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BACKGROUND: Transcranial direct current stimulation (tDCS) is a therapeutic tool for improving post-stroke gait disturbances, with ongoing research focusing on specific protocols for its application. We evaluated the feasibility of a rehabilitation protocol that combines tDCS with conventional gait training. METHODS: This was a randomized, double-blind, single-center pilot clinical trial. Patients with unilateral hemiplegia due to ischemic stroke were randomly assigned to either the tDCS with gait training group or the sham stimulation group. The anodal tDCS electrode was placed on the tibialis anterior area of the precentral gyrus while gait training proceeded. Interventions were administered 3 times weekly for 4 weeks. Outcome assessments, using the 10-meter walk test, Timed Up and Go test, Berg Balance Scale, Functional Ambulatory Scale, Modified Barthel Index, and European Quality of Life 5 Dimensions 3 Level Version, were conducted before and after the intervention and again at the 8-week mark following its completion. Repeated-measures analysis of variance (ANOVA) was used for comparisons between and within groups. RESULTS: Twenty-six patients were assessed for eligibility, and 20 were enrolled and randomized. No significant differences were observed between the tDCS with gait training group and the sham stimulation group in gait speed after the intervention. However, the tDCS with gait training group showed significant improvement in balance performance in both within-group and between-group comparisons. In the subgroup analysis of patients with elicited motor-evoked potentials, comfortable pace gait speed improved in the tDCS with gait training group. No serious adverse events occurred throughout the study. CONCLUSIONS: Simultaneous anodal tDCS during gait training is a feasible rehabilitation protocol for chronic stroke patients with gait disturbances. CLINICAL TRIAL REGISTRATION: URL: https://cris.nih.go.kr; Registration number: KCT0007601; Date of registration: 11 July 2022.
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Estudios de Factibilidad , Rehabilitación de Accidente Cerebrovascular , Estimulación Transcraneal de Corriente Directa , Humanos , Estimulación Transcraneal de Corriente Directa/métodos , Masculino , Proyectos Piloto , Método Doble Ciego , Femenino , Persona de Mediana Edad , Rehabilitación de Accidente Cerebrovascular/métodos , Anciano , Trastornos Neurológicos de la Marcha/rehabilitación , Trastornos Neurológicos de la Marcha/etiología , Accidente Cerebrovascular/complicaciones , Accidente Cerebrovascular/fisiopatología , Enfermedad Crónica , Terapia por Ejercicio/métodos , Evaluación de Resultado en la Atención de Salud , Hemiplejía/rehabilitación , Hemiplejía/etiología , Hemiplejía/fisiopatología , Accidente Cerebrovascular Isquémico/rehabilitación , Accidente Cerebrovascular Isquémico/complicaciones , Accidente Cerebrovascular Isquémico/fisiopatologíaRESUMEN
Spinocerebellar ataxia (SCA) is a hereditary neurodegenerative disorder that presents as ataxia. Due to the decline in balance, patients with SCA often experience restricted mobility and a decreased quality of life. Thus, many studies have emphasized the importance of physiotherapies, including gait training, in SCA patients. However, few studies have examined the effectiveness of robotic gait training in SCA. Here, we report the therapeutic outcomes of exoskeleton-assisted gait training in a patient with SCA. A 23-year-old woman with SCA participated in a gait training program using a powered lower-limb robotic exoskeleton, ANGELLEGS. The 8-week training program consisted of standing training, weight-shifting exercises, and gait training. Several measures of general function, balance, gait, and cardiopulmonary function were applied before, after, and 4 weeks after the program. After the program, overall improvements were found on scales measuring balance and gait function, and these improvements remained at 4 weeks after the program. Cardiopulmonary function was also improved 4 weeks after the program. Robotic exoskeleton gait training can be a beneficial option for training balance, gait, and cardiopulmonary function in SCA.
