Surgical repair alone does not lead to satisfactory recovery after nerve laceration injury, yet no adjuvant clinical treatments are available. The goal of this review is to systematically survey all adjuvant treatments after surgery investigated in rat and mouse models. Both PubMed and Embase were explored with a systematic bibliographic search algorithm. Inclusion criteria consisted of treatments applied to rats or mice after complete transection and microsurgical repair of lower-limb motor or mixed nerves. Effect size statistics enabled numerical comparison between outcomes of treated and untreated animals and ranked the best treatments. 1,553 articles were found according to our search strategies, and 22 of them corresponded to our pre-defined inclusion criteria. After data extraction and analysis, the top 3 adjuvant strategies in terms of combined average effect size were citicoline, neurotrophin-4, and nitric oxide synthesis inhibitor, with values of 5.52, 5.14 and 4.08, respectively. Definitive treatment comparison was difficult due to the lack of uniformity in outcome evaluation in the experiments performed. Animal studies, comparing treatments administered within the same experimental protocol, are needed to truly assess efficiency and to provide solid recommendations for future clinical investigation.

Surgical repair alone does not lead to satisfactory recovery after nerve laceration injury, yet no adjuvant clinical treatments are available. The goal of this review is to systematically survey all adjuvant treatments after surgery investigated in rat and mouse models. Both PubMed and Embase were explored with a systematic bibliographic search algorithm. Inclusion criteria consisted of treatments applied to rats or mice after complete transection and microsurgical repair of lower-limb motor or mixed nerves. Effect size statistics enabled numerical comparison between outcomes of treated and untreated animals and ranked the best treatments. 1,553 articles were found according to our search strategies, and 22 of them corresponded to our pre-defined inclusion criteria. After data extraction and analysis, the top 3 adjuvant strategies in terms of combined average effect size were citicoline, neurotrophin-4, and nitric oxide synthesis inhibitor, with values of 5.52, 5.14 and 4.08, respectively. Definitive treatment comparison was difficult due to the lack of uniformity in outcome evaluation in the experiments performed. Animal studies, comparing treatments administered within the same experimental protocol, are needed to truly assess efficiency and to provide solid recommendations for future clinical investigation.

The problem of the study was to determine the better predictors of sprint performance for male and female sprinters from selected leg power and isokinetic strength tests. Ten male and five female sprinters volunteered to be measured for vertical jump performance, anaerobic power and capacity, peak isokinetic torque at the hip, knee, and ankle joint, and sprint performance. A forward stepwise multiple regression analysis was performed to allow selection from all strength and power variables regressed on the dependent variables of 30 meters, 60 meters, and flying 30 meter sprints. This procedure allowed one to examine the contribution of each predictor variable to the regression model. Only the independent variables that elicited a regression equation significant at the .05 level were used in final regression models. The regression models developed for the males were: 30 meters (crouch start) = 6.115 - .083(anaerobic power) - .055(vertical jump) - .044(plantarflex 120"/s) - .022(knee flex 60'/s); 60 meters (crouch start) = 11.111 - .145(vertical jump) - .086 (anaerobic power) - .172(hip flex 300'/s) - .098(knee flex 60'/s); and 30 meters (flying start) = 4.295- .055(anaerobic power) - .312(knee flex 180'/s) - .090(hip flex 300'/s). The regression models for the women were different than the males and were: 30 meters (crouch start) = 9.530 - .346(vertical jump); 60 meters (crouch start) = 18.083- .686(vertical jump); and 30 meters (flying start) = 8.733- .352(vertical jump) . By knowledge of the variance of the better strength and power measures, 83.2% to 98.0% of the variance of the respective sprint tests were explained. The regression models could allow for the identification of potential sprint performers and the development of optimal sprint training program.

