Predictive factors of sleep quality in patients with chronic migraine.

INTRODUCTION: One of the factors contributing to transformation of migraine are sleep disorders, which can act as a trigger and/or perpetuating factor in these patients. This study's primary objective was to identify predictive factors related to sleep quality in patients with chronic migraine (CM); the secondary objective was to identify any differences in psychological variables and disability between patients with CM with better or poorer sleep quality. METHODS: A total of 50 patients with CM were included in an observational, cross-sectional study. We recorded data on demographic, psychological, and disability variables using self-administered questionnaires. RESULTS: A direct, moderate-to-strong correlation was observed between the different disability and psychological variables analysed (P < .05). Regression analysis identified depressive symptoms, headache-related disability, and pain catastrophising as predictors of sleep quality; together, these factors explain 33% of the variance. Statistically significant differences were found between patients with better and poorer sleep quality for depressive symptoms (P = .016) and pain catastrophising (P = .036). CONCLUSIONS: The predictive factors for sleep quality in patients with CM were depressive symptoms, headache-related disability, and pain catastrophising. Patients with poorer sleep quality had higher levels of pain catastrophising and depressive symptoms.

Factores predictores de la calidad del sueño en pacientes con migraña crónica / Predictive factors of sleep quality in patients with chronic migraine

Introducción: Uno de los factores contribuyentes en la cronificación de la migraña son los trastornos del sueño que pueden actuar como un factor precipitante y/o perpetuador en estos sujetos. El objetivo primario de este estudio fue identificar los factores predictores relacionados con la calidad del sueño en pacientes con migraña crónica (MC) y el objetivo secundario fue identificar si existían diferencias en variables psicológicas y de discapacidad entre los pacientes con MC que presentaban menor o mayor calidad del sueño. Métodos: Se llevó a cabo un estudio observacional, transversal, formado por 50 participantes con MC. Se registraron una serie de variables demográficas, psicológicas y de discapacidad mediante cuestionarios de autorregistro. Resultados: Se observaron correlaciones directas, moderadas-fuertes, entre las diferentes variables de discapacidad y psicológicas analizadas (p < 0,05). En la regresión, se estableció como variable criterio la calidad del sueño y las variables predictores fueron los síntomas depresivos, la discapacidad relacionada con la cefalea y el catastrofismo ante el dolor que, en conjunto, explican el 33% de la varianza. En cuanto a la comparación de los grupos de mayor y menor afectación del sueño, se encontraron diferencias estadísticamente significativas en la variable de síntomas depresivos (p = 0,016) y catastrofismo ante el dolor (p = 0,036). Conclusiones: Los factores predictores de la calidad del sueño en pacientes con MC fueron los síntomas depresivos, la discapacidad relacionada con la cefalea y, en menor medida, el catastrofismo ante el dolor. Los sujetos con peor calidad de sueño presentaron mayores niveles de catastrofismo ante el dolor y síntomas depresivos. (AU)

Introduction: One of the factors contributing to transformation of migraine are sleep disorders, which can act as a trigger and/or perpetuating factor in these patients. This study's primary objective was to identify predictive factors related to sleep quality in patients with chronic migraine (CM); the secondary objective was to identify any differences in psychological variables and disability between patients with CM with better or poorer sleep quality. Methods: A total of 50 patients with CM were included in an observational, cross-sectional study. We recorded data on demographic, psychological, and disability variables using self-administered questionnaires. Results: A direct, moderate-to-strong correlation was observed between the different disability and psychological variables analysed (P < .05). Regression analysis identified depressive symptoms, headache-related disability, and pain catastrophising as predictors of sleep quality; together, these factors explain 33% of the variance. Statistically significant differences were found between patients with better and poorer sleep quality for depressive symptoms (P = .016) and pain catastrophising (P = .036). Conclusions: The predictive factors for sleep quality in patients with CM were depressive symptoms, headache-related disability, and pain catastrophising. Patients with poorer sleep quality had higher levels of pain catastrophising and depressive symptoms. (AU)

Predictive factors of sleep quality in patients with chronic migraine. / Factores predictores de la calidad del sueño en pacientes con migraña crónica.