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Dispositivo Exoesqueleto , Ataxias Espinocerebelosas , Adulto , Terapia por Ejercicio , Femenino , Marcha , Humanos , Calidad de Vida , Adulto JovenRESUMEN
RATIONALE: Joubert syndrome (JS) is a rare genetic disorder that presents with various neurological symptoms, primarily involving central nervous system dysfunction. Considering the etiology of JS, peripheral nervous system abnormalities cannot be excluded; however, cases of JS accompanied by peripheral nervous system abnormalities have not yet been reported. Distinct radiological findings on brain magnetic resonance imaging were considered essential for the diagnosis of JS. However, recently, cases of JS with normal or nearly normal brain morphology have been reported. To date, there is no consensus on the most appropriate diagnostic method for JS when imaging-based diagnostic approach is challenging. This report describes the case of an adult patient who exhibited bilateral peroneal neuropathies and was finally diagnosed with JS through genetic testing. PATIENT CONCERNS AND DIAGNOSIS: A 27-year-old man visited our outpatient clinic due to a gait disturbance that started at a very young age. The patient exhibited difficulty maintaining balance, especially when walking slowly. Oculomotor apraxia was observed on ophthalmic evaluation. During diagnostic workups, including brain imaging and direct DNA sequencing, no conclusive findings were detected. Only nerve conduction studies revealed profound bilateral peroneal neuropathies. We performed whole genome sequencing to obtain a proper diagnosis and identify the gene mutation responsible for JS. LESSONS: This case represents the first instance of peripheral nerve dysfunction in JS. Further research is needed to explore the association between JS and peripheral nervous system abnormalities. Detailed genetic testing may serve as a valuable tool for diagnosing JS when no prominent abnormalities are detected in brain imaging studies.
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Anomalías Múltiples , Cerebelo , Cerebelo/anomalías , Anomalías del Ojo , Enfermedades Renales Quísticas , Neuropatías Peroneas , Retina , Retina/anomalías , Humanos , Masculino , Adulto , Enfermedades Renales Quísticas/diagnóstico , Enfermedades Renales Quísticas/genética , Enfermedades Renales Quísticas/complicaciones , Cerebelo/diagnóstico por imagen , Anomalías del Ojo/diagnóstico , Anomalías del Ojo/genética , Neuropatías Peroneas/diagnóstico , Anomalías Múltiples/diagnóstico , Anomalías Múltiples/genética , Retina/diagnóstico por imagen , Imagen por Resonancia MagnéticaRESUMEN
Orthostatic tremor (OT) is an uncommon progressive movement disorder that involves a leg tremor when standing or weight bearing. Additionally, OT can accompany other medical or neurodegenerative disorders. In this article, we report an unusual case of OT after trauma in an 18-year-old male patient whose symptoms of OT have been resolved after a multimodal therapeutic approach, including botulinum toxin injection. Surface electromyography, including a tremor recording, was used for the diagnosis of OT. The patient completely recovered after the rehabilitation. A comprehensive rehabilitative treatment is required in the management of OT as the patient's quality of life is greatly affected.
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BACKGROUND: Simultaneous pulmonary thromboembolism (PTE) and hemopericardium is a rare but life-threatening condition. As hemopericardium is a contraindication to anticoagulation treatment, it is challenging to handle both conditions together. OBJECTIVE: The objective of the study was to report a rare case of a man with thoracic spinal cord injury presenting with simultaneous PTE and hemopericardium. DESIGN: Case report. SUBJECT: A 43-year-old man with incomplete T9 paraplegia (American Spinal Injury Association Impairment Scale D) complained of fever one and a half months after spinal cord injury sustained in a fall. FINDINGS: During evaluation of fever origin, chest computed tomography and transthoracic echocardiogram revealed simultaneous PTE and hemopericardium. After serial echocardiograms over 2 days demonstrated stability, intravenous heparin, and oral warfarin were administered and his medical status was observed closely. Ultimately, both conditions improved without significant complications. CONCLUSION: We report successful treatment of man with acute spinal cord injury who presented with simultaneously diagnosed PTE and hemopericardium, a rare complication involving two distinct and opposing pathological mechanisms and conflicting treatments.
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Derrame Pericárdico/diagnóstico por imagen , Embolia Pulmonar/diagnóstico por imagen , Traumatismos de la Médula Espinal/diagnóstico por imagen , Adulto , Humanos , Masculino , Paraplejía/complicaciones , Paraplejía/diagnóstico por imagen , Derrame Pericárdico/complicaciones , Embolia Pulmonar/complicaciones , Radiografía , Traumatismos de la Médula Espinal/complicaciones , Vértebras Torácicas/diagnóstico por imagenRESUMEN
It is well known that graphene is a very promising material due to its excellent physical, chemical, and thermal properties. Previously, ridges in graphene on a substrate were found in epitaxial graphene on a SiC substrate. It was found in this study that ridges can be made on a graphene layer via mechanical exfoliation on a sapphire substrate, and that ridges can be created or removed through heating and cooling. Due to the difference of the thermal-expansion coefficients of the substrate and graphene, it can be said that thermal cycling causes compressive strain, which is released by forming ridges. Annealing was carried out in a vacuum chamber within the pressure range of 10(-3)-10(-6) Torr and at 900-1100 degrees C. To analyze the shapes and mechanical properties of the ridges, Raman spectroscopy and AFM measurement were performed. It was found that the ridges can be extended by defect as a nucleation center, and the graphene layer can be folded along the preexisting ridge during heating and cooling.
