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Romine, Perrin E., Dan K. Kiely, Nicole Holt, Sanja Percac-Lima, Suzanne Leveille, and Jonathan F. Bean. "Task-Specific Fatigue Among Older Primary Care Patients." Journal of Aging and Health 29, no. 2 (July 8, 2016): 310–23. http://dx.doi.org/10.1177/0898264316635567.
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Objective: Fatigue is a common condition contributing to disability among older patients. We studied self-reported task-specific fatigue and its relation with mobility task performance among community-dwelling primary care patients. Method: Cross-sectional analysis of baseline demographic and health data from a prospective cohort study of 430 primary care patients aged 65 years or older. Fatigue was measured using the Avlund Mobility–Tiredness Scale. Performance tasks included rising from a chair, walking 4 m, and climbing two flights of stairs. Results: Among demographic and health factors, pain was the only attribute consistently predictive of fatigue status. Self-reported chair rise fatigue and walking fatigue were associated with specific task performance. Stair climb fatigue was not associated with stair climb time. Discussion: Pain is strongly associated with fatigue while rising from a chair, walking indoors, and climbing stairs. This study supports the validity of self-reported chair rise fatigue and walking fatigue as individual test items.
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Pearson, B., T. M. Manini, B. C. Clark, and L. L. Ploutz-Snyder. "RELIABILITY OF CHAIR RISE AND STAIR CLIMB EVALUATIONS." Medicine & Science in Sports & Exercise 33, no. 5 (May 2001): S124. http://dx.doi.org/10.1097/00005768-200105001-00707.
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Zhang, Man, Jingde Huang, and Chenbo Jiang. "Research on multifunctional integrated intelligent stair-climbing chair based on ergonomics." E3S Web of Conferences 260 (2021): 03011. http://dx.doi.org/10.1051/e3sconf/202126003011.
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In view of the practical problems faced by the group with travel inconvenience, the wheelchairs in today’s Chinese market can’t meet the needs of society. Taking the integrated function chair as the research object, this paper puts forward the whole structure of the self-help ladder climbing intelligent chair. The chair is designed on the basis of analyzing the working principle of the main and the auxiliary structure. Based on Ergonomics, the composition and driving mode of each core module and auxiliary mechanism are developed, and the three-dimensional model of self-help ladder climbing intelligent chair is established by using UG. Selfhelp intelligent stair-climbing chair is not only conductive to improving the quality of life of special people and easing their family burden, but also has positive significance to the healthy and sustainable development of wheelchair industry.
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Drobinsky, Sergey, Mark Verjans, Philipp Schleer, Benedikt Kolk, Henrike Bensiek, Klaus Radermacher, and Armin Janß. "Workflow and Human-Centered Risk Analysis for Novel Mechatronic Rescue Aids II." Current Directions in Biomedical Engineering 6, no. 3 (September 1, 2020): 616–19. http://dx.doi.org/10.1515/cdbme-2020-3157.
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AbstractParamedics face rising numbers of deployments every year. As obstacles like stairs occur often, paramedics must frequently manually carry patients and are thereby exposed to loads multitudes higher than recommended. This creates the need for patient transport aids (PTA), which can physically support paramedics in a wide variety of transport situations, without slowing down the transport. In this paper a workflow analysis for transport missions in an urban context and basic tasks for PTAs are presented. Subsequently, the high-level task modelling and human-centered risk analysis according to the HiFEM method are presented for the use case of a patient transport over stairs with a passive PTA, like a rescue chair, and an active PTA like the novel SEBARES prototype. The analysis shows that conventional PTA’s have a simple linear use process, however, impose excessive physical workloads, which cause risks like the paramedic or the PTA falling down the stairs. Contrary, active PTA’s reduce physical workloads, however, introduce additional concurrent steps, like identifying and correcting misalignments, which create further risks. In order to mitigate risks with active, stair climbing PTAs, either new kinematic designs or intelligent assistance functions, like automatic stair detection, are necessary.
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Drobinsky, Sergey, Mark Verjans, Philipp Schleer, Benedikt Kolk, Henrike Bensiek, Klaus Radermacher, and Armin Janß. "Workflow and Human-Centered Risk Analysis for Novel Mechatronic Rescue Aids I." Current Directions in Biomedical Engineering 6, no. 3 (September 1, 2020): 612–15. http://dx.doi.org/10.1515/cdbme-2020-3156.
