Treadmill training in Parkinson's patients after deep brain stimulation: Effects on gait kinematic.

OBJECTIVE: The purpose of this study was to evaluate the effect of treadmill training with body weight support on gait kinematics parameters in patients with PD using DBS. DESIGN: Twelve patients completed the protocols (age: 60.9±10.6 years; disease duration: 20±7 years; and time since DBS surgery: 20±4 months). The same set of patients underwent two trainings protocols and four gait analyses (before and after each training). They received eight weeks of treadmill training without body weight support (16 sessions) in conjunction with physiotherapy program followed by six weeks of wash out period, followed by eight weeks of body-weight-supported treadmill training in conjunction with a same physiotherapy program. The Gait Kinematic Analysis involved eight infrared cameras that detected 19 reflective spherical markers attached in limb lower of patients. Statistical analysis used the Wilcoxon test (p≤0.05). RESULTS: Both the training no showed significant differences in linear variables. As the angular variables, only training with support showed significant increase of ranges of motion: pelvis tilt, obliquity and rotation amplitude; hip adduction-abduction and rotation amplitude; percentage of peak flexion in swing phase; foot progression amplitude. CONCLUSION: The body weight supported treadmill training may promote increase of mobility of lower limbs during gait and it could be a targeted intervention for PD patients treated with DBS.

RIPK3 deficiency or catalytically inactive RIPK1 provides greater benefit than MLKL deficiency in mouse models of inflammation and tissue injury.

Necroptosis is a caspase-independent form of cell death that is triggered by activation of the receptor interacting serine/threonine kinase 3 (RIPK3) and phosphorylation of its pseudokinase substrate mixed lineage kinase-like (MLKL), which then translocates to membranes and promotes cell lysis. Activation of RIPK3 is regulated by the kinase RIPK1. Here we analyze the contribution of RIPK1, RIPK3, or MLKL to several mouse disease models. Loss of RIPK3 had no effect on lipopolysaccharide-induced sepsis, dextran sodium sulfate-induced colitis, cerulein-induced pancreatitis, hypoxia-induced cerebral edema, or the major cerebral artery occlusion stroke model. However, kidney ischemia-reperfusion injury, myocardial infarction, and systemic inflammation associated with A20 deficiency or high-dose tumor necrosis factor (TNF) were ameliorated by RIPK3 deficiency. Catalytically inactive RIPK1 was also beneficial in the kidney ischemia-reperfusion injury model, the high-dose TNF model, and in A20(-/-) mice. Interestingly, MLKL deficiency offered less protection in the kidney ischemia-reperfusion injury model and no benefit in A20(-/-) mice, consistent with necroptosis-independent functions for RIPK1 and RIPK3. Combined loss of RIPK3 (or MLKL) and caspase-8 largely prevented the cytokine storm, hypothermia, and morbidity induced by TNF, suggesting that the triggering event in this model is a combination of apoptosis and necroptosis. Tissue-specific RIPK3 deletion identified intestinal epithelial cells as the major target organ. Together these data emphasize that MLKL deficiency rather than RIPK1 inactivation or RIPK3 deficiency must be examined to implicate a role for necroptosis in disease.

Performance during cardiopulmonary exercise test and quality of life of long-distance elderly runners and of non-exerciser elderly.

AIM: Regular physical exercises are associated to decreased morbidity and mortality, but their relationship with quality of life perception is still not well established. The aim of this paper was to compare cardiopulmonary exercise indicators of functional performance and quality of life (QOL) between a group of untrained elderly (GUE) and a group of trained elderly (GTE) in long-distance running. METHODS: GUE was made up of 19 individuals with mean age of 73.5±6.4 years and GTE by 27 trained elderly with mean age of 73.1±4.3 years. All were submitted to cardiopulmonary and metabolic evaluation by expired gases analysis. Maximum physical capacity was determined on a motor-driven treadmill with continuous graded protocol and fixed slope of 1%. Quality of Life was evaluated in four domains (physical, psychological, social relations and environment) by Whoqol-Bref questionnaire (WHO) and quantified by total score for each domain. RESULTS: At maximal oxygen intake, GUE and GTE presented: VO2max: 27.0±5.4 vs. 38.1±4.5 mL/[kg.min] (P<0.001); O2 pulse: 11.7±3.0 vs. 15.5±2.4 mL/bpm (P<0.001); running speed: 9.7±2.5 vs. 13.8±1.7 km/h (P<0.001) and tolerance time: 9.6±2.9 vs.14.8±4.4 min (P<0.001). QOL measured by Whoqol-Bref questionnaire in four domains for GUE and GTE was respectively: physical: 75.6±13.6 vs. 80.6 ±14.2 (P=0.210), psychological: 79.2±11.3 vs. 79.2±13.8 (P=0.893), social relations: 74.6±14.3 vs. 74.7±19.1 (P=0.726), environment: 61.4±15.9 vs. 69.0±15.5 (P=0.131). CONCLUSION: GTE cardiopulmonary performance was better as compared to GUE, and QOL of the elderly from both groups was not associated to cardiopulmonary exercise test performance.