INTRODUCTION: One of the factors contributing to transformation of migraine are sleep disorders, which can act as a trigger and/or perpetuating factor in these patients. This study's primary objective was to identify predictive factors related to sleep quality in patients with chronic migraine (CM); the secondary objective was to identify any differences in psychological variables and disability between patients with CM with better or poorer sleep quality. METHODS: A total of 50 patients with CM were included in an observational, cross-sectional study. We recorded data on demographic, psychological, and disability variables using self-administered questionnaires. RESULTS: A direct, moderate-to-strong correlation was observed between the different disability and psychological variables analysed (P<.05). Regression analysis identified depressive symptoms, headache-related disability, and pain catastrophising as predictors of sleep quality; together, these factors explain 33% of the variance. Statistically significant differences were found between patients with better and poorer sleep quality for depressive symptoms (P=.016) and pain catastrophising (P=.036). CONCLUSIONS: The predictive factors for sleep quality in patients with CM were depressive symptoms, headache-related disability, and pain catastrophising. Patients with poorer sleep quality had higher levels of pain catastrophising and depressive symptoms.

Correlates of Physical Functioning and Performance Across the Spectrum of Kidney Function.

The aim of this study was to determine the extent to which poor physical functioning, low participation in physical activity, and muscle atrophy observed among patients on hemodialysis are evident in the earlier stages of chronic kidney disease (CKD). We enrolled adults in three groups: no CKD, Stages 3 to 4 CKD, and hemodialysis. Outcomes measured were physical activity, muscle size, thigh muscle strength, physical performance, and self-reported physical function. Patients with CKD had muscle area intermediate between the no CKD and hemodialysis groups, but they had low levels of physical activity that were similar to the hemodialysis group. Physical activity and muscle size were significantly associated with all outcomes. Kidney function was not significantly associated with muscle strength or physical performance after adjustment for physical activity and muscle size. In conclusion, interventions aimed to increase muscle mass and energy expenditure might have an impact on improving physical function of CKD patients.

Highly sensitive and ultrafast read mapping for RNA-seq analysis.

As sequencing technologies progress, the amount of data produced grows exponentially, shifting the bottleneck of discovery towards the data analysis phase. In particular, currently available mapping solutions for RNA-seq leave room for improvement in terms of sensitivity and performance, hindering an efficient analysis of transcriptomes by massive sequencing. Here, we present an innovative approach that combines re-engineering, optimization and parallelization. This solution results in a significant increase of mapping sensitivity over a wide range of read lengths and substantial shorter runtimes when compared with current RNA-seq mapping methods available.

Trigger point dry needling versus strain-counterstrain technique for upper trapezius myofascial trigger points: a randomised controlled trial.

BACKGROUND: Treatment of active myofascial trigger points includes both invasive and non-invasive techniques. OBJECTIVES: To compare the effects of upper trapezius trigger point dry needling (DN) and strain-counterstrain (SCS) techniques versus sham SCS. STUDY DESIGN: Randomised controlled trial. METHOD: 34 study subjects with active trigger points were randomly assigned to one of three treatment groups, and received either three sessions of DN (n=12), six sessions of SCS (n=10), or sham SCS (n=12) over a 3-week period. Subjective pain response and subjects' own ratings of perceived disability were measured. RESULTS: The analysis of variance mixed model showed a significant time effect for pain (p<0.001), elicited pain (p<0.001), pain pressure threshold (p<0.01), and neck disability index (p=0.016). Pain at rest decreased in all groups, as follows: DN 18.5 mm (95% CI 4.3 to 32.7 mm); SCS 28.3 mm (95% CI 12.4 to 44.1 mm); sham SCS 21.9 mm (95% CI 3.5 to 40.1 mm). Reductions in disability score (points) were significant in the SCS group (5.5, 95% CI 1.6 to 9.4) but not in the DN (1.4, 95% CI -4.9 to 2.1) or sham SCS (1.8, 95% CI -6.4 to 2.7) groups. There was no significant group×time interaction effect for any variables studied. CONCLUSIONS: There were no differences between the sham SCS, SCS, and DN groups in any of the outcome measures. DN relieved pain after fewer sessions than SCS and sham SCS, and thus may be a more efficient technique. Future studies should include a larger sample size. TRIAL REGISTRATION NUMBER: NCT01290653.

The effectiveness of a video-supported group-based Otago exercise programme on physical performance in community-dwelling older adults: a preliminary study.

