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Milano, Italy

Maggioni M.A.,University of Milan | Ce E.,University of Milan | Ce E.,Foundation Medicine | Giordano G.,Palazzolo Institute | And 6 more authors.
Aging Clinical and Experimental Research

Background and aims: Long-stay hospitalized elderly women usually reduce daily living activities: this may lead to an accelerated worsening of body composition, cardio-metabolic condition and falls risk. Exercise training and electrical stimulation may ameliorate such condition. Methods: The effects of 3 different short-term rehabilitation programs on lower limbs (kinesitherapy [KT], electrical stimulation [ES], KT combined with ES [KT+ES], 3 day/week for 6 weeks) were assessed on 40 hospitalized elderly women (82±7 yrs, 59.5±12.3 kg, 152±7 cm [m±SD]; n=10 for each intervention group and n=10 as control subjects [no intervention]). Segmental (upper and lower limbs) and total body fat mass (FM), fat free mass (FFM), bone mineral content (BMC) and density (BMD), resting energy expenditure (REE), maximum voluntary force (MVC) of leg extensor muscles and cardiorespiratory performance (6-min walking test [6MVT]) were evaluated before and after intervention. Results: Compared to baseline, the distance covered by the 6MWT significantly increased after all rehabilitation programs (from 247±79 to 271±87 m, p<0.01), whereas significant increases in leg extensor muscles MVC were found after ES (+26%) and KT+ES (+16%) only, p<0.05. No changes in segmental and total body FM, FFM and REE were observed, whereas legs BMC significantly increased (2.7%) after KT only (p<0.05). Conclusions: Although all treatments increased cardiorespiratory performance, and KT and ES ameliorated muscle force, the proposed short-term exercise programs had poor effects on body composition. This suggests that longer programs, maybe combined with a tailored dietary intervention, should be administered to improve body composition in rehabilitating institutionalized elderly people. ©2012, Editrice Kurtis. Source

Maggioni M.A.,University of Milan | Ce E.,University of Milan | Ce E.,Foundation Medicine | Rampichini S.,University of Milan | And 6 more authors.
Archives of Gerontology and Geriatrics

Long-stay hospitalized elderly patients frequently develop a decrease in strength, cardiovascular fitness and balance, which can be improved by exercise. Neuromuscular electrical stimulation (ES) might also be effective in this population. The effect of different lower limb rehabilitation programs (3 interventions/week for 6 weeks) on functional fitness in 40 hospitalized old females (82 ± 7 years) were evaluated: kinesitherapy (KT), ES, KT alternated with ES (KT + ES), and no treatment (C). Outcome variables after rehabilitation were: (a) maximal strength of leg extensor and finger flexor muscles; (b) cardiorespiratory fitness (6-min walking test, 6MWT; heart rate, HR); (c) static and dynamic balance and gait skills (Tinetti test). The maximal strength of leg extensor (but not finger flexor) muscles significantly improved in ES (+26%) and KT + ES (+16%) groups only. The distance covered during the 6MWT significantly increased in KT (+15%), ES (+14%) and KT + ES (+9%) groups, but the post-test HR recovery improved in KT group only. Balance (but not gait) skill scores significantly and similarly increased in KT (+11%), ES (+10%) and KT + ES (+11%) groups. In long-stay hospitalized old females ES and KT + ES improved lower limbs isometric strength. Walking ability was improved by all treatments, whereas cardiovascular performance and recovery were ameliorated by KT only. © 2009 Elsevier Ireland Ltd. All rights reserved. Source

Greppi N.,Foundation Medicine | Mazzucco L.,Transfusion Medicine | Galetti G.,Palazzolo Institute | Bona F.,Transfusion Medicine | And 8 more authors.

We evaluated growth factor contents and clinical efficacy of allogeneic platelet gel (PG) prepared with standard blood banking procedures from routine platelet concentrates (PCs) obtained from buffy coats. The PGs were used to treat 11 hypomobile very elderly patients unable to undergo autologous blood processing and previously ineffectively treated with expensive advanced medications for 8-275 weeks.PGs were prepared by platelet activation with human thrombin or commercial batroxobin. Median and range growth factor contents (ng/mL) were: platelet derived growth factor (PDGF-AB/-BB) 112 (31-157) and 20 (3.8-34); transforming growth factor (TGF-β1/-β2) 214 (48-289) and 0.087 (0.03-0.28); basic-fibroblast growth factor (b-FGF) 0.03 (0.006-0.214); vascular endothelial growth factor (VEGF) 1.15 (0.18-2.46); epidermal growth factor (EGF) 4.50 (0.87-6.64); insulin-like growth factor (IGF-l) 116 (72-156).In the clinical study, 222 PGs were used within 2 h of activation to treat 14 chronic skin ulcers in the 11 patients. No improvement was seen in 3 patients with 24, 27 and 30 cm3 ulcers who could be treated for no more than 4, 7 and 8 weeks due to progressively worsening clinical conditions, while 11 ulcers with 3.2 cm3 median size (range 0.2-3.6) in the remaining 8 patients showed 91 ± 14 % reduction after a median of 12 weeks (range 1-20). Cost of PG treatment (19,976 euro) amounted to about 10% of the ineffective advanced medication hospital reimbursement fees (191,236 euro).This study supports efficacy and feasibility of allogeneic PG to treat recalcitrant ulcers in very elderly hypomobile patients for whom autologous blood processing may be difficult. © 2011 The International Association for Biologicals. Source

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