The influence of one-time biofeedback electromyography session on the firing order in the pelvic floor muscle contraction in pregnant woman-A randomized controlled trial.

Many women are initially unable to contract the pelvic floor muscles (PFMs) properly, activating other muscle groups before, or instead of, PFM. Numerous authors have proved that biofeedback can be an ideal tool supporting learning of the PFM contraction. However, there is currently a lack of scientific data on how many biofeedback sessions are necessary in this educational process. In this study we aimed at assessing the effects of one-time electromyography (EMG) biofeedback session on the order in which PFM are activated (so called firing order) during conscious contractions in relation to selected synergistic muscles in pregnant, continent women. A randomized controlled trial was conducted in 90 healthy nulliparous women with uncomplicated pregnancies and without diagnosed urinary incontinence. We divided the participants into a biofeedback group (50) and a control group (40). They were, respectively: 30 ± 4 and 30 ± 4 years old, at their 23 ± 5 or 25 ± 7 week of gestation and presented 23 ± 5 or 24 ± 5 kg/m2 BMI value (M + SD). Surface EMG with vaginal probes has been used to assess the PFM firing order in selected tasks: in five 3-s maximal contractions (quick flicks), five 10-s contractions, and in a 60-s contraction (static hold). We used the 1-5 scale, where "1" meant the best score, awarded when PFM was activated first in order. The most important finding of our study is that a single EMG biofeedback substantially improved the PFM contractions in pregnant women. First, when applying one-time biofeedback session, more women maintained correct technique or improved it in the second assessment, compared to the control group (73 vs. 65%). Secondly, using the quantitative and qualitative analysis with the Chi-square McNamara B/C test, in the biofeedback group we observed a statistically significant improvement of PFM firing order in four tasks: in the first quick flicks (p = 0.016), third quick flicks (p = 0.027), fifth quick flicks (p = 0.008), and in the first 10-s contractions (p = 0.046). In the control group we observed better outcome only in one motor task: in the fourth 10-s contraction (p = 0.009). Given the positive effects of a single session of EMG biofeedback on the firing order in the PFM contractions, it should be recommended for pregnant women without urinary incontinence to teach them how to perform PFM exercises correctly.

High-impact aerobics programme supplemented by pelvic floor muscle training does not impair the function of pelvic floor muscles in active nulliparous women: A randomized control trial.

BACKGROUND: We aimed to test the hypothesis that high-impact aerobics programme, combined with pelvic floor muscle training does not impair pelvic floor muscle function in young active women. METHODS: A randomized control trial was conducted among active nulliparous, sport university students (age 23 ±â€Š3 years, mean ±â€ŠSD). Experimental group (n = 13) attended high-impact aerobics programme, supplemented by pelvic floor muscle training with one biofeedback session, for 6 weeks. The control group (n = 19) did not get any intervention. Before and after the experiment, we assessed pelvic floor muscle function in both groups with surface electromyography using vaginal probes. In both groups, we assessed the participants' quality of life related to pelvic floor functions with the Incontinence Impact Questionnaires. RESULTS: We recorded no impairments in neuromuscular activity of pelvic floor muscles and in quality of life in women regularly performing high-impact aerobics. What is even more positive, after 6 weeks, experimental group presented better skills both in contracting and relaxing their pelvic floor muscles, although the pre-post intervention EMG change was not statistically significant. All participants maintained good quality of life related to pelvic floor functions. CONCLUSIONS: High-impact aerobics, supplemented by pelvic floor muscle training can be recommended for active nulliparas.

Functional fitness normative values for elderly polish population.