Obesity, as an inflammatory state, can cause multi-organ disease, which often manifested in poor physical fitness involving the respiratory, cardio-vascular and muscles limitation. Bariatric surgery has become an important treatment option in severe obesity. The remarkably and rapid surgical weight loss, the obese patient gave feedback that they can walk further, but feels “no energy in his feet to speed up, when they need to run a few steps to catch the bus”. Had her physical condition already improved? Does weight loss after surgery equal improved physical condition? How does the heart, lungs, and muscles response to exercise? In order to search for the answer, we reviewed the previous relevant research, regarding the changes of postoperative aerobic capacity and we tried to discuss from a holistic perspective our observations.The thesis is divided into two modules including three studies.The first module including study 1 and 2, which are designed to identifies the determinants of the aerobic exercise capacity following weight loss reduced by bariatric surgery. We turn the daily problems feedback from obese patients who underwent bariatric surgery into three scientific questions:- What is the impact of adipose tissue on determinants of aerobic exercise capacity?- What is the impact of bariatric surgery on determinants of aerobic exercise capacity?- Do obese patients return to normal after bariatric surgery?Based on the limited knowledge and experience of predecessors about how obesity influences exercise pulmonary hemodynamics, the second module including study 3, which are designed to further analysed the right ventricle - pulmonary circulation during exercise and to answer the following question:- how does obesity affect right ventricular, pulmonary circulation and gas exchange adaptation during exercise?To answer these questions, we recruited 29 obese subjects and paired to age-, sex- and height- matched 29 healthy controls. A subgroup of thirteen patients who underwent bariatric surgery were retested 6 months after surgery and compared with theirs controls. Then, we comprehensive analysed the results of following tests: blood test, clinical assessment, body composition analysis, muscle strength measurements, pulmonary function (spirometry and diffusion capacity), exercise stress echocardiography, questionnaires and exercise capacity tests.The results of study 1 shown that, obese subjects had lower weekly moderate-to-vigorous physical activity (MVPA) and SF-36 scores, maximal workload and peak oxygen consumption (VO2peak) relative to body weight, but similar absolute VO2peak. Bariatric surgery resulted in -22% body weight,vi- 34% fat mass, -40% visceral adipose tissue and -12% lean mass (LM) changes. Absolute handgrip, quadriceps or respiratory muscle strength remained unaffected but accompanied by an increase in MVPA, SF-36 scores and quadriceps strength relative to LM. No changes in absolute VO2peak were observed after surgery but the ventilatory threshold was decreased.The results of study 2 shown that, obese subject had lower resting lung diffusion capacity with mainly a reduction in pulmonary capillary blood volume and alveolar volume (VA). After bariatric surgery, lung diffusion capacity for nitric oxide, VA and membrane diffusion capacity have improved to varying degrees.The results of study 3 shown that, there was no difference in pulmonary circulation at rest between the two groups, but the pulmonary vascular resistance index (PVRi) was higher with lower heart rate, cardiac output, cardiac index (CI) and mean pulmonary arterial pressure (mPAP) in obese subjects at peak exercise. After being normalized by CI at a common maximum exercise level, the PVRi was still higher, but the difference of mPAP disappeared and manifested a higher mPAP and mPAP/CI slope. The tricuspid annular plane systolic excursion /systolic PAP was lower at rest and at a common maximum exercise level when normalized by CI.In summary, obesity was associated to low vigorous daily physical activity levels, SF-36 physical and mental component scores, higher muscle mass but lower strength/LM ratio and aerobic capacity. Lower spirometry and lung diffusion capacity with mainly reduction in Vc and VA may also limit maximum aerobic exercise capacity. At rest, the pulmonary hemodynamic is preserved, but with a weakness of right ventricular-arterial coupling. At exercise, obesity has a modest, but observable impact on the pulmonary circulation and right ventricular adaptation at exercise, with unexhausted chronotropic reserve and normal chemo-sensibility.Bariatric surgery shows beneficial effects on fat mass loss, metabolic parameters, daily physical activities, SF-36 scores, lung function and stimulated the chronotropic response. However, aerobic capacity is not improved and is associated with a reduced LM and ventilatory threshold potentially triggering hyperventilation. / Doctorat en Sciences de la motricité / info:eu-repo/semantics/nonPublished

