Does CABG with Saphenous Vein Grafting and Standard Cardiac Rehabilitation Affect Lower Limb Function? A Clinical Study.

BACKGROUND: The aim of the study was to assess lower limb function in response to two cardiac rehabilitation (CR) protocols after coronary artery bypass surgery with saphenous vein grafting. METHODS: Clinically-stable male patients aged 50-70 years were recruited 4 weeks post-surgery in which to group. Group I (n = 47) receive standard CR in a hospital setting for 3 weeks and Group II (n = 14) receive CR with a resistance training component in an outpatient setting for 8 weeks. Measures included body mass and composition, lower limb temperature distribution, lower limb hemodynamics, and dorsal and plantar flexor muscle strength. RESULTS: Average temperature of the operated limb decreased only in Group II after cardiac rehabilitation. Venous blood flow improved in both groups as evidenced by increased blood refilling time. Isokinetic strength was greater in Group I. CONCLUSIONS: The results suggest a 3-week intensive CR protocol to be most effective in restoring lower limb function in CABG patients after saphenectomy.

The role of MMP-12 gene polymorphism - 82 A-to-G (rs2276109) in immunopathology of COPD in polish patients: a case control study.

BACKGROUND: Major symptoms of chronic obstructive pulmonary disease (COPD) are chronic bronchitis and emphysema leading from lung tissue destruction, that is an effect of an imbalance between metalloproteinases (MMPs) and their tissue inhibitors activity. As potential factor involved in this COPD pathogenesis, MMP-12 is considered. We investigated the role of genetic polymorphism and protein level of MMP-12 in the COPD development among Poles. METHODS: We analyzed - 82 A > G SNP in the promoter region of MMP-12 gene (rs2276109) among 335 smoked COPD patients and 309 healthy individuals, including 110 smokers. Additionally, 60 COPD patients and 61 controls (23 smokers) were tested for serum levels of MMP-12 using ELISA. All subjects were analyzed for lung function using spirometry (FEV1% and FEV1/FVC parameters). RESULTS: We observed that -82G allele and -82GG homozygous genotype frequencies of the SNP rs2276109 were significantly lower in COPD patients than in controls (12.5% vs 16.9%, respectively; χ2 = 4.742, p = 0.02 for allele and 0.5% vs 3.9%, respectively; χ2 = 9.0331, p = 0.01 for genotype). Moreover, -82G allele was more frequent in controls smokers than in non-smokers (22.3% vs 14.1%, χ2 = 6.7588, p = 0.01). Serum level of MMP-12 was significantly higher in COPD patients than in controls groups (6.8 ng/ml vs 3.3 ng/ml, respectively; F = 7.433, p < 0.0001), although independently of analyzed gene polymorphisms. Additionally, no correlation between parameters of lung function (FEV1% and FEV1/FVC) and protein level was found. CONCLUSIONS: We found that -82G allele of SNP rs2276109 was associated with reduced risk of COPD, and COPD patients released more MMP-12 than healthy individuals, but independently on this SNP.

Analysis of the dynamics of venous blood flow in the context of lower limb temperature distribution and tissue composition in the elderly.

OBJECTIVE: The elderly are particularly vulnerable to degenerative diseases, such as circulatory and respiratory system and vascular system diseases. The objective of this study was therefore to evaluate the distribution of temperature and the dynamics of venous blood flow in the lower limbs (LLs) and to assess the interdependence of these parameters in terms of the somatic components in males and females participating in activities at the University of the Third Age. MATERIALS AND METHODS: The study included 60 females (mean age 67.4 years) and 40 males (mean age 67.5 years). A body composition assessment was performed using the bioimpedance technique - Tanita BC-418MA. The following parameters were examined: fat%, fat mass, fat-free mass, and total body water. The minimal, maximal, and mean temperature values and their distributions were examined using infrared thermographic camera VarioCAM Head. Measurements of the venous refilling time and the work of the LL venous pump were examined using a Rheo Dopplex II PPG. RESULTS: In males, the mean value of the right LL temperature was 30.58 and the mean value of the left LL was 30.28; the P-value was 0.805769. In females, the mean value of the right LL temperature was 29.58 and the mean value of the left limb was 29.52; the P-value was 0.864773. In males, the right limb blood flow was 34.17 and the left limb blood flow was 34.67; the P-value was 0.359137. In females, the right limb blood flow was 26.89 and the left limb blood flow was 26.09; the P-value was 0.796348. CONCLUSION: Research results showed that the temperature distribution and the dynamics of blood flow are not significantly different between the right and left extremities in both males and females. However, significant temperature differences were found between the gender groups. Significantly higher temperature values in both the right and left extremities were recorded in males than in females.

Assessment of neuromuscular control in patients after anterior cruciate ligament reconstruction.

BACKGROUND: The anterior cruciate ligament (ACL) is one of the most important stabilisers of the knee joint. The key role of ACL is to resist anterior translation of the tibia in relation to the femur. At the same time, ACL does not only perform a mechanical limiting function, but is also an important component of the sensorimotor system. The aim of this study was to assess neuromuscular control in patients after ACL reconstruction by evaluatingthe maintenance of dynamic balance. MATERIAL AND METHODS: Twenty-six patients (aged 28.4±6.3 years) after ACL reconstruction (ACLR group) were enrolled. All patients had undergone arthroscopic reconstruction of ACL, and were recruited to the study 11-13 months after the surgery. Thirty-seven healthy individuals served as a control group (CTRL). The maintenance of the single-leg and two-leg standing position on an unstable surface was assessed using the Biodex Balance System SD. RESULTS: The ACLR group differed from the control group in the values of the overall stability index (p<0.05; 6.53±2.04, and 5.27±1.42, respectively) when stability control in the two-leg position was assessed. Additionally, in the single-leg position, the values of the study parameters were significantly higher (p<0.05) in ACLR in comparison to CTRL: 9.73±2.55 vs.7.23±1.48, and 9.42±2.38 vs. 5.64±1.51 respectively, for the dominant and non-dominant leg. CONCLUSIONS: At one year after ACL reconstruction, significant deficits of neuromuscular control were observed during motor tasks requiring considerable sensorimotor system involvement.