OBJECTIVES: To evaluate the short-term effects of a video-supported group-based Otago exercise programme (OEP) on physical performance variables in independent community-dwelling older adults. DESIGN: Preliminary randomized controlled trial. SETTING: Local senior centre. PARTICIPANTS: Fifty-one adults aged 65 and older with no cognitive impairment. INTERVENTION: Participants were randomly allocated to the intervention group (IG) or to the control group (CG). During 4 months, IG participants performed the exercise routine. MEASUREMENTS: The primary outcome measure was the Timed 'Up-and-Go' test (TUG). Secondary outcome measurements included functional balance, one-leg balance, lower-limb function and aerobic endurance. All data were collected before and after intervention. RESULTS: TUG scores showed a significant reduction in the performance time in the IG compared to CG after intervention [IG 7.5 (2.0) vs CG 8.8 (1.9), mean difference -1.3seconds, 95% confidence interval (CI) of the difference -2.3 to -0.1; P=0.03]. Secondary outcomes also showed a significant improvement in the performance of the functional balance [IG 54.9 (2.5) vs CG 51.4 (5.3), mean difference 3.5 points, 95% CI 1.2 to 5.8; P=0.003], one-leg balance [IG 39.1 (21.6) vs CG 15.6 (12.1), mean difference 23.5seconds, 95% CI 13.3 to 33.7; P<0.001] and lower extremity strength [IG 8.7 (3.8) vs CG 10.9 (3.3), mean difference -2.2seconds, 95% CI -4.2 to -0.1; P=0.035] in the IG compared to CG. CONCLUSION: This study shows that, from a short-term perspective, a video-supported group-based OEP programme can significantly improve the levels of mobility, functional balance, one-leg balance and lower extremity strength in community-dwelling older adults. TRIAL REGISTRATION: ClincicalTrials.gov ID: NCT02218411.

Effects of three different low-intensity exercise interventions on physical performance, muscle CSA and activities of daily living: a randomized controlled trial.

OBJECTIVES: To evaluate the short-term effects of three different resistance training programs, conducted at low intensity, on physical performance, muscle cross-sectional area (CSA) and the capacity to perform daily tasks in older adults living in a geriatric nursing home. DESIGN: Randomized controlled trial, with a 4-month intervention period. SETTING: A geriatric nursing home in Valencia, Spain. PARTICIPANTS: Eighty-nine adults aged 75 to 96 who were independent in their daily activities. INTERVENTION: After a baseline assessment, the participants were randomly assigned to the control group or one of the three intervention groups: volitional contraction (VC; n=22), neuromuscular electrical stimulation (NMES; n=22), or neuromuscular electrical stimulation superimposed onto voluntary contractions (NMES+; n=22). The intervention focused on knee extension exercises and its intensity was set at 40% of one-repetition maximum (1RM). MEASUREMENTS: The primary outcome measure was mobility. Secondary outcomes were rectus femoris CSA, balance, aerobic endurance, upper-body strength and the capacity to perform daily tasks. All data were collected at baseline and after the 4-month intervention period. RESULTS: The two-way ANOVA analysis showed a significant group×time interaction effect for the mobility (P=.022), rectus femoris CSA (P=.001), and the capacity to perform daily tasks (P=.05). The within-group analysis found a more prominent effect in the NMES+ group. Significant improvements were seen in rectus femoris CSA and the capacity to perform daily tasks in all intervention groups. Mobility only improved in the NMES+ group (P=.026). CONCLUSION: From a short-term perspective, NMES+ exercise training, performed at low intensity, can improve physical performance, muscle CSA, and the capacity to perform daily activities, and to partially mitigate age-related consequences in older adults.

Improving the energy efficiency of sparse linear system solvers on multicore and manycore systems.

While most recent breakthroughs in scientific research rely on complex simulations carried out in large-scale supercomputers, the power draft and energy spent for this purpose is increasingly becoming a limiting factor to this trend. In this paper, we provide an overview of the current status in energy-efficient scientific computing by reviewing different technologies used to monitor power draft as well as power- and energy-saving mechanisms available in commodity hardware. For the particular domain of sparse linear algebra, we analyse the energy efficiency of a broad collection of hardware architectures and investigate how algorithmic and implementation modifications can improve the energy performance of sparse linear system solvers, without negatively impacting their performance.

Obtaining the lattice energy of the anthracene crystal by modern yet affordable first-principles methods.

The non-covalent interactions in organic molecules are known to drive their self-assembly to form molecular crystals. We compare, in the case of anthracene and against experimental (electronic-only) sublimation energy, how modern quantum-chemical methods are able to calculate this cohesive energy taking into account all the interactions between occurring dimers in both first-and second-shells. These include both O(N(6))- and O(N(5))-scaling methods, Local Pair Natural Orbital-parameterized Coupled-Cluster Single and Double, and Spin-Component-Scaled-Møller-Plesset perturbation theory at second-order, respectively, as well as the most modern family of conceived density functionals: double-hybrid expressions in several variants (B2-PLYP, mPW2-PLYP, PWPB95) with customized dispersion corrections (-D3 and -NL). All-in-all, it is shown that these methods behave very accurately producing errors in the 1-2 kJ/mol range with respect to the experimental value taken into account the experimental uncertainty. These methods are thus confirmed as excellent tools for studying all kinds of interactions in chemical systems.

