static group. UPDRS Motor III scores predicted from the pattern variability data were correlated to measured scores in both groups. These results support our previous study which explained how variability analysis results for biomechanical and physiological parameters of exercise can be used to predict improvements in motor function.

  10. Recommendations for resistance exercise in cardiac rehabilitation. Recommendations of the German Federation for Cardiovascular Prevention and Rehabilitation.

    Science.gov (United States)

    Bjarnason-Wehrens, B; Mayer-Berger, W; Meister, E R; Baum, K; Hambrecht, R; Gielen, S

    2004-08-01

    Aerobic endurance training has been an integral component of the international recommendations for cardiac rehabilitation for more than 30 years. Notwithstanding, only in recent years have recommendations for a dynamic resistance-training program been cautiously put forward. The perceived increased risk of cardiovascular complications related to blood pressure elevations are the primary concern with resistance training in cardiac patients; recent studies however have demonstrated that this need not be a contraindication in all cardiac patients. While blood pressure certainly may rise excessively during resistance training, the actual rise depends on a variety of controllable factors including magnitude of the isometric component, the load intensity, the amount of muscle mass involved as well as the number of repetitions and/or the load duration. Intra-arterial blood pressure measurements in cardiac patients have demonstrated that that during low-intensity resistance training [40-60% maximum voluntary contraction (MVC)] with 15-20 repetitions, only modest elevations in blood pressure are revealed, similar to those seen during moderate endurance training. When properly implemented by an experienced exercise therapist, in specific patient groups an individually tailored, medically supervised dynamic resistance training program carries no inherent higher risk for the patient than aerobic endurance training. As an adjunct to endurance training, in selected patients, resistance training can increase muscle strength and endurance, as well as positively influence cardiovascular risk factors, metabolism, cardiovascular function, psychosocial well-being and quality of life. According to present data, resistance training is however not recommended for all patient groups. The appropriate training method and correct performance are highly dependent on each patient's clinical status, cardiac stress tolerance and possible comorbidities. Most studies have used middle-aged men of

  11. Secondary prevention through cardiac rehabilitation: physical activity counselling and exercise training: key components of the position paper from the Cardiac Rehabilitation Section of the European Association of Cardiovascular Prevention and Rehabilitation

    DEFF Research Database (Denmark)

    Corrà, Ugo; Piepoli, Massimo F; Carré, François

    2010-01-01

    and global long-term care of cardiac patients. The CR approach is delivered in tandem with a flexible follow-up strategy and easy access to a specialized team. To promote implementation of cardiac prevention and rehabilitation, the CR Section of the EACPR (European Association of Cardiovascular Prevention......, exercise training, diet/nutritional counselling, weight control management, lipid management, blood pressure monitoring, smoking cessation, and psychosocial management. Cardiac rehabilitation services are by definition multi-factorial and comprehensive, with physical activity counselling and exercise...

  12. Suitability of functional evaluation embedded in serious game rehabilitation exercises to assess motor development across lifespan.

    Science.gov (United States)

    Bonnechère, B; Sholukha, V; Omelina, L; Van Vooren, M; Jansen, B; Van Sint Jan, S

    2017-09-01

    The aim of this study was to determine if the results of activities performed using specially developed serious games for physical rehabilitation could be used as an indicator of the natural maturation and decline of motor control in healthy participants. Eighty-one participants (19 children (5-15 years old), 40 adults (18-65 years old) and 22 aged subjects (60-88 years old) participated in this study. Motions performed were recorded using the Kinect sensor. Three different exercises embedded in the games were used to assess upper limb, trunk and lower limb control. The trial duration and accuracy, measures of gross motor function and fine motor control, respectively, were computed for each participant. ANOVA tests shows statistically significant differences between the three groups for duration (53±15, 27±10 and 119±30s for children, adults and elderly subjects respectively) and accuracy (87±5, 89±10 and 70±8% for children, adults and elderly subjects respectively). The slopes of the curves that approximated the evolution of the performance over various ages are coherent with previous studies about motor control development and physiological decline. The proposed solution, i.e. serious games rehabilitation exercises coupled to motion analysis, seems to be an interesting tool to assess global motor function. Further studies are needed to study the influence of pathologies on the studied parameters. Copyright © 2017. Published by Elsevier B.V.

  13. Anaerobic exercise testing in rehabilitation: A systematic review of available tests and protocols.

    Science.gov (United States)

    Krops, Leonie A; Albada, Trijntje; van der Woude, Lucas H V; Hijmans, Juha M; Dekker, Rienk

    2017-04-06

    Anaerobic capacity assessment in rehabilitation has received increasing scientific attention in recent years. However, anaerobic capacity is not tested consistently in clinical rehabilitation practice. This study reviews tests and protocols for anaerobic capacity in adults with various disabilities (spinal cord injury, cerebral palsy, cerebral vascular accident, lower-limb amputation(s)) and (able-bodied) wheelchair users. PubMed, CINAHL and Web of Science. Papers were screened by 2 independent assessors, and were included when anaerobic exercise tests were performed on the above-selected subject groups. Included articles were checked for methodological quality. A total of 57 papers was included. Upper-body testing [56 protocols] was conducted with arm crank [16] and wheelchair tests [40]. With a few [2] exceptions, modified Wingate (Wingate) protocols and wheelchair sprint tests dominated upper-body anaerobic testing. In lower-body anaerobic work [11], bicycle [3] and recumbent [1], and overground tests [7] were used, in which Wingate, sprint or jump protocols were employed. When equipment is available a Wingate protocol is advised for assessment of anaerobic capacity in rehabilitation. When equipment is not avail-able a 20-45 s sprint test is a good alternative. Future research should focus on standardized tests and protocols specific to different disability groups.

  14. Long-term Exercise Adherence After High-intensity Interval Training in Cardiac Rehabilitation: A Randomized Study.

    Science.gov (United States)

    Aamot, Inger-Lise; Karlsen, Trine; Dalen, Håvard; Støylen, Asbjørn

    2016-03-01

    Exercise adherence in general is reported to be problematic after cardiac rehabilitation. Additionally, vigorous exercise is associated with impaired exercise adherence. As high-intensity interval training (HIT) is frequently used as a therapy to patients with coronary artery disease in cardiac rehabilitation, the objective was to assess long-term exercise adherence following an HIT cardiac rehabilitation programme. A multicentre randomized study was carried out. Eligible participants were adults who had previously attended a 12-week HIT cardiac rehabilitation programme, as either a home-based or hospital-based HIT (treadmill exercise or group exercise). The primary outcome was change in peak oxygen uptake; secondary outcomes were self-reported and objectively measured physical activity. Out of 83 eligible participants, 76 were available for assessment (68 men/8 women, mean age 59 (8) years) at a one-year follow-up. Peak oxygen uptake was significantly elevated above baseline values, (treadmill exercise: 35.8 (6.4) vs. 37.4 (7.4) ml kg(-1)  min(-1) , group exercise: 32.7 (6.5) vs. 34.1 (5.8) ml kg(-1)  min(-1) and home-based exercise: 34.5 (4.9) vs. 36.7 (5.8) ml kg(-1)  min(-1) at baseline and follow-up, respectively), with no significant differences between groups. The majority of the participants (>90%) met the recommended daily level of 30 minutes of moderate physical activity. The home-based group showed a strong trend towards increased physical activity compared with the hospital-based groups. The results from this study have shown that both home-based and hospital-based HIT in cardiac rehabilitation induce promising long-term exercise adherence, with maintenance of peak oxygen uptake significantly above baseline values at a one-year follow-up. The implication for physiotherapy practice is that HIT in cardiac rehabilitation induces satisfactory long-term exercise adherence. Copyright © 2015 John Wiley & Sons, Ltd.

  15. CHA2DS2-VASc score and exercise capacity of patients with coronary artery disease participating in cardiac rehabilitation programs.

    Science.gov (United States)

    Haskiah, Feras; Shacham, Yacov; Minha, Saar; Rozenbaum, Zach; Pereg, David

    2017-12-01

    Exercise based cardiac rehabilitation improves prognosis and quality of life in patients with coronary artery disease. We aimed to investigate whether the CHA2DS2-VASc score may be a predictor of improvement in exercise capacity in acute coronary syndrome (ACS) patients participating in a cardiac rehabilitation program. Included were patients following a hospital admission due to ACS and were subsequently referred for an exercise based cardiac rehabilitation during 2010-2015. Participants were divided into three groups of low (1-2), intermediate (3) and high (4≤) CHA2DS2-VASc score. Exercise capacity was evaluated by a treadmill stress test at baseline and following 9 months. The primary endpoint was the percent of patients who achieved at least 25% improvement in exercise capacity. The 597 patients included in the study had a mean age of 65.5±9.3 years and consisted of 22.5% women. The primary endpoint of at least 25% improvement in exercise capacity following 9 months of cardiac rehabilitation occurred more frequently in patients in the high CHA2DS2-VASc group compared to the intermediate and low CHA2DS2-VASc score groups (47.3, 29.9 and 36.1% in the high, intermediate and low CHA2DS2-VASc score groups respectively, P=0.002). The CHA2DS2-VASc score may serve as a predictor of exercise capacity improvement. Its use for tailoring specific cardiac rehabilitation programs for ACS patients may yield further improvement in functional capacity and better utilization of resources.

  16. Economic Evaluation of Exercise-Based Cardiac Rehabilitation Programs for Chronic Heart Failure Patients in Colombia.

    Science.gov (United States)

    Rincón, Mónica; Rojas, Maria Ximena; Rodriguez Romero, Viviana Alejandra; Tamayo, Diana Carolina; Franco, Camilo; Castro, Hector; Brophy, James; Dennis, Rodolfo

    2016-01-01

    Cardiac rehabilitation (CR) in patients with chronic heart failure (CHF) has met with resistance from third-party payers in low- and middle-income countries because of lack of evidence regarding its cost-effectiveness. We aimed to provide information to help better inform this decision-making process. Costs associated with a 12-week exercise-based rehabilitation program in Colombia for patients with CHF were estimated. We collected data on all medical resources used in ambulatory care and data on hospital costs incurred for treating patients with uncompensated CHF. A literature search to establish the hospitalization rates because of uncompensated CHF, death because of CHF, and potential decreases in these data because of the utilization of CR was conducted. We modeled incremental costs and effectiveness over a period of 5 years from the perspective of the third-party payer. All costs were converted from Colombian pesos to US dollars. For an exercise-based CR program of 12-week duration (36 sessions), costs ranged from US$265 to US$369 per patient. Monthly costs associated with ambulatory care of CHF averaged US$128 ± US$321 per patient, and hospitalization costs were US$3621 ± US$5 444 per event. Yearly hospitalization incidence rates with and without CR were 0.154 and 0.216, respectively. The incremental cost of CR would be US$998 per additional quality-adjusted life-year. Sensitivity analysis did not significantly change these results. Cardiac rehabilitation in patients with CHF in settings such as Colombia can be a cost-effective strategy, with minimal incremental costs and better quality of life, mainly because of decreased rates of hospitalization.

  17. Aerobic Exercise Prescription in Stroke Rehabilitation: A Web-Based Survey of US Physical Therapists.

    Science.gov (United States)

    Boyne, Pierce; Billinger, Sandra; MacKay-Lyons, Marilyn; Barney, Brian; Khoury, Jane; Dunning, Kari

    2017-04-01

    Best practice recommendations indicate that aerobic exercise (AEX) should be incorporated into stroke rehabilitation. However, this may be challenging in clinical settings. The purpose of this study was to assess physical therapist (PT) AEX prescription for patients with stroke, including AEX utilization, barriers to AEX prescription, dosing parameters, and safety considerations. A cross-sectional Web-based survey study was conducted. Physical therapists with valid e-mail addresses on file with the state boards of Florida, New Jersey, Ohio, Texas, and Wyoming were eligible to participate. Survey invitations were e-mailed to all licensed PT in these states. Analysis focused on respondents who were currently involved with clinical stroke rehabilitation in common practice settings. Results from 568 respondents were analyzed. Most respondents (88%) agreed that AEX should be incorporated into stroke rehabilitation, but 84% perceived at least one barrier. Median prescribed AEX volume varied between practice settings from 20- to 30-minute AEX sessions, 3 to 5 days per week for 2 to 8 weeks. Prescribed intensity was most commonly light or moderate; intensity was determined by the general response to AEX and patient feedback. Only 2% of respondents reported that the majority of their patients with stroke had stress tests. Most US PTs appear to recognize the importance of AEX for persons poststroke, but clinical implementation can be challenging. Future studies and consensus are needed to clarify best practices and to develop implementation interventions to optimize AEX utilization in stroke rehabilitation.Video Abstract available for more insights from the authors (see Video, Supplemental Digital Content 1, http://links.lww.com/JNPT/A167).

  18. Clinical Outcomes of Different Tempos of Music During Exercise in Cardiac Rehabilitation Patients.

    Science.gov (United States)

    Miller, Jarad S; Terbizan, Donna J

    2017-01-01

    This study examined the effects of stimulating and sedative music on ratings of perceived exertion (RPE), heart rate (HR), blood pressure (BP), and feeling status during exercise in cardiac rehabilitation (CR) patients. Twenty-two male and female older adults age 64 ± 8.0 y currently enrolled in phase III CR completed the study. Repeated measures crossover designs guided data collection. The manipulated independent variable was music condition (sedative, stimulating, and non-music control). The dependent variables were RPE, BP, HR, and feeling status with each represented by four repeated measures ANOVAs over time via SAS 9.3. Data analysis indicated significant differences for all exercise related variables besides BP. While standardizing the exercise, we observed that sedative music is the best choice to manipulate for decreases in RPE (p=.0019), increases in feeling status (p=.0192), and decreases in HR (pmusic is the best choice to observe decreases in RPE, increases in feeling status, and decreases HR. Stimulating music would only be the correct choice to observe increases in HR, and does not have as much of a beneficial effect on RPE and feeling status as sedative music. There were no significant effects of either type of music on BP.

  19. Design and Development of a Smart Exercise Bike for Motor Rehabilitation in Individuals with Parkinson's Disease.

    Science.gov (United States)

    Mohammadi-Abdar, Hassan; Ridgel, Angela L; Discenzo, Fred M; Loparo, Kenneth A

    2016-06-01

    Recent studies in rehabilitation of Parkinson's disease (PD) have shown that cycling on a tandem bike at a high pedaling rate can reduce the symptoms of the disease. In this research, a smart motorized bicycle has been designed and built for assisting Parkinson's patients with exercise to improve motor function. The exercise bike can accurately control the rider's experience at an accelerated pedaling rate while capturing real-time test data. Here, the design and development of the electronics and hardware as well as the software and control algorithms are presented. Two control algorithms have been developed for the bike; one that implements an inertia load (static mode) and one that implements a speed reference (dynamic mode). In static mode the bike operates as a regular exercise bike with programmable resistance (load) that captures and records the required signals such as heart rate, cadence and power. In dynamic mode the bike operates at a user-selected speed (cadence) with programmable variability in speed that has been shown to be essential to achieving the desired motor performance benefits for PD patients. In addition, the flexible and extensible design of the bike permits readily changing the control algorithm and incorporating additional I/O as needed to provide a wide range of riding experiences. Furthermore, the network-enabled controller provides remote access to bike data during a riding session.