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BACKGROUND: Many studies have reported that exercise is effective for fibromyalgia and various types of exercise are recommended. However, most of exercises lack evidence for fibromyalgia symptoms. We aimed to examine the effect of core muscle strengthening exercise compared to general stretching exercise in fibromyalgia patients. METHODS: Forty fibromyalgia patients were enrolled. They were provided exercise program twice a week for 4âweeks: core muscle strengthening exercise and general stretching exercise.Outcome measures were Visual Analogue Scale, Borg Scale, fibromyalgia impact questionnaire (FIQ), widespread pain index, Symptom Severity Scale (SS), and balance scale and measured before and after exercise program. Balance function was assessed by checking the distance of sway on soft pad with eyes open (EO) and with eyes closed (EC). RESULTS: After program, FIQ, SS, EO, and eyes closed showed statistically significant differences in the strengthening group while Visual Analogue Scale, Borg scale, FIQ, widespread pain index, SS showed statistically significant differences in stretching group. And EO showed statistically significant differences in the intergroup analysis. CONCLUSIONS: Both exercise could improve symptoms of fibromyalgia but showed no significantly better efficiency with intergroup analysis. Only some balance function was improved with core muscle strengthening exercise with significant difference. Our study presents preliminary results regarding the comparison between both exercises for fibromyalgia through a randomized controlled trial.
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Terapia por Ejercicio/métodos , Fibromialgia/terapia , Femenino , Humanos , Persona de Mediana Edad , Contracción Muscular , Músculos , Dolor , Docilidad , Estudios Prospectivos , Calidad de Vida , Método Simple Ciego , Resultado del TratamientoRESUMEN
Transcranial alternating current stimulation (tACS) is a neuromodulation procedure that is currently studied for the purpose of improving cognitive function in various diseases. A few studies have shown positive effects of tACS in Alzheimer's disease (AD). However, the mechanism underlying tACS has not been established. The purpose of this study was to investigate the mechanism of tACS in five familial AD mutation (5xFAD) mouse models. We prepared twenty 4-month-old mice and divided them into four groups: wild-type mice without stimulation (WT-NT group), wild-type mice with tACS (WT-T group), 5xFAD mice without stimulation (AD-NT group), and 5xFAD mice with tACS (AD-T group). The protocol implemented was as follows: gamma frequency 200 µA over the bilateral frontal lobe for 20 min over 2 weeks. The following tests were conducted: excitatory postsynaptic potential (EPSP) recording, Western blot analysis (cyclic AMP response element-binding (CREB) proteins, phosphorylated CREB proteins, brain-derived neurotrophic factor, and parvalbumin) to examine the synaptic plasticity. The EPSP was remarkably increased in the AD-T group compared with in the AD-NT group. In the Western blot analysis, the differences among the groups were not significant. Hence, tACS can affect the long-lasting enhancement of synaptic transmission in mice models of AD.
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RATIONALE: Pelizaeus-Merzbacher disease (PMD) is an X-linked recessive trait and a rare disease characterized by abnormal myelin formation in the central nervous system. Since Pelizaeus and Merzbacher reported the pathology of PMD in the 1990s most studies have examined pharmacological treatments. No studies have reported the effects of rehabilitation on patients with PMD aimed at improving their functional abilities. We report the first case of improved development after rehabilitation in a patient with Pelizaeus-Merzbacher disease. PATIENT CONCERNS: A 1-month-boy developed focal seizures, nystagmus, and jerky head movements. He was brought to our outpatient clinic for rehabilitation of developmental delay at 11 months of age. He showed hypotonia, nystagmus, and developmental delay of 4 to 5 months in his gross and fine motor ability. DIAGNOSES: Developmental delay in a patient with PMD. INTERVENTIONS: A child with PMD was hospitalized 3 times for 3 months and underwent rehabilitation to improve developmental delay. Developmental assessments were conducted before and after each admission for rehabilitation training. OUTCOMES: Before training, the patient was unable to maintain a sitting position. After the first and second training sessions, his gross motor ability had improved, and he could sit with a mild assist. Fine motor function also improved. Before training, the patient was able to transfer a cube from one hand to the other. After training, he could perform a pincher grasp. LESSONS: Rehabilitation training can help PMD patients achieve maximal function and catch-up in their growth.
