Treadmill training in Parkinson's patients after deep brain stimulation: Effects on gait kinematic.

OBJECTIVE: The purpose of this study was to evaluate the effect of treadmill training with body weight support on gait kinematics parameters in patients with PD using DBS. DESIGN: Twelve patients completed the protocols (age: 60.9±10.6 years; disease duration: 20±7 years; and time since DBS surgery: 20±4 months). The same set of patients underwent two trainings protocols and four gait analyses (before and after each training). They received eight weeks of treadmill training without body weight support (16 sessions) in conjunction with physiotherapy program followed by six weeks of wash out period, followed by eight weeks of body-weight-supported treadmill training in conjunction with a same physiotherapy program. The Gait Kinematic Analysis involved eight infrared cameras that detected 19 reflective spherical markers attached in limb lower of patients. Statistical analysis used the Wilcoxon test (p≤0.05). RESULTS: Both the training no showed significant differences in linear variables. As the angular variables, only training with support showed significant increase of ranges of motion: pelvis tilt, obliquity and rotation amplitude; hip adduction-abduction and rotation amplitude; percentage of peak flexion in swing phase; foot progression amplitude. CONCLUSION: The body weight supported treadmill training may promote increase of mobility of lower limbs during gait and it could be a targeted intervention for PD patients treated with DBS.

Performance during cardiopulmonary exercise test and quality of life of long-distance elderly runners and of non-exerciser elderly.

AIM: Regular physical exercises are associated to decreased morbidity and mortality, but their relationship with quality of life perception is still not well established. The aim of this paper was to compare cardiopulmonary exercise indicators of functional performance and quality of life (QOL) between a group of untrained elderly (GUE) and a group of trained elderly (GTE) in long-distance running. METHODS: GUE was made up of 19 individuals with mean age of 73.5±6.4 years and GTE by 27 trained elderly with mean age of 73.1±4.3 years. All were submitted to cardiopulmonary and metabolic evaluation by expired gases analysis. Maximum physical capacity was determined on a motor-driven treadmill with continuous graded protocol and fixed slope of 1%. Quality of Life was evaluated in four domains (physical, psychological, social relations and environment) by Whoqol-Bref questionnaire (WHO) and quantified by total score for each domain. RESULTS: At maximal oxygen intake, GUE and GTE presented: VO2max: 27.0±5.4 vs. 38.1±4.5 mL/[kg.min] (P<0.001); O2 pulse: 11.7±3.0 vs. 15.5±2.4 mL/bpm (P<0.001); running speed: 9.7±2.5 vs. 13.8±1.7 km/h (P<0.001) and tolerance time: 9.6±2.9 vs.14.8±4.4 min (P<0.001). QOL measured by Whoqol-Bref questionnaire in four domains for GUE and GTE was respectively: physical: 75.6±13.6 vs. 80.6 ±14.2 (P=0.210), psychological: 79.2±11.3 vs. 79.2±13.8 (P=0.893), social relations: 74.6±14.3 vs. 74.7±19.1 (P=0.726), environment: 61.4±15.9 vs. 69.0±15.5 (P=0.131). CONCLUSION: GTE cardiopulmonary performance was better as compared to GUE, and QOL of the elderly from both groups was not associated to cardiopulmonary exercise test performance.

Aerobic power and muscle strength of individuals living with HIV/AIDS.

AIM: We wished to evaluate any continuing adverse effects upon peak aerobic power and muscle strength associated with either HAART therapy or persistently low CD4⁺ counts in men living with HIV/AIDS. METHODS: We studied 39 HIV/AIDS patients with an average disease history of 6.1 years, and 28 normal sedentary volunteers. All subjects performed tests of peak aerobic power and isokinetic muscle force, and the HIV/AIDS group also completed the Profile of Mood States (POMS) and WHO Quality of Life questionnaires. Blood was sampled for standard measures of immune function (CD4⁺ and CD8⁺ counts) and viral load. RESULTS: Patient values were generally as in the normal subjects and appeared to be uninfluenced by the CD4+ nadir or the use of HAART therapy. However, the isokinetic muscle strength was lower in individuals with a low current CD4⁺ count. Isokinetic strength was also negatively correlated with current CD4⁺ and CD8⁺ counts. CONCLUSION: HAART therapy does not appear to have an adverse long-term effect on either aerobic power or muscle strength. Many ambulatory volunteers living with HIV/AIDS have a normal peak aerobic power. However, isokinetic strength can remain low, particularly in those with low current T-cell counts.

Resistance exercise intensity progression in older men.

Our purpose was to examine possible influences of age on resistance exercise (RE) intensity progression in men. Twenty-four men, divided in young sedentary (YS; n=10; 25.9+/-3.7 years), older sedentary (OS; n=7; 67.4+/-5.2 years), and older runners (OR; n=7; 71.3+/-3.0 years), underwent a 2 times-a-week RE program for 13 weeks. Muscle strength was assessed before and after training by 1-repetition maximum test. RE workloads were recorded for each exercise session, and increases of 5-10% were made whenever adaptation occurred. Muscle strength improved similarly in all groups after RE (P<0.001). Relative RE intensity progression was not significantly different between YS and OS, except for a greater increase in calf raise relative workload observed in YS (P<0.05). In contrast, OR displayed greater relative workload increase in 7 and 6 exercises than YS and OS, respectively (P<0.05). The RE was safe as no injuries or major muscle pain were observed in either group. These results suggest that healthy sedentary older men are capable to exercise and increase RE intensity in the same way as young men, while physically active older men are capable to increase RE intensity in greater way than sedentary young and older men.

