Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 38.425
Filtrar
1.
Medicine (Baltimore) ; 98(50): e18286, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31852105

RESUMO

RATIONALE: Spinal cord injury (SCI) patients who experience difficulties with independent walking use gait-assistive devices such as a cane, walker, or wheelchair. Few studies have explored gait patterns or cardiopulmonary function in chronic SCI patients after powered exoskeleton training. We investigated whether the cardiopulmonary function of a patient with an incomplete chronic cervical SCI and a hemiplegic gait pattern could be improved by walking training using a powered exoskeleton (Angelegs). PATIENT CONCERNS: A 57-year-old male was diagnosed with an SCI at C3-C4. The right upper and lower limb motor functions differed when evaluated before entry into the program. Motor function was good in the right leg but poor in the left one. Before program entry, the patient could walk for about 10 m using a cane. He did not have a history of severe medical or psychological problems and was not cognitively impaired. DIAGNOSIS: The patient was tetraplegia with incomplete SCI at C3-C4. INTERVENTIONS: The patient was trained for 6 weeks using a powered exoskeleton. The training program consisted of sit-to-stand and stand-to-sit movements, maintenance of balanced standing for 5 minutes, and walking for 15 minutes. OUTCOMES: After 6 weeks of training, gait speed improved in the timed up-and-go test, and cardiac function was enhanced as measured by the metabolic equivalent and VO2 tests. LESSIONS: Walking training using a powered exoskeleton can facilitate the effective rehabilitation and improve the gait speed and cardiopulmonary function of patients with chronic SCIs or strokes.


Assuntos
Vértebras Cervicais/lesões , Terapia por Exercício/instrumentação , Exoesqueleto Energizado , Extremidade Inferior/fisiopatologia , Traumatismos da Medula Espinal/reabilitação , Velocidade de Caminhada/fisiologia , Caminhada/fisiologia , Desenho de Equipamento , Humanos , Masculino , Pessoa de Meia-Idade , Traumatismos da Medula Espinal/fisiopatologia
2.
Ther Umsch ; 76(6): 323-327, 2019 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-31762415

RESUMO

Pulmonary Rehabilitation Abstract. Pulmonary rehabilitation is a comprehensive therapeutic approach for patients with advanced chronic lung diseases which leads to a decline of dyspnea, an increase of exercise capacity and an increase of quality of life. Further effects are a reduction of frequency of hospitalisations and an increase of physical activity, if a self management education program is integrated. Pulmonary rehabilitation incorporates an individualised training program with focus on endurance, strength and mobility, further a disease specific education with the goal to improve self efficacy and self management of the patients, specially with the goal to improve their daily physical activity. Due to the good evidence of pulmonary rehabilitation, the accredited programs are accepted and paid by the swiss insurances.


Assuntos
Terapia por Exercício , Pneumopatias , Doença Pulmonar Obstrutiva Crônica , Dispneia/etiologia , Dispneia/prevenção & controle , Exercício , Humanos , Pneumopatias/reabilitação , Resistência Física , Doença Pulmonar Obstrutiva Crônica/reabilitação , Qualidade de Vida , Resultado do Tratamento
3.
Pneumologie ; 73(11): 677-685, 2019 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-31715636

RESUMO

BACKGROUND: Pulmonary hypertension (PH) is defined as an elevation of mean pulmonary-arterial pressure by > 20 mmHg at rest, which may lead to right heart failure. Physical exercise has not been regularly recommended for PH patients for fear of symptom deterioration or occurrence of exercise-induced adverse events. METHODS: Three electronic databases were searched for randomized, controlled trials investigating exercise training in PH patients using the following keywords: "pulmonary hypertension" OR "pulmonary arterial hypertension" AND "exercise" OR "pulmonary rehabilitation" AND "randomized". RESULTS: Five studies involving 187 PH patients were included in this systematic review. Exercise programs lasted for 3 - 12 weeks (e. g. endurance training for 10 - 45 minutes; 60 - 80 % of the peak heart rate). PH patients significantly improved exercise capacity compared to controls in 6-minute walk distance (+ 45 m; 95 % CI: 26 m - 64 m) or peak oxygen consumption (+ 2.3 ml/kg/min; 95 % CI: 1.8 - 2.9 ml/kg/min), both p < 0.001. Also, physical and mental quality of life improved significantly by exercise training. No exercise-induced adverse events were observed. CONCLUSION: Supervised exercise training can safely and significantly improve physical performance and quality of life in clinically stable PH patients with optimal drug treatment. However, larger studies including a wider range of PH are mandatory.