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Discapacidades del Desarrollo/rehabilitación , Enfermedad de Pelizaeus-Merzbacher/rehabilitación , Humanos , Lactante , MasculinoRESUMEN
OBJECTIVE: To test the hypothesis that a longer duration of phase II cardiac rehabilitation is required to recover the exercise capacity of elderly patients compared to younger patients. METHODS: We retrospectively reviewed and analyzed the medical records of patients who were referred to our cardiac rehabilitation (CR) center and underwent percutaneous coronary intervention for acute myocardial infarction (AMI). A total of 70 patients were enrolled who underwent an exercise tolerance test (ETT) 3 weeks after the occurrence of an AMI (T0), 6 weeks after the first ETT (T1), and 12 weeks after the first ETT (T2). Patients older than 65 years were assigned to the elderly group (n=24) and those aged 65 years and younger to the younger group (n=46). Both groups performed center-based or home-based CR for 12 weeks (3 times per week and 1 session per day). Exercise intensity for each individual was based on the target heart rate calculated by the Karvonen formula. The change in maximal metabolic equivalents (METmax) of the two groups was measured at each assessment point (T0, T1, and T2) to investigate the recovery of exercise capacity. RESULTS: The younger group showed improvement in METmax between T0 and T1. However, METmax of the elderly group showed no significant improvement between T0 and T1. The exercise capacity, measured with METmax, of all groups showed improvement between T0 and T2. CONCLUSION: Elderly patients with AMI need a longer duration of CR (>6 weeks) than younger patients with AMI.
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INTRODUCTION: A 25-year-old male underwent allogenic peripheral blood stem cell transplantation and developed sclerodermoid chronic graft versus host disease. He complained of limitation of motion of major joints and some difficulties with activities of daily living (ADL) performances. DISCUSSION: He had been treated with physical and occupational therapies. After the rehabilitative managements, range of motion and ADL performances improved slightly. CONCLUSION: Active and continuous multimodal rehabilitative treatment would be helpful in managing contracture and functional impairment and preventing the progression of the disease.
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Enfermedad Injerto contra Huésped/rehabilitación , Trasplante de Células Madre de Sangre Periférica/efectos adversos , Esclerodermia Localizada/rehabilitación , Actividades Cotidianas , Adulto , Enfermedad Crónica , Contractura/etiología , Contractura/rehabilitación , Enfermedad Injerto contra Huésped/etiología , Humanos , Linfoma no Hodgkin/terapia , Masculino , Esclerodermia Localizada/etiología , Trasplante HomólogoRESUMEN
The aim of this study was to report on nine dysphagic patients with medullary infarction and to evaluate swallowing characteristics based on the location of the lesions.We retrospectively reviewed the medical records of these nine patients. The medullary lesions were midlateral (three patients), dorsolateral (one patient), inferodorsolateral (four patients), and paramedian (one patient). The levels of the lesions were upper (four patients), middle (two patients), upper and middle (two patients), and middle and lower medulla (one patient). Dysphagia after medullary infarction was more common in patients with upper or middle medullary level and dorsolateral medullary level lesions. The common findings on videofluoroscopic swallowing studies in patients with lateral medullary infarctions were impaired upper esophageal sphincter opening, aspiration from pyriform sinuses' residue caused by pharyngeal weakness, and multiple swallowing to clear boluses from the pharynx to the esophagus. In patients with medullary infarctions, the lesion levels and loci and their related clinical findings can be useful in predicting dysphagia and aspiration. Because severe dysphagia with serious complication is very common in patients with medullary infarctions, active diagnostic and therapeutic approaches are needed.
