Assuntos
Antebraço/fisiologia , Hipertonia Muscular/diagnóstico , Dinamômetro de Força Muscular , Tono Muscular/fisiologia , Adolescente , Adulto , Idoso , Desenho de Equipamento , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Hipertonia Muscular/fisiopatologia , Adulto JovemRESUMO
Fatigue is a major barrier to recovery for burned individuals. Studies indicate that a slow return to normal or near-normal muscle strength is the natural course of recovery. With no special interventions, other than the "usual care" tailored to the needs of the individual, postburn patients will make gradual improvement in strength and aerobic capacity. Using the principle of initial condition (the worse the initial condition, the greater the response to exercise intervention) the authors outline an augmented exercise program that should result in a robust improvement in aerobic capacity.
Assuntos
Queimaduras/reabilitação , Terapia por Exercício/métodos , Fadiga/etiologia , Humanos , Debilidade Muscular/complicações , Aptidão Física , Fatores de TempoRESUMO
OBJECTIVES: Gait abnormalities are an early clinical symptom in normal pressure hydrocephalus (NPH), and subjective improvement in gait after temporary removal of CSF is often used to decide to perform shunt surgery. We investigated objective measures to compare gait before and after CSF drainage and shunt surgery. DESIGN: Twenty patients and nine controls were studied. Quantitative gait measures were obtained at baseline, after 3 days of controlled CSF drainage, and after shunt surgery. Decision to perform surgery was based on response to drainage, and patients were assigned to shunted or unshunted groups for comparison. RESULTS: There was no improvement after CSF drainage in the unshunted group (n = 4). In the shunted group (n = 15) velocity, double-support time, and cadence improved significantly after drainage, and improved further after shunt surgery. The degree of improvement after drainage significantly correlated to the degree of improvement postshunt for velocity, double-support time, cadence, and stride length. CONCLUSIONS: There are significant, quantifiable changes in gait after CSF drainage that correspond to improvement after shunt surgery for patients with NPH. Use of objective gait assessment may improve the process of identifying these candidates when response to CSF removal is used as a supplemental prognostic test for shunt surgery.
Assuntos
Transtornos Neurológicos da Marcha/etiologia , Hidrocefalia de Pressão Normal/cirurgia , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Derivações do Líquido Cefalorraquidiano , Feminino , Humanos , Hidrocefalia de Pressão Normal/complicações , Hidrocefalia de Pressão Normal/diagnóstico , Masculino , Seleção de Pacientes , Prognóstico , Estudos Prospectivos , Resultado do TratamentoRESUMO
Frailty is a complex subject, and all aspects of frailty are intertwined. This article identifies and discusses the individual aspects of frailty. These aspects, including sarcopenia, nutrition, obesity, relative strength, inflammatory markers, osteopenia and osteoporosis, aerobic capacity, absolute strength, balance, and prevention of frailty, must be reunited, albeit in varying combinations, if the effects of frailty on women are to be understood and treated. This article does not exhaust the topic, but covers what the authors consider to be the major issues.