Does daily physical activity reflect claudication distance measured on a treadmill and in a community outdoor setting?

INTRODUCTION AND OBJECTIVE: Low physical activity in patients with claudication is associated with lower walking abilities as assessed by the treadmill test. The impact of physical activity on the ability to walk in a natural environment is unknown. The study aimed to assess the level of daily physical activity among patients with claudication, as well as the relationship between the level of daily physical activity and claudication distance measured during the outdoor walking and treadmill tests. MATERIAL AND METHODS: The study included 37 patients (24 males), aged 70.03±5.9, with intermittent claudication. Daily step count was assessed using the Garmin Vivofit activity monitor, worn on the non-dominant wrist for 7 consecutive days. Pain-free walking distance (PFWDTT) and maximal walking distance (MWDTT) were measured via the treadmill test. During 60-minute outdoor walking, the maximal walking distance (MWDGPS), total walking distance (TWDGPS), walking speed (WSGPS), number of stops (NSGPS) and stop durations (SDGPS) were assessed. RESULTS: Mean daily step count - 7,102±3,433. A significant correlation was observed between daily step count and MWDTT, TWDGPS (R=0.33, R=0.37, respectively (p<0.05). Furthermore, 51% of patients reached less than 7,500 steps/day and presented significantly shorter MWDTT, MWDGPS and TWDGPS, compared to the participants covering ≥7,500 steps (p<0.05). CONCLUSIONS: The daily step count reflects claudication distance measured on a treadmill and only partially in a community outdoor setting. The minimal daily step count that should be recommended for patients with claudication, allowing achievement of significantly better results with regard to walking abilities, both on the treadmill and in outdoor settings, is at least 7,500 steps per day.

The Role of Dysregulated miRNAs in the Pathogenesis, Diagnosis and Treatment of Age-Related Macular Degeneration.

Age-related macular degeneration (AMD) is an eye disease causing damage to the macular region of the retina where most of the photoreceptors responsible for central visual acuity are located. MicroRNAs (miRNAs) are small single-stranded non-coding RNA molecules that negatively regulate genes by silent post-transcriptional gene expressions. Previous studies have shown that changes in specific miRNAs are involved in the pathogenesis of eye diseases, including AMD. Altered expressions of miRNAs are related to disturbances of regulating oxidative stress, inflammation, angiogenesis, apoptosis and phagocytosis, which are known factors in the pathogenesis of AMD. Moreover, dysregulation of miRNA is involved in drusen formation. Thus, miRNAs may be used as potential molecular biomarkers for the disease and, furthermore, tailoring therapeutics to particular disturbances in miRNAs may, in the future, offer hope to prevent irreversible vision loss. In this review, we clarify the current state of knowledge about the influence of miRNA on the pathogenesis, diagnosis and treatment of AMD. Our study material consisted of publications, which were found in PubMed, Google Scholar and Embase databases using "Age-related macular degeneration", "miRNA", "AMD biomarkers", "miRNA therapeutics" and "AMD pathogenesis" as keywords. Paper search was limited to articles published from 2011 to date. In the section "Retinal, circulating and vitreous body miRNAs found in human studies", we limited the search to studies with patients published in 2016-2021.

Physiological Gait versus Gait in VR on Multidirectional Treadmill-Comparative Analysis.