Aerobic power and muscle strength of individuals living with HIV/AIDS.

AIM: We wished to evaluate any continuing adverse effects upon peak aerobic power and muscle strength associated with either HAART therapy or persistently low CD4⁺ counts in men living with HIV/AIDS. METHODS: We studied 39 HIV/AIDS patients with an average disease history of 6.1 years, and 28 normal sedentary volunteers. All subjects performed tests of peak aerobic power and isokinetic muscle force, and the HIV/AIDS group also completed the Profile of Mood States (POMS) and WHO Quality of Life questionnaires. Blood was sampled for standard measures of immune function (CD4⁺ and CD8⁺ counts) and viral load. RESULTS: Patient values were generally as in the normal subjects and appeared to be uninfluenced by the CD4+ nadir or the use of HAART therapy. However, the isokinetic muscle strength was lower in individuals with a low current CD4⁺ count. Isokinetic strength was also negatively correlated with current CD4⁺ and CD8⁺ counts. CONCLUSION: HAART therapy does not appear to have an adverse long-term effect on either aerobic power or muscle strength. Many ambulatory volunteers living with HIV/AIDS have a normal peak aerobic power. However, isokinetic strength can remain low, particularly in those with low current T-cell counts.

Correlation of postural balance and knee muscle strength in the sit-to-stand test among women with and without postmenopausal osteoporosis.

UNLABELLED: The task of standing up from a chair forms a part of daily life for all independent individuals. However, this task becomes more difficult with advancing age. Women with postmenopausal osteoporosis presented diminished knee extensor and flexor muscle strength. There was a weak correlation between knee muscle strength (greater with extensor strength) and postural balance during the act of standing up. INTRODUCTION: This study aims to evaluate postural balance during the transition from sitting to standing and its relationship with knee extensor and flexor strength among women with and without postmenopausal osteoporosis. METHODS: Assessments were made on 126 women (aged 55-65 years), divided into osteoporosis and control groups according to lumbar bone density. Their balance during the task of standing up from a chair was evaluated using the Balance Master® device. Knee muscle strength was evaluated using an isokinetic dynamometer (Biodex®), in concentric/concentric mode, at a velocity of 60°/s. Spearman's correlation between the variables of muscle strength and postural balance was evaluated. Subsequently, to evaluate the association of each balance variable with the group and with muscle strength, multiple linear regression models were fitted. The significance level was set at 0.05. RESULTS: There was a difference in knee muscle strength between the groups (P < 0.05). However, independent of the muscle strength values, there were no differences in relation to weight transfer times (P = 0.556) or center of gravity sway velocity (P = 0.952). Transfer time diminished with increasing extensor strength (P = 0.025). The center of gravity sway velocity tended to increase with increasing extensor strength (P = 0.013) and was the same in the two groups (P = 0.264). CONCLUSION: Women with postmenopausal osteoporosis presented diminished knee extensor and flexor muscle strength. There was a weak correlation between knee muscle strength (greater with extensor strength) and postural balance during the act of standing up.

Quality of life after spinal cord injury: a comparison across six countries.

STUDY DESIGN: An international cross-sectional study. OBJECTIVE: To examine the quality of life (QoL) of people with spinal cord injury (SCI) across six countries worldwide, controlling for socio-demographic and lesion-related sample characteristics and using a cross-culturally valid assessment. METHODS: Data from 243 persons with SCI from Australia, Brazil, Canada, Israel, South Africa and the United States were analyzed. QoL was measured using five satisfaction items from the World Health Organization Quality of Life Assessment. Cross-culturally valid, Rasch-transformed scores were used for comparison. RESULTS: Analysis of variance showed a significant difference in QoL between countries (F=3.938; df=5; P=0.002). Shorter time since injury, no paid employment and living in Brazil were significant predictors of lower QoL, explaining 13% of variance in linear regression. Using multilevel regression with country as higher-order variable, time since injury and paid employment remained significant predictors and explained 18% of variance in QoL. The intraclass correlation coefficient (0.05) indicates that 5% of the variability can be accounted for by country. CONCLUSION: This study showed QoL differences between countries that could not be explained by differences in demographic and lesion-related characteristics. Results point to the relevance of reintegration of people with SCI into the workforce. Further international comparative research using larger samples is recommended.

