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Rationale: Chronic obstructive pulmonary disease (COPD) is not only a common lung disease but is a major cause of morbidity and mortality worldwide. Pulmonary rehabilitation (PR) helps optimize function and independence by increasing exercise capacity, reducing symptoms and improving health related quality of life (HRQL). Exercise training is certainly a key component of the PR programs; however, many of its aspects still need to be better defined such as optimal exercise assessment and training modality for these patients. The general purpose of this thesis was to generate new knowledge that could contribute to new strategies for exercise assessment and training in patients with COPD. Methods and results: This thesis is comprised of four independent studies. Thigh muscle strength, endurance and fatigue were compared between 42 patients with moderate to severe COPD and 53 healthy controls (Study I). Impaired thigh muscle strength and endurance in patients with COPD was found, except for muscle strength in knee extension in male patients. Female patients had higher fatigue index than female controls while no difference was found between male patients and controls. The six-minute walk test (6MWD) performed on a non-motorized treadmill (6MWD-T) was compared with the 6MWD performed in a corridor (6MWD-C) in 16 healthy elderly subjects (Study II). They performed twelve tests (six 6MWD-C and six 6MWD-T) on two different days in a randomized order. An average discrepancy was found between the two methods with the subjects walking a shorter distance on the non-motorized treadmill. However, the results showed good test-retest reliability between days and test repetitions. A systematic review (Study III) was done of studies that investigated the effects of an arm training program in patients with COPD. The findings of this review indicated that there is evidence that an arm training program improves arm exercise capacity, but its effects on dyspnea, arm fatigue and healthy-related quality of life is unclear. Finally, a two-armed randomized controlled trial examined the effects of an arm training program on arm function, arm exercise capacity, muscle strength, symptoms and HRQL in patients with COPD (Study IV). The groups were randomized to arm training or sham. Compared with the changes observed in the control group, the magnitude of change in the intervention group was greater for arm function, arm exercise capacity and muscle strength. There was no difference between groups in HRQL or symptoms. Conclusions: Upper extremity resistance training improves arm exercise capacity, arm function and muscle strength in patients with COPD. Training and assessment of upper and lower limb muscles should be included into PR programs. The 6MWD performed on a non-motorized treadmill may offer an alternative option to the standard 6MWD when a 30-meter corridor is not available.

The aims of the Lithuanian Health Programme (1998) are to reduce the death rate in patients following stoke, age younger than 65 years old by 15%, and by 10% in patients at age of 65-74 years old, up to year 2010. While trying to enhance the recovery results following the abovementioned disease it is necessary to erect and renew the effective rehabilitation system. The aim is to estimate the effectiveness of The Constrain – Induce Movement Test on arm functions’ recovery of the post - stroke patients. The were two groups of testees, experimental group and control group, each composed of 30 stroke patients. The methods used while writing this study were as follows: the analysis of the used literature sources, and the testing (the evaluation of movements and the Nine Hole Peg Test). The Constrain – Induce Movement Test applied while carrying out this experiment statistically credibly improved the function of the patients’ arms. The average of the evaluation of shoulders arch movements in the control group is 3,13 ± 0,61 points. In the experimental group the average is 4,53 ± 0,97 points. The margin of 1,4 point is statistically reliable (p<0,05). There was also noticed a significant improvement in hand movements in the experimental group. The average of the evaluation of hand movements in the control group is 3,4 ± 0,67 points, while in the experimental group the average is 5,07 ± 0,87 points. The margin is 1,67 points (p<0,05). Analogous results were drawn while estimating... [to full text]

Tyrimo tikslas – įvertinti ligonių, po galvos smegenų insulto, pažeistos rankos funkciją bei reakcijos laiką reabilitacijos eigoje.Tyrimo uždaviniai: 1) įvertinti ligonių, po galvos smegenų insulto pažeistos rankos plaštakos jėgą dinamometru reabilitacijos eigoje; 2) įvertinti ligonių, po galvos smegenų insulto pažeistos rankos funkciją per duotą laiką pagal Frenchay rankos testą reabilitacijos eigoje; 3) įvertinti ligonių, po galvos smegenų insulto pažeistos rankos reakcijos laiką taikant „Liniuotės“ testą reabilitacijos eigoje; 4) nustatyti veiksnius, įtakojančius ligonių, po galvos smegenų insulto pažeistos rankos funkciją bei reakcijos laiką reabilitacijos eigoje.Tyrimo metodika: tyrimas buvo atliekamas Abromiškių reabilitacijos ligoninės neurologijos skyriuje 2009 – 2010 m. Tyrime dalyvavo 21 moteris ir 21 vyras. Tiriamųjų amžiaus vidurkis buvo 63,3 ± 11,8 m. Bendradarbiaujant su reabilitacijos ligoninėje dirbančiais psichologais ir pritaikius atrankos priemonę, trumpą protinės būklės tyrimą (TPBT), tyrimui buvo atrinkti tiriamieji, kurių TPBT buvo ne mažiau kaip 20 balų, nes tolimesniam tyrimui reikėjo, kad ligoniai suprastų komandas ir jas vykdytų. JAMAR® hidrauliniu rankos dinamometru buvo vertinta ligonių rankų raumenų jėga. Frenchay rankos testu buvo vertintas rankos ir plaštakos su pareze miklumas. Ligonių pažeistos rankos reakcijos laiką vertinome „Liniuotės“ testu. Matavimai buvo atliekami 2 kartus: prieš ir po reabilitacijos.Tyrimo išvados: 1) reabilitacijos... [toliau žr. visą tekstą] / The aim of the research - to evaluate the function and reaction speed of the affected hand of the patient after stroke during the rehabilitation.The tasks of the research: 1) to evaluate the strength of the stroke affected hand using dynamometer during the rehabilitation; 2) to evaluate the function of the stroke affected hand in given time using Frenchay arm test during the rehabilitation; 3) to evaluate the reaction time of the stroke affected hand using “Ruler” test during the rehabilitation; 4) to determine the factors that influence the function and reaction of the stroke affected hand during the rehabilitation. Research methodology: the research was executed in Abromiškės rehabilitation clinic, neurology department in 2009 – 2010. 21 men and 21 women participated in it. The average age of the examined people was 63,3 ± 11,8 years. With the help of the psychologists of the clinic and selection method of Mini Mental State Examination (MMSE) patients were selected for the research with MMSE no less than 20 points because it was essential for the patients to understand and follow the commands. The strength of the arm muscles was measured with JAMAR® hydraulic hand dynamometer. The dexterity of the arm and palm with paresis was evaluated by Frenchay arm test. The affected hand reaction time was evaluated by “Ruler” test. The tests were performed twice: before and after rehabilitation.Research conclusions: 1) at the beginning of the rehabilitation the average strength of... [to full text]