BACKGROUND AND OBJECTIVES: Virtual reality (VR) is increasingly often finding applications in physiotherapy and health promotion. Recent years have seen the use of advanced technologies in the promotion of physical activity (PA) in society. New simulators, e.g., treadmills, enable the performance of PA (e.g., locomotive movements) in VR (artificially created virtual world). The question of how such movements are similar to natural forms of human locomotion (march, run) inspired the comparative analysis of physiological gait and gait in VR on a multidirectional Omni treadmill. MATERIALS AND METHODS: The tests involved the use of the BTS Smart system for the triplanar analysis of motion. The test involved 10 healthy females aged 20-24 (weight: 52 ± 3.1 kg, height 162 ± 5.4 cm). Measurements were performed at two stages. The first stage involved the standard assessment of physiological gait, whereas the second was focused on gait forced by the Omni treadmill. The following gait parameters were analyzed: Flexion-extension in the ankle, knee joint and hip joint, rotation in the hip joint and knee joint, foot progression, adduction-abduction in the knee joint and hip joint, pelvic obliquity, pelvic tilt, pelvic rotation as well as energy expenditure and the movement of the body center of mass. RESULTS: The analysis of the test results revealed the existence of differences in the kinematics of physical gait and gait on the treadmill. The greatest differences were recorded in relation to the dorsal-plantar flexion in the ankle, the foot progression, the rotation of the knee joint, pelvic tilt and rotation. In addition, the gait on the treadmill is characterized by the longer duration of the stance phase and reduced ranges of the following movements: Flexion-extension in the ankle, knee joint and hip joint, adduction-abduction in the hip joint as well as rotation in the ankle and hip joint. The values of potential, kinetic and total energy recorded in relation to forced gait are significantly lower than those of physiological gait. CONCLUSIONS: Because of the fact that the parameters of gait on the Omni platform vary significantly from the parameters of physical gait, the application of the Omni treadmill in the re-education of gait during rehabilitation should be treated with considerable care. Nonetheless, the treadmill has adequate potential to become a safe simulator enabling active motion in VR using locomotive movements.

Impact of diaphragm function parameters on balance maintenance.

The diaphragm is well known for its role as the principal muscle of respiration. However, according to previous studies, its role is multifactorial, from breathing through pain perception, regulation of emotional sphere, collaborating in gastroesophageal functions, facilitating the venous and lymphatic return, to an essential role in the maintenance of lumbar spine stability. The purpose of the study was to examine whether diaphragm function parameters (thickness and range of motion) are associated with static balance maintenance. A total of 142 participants were examined and divided into three groups: G1-patients qualified for lung resection due to cancer; G2 -patients after lobe resection; G3 -healthy subjects. Diaphragm thickness and excursion was measured using ultrasonography. Stabilometric parameters of balance were assessed by Zebris FDM-S platform. Greater diaphragm thickening during active breathing and diaphragm thickness fraction were associated with better static balance parameters. Limitation of diaphragm motion during quiet breathing and deep breathing was linked to balance disorders. There was no correlation between diaphragm muscle excursion during sniff maneuvers and balance parameters. Deterioration of diaphragm function observed after thoracic surgery was closely related with deterioration of balance maintenance. Impairment of diaphragm function manifested by decrease of muscle thickness and movement restriction is strongly associated with balance disorders in a clinical sample and among healthy subjects.

The Upper Limb Motion Deviation Index: A new comprehensive index of upper limb motion pathology.

PURPOSE: The aim of the research was to formulate a new index enabling assessment of the overall pathology of the upper limb movement. It defines the difference between the pathological movement and a normal movement pattern. METHODS: Methodology of determining the index is based on a mathematical algorithm for calculating the Gait Deviation Index which is based on advanced methods of image comparison. To calculate the ULMDI index, one must divide the analyzed movement into cycles appropriate to the nature of the movement (similarly in gait it is the gait cycle) and then determine kinematic quantities (courses of joint angles). RESULTS: A group of 23 healthy people (10 women: k1-k10 and 13 men: m1-m13) as the reference group and a group of 3 persons with mobility impairments (p1-p3) took part in the research. Time values of the angles of the joints on both upper limbs were registered and then ULMDI indexes were calculated. CONCLUSIONS: It has been shown that the developed ULMDI index allows to detect the deviations from the accepted norm in the performance of movements. The results showed that both the description of the motor dysfunction of examined person based on the diagnosis of the physician, a detailed analysis of kinematic waveforms received during the tests and the calculated values provide a coherent picture of the state of a human movement. The index analysis is less time-consuming for the doctor, and the comparison of the results at various stages of therapy gives an objective picture of the rehabilitation progress.

Motor functions assessment method based on energy changes in gait cycle.