Gait analysis following treadmill training with body weight support versus conventional physical therapy: a prospective randomized controlled single blind study.

STUDY DESIGN: Single-blind randomized, controlled clinical study. OBJECTIVES: To evaluate, using kinematic gait analysis, the results obtained from gait training on a treadmill with body weight support versus those obtained with conventional gait training and physiotherapy. SETTING: Thirty patients with sequelae from traumatic incomplete spinal cord injuries at least 12 months earlier; patients were able to walk and were classified according to motor function as ASIA (American Spinal Injury Association) impairment scale C or D. METHODS: Patients were divided randomly into two groups of 15 patients by the drawing of opaque envelopes: group A (weight support) and group B (conventional). After an initial assessment, both groups underwent 30 sessions of gait training. Sessions occurred twice a week, lasted for 30 min each and continued for four months. All of the patients were evaluated by a single blinded examiner using movement analysis to measure angular and linear kinematic gait parameters. Six patients (three from group A and three from group B) were excluded because they attended fewer than 85% of the training sessions. RESULTS: There were no statistically significant differences in intra-group comparisons among the spatial-temporal variables in group B. In group A, the following significant differences in the studied spatial-temporal variables were observed: increases in velocity, distance, cadence, step length, swing phase and gait cycle duration, in addition to a reduction in stance phase. There were also no significant differences in intra-group comparisons among the angular variables in group B. However, group A achieved significant improvements in maximum hip extension and plantar flexion during stance. CONCLUSION: Gait training with body weight support was more effective than conventional physiotherapy for improving the spatial-temporal and kinematic gait parameters among patients with incomplete spinal cord injuries.

Resistance exercise intensity progression in older men.

Our purpose was to examine possible influences of age on resistance exercise (RE) intensity progression in men. Twenty-four men, divided in young sedentary (YS; n=10; 25.9+/-3.7 years), older sedentary (OS; n=7; 67.4+/-5.2 years), and older runners (OR; n=7; 71.3+/-3.0 years), underwent a 2 times-a-week RE program for 13 weeks. Muscle strength was assessed before and after training by 1-repetition maximum test. RE workloads were recorded for each exercise session, and increases of 5-10% were made whenever adaptation occurred. Muscle strength improved similarly in all groups after RE (P<0.001). Relative RE intensity progression was not significantly different between YS and OS, except for a greater increase in calf raise relative workload observed in YS (P<0.05). In contrast, OR displayed greater relative workload increase in 7 and 6 exercises than YS and OS, respectively (P<0.05). The RE was safe as no injuries or major muscle pain were observed in either group. These results suggest that healthy sedentary older men are capable to exercise and increase RE intensity in the same way as young men, while physically active older men are capable to increase RE intensity in greater way than sedentary young and older men.

Haemodynamic, metabolic and neuro-humoral abnormalities in young normotensive women at high familial risk for hypertension.

We analysed the haemodynamic, metabolic and hormonal status at rest and in response to exercise, in young normotensive women with two hypertensive parents (FH++; n=17; 25.1±4.8 years), one hypertensive parent (FH+; n=18; 24.9±4.1 years) and normotensive parents (FH-; n=15; 25.3±3.8 years). Casual and ambulatorial blood pressure (BP), carotid-femoral pulse wave velocity (PWV) and biochemistry were analysed. BP, nor-epinephrine (NE), epinephrine (EPI), endothelin-1 (ET-1) and nitrite/nitrate (NOx) levels were also analysed during a graded exercise test (GXT). Casual and ambulatorial BP were not different between groups, but PWV was 7.5 and 12.6% higher in FH++ than FH+ and FH-, respectively, and 4.8% higher in FH+ than FH- (P≤0.01). Insulin and insulin-to-glucose ratio were increased in FH++ and FH+ (P<0.05), and low-density lipoprotein (LDL)-cholesterol tended to be higher only in FH++ (P=0.07). FH++ showed higher exercise and recovery diastolic BP and EPI levels, and increased resting, exercise and recovery NE, and ET-1 levels than FH- (P<0.05). FH+ showed only greater resting, exercise and recovery NE, and rest ET-1 (P<0.05). Resting, exercise and recovery NOx were lower in FH++ and FH+ than FH- (P<0.01). Haemodynamic, metabolic and hormonal abnormalities were presented in nonhypertensive young women offspring of hypertensive parents before any increase in BP. Greater abnormalities were observed in women with a strong family history of hypertension (FH++). These results suggest that there is an early vascular, metabolic and hormonal involvement in a familial hypertensive disorder.