  20. Exercise rehabilitation following intensive care unit discharge for recovery from critical illness.

    Science.gov (United States)

    Connolly, Bronwen; Salisbury, Lisa; O'Neill, Brenda; Geneen, Louise; Douiri, Abdel; Grocott, Michael P W; Hart, Nicholas; Walsh, Timothy S; Blackwood, Bronagh

    2015-06-22

    Skeletal muscle wasting and weakness are significant complications of critical illness, associated with degree of illness severity and periods of reduced mobility during mechanical ventilation. They contribute to the profound physical and functional deficits observed in survivors. These impairments may persist for many years following discharge from the intensive care unit (ICU) and can markedly influence health-related quality of life. Rehabilitation is a key strategy in the recovery of patients after critical illness. Exercise-based interventions are aimed at targeting this muscle wasting and weakness. Physical rehabilitation delivered during ICU admission has been systematically evaluated and shown to be beneficial. However, its effectiveness when initiated after ICU discharge has yet to be established. To assess the effectiveness of exercise rehabilitation programmes, initiated after ICU discharge, for functional exercise capacity and health-related quality of life in adult ICU survivors who have been mechanically ventilated longer than 24 hours. We searched the following databases: the Cochrane Central Register of Controlled Trials (CENTRAL), Ovid SP MEDLINE, Ovid SP EMBASE and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) via EBSCO host to 15 May 2014. We used a specific search strategy for each database. This included synonyms for ICU and critical illness, exercise training and rehabilitation. We searched the reference lists of included studies and contacted primary authors to obtain further information regarding potentially eligible studies. We also searched major clinical trials registries (Clinical Trials and Current Controlled Trials) and the personal libraries of the review authors. We applied no language or publication restriction. We reran the search in February 2015 and will deal with the three studies of interest when we update the review. We included randomized controlled trials (RCTs), quasi-RCTs and controlled clinical

  1. The Role of ExerciseRehabilitation on Energy Cost and Metabolic Efficiency in Dipelegic Spastic Cerebral Palsy Children

    Directory of Open Access Journals (Sweden)

    M. Izadi

    2005-07-01

    Full Text Available Introduction & Objective: The aim of this study was to compare the resting energy expenditure and metabolic efficiency before and after of aerobic exercise in spastic cerebral palsy children (mean age of 11 years and also to compare with those of normal children. Materials & Methods : Fifteen dipelegia spastic cerebral palsy children (experimental group participated in exercise–rehabilitation program by voluntarily and the peers eighteen able body children(control group were selected randomly. The experimental group(cp performed rehabilitation program for 3 months,3 session in week with work intensity(%HRR=462.5equal to144bpm of heart rate. The values were measured on tantory cycle ergometer according to Macmaster protocol.Results: Rest and exercise heart rate and exercise intensity(%HRR in patients decreased after rehabilitation program(P<0.05. The resting energy expenditure was similar in cp and normal groups. The rate of oxygen cost of patients decreased in post test(P<0.05 that showed increasing in metabolic efficiency.Conclusion: cerebral palsy children have greater exercise energy cost and lower cardiovascular fitness than normal children and exercise–rehabilitation leads to enhance of metabolic efficiency in this patients that is remarkable from clinical perception.

  2. AN ASSESSMENT OF PATIENT NEED FOR A TECHNOLOGY-ENABLED REMOTE EXERCISE REHABILITATION PROGRAMME AMONG A CHRONIC ILLNESS POPULATION

    Directory of Open Access Journals (Sweden)

    Deirdre Walsh

    2015-10-01

    Conclusion: This study provides evidence of patient desire for a technology-enabled remote exercise rehabilitation programme. Further to this, the current study provides promising preliminary evidence for both the high level of technology use and capability among a cohort of people with chronic illness.

  3. Efficacy of multimodal exercise-based rehabilitation on physical activity, cardiorespiratory fitness, and patient-reported outcomes in cancer survivors

    DEFF Research Database (Denmark)

    Midtgaard, J; Christensen, Jesper Frank; Tolver, Anders

    2013-01-01

    Sedentary behavior and impaired cardiovascular reserve capacity are common late effects of cancer therapy emphasizing the need for effective strategies to increase physical activity (PA) in cancer survivors. We examined the efficacy of a 12-month exercise-based rehabilitation program on self...

  4. The effect of exercise repetition on the frequency characteristics of motor output force: implications for Achilles tendinopathy rehabilitation.

    Science.gov (United States)

    Grigg, Nicole L; Wearing, Scott C; O'Toole, John M; Smeathers, James E

    2014-01-01

    To investigate the frequency characteristics of the ground reaction force (GRF) recorded throughout the eccentric Achilles tendon rehabilitation programme described by Alfredson. Controlled laboratory study, longitudinal. Nine healthy adult males performed six sets (15 repetitions per set) of eccentric ankle exercise. Ground reaction force was recorded throughout the exercise protocol. For each exercise repetition the frequency power spectrum of the resultant ground reaction force was calculated and normalised to total power. The magnitude of peak relative power within the 8-12 Hz bandwidth and the frequency at which this peak occurred was determined. The magnitude of peak relative power within the 8-12 Hz bandwidth increased with each successive exercise set and following the 4th set (60 repetitions) of exercise the frequency at which peak relative power occurred shifted from 9 to 10 Hz. The increase in magnitude and frequency of ground reaction force vibrations with an increasing number of exercise repetitions is likely connected to changes in muscle activation with fatigue and tendon conditioning. This research illustrates the potential for the number of exercise repetitions performed to influence the tendons' mechanical environment, with implications for tendon remodelling and the clinical efficacy of eccentric rehabilitation programmes for Achilles tendinopathy. Copyright © 2013 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  5. An Activity Recognition Model Using Inertial Sensor Nodes in a Wireless Sensor Network for Frozen Shoulder Rehabilitation Exercises

    Directory of Open Access Journals (Sweden)

    Hsueh-Chun Lin

    2015-01-01

    Full Text Available This paper proposes a model for recognizing motions performed during rehabilitation exercises for frozen shoulder conditions. The model consists of wearable wireless sensor network (WSN inertial sensor nodes, which were developed for this study, and enables the ubiquitous measurement of bodily motions. The model employs the back propagation neural network (BPNN algorithm to compute motion data that are formed in the WSN packets; herein, six types of rehabilitation exercises were recognized. The packets sent by each node are converted into six components of acceleration and angular velocity according to three axes. Motor features such as basic acceleration, angular velocity, and derivative tilt angle were input into the training procedure of the BPNN algorithm. In measurements of thirteen volunteers, the accelerations and included angles of nodes were adopted from possible features to demonstrate the procedure. Five exercises involving simple swinging and stretching movements were recognized with an accuracy of 85%–95%; however, the accuracy with which exercises entailing spiral rotations were recognized approximately 60%. Thus, a characteristic space and enveloped spectrum improving derivative features were suggested to enable identifying customized parameters. Finally, a real-time monitoring interface was developed for practical implementation. The proposed model can be applied in ubiquitous healthcare self-management to recognize rehabilitation exercises.

  6. Short time sports exercise boosts motor imagery patterns: Implications of mental practice in rehabilitation programs

    Directory of Open Access Journals (Sweden)

    Selina Christin Wriessnegger

    2014-06-01

    Full Text Available Motor imagery (MI is a commonly used paradigm for the study of motor learning or cognitive aspects of action control. The rationale for using MI training to promote the relearning of motor function arises from research on the functional correlates that MI shares with the execution of physical movements. While most of the previous studies investigating MI were based on simple movements in the present study a more attractive mental practice was used to investigate cortical activation during MI. We measured cerebral responses with functional magnetic resonance imaging (fMRI in twenty three healthy volunteers as they imagined playing soccer or tennis before and after a short physical sports exercise. Our results demonstrated that only 10 minutes of training are enough to boost motor imagery patterns in motor related brain regions including premotor cortex and supplementary motor area (SMA but also fronto-parietal and subcortical structures. This supports previous findings that motor imagery has beneficial effects especially in combination with motor execution when used in motor rehabilitation or motor learning processes. We conclude that sports MI combined with an interactive game environment could be a promising additional tool in future rehabilitation programs aiming to improve upper or lower limb functions or support neuroplasticity.

  7. Short time sports exercise boosts motor imagery patterns: implications of mental practice in rehabilitation programs.

    Science.gov (United States)

    Wriessnegger, Selina C; Steyrl, David; Koschutnig, Karl; Müller-Putz, Gernot R

    2014-01-01

    Motor imagery (MI) is a commonly used paradigm for the study of motor learning or cognitive aspects of action control. The rationale for using MI training to promote the relearning of motor function arises from research on the functional correlates that MI shares with the execution of physical movements. While most of the previous studies investigating MI were based on simple movements in the present study a more attractive mental practice was used to investigate cortical activation during MI. We measured cerebral responses with functional magnetic resonance imaging (fMRI) in twenty three healthy volunteers as they imagined playing soccer or tennis before and after a short physical sports exercise. Our results demonstrated that only 10 min of training are enough to boost MI patterns in motor related brain regions including premotor cortex and supplementary motor area (SMA) but also fronto-parietal and subcortical structures. This supports previous findings that MI has beneficial effects especially in combination with motor execution when used in motor rehabilitation or motor learning processes. We conclude that sports MI combined with an interactive game environment could be a promising additional tool in future rehabilitation programs aiming to improve upper or lower limb functions or support neuroplasticity.

  8. Effect of exercise-based cardiac rehabilitation on ejection fraction in coronary artery disease patients: a randomized controlled trial.

    Science.gov (United States)

    Haddadzadeh, Mohammad H; Maiya, Arun G; Padmakumar, R; Shad, Bijan; Mirbolouk, Fardin

    2011-04-01

    Exercise training as a part of cardiac rehabilitation aims to restore patient with heart disease to health. However, left ventricular ejection fraction (LVEF) is clinically used as a predictor of long-term prognosis in coronary artery disease (CAD) patients, there is a scarcity of data on the effectiveness of exercise-based cardiac rehabilitation on LVEF. To investigate the effectiveness of exercise-based cardiac rehabilitation on LVEF in early post-event CAD patients. In a single blinded, randomized controlled trial, post-coronary event CAD patients from the age group of 35-75 years, surgically (Coronary artery bypass graft or percutaneous coronary angioplasty) or conservatively treated, were recruited from Golsar Hospital, Iran. Exclusion criteria were high-risk group (AACVPR-99) patients and contraindications to exercise testing and training. Forty-two patients were randomized either into Study or Control. The study group underwent a 12-week structured individually tailored exercise program either in the form of Center-based (CExs) or Home-based (HExs) according to the ACSM-2005 guidelines. The control group only received the usual cardiac care without any exercise training. LVEF was measured before and after 12 weeks of exercise training for all three groups. Differences between and within groups were analyzed using the general linear model, two-way repeated measures at alfa=0.05. Mean age of the subjects was 60.5 ± 8.9 years. There was a significant increase in LVEF in the study (46.9 ± 5.9 to 61.5 ± 5.3) group compared with the control (47.9 ± 7.0 to 47.6 ± 6.9) group (P=0.001). There was no significant difference in changes in LVEF between the HExs and CExs groups (P=1.0). A 12-week early (within 1 month post-discharge) structured individually tailored exercise training could significantly improve LVEF in post-event CAD patients.

  9. Patient motivation and adherence to postsurgery rehabilitation exercise recommendations: the influence of physiotherapists' autonomy-supportive behaviors.

    Science.gov (United States)

    Chan, Derwin K; Lonsdale, Chris; Ho, Po Y; Yung, Patrick S; Chan, Kai M

    2009-12-01

    Chan DK, Lonsdale C, Ho PY, Yung PS, Chan KM. Patient motivation and adherence to postsurgery rehabilitation exercise recommendations: the influence of physiotherapists' autonomy-supportive behaviors. To investigate the impact of physiotherapists' autonomy-supportive behaviors on patients' motivation and rehabilitation adherence after anterior cruciate ligament (ACL) reconstruction surgery. Retrospective study. Outpatient orthopedic clinic of a university medical center. Postsurgery ACL reconstruction patients (N=115; minimum postsurgery interval, 6mo; mean +/- SD postsurgery interval, 1.77+/-0.8y). Not applicable. Questionnaires measuring autonomy support from physiotherapists (Health Care Climate Questionnaire), treatment motivation (Treatment Self-Regulation Questionnaire), and rehabilitation adherence (adapted from the Sport Injury Rehabilitation Adherence Scale and the Patient Self-Report Scales of Their Home-Based Rehabilitation Adherence). Structural equation modeling analyses revealed that patients' treatment motivation mediated the relationship between physiotherapists' autonomy-supportive behaviors and rehabilitation adherence. Autonomy-supportive behavior positively predicted autonomous treatment motivation (beta=.22, Pmotivation (beta=.64, Pmotivation (beta=-.28, P<.05). These preliminary findings are promising and provide an empirical basis for further research to test the efficacy of autonomy support training designed to increase patients' rehabilitation adherence.

  10. Rehabilitering

    DEFF Research Database (Denmark)

    Hørdam, Britta

    2008-01-01

    En interviewundersøgelse af patienter, der får gennemført hofteoperation, en opgørelse af deres selvvurdere helbredsstatus med henblik på at tilrettelægge rehabilitering baseret på patienternes egne præmisser.......En interviewundersøgelse af patienter, der får gennemført hofteoperation, en opgørelse af deres selvvurdere helbredsstatus med henblik på at tilrettelægge rehabilitering baseret på patienternes egne præmisser....

  11. The effect of rehabilitation exercises on the gait in people with Down syndrome

    Directory of Open Access Journals (Sweden)

    M Marchewka

    2008-12-01

    Full Text Available Objective: The following question was set: Do special exercises decrease disturbances of gait in people with Down syndrome and allow for spacio-temporal parameters closer in values to the variables achieved by healthy people? The research involved 10 persons with Down syndrome, including 9 male pupils and 1 female pupil of the Complex of Special Schools in Cracow, Poland, aged 16-22, with the average age of 17.8±2.69. All the subjects had documented moderate and considerable mental handicap, with the average IQ equalling 37.6±4.29, measured in the Terman-Merrill scale. Background: People with Down syndrome have problems with keeping their balance, both while standing and walking. The dysfunction of lower extremities, manifesting itself in a gait different from the norm of healthy people, releases compensation mechanisms levelling disturbances and leading to unavoidable overloads, and in consequence to the damage of different segments of the locomotor system. Methods: Vicon 250, a computerized system of a three-dimensional analysis of motion, connected with five video cameras working in infrared was implemented to assess the parameters of gait. Results: All the spacio-temporal parameters of gait in people with Down syndrome were significantly improved after the period of rehabilitation, and in the case of step frequency equalled the norm of healthy people. Interpretation. The implementation of additional exercises affects the improvement of the gait parameters of mentally handicapped people, suffering from Down syndrome.

  12. Effects of cardiac rehabilitation in diabetic patients: both cardiac and noncardiac factors determine improvement in exercise capacity.

    Science.gov (United States)

    St Clair, Mitchell; Mehta, Hardik; Sacrinty, Matthew; Johnson, Dominic; Robinson, Killian

    2014-04-01

    Diabetic patients have a worse prognosis than nondiabetic patients after myocardial infarction. Although exercise improves risk factors, exercise capacity, and mortality, it is still unclear if these benefits are the same as in nondiabetics. Furthermore, although exercise tolerance is predicted by systolic and diastolic dysfunction in nondiabetics, its role as a predictor of exercise capacity in diabetics remains unclear. Diabetics and nondiabetics see a similar improvement in their cardiac risk factors and exercise parameters from exercise-based cardiac rehabilitation (CR). A series of 370 diabetics and 942 nondiabetics entered a 36-session outpatient CR program after interventions for coronary heart disease or after bypass or cardiac valve surgery. The program consisted of physical exercise, lifestyle modification, and pharmacotherapy. Quality of life, weight, blood pressure, and lipid profiles improved significantly in both groups during the 12-week program. Baseline metabolic equivalents (METs) were lower in diabetics vs nondiabetics at the start of CR (2.4 vs 2.7, P diabetics had less improvement (change in METs 1.7 vs 2.6, P diabetes remained a significant predictor of reduced improvement in exercise capacity. Diabetics saw a significant benefit in quality of life, weight, exercise tolerance, and cardiac risk factors, but to a lesser extent when compared with nondiabetics. The mechanisms for poorer improvement in diabetics following CR also include noncardiac factors and require further study. © 2014 Wiley Periodicals, Inc.