Assuntos
Terapia por Exercício/métodos , Tolerância ao Exercício , Exercício , Hipertensão Pulmonar/terapia , Ensaios Clínicos Controlados Aleatórios como Assunto , Humanos , Hipertensão Pulmonar/psicologia , Aptidão Física , Qualidade de Vida/psicologia , Resultado do Tratamento
4.
Zhonghua Yi Xue Za Zhi ; 99(41): 3255-3259, 2019 Nov 05.
Artigo em Chinês | MEDLINE | ID: mdl-31694122

RESUMO

Objective: To explore whether exercise could influence outcomes and improve life quality of patients with knee osteoarthritis. Methods: This study included 210 patients diagnosed with knee osteoarthritis from October to December 2018 in Shijiazhuang Derui Exercise Rehabilitation Medical Center. These patients were divided into two groups with random number table: experiment and control group. Patients in experimental group got exercise rehabilitation training and routine therapy,but patients in control group got routine treatment only that included physical therapy and non-steroidal anti-inflammatory drugs (NSAIDs). We applied different kinds of measure to follow-up these patients,which included Lysholm scale, the Western Ontario and McMaster Osteoarthritis Index (WOMAC), SF-36 life quality questionnaire, and knee range of motion.The degree of pain and symptoms and the knee function and the quality of life in the two groups were recorded too. Paired sample t test was used to compare the data between the two groups. Results: There were 105 patients in each group, but 13 cases (12.4%) in experimental group and 6 patients (5.7%) in control group were lost,respectively.All the patients were followed up for (12.0±2.3) weeks. There was no significant differences in age, body mass index, gender between the two groups. At the final follow-up, the WOMAC score in the experiment group was 84.4±6.8, and it was 108.3±1.7 in the control group (t=-4.71, P<0.05);the Lysholm score of the experimental group was 65.5±4.7, and it was 41.2±1.4 in the control group (t=7.29, P<0.05); the knee range of motion in the experiment group and control group was 121°±7° and 114°±3°, respectively (t=1.83, P<0.05); the SF-36 score in the two groups was 90.0±2.8 and 75.6±1.5, respectively (t=6.15, P<0.05). Conclusion: Exercise rehabilitation plus routine therapy for patients with knee osteoarthritis can effectively improve outcome, promote functional recovery and improve quality of life.


Assuntos
Terapia por Exercício , Osteoartrite do Joelho , Humanos , Articulação do Joelho , Osteoartrite do Joelho/terapia , Qualidade de Vida , Amplitude de Movimento Articular , Resultado do Tratamento
5.
Medicine (Baltimore) ; 98(45): e17733, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31702624

RESUMO

BACKGROUND: Cervical radiculopathy (CR), which is most often stems from degenerative disease in the cervical spine, has increasingly become a common and frequently occurring disease in clinic due to the popularity of electronic products, such as computes and cell phones. Some studies have shown that exercise or exercise combined with other treatments can effectively decrease pain and improve functional status. The objective was to analyze the effects of exercise for treating patients with CR. METHODS: Seven databases were searched from inception to December 2018. Randomized controlled trials involving exercise alone or exercise combined with conventional treatment were enrolled. Data were pooled after trials quality assessment for meta-analysis. Outcomes were pain (visual analog scale [VAS]), quality of life (12-short form health survey, 36-short form health survey), and physical function accessed by neck disability index (NDI). RESULTS: Ten studies involving 871 participants with CR were included. Meta-analysis revealed that compared with control group, there was a reduction in VAS (standardized mean difference = -0.89; 95% confidence interval [CI]: -1.34 to -0.44; Z = 3.89; P < .001). There was also an improvement of NDI (mean difference = -3.60; 95% CI: -6.27 to -0.94; Z = 2.65; P = .008)]. Additionally, although the results of subgroup analyses were changed due to the paucity of the quantity and quality of the included studies. The pooled results were verified to be stable by sensitivity analyses. Besides, the grading of recommendations assessment, development, and evaluation level of evidence is low for each outcome. CONCLUSION: Exercise alone or exercise plus other treatment may be helpful to patients with CR. However, exercise option should be carefully considered for each patient with CR in accordance with their different situations. Large-scale studies using proper methodology are recommended.