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AbstractParamedics face rising numbers of deployments every year. As obstacles like stairs occur often, paramedics must frequently manually carry patients and are thereby exposed to loads multitudes higher than recommended. This creates the need for patient transport aids (PTA), which can physically support paramedics in a wide variety of transport situations, without slowing down the transport. In this paper a workflow analysis for transport missions in an urban context and basic tasks for PTAs are presented. Subsequently, the high-level task modelling and human-centered risk analysis according to the HiFEM method are presented for the use case of a patient transport over stairs with a passive PTA, like a rescue chair, and an active PTA like the novel SEBARES prototype. The analysis shows that conventional PTA’s have a simple linear use process, however, impose excessive physical workloads, which cause risks like the paramedic or the PTA falling down the stairs. Contrary, active PTA’s reduce physical workloads, however, introduce additional concurrent steps, like identifying and correcting misalignments, which create further risks. In order to mitigate risks with active, stair climbing PTAs either new kinematic designs or intelligent assistance functions, like automatic stair detection, are necessary.
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Seynnes, Olivier, Olivier A. Hue, Frédéric Garrandes, Serge S. Colson, Pierre L. Bernard, Patrick Legros, and Maria A. Fiatarone Singh. "Force Steadiness in the Lower Extremities as an Independent Predictor of Functional Performance in Older Women." Journal of Aging and Physical Activity 13, no. 4 (October 2005): 395–408. http://dx.doi.org/10.1123/japa.13.4.395.
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The relationship between isometric force control and functional performance is unknown. Submaximal steadiness and accuracy were measured during a constant force-matching task at 50% of maximal isometric voluntary contraction (MVC) of the knee extensors in 19 older women (70–89 years). Other variables included MVC, rate of torque development, and EMG activity. Functional performance was assessed during maximal performance of walking endurance, chair rising, and stair climbing. Isometric steadiness (but not accuracy) was found to independently predict chair-rise time and stair-climbing power and explained more variance in these tasks than any other variable. Walking endurance was related to muscle strength but not steadiness. These results suggest that steadiness is an independent predictor of brief, stressful functional-performance tasks in older women with mild functional impairment. Thus, improving steadiness might help reduce functional limitations or disability in older adults.
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Jyoti Baishya, Nayan, and Harutoshi Ogai. "Wa-Chair: A concept for development of economical stair-climbing wheelchair." IOP Conference Series: Materials Science and Engineering 307 (February 2018): 012010. http://dx.doi.org/10.1088/1757-899x/307/1/012010.
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Mesinovic, Jakub, Lachlan McMillan, Catherine Shore-Lorenti, Barbora De Courten, Peter Ebeling, and David Scott. "Metabolic Syndrome and Its Associations with Components of Sarcopenia in Overweight and Obese Older Adults." Journal of Clinical Medicine 8, no. 2 (January 27, 2019): 145. http://dx.doi.org/10.3390/jcm8020145.
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Ageing, obesity and the metabolic syndrome (MetS) may all contribute to poor muscle health (sarcopenia). This study aimed to determine the cross-sectional associations between MetS (International Diabetes Federation classification) and sarcopenia (revised European Working Group on Sarcopenia in Older People definition) in 84 overweight and obese older adults. Components of sarcopenia included muscle strength (hand grip and leg extension), physical performance (stair climb test and short physical performance battery (SPPB), including gait speed and repeated chair stands time), muscle mass (appendicular lean mass (ALM), dual-energy X-ray absorptiometry), muscle size (peripheral quantitative computed tomography-determined calf and forearm cross-sectional area (CSA)) and muscle quality (muscle density and strength normalised to lean mass). Waist circumference was associated with greater muscle size, but poorer leg extension strength, chair stands and stair climb time, gait speed, SPPB scores and muscle quality measures (all p < 0.05). MetS was positively associated with ALM and forearm muscle CSA, and negatively associated with muscle quality measures and chair stands time (all p < 0.05). MetS is associated with larger muscle size, yet poorer muscle quality in overweight and obese older adults. Assessments of muscle function and quality should be considered for obese older adults and those with MetS.
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Kumar, S. "Stair-chair passenger transfer from the ground to airplane: A case study." International Journal of Industrial Ergonomics 4, no. 1 (July 1989): 29–37. http://dx.doi.org/10.1016/0169-8141(89)90047-4.
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van Leeuwen, D. M., C. J. de Ruiter, P. A. Nolte, and A. de Haan. "Preoperative Strength Training for Elderly Patients Awaiting Total Knee Arthroplasty." Rehabilitation Research and Practice 2014 (2014): 1–9. http://dx.doi.org/10.1155/2014/462750.