Efectividad de la punción seca de un punto gatillo miofascial versus manipulación de codo sobre el dolor y fuerza máxima de prensión de la mano / Effectiveness of a myofascial trigger point dry needling versus elbow manipulation on pain and maximum hand grip strength

Objetivo Comparar el efecto provocado por la aplicación de manipulación de codo, punción seca o punción seca placebo sobre el umbral de dolor a la presión (UDP), la intensidad subjetiva de dolor y la fuerza de agarre en sujetos con punto gatillo miofascial (PGM) latente en la musculatura epicondílea. Material y métodos Se seleccionó a 52 participantes (26,9±7,6 años) con PGM latente en la musculatura epicondílea; 50 sujetos se integraron en el estudio controlado, doble ciego y aleatorizado. Se utilizó un algómetro para la medición de UDP, una escala analógica visual (EAV) para la intensidad subjetiva de dolor y un dinamómetro de mano para la fuerza máxima de prensión. Todo ello en 3 momentos de medición: preintervención, post-intervención y transcurridos 10 min. El análisis estadístico se realizó mediante un ANOVA mixto, p ≤ 0,05.ResultadosLos datos obtenidos mostraron un efecto significativo de la interacción grupo y tiempo para el UDP (p=0,01). Se produjo una disminución del UDP significativa (p=0,02) a los 10 min de la intervención comparado con el valor obtenido inmediatamente tras la intervención en el grupo manipulación. Para la variable del dolor medido mediante la EAV se observó un efecto significativo del factor tiempo (p=0,004).Conclusiones No se ha podido demostrar que la manipulación o la punción seca resulten superiores a la punción placebo en beneficios sobre el dolor, el UDP y la respuesta de fuerza de agarre en mano(AU)

Objective To compare the effect caused by a single application of elbow manipulation, dry needling and sham dry needling on pain and grip strength threshold (PPT) on subjects with latent myofascial trigger point (MTP) in the lateral epicondyle musculature. Material and methods A total of 52 participants (26.9±7.6 age) with latent MTP in the epicondyle musculature were enrolled. Fifty subjects were integrated in the double blind, randomized and controlled study. An algometer was used to measure PPT, Visual Analogue Scale (VAS) to measure the subjective intensity of pain and hand dynamometer to measure maximum grip strength. Three different points in time were measured: pre-intervention, post-intervention and 10minutes following the intervention. The statistical analysis was performed by a mixed ANOVA using P≤.05.ResultsStatistical analysis showed a significant effect for group per time interaction for the PPT (P=.01). Post-hoc tests showed a significant decrease of the PPT (P=.02) 10 minutes after the intervention compared to the post-intervention value for the manipulation group. Subjective pain measured by the VAS showed a significant effect for the time factor (P=.004).Conclusions It was not possible to demonstrate that manipulation or dry needling is superior to placebo puncture in benefits on pain, PPT and handgrip strength (AU)

Impact of biomedical and biopsychosocial training sessions on the attitudes, beliefs, and recommendations of health care providers about low back pain: a randomised clinical trial.

The beliefs and attitudes of health care providers may contribute to chronic low back pain (LBP) disability, influencing the recommendations that they provide to their patients. An excessively biomedical style of undergraduate training can increase negative beliefs and attitudes about LBP, whereas instruction following a biopsychosocial model could possibly lessen these negative beliefs in health care professionals. The objectives of this study were to determine the effectiveness of 2 brief educational modules with different orientations (biomedical or biopsychosocial) on changing the beliefs and attitudes of physical therapy students and the recommendations that they give to patients. The intervention in the experimental group was based on the general biopsychosocial model, whereas the sessions in the control group dealt with the basics of the biomechanics of back pain. The participants completed the Fear-Avoidance Beliefs Questionnaire (FABQ), Health Care Providers' Pain and Impairment Relationship Scale (HC-PAIRS), and Rainville et al. Clinical Cases questionnaire before and after the interventions. The participants attending the biopsychosocial session displayed a reduction in fear-avoidance beliefs (P<.001) and Pain-Impairement beliefs (P<.001), which was strongly correlated with an improvement in clinicians' activity and work recommendations. However, the students assigned to the biomechanics sessions increased their fear-avoidance scores (P<.01), and their recommendations for activity levels worsened significantly (P<.001). Our results confirm the possibility of modifying the behaviour of students through the modification of their beliefs and attitudes. We also conclude that a strictly biomedical education exacerbates maladaptive beliefs, and consequently results in inadequate activity recommendations. The implications of this study are important for both the development of continuing medical education and the design of the training curriculum for undergraduate students.