Assuntos
Terapia por Exercício/métodos , Radiculopatia/reabilitação , Humanos , Medição da Dor , Qualidade de Vida , Resultado do Tratamento , Escala Visual Analógica
6.
Medicine (Baltimore) ; 98(45): e17946, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31702684

RESUMO

BACKGROUND: Adaptive balance control is often compromised in children with developmental coordination disorder (DCD). Neuromuscular training (NMT) is commonly used in clinical settings to improve neuromuscular control and hence balance performance in these children. However, its effectiveness has not been proven scientifically. This randomized controlled study aimed to explore the effectiveness of NMT for improving adaptive balance performance and the associated leg muscle activation times in children with DCD. METHODS: Eighty-eight children with DCD were randomly assigned to the NMT or control group (44 per group). The NMT group received two 40-minute NMT sessions/week for 3 months, whereas the control group received no intervention. The outcomes were measured at baseline and 3 and 6 months. The primary outcome was the sway energy score (SES) in both the toes-up and toes-down conditions as derived using the Adaptation Test (ADT). Secondary outcomes included the medial gastrocnemius, medial hamstring, tibialis anterior and rectus femoris muscle activation onset latencies during ADT, measured using surface electromyography and accelerometry. Data were analyzed using a repeated measures analysis of covariance based on the intention-to-treat principle. RESULTS: At 3 months, no significant within-group or between-group differences were noted in the SESs for either group. At 6 months, the toes-down SES decreased by 6.8% compared to the baseline value in exclusively the NMT group (P = .004). No significant time, group or group-by-time interaction effects were observed in any leg muscle activation outcomes. CONCLUSIONS: Short-term NMT failed to improve adaptive balance performance and leg muscle activation times in children with DCD. Further studies should explore the clinical applications of longer-term task-specific interventions intended to improve the adaptive balance performance of these children.


Assuntos
Terapia por Exercício/métodos , Transtornos das Habilidades Motoras/reabilitação , Equilíbrio Postural , Adaptação Fisiológica , Criança , Eletromiografia , Feminino , Humanos , Masculino , Método Simples-Cego , Resultado do Tratamento
7.
Medicine (Baltimore) ; 98(44): e17865, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31689879

RESUMO

RATIONALE: Most cases of foot drop are known to result from lower motor neuron pathologies, particularly lumbar radiculopathy and peripheral neuropathy, including common peroneal neuropathy. To improve the prognosis of foot drop, it is important to quickly and accurately diagnose the etiology and provide appropriate treatment. PATIENT CONCERNS: A 65-year-old female patient with a history of L4-5 intervertebral disc herniation presented with right foot drop that had developed 1 month previously. DIAGNOSIS: Electrodiagnostic examination revealed common peroneal neuropathy combined with L5 radiculopathy, with the former being the main cause of the foot drop. MRI of the right knee was performed to identify the cause of the peroneal nerve lesion, which revealed an intraneural ganglion cyst in the common peroneal nerve. INTERVENTIONS: The patient was treated by ultrasound-guided percutaneous cyst aspiration and corticosteroid injection into the decompressed ganglion, followed by strengthening exercise, electrical stimulation therapy, and prescription of an ankle foot orthosis. OUTCOMES: We confirmed regeneration of the injured peroneal nerve at the follow-up electrodiagnostic examination 12 weeks after the intervention. In addition, the manual motor power test demonstrated an increase in the ankle dorsiflexor function score by one grade. LESSONS: Diagnosing the cause of foot drop can be difficult with multiple co-existing pathologies, and consideration of various possible etiologies is the key for appropriate diagnosis and treatment. In addition to imaging modalities such as MRI, electrodiagnostic examination can help to improve diagnostic accuracy. Intraneural ganglion cyst of the common peroneal nerve is rare, but should be considered as a possible cause of foot drop.