京都大学 / 0048 / 新制・課程博士 / 博士(人間健康科学) / 甲第21039号 / 人健博第55号 / 新制||人健||4(附属図書館) / 京都大学大学院医学研究科人間健康科学系専攻 / (主査)教授 二木 淑子, 教授 藤井 康友, 教授 妻木 範行 / 学位規則第4条第1項該当 / Doctor of Human Health Sciences / Kyoto University / DFAM

A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in partial fulfillment of the requirements for the degree of Master of Science in Physiotherapy. Johannesburg, 2015 / The Human Immunodeficiency Virus (HIV) has been found to cause muscle weakness, wasting and peripheral neuropathies. The specific relationship between lower limb muscle strength and lower limb function in HIV positive patients on Highly Active Antiretroviral Therapy (HAART) has not been examined. The aims of the current study were to establish lower limb muscle strength in HIV positive patients on HAART, establish lower limb muscle strength in HIV negative people, compare lower limb muscle strength between patients who are HIV positive on HAART and HIV negative people, establish lower limb function in patients who are HIV positive on HAART and to establish the relationship between lower limb muscle strength and lower limb function in patients who are HIV positive on HAART. A cross-sectional, descriptive study design was used. Dynamometry was used to measure lower limb muscle strength. The lower Extremity Functional Scale (LEFS) was used to determine lower limb function. A pilot study was done to establish the feasibility and proficiency required to perform hand held dynamometry. Intra and inter-rater reliability were also determined during the pilot phase. Intra and inter-rater reliability were high for the raters' measurement of lower limb muscle strength using a dynamometer with 'r' values of 0.97. For HIV positive patients on HAART, 19% (n=22) were in the age band 45-49years, whereas 33% (n=10) of HIV negative subjects were in age interval 25-29 years. Those over 45 years who were HIV positive on HAART constituted 57% (n=64) of the sample. The mean muscle strength obtained ranged from 9.30kg/m2 in ankle dorsiflexors to 15.80kg/m2 in hip extensors in HIV positive people on HAART for an average of 4 years while knee flexors generated 11.81 kg/m2 and knee extensors generated 15.36kg/m2 in this cohort.Jn the HIV negative matched group, the mean muscle strength ranged from 11.20 kg/m2 in ankle dorsiflexors to 17.70 kg/m2 in hip extensors while knee flexors generated 12.65kg/m2 and knee extensors generated 17.07kg/m2. The majority 78% (n=88) of HIV positive patients on HAART had no difficulty with lower limb function while 22% (n=17) had difficulty. Only 2% (n=2) of HIV positive patients on HAART had quite a bit of difficulty with lower limb functional activities after measurements using the Lower Extremity Functional scale (LEFS). A multiple linear regression showed that there was a positive correlation coefficient of r=0.71 (p-value= 0.00) between lower limb muscle strength and lower limb function. The coefficient of determination 0.50 means that 50% of the changes in lower limb function are attributable to lower limb muscle strength. Gender, employment status and mode of transport also positively affected lower limb function. A detailed regression model showed that lower limb ankle plantar flexors contributed the most to lower limb function in this cohort. This is contrary to International literature which states that hip and trunk muscles are the most active in HIV negative people during lower limb functional activities. That plantar flexors contribute the most in lower limb functional activities instead of hip and trunk muscles confirms the existence of proximal weakness in this cohort which was established by other researchers. This study highlighted that 50% of lower limb function is a result of lower limb muscle strength in HIV positive people on HAART attending an outpatient clinic in Mutare, Zimbabwe. Ankle plantar flexors instead of hip flexors were the most active muscle group in lower limb functional activities in this cohort. It therefore means exercise prescription to activate/strengthen hip flexors and other proximal muscles will improve this population's lower limb functional activities since progressive resisted aerobic exercises have been proved to strengthen muscles. / AC2016

No description available.

