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Edinburgh, Australia

Hagovska M.,Physiatry | Takac P.,Physiatry | Dzvonik O.,Institute of Aviation Medicine
European Journal of Physical and Rehabilitation Medicine | Year: 2016

Background: An optimal frequency and duration of cognitive trainings and exercise has not yet been determined for improving balance and for positively influencing cognitive functions. Aim: To investigate whether the CogniPlus method with a dynamic balance training not only improves cognitive functions but also improves the postural control and functional status more than a balance training session alone in seniors with a mild cognitive deficit. Design: Randomized, controlled trial. Setting: Outpatient psychiatric clinic. Population : The research sample was composed of 80 seniors with a mild cognitive deficit (average age 67.07 years), an experimental group (N.=40) and a control group (N.=40). Methods: The experimental group was engaged in 20 cognitive training sessions twice per week, using CogniPlus together with balance training. The control group was given only the balance training programme for the same duration and frequency. Both groups performed dynamic balance training for 30 minutes daily in a domestic environment for ten weeks, in accordance with instructions given by a physiotherapist. Cognitive functions were assessed by Addenbrooke's cognitive examination, data on daily life activities were collected by the Functional Activities Questionnaire (FAQ-CZ) and coordination abilities were evaluated by the Balance Evaluation - Systems Test (BESTest). Results : After training, there were significant differences between these two groups recorded in the assessment of several cognitive functions by the Addenbrooke's cognitive examination (P<0.05-0.0001) in favour of the experimental group. Also, the assessment of postural reactions and the total score of the BESTest were in favour of the experimental group (P<0.05-0.0001). Effect size was small. No significant differences were noted in the evaluation of functional activities. Conclusion: Combining cognitive and dynamic balanced training achieved significantly higher improvements not only in the evaluation of cognitive domains but also in postural control, than balance training alone in seniors with mild cognitive impairment. Clinical Rehabilitation Impact : CogniPlus with dynamic balance training could be recommended as a therapeutic procedure for the prevention and treatment of cognitive and balance disorders. Copyright © 2016 EDIZIONI MINERVA MEDICA.

Truska O.,Institute of Aviation Medicine | Sokol M.,Military Institute of Forensic Pathology
Aviation Space and Environmental Medicine | Year: 2013

Introduction: The major causes of in-flight fatal incapacitation in civil pilots are acute coronary events, new onset idiopathic epilepsy, and physiological problems. Less than 1% of all air accidents are due to sudden incapacitaion. The problem with acute coronary disease is very serious when occurring during critical stages of the flight, such as takeoffor landing, rather than during the cruising phase. Case Report: The authors describe the fatal in-flight incapacitation in a Czech airline captain during the approach for landing. In this case, the first officer tried to communicate with the captain, but there was no response and first aid was unsuccessful. The post-mortem examination showed the cause of the sudden death to be an aortic dissection with cardiac tamponade due to cystic medial necrosis (Erdheim disease). The authors describe the clinical and histological features of Erdheim disease. Discussion: The normal aorta contains collagen, elastin, and smooth muscle cells that form the vessel wall. Degenerative changes lead to breakdown of the collagen, elastin, and smooth muscle, and an increase in basophillic ground substance with the formation of cysts and accumulation of mucopolysaccharide. Medical incapacitation in the cockpit is rare. The leading causes of fatal in-flight incapacitation are myocardial infarction, cardiac arrhythmias, and epileptic seizures; cystic medial necrosis is very rare and no similar cases were found in the aviation literature. © by the Aerospace Medical Association.

Holy R.,Charles University | Navara M.,Charles University | Dosel P.,Institute of Aviation Medicine | Fundova P.,Charles University | And 2 more authors.
Undersea and Hyperbaric Medicine | Year: 2011

The main basic effect of hyperbaric oxygenation (HBO2) on the human body, in our study, was an increased partial pressure of oxygen resulting from an increased amount of oxygen dissolved in plasma. Thus the plasma can become capable of carrying enough oxygen to meet the needs of the body's tissues. From 1 January 2004 to 31 December 2007, a total of 61 patients (62 ears) received medical treatment at the ENT clinic of the 3rd Faculty of Medicine, Charles University, and at the Central Military Hospital in Prague. Treatment consisted of a combination of vasodilatation infusion treatment and HBO2 therapy. The results were evaluated in a retrospective study. The overall percentage of patients showing improvement was 59.7%. However, for those patients who started HBO2 treatment within 10 days of onset, complete recovery, or significant improvement was noted in 65.9%. In contrast, patients who started treatment after 10 days of onset, improvement was noted in only 38.9%. NMR examination revealed that two patients had vestibular schwannoma (also known as acoustic neuroma). Copyright © 2011 Undersea & Hyperbaric Medical Society, Inc.

Tucker B.,Deakin University | Netto K.,Deakin University | Hampson G.,Institute of Aviation Medicine | Oppermann B.,Institute of Aviation Medicine | Aisbett B.,Deakin University
Military Medicine | Year: 2012

Objective: Fighter pilots frequently report neck pain and injury, and although risk factors have been suggested, the relationships between risk factors and neck pain have not been quantified. The aim of this study was to identify personal and work behaviors that are significantly associated with neck pain in fighter pilots. Methods: Eighty- two Royal Australian Air Force fighter pilots were surveyed about their flying experience, neck pain prevalence, and prevention. Multinomial logistic regressions were used to fit models between pilots' neck pain during and after flight and a range of personal and work characteristics. Results: In-flight neck pain was very weakly, yet positively associated with flight hours. Duration of postflight pain was positively associated with the weekly desktop work hours and the sum of preventative actions taken in flight. The duration pilots were considered temporarily medically unfit for flying was positively associated with pilots' age and their weekly desktop work hours. Discussion: The risk factors identified by the current study should guide neck pain prevention for fighter pilots. In particular, reducing desktop working hours as well as incorporating specific neck-strengthening exercises and in-flight bracing actions should be considered by agencies to help alleviating neck pain in their pilots. © Association of Military Surgeons of the U.S.

Haughom B.,Institute of Aviation Medicine | Strand T.-E.,Institute of Aviation Medicine
Acta Ophthalmologica | Year: 2013

Purpose: Limited information is available regarding the normal range of mesopic sine wave contrast sensitivity (CS). The aim of this study was therefore to define a reference range and in addition to identify factors related to mesopic CS in a young population. Methods: Individuals with normal visual acuity (VA) were included from a population of air crew members visiting the Institute of Aviation Medicine for routine medical examinations. CS was measured using the Optec 6500/FACT and evaluated by (i) the CS curve with five frequencies and (ii) the index of contrast sensitivity (ICS). ICS was defined as the sum of the weighted differences from the median CS value for each frequency. Multivariate analyses were performed to identify factors related to CS. Results: In a total of 197 subjects included, the mean mesopic CS score was significantly lower compared to the corresponding photopic measurements for all five frequencies tested. Median CS score for frequencies 1.5, 3, 6, 12 and 18 cycles per degree was 50, 114, 180, 60 and 33 for photopic and 71, 80, 90, 22 and 12 for mesopic (- glare) conditions, respectively. Better binocular VA was positively associated, while the use of corrective lenses was negatively associated with CS performance. Conclusion: We have provided reference values for mesopic CS and identified factors important for CS. The difference between mesopic and photopic measurements highlights the need for separate population norms. The new ICS score may be a useful collective descriptor of the traditional CS curve with five frequencies. © 2011 The Authors. Acta Ophthalmologica © 2011 Acta Ophthalmologica Scandinavica Foundation.

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