  13. A mHealth cardiac rehabilitation exercise intervention: findings from content development studies

    Directory of Open Access Journals (Sweden)

    Pfaeffli Leila

    2012-05-01

    Full Text Available Abstract Background Involving stakeholders and consumers throughout the content and study design ensures interventions are engaging and relevant for end-users. The aim of this paper is to present the content development process for a mHealth (mobile phone and internet-based cardiac rehabilitation (CR exercise intervention. Methods An innovative mHealth intervention was developed with patient input using the following steps: conceptualization, formative research, pre-testing, and pilot testing. Conceptualization, including theoretical and technical aspects, was undertaken by experts. For the formative component, focus groups and interviews with cardiac patients were conducted to discuss their perceptions of a mHealth CR program. A general inductive thematic approach identified common themes. A preliminary library of text and video messages were then developed. Participants were recruited from CR education sessions to pre-test and provide feedback on the content using an online survey. Common responses were extracted and compiled. An iterative process was used to refine content prior to pilot testing and conduct of a randomized controlled trial. Results 38 CR patients and 3 CR nurses participated in the formative research and 20 CR patients participated in the content pre-testing. Participants perceived the mHealth program as an effective approach to inform and motivate patients to exercise. For the qualitative study, 100% (n = 41 of participants thought it to be a good idea, and 11% of participants felt it might not be useful for them, but would be for others. Of the 20 participants who completed the online survey, 17 out of 20 (85% stated they would sign up to a program where they could receive information by video messages on a website, and 12 out of 20 (60% showed interest in a texting program. Some older CR patients viewed technology as a potential barrier as they were unfamiliar with text messaging or did not have mobile phones. Steps to

  14. A mHealth cardiac rehabilitation exercise intervention: findings from content development studies.

    Science.gov (United States)

    Pfaeffli, Leila; Maddison, Ralph; Whittaker, Robyn; Stewart, Ralph; Kerr, Andrew; Jiang, Yannan; Kira, Geoff; Carter, Karen; Dalleck, Lance

    2012-05-30

    Involving stakeholders and consumers throughout the content and study design ensures interventions are engaging and relevant for end-users. The aim of this paper is to present the content development process for a mHealth (mobile phone and internet-based) cardiac rehabilitation (CR) exercise intervention. An innovative mHealth intervention was developed with patient input using the following steps: conceptualization, formative research, pre-testing, and pilot testing. Conceptualization, including theoretical and technical aspects, was undertaken by experts. For the formative component, focus groups and interviews with cardiac patients were conducted to discuss their perceptions of a mHealth CR program. A general inductive thematic approach identified common themes. A preliminary library of text and video messages were then developed. Participants were recruited from CR education sessions to pre-test and provide feedback on the content using an online survey. Common responses were extracted and compiled. An iterative process was used to refine content prior to pilot testing and conduct of a randomized controlled trial. 38 CR patients and 3 CR nurses participated in the formative research and 20 CR patients participated in the content pre-testing. Participants perceived the mHealth program as an effective approach to inform and motivate patients to exercise. For the qualitative study, 100% (n = 41) of participants thought it to be a good idea, and 11% of participants felt it might not be useful for them, but would be for others. Of the 20 participants who completed the online survey, 17 out of 20 (85%) stated they would sign up to a program where they could receive information by video messages on a website, and 12 out of 20 (60%) showed interest in a texting program. Some older CR patients viewed technology as a potential barrier as they were unfamiliar with text messaging or did not have mobile phones. Steps to instruct participants to receive texts and view the

  15. Recovery of dynamic visual acuity in bilateral vestibular hypofunction.

    Science.gov (United States)

    Herdman, Susan J; Hall, Courtney D; Schubert, Michael C; Das, Vallabh E; Tusa, Ronald J

    2007-04-01

    To determine the effect of vestibular exercises on the recovery of visual acuity during head movement in patients with bilateral vestibular hypofunction (BVH). Prospective, randomized, double-blinded study. Outpatient clinic, academic setting. Thirteen patients with BVH, aged 47 to 73 years. One group (8 patients) performed vestibular exercises designed to enhance remaining vestibular function, and the other (5 patients) performed placebo exercises. Measurements of dynamic visual acuity (DVA) during predictable head movements using a computerized test; measurement of intensity of oscillopsia using a visual analog scale. As a group, patients who performed vestibular exercises showed a significant improvement in DVA (P = .001), whereas those performing placebo exercises did not (P = .07). Only type of exercise (ie, vestibular vs placebo) was significantly correlated with change in DVA. Other factors examined, including age, time from onset, initial DVA, and complaints of oscillopsia and disequilibrium, were not significantly correlated with change in DVA. Change in oscillopsia did not correlate with change in DVA. Use of vestibular exercises is the main factor involved in recovery of DVA in patients with BVH. We theorize that exercises may foster the use of centrally programmed eye movements that could substitute for the vestibulo-ocular reflex. clinicaltrials.gov Identifier: NCT00411216.

  16. Effects of home-based exercise rehabilitation on quality of life after coronary artery bypass graft and PCI early post-discharge

    Directory of Open Access Journals (Sweden)

    Shadi Moafi

    2011-11-01

    Full Text Available Background: The barriers to participation in cardiac rehabilitation programs are individual and economic problems and limited availability and access of rehabilitation services. Because of the important role of rehabilitation, home based exercise rehabilitation is a new approach to participate in such programs. The purpose of this study was to evaluate the effects of home-based rehabilitation on quality of life (QoL in patients with coronary artery disease after coronary artery bypass graft (CABG and PCI.Materials and Method: Participants included 18 CABG (3 women, 15 men and 40 PCI (12 women, 28 men low to moderate risk patients. Finally 17 patients in the exercise group and 16 patients in the control group remained. The SF-36 was used to evaluate changes in QoL before and after the program.Result: forty-three percent was dropped out from the program. Before and after program, the exercise group was better in all domains of QoL (p<0.05. After 8 weeks of cardiac rehabilitation, significant improvements were observed in quality of life in both groups (p<0.05 but the exercise group showed more improvements in three domains.Conclusion: Home-based exercise rehabilitation after CABG and PCI may improve QoL and provide an efficient low-cost approach to cardiac rehabilitation. It may be helpful due to limited availability and resources in Iran. Nevertheless, for increasing participation and decreasing drop out it needs more training

  17. [Improving of muscle mass and force in rehabilitation of heart-lung patients. Aerobic interval training, resistance-exercises, excentric exercises, vibration].

    Science.gov (United States)

    Apor, Péter; Tihanyi, József; Borka, Péter

    2005-09-18

    Improvement of muscle mass and force which got depleted by inactivity or pathological processes is one of the aims and also a prerequisite of a rehabilitative intervention. Metabolically active larger and stronger muscles diminish the cardiovascular risk, permit the aerobic preventive and rehabilitative activities and enables a higher quality of life. Interval forms of aerobic exercise improves also the muscles. The resistance training plays an important part in rehabilitation. Beside the traditional dynamic strength training with weights, gym machines, body weight etc. the excentric type of muscle activity potentiates higher muscle load with lesser energy consumption, therefore it is suitable in the case of smaller performance ability. Vibration of the whole body or parts of it by machines improves the co-activity of the motor units and results in force development with small metabolic involvement.

  18. Cardiac acceleration at the onset of exercise: a potential parameter for monitoring progress during physical training in sports and rehabilitation.

    Science.gov (United States)

    Hettinga, Florentina J; Monden, Paul G; van Meeteren, Nico L U; Daanen, Hein A M

    2014-05-01

    There is a need for easy-to-use methods to assess training progress in sports and rehabilitation research. The present review investigated whether cardiac acceleration at the onset of physical exercise (HRonset) can be used as a monitoring variable. The digital databases of Scopus and PubMed were searched to retrieve studies investigating HRonset. In total 652 studies were retrieved. These articles were then classified as having emphasis on HRonset in a sports or rehabilitation setting, which resulted in 8 of 112 studies with a sports application and 6 of 68 studies with a rehabilitation application that met inclusion criteria. Two co-existing mechanisms underlie HRonset: feedforward (central command) and feedback (mechanoreflex, metaboreflex, baroreflex) control. A number of studies investigated HRonset during the first few seconds of exercise (HRonsetshort), in which central command and the mechanoreflex determine vagal withdrawal, the major mechanism by which heart rate (HR) increases. In subsequent sports and rehabilitation studies, interest focused on HRonset during dynamic exercise over a longer period of time (HRonsetlong). Central command, mechanoreflexes, baroreflexes, and possibly metaboreflexes contribute to HRonset during the first seconds and minutes of exercise, which in turn leads to further vagal withdrawal and an increase in sympathetic activity. HRonset has been described as the increase in HR compared with resting state (delta HR) or by exponential modeling, with measurement intervals ranging from 0-4 s up to 2 min. Delta HR was used to evaluate HRonsetshort over the first 4 s of exercise, as well as for analyzing HRonsetlong. In exponential modeling, the HR response to dynamic exercise is biphasic, consisting of fast (parasympathetic, 0-10 s) and slow (sympathetic, 1-4 min) components. Although available studies differed largely in measurement protocols, cross-sectional and longitudinal training studies showed that studies analyzing HRonset

  19. Prescribed exercise programs may not be effective in reducing impairments and improving activity during upper limb fracture rehabilitation: a systematic review

    OpenAIRE

    Andrea M Bruder; Nora Shields; Karen J Dodd; Nicholas F Taylor

    2017-01-01

    Question: What is the effect of exercise on increasing participation and activity levels and reducing impairment in the rehabilitation of people with upper limb fractures? Design: Systematic review of controlled trials. Participants: Adults following an upper limb fracture. Intervention: Any exercise therapy program, including trials where exercise was delivered to both groups provided that the groups received different amounts of exercise. Outcome measures: Impairments of body st...

  20. Rehabilitering

    DEFF Research Database (Denmark)

    Caswell, Dorte; Høybye-Mortensen, Matilde; Dall, Tanja

    2013-01-01

    Rehabilitering som både begreb og indsats har været genstand for stigende fokus i de seneste år, på både politisk, organisatorisk og praksis-niveau. Fra januar 2013 træder en større reform af førtidspension og fleksjob i kraft, og med reformen etableres ’rehabilitering’ som både mål og middel i...

  1. Development of a fuzzy logic based intelligent system for autonomous guidance of post-stroke rehabilitation exercise.

    Science.gov (United States)

    Huq, Rajibul; Wang, Rosalie; Lu, Elaine; Hebert, Debbie; Lacheray, Hervé; Mihailidis, Alex

    2013-06-01

    This paper presents preliminary studies in developing a fuzzy logic based intelligent system for autonomous post-stroke upper-limb rehabilitation exercise. The intelligent system autonomously varies control parameters to generate different haptic effects on the robotic device. The robotic device is able to apply both resistive and assistive forces for guiding the patient during the exercise. The fuzzy logic based decision-making system estimates muscle fatigue of the patient using exercise performance and generates a combination of resistive and assistive forces so that the stroke survivor can exercise for longer durations with increasing control. The fuzzy logic based system is initially developed using a study with healthy subjects and preliminary results are also presented to validate the developed system with healthy subjects. The next stage of this work will collect data from stroke survivors for further development of the system.

  2. A Rehabilitation-Internet-of-Things in the Home to Augment Motor Skills and Exercise Training.

    Science.gov (United States)

    Dobkin, Bruce H

    2017-03-01

    Although motor learning theory has led to evidence-based practices, few trials have revealed the superiority of one theory-based therapy over another after stroke. Nor have improvements in skills been as clinically robust as one might hope. We review some possible explanations, then potential technology-enabled solutions. Over the Internet, the type, quantity, and quality of practice and exercise in the home and community can be monitored remotely and feedback provided to optimize training frequency, intensity, and progression at home. A theory-driven foundation of synergistic interventions for walking, reaching and grasping, strengthening, and fitness could be provided by a bundle of home-based Rehabilitation Internet-of-Things (RIoT) devices. A RIoT might include wearable, activity-recognition sensors and instrumented rehabilitation devices with radio transmission to a smartphone or tablet to continuously measure repetitions, speed, accuracy, forces, and temporal spatial features of movement. Using telerehabilitation resources, a therapist would interpret the data and provide behavioral training for self-management via goal setting and instruction to increase compliance and long-term carryover. On top of this user-friendly, safe, and conceptually sound foundation to support more opportunity for practice, experimental interventions could be tested or additions and replacements made, perhaps drawing from virtual reality and gaming programs or robots. RIoT devices continuously measure the actual amount of quality practice; improvements and plateaus over time in strength, fitness, and skills; and activity and participation in home and community settings. Investigators may gain more control over some of the confounders of their trials and patients will have access to inexpensive therapies.

  3. Qualidade de vida de indivíduos submetidos à reabilitação vestibular

    OpenAIRE

    Gomes Patatas, Olívia Helena; Freitas Ganança, Cristina; Freitas Ganança, Fernando

    2009-01-01

    Balance disorders affect social, family and professional activities. Vestibular rehabilitation can reduce the impact of these disorders on the quality of life of individuals with vertigo. AIM: to study the influence of vestibular rehabilitation on the quality of life of individuals, correlating it with gender, age, results from computerized vectoelectronystagmography and vertigo. Study type: Retrospective. MATERIALS AND METHODS:Twenty-two individuals were submitted to customized vestibular re...

  4. Reabilitação vestibular: tendências e indicações

    OpenAIRE

    Teixeira,Clarissa Stefani; Pereira, Érico Felden; Rossi, Angela Garcia; Daronco, Luciane Sanchotene Etchepare

    2012-01-01

    The vestibular rehabilitation, generally recommended for the treatment of dysfunctions in the vestibular system, has been prescribed for people with other problems related to balance and to spacial orientation. This study, with a bibliographic basis, had as objective to make a synthesis of the studies about vestibular rehabilitation that are focused in other morbidities besides the vestibulopathies, pointing out the tendencies of investigations and the main results, specially the ones with in...

  5. Prescribed exercise programs may not be effective in reducing impairments and improving activity during upper limb fracture rehabilitation: a systematic review

    Directory of Open Access Journals (Sweden)

    Andrea M Bruder

    2017-10-01

    Registration: CRD42016041818. [Bruder AM, Shields N, Dodd KJ, Taylor NF (2017 Prescribed exercise programs may not be effective in reducing impairments and improving activity during upper limb fracture rehabilitation: a systematic review. Journal of Physiotherapy 63: 205–220

  6. Rehabilitation after ACL Injury: A Fluoroscopic Study on the Effects of Type of Exercise on the Knee Sagittal Plane Arthrokinematics

    Directory of Open Access Journals (Sweden)

    Sadegh Norouzi

    2013-01-01

    Full Text Available A safe rehabilitation exercise for anterior cruciate ligament (ACL injuries needs to be compatible with the normal knee arthrokinematics to avoid abnormal loading on the joint structures. The objective of this study was to measure the amount of the anterior tibial translation (ATT of the ACL-deficient knees during selective open and closed kinetic chain exercises. The intact and injured knees of fourteen male subjects with unilateral ACL injury were imaged using uniplanar fluoroscopy, while the subjects performed forward lunge and unloaded/loaded open kinetic knee extension exercises. The ATTs were measured from fluoroscopic images, as the distance between the tibial and femoral reference points, at seven knee flexion angles, from 0° to 90°. No significant differences were found between the ATTs of the ACL-deficient and intact knees at all flexion angles during forward lunge and unloaded open kinetic knee extension (. During loaded open kinetic knee extension, however, the ATTs of the ACL deficient knees were significantly larger than those of the intact knees at 0° (. It was suggested that the forward lunge, as a weight-bearing closed kinetic chain exercise, provides a safer approach for developing muscle strength and functional stability in rehabilitation program of ACL-deficient knees, in comparison with open kinetic knee extension exercise.

  7. Rehabilitation after ACL Injury: A Fluoroscopic Study on the Effects of Type of Exercise on the Knee Sagittal Plane Arthrokinematics

    Science.gov (United States)

    Norouzi, Sadegh; Esfandiarpour, Fateme; Shakourirad, Ali; Salehi, Reza; Akbar, Mohammad; Farahmand, Farzam

    2013-01-01

    A safe rehabilitation exercise for anterior cruciate ligament (ACL) injuries needs to be compatible with the normal knee arthrokinematics to avoid abnormal loading on the joint structures. The objective of this study was to measure the amount of the anterior tibial translation (ATT) of the ACL-deficient knees during selective open and closed kinetic chain exercises. The intact and injured knees of fourteen male subjects with unilateral ACL injury were imaged using uniplanar fluoroscopy, while the subjects performed forward lunge and unloaded/loaded open kinetic knee extension exercises. The ATTs were measured from fluoroscopic images, as the distance between the tibial and femoral reference points, at seven knee flexion angles, from 0° to 90°. No significant differences were found between the ATTs of the ACL-deficient and intact knees at all flexion angles during forward lunge and unloaded open kinetic knee extension (P < 0.05). During loaded open kinetic knee extension, however, the ATTs of the ACL deficient knees were significantly larger than those of the intact knees at 0° (P = 0.002) and 15° (P = 0.012). It was suggested that the forward lunge, as a weight-bearing closed kinetic chain exercise, provides a safer approach for developing muscle strength and functional stability in rehabilitation program of ACL-deficient knees, in comparison with open kinetic knee extension exercise. PMID:24066288

  8. Rehabilitation of anterior cruciate ligament insufficiency in a dancer using the clinical reformer and a balanced body exercise method.

    Science.gov (United States)

    Brown, S E; Clippinger, K

    1996-01-01

    Severe ligamentous knee injuries are uncommon in dance, but partial instability can be disabling. Because of the aesthetics required, use of a brace is not practical. The balanced body approach of exercise and rehabilitation can maximize the physiologic stabilizers of the knee and allow return to dance. While derived from the original principles of Joseph H. Pilates, current practitioners apply modern biomechanical and medical knowledge. The Reformer, a spring loaded exercise device first used by J.H. Pilates, can provide both a simulated environment for dance technique while allowing rest of the injured part and a method of cross training.