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Objective. To investigate the feasibility and effects of additional preoperative high intensity strength training for patients awaiting total knee arthroplasty (TKA).Design. Clinical controlled trial.Patients. Twenty-two patients awaiting TKA.Methods. Patients were allocated to a standard training group or a group receiving standard training with additional progressive strength training for 6 weeks. Isometric knee extensor strength, voluntary activation, chair stand, 6-minute walk test (6MWT), and stair climbing were assessed before and after 6 weeks of training and 6 and 12 weeks after TKA.Results. For 3 of the 11 patients in the intensive strength group, training load had to be adjusted because of pain. For both groups combined, improvements in chair stand and 6MWT were observed before surgery, but intensive strength training was not more effective than standard training. Voluntary activation did not change before and after surgery, and postoperative recovery was not different between groups (P>0.05). Knee extensor strength of the affected leg before surgery was significantly associated with 6-minute walk (r=0.50) and the stair climb (r−=0.58,P<0.05).Conclusion. Intensive strength training was feasible for the majority of patients, but there were no indications that it is more effective than standard training to increase preoperative physical performance. This trial was registered withNTR2278.
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Ritt, Luiz Eduardo Fonteles, Jessica Porto, Thaissa Claro, Daniela Cavalcante, Cristiane M. Feitosa, Eloisa Prado, Gustavo F. Feitosa, and Eduardo Darze. "STAIR STEP TEST AND SITTING RISING CHAIR TEST AS PREDICTORS OF MAXIMAL OXIGEN UPTAKE." Journal of the American College of Cardiology 69, no. 11 (March 2017): 1733. http://dx.doi.org/10.1016/s0735-1097(17)35122-7.
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Amaro, Joicemar Tarouco, João Victor Novaretti, Diego Costa Astur, Elton Luiz Batista Cavalcante, Adilson Góes Rodrigues Junior, Pedro Debieux, Camila Cohen Kaleka, and Moisés Cohen. "Higher Axial Tibiofemoral Rotation and Functional Outcomes with Mobile-Bearing Compared with Fixed-Bearing Total Knee Arthroplasty at 1- but Not at 2-Year Follow-Up—A Randomized Clinical Trial." Journal of Knee Surgery 33, no. 05 (February 12, 2019): 474–80. http://dx.doi.org/10.1055/s-0039-1678675.
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AbstractThe objective of this study was to determine in vivo knee kinematics and clinical outcomes of patients who underwent fixed- and mobile-bearing total knee arthroplasty (TKA) at 1- and 2-year follow-up. This prospective double-blinded randomized controlled trial was performed from November 2011 to December 2012. A total of 64 patients were randomized to fixed- and mobile-bearing TKA groups (32 patients in each group). All patients were evaluated with the following: three-dimensional in vivo knee kinematics analysis during gait, stepping up and stepping down stair steps, and getting up from and sitting on a chair; and knee range of motion and patient-reported outcome measures (Knee Outcome Survey Activities of Daily Living Scale [KOS-ADLS] and pain visual analog scale [VAS]) at 1- and 2-year follow-up. Descriptive statistics (means, standard deviations, and percentages) were calculated for all variables. The Kolmogorov–Smirnov test was used to test if variables were normally distributed. A Student's t-test was used to compare continuous variables between patients in the two groups. The chi-square test was used to compare the groups with respect to categorical variables. The α level for statistical significance was set at p < 0.05. The mean axial tibiofemoral rotation in patients who underwent mobile-bearing TKA was significantly higher during gait (13.3 vs. 10.7), stepping up (12.8 vs. 10) stair steps, and getting up (16.1 vs. 12.1) from a chair compared with fixed-bearing TKA patients at 1-year follow-up (p < 0.05). KOS-ADLS function score was significantly higher in the mobile-bearing compared with the fixed-bearing TKA group (32 vs. 27.7) at 1-year follow-up (p < 0.05). No significant difference in kinematics and clinical outcomes between fixed- and mobile-bearing TKA groups was observed at 2-year follow-up (p > 0.05). Based on the results of this study, mobile-bearing TKA allowed a higher degree of rotation when walking, stepping up stair steps, and standing up from a chair, and had higher functional outcomes compared with fixed-bearing TKA at 1-year follow-up. However, no difference in in vivo kinematics or in clinical outcomes was observed between fixed- and mobile-bearing prostheses at 2-year follow-up.
