Correction: Experienced sitting-related problems and association with personal, lesion and wheelchair characteristics in persons with long-standing paraplegia and tetraplegia.

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Experienced sitting-related problems and association with personal, lesion and wheelchair characteristics in persons with long-standing paraplegia and tetraplegia.

STUDY DESIGN: Cross-sectional study. OBJECTIVES: To describe experienced sitting-related health and stability problems among persons with paraplegia (PP) or tetraplegia (TP) and to investigate associations with personal, lesion and wheelchair characteristics as well as satisfaction with sitting posture. SETTING: Dutch community. METHODS: A self-report questionnaire on seating was developed and completed by wheelchair-users living with Spinal Cord Injury (SCI) for ≥10 years (N = 264). Sitting-related problems and satisfaction with sitting posture were compared between participants with PP and TP using Chi-square and t-tests. Logistic regression analyses were performed to investigate associated characteristics. RESULTS: Reported sitting-related problems comprised: sitting to be tiring (regularly to always) (33%), sitting to be painful (28%), pressure ulcers in the last three months (29%), instability while sitting (8%) and instability during reaching (33%). Except for instability during reaching, no differences in occurrence of sitting-problems were found between lesion-group. Persons with TP were more dissatisfied with their sitting posture than persons with PP: 51% vs 36% (p = 0.022) and 51% and 47% respectively thought their sitting posture could be improved (p = 0.670). 'Experienced lack of support in the wheelchair' was associated with most sitting-problems. Pain and instability were associated with dissatisfaction with sitting posture. CONCLUSION: Sitting-related problems and dissatisfaction with sitting posture were frequently reported by persons with long-standing SCI. Sitting problems appeared to associate with lacking support in the wheelchair/seating. A comprehensive feedback from the wheelchair user and a stability check (reach task), as part of the wheelchair/seating-user fitting, may contribute to prevention of sitting-related problems.

Mountain time trial in handcycling: exercise intensity and predictors of race time in people with spinal cord injury.

STUDY DESIGN: Cross-sectional analyses. OBJECTIVES: To analyze exercise intensity during a mountain time trial in handcycling and to determine predictors of race time. SETTING: Eight Dutch rehabilitation centers and Austrian mountain. METHODS: Forty participants with spinal cord injury (SCI; high lesion level (>T6): N=11; low lesion level (⩽T6): N=29) handcycled a 20.2-km mountain time trial. Heart rate (HR) was monitored in 17 (high: N=5, low: N=12) participants during the race to determine exercise intensity, expressed relative to the heart rate reserve (%HRR). Two weeks before the race all participants completed laboratory tests to measure anthropometrics and peak values for power output (POpeak), oxygen uptake (VO2peak) and HR. RESULTS: Mean race time was 4 h and 1 min (s.d.: 1 h and 24 min), with no difference in race time between lesion groups. Mean exercise intensity during the race was 70±7%HRR. Exercise was mainly (73% of the race time) at a vigorous intensity (60-89%HRR), with 29% of the total time in the 80-89%HRR zone. No clear differences were found in exercise intensities between lesion groups. The strongest predictors for better race times were higher mean %HRR during race (R(2)=57%), lower waist circumference (R(2)=39%), higher POpeak (R(2)=39%) and VO2peak (R(2)=32%). CONCLUSION: A 20-km mountain time trial in a handcycle is intensive. Faster race times were achieved by those with a lower waist circumference, greater fitness level and ability to perform at higher average exercise intensities during the race. Level of SCI was not significantly associated with race time.

Hand-cycling: an active form of wheeled mobility, recreation, and sports.

By studying exercise and performance in hand-cycling in both activities of daily living and in Paralympic sport settings, new insights can be gained for rehabilitation practice, adapted physical activity, and sports. This review looks into the pros and cons of hand-cycling in both rehabilitation and optimal sports performance settings as suggested from the current-but still limited-scientific literature and experimentation. Despite the limited evidence-base and the diversity of study approaches and methodologies, this study suggests an important role for hand-cycling during and after rehabilitation, and in wheeled mobility recreation and sports. An approach that combines biomechanical, physiological, and psychosocial elements may lead to a better understanding of the benefits of hand-cycling and of the fundamentals of exercise in rehabilitation, activities of daily living, and sports.

The individual relationship between heart rate and oxygen uptake in people with a tetraplegia during exercise.

STUDY DESIGN: Descriptive study. OBJECTIVE: To examine the individual heart rate-oxygen uptake (HR-VO(2)) relationship during exercise in persons with tetraplegia (TP). SETTING: Rehabilitation Centre Heliomare, Wijk aan Zee, The Netherlands. METHODS: The HR-VO(2) relationship was determined in untrained subjects with motor complete TP (C5 or C6, n=10 and C7 or C8, n=10) during a discontinuous graded exercise hand cycle test. The mean HR and VO(2) of the final 60 s of 2-min exercise blocks were used for calculation of the individual correlation coefficient and the standard error of the estimate (SEE). RESULTS: Two subjects of the C5-C6 group were not able to complete the test. Individual Pearson's correlation coefficients (r) ranged from 0.68 to 0.97 and SEE from 2.6 to 22.4% VO(2)-Reserve (VO(2)R). The mean Pearson's r and SEE were 0.81+/-0.12 and 10.6+/-5.6% VO(2)R in the C5-C6 group and 0.91+/-0.07 and 7.0+/-3.2% VO(2)R in the C7-C8 group, respectively. Two subjects of the C5-C6 group and six subjects of the C7-C8 group attained a linear HR-VO(2) relationship with an acceptable SEE (< or =6.0%) and r (>0.90). CONCLUSIONS: The HR-VO(2) relationship appeared linear in only eight out of 18 subjects. An individual analysis of the HR-VO(2) relationship is necessary to determine whether HR can be used to quantify exercise intensity. The use of HR to prescribe training intensity should be reconsidered in persons with TP. SPONSORSHIP: This study is supported from a grant by ZON-MW.