  9. Oxidative stress during rehabilitation from protein malnutrition associated with aerobic exercise in rats

    Directory of Open Access Journals (Sweden)

    Francisco José Andriotti Prada

    2007-01-01

    Full Text Available This study was designed to evaluate biomarkers of oxidative stress in rats with or without aerobic exercise during recovery from protein malnutrition. From the 30th to the 90th day of life, male Wistar rats were fed a low protein diet (LP + 6% followed by a normal protein diet (NP = 17% until the 120th day and separated in two groups: sedentary (S and exercise trained (E = swimming 1h/day, 5 days/week, with from the 90th to the 120th day. Rats fed a normal protein diet were used as controls. Results showed that physical exercise had beneficial effects on body weight gain during nutrition rehabilitation. Erythrocytes catalase and glutathione reductase (biomarkers of the antioxidant system were significantly reduced in all groups in comparison to the sedentary control group. The plasma concentration of TBARs (biomarkers of the oxidative damage was also lower in the recovered rats, suggesting that the improvement in body growth after nutritional rehabilitation with physical exercise could be related to a decrease in the oxidative stress level.O presente estudo foi delineado para avaliar biomarcadores de estresse oxidativo em ratos submetidos ou não ao exercício físico durante a recuperação da desnutrição protéica. Para tanto, ratos Wistar alimentados com dieta hipoprotéica (LP = 6% dos 30 dias até 90 dias, e então com dieta normoprotéica (NP = 17% até 120 dias, foram separados em dois grupos: sedentário (S e exercitado (E = natação 1h/dia, 5 dia/semana, dos 90 até os 120 dias de vida. Ratos alimentados com dieta normoprotéica foram usados como controles. Nossos resultados mostraram que o exercício físico durante recuperação nutricional, teve efeitos benéficos no ganho de peso corporal e no metabolismo glicídico muscular. Catalase e glutationa reductase (biomarcadores do sistema de antioxidante mostraram-se significativamente reduzidas em todos os grupos quando comparadas ao grupo controle sedentário. A concentração plasm

  10. Peripheral Vestibular System Disease in Vestibular Schwannomas

    DEFF Research Database (Denmark)

    Møller, Martin Nue; Hansen, Søren; Caye-Thomasen, Per

    2015-01-01

    that this may be caused by both cochlear and retrocochlear mechanisms. Multiple mechanisms may also be at play in the case of dizziness, which may broaden perspectives of therapeutic approach. This study presents a systematic and detailed assessment of vestibular histopathology in temporal bones from patients...... with VS. METHODS: Retrospective analysis of vestibular system histopathology in temporal bones from 17 patients with unilateral VS. The material was obtained from The Copenhagen Temporal Bone Collection. RESULTS: Vestibular schwannomas were associated with atrophy of the vestibular ganglion, loss of fiber...... density of the peripheral vestibular nerve branches, and atrophy of the neuroepithelium of the vestibular end organs. In cases with small tumors, peripheral disease occurred only in the tissue structures innervated by the specific nerve from which the tumor originated. CONCLUSION: Vestibular schwannomas...

  11. Exercise-based rehabilitation after hospital discharge for survivors of critical illness with intensive care unit?acquired weakness: A pilot feasibility trial ? ??

    OpenAIRE

    Connolly, Bronwen; Thompson, April; Douiri, Abdel; Moxham, John; Hart, Nicholas

    2015-01-01

    Purpose The aim of this study was to investigate feasibility of exercise-based rehabilitation delivered after hospital discharge in patients with intensive care unit?acquired weakness (ICU-AW). Materials and methods Twenty adult patients, mechanically ventilated for more than 48 hours, with ICU-AW diagnosis at ICU discharge were included in a pilot feasibility randomized controlled trial receiving a 16-session exercise-based rehabilitation program. Twenty-one patients without ICU-AW participa...

  12. Exercise and Life-Satisfactory-Fitness: Complementary Strategies in the Prevention and Rehabilitation of Illnesses

    Directory of Open Access Journals (Sweden)

    Christiane Jennen

    2004-01-01

    Full Text Available Moderate training of an endurance nature, but also other exercise activities, not only has a preventive effect on various illnesses and pre-illness states such as the metabolic syndrome and cancer, but is also effective in treating patients in the rehabilitation phase after illness, e.g. cardiovascular or cancer. Our investigation demonstrates that even low level physical activity has a very good preventive effect too, which is enhanced when it is accompanied by mental activity and psychological well-being. In total, we investigated 13 000 people on the basis of socio-economic panel polls with respect to life contentment, health status and leisure-time activities. Life contentment is positively linked to contentment with labor, which seems to be an essential aspect with regard to the increasing number of unemployed people in Europe. The second important factor is health-promoting activities during leisure time. Exercise, especially, has a significant influence on life satisfaction as a feeling of physical fitness feeling is regarded as synonymous with good health. The results underline the psycho-neuroimmunological network, which stabilizes our health and shows that different activities in older adults have a significant effect on the aging process and age-related illnesses. Besides the various activities that are important in this arena, namely muscle and mental mobility (‘brawn and brain’, a third component must be taken into consideration: life contentment in the form of a successful retrospective view and a positive outlook, embedded in a psychosocial family environment (‘brood’ and integrated in a stress-free biotope, where life does make sense. Alternative and complementary strategies should be considered in light of these three aspects when we think about additional anti-inflammatory strategies in preventing diseases or treating them and their relapses.

  13. Compromised Cardiopulmonary Exercise Capacity in Patients Early After Endoscopic Atraumatic Coronary Artery Bypass Graft: Implications for Rehabilitation.

    Science.gov (United States)

    Hansen, Dominique; Roijakkers, Ruben; Jackmaert, Lore; Robic, Boris; Hendrikx, Marc; Yilmaz, Alaaddin; Frederix, Ines; Rosseel, Michael; Dendale, Paul

    2017-02-01

    The purpose of this work was to test the hypothesis that cardiopulmonary exercise tolerance is better preserved early after endoscopic atraumatic coronary artery bypass graft (endo-ACAB) surgery versus coronary artery bypass graft (CABG) surgery. Twenty endo-ACAB surgery patients, 20 CABG surgery patients, and 15 healthy subjects executed a maximal cardiopulmonary exercise test, with assessment and comparison of cycling power output, O2 uptake, CO2 output, respiratory gas exchange ratio, end-tidal O2 and CO2 pressures, equivalents for O2 uptake and CO2 output, heart rate, O2 pulse, expiratory volume, tidal volume, respiratory rate, at peak exercise and ventilatory threshold. In patients, forced expiratory volume and forced vital capacity were measured. Oxygen uptake, CO2 output, expiratory and tidal volume, equivalents for O2 uptake and CO2 output, end-tidal O2 and CO2 pressures at peak exercise (matched peak respiratory gas exchange ratio between patient groups), and ventilatory threshold were significantly worse in patients versus healthy controls (P power, >0.80). All these parameters, and lung function, were, however, comparable between CABG and endo-ACAB surgery patients (P > 0.10). Exercise tolerance and ventilatory function during exercise seems, in contrast to expectation, equally compromised early after endo-ACAB surgery as opposed to after CABG surgery. These data may signify the need for exercise-based rehabilitation intervention early after endo-ACAB surgery.

  14. Does rating of perceived exertion result in target exercise intensity during interval training in cardiac rehabilitation? A study of the Borg scale versus a heart rate monitor.

    Science.gov (United States)

    Aamot, Inger-Lise; Forbord, Siv Hege; Karlsen, Trine; Støylen, Asbjørn

    2014-09-01

    To assess whether rating of perceived exertion using the Borg 6-20 scale is a valid method for achieving target exercise intensity during high-intensity interval training in cardiac rehabilitation. A single-group cross-over design. Ten participants (56 (6.5) years) who were enrolled in a high-intensity interval training cardiac rehabilitation program were recruited. A target exercise intensity of Borg 17 (very hard) was used for exercise intensity guidance in the initial four exercise sessions that took place before a cardiopulmonary exercise test, as in usual care rehabilitation. The heart rate was recorded and blinded to the participants. After performing the test, the participants were then instructed using heart rate monitors openly for exercise guidance in four subsequent exercise sessions, at an intensity corresponding to 85-95% of peak heart rate. The mean exercise intensity during high-intensity bouts was 82% (6%) of peak heart rate for the rating of perceived exertion and 85% (6%) using heart rate monitors (p=0.005). Bland-Altman limits of agreement analysis with a mean bias showed a bias of 2.97 (-2.08, 8.02) percentage points for the two methods. Exercise intensity was highly repeatable with intra-class correlations of 0.95 (95% CI 0.86-0.99, phigh-intensity interval training bouts in cardiac rehabilitation. Heart rate monitoring should be used for accurate intensity guidance. Copyright © 2013 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  15. Promotion of the Journal of Exercise Rehabilitation to the international level based on journal metrics.

    Science.gov (United States)

    Huh, Sun

    2016-12-01

    The aim of this study was to use journal metrics to confirm that the Journal of Exercise Rehabilitation has been promoted to the international level after changing its language to English-only in April 2013. Journal metrics, including the number of articles per year, countries of authors, countries of the editorial board members, impact factor, total citations, and the Hirsch index, were counted or calculated based on the journal homepage and the Web of Science Core Collection in December 2016. The number of citable articles was 52, 62, 59, and 74 in 2013, 2014, 2015, and 2016, respectively. All authors were from Korea in 2013 and 2014, but the authors were from 11 countries in 2015 and from 16 countries in 2016. The editorial board members are currently from 11 countries. The impact factor without self-citations for 2015 was 0.912, corresponding to a Journal Citation Reports ranking of 32.9% out of 82 journals in the category of sport sciences. The total citations increased from 1 in 2013 to 130 in 2016. This journal was cited in 208 other source journals in the Web of Science. The citing authors were from 47 countries. The Hirsch index was 7, and review articles were the most frequently cited articles. The above results show a rapid development to the international level over 4 years. The introduction of digital technology to journals to improve their accessibility across multiple platforms is recommended.

  16. ANAEROBIC EXERCISE TESTING IN REHABILITATION : A SYSTEMATIC REVIEW OF AVAILABLE TESTS AND PROTOCOLS

    NARCIS (Netherlands)

    Krops, Leonie A.; Albada, Trijntje; van der Woude, Lucas H. V.; Hijmans, Juha M.; Dekker, Rienk

    Objective: Anaerobic capacity assessment in rehabilitation has received increasing scientific attention in recent years. However, anaerobic capacity is not tested consistently in clinical rehabilitation practice. This study reviews tests and protocols for anaerobic capacity in adults with various

  17. Effects of the application of ankle functional rehabilitation exercise on the ankle joint functional movement screen and isokinetic muscular function in patients with chronic ankle sprain.

    Science.gov (United States)

    Ju, Sung-Bum; Park, Gi Duck

    2017-02-01

    [Purpose] This study was conducted to investigate the effects of ankle functional rehabilitation exercise on ankle joint functional movement screen results and isokinetic muscular function in patients with chronic ankle sprain patients. [Subjects and Methods] In this study, 16 patients with chronic ankle sprain were randomized to an ankle functional rehabilitation exercise group (n=8) and a control group (n=8). The ankle functional rehabilitation exercise centered on a proprioceptive sense exercise program, which was applied 12 times for 2 weeks. To verify changes after the application, ankle joint functional movement screen scores and isokinetic muscular function were measured and analyzed. [Results] The ankle functional rehabilitation exercise group showed significant improvements in all items of the ankle joint functional movement screen and in isokinetic muscular function after the exercise, whereas the control group showed no difference after the application. [Conclusion] The ankle functional rehabilitation exercise program can be effectively applied in patients with chronic ankle sprain for the improvement of ankle joint functional movement screen score and isokinetic muscular function.

  18. Repercussão das medidas de correção das comorbidades no resultado da reabilitação vestibular de idosos The treatment of diseases related to balance disorders in the elderly and the effectiveness of vestibular rehabilitation

    Directory of Open Access Journals (Sweden)

    Roseli Saraiva Moreira Bittar

    2007-06-01

    Full Text Available OBJETIVO: Considerando o aumento da população idosa e conseqüentemente as alterações de equilíbrio a ela relacionadas, realizamos um estudo para avaliar o impacto do tratamento adequado das doenças coexistentes ao desequilíbrio corporal no resultado da Reabilitação Vestibular (RV. MATERIAL E MÉTODOS: 52 idosos com queixa de tontura e/ou desequilíbrio com indicação RV participaram deste ensaio clínico aberto e prospectivo realizado no Ambulatório de Otoneurologia Geriátrica da Instituição, entre 2003 e 2005. Os pacientes do grupo de estudo foram previamente tratados das doenças clínicas diagnosticadas e posteriormente submetidos à RV. Foram então comparados com o grupo total de idosos tratados pela RV no mesmo período. RESULTADOS: Os pacientes do grupo de estudo apresentaram 65 comorbidades diagnosticadas, com média de 1,25 por paciente. A efetividade total foi de 84,5% neste grupo contra 81,8% no grupo controle, sem diferença significante. No entanto, a completa remissão dos sintomas ocorreu em 69,2% dos casos contra 43,18% dos controles, significante para pThe aim of this study was to assess the impact of adequate treatment of concomitant diseases in the elderly undergoing Vestibular Rehabilitation (VR. METHOD: 52 elderly patients with complaints of vertigo and/or imbalance requiring VR participated in this prospective study. The trial was designed as an open clinical assay at the Ear Nose and Throat Department Geriatric Otoneurology Clinic, and was done between 2003 and 2005. Patients were compared with the total group of elderly individuals treated with VR during the same period. RESULTS: 65 diseases were diagnosed in the study group, an average 1.25 diseases per patient. After the treatment of these diseases, patients underwent VR. The effectiveness of VR (remission and partial improvement rates was 84.5% in the study group against 81.8% in the control group, which was not significant. Remission of symptoms

  19. Important aspects in relation to patients' attendance at exercise-based cardiac rehabilitation - facilitators, barriers and physiotherapist's role: a qualitative study.

    Science.gov (United States)

    Bäck, Maria; Öberg, Birgitta; Krevers, Barbro

    2017-03-14

    In order to improve attendance at exercise-based cardiac rehabilitation (CR), a greater insight into patients' perspectives is necessary. The aim of the study was to explore aspects that influence patients' attendance at exercise-based CR after acute coronary artery disease (CAD) and the role of the physiotherapist in patients' attendance at exercise-based CR. A total of 16 informants, (5 women; median age 64.5, range 47-79 years), diagnosed with CAD, were included in the study at the Cardiology Department, Linköping University Hospital, Sweden. Qualitative interviews were conducted and analysed according to inductive content analysis. Four main categories were identified: (i) previous experience of exercise, (ii) needs in the acute phase, (iii) important prerequisites for attending exercise-based CR and (iv) future ambitions. The categories demonstrate that there are connections between the past, the present and the future, in terms of attitudes to facilitators, barriers and the use of strategies for managing exercise. An overall theme, defined as existential thoughts, had a major impact on the patients' attitudes to attending exercise-based CR. The interaction and meetings with the physiotherapists in the acute phase were described as important factors for attending exercise-based CR. Moreover, informants could feel that the physiotherapists supported them in learning the right level of effort during exercise and reducing the fear of exercise. This study adds to previous knowledge of barriers and facilitators for exercise-based CR that patients with CAD get existential thoughts both related to exercise during the rehabilitation process and for future attitudes to exercise. This knowledge might necessitate greater attention to the physiotherapist-patient interaction. To be able to tailor exercise-based CR for patients, physiotherapists need to be aware of patients' past experiences of exercise and previous phases of the rehabilitation process as these are

  20. 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

  1. Short-term effects of exercise and music on cognitive performance among participants in a cardiac rehabilitation program.

    Science.gov (United States)

    Emery, Charles F; Hsiao, Evana T; Hill, Scott M; Frid, David J

    2003-01-01

    Exercise has been associated with improved cognitive performance among patients with coronary artery disease. Music listening has been associated with enhanced cognitive functioning among healthy adults. This study evaluated the combined influence of exercise and music listening on cognitive performance among patients in cardiac rehabilitation (CR). Using a within-subjects repeated measures design, this study was conducted in an outpatient University-based CR facility. Thirty-three men and women (mean age = 62.6 +/- 10.5 years) participated in this study. Participants completed 1 exercise session accompanied by music and a second exercise session without music. Order of conditions was assigned randomly. Before and after each exercise session, participants completed a brief assessment of depression and anxiety, and a cognitive test of verbal fluency. The music condition was associated with significant improvements in verbal fluency, but the no-music control condition was not associated with cognitive change. The study provides preliminary evidence of the combined benefit of exercise and music listening for cognitive performance among patients in CR.

  2. Adherence to a maintenance exercise program 1 year after pulmonary rehabilitation: what are the predictors of dropout?