BACKGROUND: It's really important to measure the actual functional physical fitness of elderly independent living persons from different environments to know the level and rate of decrease may inform about the threat of loss of functional independence, hence the need to monitor and assess the senior's motor realm and adapt to it the appropriate programs and treatments in the care for the elderly person. METHODS: The study involved 5367 people (mean age 69,63 ± 7,06), including 4164 women (mean age 69,55 ± 7,11) and 1203 men (mean age 69,91 ± 6,86) aged 60 to 93 years old. We have measured basic anthropometric features and physical fitness (by using Senior Fitness Test). RESULTS: The average values in individual SFT tests significantly decrease along with age. After age of 80 and 85 there were no sex differences in SFT. The largest deficits concern the dynamic balance and the decrease reaches 69% in men and 62% in women A significantly higher rate of decline in aerobic capacity concerns men (43%) than women (36.9%). A clearly lower rate of loss occurs in the muscular strength of the lower and upper body and does not exceed 30%. CONCLUSIONS: The results are of great clinical importance for the development of effective prevention and gerontological education programs in terms of promoting active lifestyle and successful ageing, at the same time limiting the economic consequences of treatment and hospitalisation.

The beneficial effects of 15 units of high-intensity circuit training in women is modified by age, baseline insulin resistance and physical capacity.

AIM: To investigate the effect of a single and 15 units of high-intensity circuit training (HICT) programme on glucose metabolism, myokines' response and selected genes' expression in women. METHODS: Thirty-three, non-active women (mean age: 38 ±â€¯12) were split into a HICT (n = 20) or a control group (CON, n = 13). The training protocol included three circuits of nine exercises with own body weight as a workload performed 3 times a week for five weeks. The CON group performed HICT twice. Blood samples were taken before, 1 h and 24 h after the first and last unit to determine IGF-1, myostatin, irisin, decorin, HSP27, interleukin-15 concentrations using the ELISA immunoenzymatic method. To evaluate HSPB1, TNF-α and DCN mRNA, real-time PCR was used. Pre- and post-intervention, the oral glucose test and body composition assessment were completed. RESULTS: The following parameters tended to decrease after the 5-week HICT program: insulin and HOMA-IR Training diminished insulin/IGF-1 ratio (51% CI: -63% to -34%) and induced the drop of myostatin concentration but significantly only among middle-aged women and at baseline insulin resistance. CONCLUSION: Obtained data revealed that HICT improved an insulin sensitivity and diminished myostatin concentration among older, insulin-resistant women with lower baseline physical capacity.

Pleomorphic adenoma - the results of a retrospective analysis of 104 patients treated at the Clinical Department of Cranio-Maxillofacial Surgery, Clinic of Otolaryngology and Laryngologic Oncology of the Military Institute of Medicine.

Pleomorphic adenoma, also known as tumor mixtus, is one of the most common types of benign neoplasm of the salivary gland, which presents as a slow growing, painless tumor. Major salivary glands are the typical localization of this neoplasm. It rarely undergoes malignant transformation, however may recur locally post resection. In this study, we present the results of a retrospective analysis of 104 patients treated at the Clinical Department of Cranio-Maxillofacial Surgery, Clinic of Otolaryngology and Laryngologic Oncology of the Military Institute of Medicine between 2004 and 2015 due to pleomorphic adenoma. The study confirmed the parotid gland as the most common location of tumor mixtus. In some cases, the large size of the tumor and its location were the cause of life-threatening complications.

Temporal muscle flap in reconstruction of maxillo-facial tissues.

AIM OF THE STUDY: Presents our experience in reconstruction of postsurgical defects with use of temporal muscle flap. MATERIAL AND METHODS: In the years 1996-2010 we treated 10 patients with malignant neoplasms of maxillo-facial region. Following tumor removal the fascia-muscle flaps of temporal muscle were used for reconstruction. Temporal muscle flaps were applied in 5 cases for reconstructing the defect of eye socket tissue after extensive resections and in the other 5 patients was used for reconstructing the defect of palate following maxillary resections. RESULTS: All the flaps of temporal muscle that were used for reconstructing eye sockets incorporated with no local reaction. In one case of flap applied into the oral cavity for tightly separate from nasal, partial necrosis of flap's edge and oro-nasal fistula occurred. CONCLUSIONS: Fascia-muscular flap of temporal muscle is a simple, easy and effective method of tissue reconstruction in maxillo-facial region following extensive oncologic procedures.

IVRT'/IVRT index is a useful tool for detection of elevated left ventricular filling pressure in patients with preserved ejection fraction.