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Pakhaliuk, Vladimir, and Aleksandr Poliakov. "SIMULATION OF WEAR IN A SPHERICAL JOINT WITH A POLYMERIC COMPONENT OF THE TOTAL HIP REPLACEMENT CONSIDERING ACTIVITIES OF DAILY LIVING." Facta Universitatis, Series: Mechanical Engineering 16, no. 1 (February 14, 2018): 51. http://dx.doi.org/10.22190/fume171226006p.
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The present study assesses the impact of the main typical activities of patients' daily living (ADL) after total hip arthroplasty (THA) on the wear parameters of sliding couple's materials by simulating linear and volumetric wear according to the Archard's law in a spherical joint with a polymeric element of the total hip replacement (THR). The mathematical wear model, built on the basis of algorithms and custom codes of the finite element analysis in ANSYS and MATLAB software systems, has been studied numerically. The activities used in the model are: level walking, stair ascending-stair descending, chair sitting-chair rising, and deep squatting. They were described by typical waveforms of the angular displacements of the THR's femoral component and the waveforms of the applied force. The results of the simulation show that for the same duration the overall wear value with ADL is significantly higher than in the case of level walking according to the requirements of ISO 14242-1. Therefore, the evaluation of the wear value for ADL is more informative for predicting the functional life time of the THR. Analysis of the simulation results shows that the amount of wear calculated for all activities separately is practically the same as the overall wear value obtained at summary action of ADL. This effect of the independence of contributions to the total amount of wear of each activity makes it possible to significantly simplify the solution of the problem of wear estimation for typical activities, including stochastic ones.
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Acar, M. E., D. Bayraktar, S. Gucenmez, D. C. Saraç, N. Buker, U. Z. Kocak, D. Solmaz, and S. Akar. "AB0862-HPR THE RELATIONSHIP BETWEEN ANAEROBIC EXERCISE CAPACITY AND LOWER EXTREMITY FUNCTIONALITY IN PATIENTS WITH FAMILIAL MEDITERRANEAN FEVER." Annals of the Rheumatic Diseases 80, Suppl 1 (May 19, 2021): 1454.2–1455. http://dx.doi.org/10.1136/annrheumdis-2021-eular.2380.
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Background:Familial Mediterranean fever (FMF) is an auto-inflammatory disease commonly affects people from Mediterranean basin. It is characterized by acute self-limiting inflammatory attacks of serous membranes. The disease is commonly associated with musculoskeletal symptoms of lower extremities such as arthritis, exercise induced leg pain, as well as protracted febrile myalgia. The term of anaerobic exercise capacity describes the ability of performing quick and explosive tasks such as stair climbing and brisk walking. It is well known that anaerobic exercise capacity is closely related to functional status.Objectives:To assess the relationship between anaerobic exercise capacity and lower extremity functionality in patients with FMF.Methods:Twenty-eight FMF patients (57% female) were included in the study. Median age was 33.5 (IQR 25/75: 23.3/44.3) years, median body mass index was 24.3 (IQR 25/75: 21.0/27.8) kg/m2, median time since symptom onset was 20.0 (IQR 25/75: 11.5/24.5) years, median time since diagnosis was 10.0 (IQR 25/75: 3.75/17.5) years, and median colchicine dosage was 1.5 (IQR 25/75: 1.0/1.5) mg/day. Anaerobic exercise capacity was measured with Wingate Anaerobic Test by using a cycle ergometer. Peak power (watt/kg) and average power (watt/kg) were calculated. Stair climbing, standing from a chair, and walking were assessed by using 9-step stair climb test, 10-repetition chair stand test, and 6-minute walking distance, respectively. Spearman’s rank-order correlation test was used to analyse the relationships between anaerobic exercise capacity and lower extremity functional tests.Results:The results of the anaerobic exercise capacity and lower extremity functional test scores of patients with FMF were summarized in table 1. Moderate relationships were found between both peak and average anaerobic exercise capacities and lower extremity functional status tests (Table 1, p<0.05). Six-minute walking distance has the strongest association with both peak (rho: .672, p<0.001) and average (rho: .689, p<0.001) anaerobic exercise capacity.Table 1.Anaerobic exercise capacity scores and lower extremity functionality as well as the relationships between anaerobic capacity and functional tests in patient with familial Mediterranean fever.CharacteristicsMedian (IQR 25/75)(n:28)The correlation results, rho, p valuesPeak Power(watt/kg)Average Power (watt/kg)9-step stair climb test (seconds)5.7 (5.1/6.4)-.590*-.648*p:0.001p: 0.00110-repetition chair stand test (seconds)16.6 (13.7/18.7)-.493*-.476*p:0.008p:0.0106-minute walking distance (meters)594.1 (551.1/643.3).672*.689*p<0.001p<0.001Peak power (watt/kg)5.8 (4.1/7.9)Average power (watt/kg)4.6 (3.1/5.9)IQR 25/75: Interquartile range between 25th and 75th percentiles; kg: kilograms, *Spearman’s rank-order correlation test, p<0.05.Conclusion:According to our results, anaerobic exercise capacity is related to lower extremity functional status in patients with FMF. Improving anaerobic capacity by using optimal rehabilitation programs including speed and agility exercises may help to improve anaerobic exercise capacity, and consequently lower extremity functionality in those patients.Disclosure of Interests:None declared
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Bassey, E. Joan, Maria A. Fiatarone, Evelyn F. O'neill, Margaret Kelly, William J. Evans, and Lewis A. Lipsitz. "Leg extensor power and functional performance in very old men and women." Clinical Science 82, no. 3 (March 1, 1992): 321–27. http://dx.doi.org/10.1042/cs0820321.