    Science.gov (United States)

    Heerema-Poelman, Ankie; Stuive, Ilse; Wempe, Johan B

    2013-01-01

    To evaluate adherence to a maintenance exercise program in patients with chronic obstructive pulmonary disease (COPD) and explore predictors for adherence. Seventy patients with COPD were referred to a home-care maintenance exercise program after completing pulmonary rehabilitation (PR) in the rehabilitation center. Adherence (yes/no) to the maintenance program was assessed by a self-reported questionnaire, where adherence was defined as attending the maintenance program 1 year after PR. Early dropouts received a self-reported questionnaire after 6 months and the remaining patients after 12 months. Lung function, exercise capacity, exercise self-efficacy, illness perceptions, health-related quality of life, levels of anxiety and depression, duration of PR, and the number of exacerbations were studied as possible predictors of adherence. Ten patients died or were lost to followup. Of the remaining 60 patients, 73.3% and 63.3% were adherent to the maintenance exercise program after 6 and 12 months, respectively. Forced expiratory volume in 1 second (FEV1) (P = .021), Hospital Anxiety and Depression Scale depression score (P = .025), and duration of PR (P = .018) were significant predictors of adherence to the maintenance program. Adherence to the maintenance exercise program included a 36.7% drop-out rate during the first year after completing PR. Experiencing exacerbations was the most reported reason for dropout. Poorer lung function, shorter initial PR course measured by reviewing patient records, and higher level of depressive symptoms were predictive of drop-out to the maintenance program. Adherence to the maintenance program needs to be improved for patients with lower FEV1, with signs of depression, or with a shorter initial PR course.

  3. Self-rating level of perceived exertion for guiding exercise intensity during a 12-week cardiac rehabilitation programme and the influence of heart rate reducing medication

    DEFF Research Database (Denmark)

    Tang, Lars; Zwisler, Ann-Dorthe; Taylor, Rod S.

    2016-01-01

    OBJECTIVES: To investigate whether self-rating level of perceived exertion can adequately guide exercise intensity during a 12-week cardiac rehabilitation programme. DESIGN: Linear regression analysis using rehabilitation data from two randomised controlled trials. METHODS: Patients undergoing ra......-led and self-regulated model using rating of perceived exertion can help guide exercise intensity in everyday clinical practice among patients with heart disease, irrespective if they are taking heart rate-reducing medication.......OBJECTIVES: To investigate whether self-rating level of perceived exertion can adequately guide exercise intensity during a 12-week cardiac rehabilitation programme. DESIGN: Linear regression analysis using rehabilitation data from two randomised controlled trials. METHODS: Patients undergoing...

  4. [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

  5. Essential amino acids and exercise tolerance in elderly muscle-depleted subjects with chronic diseases: a rehabilitation without rehabilitation?

    Science.gov (United States)

    Aquilani, Roberto; D'Antona, Giuseppe; Baiardi, Paola; Gambino, Arianna; Iadarola, Paolo; Viglio, Simona; Pasini, Evasio; Verri, Manuela; Barbieri, Annalisa; Boschi, Federica

    2014-01-01

    Exercise intolerance remains problematic in subjects with chronic heart failure (CHF) and/or chronic obstructive pulmonary disease (COPD). Recent studies show that supplemented essential amino acids (EAAs) may exert beneficial effects on CHF/COPD physical capacity. The results from 3 investigations (2 conducted on CHF and 1 on COPD subjects) served as the basis for this paper. The 3 studies consistently showed that elderly CHF and COPD improved exercise intolerance after 1-3 months of EAA supplementation (8 g/d). In CHF exercise capacity increased 18.7% to 23% (watts; bicycle test), and 12% to 22% (meters) in 6 min walking test. Moreover, patients reduced their resting plasma lactate levels (by 25%) and improved tissue insulin sensitivity by 16% (HOMA index). COPD subjects enjoyed similar benefits as CHF ones. They increased physical autonomy by 78.6% steps/day and decreased resting plasma lactate concentrations by 23%. EAA mechanisms explaining improved exercise intolerance could be increases in muscle aerobic metabolism, mass and function, and improvement of tissue insulin sensitivity (the latter only for the CHF population). These mechanisms could be accounted for by EAA's intrinsic physiological activity which increases myofibrils and mitochondria genesis in skeletal muscle and myocardium and glucose control. Supplemented EAAs can improve the physical autonomy of subjects with CHF/COPD.

  6. Essential Amino Acids and Exercise Tolerance in Elderly Muscle-Depleted Subjects with Chronic Diseases: A Rehabilitation without Rehabilitation?

    Directory of Open Access Journals (Sweden)

    Roberto Aquilani

    2014-01-01

    Full Text Available Exercise intolerance remains problematic in subjects with chronic heart failure (CHF and/or chronic obstructive pulmonary disease (COPD. Recent studies show that supplemented essential amino acids (EAAs may exert beneficial effects on CHF/COPD physical capacity. The results from 3 investigations (2 conducted on CHF and 1 on COPD subjects served as the basis for this paper. The 3 studies consistently showed that elderly CHF and COPD improved exercise intolerance after 1–3 months of EAA supplementation (8 g/d. In CHF exercise capacity increased 18.7% to 23% (watts; bicycle test, and 12% to 22% (meters in 6 min walking test. Moreover, patients reduced their resting plasma lactate levels (by 25% and improved tissue insulin sensitivity by 16% (HOMA index. COPD subjects enjoyed similar benefits as CHF ones. They increased physical autonomy by 78.6% steps/day and decreased resting plasma lactate concentrations by 23%. EAA mechanisms explaining improved exercise intolerance could be increases in muscle aerobic metabolism, mass and function, and improvement of tissue insulin sensitivity (the latter only for the CHF population. These mechanisms could be accounted for by EAA’s intrinsic physiological activity which increases myofibrils and mitochondria genesis in skeletal muscle and myocardium and glucose control. Supplemented EAAs can improve the physical autonomy of subjects with CHF/COPD.

  7. Are Pulley Exercises Initiated 6 Weeks After Rotator Cuff Repair a Safe and Effective Rehabilitative Treatment? A Randomized Controlled Trial.

    Science.gov (United States)

    Baumgarten, Keith M; Osborn, Roy; Schweinle, Will E; Zens, Matthew J; Helsper, Elizabeth A

    2016-07-01

    There are few level 1 or 2 evidence studies that examine rehabilitation after rotator cuff repair. Pulleys have been used in postoperative shoulder rehabilitation with the intention of improving range of motion and developing strength. There is a concern that the use of pulleys in rehabilitation of rotator cuff repairs may contribute to excessive scapular motion (scapular substitution) and potentially inferior outcomes. Rotator cuff repair patients treated with pulley exercises would have increased scapular substitution and inferior patient-determined outcome scores, range of motion, and strength compared with patients treated with an alternative rehabilitation program without pulleys. Randomized controlled trial; Level of evidence, 1. A total of 27 patients who underwent rotator cuff repair were randomized to a rehabilitation group that used pulleys initiated 6 weeks postoperatively, and 26 patients followed a rehabilitation protocol without pulleys. Inclusion criteria were patients undergoing arthroscopic rotator cuff repair. Exclusion criteria were large to massive rotator cuff tears, revision rotator cuff repair, glenohumeral osteoarthritis, adhesive capsulitis, and a symptomatic contralateral shoulder. Outcomes of intervention were patient-determined outcome scores (Western Ontario Rotator Cuff Index [WORC], American Shoulder and Elbow Surgeons [ASES] Shoulder Score, Single Assessment Numeric Evaluation [SANE], Shoulder Activity Level, and Simple Shoulder Test [SST]), range of motion, scapular substitution, and strength. Outcomes were determined at 6, 12, 18, 26, and 52 weeks. A power analysis determined that 22 patients were needed per group to have a power of 0.80, α = 0.05, and effect size of f = 0.5. Both groups had statistically significant improvements in WORC, ASES Shoulder Score, SST, and SANE scores over time after rotator cuff repair (P pulleys does not result in inferior outcomes, as determined by patient-determined outcome scores, measurements of

  8. Exerciser for rehabilitation of the Arm (ERA): Development and unique features of a 3D end-effector robot.

    Science.gov (United States)

    Milot, Marie-Helene; Hamel, Mathieu; Provost, Philippe-Olivier; Bernier-Ouellet, Julien; Dupuis, Maxime; Letourneau, Dominic; Briere, Simon; Michaud, Francois

    2016-08-01

    Stroke is one of the leading causes of disability worldwide. Consequently, many stroke survivors exhibit difficulties undergoing voluntary movement in their affected upper limb, compromising their functional performance and level of independence. To minimize the negative impact of stroke disabilities, exercises are recognized as a key element in post-stroke rehabilitation. In order to provide the practice of exercises in a uniform and controlled manner as well as increasing the efficiency of therapists' interventions, robotic training has been found, and continues to prove itself, as an innovative intervention for post-stroke rehabilitation. However, the complexity as well as the limited degrees of freedom and workspace of currently commercially available robots can limit their use in clinical settings. Up to now, user-friendly robots covering a sufficiently large workspace for training of the upper limb in its full range of motion are lacking. This paper presents the design and implementation of ERA, an upper-limb 3-DOF force-controlled exerciser robot, which presents a workspace covering the entire range of motion of the upper limb. The ERA robot provides 3D reaching movements in a haptic virtual environment. A description of the hardware and software components of the ERA robot is also presented along with a demonstration of its capabilities in one of the three operational modes that were developed.

  9. The European Association of Preventive Cardiology Exercise Prescription in Everyday Practice and Rehabilitative Training (EXPERT) tool: A digital training and decision support system for optimized exercise prescription in cardiovascular disease. Concept, definitions and construction methodology.

    OpenAIRE

    Hansen, Dominique; Dendale, Paul; Coninx, Karin; Vanhees, Luc; Piepoli, Massimo F.; Niebauer, Josef; Cornelissen, Veronique; Pedretti, Roberto; Geurts, Eva; Rovelo Ruiz, Gustavo; Corra, U.; Schmid, Jean-Paul; Greco, Eugenio; Davos, Constantinos; Edelmann, Frank

    2017-01-01

    Background Exercise rehabilitation is highly recommended by current guidelines on prevention of cardiovascular disease, but its implementation is still poor. Many clinicians experience difficulties in prescribing exercise in the presence of different concomitant cardiovascular diseases and risk factors within the same patient. It was aimed to develop a digital training and decision support system for exercise prescription in cardiovascular disease patients in clinical practice: the European A...

  10. Exercise Training Workloads Upon Exit From Cardiac Rehabilitation in Men and Women: THE HENRY FORD HOSPITAL EXPERIENCE.

    Science.gov (United States)

    Keteyian, Steven J; Kerrigan, Dennis J; Ehrman, Jonathan K; Brawner, Clinton A

    2017-07-01

    To describe exercise training workloads, estimated as metabolic equivalents of task (METs) both upon exit from cardiac rehabilitation (CR) and as the change in MET level following CR, stratified by age, sex, initial MET level, number of sessions completed, and qualifying event at entry into CR. A retrospective study involving 8319 (31% female) patients who completed ≥9 exercise training sessions in the early outpatient CR program at Henry Ford Hospital. Exercise training MET levels achieved during CR were estimated on the basis of the speed and grade recorded from a treadmill. Exercise training METs at the start of CR were defined as the average of the second and third sessions, whereas MET level upon exit from CR was determined from the average of the last 2 patient encounters. The overall mean MET level while training just prior to exit from CR was 3.9 ± 1.4 (4.1 ± 1.4 and 3.3 ± 1.0 in men and women, respectively). The mean change in METs after CR was 1.3 ± 1.1 (+45% ± 37%) and 0.9 ± 0.7 (+40% ± 32%) in men and women, respectively. In a large and demographically diverse cohort of patients who participated in CR, increases in mean workload (ie, METs) during exercise training were observed that approximated 45% in men and 40% in women. These data could be considered when establishing benchmarks for program-related performance outcome measures.

  11. Effects of a program of cognitive-behavioural group therapy, vestibular rehabilitation, and psychoeducational explanations on patients with dizziness and no quantified balance deficit, compared to patients with dizziness and a quantified balance deficit.

    Science.gov (United States)

    Schmid, D A; Allum, J H J; Sleptsova, M; Gross, S; Gaab, J; Welge-Lüssen, A; Schaefert, R; Langewitz, W

    2018-02-01

    We examined whether a program combining cognitive-behavioural therapy (CBT), vestibular rehabilitation (VR) and psychoeducation is equally effective in improving psychometric measures in patients with dizziness independent of a balance deficit. Measures of patients with dizziness only (DO) were compared to those of patients also having a quantified balance deficit (QBD). 32 patients (23 female, 9 male) with persistent dizziness were analysed as 2 groups based on stance and gait balance control: those with QBD (pathological balance) or DO (normal balance). Dizziness Handicap Inventory (DHI) and Brief Symptom Inventory (BSI) questionnaires were used pre- and post-therapy to assess psychometric measures. Patients then received the same combination therapy in a group setting. The QBD group mean age was 60.6, SD 8.3, and DO group mean age 44.8, SD 12.1, years. Pre-therapy, questionnaire scores were pathological but not different between groups. Balance improved significantly for the QBD group (p=0.003) but not for the DO group. DHI and BSI scores improved significantly in the DO group (0.001VR, and psychoeducation improves psychological measures in DO patients but not significantly in QBD patients, despite their balance control improving to near normal. Possibly, greater focus on phobic anxiety during the group therapy program would have improved psychological measures of QBD patient. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Design and methods of the Gentle Cardiac Rehabilitation Study--A behavioral study of tai chi exercise for patients not attending cardiac rehabilitation.

    Science.gov (United States)

    Salmoirago-Blotcher, Elena; Wayne, Peter; Bock, Beth C; Dunsiger, Shira; Wu, Wen-Chih; Stabile, Loren; Yeh, Gloria

    2015-07-01

    Cardiac rehabilitation (CR) programs reduce overall and cardiovascular mortality in patients with a history of acute coronary events or revascularization procedures, but only 30% of patients enroll in CR and attrition rates reach up to 60%. Tai chi, a mind-body practice based on light/moderate aerobic exercise accompanied by meditative components could be a possible exercise option for patients who do not attend CR. Sixty patients will be randomized to a "LITE" condition (one tai chi session twice weekly for 12 weeks) or to a "PLUS" condition (one tai chi session 3 times weekly for 12 weeks, followed by maintenance classes 1-2 times weekly for an additional 12 weeks). Measurements will be conducted at baseline, 3-, 6-, and 9 months after enrollment. The primary outcome is to determine the feasibility, acceptability and safety of each dose. Secondary outcomes include estimates of effect size of each dose on accelerometry-assessed physical activity; the proportion of patients meeting current recommendations for physical activity; and measures of fitness, quality of life, body weight, and sleep. In addition, we will collect exploratory information on possible mediators (exercise self-efficacy, perceived social support, resilience, mindfulness, and depression). Findings from this pilot study will provide preliminary indications about the usefulness of tai chi as an exercise option for patients not attending traditional CR programs. Results will also shed light on the possible mechanisms by which tai chi practice may improve overall physical activity among patients with atherosclerotic coronary heart disease. Copyright © 2015 Elsevier Inc. All rights reserved.

  13. Evaluation of functional and neuromuscular changes after exercise rehabilitation for low back pain using a Swiss ball: a pilot study.

    Science.gov (United States)

    Marshall, Paul W M; Murphy, Bernadette A

    2006-09-01

    The purpose of this pilot study was to use a multidimensional model to evaluate deficits in patients with low back pain (LBP) over the course of a 12-week rehabilitation program using the Swiss ball. A within-subjects, repeated-measures design based at the University exercise training clinic was used. Twenty patients with chronic nonspecific LBP (12 men, 8 women; symptom duration, 4.8 years; 38.8 +/- 12.1 years old; height, 1.76 +/- 0.06 m; weight, 76.15 +/- 7.21 kg) participated in this study. Self-report measures were the Oswestry Disability Index, Visual Analog Scale, Medical Outcomes 12-Item Short Form Health Survey, and Self-Efficacy For Exercise Scale. Physiologic measures were electromyography measurement of feedforward muscle activation, flexion relaxation phenomenon, myoelectric fatigue, endurance capacity measured by the Sorenson test, and a modified sit-up test. Individuals performed 12 weeks of progressive exercise periodized every 4 weeks using a Swiss ball. Outcome measures were assessed at baseline, 4 weeks, 8 weeks, 12 weeks, and at a 3-month follow-up. Repeated-measures analysis for variance for time differences and regression analysis for variance in Oswestry scores were performed. The Oswestry score for self-reported disability significantly decreased over the intervention (F(4,14) = 19.456, P Swiss ball may be successfully used in a rehabilitation context for patients with LBP. This pilot study has used a novel approach to assess improvements during a rehabilitation program, which may be used in the future to explain differences between different treatment modalities.

  14. Efficacy of exercise training in symptomatic patients with hypertrophic cardiomyopathy: results of a structured exercise training program in a cardiac rehabilitation center.