OBJECTIVE: Deterioration of active relaxation results in prolongation of isovolumteric relaxation time (IVRT), however, when left ventricular filling pressure elevates, mitral valve opens earlier and IVRT shortens. This shortening is not seen when IVRT is measured with tissue Doppler imaging (IVRT'). Then, IVRT' prolongs with the deceleration of active relaxation independent of left ventricular filling pressure. We hypothesized that IVRT' reflects the relaxation rate, thus, the ratio of IVRT' to IVRT may possibly detect left ventricular filling pressure elevation. METHODS: The group of 39 subjects (aged 64 +/- 5 years) with preserved ejection fraction (EF > 50%) underwent combined echocardiographic and hemodynamic examinations. Echocardiographic parameters of mitral inflow and mitral annular motion were correlated with invasive indices of left ventricular relaxation and filling pressure. RESULTS: Time constant of isovolumetric pressure decline (tau) correlated closely with IVRT' (r = 0.73, P < 0.001) but not with early diastolic velocity of mitral annulus (E') (r =-0.207, P = 0.206). The best parameter correlating with M-LVDP was IVRT'/IVRT (r = 0.694, P < 0.001, M-LVDP = 7.7 x IVRT'/IVRT + 5.1). A weaker relation was also noted between the ratio of early mitral peak inflow velocity to early diastolic velocity of mitral annulus (E/E') and M-LVDP (r = 0.469, P < 0.001). The relationships between standard Doppler parameters and left ventricular diastolic pressures were uniformly poor. CONCLUSIONS: The study demonstrated that IVRT' may serve as a surrogate of left ventricular active relaxation. IVRT'/IVRT index may be applied to estimate left ventricular filling pressure.

[Percutaneous transluminal septal myocardial ablation: early results and long-term follow-up]. / Bezposrednie i odlegle wyniki przezskórnej ablacji alkoholowej przegrody miedzykomorowej u chorych z kardiomiopatia przerostowa zawezajaca droge wyplywu.

BACKGROUND: Percutaneous transluminal septal myocardial ablation (PTSMA) is becoming an alternative to surgical myectomy in the treatment of severe, drug refractory, hypertrophic obstructive cardiomyopathy (HOCM). The aim of our study was to analyze early results, complications and long-term follow-up in patients after PTSMA. METHODS: Out of eighteen patients [11 M] initially accepted for PTSMA, the procedure was performed in 12 patients [6 M] age from 22 to 70 y. All the patients underwent clinical evaluation, echocardiography and cardiopulmonary exercise testing (CPX) before the procedure, and after a median of 38 months of observation. In echo-cardiography left ventricle outflow tract gradient (LVOTG) and intraventricular septum diastolic diameter were assessed. The following parameters of CPX were analyzed: exercise duration, anaerobic threshold, peak oxygen consumption, peak exercise heart rate and carbon dioxide ventilating equivalent. RESULTS: The procedure was successful in 11 patient. There were 2 acute complications: 3rd degree AV block requiring peacemaker implantation and LVOTG increase with SAM exacerbation requiring urgent cardiosurgical intervention. During long-term follow-up 1 cerebral stroke and 1 death occurred. PTSMA resulted in significant reduction of left ventricle outflow tract gradient (89 +/- 44 vs. 17 +/- 17 mmHg) and intraventricular septum diastolic diameter (24 +/- 4 vs 18 +/- 5 mm) (p < or = 0.01 for both). We also observed improvement of CPX parameters: exercise duration (487 +/- 268 vs. 730 +/- 292 sec), anaerobic threshold (34.3 +/- 8.9 vs. 53.2 +/- 13.4% VO2max predicted), peak oxygen consumption (18.5 +/- 6 vs. 26.8 +/- 10.1 ml/kg/min), peak exercise heart rate (70.3 +/- 8.3 vs. 83.6 +/- 11.7%) and carbon dioxide ventilating equivalent (31 +/- 6.1 vs. 28 +/- 4.8); (p < or = 0.01 for all). CONCLUSIONS: PTSMA is an effective method of treatment in patients with severe, drug refractory HOCM. PTSMA is safe and is associated with a low percentage of severe complications.