Efectos de la aplicación del Kinesio taping(TM) en el diafragma en el resultado la cicloergoespirometría y la prueba marcha de 6 minutos / Effects of the application of kinesio taping on the diaphragm on the

El objetivo de este estudio es comprobar si la aplicación de técnica diafragmática anterior de Kinesio™ taping (KT) mejora el rendimiento deportivo de sujetos sanos.DiseñoPruebas repetidas, aleatorización en el orden de realización de las pruebas con o sin vendaje.Material y métodosLa muestra del estudio incluyó a 17 sujetos, con edades comprendidas entre los 21 y los 38 años, 10 varones y 7 mujeres. Se realizaron pruebas de cicloerogespirometría y de marcha de 6 minutos. Los sujetos fueron citados en dos días distintos, con una semana de diferencia, de forma que un día se realizaban las pruebas con KT y otro día sin el vendaje diafragmático. En primer lugar se calculó el peso muscular del sujeto por cineantropometría y bioimpedancia. En la cicloerogespirometría, se registraron valores de consumo máximo de oxígeno relativo al peso muscular. Los resultados de la prueba de marcha de 6 minutos marcha se expresaron como metros recorridos y trabajo realizado (metros por kg de masa muscular).ResultadosNo se observaron efectos significativos de la aplicación del KT. Se encontraron diferencias significativas en la prueba de marcha de 6 minutos marcha entre la primera y la segunda prueba, tanto en los metros recorridos (distancia 1.ª prueba=834,69±107,03 m; 2.ª prueba=891,12±93,91 m; p=0,007), como en el trabajo realizado considerando la masa magra medida mediante bioimpedancia eléctrica (p=0,008) o la masa muscular medida mediante cineantropometría (p=0,009).ConclusionesLa aplicación anterior de KT no tiene efecto en el resultado de la cicloergometría y prueba de marcha de 6 minutos. Se confirma el efecto de aprendizaje en la prueba de marcha de 6 minutos (AU)

Objective: The aim of the study was to verify whether the application of the anterior diaphragmatictechnique of KinesioTM taping (KT) improves the performance in sports in healthysubjects.Design: Repeated measures with randomization in order of tests, with or without KT.Material and methods: The study sample included 17 subjects, 10 men and 7 women, 21 to38 years old. A cycloergospirometric or graded exercise test (bike test with spirometry) and6 minute walk test were performed. The subjects came on two separate days, 7 days apart,performing the KT tests on one of the days and the tests without the KT on the other. In thefirst place, muscle weight was calculated through anthropometry and bioimpedance. Duringthe cycloergospirometric test, variables that included the maximal oxygen consumption per kgof muscle achieved on the graded exercise test were measured. The results analyzed from the6 minute walk test included distance covered and work performed (distance per kg of musclemass).Results: The KT did not produce any significant changes in the variables measured duringthe graded exercise test or the 6 minute walk test. A significant learning effect was observedonly for the 6 minute walking test results, both for the distance covered (Distance 1sttest = 834.69±107.03 m; 2nd test = 891.12±93.91 m; p = .007) and for the work achieved(P = .008).Conclusions: There was no significant effect of diaphragmatic KT on results of the gradedexercise test and 6 minute walk test. There is a learning effect for the 6 minute walk test (AU)

Ejercicio en pacientes en hemodiálisis: revisión sistemática de la literatura / Exercise in haemodyalisis patients: aa systematic literature review

