Effects of combined resistance and aerobic training program on myoelectric activity of Vastus Lateralis in patients with breast cancer during adjuvant chemotherapy period.

OBJECTIVE: Chemotherapy and/or radiation are normally the predominant therapies administered to cancer patients. Commonly, patients express complaints of fatigue during adjuvant treatment. Furthermore, regular practice of physical exercise during adjuvant treatment seems to have positive effects. The aim of this study was to investigate the effects of combined muscle strength, and a supervised aerobic training program on myoelectric activity of Vastus Lateralis during isometric test in patients with breast cancer undergoing adjuvant chemotherapy. PATIENTS AND METHODS: Thirty-two women with breast cancer (20 patients in the training group and 12 patients as controls) undergoing adjuvant chemotherapy participated in the study. They took part in a 6-week training period. A muscle-strength program included isometric contraction and electrical muscle stimulation (EMS). Aerobic training program consisted of supervised intermittent cycling exercise and home-based walking exercise. The outcome measures were Root Mean Square (RMS), Mean Power Frequency (MPF), Maximal Voluntary isometric Contraction (MViC), and Endurance Time (ET) of Vastus Lateralis, before and after the training period in the two groups. RESULTS: Compared to controls, a significant increase in MViC (p=0.001) and ET (p=0.005) in quadriceps accompanied by a significant decrease in RMS (p=0.007) and a significant increase in MPF (p=0.002) has been obtained in the training group. CONCLUSIONS: Supervised muscle strength and supervised aerobic training programs enhanced muscle activity and muscular performance in women with breast cancer during adjuvant chemotherapy treatment and optimized the decrease of muscular fatigue.

[Early muscular strengthening after total hip arthroplasty: association of two models of rehabilitation]. / Renforcement musculaire précoce après arthroplastie totale de hanche : association de deux modèles de rééducation.

OBJECTIVE: To assess the effect of combining two rehabilitation models during early-stage muscle reinforcement in patients having undergone total hip arthroplasty (THA). METHODOLOGY: Our study was carried out on a total of 81 unilateral THA patients aged between 61 and 84. Forty-one control group (CG) patients participated in a standard rehabilitation (SR) program, whereas the 40 patients in the test group (TG) performed both SR and isometric exercises with electromyographic feedback. We performed three tests in each group, on the day before surgery (T(1)) and then three days (T(2)) and seven days (T(3)) after surgery. These tests enabled measurement of the integrated electromyographic peak (EMG(ipeak)) for the gluteus medius, the peak voluntary isometric strength (VIS(peak)) of each leg (i.e., both the operated and nonoperated sides) and the operated gluteus medius' maintenance time at 50% of the EMG(ipeak) during isometric exercises with electromyographic feedback. RESULTS: For the operated gluteus medius, the TG's EMG(ipeak) values were similar to those measured in the CG (P>0.05) at T(1) and T(2). Likewise, the VIS(peak) values for the corresponding legs at T(1) and T(2) did not differ significantly. However, at T(3), the EMG(ipeak) of the gluteus medius and the leg VIS(peak) on the operated side increased in both groups and were higher in the TG than in the CG (P<0.001). Compared with the CG, the TG also displayed a longer maintenance time at 50% of the EMG(ipeak) for the operated gluteus medius during isometric exercises with electromyographic feedback. CONCLUSION: This preliminary study showed that a combination of two rehabilitation models leads to faster post-THA recovery than the application of SR alone.

Fatigue and respiratory disorders.

OBJECTIVES: To analyze the factors at the origin of fatigue in respiratory disorders. To assess fatigue and its functional impact on patients affected from respiratory diseases. To evaluate the results of comprehensive care on fatigue and functional capacity. MATERIALS AND METHODS: We systematically reviewed the literature in Medline and the Cochrane Library, using the following keywords: fatigue, respiratory disorders, questionnaire, evaluation, assessment, randomized controlled trial, meta-analysis. RESULTS: Fatigue is a high frequency symptom (90%) and takes an important place, as much as dyspnea, in the genesis of the respiratory induced handicap. Its assessment is varied, according to the studies. It originates from multiple causes, as shown from clinical and experimental studies. The main treatment consists in rehabilitation, using physical exercises. Its efficacy is demonstrated on physical endurance, but is not clear in terms of general fatigue. CONCLUSION: Although fatigue is very frequent complaint, along with a major disabling condition, the comprehensive assessment of fatigue, in respiratory disorders, including its physical and cognitive components, is not still really codified. Rehabilitation is the main treatment. Its efficiency has been demonstrated on the physical and functional components of fatigue. Its results on perceived fatigue remains to be evaluated.