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Infarto Encefálico/complicaciones , Trastornos de Deglución , Deglución , Esfínter Esofágico Superior/patología , Bulbo Raquídeo/patología , Accidente Cerebrovascular/complicaciones , Adulto , Anciano , Anciano de 80 o más Años , Infarto Encefálico/patología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Accidente Cerebrovascular/patología , Factores de TiempoRESUMEN
This study was performed to evaluate the effect of C-reactive protein (CRP) measured within 24 hr after stroke onset on functional outcome in ischemic stroke patients. The medical records of 28 first-ever hemiplegic ischemic stroke patients with the lesions on the middle cerebral arterial territory were reviewed. Subjects were classified into experimental group (serum CRP >or= 0.5 mg/dL) and control group (serum CRP<0.5 mg/dL) based on the level of serum CRP measured within 24 hr after stroke onset. Serum CRP measured within 24 hr after stroke onset was significantly correlated with functional scales in ischemic stroke patients.
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Isquemia Encefálica/diagnóstico , Proteína C-Reactiva/metabolismo , Evaluación de Resultado en la Atención de Salud/métodos , Accidente Cerebrovascular/diagnóstico , Anciano , Biomarcadores/análisis , Biomarcadores/sangre , Isquemia Encefálica/sangre , Isquemia Encefálica/fisiopatología , Proteína C-Reactiva/análisis , Comorbilidad , Diabetes Mellitus/epidemiología , Progresión de la Enfermedad , Dislipidemias/epidemiología , Femenino , Cardiopatías/epidemiología , Humanos , Hipertensión/epidemiología , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Pronóstico , Estudios Retrospectivos , Factores de Riesgo , Accidente Cerebrovascular/sangre , Accidente Cerebrovascular/fisiopatología , Factores de TiempoRESUMEN
RATIONALE: Spinal cord injury (SCI) patients who experience difficulties with independent walking use gait-assistive devices such as a cane, walker, or wheelchair. Few studies have explored gait patterns or cardiopulmonary function in chronic SCI patients after powered exoskeleton training. We investigated whether the cardiopulmonary function of a patient with an incomplete chronic cervical SCI and a hemiplegic gait pattern could be improved by walking training using a powered exoskeleton (Angelegs). PATIENT CONCERNS: A 57-year-old male was diagnosed with an SCI at C3-C4. The right upper and lower limb motor functions differed when evaluated before entry into the program. Motor function was good in the right leg but poor in the left one. Before program entry, the patient could walk for about 10 m using a cane. He did not have a history of severe medical or psychological problems and was not cognitively impaired. DIAGNOSIS: The patient was tetraplegia with incomplete SCI at C3-C4. INTERVENTIONS: The patient was trained for 6 weeks using a powered exoskeleton. The training program consisted of sit-to-stand and stand-to-sit movements, maintenance of balanced standing for 5âminutes, and walking for 15âminutes. OUTCOMES: After 6 weeks of training, gait speed improved in the timed up-and-go test, and cardiac function was enhanced as measured by the metabolic equivalent and VO2 tests. LESSIONS: Walking training using a powered exoskeleton can facilitate the effective rehabilitation and improve the gait speed and cardiopulmonary function of patients with chronic SCIs or strokes.
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Vértebras Cervicales/lesiones , Terapia por Ejercicio/instrumentación , Dispositivo Exoesqueleto , Extremidad Inferior/fisiopatología , Traumatismos de la Médula Espinal/rehabilitación , Velocidad al Caminar/fisiología , Caminata/fisiología , Diseño de Equipo , Humanos , Masculino , Persona de Mediana Edad , Traumatismos de la Médula Espinal/fisiopatologíaRESUMEN
OBJECTIVE: To compare a center-based cardiac rehabilitation (CR) program with a home-based CR program in terms of improving obesity related index and cardiopulmonary exercise capacity after the completing a phase II CR program. METHODS: In this study, there were seventy-four patients with acute myocardial infarction after percutaneous coronary intervention who were analyzed. Patients with mild to moderate risk (ejection fraction >40%) were included in the group. The patients underwent an exercise tolerance test by measurement of the modified Bruce protocol at three assessment points. Those in the center-based CR group participated in a 4-week training program with electrocardiography monitoring of the patient's progress and results, while those patients who were in the home-based CR group underwent self-exercise training. We measured the obesity related indices such as body mass index, fat free mass index (FFMI), and cardiopulmonary exercise capacity including peak oxygen consumption (VO2max), metabolic equivalents (METs), heart rate, resting systolic blood pressure and the diastolic blood pressure of the participants and noted the results. RESULTS: Of the 74 patients, 25 and 49 participated in the center-based and home-based CR programs, respectively. Both groups showed significant improvement in VO2max and METs at 1-month and 6-month follow-up. However, FFMI was significantly improved only in the center-based CR group after 1 month of the phase II CR. CONCLUSION: Both groups identified in the study showed significant improvement of VO2max and METs at 1-month and 6-month follow-up. However, there was no significant difference in the intergroup analysis. A significant improvement of FFMI was seen only in the center-based CR group after phase II CR.