    Science.gov (United States)

    Klempfner, Robert; Kamerman, Tamir; Schwammenthal, Ehud; Nahshon, Amira; Hay, Ilan; Goldenberg, Ilan; Dov, Freimark; Arad, Michael

    2015-01-01

    Recent data suggest that exercise training (ET) confers significant symptomatic and functional improvements in patients with diastolic dysfunction, and thus may be beneficial in patients with hypertrophic cardiomyopathy (HCM). However, there are no data regarding the safety or efficacy of ET in HCM patients. A prospective non-randomized intervention design was used. We enrolled 20 patients with symptomatic HCM, significantly limited in everyday activity, into a supervised cardiac rehabilitation exercise program. Patients were 62 ± 13 years old, in New York Heart Association (NYHA) functional class II (35%) or III (65%), had a mean interventricular septum dimension of 17 ± 5 mm and left ventricular ejection fraction (LVEF) of 53 ± 15%. Left ventricular outflow gradient was present at rest in nine patients (mean 51 ± 24 mm Hg) and six patients had an implantable defibrillator. Exercise prescription was based on heart rate reserve (HRR) determined from a symptom-limited graded exercise stress test. Exercise intensity was gradually increased from 50% to 85% of the HRR over the training period. Patients completed an average of 41 ± 8 hours of aerobic ET. No adverse events or sustained ventricular arrhythmias occurred during the training program. Functional capacity, assessed by a graded exercise test, improved from 4.7 ± 2.2 to 7.2 ± 2.8 metabolic equivalents (METs) (p = 0.01). NYHA functional class improved from baseline by ≥ 1 grade in 10 patients (50%) and none experiencing deterioration during follow-up. The present study suggests that patients with HCM who remain symptomatic despite medical therapy may achieve considerable functional improvement through a supervised ET program. © The European Society of Cardiology 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  15. Impact of Cardiac Rehabilitation and Exercise Training on Psychological Risk Factors and Subsequent Prognosis in Patients With Cardiovascular Disease.

    Science.gov (United States)

    Lavie, Carl J; Menezes, Arthur R; De Schutter, Alban; Milani, Richard V; Blumenthal, James A

    2016-10-01

    The role of psychological risk factors has been under-recognized in most subspecialties of medicine, as well as in general medicine practices. However, considerable evidence indicates that psychosocial factors are involved in the pathogenesis and progression of cardiovascular disease (CVD). Emerging data from cardiac rehabilitation (CR) settings and CR exercise training (CRET) programs have demonstrated the value of comprehensive CRET to improve psychological functioning and reduce all-cause mortality. Recent evidence also supports the role of CRET and the added value of stress management training in the secondary prevention of CVD. Copyright © 2016 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

  16. Efficacy of a respiratory rehabilitation exercise training package in hospitalized elderly patients with acute exacerbation of COPD: a randomized control trial.

    Science.gov (United States)

    Liao, Lin-Yu; Chen, Kuei-Min; Chung, Wei-Sheng; Chien, Jung-Yien

    2015-01-01

    NCT02329873. Acute exacerbation (AE) of COPD is characterized by a sudden worsening of COPD symptoms. Previous studies have explored the effectiveness of respiratory rehabilitation for patients with COPD; however, no training program specific to acute exacerbation in elderly patients or unstable periods during hospitalization has been developed. To evaluate the effects of a respiratory rehabilitation exercise training package on dyspnea, cough, exercise tolerance, and sputum expectoration among hospitalized elderly patients with AECOPD. A randomized control trial was conducted. Pretest and posttest evaluations of 61 elderly inpatients with AECOPD (experimental group n=30; control group n=31) were performed. The experimental group received respiratory rehabilitation exercise training twice a day, 10-30 minutes per session for 4 days. The clinical parameters (dyspnea, cough, exercise tolerance, and sputum expectoration) were assessed at the baseline and at the end of the fourth day. All participants (median age =70 years, male =60.70%, and peak expiratory flow 140 L) completed the study. In the patients of the experimental group, dyspnea and cough decreased and exercise tolerance and sputum expectoration increased significantly compared with those of the patients in the control group (all Prespiratory rehabilitation exercise training package reduced symptoms and enhanced the effectiveness of the care of elderly inpatients with AECOPD.

  17. The effect of Sub-maximal exercise-rehabilitation program on cardio-respiratory endurance indexes and oxygen pulse in patients with spastic cerebral palsy

    Directory of Open Access Journals (Sweden)

    M Izadi

    2006-05-01

    Full Text Available Background: Physical or cardio-respiratory fitness are of the best important physiological variables in children with cerebral palsy (CP, but the researches on exercise response of individuals with CP are limited. Our aim was to determine the effect of sub-maximal rehabilitation program (aerobic exercise on maximal oxygen uptake, oxygen pulse and cardio- respiratory physiological variables of children with moderate to severe spastic cerebral palsy diplegia and compare with able-bodied children. Methods: In a controlled clinical trial study, 15 children with diplegia spastic cerebral palsy, were recruited on a voluntarily basis (experimental group and 18 subjects without neurological impairments selected as control group. In CP group, aerobic exercise program performed on the average of exercise intensity (144 beat per minute of heart rate, 3 times a week for 3 months. The time of each exercise session was 20-25 minutes. Dependent variables were measured in before (pretest and after (post test of rehabilitation program through Mac Master Protocol on Tantories cycle ergometer in CP group and compared with the control group. Results: The oxygen pulse (VO2/HR during ergometery protocol was significantly lower in CP group than normal group (P<0.05. No significant statistical difference in maximal oxygen uptake (VO2 max was found between groups. The rehabilitation program leads to little increase of this variable in CP group. After sub-maximal exercise in pretest and post test, the heart rate of patient group was greater than control group, and aerobic exercise leads to significant decrease in heart rate in CP patients(P<0.05. Conclusion: The patients with spastic cerebral palsy, because of high muscle tone, severe spasticity and involuntarily movements have higher energy cost and lower aerobic fitness than normal people. The rehabilitation exercise program can improve physiological function of muscle and cardio-respiratory endurance in these

  18. Effects of proprioceptive exercises on pain and function in chronic neck- and low back pain rehabilitation: a systematic literature review.

    Science.gov (United States)

    McCaskey, Michael A; Schuster-Amft, Corina; Wirth, Brigitte; Suica, Zorica; de Bruin, Eling D

    2014-11-19

    Proprioceptive training (PrT) is popularly applied as preventive or rehabilitative exercise method in various sports and rehabilitation settings. Its effect on pain and function is only poorly evaluated. The aim of this systematic review was to summarise and analyse the existing data on the effects of PrT on pain alleviation and functional restoration in patients with chronic (≥ 3 months) neck- or back pain. Relevant electronic databases were searched from their respective inception to February 2014. Randomised controlled trials comparing PrT with conventional therapies or inactive controls in patients with neck- or low back pain were included. Two review authors independently screened articles and assessed risk of bias (RoB). Data extraction was performed by the first author and crosschecked by a second author. Quality of findings was assessed and rated according to GRADE guidelines. Pain and functional status outcomes were extracted and synthesised qualitatively and quantitatively. In total, 18 studies involving 1380 subjects described interventions related to PrT (years 1994-2013). 6 studies focussed on neck-, 12 on low back pain. Three main directions of PrT were identified: Discriminatory perceptive exercises with somatosensory stimuli to the back (pPrT, n=2), multimodal exercises on labile surfaces (mPrT, n=13), or joint repositioning exercise with head-eye coordination (rPrT, n=3). Comparators entailed usual care, home based training, educational therapy, strengthening, stretching and endurance training, or inactive controls. Quality of studies was low and RoB was deemed moderate to high with a high prevalence of unclear sequence generation and group allocation (>60%). Low quality evidence suggests PrT may be more effective than not intervening at all. Low quality evidence suggests that PrT is no more effective than conventional physiotherapy. Low quality evidence suggests PrT is inferior to educational and behavioural approaches. There are few relevant

  19. The effects of balance and postural stability exercises on spa based rehabilitation programme in patients with ankylosing spondylitis.

    Science.gov (United States)

    Gunay, Selim M; Keser, Ilke; Bicer, Zemzem T

    2017-09-08

    Ankylosing spondylitis (AS) can cause severe functional disorders that lead to loss of balance. The aim of this study was to investigate the effects of balance and postural stability exercises on spa based rehabilitation programme in AS subjects. Twenty-one participants were randomized to the study (n= 11) and control groups (n= 10). Patients balance and stability were assessed with the Berg Balance Scale (BBS), Timed Up and Go (TUG) Test, Single Leg Stance Test (SLST) and Functional Reach Test (FRT). AS spesicied measures were used for assessing to other parameters. The treatment plan for both groups consisted of conventional transcutaneous electrical nerve stimulation (TENS), spa and land-based exercises 5 days per week for 3 weeks. The study group performed exercises based on postural stability and balance with routine physiotherapy practice in thermal water and in exercise room. The TUG, SLST and FUT scores were significantly increased in the study group. In both groups, the BASMI, BASFI, BASDAI and ASQoL scores decreased significantly by the end of the treatment period (pspa based routine approaches can increase the duration of maintaining balance and can improve the benefits of physiotherapy.

  20. Participation in Leisure Activity and Exercise of Chronic Stroke Survivors Using Community-Based Rehabilitation Services in Seongnam City

    Science.gov (United States)

    Yi, Tae Im; Lee, Ko Eun; Ha, Seung A

    2015-01-01

    Objective To clarify how participation in leisure activities and exercise by chronic stroke survivors differs before and after a stroke. Methods Sixty chronic stroke survivors receiving community-based rehabilitation services from a health center in Seongnam City were recruited. They completed a questionnaire survey regarding their demographic characteristics and accompanying diseases, and on the status of their leisure activities and exercise. In addition, their level of function (Korean version of Modified Barthel Index score), risk of depression (Beck Depression Inventory), and quality of life (SF-8) were measured. Results After their stroke, most of the respondents had not returned to their pre-stroke levels of leisure activity participation. The reported number of leisure activities declined from a mean of 3.9 activities before stroke to 1.9 activities post-stroke. In addition, many participants became home-bound, sedentary, and non-social after their stroke. The most common barriers to participation in leisure activities were weakness and poor balance, lack of transportation, and cost. The respondents reported a mean daily time spent on exercise of 2.6±1.3 hours. Pain was the most common barrier to exercise participation. Conclusion Chronic stroke survivors need information on leisure activities and appropriate pain management. PMID:25932420

  1. Cardiac rehabilitation

    Science.gov (United States)

    ... ncbi.nlm.nih.gov/pubmed/25503364 . Balady GJ, Williams MA, Ades PA, et al. Core components of ... ncbi.nlm.nih.gov/pubmed/22070836 . Thompson PD. Exercise-based, comprehensive cardiac rehabilitation. In: Mann DL, Zipes ...

  2. Validation of a mechanism to balance exercise difficulty in robot-assisted upper-extremity rehabilitation after stroke

    Directory of Open Access Journals (Sweden)

    Zimmerli Lukas

    2012-02-01

    Full Text Available Abstract Background The motivation of patients during robot-assisted rehabilitation after neurological disorders that lead to impairments of motor functions is of great importance. Due to the increasing number of patients, increasing medical costs and limited therapeutic resources, clinicians in the future may want patients to practice their movements at home or with reduced supervision during their stay in the clinic. Since people only engage in an activity and are motivated to practice if the outcome matches the effort at which they perform, an augmented feedback application for rehabilitation should take the cognitive and physical deficits of patients into account and incorporate a mechanism that is capable of balancing i.e. adjusting the difficulty of an exercise in an augmented feedback application to the patient's capabilities. Methods We propose a computational mechanism based on Fitts' Law that balances i.e. adjusts the difficulty of an exercise for upper-extremity rehabilitation. The proposed mechanism was implemented into an augmented feedback application consisting of three difficulty conditions (easy, balanced, hard. The task of the exercise was to reach random targets on the screen from a starting point within a specified time window. The available time was decreased with increasing condition difficulty. Ten subacute stroke patients were recruited to validate the mechanism through a study. Cognitive and motor functions of patients were assessed using the upper extremity section of the Fugl-Meyer Assessment, the modified Ashworth scale as well as the Addenbrookes cognitive examination-revised. Handedness of patients was obtained using the Edinburgh handedness inventory. Patients' performance during the execution of the exercises was measured twice, once for the paretic and once for the non-paretic arm. Results were compared using a two-way ANOVA. Post hoc analysis was performed using a Tukey HSD with a significance level of p Results

  3. Kinematic evaluation of patients with total and reverse shoulder arthroplasty during rehabilitation exercises with different loads

    NARCIS (Netherlands)

    de Toledo, Joelly Mahnic; Loss, Jefferson Fagundes; Janssen, Thomas W.; van der Scheer, Jan W.; Alta, Tjarco D.; Willems, W. Jaap; Veeger, DirkJan (H. E. J)

    2012-01-01

    Background: Following shoulder arthroplasty, any well-planned rehabilitation program should include muscle strengthening. However, it is not always clear how different external loads influence shoulder kinematics in patients with shoulder prostheses. The objective of this study was to describe

  4. EXERCISE REHABILITATION IN THE NON-OPERATIVE MANAGEMENT OF ROTATOR CUFF TEARS: A REVIEW OF THE LITERATURE.

    Science.gov (United States)

    Edwards, Peter; Ebert, Jay; Joss, Brendan; Bhabra, Gev; Ackland, Tim; Wang, Allan

    2016-04-01

    The incidence of rotator cuff tears increases with age, with full-thickness rotator cuff tears present in approximately 25% of individuals in their sixties, and more than 50% of those in their eighties. While surgery is considered an effective treatment, recurrent tears at the insertion site are common, especially with degenerative tears, which are frequent in the older population. More recently, there has been increasing interest in exercise rehabilitation and physical therapy as a means to manage partial and full thickness tears of the rotator cuff by addressing weakness and functional deficits. Recent studies have suggested that patients opting for physical therapy have demonstrated high satisfaction, an improvement in function, and success in avoiding surgery. When considering the increasing rate of shoulder surgery and the associated economic and social burden rotator cuff surgery places on both the patient and the health care system, non-surgical management such as physical therapy and exercise may, in selected cases, be a treatment alternative to surgical repair. The purpose of this clinical commentary is to provide an overview of rotator cuff pathology and pathogenesis, and to present an evidence-based case for the role of conservative rehabilitation in the management of rotator cuff injuries. Level 5.

  5. Advantages of exercise in rehabilitation, treatment and prevention of altered morphological features in knee osteoarthritis. A narrative review.

    Science.gov (United States)

    Musumeci, Giuseppe; Loreto, Carla; Imbesi, Rosa; Trovato, Francesca Maria; Di Giunta, Angelo; Lombardo, Claudia; Castorina, Sergio; Castrogiovanni, Paola

    2014-06-01

    Knee osteoarthritis (OA) represents one of the most common causes of disability in the world. It leads to social, psychological and economic costs with financial consequences, also because a further increase is expected. Different knee OA treatments are usually considered in relation to the stage of the disease, such as surgical management and pharmacologic and non-pharmacologic treatments. Treatment should begin with the safest and least invasive one, before proceeding to more invasive, expensive ones. Non-pharmacologic, behavioral treatments of knee OA are recommended not only in rehabilitation but also in prevention because many risk factors, such as excess weight, obesity and joint tissue inflammation, can be monitored and thus prevented. In the present review, we analyze data from the most recent literature in relation to the effects of physical exercise on prevention, therapy and rehabilitation in knee OA. All data suggest that physical exercise is an effective, economical and accessible tool to everyone, in the treatment and prevention of knee OA. The literature search was conducted on PubMed, Scopus and Google Scholar using appropriate keywords in relation to knee osteoarthritis.

  6. Randomized trial of exercise and an online recovery tool to improve rehabilitation outcomes of cancer survivors.

    Science.gov (United States)

    Schwartz, Anna L; Biddle-Newberry, Mary; de Heer, Hendrik Dirk

    2015-05-01

    The purpose of this study was to test the effects of a cancer survivor exercise program and an online recovery awareness program (Restwise) on physical outcomes of aerobic capacity and muscle strength. Randomized controlled trial design. Treasure Valley Family YMCA, Boise, ID. Fifty cancer survivors. Subjects were randomly assigned to the 12-week exercise program or the exercise program and Restwise. Restwise required users to complete daily objective and subjective ratings. Restwise compiles these data to provide individualized feedback recommending the exercise dose to maximize recovery and minimize fatigue. Baseline and posttest measures of physical performance (6-minute walk, 1-repetition maximum of lower and upper body strength). The exercise plus Restwise group demonstrated significant improvements (P exercise-only group demonstrated significant within-group improvement only on the 6-minute walk. The exercise plus Restwise group demonstrated an 18.5% greater improvement in the 6-minute walk, and a 35.2% and 45%, respectively, greater improvement on the leg and chest press than the exercise-only group. However, the between-group differences were not significant. Cancer survivors who use the Restwise online recovery program in conjunction with an exercise program demonstrated minimal clinically important differences compared with other clinical populations on all 3 measures, whereas the exercise-only group had improvements only on the 6-minute walk. Patient adherence to the Restwise program was good, and patients provided positive feedback.