Assuntos
Cistos Glanglionares/complicações , Neuropatias Fibulares/etiologia , Radiculopatia/complicações , Corticosteroides/uso terapêutico , Idoso , Terapia Combinada , Terapia por Estimulação Elétrica , Eletrodiagnóstico , Terapia por Exercício , Feminino , Órtoses do Pé , Cistos Glanglionares/diagnóstico , Cistos Glanglionares/terapia , Humanos , Vértebras Lombares , Imagem por Ressonância Magnética , Paracentese , Neuropatias Fibulares/terapia , Radiculopatia/diagnóstico , Radiculopatia/terapia
8.
Medicine (Baltimore) ; 98(46): e17240, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31725601

RESUMO

BACKGROUND: Neck pain is an important cause of disability. In spite of its high prevalence rate, treatment of the disorder is a challenging topic. Exercise therapy appears to be effective at decreasing pain and improving function for patients with NP in practice guidelines. Core stability exercise is becoming increasingly popular for NP. However, it is currently unknown whether core stability exercise produces more beneficial effects than general exercise in patients with NP. The aim of this study is to explore the therapeutic effect of core stability exercise for neck pain. METHODS: This review will only include randomized controlled trials (RCTs). Published articles from July 2009 to July 2019 will be identified using electronic searches. Search strategy will be performed in 3 English databases, 1 Chinese database, and the WHO International Clinical Trials Registry Platform. Two reviewers will screen, select studies, extract data, and assess quality independently. The methodological quality including the risk of bias of the included studies will be evaluated using a modified assessment form, which is based on Cochrane assessment tool and Physiotherapy Evidence Database scale. Review Manager Software (Revman5.3) will be used for heterogeneity assessment, generating funnel-plots, data synthesis, subgroup analysis, and sensitivity analysis. We will use GRADE system to evaluate the quality of our evidence. RESULTS: We will provide some more practical and targeted results investigating the effect of Core Stability Exercise (CSE) for Neck Pain (NP) in the current meta-analysis. Meanwhile, we will ascertain study progress of Core Stability Exercise for Neck Pain and find out defects or inadequacies of previous studies, so that future researchers could get beneficial guidance for more rigorous study. CONCLUSION: The stronger evidence about Neck Pain's rehabilitative effect and safety will be provided for clinicians and policymakers. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42017055711. ETHICS AND DISSEMINATION: We do not apply for formal ethical approval from ethics committee because all of the study data in our review will be obtained in an anonymous way. Findings of this study are projected to be disseminated through peer-review publications.


Assuntos
Terapia por Exercício/métodos , Cervicalgia/reabilitação , Exercício/fisiologia , Humanos , Metanálise como Assunto , Força Muscular , Músculo Esquelético/fisiopatologia , Cervicalgia/fisiopatologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Projetos de Pesquisa , Revisão Sistemática como Assunto , Tronco/fisiopatologia , Resultado do Tratamento
9.
Endocrinol. diabetes nutr. (Ed. impr.) ; 66(9): 563-570, nov. 2019.
Artigo em Espanhol | IBECS | ID: ibc-184379

RESUMO

Objetivo: Evaluar en el paciente diabético anciano la probabilidad de mejorar la fragilidad tras realizar ejercicios de fuerza con una banda elástica y ejercicio aeróbico. Métodos: Estudio prospectivo de pacientes diabéticos mayores de 70 años, con Barthel > 80 puntos y Global Deterioration Scale-Functional Assessment Staging < 3 puntos. Se recomendaron ejercicios de fuerza con una banda elástica 3 días a la semana y caminar 30 min al día 5 días a la semana. Se revisó la adherencia a los ejercicios mediante la pregunta de Haynes-Sacket. En el momento basal y a los 6 meses se evaluaron la fragilidad según los criterios de Fried y la capacidad funcional mediante el Short Physical Performance Battery. Resultados: Un total de 44 pacientes completaron los 6 meses de seguimiento. Se produjo falta de adherencia a los ejercicios aeróbicos en el 38,6% de los casos y a los ejercicios con bandas elásticas en el 47,7%. La prevalencia de fragilidad disminuyó del 34,1% inicial al 25% a los 6 meses (p = 0,043), y el porcentaje de sujetos con una limitación funcional moderada-grave se redujo del 26,2 al 21,4% (p = 0,007). La adherencia a los ejercicios aeróbicos (p = 0,034) y la ausencia de cardiopatía isquémica coronaria (p = 0,043) predispusieron a mejorar la fragilidad. Conclusiones: Realizar durante 6 meses ejercicios de fuerza con una banda elástica y ejercicio aeróbico reduce la prevalencia de fragilidad en pacientes diabéticos ancianos. La probabilidad de mejorar la fragilidad disminuye en caso de cardiopatía isquémica coronaria y aumenta con la adherencia a los ejercicios aeróbicos