El ejercicio como herramienta terapéutica en pacientes con enfermedad renal crónica en estadio V (ERC-V) en hemodiálisis (HD) no se está utilizando en la rutina de estos pacientes, como ocurre con cohortes con patología cardiaca o respiratoria. El desconocimiento de la investigación en este campo puede contribuir a ello. Por lo tanto, los objetivos de esta revisión son: 1) revisar sistemáticamente los estudios realizados en pacientes adultos en HD; 2) proporcionar evidencias de los efectos del ejercicio para contrarrestar el deterioro fisiológico, funcional y psicológico asociado con la ERC-V, incluso en pacientes de edad avanzada; 3) recomendar los requisitos de futuras investigaciones para conseguir la integración de la prescripción de ejercicio en la práctica médica en estos pacientes. Se efectuaron búsquedas en las siguientes bases de datos desde 2005 hasta 2009: MEDLINE (Ovid), CINAHL (EBSCOHost), SportDicus (EBSCOHost), Academic Search Complete (EBSCOHost), Fuente Académica (EBSCOHost), MedicLatina (EBSCOHost), PEDro y PubMed. Otras fuentes utilizadas fueron las listas de referencias de los artículos identificados por el revisor y revisiones sobre la ERC-V, así como resúmenes de congresos publicados. Se seleccionaron ensayos aleatorios que utilizaron el ejercicio aeróbico, de fuerza o la combinación de ambos en el tratamiento de pacientes en HD. Se extrajeron los datos de cada estudio y se evaluó la calidad metodológica según los criterios de Van Tulder. Sólo se pudo aplicar el metaanálisis en los resultados de 6 estudios con ejercicio aeróbico, 2 estudios con ejercicio de fuerza y 5 estudios con ejercicio combinado. Hubo un total de 640 sujetos en los 16 estudios incluidos. Los efectos de los distintos tipos de ejercicio en pacientes en HD sobre la función física, calidad de vida y otras medidas de interés se resumieron mediante el cálculo de la diferencia de medias estandarizada (DME). Hay pruebas de calidad moderada de que el entrenamiento aeróbico produce efectos positivos el consumo pico de oxígeno en la prueba de esfuerzo (DME 6,55; intervalo de confianza [IC] 95%, 4,31-8,78). Existe evidencia alta de que el entrenamiento de fuerza posee un efecto positivo sobre la calidad de vida relacionada con la salud (DME 11,03; IC 95%, 5,63-16,43). Por último, hay pruebas moderadas de que el entrenamiento combinado produce efectos positivos sobre el consumo pico de oxígeno en la prueba de esfuerzo (DME 5,57; IC 95%, 2,52-8,61). En conclusión, existen evidencias moderadas de que el ejercicio aeróbico, aislado o combinado con ejercicio de fuerza, mejora la capacidad de ejercicio, y de que el ejercicio de fuerza mejora la calidad de vida, la capacidad funcional del sujeto y la fuerza de los miembros inferiores. Futuros estudios deberán responder a la pregunta de qué tipo de ejercicio, aeróbico, resistido o combinado, es el más beneficioso para los pacientes en HD (AU)

Exercise as a therapeutic tool used in End-stage renal disease patients (ESRD) in hemodialysis (HD) is not routinately applied, as it occurs with cardiac or respiratory patients. Lack of awareness of research in this field may contribute to the current situation. Thus, the aims of this review are: 1) to systematically review the literature of exercise training on adult HD patients or patients at a pre-HD stage; 2) to show the evidence on the benefits of exercise for counteracting physiological, functional and psychological impairments found even in older ESRD patients; 3) to recommend requirements of future research in order to include exercise prescription in the HD patients treatment. The Data bases reviewed from 2005 to 2009 were: MEDLINE (Ovid), CINAHL (EBSCOHost), SportDicus (EBSCOHost), Academic Search Complete (EBSCOHost), Fuente Académica (EBSCOHost), MedicLatina (EBSCOHost), PEDro y PubMed. Additionally, references from identified articles, several reviews on ESRD and abstracts to Nephrology Congresses were also reviewed. Randomized Controlled Trials on aerobic, strength and combined programs for HD patients were selected. Data from the studies was compiled and Van Tulder criteria were used for methodological quality assessment. Metanalysis included 6 studies on aerobic exercise, 2 on strength exercise and 5 on combined exercise programs. 640 patients were included in 16 included studies. Effects on physical function, health related quality of life and other secondary measurements were summarized by the Standardized Mean Difference (SMD) Moderate evidence exists on positive effects of aerobic training on peak oxygen consumption at the graded exercise test (SMD 6.55; CI 95%: 4.31-8.78). There is high evidence on positive effects of strength training on health related quality of life (SMD 11.03; CI 95%: 5.63-16.43). Finally, moderate evidence exists on positive effects of combined exercise on peak oxygen consumption at the graded exercise test (SMD 5.57; CI 95%: 2.52-8.61). Summarizing, moderate evidence exists on the improvement on exercise capacity of aerobic training, isolated or combined with strength training. Strength training improves health related quality of life, functional capacity and lower limbs strength. Future studies should clarify which out of the three modalities results in higher benefits for HD patients (AU)

Análisis de correlaciones entre los resultados de una prueba de esfuerzo y de la prueba de 6 minutos marcha en población sana / Analysis of correlations between the results of an exercise test and 6 minute walking test in a healthy population