  7. The European Association of Preventive Cardiology Exercise Prescription in Everyday Practice and Rehabilitative Training (EXPERT) tool: A digital training and decision support system for optimized exercise prescription in cardiovascular disease. Concept, definitions and construction methodology.

    Science.gov (United States)

    Hansen, Dominique; Dendale, Paul; Coninx, Karin; Vanhees, Luc; Piepoli, Massimo F; Niebauer, Josef; Cornelissen, Veronique; Pedretti, Roberto; Geurts, Eva; Ruiz, Gustavo R; Corrà, Ugo; Schmid, Jean-Paul; Greco, Eugenio; Davos, Constantinos H; Edelmann, Frank; Abreu, Ana; Rauch, Bernhard; Ambrosetti, Marco; Braga, Simona S; Barna, Olga; Beckers, Paul; Bussotti, Maurizio; Fagard, Robert; Faggiano, Pompilio; Garcia-Porrero, Esteban; Kouidi, Evangelia; Lamotte, Michel; Neunhäuserer, Daniel; Reibis, Rona; Spruit, Martijn A; Stettler, Christoph; Takken, Tim; Tonoli, Cajsa; Vigorito, Carlo; Völler, Heinz; Doherty, Patrick

    2017-07-01

    Background Exercise rehabilitation is highly recommended by current guidelines on prevention of cardiovascular disease, but its implementation is still poor. Many clinicians experience difficulties in prescribing exercise in the presence of different concomitant cardiovascular diseases and risk factors within the same patient. It was aimed to develop a digital training and decision support system for exercise prescription in cardiovascular disease patients in clinical practice: the European Association of Preventive Cardiology Exercise Prescription in Everyday Practice and Rehabilitative Training (EXPERT) tool. Methods EXPERT working group members were requested to define (a) diagnostic criteria for specific cardiovascular diseases, cardiovascular disease risk factors, and other chronic non-cardiovascular conditions, (b) primary goals of exercise intervention, (c) disease-specific prescription of exercise training (intensity, frequency, volume, type, session and programme duration), and (d) exercise training safety advices. The impact of exercise tolerance, common cardiovascular medications and adverse events during exercise testing were further taken into account for optimized exercise prescription. Results Exercise training recommendations and safety advices were formulated for 10 cardiovascular diseases, five cardiovascular disease risk factors (type 1 and 2 diabetes, obesity, hypertension, hypercholesterolaemia), and three common chronic non-cardiovascular conditions (lung and renal failure and sarcopaenia), but also accounted for baseline exercise tolerance, common cardiovascular medications and occurrence of adverse events during exercise testing. An algorithm, supported by an interactive tool, was constructed based on these data. This training and decision support system automatically provides an exercise prescription according to the variables provided. Conclusion This digital training and decision support system may contribute in overcoming barriers in

  8. 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...

  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 training in patients with end-stage renal disease on hemodialysis: comparison of three rehabilitation programs.

    Science.gov (United States)

    Konstantinidou, Erasmia; Koukouvou, Georgia; Kouidi, Evangelia; Deligiannis, Asterios; Tourkantonis, Achilleas

    2002-01-01

    Functional capacity of end-stage renal disease patients is dramatically impaired. Although exercise training programs appear to have beneficial morphological, functional and psychosocial effects in end-stage renal disease patients on hemodialysis (HD), the adherence rate is high. The purpose of this study was to compare the effects of three modes of exercise training on aerobic capacity and to identify the most favourable, efficient and preferable to patients on HD with regard to functional improvements and participation rate in the programs. Fifty-eight volunteer patients were screened for low-risk status and selected from the dialysis population. The 48 patients who completed the study protocol were randomly assigned either to one of the three training groups or to a control group. Sixteen of them (Group A - mean age 46.4+/-13.9 years) completed a 6-month supervised outpatient exercise renal rehabilitation program consisting of three weekly sessions of aerobic and strengthening training on the non-dialysis days; 10 (Group B - mean age 48.3+/-12.1 years) completed a 6-month exercise program during HD; 10 (Group C - mean age 51.4+/-12.5 years) followed an unsupervised moderate exercise program at home, and 12 patients (Group D-mean age 50.2+/-7.9 years) were used as patient controls. The level of anemia, the medications and the HD prescription remained stable during the study. Fifteen sex- and age-matched sedentary individuals (Group E - mean age 46.9+/-6.4 years) comprised a healthy control group for baseline data. All subjects at the beginning and end of the study underwent clinical examination, laboratory tests and a treadmill exercise test to fatigue endpoints with direct measurement of aerobic capacity. Group A had a higher dropout rate (24%) compared to groups B (17%) and C (17%). Peak oxygen consumption (VO2 peak) increased by 43% (p exercise time by 33% (p exercise training on non-dialysis days is the most effective way of training, whereas exercise during

  11. Rotator Cuff Exercises

    Science.gov (United States)

    ... Home Prevention and Wellness Exercise and Fitness Injury Rehabilitation Rotator Cuff Exercises Rotator Cuff Exercises Share Print Rotator Cuff ... Best Rotator Cuff ExercisesNational Institutes of Health: MedlinePlus, ... and WellnessTags: Exercise Prescription, prevention, Shoulder Problems, ...

  12. EFFECT OF SUPERVISED MODERATE INTENSITY EXERCISE PROGRAM IN PHASE ONE CARDIAC REHABILITATION OF POST OPERATIVE CABG PATIENTS - A RANDOMIZED CONTROLLED TRAIL

    Directory of Open Access Journals (Sweden)

    Rajan Modi

    2014-10-01

    Full Text Available Background: With the increasing number of cases for CABG, the cardiac rehabilitation has gained importance. The trends in rehabilitation of a coronary artery disease patient are changing by incorporating a variety of aerobic exercises and resisted training in to their rehabilitation program. The outcome of any exercise chiefly depends on the training parameters like intensity, frequency and duration. Hence the present study focused to know the effects of supervised moderate intensity exercises on patients during hospital discharge following CABG. The objective of is to study the effectiveness of supervised moderate intensity exercise on distance walked and Quality of Life at hospital discharge following CABG. Methods: Study recruited randomly 46 patients between age group 40-65 years who were posted for non-emergency CABG for the first time. Pre-operative assessment was done thoroughly and was divided in to two groups, Group A conventional treatment and Group B Moderate intensity exercise group. The patients were treated using different protocols in terms of intensity for 8-10 days immediate post CABG. Then the outcome parameters of 6MWT and sf-36 were compared for analysis. Results: Both groups individually showed extremely significant results for two outcome measures. 6 MWD difference between two treatment groups showed significant results with unpaired t test (t = 8.5720,p<0.001. Quality of life score difference within group showed very significant results but there is no difference found between both groups. Conclusion: Moderate intensity exercises can also be included in the immediate post-operative phase of CABG, as they reduce the length of hospital stay and quicken the cardiac rehabilitation process. But there need to be a lot of randomized control trails to confirm the benefits of moderate intensity exercises in phase one rehabilitation program after CABG.

  13. Effects of pulmonary rehabilitation on exercise capacity in patients with COPD: A number needed to treat study

    Directory of Open Access Journals (Sweden)

    Gian Galeazzo Riario-Sforza

    2009-08-01

    Full Text Available Gian Galeazzo Riario-Sforza1, Cristoforo Incorvaia1, Fulvia Paterniti1, Laura Pessina1, Roberta Caligiuri1, Chiara Pravettoni1, Fabiano Di Marco2, Stefano Centanni21Pulmonary Rehabilitation, Istituti Clinici di Perfezionamento, Milan, Italy; 2Unit of Respiratory Medicine, University of Milan, San Paolo Hospital, Milan, ItalyBackground: Pulmonary rehabilitation (PR is recognized as an evidence-based treatment in improving dyspnea and quality of life in patients with COPD. We evaluated the number needed to treat (NNT to achieve an increase in physical capacity, as defined by a significant improvement in the six-minute walk test (6MWT in patients with COPD undergoing PR.Methods: The study enrolled 284 patients aged 41 to 86 years (mean age 69.4 years divided into two groups: a study group (222 patients undergoing a PR program, and a control group (62 patients treated only with drugs. The study group included patients with COPD divided in four subgroups according to GOLD stages.Results: In the study group, 142 out of 222 patients (64% had an increase of at least 54 m in the 6MWT following PR versus 8 out of 62 patients (13% in the control group after the same time interval. The NNT in the overall study group was 2; the same NNT was obtained in GOLD stages 2, 3, and 4, but was 8 in stage 1.Conclusions: PR is highly effective in improving the exercise capacity of patients with COPD, as demonstrated by a valuable NNT, with better results in patients with a more severe disease.Keywords: chronic obstructive lung disease, exercise capacity, number needed to treat, pulmonary rehabilitation, six-minute walk test

  14. Visual dependency and dizziness after vestibular neuritis.

    Directory of Open Access Journals (Sweden)

    Sian Cousins

    Full Text Available Symptomatic recovery after acute vestibular neuritis (VN is variable, with around 50% of patients reporting long term vestibular symptoms; hence, it is essential to identify factors related to poor clinical outcome. Here we investigated whether excessive reliance on visual input for spatial orientation (visual dependence was associated with long term vestibular symptoms following acute VN. Twenty-eight patients with VN and 25 normal control subjects were included. Patients were enrolled at least 6 months after acute illness. Recovery status was not a criterion for study entry, allowing recruitment of patients with a full range of persistent symptoms. We measured visual dependence with a laptop-based Rod-and-Disk Test and severity of symptoms with the Dizziness Handicap Inventory (DHI. The third of patients showing the worst clinical outcomes (mean DHI score 36-80 had significantly greater visual dependence than normal subjects (6.35° error vs. 3.39° respectively, p = 0.03. Asymptomatic patients and those with minor residual symptoms did not differ from controls. Visual dependence was associated with high levels of persistent vestibular symptoms after acute VN. Over-reliance on visual information for spatial orientation is one characteristic of poorly recovered vestibular neuritis patients. The finding may be clinically useful given that visual dependence may be modified through rehabilitation desensitization techniques.

  15. Patients' preference for exercise setting and its influence on the health benefits gained from exercise-based cardiac rehabilitation

    DEFF Research Database (Denmark)

    Tang, Lars H.; Berg, Selina Kikkenborg; Christensen, Jan

    2017-01-01

    ablation for atrial fibrillation were given the choice to perform a 12-week exercise programme in either a supervised centre-based, or a self-management home-based setting. Exercise capacity and physical and mental health outcomes were assessed for up to 24months after hospital discharge. Outcomes between......% CI: 37% to 53%, p=0.233). At baseline, those who preferred a home-based setting reported better physical health (mean difference in physical component score: 5.0, 95% CI 2.3 to 7.4; p=0.001) and higher exercise capacity (mean between group difference 15.9watts, 95% CI 3.7 to 28.1; p=0.......011). With the exception of the depression score in the Hospital Anxiety and Depression Score (F(3.65), p=0.004), there was no evidence of a significant difference in outcomes between settings. CONCLUSION: The preference of patients to participate in home-based and centre-based exercise programmes appears to be equivalent...

  16. Evaluation and treatment of vestibular dysfunction in children.

    Science.gov (United States)

    Rine, Rose Marie; Wiener-Vacher, Sylvette

    2013-01-01

    The effect of vestibular dysfunction since birth is more debilitating than that attained later in life, and unlike adults, children with vestibular dysfunction since or shortly after birth do not recover function without intervention. The purpose of this report is to provide an overview of the etiology of vestibular dysfunction in children as well as the related impairments, and to describe testing methods and evidence based interventions to ameliorate the vestibular related impairments in children. In recent years, investigations have revealed that vestibular dysfunction is more common in children than previously thought, with consequent impairments in motor development, balance and reading abilities. The dysfunction may be due to central or peripheral lesions, each with distinct presentation of symptoms and test results. Common etiologies and clinical presentation of vestibular dysfunction in children are reviewed; appropriate screening and diagnostic techniques and efficacious medical and rehabilitation interventions are presented. Despite advances in clinical and diagnostic testing of vestibular function in children and infants, testing of vestibular function is not typically done. Comprehensive testing of signs and symptoms is critical for diagnosis and implementation of appropriate interventions.

  17. Exercise performance and differences in physiological response to pulmonary rehabilitation in severe chronic obstructive pulmonary disease with hyperinflation

    Directory of Open Access Journals (Sweden)

    André Luis Pereira de Albuquerque

    2016-04-01

    Full Text Available Objective: Pulmonary rehabilitation (PR improves exercise capacity in most but not all COPD patients. The factors associated with treatment success and the role of chest wall mechanics remain unclear. We investigated the impact of PR on exercise performance in COPD with severe hyperinflation. Methods: We evaluated 22 COPD patients (age, 66 ± 7 years; FEV1 = 37.1 ± 11.8% of predicted who underwent eight weeks of aerobic exercise and strength training. Before and after PR, each patient also performed a six-minute walk test and an incremental cycle ergometer test. During the latter, we measured chest wall volumes (total and compartmental, by optoelectronic plethysmography and determined maximal workloads. Results: We observed significant differences between the pre- and post-PR means for six-minute walk distance (305 ± 78 vs. 330 ± 96 m, p < 0.001 and maximal workload (33 ± 21 vs. 39 ± 20 W; p = 0.02. At equivalent workload settings, PR led to lower oxygen consumption, carbon dioxide production (VCO2, and minute ventilation. The inspiratory (operating rib cage volume decreased significantly after PR. There were 6 patients in whom PR did not increase the maximal workload. After PR, those patients showed no significant decrease in VCO2 during exercise, had higher end-expiratory chest wall volumes with a more rapid shallow breathing pattern, and continued to experience symptomatic leg fatigue. Conclusions: In severe COPD, PR appears to improve oxygen consumption and reduce VCO2, with a commensurate decrease in respiratory drive, changes reflected in the operating chest wall volumes. Patients with severe post-exercise hyperinflation and leg fatigue might be unable to improve their maximal performance despite completing a PR program.

  18. Exercise and rehabilitation delivered through exergames in older adults: An integrative review of technologies, safety and efficacy.

    Science.gov (United States)

    Skjæret, Nina; Nawaz, Ather; Morat, Tobias; Schoene, Daniel; Helbostad, Jorunn Lægdheim; Vereijken, Beatrix

    2016-01-01

    There has been a rapid increase in research on the use of virtual reality (VR) and gaming technology as a complementary tool in exercise and rehabilitation in the elderly population. Although a few recent studies have evaluated their efficacy, there is currently no in-depth description and discussion of different game technologies, physical functions targeted, and safety issues related to older adults playing exergames. This integrative review provides an overview of the technologies and games used, progression, safety measurements and associated adverse events, adherence to exergaming, outcome measures used, and their effect on physical function. We undertook systematic searches of SCOPUS and PubMed databases. Key search terms included "game", "exercise", and "aged", and were adapted to each database. To be included, studies had to involve older adults aged 65 years or above, have a pre-post training or intervention design, include ICT-implemented games with weight-bearing exercises, and have outcome measures that included physical activity variables and/or clinical tests of physical function. Sixty studies fulfilled the inclusion criteria. The studies had a broad range of aims and intervention designs and mostly focused on community-dwelling healthy older adults. The majority of the studies used commercially available gaming technologies that targeted a number of different physical functions. Most studies reported that they had used some form of safety measure during intervention. None of the studies reported serious adverse events. However, only 21 studies (35%) reported on whether adverse events occurred. Twenty-four studies reported on adherence, but only seven studies (12%) compared adherence to exergaming with other forms of exercise. Clinical measures of balance were the most frequently used outcome measures. PEDro scores indicated that most studies had several methodological problems, with only 4 studies fulfilling 6 or more criteria out of 10. Several

  19. Common Vestibular Disorders

    OpenAIRE

    Balatsouras, Dimitrios G

    2017-01-01

    The three most common vestibular diseases, benign paroxysmal positional vertigo (BPPV), Meniere's disease (MD) and vestibular neuritis (VN), are presented in this paper. BPPV, which is the most common peripheral vestibular disorder, can be defined as transient vertigo induced by a rapid head position change, associated with a characteristic paroxysmal positional nystagmus. Canalolithiasis of the posterior semicircular canal is considered the most convincing theory of its pathogenesis and the ...

  20. Design and Development of a Smart Exercise Bike for Motor Rehabilitation in Individuals with Parkinson’s Disease

    Science.gov (United States)

    Mohammadi-Abdar, Hassan; Ridgel, Angela L.; Discenzo, Fred M.; Loparo, Kenneth A.

    2016-01-01

    Recent studies in rehabilitation of Parkinson’s disease (PD) have shown that cycling on a tandem bike at a high pedaling rate can reduce the symptoms of the disease. In this research, a smart motorized bicycle has been designed and built for assisting Parkinson’s patients with exercise to improve motor function. The exercise bike can accurately control the rider’s experience at an accelerated pedaling rate while capturing real-time test data. Here, the design and development of the electronics and hardware as well as the software and control algorithms are presented. Two control algorithms have been developed for the bike; one that implements an inertia load (static mode) and one that implements a speed reference (dynamic mode). In static mode the bike operates as a regular exercise bike with programmable resistance (load) that captures and records the required signals such as heart rate, cadence and power. In dynamic mode the bike operates at a user-selected speed (cadence) with programmable variability in speed that has been shown to be essential to achieving the desired motor performance benefits for PD patients. In addition, the flexible and extensible design of the bike permits readily changing the control algorithm and incorporating additional I/O as needed to provide a wide range of riding experiences. Furthermore, the network-enabled controller provides remote access to bike data during a riding session. PMID:27298575

  1. Effect of different modes of therapy on vestibular and balance dysfunction in Parkinson’s disease

    Directory of Open Access Journals (Sweden)

    Wafaa Abdel-Hay El-Kholy

    2015-07-01

    Conclusions: Since patients with PD receiving physiotherapy in conjunction with medical treatment showed better control of their vestibular and balance functions, efforts should be directed to start physiotherapy including vestibular rehabilitation as early as possible in order to improve balance, thus increasing independence in daily life activities.

  2. The order of exercise during concurrent training for rehabilitation does not alter acute genetic expression, mitochondrial enzyme activity or improvements in muscle function.

    Science.gov (United States)

    MacNeil, Lauren G; Glover, Elisa; Bergstra, T Graham; Safdar, Adeel; Tarnopolsky, Mark A

    2014-01-01

    Concurrent exercise combines different modes of exercise (e.g., aerobic and resistance) into one training protocol, providing stimuli meant to increase muscle strength, aerobic capacity and mass. As disuse is associated with decrements in strength, aerobic capacity and muscle size concurrent training is an attractive modality for rehabilitation. However, interference between the signaling pathways may result in preferential improvements for one of the exercise modes. We recruited 18 young adults (10 ♂, 8 ♀) to determine if order of exercise mode during concurrent training would differentially affect gene expression, protein content and measures of strength and aerobic capacity after 2 weeks of knee-brace induced disuse. Concurrent exercise sessions were performed 3x/week for 6 weeks at gradually increasing intensities either with endurance exercise preceding (END>RES) or following (RES>END) resistance exercise. Biopsies were collected from the vastus lateralis before, 3 h after the first exercise bout and 48 h after the end of training. Concurrent exercise altered the expression of genes involved in mitochondrial biogenesis (PGC-1α, PRC, PPARγ), hypertrophy (PGC-1α4, REDD2, Rheb) and atrophy (MuRF-1, Runx1), increased electron transport chain complex protein content, citrate synthase and mitochondrial cytochrome c oxidase enzyme activity, muscle mass, maximum isometric strength and VO 2peak. However, the order in which exercise was completed (END>RES or RES>END) only affected the protein content of mitochondrial complex II subunit. In conclusion, concurrent exercise training is an effective modality for the rehabilitation of the loss of skeletal muscle mass, maximum strength, and peak aerobic capacity resulting from disuse, regardless of the order in which the modes of exercise are performed.

  3. Acceptability and validity of a home exercise diary used in home-based pulmonary rehabilitation: A secondary analysis of a randomised controlled trial.

    Science.gov (United States)

    Lahham, Aroub; McDonald, Christine F; Mahal, Ajay; Lee, Annemarie L; Hill, Catherine J; Burge, Angela T; Cox, Narelle S; Moore, Rosemary; Nicolson, Caroline; O'halloran, Paul; Gillies, Rebecca; Holland, Anne E

    2018-02-02

    Evaluating adherence to home-based pulmonary rehabilitation (PR) could be challenging due to lack of direct supervision and the complex nature of the rehabilitation model. To measure adherence to home-based PR in the HomeBase trial, participants were encouraged to work towards a goal of at least 30 min of whole-body exercise on most days of the week and report their participation using a home exercise diary. This project aimed to evaluate the acceptability and validity of the home exercise diary. Diary return and completion rates assessed acceptability of the home exercise diary. Home participants underwent physical activity (PA) monitoring using the Sensewear armband during the final week of an 8-week PR. The correlation between self-documented and objective daily exercise minutes was calculated. Objective exercise minutes were defined as bouts of ≥10 min spent in ≥ moderate PA. Differences in self-documented weekly exercise minutes between sufficiently active (≥7000 daily steps) and inactive participants were computed. Diaries were returned by 92% of programme completers. Of those who returned diaries, 72% have completed exercise documentation. Fifteen programme completers underwent PA monitoring [mean age 69 (9) (SD) years, FEV 1 55 (19) %predicted]. A moderate correlation was observed between self-documented and objective mean daily exercise minutes (r = .59, P = .02). Active participants [n = 6, 10 253 (1521) daily steps] documented more exercise (111 min) during week eight compared with inactive participants [n = 9, 2705 (1772) daily steps, P = .002]. The self-documented home exercise diary is an acceptable and valid method to reflect exercise participation during home-based PR. © 2018 John Wiley & Sons Ltd.

  4. The order of exercise during concurrent training for rehabilitation does not alter acute genetic expression, mitochondrial enzyme activity or improvements in muscle function.

    Directory of Open Access Journals (Sweden)

    Lauren G MacNeil

    Full Text Available Concurrent exercise combines different modes of exercise (e.g., aerobic and resistance into one training protocol, providing stimuli meant to increase muscle strength, aerobic capacity and mass. As disuse is associated with decrements in strength, aerobic capacity and muscle size concurrent training is an attractive modality for rehabilitation. However, interference between the signaling pathways may result in preferential improvements for one of the exercise modes. We recruited 18 young adults (10 ♂, 8 ♀ to determine if order of exercise mode during concurrent training would differentially affect gene expression, protein content and measures of strength and aerobic capacity after 2 weeks of knee-brace induced disuse. Concurrent exercise sessions were performed 3x/week for 6 weeks at gradually increasing intensities either with endurance exercise preceding (END>RES or following (RES>END resistance exercise. Biopsies were collected from the vastus lateralis before, 3 h after the first exercise bout and 48 h after the end of training. Concurrent exercise altered the expression of genes involved in mitochondrial biogenesis (PGC-1α, PRC, PPARγ, hypertrophy (PGC-1α4, REDD2, Rheb and atrophy (MuRF-1, Runx1, increased electron transport chain complex protein content, citrate synthase and mitochondrial cytochrome c oxidase enzyme activity, muscle mass, maximum isometric strength and VO 2peak. However, the order in which exercise was completed (END>RES or RES>END only affected the protein content of mitochondrial complex II subunit. In conclusion, concurrent exercise training is an effective modality for the rehabilitation of the loss of skeletal muscle mass, maximum strength, and peak aerobic capacity resulting from disuse, regardless of the order in which the modes of exercise are performed.

  5. Frenulectomy of the tongue and the influence of rehabilitation exercises on the sEMG activity of masticatory muscles.

    Science.gov (United States)

    Tecco, Simona; Baldini, Aberto; Mummolo, Stefano; Marchetti, Enrico; Giuca, Maria Rita; Marzo, Giuseppe; Gherlone, Enrico Felice

    2015-08-01

    This study aimed to assess by surface electromyography (sEMG) the changes in sub-mental, orbicularis oris, and masticatory muscle activity after a lingual frenulectomy. Rehabilitation exercises in subjects with ankyloglossia, characterized by Class I malocclusion, were assessed as well. A total of 24 subjects were selected. Thirteen subjects (mean age 7±2.5years) with Class I malocclusion and ankyloglossia were treated with lingual frenulectomy and rehabilitation exercises, while 11 subjects (mean age 7±0.8years) with normal occlusion and normal lingual frenulum were used as controls. The inclusion criteria for both groups were the presence of mixed dentition and no previous orthodontic treatment. The sEMG recordings were taken at the time of the first visit (T0), and after 1 (T1) and 6months (T2) for the treated group. Recordings were taken at the same time for the control group. Due to the noise inherent with the sEMG recording, special attention was paid to obtain reproducible and standardized recordings. The tested muscles were the masseter, anterior temporalis, upper and lower orbicularis oris, and sub-mental muscles. The sEMG recordings were performed at rest, while kissing, swallowing, opening the mouth, clenching the teeth and during protrusion of the mandible. These recordings were made by placing electrodes in the area of muscle contraction. At T0, the treated group showed different sEMG activity of the muscles with respect to the control group, with significant differences at rest and during some test tasks (pmuscle, from T0 to T2, during maximal voluntary clenching. During swallowing and kissing, the masseter and sub-mental muscles showed a significant increase in their sEMG potentials from T0 to T2. During the protrusion of the mandible, the masseter and anterior temporalis significantly decreased their sEMG activity, while the sub-mental area increased significantly. No significant change was observed in the control group during the follow-up. The s

  6. Long-term effects of physical exercise during rehabilitation in patients with severe burns.

    Science.gov (United States)

    Wurzer, Paul; Voigt, Charles D; Clayton, Robert P; Andersen, Clark R; Mlcak, Ronald P; Kamolz, Lars-P; Herndon, David N; Suman, Oscar E

    2016-09-01

    We have reported that a 12-week exercise program is beneficial for the exercise performance of severely burned children. It is not known, however, whether the beneficial effects remain at 2 years postburn. Severely burned children who received no long-term anabolic drugs were consented to this Institutional Review Board-approved study. Patients chose between a voluntary exercise program (EX-group) and no exercise (NoEX-group) after discharge from the acute burn unit. Peak torque per lean leg mass, maximal oxygen consumption, and percent predicted peak heart rate were assessed. In addition, body mass index percentile and lean body mass index were recorded. Both groups were compared for up to 2 years postburn using mixed multiple analysis of variance. A total of 125 patients with a mean age of 12 ± 4 years were analyzed. Demographics between the EX-group (N = 82) and NoEX-group (N = 43) were comparable. In the EX-group, peak torque per lean leg mass, percent predicted peak heart rate, and maximal oxygen consumption increased significantly with exercise (P Group (P group. There were no significant differences between groups in body mass index percentile, lean body mass index, peak torque per lean leg mass, and maximal oxygen consumption at 24 months postburn. Exercise significantly improves the physical performance of burned children. The benefits are limited to early time points, however, and greatly narrow with further recovery time. Continued participation in exercise activities or a maintenance exercise program is recommended for exercise-induced adaptations to continue. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. The Contribution of Individual Exercise Training Components to Clinical Outcomes in Randomised Controlled Trials of Cardiac Rehabilitation: A Systematic Review and Meta-regression.

    Science.gov (United States)

    Abell, Bridget; Glasziou, Paul; Hoffmann, Tammy

    2017-12-01

    While the clinical benefits of exercise-based cardiac rehabilitation are well established, there is extensive variation in the interventions used within these trials. It is unknown whether variations in individual components of these exercise interventions provide different relative contributions to overall clinical outcomes. This study aims to systematically examine the relationship between individual components of the exercise intervention in cardiac rehabilitation (such as intensity and frequency) and clinical outcomes for people with coronary heart disease. In this systematic review, eligible trials were identified via searches of databases (PubMed, Allied and Complementary Medicine, EMBASE, PEDro, Science Citation Index Expanded, CINAHL, The Cochrane Library, SPORTDiscus) from citation tracking and hand-searching. Studies were included if they were randomised trials of a structured exercise intervention (versus usual care) for participants with coronary heart disease and reported at least one of cardiovascular mortality, total mortality, myocardial infarction or revascularisation outcomes. Each included trial was assessed using the Cochrane Risk of Bias Tool. Authors were also contacted for missing intervention details or data. Random effects meta-analysis was performed to calculate a summary risk ratio (RR) with 95% confidence interval (CI) for the effect of exercise on outcomes. Random effects meta-regression and subgroup analyses were conducted to examine the association between pre-specified co-variates (exercise components or trial characteristics) and each clinical outcome. Sixty-nine trials were included, evaluating 72 interventions which differed markedly in terms of exercise components. Exercise-based cardiac rehabilitation was effective in reducing cardiovascular mortality (RR 0.74, 95% CI 0.65 to 0.86), total mortality (RR 0.90, 95% CI 0.83 to 0.99) and myocardial infarction (RR 0.80, 95% CI 0.70 to 0.92). This effect generally demonstrated no

  8. Vestibular perception following acute unilateral vestibular lesions.

    Directory of Open Access Journals (Sweden)

    Sian Cousins

    Full Text Available Little is known about the vestibulo-perceptual (VP system, particularly after a unilateral vestibular lesion. We investigated vestibulo-ocular (VO and VP function in 25 patients with vestibular neuritis (VN acutely (2 days after onset and after compensation (recovery phase, 10 weeks. Since the effect of VN on reflex and perceptual function may differ at threshold and supra-threshold acceleration levels, we used two stimulus intensities, acceleration steps of 0.5°/s(2 and velocity steps of 90°/s (acceleration 180°/s(2. We hypothesised that the vestibular lesion or the compensatory processes could dissociate VO and VP function, particularly if the acute vertiginous sensation interferes with the perceptual tasks. Both in acute and recovery phases, VO and VP thresholds increased, particularly during ipsilesional rotations. In signal detection theory this indicates that signals from the healthy and affected side are still fused, but result in asymmetric thresholds due to a lesion-induced bias. The normal pattern whereby VP thresholds are higher than VO thresholds was preserved, indicating that any 'perceptual noise' added by the vertigo does not disrupt the cognitive decision-making processes inherent to the perceptual task. Overall, the parallel findings in VO and VP thresholds imply little or no additional cortical processing and suggest that vestibular thresholds essentially reflect the sensitivity of the fused peripheral receptors. In contrast, a significant VO-VP dissociation for supra-threshold stimuli was found. Acutely, time constants and duration of the VO and VP responses were reduced - asymmetrically for VO, as expected, but surprisingly symmetrical for perception. At recovery, VP responses normalised but VO responses remained shortened and asymmetric. Thus, unlike threshold data, supra-threshold responses show considerable VO-VP dissociation indicative of additional, higher-order processing of vestibular signals. We provide evidence of

  9. The effect of rehabilitation exercises on the gait in people with Down syndrome

    National Research Council Canada - National Science Library

    M Marchewka; W Chwała

    2008-01-01

    Objective: The following question was set: Do special exercises decrease disturbances of gait in people with Down syndrome and allow for spacio-temporal parameters closer in values to the variables achieved by healthy people...

  10. Rest and treatment/rehabilitation following sport-related concussion: a systematic review.

    Science.gov (United States)

    Schneider, Kathryn J; Leddy, John J; Guskiewicz, Kevin M; Seifert, Tad; McCrea, Michael; Silverberg, Noah D; Feddermann-Demont, Nina; Iverson, Grant L; Hayden, Alix; Makdissi, Michael

    2017-06-01

    The objective of this systematic review was to evaluate the evidence regarding rest and active treatment/rehabilitation following sport-related concussion (SRC). Systematic review. MEDLINE (OVID), CINAHL (EbscoHost), PsycInfo (OVID), Cochrane Central Register of Controlled Trials (OVID), SPORTDiscus (EbscoHost), EMBASE (OVID) and Proquest DissertationsandTheses Global (Proquest) were searched systematically. Studies were included if they met the following criteria: (1) original research; (2) reported SRC as the diagnosis; and (3) evaluated the effect of rest or active treatment/rehabilitation. Review articles were excluded. Twenty-eight studies met the inclusion criteria (9 regarding the effects of rest and 19 evaluating active treatment). The methodological quality of the literature was limited; only five randomised controlled trials (RCTs) met the eligibility criteria. Those RCTs included rest, cervical and vestibular rehabilitation, subsymptom threshold aerobic exercise and multifaceted collaborative care. A brief period (24-48 hours) of cognitive and physical rest is appropriate for most patients. Following this, patients should be encouraged to gradually increase activity. The exact amount and duration of rest are not yet well defined and require further investigation. The data support interventions including cervical and vestibular rehabilitation and multifaceted collaborative care. Closely monitored subsymptom threshold, submaximal exercise may be of benefit. PROSPERO 2016:CRD42016039570. © 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.

  11. Rehabilitation in patients with chronic respiratory disease other th