Haemodynamic, metabolic and neuro-humoral abnormalities in young normotensive women at high familial risk for hypertension.

We analysed the haemodynamic, metabolic and hormonal status at rest and in response to exercise, in young normotensive women with two hypertensive parents (FH++; n=17; 25.1±4.8 years), one hypertensive parent (FH+; n=18; 24.9±4.1 years) and normotensive parents (FH-; n=15; 25.3±3.8 years). Casual and ambulatorial blood pressure (BP), carotid-femoral pulse wave velocity (PWV) and biochemistry were analysed. BP, nor-epinephrine (NE), epinephrine (EPI), endothelin-1 (ET-1) and nitrite/nitrate (NOx) levels were also analysed during a graded exercise test (GXT). Casual and ambulatorial BP were not different between groups, but PWV was 7.5 and 12.6% higher in FH++ than FH+ and FH-, respectively, and 4.8% higher in FH+ than FH- (P≤0.01). Insulin and insulin-to-glucose ratio were increased in FH++ and FH+ (P<0.05), and low-density lipoprotein (LDL)-cholesterol tended to be higher only in FH++ (P=0.07). FH++ showed higher exercise and recovery diastolic BP and EPI levels, and increased resting, exercise and recovery NE, and ET-1 levels than FH- (P<0.05). FH+ showed only greater resting, exercise and recovery NE, and rest ET-1 (P<0.05). Resting, exercise and recovery NOx were lower in FH++ and FH+ than FH- (P<0.01). Haemodynamic, metabolic and hormonal abnormalities were presented in nonhypertensive young women offspring of hypertensive parents before any increase in BP. Greater abnormalities were observed in women with a strong family history of hypertension (FH++). These results suggest that there is an early vascular, metabolic and hormonal involvement in a familial hypertensive disorder.

[Gait analysis and quality of life evaluation after gait training in patients with spinal cord injury]. / Analisis de la marcha y evaluación de la calidad de vida después del entrenamiento de la marcha en pacientes con lesion medular.

INTRODUCTION: Over recent years it has become possible to retrain motor activity among patients with partial spinal cord injury, especially for walking. AIM. To assess the impact of gait training on a treadmill with body weight support, regarding temporospatial parameters and quality of life. PATIENTS AND METHODS: Twelve patients of both sexes were evaluated. They had been diagnosed with partial spinal cord injury of traumatic origin at least 12 months earlier. They were able to walk and their motor function below the level of the injury was partially preserved and classified as level C or D. After the initial evaluation, the participants were trained on a treadmill with body weight support, with two sessions per week lasting 30 minutes each, over a four-month period, thus totaling 30 sessions. The patients' temporospatial gait parameters and quality of life were analyzed before and after the training. RESULTS: There were improvements in all the temporospatial parameters evaluated (p < 0.0001), but no changes in quality of life were seen (p > 0.05). CONCLUSION: Treadmill training with body weight support among patients with spinal cord injury was effective in improving the temporospatial gait parameters, but without changing their quality of life.

Análisis de la marcha y evaluación de la calidad de vida después del entrenamiento de la marcha en pacientes con lesión medular / Gait analysis and quality of life evaluation after gait training in patients with spinal cord injury

Durante los últimos años ha sido posible rehabilitar la actividad motora en los pacientes con lesiónmedular parcial, especialmente para poder caminar. Objetivo. Evaluar el impacto del entrenamiento de la marcha en una cinta sin fin con soporte del peso corporal con respecto a los parámetros temporoespaciales y la calidad de vida. Pacientes y métodos.Se estudió a 12 pacientes de ambos sexos. Se les había diagnosticado una lesión medular parcial de origen traumático al menos 12 meses antes. Podían caminar, y su función motora por debajo del nivel de la lesión estaba parcialmente preservada y clasificada como nivel C o D. Después de la evaluación inicial, los participantes se entrenaron en una cinta sin fin consoporte del peso corporal, con dos sesiones por semana de 30 minutos de duración cada una, durante un período de cuatro meses, lo que supuso un total de 30 sesiones. Los parámetros temporoespaciales de la marcha y la calidad de vida de los pacientesse analizaron antes y después del entrenamiento. Resultados. Hubo mejoras importantes en todos los parámetros temporoespaciales evaluados (p < 0,0001), pero no se observaron cambios en la calidad de vida (p > 0,05). Conclusión. El entrenamiento en una cinta sin fin con soporte del peso corporal en pacientes con lesión medular fue eficaz a la hora de mejorar los parámetros temporoespaciales de la marcha, pero no se produjeron cambios en su calidad de vida