PURPOSE: The aim of the research was to determine the energy changes during the gait cycle for a group of healthy children and a group of patients with cerebral palsy, and to compare the value of energy expenditure (EE) with the determined values of the Gillette Gait Index (GGI) and the Gait Deviation Index (GDI). METHODS: The study group consisted of 56 children with regular gait and 56 patients with diagnosed cerebral palsy (CP). The gait kinematics was determined by BTS Smart System. Based on the identified position of the body mass, the following parameters were determined: the potential energy, kinetic energy, and total energy. The values were standardized to 100% of the gait cycle. The values of the Gillette Gait Index (GGI) and the Gait Deviation Index (GDI) were calculated using the authors' own software. RESULTS: Values of potential, kinematic and mechanical energy changes and mean values of total energy (energy expenditure - EE) were calculated for a reference group and for patients with CP. The obtained results were standardized in relation to the body mass and stride length. Furthermore, the values of the Gillette Gait Index (GGI) and the Gait Deviation Index (GDI) were calculated. Statistical analysis of the obtained results was performed. The Spearman rank correlation coefficient was defined between the calculated GGI and GDI values and energy expenditure EE. CONCLUSIONS: Values of energy expenditure changes can be used as an objective comparative tool for gait results concerning children with various neurological and orthopaedic dysfunctions.

Ultrasound screening for neoplasms in children up to 6 years old.

The aim of the ultrasound (US) screening program was to detect neoplastic lesions in children, together with other pathologies of the developmental age in the area of the neck, abdomen, female pelvis, and scrotum in boys.US screening scans, including cervical, abdominal, pelvical, and scrotal US, were performed in the population of asymptomatic children aged from 9 months to 6 years. The children were scanned in Mobile Pediatric US Unit, consisting of 2 independent consulting rooms.The scans of 14,324 children were analyzed, 7247 boys and 7077 girls. Totally 42,538 US examinations were performed, including 14,187 cervical scans, 14,259 abdominal scans, 6942 female pelvical scans, and 7150 scrotal scans. Totally 5426 abnormalities were detected, which represent 12.7% of all examinations and 30% of patients. Three tumors were recognized, which are renal malignant tumor diagnosed as Wilms tumor, neurogenic tumor of the rib, and teratoma of the testis.US screening in pediatric population can be used to reveal lesions inaccessible to clinical examination, like tumors or other pathologies of developmental age before the onset of clinical symptoms. Due to the large number of detected abnormalities it should be recommended to the whole population of certain age.

Could the two-minute step test be an alternative to the six-minute walk test for patients with systolic heart failure?

BACKGROUND: The consequence of exercise intolerance for patients with heart failure is the difficulty climbing stairs. The two-minute step test is a test that reflects the activity of climbing stairs. DESIGN: The aim of the study design is to evaluate the applicability of the two-minute step test in an assessment of exercise tolerance in patients with heart failure and the association between the six-minute walk test and the two-minute step test. METHODS: Participants in this study were 168 men with systolic heart failure (New York Heart Association (NYHA) class I-IV). In the study we used the two-minute step test, the six-minute walk test, the cardiopulmonary exercise test and isometric dynamometer armchair. RESULTS: Patients who performed more steps during the two-minute step test covered a longer distance during the six-minute walk test (r = 0.45). The quadriceps strength was correlated with the two-minute step test and the six-minute walk test (r = 0.61 and r = 0.48). The greater number of steps performed during the two-minute step test was associated with higher values of peak oxygen consumption (r = 0.33), ventilatory response to exercise slope (r = -0.17) and longer time of exercise during the cardiopulmonary exercise test (r = 0.34). Fatigue and leg fatigue were greater after the two-minute step test than the six-minute walk test whereas dyspnoea and blood pressure responses were similar. CONCLUSION: The two-minute step test is well tolerated by patients with heart failure and may thus be considered as an alternative for the six-minute walk test.

[Presbyastasis ­ balance disorders and postural control therapy].

In the opinion of many researches systematic physical exercises and balance training can lead to decrease presbystasis symptoms. Involutional changes such as: decrease sense of touch and proprioception, reduced visual acuity, reduced range of motion and faulty posture all have impact on motor ef􀏐iciency and risk of falls. Based on data from the medical literature methods of rehabilitation which improve balance in older people with presbyastasis were described.

[Myokinesiotherapy as a form of rehabilitation in maxillary orthopaedics]. / Miokinezyterapia jako forma rehabilitacji w ortopedii szczekowej.