Aerobic capacity and peripheral skeletal muscle function in coronary artery disease male patients.

The aim of this study was to determine if the diminished aerobic capacity of coronary artery disease male (CAD) patients is accompanied by an impaired skeletal muscle function compared to healthy control subjects. Thirteen CAD patients and 9 healthy subjects performed both a maximal laboratory exercise testing and an assessment of the peripheral skeletal muscle function on an isokinetic apparatus. The cardiorespiratory and mechanical parameters were measured at ventilatory threshold and at maximal effort during a maximal exercise testing. The peripheral skeletal muscle function of the quadriceps was assessed from the maximal voluntary isometric force (MVIF) and from the static endurance time (SET) at an intensity of 50 % of the MVIF. The CAD patients showed a diminished aerobic capacity compared to healthy control subjects at maximal effort (maximal VO(2) uptake: p < 0.0001, maximal ventilation: p < 0.01; maximal heart rate: p < 0.0001, maximal power: p < 0.001) but also at VT (VO(2) uptake VT: p < 0.0001, Power VT: p < 0.001). No difference was found on the MVIF (p < 0.90) between the CAD patients and the control subjects whereas the SET was lower in the CAD patients (p < 0.01). The CAD patients had a lower aerobic capacity and an impaired skeletal muscle endurance compared to healthy subjects.

[Percutaneous tenorrhaphy for Achilles tendon rupture. Study of 29 cases]. / Ténorraphie percutanée pour rupture du tendon d'Achille. Etude de 29 cas.

PURPOSE OF THE STUDY: Closed percutaneous repair, described first by Ma and Griffith in 1977, have bridged the gap between surgical and conservative treatment of Achilles tendon rupture. The purpose of this study was to evaluate the results of percutaneous repair. MATERIAL AND METHODS: Between 1994 and 1996, 28 patients (18 male, 10 female) with 29 spontaneous ruptures of the Achilles tendon (one bilateral case) underwent percutaneous repair based on approximation and bringing closer both ends of the ruptured tendon using a subcutaneous suture. Material used was 2 Dacron yarn suture 30 cm length fitted with a 5 mm wide harpon and with its other end crimped into a malleable needle 12 cm length. Early mobilization was encouraged, partial weight bearing allowed at 3 weeks and full weight bearing at 6 weeks. Sutures were removed at 8 weeks without anesthesia. Two patients were lost for follow up after complication, one foreign patient returned to his country with good results, 26 tendons underwent physical examination at an average follow up of 15 months; 20 underwent ultrasound examination and Cybex testing. RESULTS: Two patients experienced reruptures after suture removal; 2 patients fell a few days after repair and had rupture of the suture; both were treated with a cast. There were no infection, skin necrosis, hematoma, neurological injuries, or deep vein thrombosis. Eighteen patients were free of pain, 7 had intermittent pain and one permanent pain. Active and passive ankle motion were similar to the contralateral side. Calf circumference measurements on the repaired and normal extremities showed a difference of less than 3 cm in 4 cases, less than 2 cm in 13 cases and 9 patients had symmetrical calves. The average difference between the width of the repaired and normal tendon was 0.5 cm. Clinical documentation of muscle strength was normal in 9 cases, decreased in 14 cases. Three tendons could not be tested. Using the Trillat and Mounier-Kuhn score, 12 patients were rated excellent; 7 good, 7 fair and 4 poor (4 complications). Ultrasound examination demonstrated homogeneous and fibrilate structure in 10 cases. The width of the tendon was found increased in all cases. The strength, power and endurance testing performed on Cybex at 90 degrees and 180 degrees/second and compared to the normal ankle, averaged 65 p. 100 for plantar flexion. DISCUSSION: Complication rate of operative and conservative treatment were compared to percutaneous repair. The results of Cybex testing points out the advantages of early mobilization after Achilles tendon rupture treatment. Ultrasound examination is useful to guide post operative rehabilitation and sports activities. All patients return to work more quickly after percutaneous repair. CONCLUSION: Percutaneous repair of the Achilles tendon is a simple, easy and reliable technique. It seems to fulfil the required conditions: bringing closer tendon ends, maintenance of strong contact, preservation of all anatomical and histological factors inducing healing and a rapid return to social and working activities.