As of 2012, 233,000 Canadians were reported to be living with inflammatory bowel disease (IBD), 2.5% of which were <18 years of age. In Ontario, the incidence of pediatric IBD is ~11.8 per 100,000 population, which is one of the highest rates in the world. Youth with IBD experience numerous health problems secondary to their diagnosis, including poor fitness and lower lean mass. The extent to which youth with IBD can respond to an exercise training program designed to improve fitness remains unknown. The aim of this thesis was to assess the safety, feasibility and physiological efficacy of an exercise training program for youth in remission from IBD. Additionally, we attempted to understand the barriers and facilitators to physical activity in this population. A total of 104 patients were approached to participate in this study, 18 demonstrated interest and 11 consented to participate. Ten youth (nine males, age: 15.4±1.2 years) with IBD completed the study. Participants trained three times per week (2d in lab, 1d at home) for 16 weeks. Training sessions lasted 30 to 60 minutes, and consisted of a customized combination of aerobic and resistance exercises. Fat mass and lean mass were measured via Dual Energy X-ray Absorptiometry. Isometric and isokinetic torque of elbow flexion and knee extension were evaluated using an isokinetic dynamometer system. Peak oxygen consumption (VO2peak) and peak mechanical power (Wpeak) were determined using the McMaster All-Out Continuous cycling test. Barriers and facilitators to physical activity were measured via qualitative interviews pre-training. Body composition, muscle strength and aerobic fitness variables were measured at baseline, after 8 weeks, and after 16 weeks of training. Participants completed 89.1±5.2% of lab training sessions and 55.0±26.5% of home training sessions. There were significant increases in whole body lean mass (p<0.001), isokinetic knee extension strength (p<0.05) and Wpeak (p<0.001) over the course of the training program with small, moderate and large effect sizes respectively. All participants were in remission post-training, demonstrated small deviations in features of disease activity and reported no adverse events with training. Participants described similar barriers and facilitators to physical activity, to those of the general public, such as lack of access to facilities and peer support, respectively. Additionally barriers and facilitators unique to individuals with this condition were identified including the physical burden of disease (e.g., episodic abdominal pain) and creating modifications to activities to facilitate accessibility. Our results demonstrate that exercise training in youth in remission from IBD is safe, feasible and has the capacity to counteract a broad range of secondary symptoms such as deficits in lean mass, muscle weakness and aerobic deconditioning. Youth with IBD should be encouraged to exercise on a regular basis. Results from this study will inform the design of a larger, randomized controlled trial. / Thesis / Master of Science in Kinesiology