During early childhood the masticatory system is susceptible to negative exo- and endogenous factors. Untreated functional and morphological disorders provoke serious consequences in adolescence. Myokinesiotherapy is a concept of exercise involving facial muscles and the masticatory system, with the main objective of preventing and treating malocclusions.

Distance covered during a six-minute walk test predicts long-term cardiovascular mortality and hospitalisation rates in men with systolic heart failure: an observational study.

QUESTION: Does the distance covered during a 6-minute walk test predict risk of death or hospitalisation for cardiovascular reasons in men with stable heart failure over three years of follow-up? DESIGN: Prospective observational study. PARTICIPANTS: 243 men with stable systolic heart failure, with a mean age of 60 yr (SD 11) and left ventricular ejection fraction of 29% (SD 8). According to the New York Heart Association (NYHA) classification, 15% of the participants were in Class I, 44% in Class II, 37% in Class III, and 4% in class IV. OUTCOME MEASURES: The exercise capacity of participants was measured using the 6-minute walk test. The participants were followed up for at least three years in the case of survivors. The primary end-points of the survival analyses included cardiovascular death or urgent cardiovascular hospitalisation. RESULTS: During the 3-year follow-up, 44% of the participants died, and 69% died or required hospitalisation for cardiovascular reasons. A multivariate analysis showed that the shorter the distance covered in the 6-minute walk test, the greater the 1-year and 3-year mortality risk. Participants with a 6-minute walk test ≤ 468 m had a mortality hazard ratio of 3.22 (95% CI 1.17 to 8.86) at one year and 2.18 (95% CI 1.18 to 4.03) at three years. Multivariate analysis also showed that higher risk mortality or hospitalisation for cardiovascular reasons was predicted by a 6-minute walk distance ≤ 468m, with a hazard ratio of 2.77 (95% CI 1.30 to 5.88) at one year and 1.71 (95% CI 1.08 to 2.72) at three years. CONCLUSION: The 6-minute walk test distance constitutes an independent predictor of mortality and mortality or hospitalisation for cardiovascular reasons in men with stable systolic heart failure.

[Physiotherapist--profession known or unknown? Knowledge of the inhabitants of the West Pomeranian region of physiotherapy. Preliminary reports]. / Fizjoterapeuta--zawód znany czy nieznany? Wiedza mieszkanców województwa zachodniopomorskiego na temat fizjoterapii. Doniesienia wstepne.

INTRODUCTION: The aim of this study was to assess the knowledge of the inhabitants of the West Pomeranian region in terms of physiotherapy, and to highlight the need for action to expand public awareness of this topic. MATERIAL AND METHODS: A questionnaire survey involved a group of 267 adult men and women aged 18 to 78 years. All subjects were residents of West Pomerania. The questionnaire consists of 15 open and closed questions. Respondents provided answers to questions about physiotherapist competence, learning opportunities, and the availability of physiotherapy services. CONCLUSIONS: Knowledge about physiotherapy is insufficient. There is a great need to disseminate information about the profession of the physiotherapist. It is necessary to undertake further studies on a larger group of participants.

[Watsu: a modern method in physiotherapy, body regeneration, and sports]. / Watsu - nowoczesna metoda znajdujaca zastosowanie w fizjoterapii, odnowie biologicznej i sporcie.

Progress in existing methods of physiotherapy and body regeneration and introduction of new methods has made it possible to precisely select the techniques according to patient needs. The modern therapist is capable of improving the physical and mental condition of the patient. Watsu helps the therapist eliminate symptoms from the locomotor system and reach the psychic sphere at the same time.

[Temporal orientation and a course of alcohol addiction therapy]. / Preferowana orientacja temporalna a przebieg leczenia odwykowego osób uzaleznionych od alkoholu.