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1. Residents of a chronic care hospital (13 men of mean age 88.5 ± 6 sd years and 13 women of mean age 86.5 ± 6 sd years) who had multiple pathologies were assessed for leg extensor capability in several ways. 2. A custom-built rig was used to assess leg extensor power, that is, maximal power output over less than 1 s in a single extension of one leg. Performance measures were obtained by timing chair rises (from a standard chair 0.43 m high), stair climbing (four risers, total height 0.635 m) and a walk (6.1 m). For each measurement the best of several trials were recorded as definitive. 3. Leg extensor power was significantly correlated with all performance measures, but the performance measures were not related to each other except for chair rising and walking speed. 4. Women had significantly less extensor power than men, but their power explained more of the variance in performance, e.g. power accounted for 86% of the variance in walking speed. 5. There was no relation within the group between age and any of the variables measured. 6. Measurement of leg extensor power in frail elderly people may prove useful in focusing effective rehabilitation programmes.
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Steingrebe, Hannah, Thorsten Stein, Klaus Bös, and Marian Hoffmann. "Biomechanical Analysis of the Knee Joint Load During a Unilateral Sit-to-Stand Movement." Open Sports Sciences Journal 11, no. 1 (December 31, 2018): 78–87. http://dx.doi.org/10.2174/1875399x01811010078.
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Background and Objectives: Sit-to-Stand (STS) movements are fundamental activities of daily living. As STS movements can be physically demanding especially for the elderly, bi- and unilateral STS movements are frequently used in motor tests to measure lower limb strength. In contrast to bilateral STS movements, the knee joint loads occurring during unilateral STS movements as well as the influences of chair height or lower limb dominance are still unknown. Methods: In a randomized study approach knee joint loads during unilateral STS movements from three different chair heights have been analyzed using biomechanical motion analysis in a population of 19 healthy middle-aged adults. Additionally, the influence of lower limb dominance and the level of perceived exertion have been investigated. Results: Lower limb dominance had no effect on knee joint load. In contrast, chair height significantly affected the peak shear forces in anterior (high: 3.94 ± 0.63 N/kg; low: 4.09 ± 0.61 N/kg) and lateral (high: 1.52 ± 0.79 N/kg; low: 1.78 ± 0.88 N/kg) direction as well as the peak knee adduction moment (high: 0.56 ± 0.29 Nm/kg; low: 0.65 ± 0.32 Nm/kg). Additionally, chair height but not limb dominance significantly affected the level of perceived exertion (high: 11.1 ± 2.8; low: 12.5 ± 3.5). Conclusion: The detected knee joint loads occurring during a unilateral STS movements are similar to those of other activities of daily living like e.g. stair ascent and thus, unilateral STS movements are applicable for usage in motor tests for middle-aged subjects. While lower limb dominance has no impact on the knee joint load, lower chair heights increase the load on the knee joint. Therefore, chair height should be considered when using unilateral STS movements in motor tests.
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Katsoulis, Konstantina, Sunita Mathur, and Catherine E. Amara. "Reliability of Lower Extremity Muscle Power and Functional Performance in Healthy, Older Women." Journal of Aging Research 2021 (February 17, 2021): 1–9. http://dx.doi.org/10.1155/2021/8817231.