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Heterotopic ossification (HO) is the abnormal development of bone within soft tissue. It is frequently encountered after traumatic brain injury or spinal cord injury, rather than lower motoneuron disease. It has been reported as a rare complication in Guillain-Barré syndrome (GBS). We present the case of a 31-year-old woman who suffered from pain and swelling with limitation of the passive range of motion on right hip joint, and who had been diagnosed with GBS about 1 year previously. She was wheelchair-bound and had incomplete tetraplegia with flaccidity. She was diagnosed as HO based on the radiologic imaging study. She did not reveal any encephalopathy-related symptoms or signs, and hypercalcemia, and/or related metabolic derangement during 1.5-year follow-up period. Owing to the paucity of other causative factors, we presumed that the long-time hypomobility, even though not accompanied by hypercalcemia, played a major role for the development of HO. Early active rehabilitative management was initiated. The outcome is not promising because of her long-standing paralyzed state; however, it was possible to prevent the aggravation of HO.
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Síndrome de Guillain-Barré/complicaciones , Articulación de la Cadera/fisiopatología , Osificación Heterotópica/etiología , Osificación Heterotópica/rehabilitación , Adulto , Terapia por Ejercicio/métodos , Femenino , Estudios de Seguimiento , Síndrome de Guillain-Barré/diagnóstico , Humanos , Osificación Heterotópica/fisiopatología , Rango del Movimiento Articular/fisiología , Enfermedades Raras , Medición de Riesgo , Índice de Severidad de la Enfermedad , Resultado del TratamientoRESUMEN
BACKGROUND: Exercise intensity is a particularly important determinant of physiological responses to exercise training in patients with acute myocardial infarction. Heart rate (HR) is commonly used as a practical way of prescribing and monitoring exercise as specific intensities based on a linear relationship between the percentage of maximum HR (%HRmax) and the percentage of maximum oxygen consumption (%VO2max) regardless of age, gender, or exercise mode. OBJECTIVE: To examine the change in variability in the correlation between %HRmax and %VO2max after acute myocardial infarction. DESIGN: Retrospective study. SETTING: Regional cardio-cerebrovascular center at a tertiary hospital. PATIENTS: A total of 66 patients were enrolled who were referred for cardiac rehabilitation (CR) after percutaneous intervention, and who had reached stage 3 of the modified Bruce Protocol (mBP) on an exercise tolerance test (ETT). METHODS: There were 54 men and 12 women with an average age of 56.7 ± 9.48 years, ejection fraction (EF) of 56.4% ± 8.89%, and body mass index (BMI) of 24.73 ± 2.86 kg/m2. All patients participated in a 4-week outpatient CR program and underwent ETT with a gas analyzer to determine maximal heart rate and maximal oxygen consumption before CR and 1 month, 3 months, and 6 months after CR. MAIN OUTCOME MEASUREMENTS: VO2max and HRmax were defined as the highest values attained during the ETT. The HR and VO2 values at each stage of the mBP were expressed as percentages of their maximum. %HRmax and %VO2max were calculated at each stage of the mBP. RESULTS: The maximum METs and VO2max significantly improved at 1 month after CR, but not significantly at 3 and 6 months after CR. The correlation between VO2max and HRmax progressively changed in a favorable manner during CR. The relationship between %HRmax and %VO2max indicated a coefficient of variation before and 1, 3, and 6 months after of 0.800, 0.826, 0.832, and 0.880, respectively. CONCLUSIONS: This study showed that the %HRmax correlates better with the %VO2max in the late-stage post-AMI than in the initial stage. We should therefore set and monitor the exercise intensity using maximal oxygen consumption in the early stage of exercise training after onset of acute myocardial infarction. LEVEL OF EVIDENCE: IV.