Meniscectomy alters the dynamic deformational behavior and cumulative strain of tibial articular cartilage in knee joints subjected to cyclic loads.

OBJECTIVE: Meniscectomy-induced osteoarthritis may be mechanically based. We asked how meniscectomy alters time-dependent deformation of physiologically loaded articular cartilage. We hypothesized that meniscectomy alters nominal strain in tibial articular cartilage, and that meniscectomy affects cartilage thickness recovery following cessation of loading. METHODS: A cyclic load simulating normal gait was applied to four sheep knees. A custom device was used to obtain MR images of cartilage at 4.7T during cyclic loading. Articular cartilage thickness and nominal strain were measured every 2.5 min during 1h of cyclic loading, and during 2.5h after cessation of loading. RESULTS: Following meniscectomy the loaded joints rapidly developed high strain centrally and minimal strain peripherally. Maximum nominal strains after 1h of loading were about 55% in the intact knees and 72% in the meniscectomized knees. Nominal strains in the peripheral tibial cartilage were significantly reduced in the meniscectomized knees. Strain recovery was markedly prolonged in the meniscectomized knees. CONCLUSIONS: With meniscectomy, tibial articular cartilage in the central load bearing region remains chronically deformed and dehydrated, even after cessation of loading. Post-meniscectomy osteoarthritis may be initiated in this region by direct damage to the cartilage matrix, or by altering the hydration of the tissue. In peripheral regions, reduced loading and strain may facilitate subchondral vascular invasion, and endochondral ossification. This is consistent with the central fibrillation and peripheral osteophyte formation seen in post-meniscectomy osteoarthritis.

[Gait analysis and quality of life evaluation after gait training in patients with spinal cord injury]. / Analisis de la marcha y evaluación de la calidad de vida después del entrenamiento de la marcha en pacientes con lesion medular.

INTRODUCTION: Over recent years it has become possible to retrain motor activity among patients with partial spinal cord injury, especially for walking. AIM. To assess the impact of gait training on a treadmill with body weight support, regarding temporospatial parameters and quality of life. PATIENTS AND METHODS: Twelve patients of both sexes were evaluated. They had been diagnosed with partial spinal cord injury of traumatic origin at least 12 months earlier. They were able to walk and their motor function below the level of the injury was partially preserved and classified as level C or D. After the initial evaluation, the participants were trained on a treadmill with body weight support, with two sessions per week lasting 30 minutes each, over a four-month period, thus totaling 30 sessions. The patients' temporospatial gait parameters and quality of life were analyzed before and after the training. RESULTS: There were improvements in all the temporospatial parameters evaluated (p < 0.0001), but no changes in quality of life were seen (p > 0.05). CONCLUSION: Treadmill training with body weight support among patients with spinal cord injury was effective in improving the temporospatial gait parameters, but without changing their quality of life.

Análisis de la marcha y evaluación de la calidad de vida después del entrenamiento de la marcha en pacientes con lesión medular / Gait analysis and quality of life evaluation after gait training in patients with spinal cord injury

Durante los últimos años ha sido posible rehabilitar la actividad motora en los pacientes con lesiónmedular parcial, especialmente para poder caminar. Objetivo. Evaluar el impacto del entrenamiento de la marcha en una cinta sin fin con soporte del peso corporal con respecto a los parámetros temporoespaciales y la calidad de vida. Pacientes y métodos.Se estudió a 12 pacientes de ambos sexos. Se les había diagnosticado una lesión medular parcial de origen traumático al menos 12 meses antes. Podían caminar, y su función motora por debajo del nivel de la lesión estaba parcialmente preservada y clasificada como nivel C o D. Después de la evaluación inicial, los participantes se entrenaron en una cinta sin fin consoporte del peso corporal, con dos sesiones por semana de 30 minutos de duración cada una, durante un período de cuatro meses, lo que supuso un total de 30 sesiones. Los parámetros temporoespaciales de la marcha y la calidad de vida de los pacientesse analizaron antes y después del entrenamiento. Resultados. Hubo mejoras importantes en todos los parámetros temporoespaciales evaluados (p < 0,0001), pero no se observaron cambios en la calidad de vida (p > 0,05). Conclusión. El entrenamiento en una cinta sin fin con soporte del peso corporal en pacientes con lesión medular fue eficaz a la hora de mejorar los parámetros temporoespaciales de la marcha, pero no se produjeron cambios en su calidad de vida

