Σάββατο, 6 Ιανουαρίου 2018

Do performance measures of strength, balance and mobility predict quality of life and community reintegration after stroke?

Publication date: Available online 6 January 2018
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Joshua W. Cohen, Tanya D. Ivanova, Brenda Brouwer, Kimberly J. Miller, Dianne Bryant, S. Jayne Garland
ObjectiveTo investigate the extent to which physical performance measures of strength, balance and mobility taken at discharge from inpatient stroke rehabilitation can predict health-related quality of life (HRQoL) and community reintegration after 6 months.DesignLongitudinal StudySettingUniversity LaboratoryParticipantsSeventy-five adults recruited within one month following discharge home from inpatient stroke rehabilitation. Inclusion criteria were: major unilateral hemispheric stroke, English speaking, able to communicate, discharged home. Serious comorbidities and a prior stroke affecting the opposite side were exclusion criteria.InterventionsNot applicable.Main Outcome Measure(s)Short Form 36-Item Health Survey (SF-36) for HRQoL and the Subjective Index of Physical and Social Outcome (SIPSO) for community reintegration. Physical performance measures were the 6-minute walk test (6MWT), Timed up and Go (TUG), Berg Balance Scale, Community Balance and Mobility scale, and isokinetic torque and power of hip, knee and ankle on the paretic and non-paretic sides. Other prognostic variables included age, sex, stroke type and location, comorbidities, and motor Functional Independence Measure.ResultsSeparate stepwise linear regressions were performed with the SF-36 and SIPSO as dependent variables. The total paretic lower limb torque and 6MWT predicted the SF-36 Physical Component Summary (Adjusted R2=0.30). Total paretic lower limb torque, and TUG predicted the SIPSO Physical component (Adjusted R2=0.47). Total paretic lower limb torque significantly predicted the SF-36 Mental Component Score, but the adjusted R2 was very low (0.06). Similarly, the TUG significantly predicted the SIPSO social component, but again, the adjusted R2 was low (0.09).ConclusionsMeasures of physical performance including muscle strength and mobility at discharge can partially predict HRQoL and community reintegration 6 months later. Further research is necessary for more accurate predictions.



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Aspiring paramedics, nurses, doctors join new year of EMS training program

By Emma Discher The Advocate BATON ROUGE, La. — Aaron Bogan is only a freshman at Denham Springs High School, but he already knows he wants to pursue a medical career. In order to solidify his future plans, Bogan is considering becoming one of the newest certified first responders in Baton Rouge through the Emergency Medical Services Explorer program. Since 1983, the program, organized under the ...

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Small Intestinal Bacterial Overgrowth and Coronary Artery Disease: What Is in the CArDs?



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The General Adaptation Syndrome: A Foundation for the Concept of Periodization

Abstract

Recent reviews have attempted to refute the efficacy of applying Selye's general adaptation syndrome (GAS) as a conceptual framework for the training process. Furthermore, the criticisms involved are regularly used as the basis for arguments against the periodization of training. However, these perspectives fail to consider the entirety of Selye's work, the evolution of his model, and the broad applications he proposed. While it is reasonable to critically evaluate any paradigm, critics of the GAS have yet to dismantle the link between stress and adaptation. Disturbance to the state of an organism is the driving force for biological adaptation, which is the central thesis of the GAS model and the primary basis for its application to the athlete's training process. Despite its imprecisions, the GAS has proven to be an instructive framework for understanding the mechanistic process of providing a training stimulus to induce specific adaptations that result in functional enhancements. Pioneers of modern periodization have used the GAS as a framework for the management of stress and fatigue to direct adaptation during sports training. Updates to the periodization concept have retained its founding constructs while explicitly calling for scientifically based, evidence-driven practice suited to the individual. Thus, the purpose of this review is to provide greater clarity on how the GAS serves as an appropriate mechanistic model to conceptualize the periodization of training.



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Cryotherapy: not as cool as it seems

Abstract

In elite sports, a significant concern for many athletes is the ability to completely recover from prolonged exhaustive exercise. Athletes make use of numerous techniques to accelerate the healing process, priming their body for future events. Among the most common is the notion of muscle cooling, widely known as cryotherapy.

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The influence of capillarization on satellite cell pool expansion and activation following exercise-induced muscle damage in healthy young men

Abstract

Factors that determine the skeletal muscle satellite cell (SC) response remain incompletely understood. It is known, however, that SC activation status is closely related to the anatomical relationship between SC and muscle capillaries. We investigated the impact of muscle fibre capillarization on the expansion and activation status of SC following a muscle damaging exercise protocol in healthy young men. Twenty-nine young men (21 ± 0.5 yrs) performed 300 unilateral eccentric contractions (180 deg·s−1) of the knee extensors. Percutaneous muscle biopsies from the vastus lateralis and blood samples from the antecubital vein were taken prior to (Pre) and at 6 h, 24 h, 72 h and 96 h of post-exercise recovery. A comparison was made between subjects who had a relative low mixed muscle capillary-to-fibre perimeter exchange index (CFPE; Low group) and high mixed muscle CFPE index (High group) at baseline. Type I and type II muscle fibre size, myonuclear content, capillarization, and SC response were determined via immunohistochemistry. Overall, there was a significant correlation (r = 0.39; P < 0.05) between the expansion of SC content (change in total Pax7+ cells/100 myofibre) 24 h following eccentric exercise and mixed muscle CFPE index. There was a greater increase in activated SC (MyoD+/Pax7+ cells) in the High as compared to the Low CFPE group 72 h following eccentric exercise (P < 0.05). The current study provides further evidence that muscle fibre capillarization may play an important role in the activation and expansion of the SC pool during the process of skeletal muscle repair.

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Genome-wide identification of WRKY transcription factors in kiwifruit ( Actinidia spp.) and analysis of WRKY expression in responses to biotic and abiotic stresses

Abstract

As one of the largest transcriptional factor families in plants, WRKY transcription factors play important roles in various biotic and abiotic stress responses. To date, WRKY genes in kiwifruit (Actinidia spp.) remain poorly understood. In our study, o total of 97 AcWRKY genes have been identified in the kiwifruit genome. An overview of these AcWRKY genes is analyzed, including the phylogenetic relationships, exon–intron structures, synteny and expression profiles. The 97 AcWRKY genes were divided into three groups based on the conserved WRKY domain. Synteny analysis indicated that segmental duplication events contributed to the expansion of the kiwifruit AcWRKY family. In addition, the synteny analysis between kiwifruit and Arabidopsis suggested that some of the AcWRKY genes were derived from common ancestors before the divergence of these two species. Conserved motifs outside the AcWRKY domain may reflect their functional conservation. Genome-wide segmental and tandem duplication were found, which may contribute to the expansion of AcWRKY genes. Furthermore, the analysis of selected AcWRKY genes showed a variety of expression patterns in five different organs as well as during biotic and abiotic stresses. The genome-wide identification and characterization of kiwifruit WRKY transcription factors provides insight into the evolutionary history and is a useful resource for further functional analyses of kiwifruit.



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