AIM: The aim of the study was assess the meaning of preferred temporal orientation for results of alcohol dependence therapy. METHODS: One hundred and sixteen (116) (95 men and 21 women) alcohol addict patients were evaluated at the beginning of the alcohol addiction outpatient therapy. The temporal orientation and attitude for time was assessed by using Temporal Orientation Questionnaire-AION and Carpe Diem, Fatalism and Hedonism Scale by Sobol-Kwapinska. RESULTS: The results showed that alcohol addict patients were in the highest degree focused on the past and the present in the hedonism and fatalism dimensions, while being relatively focused in the lowest degree on the present carpe diem dimension and the future at the beginning of the therapy. Men and women at the beginning of the therapy varied in some dimensions of temporal orientation. The differences occurred also between patients who finished and discontinued alcohol dependence therapy. CONCLUSIONS: Patients at the begging of alcohol addiction therapy prefer past and present temporal orientation. 1. There are differences between temporal orientation preferred by men and women. 2. Future temporal orientation is beneficial to finish addiction therapy by addict men. 3. Women who finish therapy are focused more on the past and hedonistic present orientation than women who discontinued therapy.

Congenital intranasal meningocele in a newborn - case raport.

BACKGROUND: Meningocele or meningocephalocele is a rare defect, which consists in the displacement of the structures of the brain or/and meninges through a congenital cavity in the cranium. Depending on the location, there are hernias of the skull vault and base or external and internal hernias. Some of them can cause breathing disorders in children. CASE REPORT: We described a case of an eutrophic, full-term newborn boy with breathing disorders. A laryngological examination found a tumor of the left nasal meatus, from which a sample was collected for histopathological study. Due to a cyst revealed under the lesion and pulsation of the tumor, it was decided to include imaging examinations into the diagnostic process. Computed tomography (CT) showed a mass of meningocele type, which was confirmed in magnetic resonance imaging (MRI). RESULTS: In case of breathing disorders and a suspected mass in the nasal meatus in a newborn, a congenital meningocele or menigocephalocele should be assumed. This constitutes a contraindication to sampling of the lesion, without prior imaging tests (CT and/or MRI).

[New methods in physiotherapy. The Halliwick concept as a form of rehabilitation in water]. / Nowe metody fizjoterapii. Koncepcja Halliwick jako forma usprawniania w srodowisku wodnym.

The Halliwick concept is not only a method teaching swimming to disabled patients; it is a holistic approach to therapy in water. The concept encompasses all areas of human life and has an impact on the physical, mental, and social development. The disabled persons have an opportunity to move unassisted in water and to swim. The logical pattern of the 10-point program provides the basis for exercises in water. By mastering subsequent points the participant becomes independent and skilled to actively participate in the exercises.

Determinants of physical fitness in males with systolic heart failure.

BACKGROUND: Heart failure (HF) is a systemic disease which affects mainly older adults. The main symptom of HF is exercise intolerance which in the course of disease can cause limitations in independent functioning. So far no study on the impact of HF on physical fitness in men, regardless of disease severity, has been reported. AIM: To evaluate physical fitness in men with HF independently of age, HF severity, concomitant diseases and pharmacological treatment. METHODS: The study group consisted of 228 men with stable systolic dysfunction (age 60+/-11, left ventricular ejection fraction--LVEF 29+/-9%, NYHA class I/II/III/IV--17/44/35/4%). In order to assess physical fitness the Functional Fitness Test by Rikli and Jones for older adults was used. RESULTS: The level of physical fitness decreased with age. Patients with greater severity of HF had worse aerobic endurance, agility and muscular endurance in comparison with men in NYHA classes I-II. A lower level of agility and dynamic balance was found in patients with higher concentration of NT-proBNP and lower levels of haemoglobin and eGFR. Coexisting atrial fibrillation and diabetes mellitus were associated with decreased physical fitness. No relationship between flexibility and clinical parameters or concomitant diseases was found in the study group. CONCLUSIONS: The most important determinants of physical fitness in men with HF were age and NYHA class. Additional factors which decreased physical fitness were atrial fibrillation and diabetes mellitus. Higher level of NT-proBNP and lower levels of haemoglobin were associated with a reduction of upper body strength and aerobic endurance.

The 12-week progressive quadriceps resistance training improves muscle strength, exercise capacity and quality of life in patients with stable chronic heart failure.