Aim: To evaluate in the elderly diabetic patient the probability of improving the frailty after performing strength exercises with an elastic band and aerobic exercise. Methods: Prospective study of diabetic patients older than 70 years, with Barthel > 80 points and Global Deterioration Scale -Functional Assessment Staging < 3 points. Strength exercises with an elastic band 3 days a week and walk 30 min a day 5 days a week were recommended. Adherence to the exercises was assessed using the Haynes-Sacket test. Frailty was assessed by the Fried criteria and functional capacity by the Short Physical Performance Battery at baseline and at 6 months. Results: 44 patients completed 6 months of follow-up. There was non-adherence to aerobic exercises in 38.6% of cases and to exercises with elastic bands in 47.7%. The prevalence of frailty decreased from an initial 34.1% to 25% at 6 months (p = 0.043) and the percentage of patients with a moderate-severe functional limitation was reduced from 26.2% to 21.4% (p = 0.007). Adherence to aerobic exercises (p = 0.034) and absence of coronary ischemic heart disease (p = 0.043) predisposed to improve frailty. Conclusions: Performing 6-month strength exercises with an elastic band and aerobic exercise reduces the prevalence of frailty in elderly diabetic patients. The probability of improving frailty decreases in case of coronary ischemic heart disease and increases with adherence to aerobic exercises


Assuntos
Humanos , Idoso , Idoso de 80 Anos ou mais , Exercício/fisiologia , Força Muscular/fisiologia , Idoso Fragilizado , Debilidade Muscular/terapia , Terapia por Exercício , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/diagnóstico , Estudos Prospectivos , Cooperação e Adesão ao Tratamento
10.
Clin Exp Rheumatol ; 37 Suppl 120(5): 112-117, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31621559

RESUMO

Most patients with knee and hip osteoarthritis (OA) should be treated in primary care by non-surgical treatments. Building on substantial evidence from randomised trials, exercise therapy and education, typically delivered by physical therapists, are core first line treatments universally recommended in treatment guidelines for OA alongside weight loss, if needed. Exercise therapy provides at least as effective pain relief as pharmacological pain medications, without serious adverse effects; furthermore, the treatment effect from exercise therapy is similar, irrespective of baseline pain intensity and radiographic OA severity. Exercise therapy should be individualised to the preferences and needs of the individual patient, but at least 12 supervised sessions, 2 sessions per week, are required initially to obtain sufficient clinical benefit. Structured patient education concerning OA and its treatment options, including self-management, is important to retain motivation and adherence to an exercise programme and thereby maintain the effects over the long-term. If treatment effects from exercise therapy and patient education are insufficient, the physical therapist can deliver supplementary interventions that include knee orthoses and manual treatment.


Assuntos
Terapia por Exercício , Osteoartrite do Quadril , Osteoartrite do Joelho , Humanos , Articulação do Joelho , Manejo da Dor
11.
Medicine (Baltimore) ; 98(41): e17289, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31593081

RESUMO

INTRODUCTION: Fibromyalgia (FM) is a chronic condition characterized by chronic pain, fatigue and loss of function which significantly impairs quality of life. Although treatment of FM remains disputed, some studies point at the efficacy of interdisciplinary therapy. This study aims to analyze the effectiveness, cost-utility and benefits of a multicomponent therapy on quality of life (main variable), functional impact, mood and pain in people suffering from FM that attend primary care centers (PCCs) of the Catalan Institute of Health (ICS). METHODS AND ANALYSIS: A 2-phase, mixed methods study has been designed following Medical Research Council guidance. Phase 1: Pragmatic randomized clinical trial with patients diagnosed with FM that attend one of the 11 PCCs of the ICS Gerència Territorial Terres de l'Ebre. We estimate a total sample of 336 patients. The control group will receive usual clinical care, while the multicomponent therapy group (MT group) will receive usual clinical care plus group therapy (consisting of health education, exercise and cognitive-behavioural therapy) during 12 weeks in 2-hourly weekly sessions. ANALYSIS: the standardized mean response and the standardized effect size will be assessed at 3, 9, and 15 months after the beginning of the study using multiple linear regression models. Utility measurements will be used for the economic analysis. Phase 2: Qualitative socio constructivist study to evaluate the intervention according to the results obtained and the opinions and experiences of participants (patients and professionals). We will use theoretical sampling, with 2 discussion groups of participants in the multicomponent therapy and 2 discussion groups of professionals of different PCCs. A thematic content analysis will be carried out. ETHICS AND DISSEMINATION: This study protocol has been approved by the Clinical Research Ethics Committee of the Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (code P18/068). Articles will be published in international, peer-reviewed scientific journals. TRIAL REGISTRATION: Clinical-Trials.gov: NCT04049006.