Over recent years it has become possible to retrain motor activity among patients with partial spinalcord injury, especially for walking. Aim. To assess the impact of gait training on a treadmill with body weight support, regarding temporospatial parameters and quality of life. Patients and methods. Twelve patients of both sexes were evaluated. They had been diagnosed with partial spinal cord injury of traumatic origin at least 12 months earlier. They were able to walkand their motor function below the level of the injury was partially preserved and classified as level C or D. After the initial evaluation, the participants were trained on a treadmill with body weight support, with two sessions per week lasting 30minutes each, over a four-month period, thus totaling 30 sessions. The patients’ temporospatial gait parameters and quality of life were analyzed before and after the training. Results. There were improvements in all the temporospatial parameters evaluated (p < 0.0001), but no changes in quality of life were seen (p > 0.05). Conclusion. Treadmill training with body weightsupport among patients with spinal cord injury was effective in improving the temporospatial gait parameters, but without changing their quality of life

Relação entre a mobilidade do tornozelo e pé e a magnitude da força vertical de reação do solo / Relationship between ankle and foot mobility and the magnitude of the vertical ground reaction force

OBJETIVO: Verificar a relação entre a mobilidade do tornozelo e do pé, e o pico da força vertical de reação do solo, considerada como porcentagem do peso corporal, gerada durante a fase de apoio da marcha. MÉTODOS: foram estudados pés normais do lado direito e esquerdo de 15 homens com 22,1±2,7 anos (19-28) e 15 mulheres 24,20±5,24 anos (19-34). Os parâmetros de exclusão foram: deformidades nos pés, doenças ou traumas, que pudessem acometer o sistema musculoesquelético e a marcha. A mobilidade do tornozelo e dos pés foi obtida através da goniometria da flexão plantar, dorsiflexão, extensão do hálux e extensão dos dedos, o pico da força vertical de reação do solo FRS, foi obtido pela baropodometria computadorizada do sistema FSCAN R. A correlação entre ambas foi feita pelo teste estatístico de Spearman. RESULTADOS: os indivíduos do grupo masculino apresentaram menores valores de mobilidade, e maiores valores do pico da força vertical de reação do solo, quando comparados com o grupo feminino. Não houve diferença entre os pés direito e esquerdo. No sexo feminino foi encontrada correlação negativa estatisticamente significante entre os valores da flexão plantar e a força vertical, e entre os valores da extensão dos dedos e a foça vertical. No sexo masculino, houve correlação negativa estatisticamente significante entre os valores da dorsiflexão e a força vertical. Entre os demais valores não foi encontrada correlação significante. CONCLUSÃO: Há relação entre a mobilidade e a força vertical gerada durante a marcha.

OBJECTIVE: To investigate the relationship between ankle and foot mobility and the peak of the vertical ground reaction force, as a percentage of body weight, generated during the gait stance phase. METHOD: Fifteen men with mean age of 22.1 ± 2.7 years (range: 19-28) and fifteen women with mean age of 24.20 ± 5.24 years (range: 19-34) with normal feet were studied. The exclusion criteria were foot deformities or a history of trauma or diseases that might have harmed both the musculoskeletal system and gait pattern. The ankle and foot mobility was obtained by means of goniometry on the plantar flexion, dorsiflexion, hallux extension and toe extension. The peak of the vertical ground reaction force was obtained by baropodometry using the FSCAN TM system. The Spearman statistical test was used to identify correlations. RESULTS: Males presented lower mobility values and higher peak values for the vertical ground reaction force, in comparison with females. There was no difference between the right and left foot. For females, there were statistically significant negative correlations between the values for plantar flexion and vertical force, and between the values for toe extension and vertical force. For males, there were statistically significant negative correlations between the values for dorsiflexion and vertical force. Among the remaining values, no significant correlation was found. CONCLUSION: There was a relationship between mobility and the vertical force generated during gait.