BACKGROUND: Abnormalities in the skeletal musculature underlie exercise intolerance in chronic heart failure (CHF). We investigated, whether in CHF selective resistance training without accompanying aerobic regime favourably affects muscle strength, muscle mass and improves exercise capacity. METHODS: Ten patients with stable ischaemic CHF in NYHA class III (9 men, age: 70+/-6 years [mean+/-SD], left ventricular ejection fraction: 30+/-5%, peak oxygen consumption [peak VO(2)]: 12.4+/-3.0 mL/min/kg) underwent the rehabilitation programme which consisted of a 12-week training phase (progressive resistance exercises restricted to the quadriceps muscles) followed by a 12-week detraining phase. RESULTS: All subjects completed a training phase of the programme with no adverse events. Resistance training markedly increased quadriceps strength (right leg: 260+/-34 vs. 352+/-28 N, left leg: 264+/-38 vs. 342+/-30 N, both p<0.01 - all comparisons: baseline vs. after training), but did not affect lean tissue mass of lower extremities (both p>0.2). It was accompanied by an improvement in clinical status (all NYHA III vs. all NYHA II, p<0.01), quality of life (Minnesota questionnaire: 44+/-15 vs. 33+/-18 points, p<0.05), exercise capacity assessed using a distance during 6-minute walk test (6MWT: 362+/-83 vs. 455+/-71 m, p<0.01), but not peak VO(2) (p>0.2). Plasma NT-proBNP remained unchanged during the training. At the end of detraining phase, only a partial improvement in quadriceps strength (p<0.05), a 6MWT distance (p<0.05) and NYHA class (p=0.07 vs. baseline) persisted. CONCLUSIONS: Applied resistance quadriceps training is safe in patients with CHF. It increases muscle strength, improves clinical status, exercise capacity, and quality of life.

[Working memory and executive functions in hyperthyroid patients with Graves' disease]. / Pamiec operacyjna i funkcje wykonawcze w nadczynnosci tarczycy w przebiegu choroby Gravesa i Basedowa.

AIM: The aim of the study was to assess working memory and executive dysfunctions, as well as the intensity of depressive symptoms in hyperthyroid patients with Graves' disease compared to healthy persons. METHOD: Thirty (30) patients with Graves' disease (20 female, 10 male), aged 18-55, participated in the study. The control group consisted of 31 healthy persons matched by age, gender and educational level with the examined group. The assessment of working memory and executive functions was estimated by the Wisconsin Card Sorting Test and the N-back test. The intensity of depressive symptoms was assessed by the Beck Depression Inventory. RESULTS AND CONCLUSIONS: In comparison to healthy subjects, significant disturbances of working memory and executive functions were noted in hyperthyroid patients with Graves' disease. Longer disease duration was associated with worse results in neuropsychological tests, while higher educational level of the patient resulted in better test outcomes. In the group of patients with Graves' disease, 1/3rd of them presented with a significant intensity of depression symptoms; additionally, the intensity of depression symptoms correlated with cognitive function impairments in the whole group of the patients studied.

[Cognitive dysfunctions in patients with alcohol dependence]. / Zaburzenia funkcji poznawczych u pacjentów uzaleznionych od alkoholu.

AIM: The assessment of cognitive functions connected with prefrontal cortex activity and the intensity of depressed symptoms in patients with alcohol dependence after discontinuation of alcohol use and after a least one year of abstinence. METHOD: 88 patients with alcohol dependence were evaluated. In 51 subjects assessment was performed directly after discontinuation of alcohol drinking and in 37 subjects, after at least one-year of abstinence. The control group consisted in 30 healthy persons matched with age, gender and education for the experimental group. The intensity of alcohol addiction was assessed using the SADD and MAST scale, while intensity of the depression symptoms was measured with the Beck Depression Inventory. Neuropsychological assessment included the Wisconsin Card Sorting Test (WCST) and N-back test for different aspects of working memory and executive functions estimation. RESULTS: Significant disturbances of working memory and executive functions in patients with alcohol dependence, both with short-term and long-term abstinence in relation to healthy subjects were noted. No significant differences between patients with short-term and long-term abstinence on the performance in neuropsychological tests was observed, except better results of nonperseverative errors obtained by patients with long-term abstinence. Longer duration of the alcohol addiction correlated with a worse, however higher level of education with a better performance in neuropsychological tests. The intensity of depression did not correlate with the level of cognitive impairment in the neuropsychological tests. CONCLUSIOS: The results obtained indicate core and enduring cognitive deficits connected with disturbances in prefrontal cortex activity in patients with alcohol addiction.