Objetivo El objetivo fundamental de este estudio es comprobar si existe correlación entre el resultado de la prueba de 6min marcha y el consumo de oxígeno obtenido en una prueba de esfuerzo mediante cicloergometría en sujetos sanos de entre 20 y 30 años aproximadamente.Material y métodoLa muestra del estudio comprendió 22 sujetos, con una edad media de 24,4±2,6 años. Las medidas antropométricas recogidas fueron peso corporal, diámetros óseos, altura y pliegues cutáneos. Realizaron una prueba de esfuerzo máxima en cicloergómetro, con determinación de consumo pico de oxígeno (VO2pico). Se realizó también la prueba de 6min marcha. A todos los sujetos se les mostró una escala de esfuerzo percibido (escala de Borg) con valores entre 6 (muy muy leve) y 20 (muy, muy duro). El análisis estadístico consistió en la prueba de correlación de Pearson entre las variables de interés, y la prueba t de Student para muestras relacionadas. Se consideró significativa un p<0,05.ResultadosLas correlaciones más altas se encontraron entre la distancia recorrida en la prueba de 6min marcha y el VO2pico ml/min de la prueba de esfuerzo (r=0,83; p<0,01; n=21). El resultado del trabajo en la prueba de 6min marcha, calculado como distancia recorrida por peso muscular medido con antropometría, presentó la mayor correlación con el VO2pico en la prueba de esfuerzo VO2pico ml/min (r=0,88; p<0,01; n=21)(AU)

Objective The primary aim of this study was to find out if there is a correlation between the results on a 6min walking test and peak oxygen consumption achieved in an exercise test using the cycle-ergometer in healthy subjects of approximately 20–30 years of age.Material and methodsThe simple included 22 subjects, mean age 24.4±2.6 years. The anthropometric measures recorded were weight, bone diameters and height and skin folds. All underwent a cycle-ergometer graded exercise test to determine VO2 peak, and the 6min walking test. All of the subjects were shown a perceived exertion scale (Borg scale) with values going from 6 (very very light) to 20 (very, very hard). The statistical analysis consisted of the Pearson correlation between main variables and the Student's T test for paired samples. Significance was determined at p<0.05.ResultsThe highest correlations were those of distance walked in the 6min walking test and VO2 peak ml/min (r=0.83; p<0.01; n=21). The work result in the 6min walking test (kg of muscle weight from anthropometry per meters covered) showed greater correlation with VO2 peak consumption on the VO2 peak ml/min exertion test ml/min (r=0.88; p<0.01; n=21)(AU)

Effect of resistance exercise during hemodialysis on physical function and quality of life: randomized controlled trial.

AIMS: The objective of this study was to determine whether 24 weeks resistance training during hemodialysis could improve exercise capacity, muscle strength, physical functioning and health-related quality of life compared to a low intensity aerobic program. MATERIAL AND METHODS: 27 patients (55.6 +/- 17.6 years) were recruited from two hemodialysis clinics in Valencia (Spain). Patients were randomized to resistance training (n = 19) or low-intensity aerobic training (n = 8). Resistance training consisted of three sets of 4 exercises at an intensity of 12 - 15 out of 20 at the rate of perceived exertion scale (Borg scale measuring self-rated exercise intensity) using weights and elastic bands on every session during 24 weeks. Primary outcomes included physical performance tests, evaluated by the "sit-to-stand-to-sit tests" and the 6 minutes walking test, and knee extensor muscles strength, evaluated by isometric dynamometry. Secondary outcomes included cardiorespiratory fitness, measured by time and METs (measure of energy expenditure as ml of oxygen per kg of weight and per minute; 1 MET is equal to 3.5 ml O(2)/kg/min) achieved on a graded exercise test, and quality of life, measured by the SF-36 questionnaire. RESULTS: No differences were noted in change-over-time between the two groups in any of the physical performance tests. However, a significant change was found in change-over-time in right knee extensor muscles dynamometry, and intragroup analysis showed a significant improvement in resistance training groups in the physical performance tests and METs. CONCLUSIONS: These findings suggest that resistance training during hemodialysis improves patient's physical functioning.

[Physiotherapy during hemodialysis: results of a progressive resistance-training programme]. / Fisioterapia durante la hemodiálisis: resultados de un programa de fuerza-resistencia.