Bakgrund: Att råka ut för en kritisk sjukdom som kräver intensivvård kan medföra en snabb reducering av muskelmassa och en samtidig muskelsvaghet. Förändringar som även är associerade med förlängd sjukhusvistelse, en minskning av den funktionella återhämtningen efter utskrivning och som kan resultera i en försämrad livskvalitet för patienten. Flera studier har visat att intensivvårdspatientens nutritionsintag efter intensivvård ofta är otillräcklig Motiv: Ungefär var tionde patient råkar ut för någon form av vårdskada och då inkluderas även skador som inte är relaterad till den underliggande sjukdomen och således hade kunnat undvikas. En säker vård innebär att ha kunskap om riskerna och att arbeta så att riskerna minimeras Syfte: Studiens syfte var att undersöka hur mycket näring intensivvårdspatienter som vårdats tre dagar eller mer på IVA erhåller på vårdavdelningen och om mängden näringstillförseln påverkar patientens rörlighet, muskelkraft och antal dagar på sjukhus. Metod: Studien har en kvantitativ design och är en del av en större pågående feasability studie. Data som samlades in var dagligt energiintag inklusive intravenöstoch enteralt intag fram till utskrivning eller max 28 dagar. Var 3–5 dag kontrollerades greppstyrka och ICU Mobility Scale för analys av muskelkraft och rörlighet. 33 patienter inkluderades genom konsekutivt urval. Kriterier för inklusion var patienter &gt;18år som vårdats tre dagar eller mer på IVA och kunnat ge muntligt och skriftligt samtycke till studien. Resultat: Resultatet visade en stor variation i intaget både vad gäller kalorier och protein. Samma patient kunde under sin vårdtid ha såväl ett betydande underskott som ett överskott när det gäller erhållna kalorier i relation till det uppmätta energibehovet. Samtidigt fanns det patienter som aldrig uppnådde sitt energibehov under hela vårdtiden. Näringsintagets påverkan på rörlighet och muskelkraft visade på en svag signifikant negativ korrelation vid den andra mätningen Konklusion: Ingen av patienterna erhöll sitt uppmätta kaloribehov under hela vårdtiden. Majoriteten av vårdtiden fick mer än hälften (57,58 %) av patienterna under 80 procent av sitt energibehov. Det fanns en signifikant men svag negativ korrelation vid andra mätningen när kalori- och proteinintaget korrelerades mot patientens rörlighet (ICU mobility) och greppkraft med undantag av kaloriintag mot rörlighet. Vid tredje mättillfället fanns sambandet inte längre kvar. / Background: Suffering from a critical illness that requires intensive care can lead to a rapid reduction in muscle mass and a simultaneous muscle weakness. Changes that are also associated with prolonged hospital stay, a decrease in functional recovery after discharge and that can result in a decreased quality of life for the patient. Several studies have shown that the intensive care patient's nutritional intake after intensive care often is insufficient.  Motive: Approximately every tenth patient experiences some form of medical injury, and this also includes injuries that are not related to the underlying disease and that could have been avoided. Safe care means having knowledge of the risks and working to minimize the risks.  Aim: The purpose of the study was to investigate how much nutrition intensive care patients who have been treated for three days or more in ICU receive in the ward and whether the amount of nutrition affect the patient's mobility, muscle strength and number of days in hospital. Methods: The study has a quantitative design and is part of a larger ongoing feasibility study. The data collected was daily energy intake including intravenous and enteral intake until discharge or a maximum of 28 days. Every 3–5 days, grip strength and the ICU Mobility Scale were checked for analysis of muscle strength and mobility. 33 patients were included through consecutive selection. Inclusion criteria were patients &gt;18 years of age who were treated for three days or more in the intensive care unit and were able to give verbal and written consent to the study.  Result: The result showed a large variation in intake both in terms of calories and protein. The same patient could, during his period of care, have both a significant deficit and an excess in terms of calories received in relation to the measured energy requirement. At the same time, there were patients who never achieved their energy needs during the entire period of care. The impact of nutritional intake on mobility and muscle strength showed a weak significant negative correlation at the second measurement.  Conclusion: None of the patients received their measured caloric needs during the entire period of care. For most of the time at the ward, more than half (57.58%) of the patients received less than 80 percent of their energy need. There was a significant but weak negative correlation at the second measurement when caloric and protein intake was correlated to the patient's mobility (ICU mobility) and grip strength except for caloric intake to mobility. At the third measurement occasion, the connection no longer existed.

The purpose of this study was to determine the effects of an eight-week walk/jog program upon strength retention. Twenty-four male executives from Dallas, Texas represented the sample size Following eight weeks of resistive training, all subjects were pretested for strength and endurance measures. After the eight-week walk/jog program, all subjects were then retested adhering to the same pretest protocol. A two-way analysis of variance with repeated measures was used to test for mean group differences between pretest and posttest strength measures. A t-test for dependent means was utilized to ascertain differences in cardiovascular measurements. The alpha chosen to test the null hypotheses was the 0.05 level of significance. Results indicated that muscular strength was retained during the eight-week walk/jog program. No change in upper or lower extremity strength occurred, but significant improvements in maximal oxygen consumption and treadmill time were evidenced.