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Rehabilitación Cardiaca/métodos , Terapia por Ejercicio/métodos , Frecuencia Cardíaca/fisiología , Monitoreo Fisiológico/métodos , Infarto del Miocardio/sangre , Consumo de Oxígeno/fisiología , Esfuerzo Físico/fisiología , Electrocardiografía , Prueba de Esfuerzo/métodos , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Infarto del Miocardio/fisiopatología , Infarto del Miocardio/rehabilitación , Estudios Retrospectivos , Volumen Sistólico , Factores de Tiempo , Resultado del TratamientoRESUMEN
OBJECTIVE: To determine whether heart rate recovery (HRR) following an exercise tolerance test (ETT) is correlated with a changing ratio of peak oxygen consumption (VO2) and maximal metabolic equivalents (METmax). METHODS: A total of 60 acute myocardial infarction (AMI) patients who underwent ETT at both assessment points - 3 weeks (T0) after the AMI attack and 3 months after T0 (T1) were included. After achieving a peak workload, the treadmill was stopped with a 5-minute cooldown period, and the patients recovered in a comfortable and relaxed seated position. HRR was defined as the difference between the maximal heart rate (HRmax) and the HR measured at specific time intervals - immediately after the cool down period (HRR-0) and 3 minutes after the completion of the ETT (HRR-3). RESULTS: HRR-0 and HRR-3 increased over time, whereas VO2max and METmax did not show significant changes. There was a positive correlation between HRR at T0 and the exercise capacity at T0. HRR at T0 also showed a positive correlation with the exercise capacity at T1. There was no significant correlation between HRR measured at T0 and the change in the ratio of VO2max and METmax, as calculated by subtracting VO2max and METmax obtained at T0 from those obtained at T1, divided by VO2max at T0 and multiplied by 100. CONCLUSION: Post-exercise HRR measured at 3 weeks after the AMI onset can reflect the exercise capacity 3 months after the first ETT. However, it may be difficult to correlate post-exercise HRR at T0 with the degree of increase in cardiopulmonary exercise capacity in patients with AMI.
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BACKGROUND: DiGeorge Syndrome is a rare disease that has variable clinical symptoms resulting from 22q11 deletions, included cardiac abnormality, abnormal face and thymic aplasia, and cognitive impairment. There was a no reports regarding the efficiency of cardiac rehabilitation (CR) in patients with DiGeorge Syndrome with tetralogy of Fallot. CASE REPORT: A 15-year-old girl with DGS visited our CR center. The patient carried out the exercise training 3 times a week for 6 weeks, using a treadmill with electrocardiogram monitoring. Exercise tolerance testing and Quality of life assessment were performed before and after 6 weeks of training. Improvement of aerobic capacity was not represented, but by her own estimation, her performance ability of daily activities was better than before. CLINICAL REHABILITATION IMPACT: Even though adolescents with congenital heart disease often limit themselves, or are restricted by others, from physical activity, CR should be recommended as a comprehensive health promotion strategy.
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Rehabilitación Cardiaca , Síndrome de DiGeorge/rehabilitación , Tetralogía de Fallot/rehabilitación , Adolescente , Síndrome de DiGeorge/fisiopatología , Tolerancia al Ejercicio , Femenino , Humanos , Tetralogía de Fallot/fisiopatologíaRESUMEN
OBJECTIVE: The objective of this study was to evaluate the safety and efficacy of tamsulosin hydrochloride 0.2 mg (TAM) and its combination with solifenacin succinate 5 mg (SOL) after transurethral resection of the prostate (TURP). PATIENTS AND METHODS: The patients were randomized into three groups: TURP (group 1), TURP plus TAM (group 2), and TURP plus TAM + SOL (group 3). Patients in group 2 and group 3 received medication for 4 weeks. The primary efficacy end points were the mean change in total International Prostate Symptom Score (IPSS) and IPSS subscores. The secondary end points included quality-of-life score, Overactive Bladder Symptom Score, and short-form voiding and storage score of International Continence Society. RESULTS: In total, 37 men (31.8%) in group 1, 37 men (31.8%) in group 2, and 42 men (36.2%) in group 3 completed the study. In total IPSS, no significant improvement was seen from baseline to the end of treatment in groups 2 and 3 compared with group 1. However, in group 2, the decrement in the IPSS storage score was smaller than group 1 (P=0.02), and in group 3, the decrement in the IPSS voiding score was smaller than group 1 (P=0.05). In groups 2 and 3 compared with group 1, improvements in the quality of life score, total score of Overactive Bladder Symptom Score, and short-form voiding score and storage score of International Continence Society were not statistically significant. CONCLUSION: Treatment with TAM and combination of TAM and SOL did not have significant additional benefits for lower urinary tract symptoms during the early recovery period after TURP.