Yoga Interventions Used for the Rehabilitation of Stroke, Parkinson's Disease, and Multiple Sclerosis: A Scoping Review of Clinical Research.

Objectives: The current body of literature was reviewed to compile and describe yoga interventions that have been applied in clinical research and neurologic rehabilitation settings with patients affected by stroke, Parkinson's disease (PD), and multiple sclerosis (MS). Design: Available literature on yoga therapy (YT) was mapped following a five-stage framework to identify key concepts, knowledge gaps, and evidence to inform practice. Publications were identified through Medline, CINAHL, EMBASE, and PsycINFO. Selected studies required subjects with a clinical diagnosis of stroke, PD, and MS to participate in a yoga intervention and have physical, cognitive, and/or psychosocial outcome measures assessed. Results: A total of 50 studies were included in this review. Study characteristics, patient demographics, description of the yoga intervention, reported outcome measures and the main findings were extracted from the studies. Conclusion: Implementing YT in neurorehabilitation can help health care professionals integrate a more holistic approach that addresses the fundamental physical and psychological challenges of living with a chronic and debilitating neurologic disorder. The included studies described yogic interventions consisting of group or individual therapy sessions lasting 60-75 min that were carried out one to three times per week for 8-12 consecutive weeks across all three conditions. All studies described in this scoping review used different yoga protocols confirming the lack of specific interventional parameters available for implementing yoga into the rehabilitation of individuals affected by stroke, PD, or MS.

Validity of the Comprehensive High-Level Activity Mobility Predictor in a heterogeneous population with lower extremity amputations.

BACKGROUND AND OBJECTIVE: Lower extremity amputee outcome measures assess basic mobility. The Comprehensive High-Level Activity Mobility Predictor was developed to assess high-level mobility. Validity evidence was collected in military men with traumatic lower extremity amputations. This study examines its validity in a broader population. STUDY DESIGN: Cross-sectional. METHODS: Forty-five lower extremity amputees (Medicare Functional Classification Level K3 or K4) completed the 2-min walk test, Amputee Mobility Predictor with Prosthesis, and Comprehensive High-Level Activity Mobility Predictor. RESULTS: The Comprehensive High-Level Activity Mobility Predictor correlated with the Amputee Mobility Predictor with Prosthesis (r = 0.77, p < 0.01) and the 2-min walk test (r = 0.65, p < 0.01). The Comprehensive High-Level Activity Mobility Predictor differentiated between K-levels, age groups, etiology of amputation, and amputation level (p < 0.005). No ceiling effect was observed (range: 2.5-29/40). CONCLUSION: This study provides convergent and discriminative validity evidence for Comprehensive High-Level Activity Mobility Predictor use in a more heterogeneous population than previously published, suggesting that clinicians should feel confident to use it as an outcome measure for individuals with amputations who are capable of more than level-ground walking. CLINICAL RELEVANCE: Clinically, the Comprehensive High-Level Activity Mobility Predictor has validity evidence for use in a more heterogeneous population than originally demonstrated, including civilians, women, people over age 40 years, and non-traumatic etiologies. The Comprehensive High-Level Activity Mobility Predictor may be more useful than standard outcome measures for high-level mobility.

The Influence of Oral L-Glutamine Supplementation on Muscle Strength Recovery and Soreness Following Unilateral Knee Extension Eccentric Exercise.

The study aimed to examine the effects that L-glutamine supplementation has on quadriceps muscle strength and soreness ratings following eccentric exercise. It was hypothesized that glutamine ingestion would quicken the recovery rate of peak force production and decrease muscle soreness ratings over a 72-hr recovery period. Sixteen healthy participants (8♀/8♂; 22 ± 4 years) volunteered in a double-blind, randomized, placebo-controlled crossover study. Supplement conditions consisted of isoenergetic placebo (maltodextrin, 0.6 g·kg-1·day-1) and L-glutamine (0.3 g·kg-1·day-1 + 0.3 g·kg-1·day-1 maltodextrin) ingestion once per day over 72 hr. Knee extensor peak torque at 0°, 30°, and 180° per second and muscle soreness were measured before, immediately following, 24, 48, and 72 hr posteccentric exercise. Eccentric exercise consisted of 8 sets (10 repetitions/set) of unilateral knee extension at 125% maximum concentric force with 2-min rest intervals. L-glutamine resulted in greater relative peak torque at 180°/sec both immediately after (71 ± 8% vs. 66 ± 9%), and 72 hr (91 ± 8% vs. 86 ± 7%) postexercise (all, p < .01). In men, L-glutamine produced greater (p < .01) peak torques at 30°/ sec postexercise. Men also produced greater normalized peak torques at 30°/sec (Nm/kg) in the L-glutamine condition than women (all, p < .05). In the entire sample, L-glutamine resulted in lower soreness ratings at 24 (2.8 ± 1.2 vs. 3.4 ± 1.2), 48 (2.6 ± 1.4 vs. 3.9 ± 1.2), and 72 (1.7 ± 1.2 vs. 2.9 ± 1.3) hr postexercise (p < .01). The L-glutamine supplementation resulted in faster recovery of peak torque and diminished muscle soreness following eccentric exercise. The effect of L-glutamine on muscle force recovery may be greater in men than women.