Assuntos
Terapia Cognitivo-Comportamental/métodos , Terapia por Exercício/métodos , Fibromialgia/terapia , Educação de Pacientes como Assunto/métodos , Atenção Primária à Saúde/métodos , Qualidade de Vida , Adulto , Terapia Cognitivo-Comportamental/economia , Terapia Combinada , Análise Custo-Benefício , Terapia por Exercício/economia , Estudos de Viabilidade , Feminino , Fibromialgia/economia , Fibromialgia/psicologia , Implementação de Plano de Saúde , Humanos , Masculino , Aceitação pelo Paciente de Cuidados de Saúde , Cooperação do Paciente , Educação de Pacientes como Assunto/economia , Atenção Primária à Saúde/economia , Ensaios Clínicos Controlados Aleatórios como Assunto , Projetos de Pesquisa
12.
JAMA ; 322(14): 1415, 2019 10 08.
Artigo em Inglês | MEDLINE | ID: mdl-31593264
14.
BMJ ; 367: l5831, 2019 10 04.
Artigo em Inglês | MEDLINE | ID: mdl-31585942
15.
BMJ ; 367: l5830, 2019 10 04.
Artigo em Inglês | MEDLINE | ID: mdl-31585943
16.
BMJ ; 367: l5456, 2019 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-31575520

RESUMO

The studyTaylor RS, Walker S, Ciani O, et al. Exercise-based cardiac rehabilitation for chronic heart failure: the EXTRAMATCH II individual participant data meta-analysis. Health Technol Assess 2019;23:1-98.This project was funded by the NIHR Health Technology Assessment Programme (project number 15/80/30).To read the full NIHR Signal, go to https://discover.dc.nihr.ac.uk/content/signal-000803/cardiac-rehabilitation-for-heart-failure-can-improve-quality-of-life-and-fitness.


Assuntos
Reabilitação Cardíaca , Insuficiência Cardíaca , Exercício , Terapia por Exercício , Humanos , Qualidade de Vida
17.
Medicine (Baltimore) ; 98(40): e17304, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31577721

RESUMO

BACKGROUND: Tongue strengthening exercise (TSE) is a remedial method for the training of swallowing-related muscles in the oropharyngeal phase. However, clinical evidence of its effectiveness is insufficient. METHODS: To investigate the effect of TSE on the oropharyngeal muscles associated with swallowing in older adults, in this study, 40 elder adults living in the community were recruited and assigned to 2 groups. The experimental group performed a TSE with a 1-repetition maximum resistance level of 70%. The exercise was divided into an isometric and isotonic part. The control group did not perform an exercise. We measured the muscle strength and thickness of the tongue and suprahyoid muscles using an Iowa Oral Performance Instrument and ultrasonography. RESULTS: The experimental group showed a statistically significant increase in tongue muscle strength and thickness in the oral phase (P = .001 and <.001, respectively). In the pharyngeal phase, the experimental group showed a statistically significant increase in the mylohyoid and digastric muscles (suprahyoid muscles) (P = .045 and .019, respectively). The control group showed no statistically significant changes. CONCLUSION: TSE is effective in increasing the strength and thickness of the oropharyngeal muscles of elder adults and is recommended for those who are vulnerable to swallowing difficulties.