Over recent years it has become possible to retrain motor activity among patients with partial spinalcord injury, especially for walking. Aim. To assess the impact of gait training on a treadmill with body weight support, regarding temporospatial parameters and quality of life. Patients and methods. Twelve patients of both sexes were evaluated. They had been diagnosed with partial spinal cord injury of traumatic origin at least 12 months earlier. They were able to walkand their motor function below the level of the injury was partially preserved and classified as level C or D. After the initial evaluation, the participants were trained on a treadmill with body weight support, with two sessions per week lasting 30minutes each, over a four-month period, thus totaling 30 sessions. The patients’ temporospatial gait parameters and quality of life were analyzed before and after the training. Results. There were improvements in all the temporospatial parameters evaluated (p < 0.0001), but no changes in quality of life were seen (p > 0.05). Conclusion. Treadmill training with body weightsupport among patients with spinal cord injury was effective in improving the temporospatial gait parameters, but without changing their quality of life

Relação entre a mobilidade do tornozelo e pé e a magnitude da força vertical de reação do solo / Relationship between ankle and foot mobility and the magnitude of the vertical ground reaction force

OBJETIVO: Verificar a relação entre a mobilidade do tornozelo e do pé, e o pico da força vertical de reação do solo, considerada como porcentagem do peso corporal, gerada durante a fase de apoio da marcha. MÉTODOS: foram estudados pés normais do lado direito e esquerdo de 15 homens com 22,1±2,7 anos (19-28) e 15 mulheres 24,20±5,24 anos (19-34). Os parâmetros de exclusão foram: deformidades nos pés, doenças ou traumas, que pudessem acometer o sistema musculoesquelético e a marcha. A mobilidade do tornozelo e dos pés foi obtida através da goniometria da flexão plantar, dorsiflexão, extensão do hálux e extensão dos dedos, o pico da força vertical de reação do solo FRS, foi obtido pela baropodometria computadorizada do sistema FSCAN R. A correlação entre ambas foi feita pelo teste estatístico de Spearman. RESULTADOS: os indivíduos do grupo masculino apresentaram menores valores de mobilidade, e maiores valores do pico da força vertical de reação do solo, quando comparados com o grupo feminino. Não houve diferença entre os pés direito e esquerdo. No sexo feminino foi encontrada correlação negativa estatisticamente significante entre os valores da flexão plantar e a força vertical, e entre os valores da extensão dos dedos e a foça vertical. No sexo masculino, houve correlação negativa estatisticamente significante entre os valores da dorsiflexão e a força vertical. Entre os demais valores não foi encontrada correlação significante. CONCLUSÃO: Há relação entre a mobilidade e a força vertical gerada durante a marcha.

OBJECTIVE: To investigate the relationship between ankle and foot mobility and the peak of the vertical ground reaction force, as a percentage of body weight, generated during the gait stance phase. METHOD: Fifteen men with mean age of 22.1 ± 2.7 years (range: 19-28) and fifteen women with mean age of 24.20 ± 5.24 years (range: 19-34) with normal feet were studied. The exclusion criteria were foot deformities or a history of trauma or diseases that might have harmed both the musculoskeletal system and gait pattern. The ankle and foot mobility was obtained by means of goniometry on the plantar flexion, dorsiflexion, hallux extension and toe extension. The peak of the vertical ground reaction force was obtained by baropodometry using the FSCAN TM system. The Spearman statistical test was used to identify correlations. RESULTS: Males presented lower mobility values and higher peak values for the vertical ground reaction force, in comparison with females. There was no difference between the right and left foot. For females, there were statistically significant negative correlations between the values for plantar flexion and vertical force, and between the values for toe extension and vertical force. For males, there were statistically significant negative correlations between the values for dorsiflexion and vertical force. Among the remaining values, no significant correlation was found. CONCLUSION: There was a relationship between mobility and the vertical force generated during gait.

Avaliacao isocinetica dos inversores e eversores de tornozelo: estudo comparativo entre atletas de futebol e sedentarios normais / Body weight influence on respiratory pressures on sitting supine and upright positions

O objetivo deste trabalho foi avaliar os grupos musculares eversores e inversores do tornozelo e fazer uma comparacao das respostas dinamicas de forca e potencia entre os agonistas e antagonistas quanto a dominancia e pratica de futebol. Metodos: foram avaliados 30 individuos do sexo masculino de 17 a 20 anos, sem lesoes, divididos em dois grupos: 15 atletas (categoria juniores) de futebol, idade 18,4 +- 0,8 anos, peso 65 +- 7,3 kg e altura 1,74 +- 0,05m e 15 nao atletas (grupo controle) com idade de 17,6 +- 0,8 anos, peso 65,8 +- 15kg e altura 1,72 +- 0,1m pela dinamometria isocinetica. Os parametros avaliados foram pico de torque (Newton metros-Nm), trabalho (joules - J) e potencia (watts - W) nas velocidades angulares de 30/s e 120/s. Resultados: a relacao dos grupos musculares agonistas/antagonistas quanto a dominancia e atividade futebolistica nao apresentou diferenca significativa. As relacoes entre os grupos inversores/eversores do tornozelo ficaram proximas de 100 (por cento)