Articular cartilage MR imaging and thickness mapping of a loaded knee joint before and after meniscectomy.

OBJECTIVE: We describe a technique to axially compress a sheep knee joint in an MRI scanner and measure articular cartilage deformation. As an initial application, tibial articular cartilage deformation patterns after 2 h of static loading before and after medial meniscectomy are compared. METHODS: Precision was established for repeated scans and repeated segmentations. Accuracy was established by comparing to micro-CT measurements. Four sheep knees were then imaged unloaded, and while statically loaded for 2 h at 1.5 times body weight before and after medial meniscectomy. Images were obtained using a 3D gradient echo sequence in a 4.7 T MRI. Corresponding 3D cartilage thickness models were created. Nominal strain patterns for the intact and meniscectomized conditions were compared. RESULTS: Coefficients of variation were all 2% or less. Root mean squared errors of MR cartilage thickness measurements averaged less than 0.09 mm. Meniscectomy resulted in a 60% decrease in the contact area (P=0.001) and a 13% increase in maximum cartilage deformation (P=0.01). Following meniscectomy, there were greater areas of articular cartilage experiencing abnormally high and low nominal strains. Areas of moderate nominal strain were reduced. CONCLUSIONS: Medial meniscectomy resulted in increased medial tibial cartilage nominal strains centrally and decreased strains peripherally. Areas of abnormally high nominal strain following meniscectomy correlated with areas that are known to develop fibrillation and softening 16 weeks after medial meniscectomy. Areas of abnormally low nominal strain correlated with areas of osteophyte formation. Studies of articular cartilage deformation may prove useful in elucidating the mechanical etiology of osteoarthritis.

Efeito de duas tecnicas de alongamento muscular dos isquiotibiais na amplitude de extensao ativa do joelho e no pico de torque / Effect of two hamstring muscle stretching techniques on the range of motion of active knee extension and on peak torque

Os exercicios de alongamento sao amplamente utilizados na fisioterapia. No entanto, seus reais beneficios nao estao compoletamente esclarecidos. Objetivo: o proposito deste estudo foi investigar o efeito do alongamento dos isquiotibiais na amplitude de movimento de extensao ativa do joelho e no pico de torque desse grupo muscular. Metodo: participaram da pesquisa 14 individuos de ambos os sexos, com idade media de 222,92+-0,9 anos, sedentarios, os quais foram submetidos a 5 ciclos de alongamentos diarios, com 30, segundos cada, por um periodo de tres semanas. Foram utilizados dois protocolos de alongamento: o primeiro grupo (G1), representado pelos membros inferiores esquerdos, realizou manobras passivas/estaticas. para a avalicao da ADM utilizou-se um goniometro universal e para o pico de torque, um dinamometro isocinetico da marca Cybex - 6000. Analise estatistica foi realizada por meio dos testes ANOVA e post-hoc Dunn`s, considerando o nivel de significancaia (<-5 por cento). Resultados: observou-se o aumento na ADM em ambos os grupos: 149+-14º para 162+-11º(p<0,01) para o G1 e de 148+-14º para 162+-11º(p<0,01) para o G2. No entanto nao houve difrenca entre os grupos. Ocorreu aumento sgnificativo no torque dos membros do grupo G1 apos a aplicacao da tecnica de alongamento do tipo FNP a 60º/s(de 89+-36Nm para 96+-40Nm) e a 240º/s(de 59+-24Nm para 68+-27Nm) - p<0,01. Por outro lado, nao houve diferenca estatisticamente significativa no torque dos membros do G2. Conclusoes: Esses dados sugerem que o programa de alongamento muscular utilizando a tecnica contrair-relaxar pode influenciar na ADM e no torque muscular. Entretanto, a tecnica de alongamento estatico/passivo produziu ganhos apenas na ADM

Avaliacao isocinetica dos inversores e eversores de tornozelo: estudo comparativo entre atletas de futebol e sedentarios normais / Body weight influence on respiratory pressures on sitting supine and upright positions