Assuntos
Transtornos de Deglutição/prevenção & controle , Deglutição/fisiologia , Terapia por Exercício/métodos , Força Muscular/fisiologia , Treinamento de Resistência/métodos , Língua/fisiologia , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , República da Coreia
18.
Rev Med Suisse ; 15(665): 1770-1774, 2019 Oct 02.
Artigo em Francês | MEDLINE | ID: mdl-31580022

RESUMO

Nowadays, new psychotropic treatments might result on rapid onset of weight gain also related to other factors such as individual vulnerability, poor diet and lack of exercise. Many studies have reported that weight gain is only the premise of a series of metabolic disturbances and cardiovascular complications. In this context, we have established since June 2017 in an ambulatory centre in Geneva, a 4F program (Fit, Fun, Feel and Food), to optimize the measures and strategies needed to prevent and reduce weight gain in these patients. This transversal program is naturalistically and systematically centered on physical activity, healthy diet and improved body perception. We will show some preliminary results of 4F program.


Assuntos
Antipsicóticos/efeitos adversos , Terapia por Exercício , Transtornos Mentais/complicações , Transtornos Mentais/terapia , Serviços Preventivos de Saúde , Ganho de Peso , Assistência Ambulatorial , Imagem Corporal , Humanos , Transtornos Mentais/psicologia , Suíça , Ganho de Peso/efeitos dos fármacos
19.
Codas ; 31(5): e20180163, 2019.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31664370

RESUMO

This research had the objective of reporting a clinical case in which the rehabilitation of tongue strength with biofeedback strategy was performed. This case report addresses a 20-year-old patient whose orofacial myofunctional evaluation revealed a severe decrease in the force of the anterior third of the tongue and changes in lingual mobility and coordination. The measurement of tongue pressure was performed using the Iowa Oral Performance Instrument (IOPI) during elevation, protrusion and lateralization, and it was verified a reduction in the values ​​obtained in all measured directions, compared with normality patterns. We performed 11 sessions of therapy, with weekly frequency, using a biofeedback strategy that consisted of computer games controlled by the tongue. An instrument embedded in the oral cavity functioned as a joystick as the input method for specific digital games. The patient performed at home the isometric exercises of pressing the tip of the tongue against a spatula, exaggerated retraction of tongue, tongue tapering, and isotonic exercise of touching the commissures and lips alternately, daily. After eight sessions, in relation to the elevation pressure, there was an improvement of 28.6% for the apex and 7.1% for the dorsum. As for protrusion, there was an improvement of 123.5%. In the measurements of left and right lateralization, the values ​​increased 53.8% and 7.4%, respectively. After twelve sessions, it was observed an improvement of 35.7%, 7.4%, 164%, 76.9% and 40.7% in relation to the initial evaluation, for apex elevation, dorsum elevation, protrusion, and lateralization to left and right, respectively. Despite the increase, values ​​recommended in the literature as normal for sex and age were not reached after 12 therapy sessions.


Assuntos
Terapia por Exercício/métodos , Força Muscular , Língua/fisiopatologia , Adulto , Biorretroalimentação Psicológica , Exercício , Terapia por Exercício/instrumentação , Paralisia Facial/complicações , Paralisia Facial/reabilitação , Feminino , Humanos , Força Muscular/fisiologia , Adulto Jovem
20.
Artigo em Russo | MEDLINE | ID: mdl-31626160

RESUMO

Pulmonary arterial hypertension (PAH) is characterized by characterized by a continuous increase in precapillary pulmonary vascular resistance with a progressive decrease in cardiac output, which leads to progressive dyspnea, fatigue, and deterioration of exercise capacity. Traditionally, the patients have been advised to limit physical exercises. Recent studies suggest that there are improvements in exercise capacity, quality of life, muscle function, and pulmonary circulation when cardiovascular and pulmonary rehabilitation programs are implemented. According to the 2015 European Society of Cardiology guidelines for the management of patients with PAH, physical rehabilitation is indicated for clinically stable patients who receive drug therapy for this disease. There are various physical rehabilitation programs, but there is no generally accepted protocol for physical exercises in patients with PAH. The review highlights the pathophysiological mechanisms for reducing exercise capacity in patients with PAH; methods for assessing the right ventricular contractile reserve, the effect of physical stress on the cardiovascular system, lungs, and muscles; the existing physical rehabilitation programs, complications and ways to overcome them are considered. Clinical trials studies are also briefly analyzed; promising areas for further development and improvement of rehabilitation programs are considered.


Assuntos
Terapia por Exercício , Hipertensão Pulmonar/reabilitação , Humanos , Hipertensão Pulmonar/fisiopatologia , Resultado do Tratamento
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA