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Alfred, Australia

Holland A.E.,Physiotherapy | Holland A.E.,La Trobe University | Holland A.E.,Institute for Breathing and Sleep | Hill C.J.,Institute for Breathing and Sleep | And 4 more authors.
Respiratory Medicine | Year: 2012

Background: Pulmonary rehabilitation improves functional capacity and symptoms in the interstitial lung diseases (ILDs), however there is marked variation in outcomes between individuals. The aim of this study was to establish the impact of the aetiology and severity of ILD on response to pulmonary rehabilitation. Methods: Forty-four subjects with ILD, including 25 with idiopathic pulmonary fibrosis (IPF), underwent eight weeks of pulmonary rehabilitation. Relationships between disease aetiology, markers of disease severity and response to pulmonary rehabilitation were assessed after eight weeks and six months, regardless of program completion. Results: In IPF, greater improvements in 6-minute walk distance (6MWD) immediately following pulmonary rehabilitation were associated with larger forced vital capacity (r = 0.49, p = 0.01), less exercise-induced oxyhaemoglobin desaturation (r S = 0.43, p = 0.04) and lower right ventricular systolic pressure (r = -0.47, p = 0.1). In participants with other ILDs there was no relationship between change in 6MWD and baseline variables. Less exercise-induced oxyhaemoglobin desaturation at baseline independently predicted a larger improvement in 6MWD at six month follow-up. Fewer participants with IPF had clinically important reductions in dyspnoea at six months compared to those with other ILDs (25% vs 56%, p = 0.04). More severe dyspnoea at baseline and diagnosis other than IPF predicted greater improvement in dyspnoea at six months. Conclusions: Patients with IPF attain greater and more sustained benefits from pulmonary rehabilitation when disease is mild, whereas those with other ILDs achieve benefits regardless of disease severity. Early referral to pulmonary rehabilitation should be considered in IPF. © 2011 Elsevier Ltd. All rights reserved. Source

Franco C.R.C.,HCPA | Leao P.,Physiotherapy | Townsend R.,Federal University of Rio Grande do Sul | Rieder C.R.M.,Movement Disorders Clinic
Arquivos de Neuro-Psiquiatria | Year: 2011

Axial rigidity is an important motor manifestation in Parkinson's disease (PD). Trunk mobility impairment can cause gait, balance and postural problems. However, only few instruments analyze the trunk mobility in PD patients. The aim of this study is to present a new Trunk Mobility Scale (TMS) and its validation in PD. The TMS constituted of dynamic tests involving trunk movements in sagittal, transversal and coronal planes. Ninety eight PD patients and 31 normal controls were analyzed. A strong correlation was found between the TMS scores and the Hoehn & Yahr staging scale (r: 0.72; p<0.01), motor Unified Parkinson's Disease Rating Scale (r: 0.84; p<0.01) and Schwab and England Activities of Daily Living (r: -0.72; p<0.01). The scale showed a satisfactory reliability rate (α Cronbach: 0.85, ICC: 099). TMS is a simple and reliable instrument to evaluate trunk mobility impairment in patients with PD. Source

Mendelson A.D.,Physiotherapy | McCullough C.,University of Toronto | McCullough C.,Inter Action Rehabilitation Inc. | Chan A.,University of Toronto
Health Education Research | Year: 2011

The Program for Arthritis Control through Education and Exercise, PACE-Ex™, is an arthritis self-management program incorporating principles and practice of self-management, goal setting and warm water exercise. The purpose of this program review is to examine the impact of PACE-Ex on participants' self-efficacy for condition management, self-management behaviors, goal achievement levels and self-reported disability, pain and health status. A retrospective review was conducted on participants who completed PACE-Ex from 1998 to 2006. A total of 347 participants completed 24 PACE-Ex programs [mean age 69.9 (±12.2) years, living with arthritis mean of 14.1 (±13.2) years]. Participants showed statistically significant improvements in their self-efficacy to manage their condition (Program for Rheumatic Independent Self-Management Questionnaire) (P < 0.001) and performance of self-management behaviors (Self-Management Behavior Questionnaire) (P < 0.01). Self-reported health status, disability and pain levels improved post-program (P < 0.01) despite reporting statistically significant increase in the total swollen and tender joint counts (Health Assessment Questionnaire) (P < 0.05). Sixty-eight percent of participants achieved or exceeded their long-term goal as measured by Goal Attainment Scaling. These findings remain to be proven with a more rigorous method yet they suggest that PACE-Ex is a promising intervention that supports healthy living for individuals with arthritis. © 2010 The Author. Published by Oxford University Press. All rights reserved. Source

Horstmann T.,TU Munich | Lukas C.,Medical Park Bad Wiessee St. Hubertus | Merk J.,Center for Rehabilitation | Brauner T.,Physiotherapy | Mundermann A.,University of Konstanz
International Journal of Sports Medicine | Year: 2012

The purpose of this study was to determine the long-term impact of surgical repair and subsequent 6-week immobilization of an Achilles tendon rupture on muscle strength, muscle strength endurance and muscle activity. 63 patients participated in this study on average 10.8±3.4 years after surgically repaired Achilles tendon rupture and short-term immobilization. Clinical function was assessed and muscle strength, strength endurance and muscle activity were measured using a dynamometer and electromyography. Ankle ROM, heel height during heel-raise tests and calf circumference were smaller on the injured than on the contralateral side. Ankle torques during the concentric dorsiflexion tasks at 60°/sec and 180°/sec and ankle torques during the eccentric plantarflexion task and during the concentric plantarflexion task at 60°/sec for the injured leg were significantly lower than those for the contralateral leg. The total work during a plantarflexion exercise at 180°/sec was 14.9% lower in the injured compared to the contralateral leg (p<0.001). Muscle activity for the gastrocnemius muscle during dorsiflexion tasks was significantly higher in the injured than in the contralateral limb. Limited ankle joint ROM and increased muscle activity in the injured leg suggest compensatory mechanisms to account for differences in muscle morphology and physiology caused by the injury. © Georg Thieme Verlag KG Stuttgart New York. Source

Hilliard P.,University of Toronto | Zourikian N.,University of Montreal | Blanchette V.,University of Toronto | Chan A.,McMaster University | And 10 more authors.
Journal of Thrombosis and Haemostasis | Year: 2013

Background: Full-dose prophylaxis is very effective at minimizing joint damage but is costly. Tailored prophylaxis has been proposed as a way of reducing costs while still protecting joints. Objective: To report detailed findings in index joints of 56 subjects with severe hemophilia A entered into the Canadian Hemophilia Prophylaxis Study, and treated with tailored prophylaxis, after 13 years. Methods: Boys with severe hemophilia A (< 2% factor) and normal joints were enrolled between the ages of 1 and 2.5 years. Initial treatment consisted of once-weekly factor infusions, with the frequency escalating in a stepwise fashion when breakthrough bleeding occurred. During the first 5 years, subjects were examined every 3 months using the modified Colorado Physical Evaluation (PE) scale; subsequently, every 6 months. The Childhood Health Assessment Questionnaire (CHAQ) was administered at each visit. Results: Median age at study entry was 19 months (range 12-30 months); median follow-up was 92 months (range 2-156). The median PE score was 2, 3 and 3 at ages 3, 6 and 10 years. Persistent findings were related to swelling, muscle atrophy and loss of range of motion. The median score for each of these items (for the six index joints) was 0 at ages 3, 6 and 10 years. The median overall CHAQ score was 0 at ages 3, 6 and 10 years, indicating excellent function. Conclusions: Canadian boys treated with tailored primary prophylaxis exhibit minimal joint change on physical examination and minimal functional disability. © 2012 International Society on Thrombosis and Haemostasis. Source

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