O objetivo deste trabalho foi avaliar os grupos musculares eversores e inversores do tornozelo e fazer uma comparacao das respostas dinamicas de forca e potencia entre os agonistas e antagonistas quanto a dominancia e pratica de futebol. Metodos: foram avaliados 30 individuos do sexo masculino de 17 a 20 anos, sem lesoes, divididos em dois grupos: 15 atletas (categoria juniores) de futebol, idade 18,4 +- 0,8 anos, peso 65 +- 7,3 kg e altura 1,74 +- 0,05m e 15 nao atletas (grupo controle) com idade de 17,6 +- 0,8 anos, peso 65,8 +- 15kg e altura 1,72 +- 0,1m pela dinamometria isocinetica. Os parametros avaliados foram pico de torque (Newton metros-Nm), trabalho (joules - J) e potencia (watts - W) nas velocidades angulares de 30/s e 120/s. Resultados: a relacao dos grupos musculares agonistas/antagonistas quanto a dominancia e atividade futebolistica nao apresentou diferenca significativa. As relacoes entre os grupos inversores/eversores do tornozelo ficaram proximas de 100 (por cento)

A T-cell-selective interleukin 2 mutein exhibits potent antitumor activity and is well tolerated in vivo.

Human interleukin 2 (IL-2; Proleukin) is an approved therapeutic for advanced-stage metastatic cancer; however, its use is restricted because of severe systemic toxicity. Its function as a central mediator of T-cell activation may contribute to its efficacy for cancer therapy. However, activation of natural killer (NK) cells by therapeutically administered IL-2 may mediate toxicity. Here we have used targeted mutagenesis of human IL-2 to generate a mutein with approximately 3,000-fold in vitro selectivity for T cells over NK cells relative to wild-type IL-2. We compared the variant, termed BAY 50-4798, with human IL-2 (Proleukin) in a therapeutic dosing regimen in chimpanzees, and found that although the T-cell mobilization and activation properties of BAY 50-4798 were comparable to human IL-2, BAY 50-4798 was better tolerated in the chimpanzee. BAY 50-4798 was also shown to inhibit metastasis in a mouse tumor model. These results indicate that BAY 50-4798 may exhibit a greater therapeutic index than IL-2 in humans in the treatment of cancer and AIDS.

Changes in interface pressure and stump shape over time: preliminary results from a trans-tibial amputee subject.

Interface stresses and stump shape were measured during sessions over a two-month interval on a trans-tibial amputee subject. Results from thirteen transducer sites monitored during four sessions showed greater interface pressure changes over time at anterior sites than at lateral or posterior locations. There was a trend of decreased pressure with stump swelling and increased pressure for stump atrophy. During one session in which stump shape was monitored over a 23.1 min interval after ambulation, stump swelling was localised. Swelling tended to increase in the regions of initial enlargement, as opposed to redistributing through different areas over time. Regions of swelling were anterior lateral and posterior proximal, areas of thick underlying soft tissue. Identification of localised areas of swelling and atrophy and understanding of their effects on interface pressures could be used to improve individual socket design.

Effects of changes in cadence, prosthetic componentry, and time on interface pressures and shear stresses of three trans-tibial amputees.

OBJECTIVE: To evaluate the effects of changes in cadence, prosthetic componentry, and time on interface pressures and resultant shear stresses in trans-tibial amputee case studies. DESIGN: Interface stresses were monitored using custom-designed instrumentation at 13 sites on three subjects with unilateral trans-tibial amputation walking with patellar-tendon-bearing prosthetic limbs. BACKGROUND: Previous studies suggested that week-to-week residual limb changes altered interface stresses more than did alterations in prosthetic alignment. No studies investigating effects of changes in cadence or componentry on interface stress distributions nor comparing their influence with week-to-week changes have been conducted previously. METHODS: Five different prosthetic componentry configurations were tested at each of three cadences in four sessions. Data were analysed for the magnitudes and timings of peak pressures and resultant shear stresses as well as corresponding resultant shear angles. RESULTS: None of the three cadences or five componentry configurations consistently induced significantly (P<0.05) higher or lower interface stress magnitudes for all subjects. However, an Aluminium Pylon/SACH Foot combination compared with an AirStance (pneumatic shank)/Seattle LightFoot unit induced later peak interface stress timings as a percentage of stance phase. Higher and more frequent interface stress changes were seen between the weekly sessions than between different cadences or between different componentry configurations. CONCLUSION: The amputees' capabilities to compensate for week-to-week residual limb changes were less than those for intra-session cadence or componentry alterations. RELEVANCE: Results suggest that effective techniques to accommodate week-to-week residual limb fluctuations could have a greater impact on maintaining consistent interface stress distributions than do adjustments in cadence or componentry.