UNLABELLED: During the last decades, aerobic exercise programs have shown beneficial effects on quality of life of End Stage Renal Disease (ESRD) patients, but there is still little evidence on the benefits of resistance training programmes. The aim of this study was to analyze the effects of a short strengthening exercise program for ESRD during hemodialysis on exercise and functional capacity and on quality of life. METHODS: 16 hemodialysis patients were assigned, according to their own election, to exercise (N>or=8) or control group (N>or=8). The experimental group performed a 6-month duration intradialytic exercise program supervised by a physiotherapist, consisting of a battery of isometric and isotonic exercises for the lower limbs. Control group remained sedentary. A graded exercise test (Naughton protocol), functional measurements (<<6 minutes walking test>> 6MWT and 'sit to stand to sit tests' STS-10 and STS-60), and the SF-36, to assess quality of life were measured pre and post intervention in the experimental group, while the control group only completed the SF-36 questionnaire. RESULTS: Considering the experimental group, both time and METS increased after the intervention, although it was not significant. Meters measured in the 6MWT significantly increased after the intervention (399.57+/-39.56 meters pre-intervention; 471.71+/-70.63 meters post-intervention p<0.01). Both time on the STS-10 (22.52+/-4.77 seconds pre-intervention; 17.71+/-1.79 seconds post-intervention p<0.05) and repetitions on the STS-60 (28.57+/-5.12 repetitions pre-intervention; 31.42+/-2.443 repetitions post-intervention p<0.05) significantly improved after the intervention. After training, the mental component scale of the SF-36 significantly increased in the experimental group compared to baseline (41.74+/-9.25 before; 50.61+/-12.13 after, p<0.05), while the control group showed a significant decrease (48.19 +/- 16.1 before; 33.7+/- 13.8 after, p<0.05). Comparison between groups also showed a significant difference in the mental component scale after the intervention (p<0.05). CONCLUSION: It is concluded that a strengthening exercise program during hemodialysis improves the functional capacity of ESRD patients (walking and standing from a seat) and improves the mental component of quality of life perceived by dialysis patients.

Fisioterapia durante la hemodiálisis: resultados de un programa de fuerza-resistencia / No disponible

El objetivo de este trabajo fue analizar los efectos de un programa de fuerza resistencia en pacientes con insuficiencia renal crónica terminal durante la hemodiálisis en la capacidad de ejercicio, capacidad funcional y calidad de vida. 16 pacientes en hemodiálisis fueron asignados al grupo control (N = 8) o al grupo de intervención (N = 8)según su propia elección. El grupo de intervención realizó un programa de ejercicio durante la hemodiálisis de 6 meses de duración. El grupo control permaneció sedentario. Las pruebas realizadas al inicio y al final del programa en el grupo de intervención fueron una prueba de esfuerzo(protocolo Naughton), medidas funcionales (prueba de6 minutos marcha y prueba de sentado a de pie y de nuevo a sentado de 10 repeticiones y en 60 segundos) y el cuestionario de SF-36 para evaluar la calidad de vida, mientras que el grupo control completó el cuestionario SF-36. En los resultados, el grupo de intervención aumentó (..) (AU)

During the last decades, aerobic exercise programs have shown beneficial effects on quality of life of End Stage Renal Disease(ESRD) patients, but there is still little evidence on the benefits of resistance training programmes. The aim of this study was to analyze the effects of a short strengthening exercise programfor ESRD during hemodialysis on exercise and functional capacity and on quality of life. Methods: 16 hemodialysis patients were assigned, according to their own election, to exercise(N = 8) or control group (N = 8). The experimental group performed a 6-month duration intradialytic exercise program supervised by a physiotherapist, consisting of a battery of isometric and isotonic exercises for the lower limbs. Control group remained sedentary. A graded exercise test (Naughton protocol), functional measurements («6 mintutes walking test» 6MWT and «sit to (..) (AU)

Programa de ejercicio para pacientes con insuficiencia renal crónica en hemodiálisis. Estudio piloto / No disponible

No disponible

[Complications of endoscopic retrograde cholangiopancreatography in patients aged more than 90 years old]. / Complicaciones de la colangiopancreatografía retrógrada endoscópica en pacientes mayores de 90 años.

INTRODUCTION: To evaluate the effectiveness of endoscopic retrograde cholangiopancreatography (ERCP) and the complication rates of this procedure in patients aged 90 years and older. PATIENTS AND METHOD: A descriptive, prospective study including 42 endoscopic procedures performed from first January 2001 until first June 2004 in 36 patients (7 males and 29 females) was performed. The mean age was 91 years (range 90-96 years). All patients underwent the following: a) clinical evaluation before and after endoscopic exploration; b) evaluation of the success or failure of the endoscopic procedure and c) assessment of complications (perforation, hemorrhage, pancreatitis and infection). Concurrent associated illnesses, as well as the existence of anatomical alterations in Vaters papilla (duodenal diverticula), were also evaluated. RESULTS: ERCP was successful in 85.7% of all explorations performed. Twenty-three patients (63.8%) had one or more major associated diseases. In 15 patients (33.3%) Vaters papilla was associated with duodenal diverticula. The complication rates were as follows: 1) acute pancreatitis in 2 explorations (4.7%), one mild (2.35%) and the other moderate (2.35%); 2) hemorrhage after endoscopic sphincterotomy in 2.8% of patients (1/35); 3) bacteriemia in one patient (2.3%) and cholangitis in one patient (2.3%), with no cases of secondary cholecystitis; 4) hypoxemia in one patient. There were no perforations or deaths related to the procedure. CONCLUSION: ERCP is a safe and effective technique with a low complication rate in patients aged 90 years or older.