Nódulos piezogénicos de las piernas: nuevo enfoque / Piezogenic nodules of the legs: new approach

De acuerdo a nuevas publicaciones y a la utilización de nuevas tecnología, se hace una revisión de los mecanismos patofisiológicos de los nódulos piezogénicos de las piernas, asimilándolos al cuadro de las fracturas por estrés. Se comentan diagnósticos diferenciales y a la luz de dos nuevos casos se los ilustra con la centellografía correspondiente. Se propone mantener el nombre de nódulos piezogénicos pero considerándolos un elemento más de alteración inicial ósea (microfracturas).

Nódulos piezogénicos de las piernas: nuevo enfoque / Piezogenic nodules of the legs: new approach

De acuerdo a nuevas publicaciones y a la utilización de nuevas tecnología, se hace una revisión de los mecanismos patofisiológicos de los nódulos piezogénicos de las piernas, asimilándolos al cuadro de las fracturas por estrés. Se comentan diagnósticos diferenciales y a la luz de dos nuevos casos se los ilustra con la centellografía correspondiente. Se propone mantener el nombre de nódulos piezogénicos pero considerándolos un elemento más de alteración inicial ósea (microfracturas). (AU)

The effect of wheelchair handrim tube diameter on propulsion efficiency and force application (tube diameter and efficiency in wheelchairs).

To determine the optimum tube diameter of a standard handrim-propelled wheelchair, the effect of tube size and shape on physiological and kinetic parameters was studied. Six able-bodied male subjects performed two tests on a wheelchair ergometer. Tests were performed against work loads comparable to every day use and with two different handrim tube diameters, a handrim with an oval 25 by 30 mm diameter (LR) and one with an 18 mm diameter (SR). The large tube diameter (LR) yielded slightly but significantly lower values for the physiological parameters. Gross mechanical efficiency was on average 7% for the LR and 6.3% for the SR. No significant results were found for force application parameters related to the direction of the applied force or the torque by the hand onto the handrim surface. As technique parameters could not explain the higher mechanical efficiency (ME) when using the LR, it is suggested that hand grip constraints in the push phase (finger flexor activity) might be responsible. Another possible explanation is that with a better hand grip using LR, less stabilization by the larger muscle groups at the elbow and shoulder is needed. The measured technique parameters seem to be determined by geometric constraints of the arm and shoulder. The technique requirements resulting from the forced trajectory of the propulsion movement are also likely to determine the technique parameters. Regarding the low mechanical efficiency of handrim propulsion, which is partly caused by the forced unfavorable trajectory of the hand, an alternative propulsion mechanism is suggested.

Nódulos piezogénicos de las piernas / Leg piezogenic nodules

Se comentan lesiones nodulares de piernas aparecidas bruscamente en una población deportiva, predominantemente del sexo femenino y acompañada de dolor. Se asimilan estas observacicones a las anteriormente conocidas como pápulas piezogénicas del pie, destacándose el exceso de peso en la mayoría de las pacientes y su iniciación luego de actividades gimnásticas intensas. Se sugiere que estos casos sean agrupados como Nódulos piezogénicos, seguidos de la denominación del lugar afectado

Nódulos piezogénicos de las piernas / Leg piezogenic nodules

Se comentan lesiones nodulares de piernas aparecidas bruscamente en una población deportiva, predominantemente del sexo femenino y acompañada de dolor. Se asimilan estas observacicones a las anteriormente conocidas como pápulas piezogénicas del pie, destacándose el exceso de peso en la mayoría de las pacientes y su iniciación luego de actividades gimnásticas intensas. Se sugiere que estos casos sean agrupados como Nódulos piezogénicos, seguidos de la denominación del lugar afectado (AU)

[Immunization of cattle against Aujeszky's disease with inactivated adjuvant vaccine]. / Imunizácia hovädzieho dobytka proti Aujeszkyho chorobe inaktivovanou adjuvantnou vakcínou.

The experiments with sheep and young cattle were carried out to test the immunizing efficacy of inactivated adjuvant vaccine against Aujeszky's disease. The vaccine application at doses of 1 ml and 2 ml to lambs at the age of eight to ten months caused the neutralizing antibody production with a significant rise of titres after revaccination. A survival of infection induced with a dose of 10(5.5) TKID50 of virulent virus was recorded in 62.5% of once vaccinated animals and in 87.5% of twice vaccinated animals. When applying different doses of vaccines (from 1 to 10 ml) to young cattle, the antibody reaction level was directly dependent on the inoculum quantity. The double inoculation of animals with vaccines of 2 ml and 5 ml caused the neutralizing antibody production at titres of 1:35, or 1:46. The animals, immunized with the live or inactivated IBR-vaccine possessing high antibody titres against IBR-virus, reacted upon the vaccination with inactivated Aujeszky's vaccine anamnestically, by early production of antibodies in high titres. Metaphylactic vaccination (2 ml of vaccine) of cattle in herds with an acute course days, however earlier during five days from the revaccination when it was carried out in seven days following the first vaccination.