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Evaluation of the long-term reliability of muscle power and functional performance tests in older, healthy adults is warranted since determining whether performance is consistent over longer durations is more relevant for intervention studies. Objective. To assess the long-term test–retest reliability of measures of muscle power and lower body functional performance in healthy, nonexercising, older women. Methods. Data were derived from a nonexercising control group (n = 18; age = 73.3 (3.4) years; height = 159.6 (7.7) cm; body mass = 69.5 (12.7) kg; BMI = 27.3 (4.8)) of a randomized controlled trial of muscle power training in older women. Participants underwent lower extremity muscle power (Biodex) and functional testing (Short Physical Performance Battery, gait speed, 30-second chair stands, stair climbing, and 400-meter walk) at week 0 (baseline), 9, and 15. Results. For the upper leg, intraclass correlation coefficients (ICCs) were very high for knee extension power (0.90–0.97) and high to very high for knee flexion power (0.83–0.96). For lower-leg power, ICCs were high to very high for plantar flexion and dorsiflexion (0.83–0.96). ICCs for functional performance were moderate to very high (0.64–0.93). Coefficient of variation of the typical error (CVTE) was <10.5% for knee extension/flexion power, 9.9–20.0% for plantar flexion/dorsiflexion power, and 1.9–14.9% for functional performance. Knee extension power and stair climb power demonstrated the highest reliability for muscle power and function, respectively. Mean values did not change over time, with the exception of the chair stands ( p < 0.05 ); however, these changes were not considered clinically meaningful. Conclusions. The current study provides evidence supporting the long-term reliability of performance assessments of muscle power and lower body functional capacity over a period of up to 15 weeks in healthy, older women.
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Nyland, John, Karen Frost, Peter Quesada, Claudia Angeli, Ann Swank, Robert Topp, and Art L. Malkani. "Self-reported chair-rise ability relates to stair-climbing readiness of total knee arthroplasty patients: A pilot study." Journal of Rehabilitation Research and Development 44, no. 5 (2007): 751. http://dx.doi.org/10.1682/jrrd.2006.11.0146.
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DAVINELLI, MARIO, RITA STAGNI, SILVIA FANTOZZI, and ANGELO CAPPELLO. "INVERSE DYNAMICS MODELING IN GAIT ANALYSIS: AN APPLICATION." Journal of Mechanics in Medicine and Biology 05, no. 04 (December 2005): 531–37. http://dx.doi.org/10.1142/s0219519405001667.
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A method based on inverse dynamics modeling for the subject specific in vivo evaluation of muscle activity in one subject during the execution of chair rising is being described in this article. The calculation of net joint loads and moments is performed through the solution of Newton–Euler mechanics applied to each body segment. Accuracy in the calculation of these quantities is a prerequisite for the reliability of the final results. This accuracy depends on several modeling factors: the choice of the inertial parameters data-set was specifically investigated here. This choice did not result in relevantly affecting the accuracy of the calculated net joint loads for stair ascending and descending, thus even more for a slow motor task like chair rising. Thus, the choice of an inertial parameter data set from the literature was acceptable for the specific application. In order to solve the undetermined problem, the method for the estimation of the contribution of each muscle from internal joint loads and moments was based on static optimization. The static optimization allowed for the estimation of the time histories of the force exerted by each muscolo-tendineous modeled actuator. Among these, the Rectus Femoris exerted the maximum force. In conclusion, the preliminary results obtained with the proposed method allowed for obtaining a realistic estimate of the force exerted in vivo by each muscle during the execution of chair rising-sitting motor task. This is promising in gaining a better understanding on the biomechanical role of muscles during every day living motor tasks, and for the planning and evaluation of surgical and/or rehabilitative procedures.
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Cešeiko, R., S. Tomsone, A. Srebnijs, A. Vētra, M. Timofejevs, E. Purmalis, and J. Eglītis. "Maximal Strength Training for Breast Cancer Patients Undergoing Adjuvant Treatment." Journal of Global Oncology 4, Supplement 2 (October 1, 2018): 102s. http://dx.doi.org/10.1200/jgo.18.29400.
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Background: Breast cancer (BC) patients lose muscle strength during adjuvant treatment, thus affecting physical functioning. Maximal strength training (MST), with an emphasis on velocity in the concentric phase, improves maximal strength and walking efficiency. However, the effect of MST for BC patients undergoing treatment remains elusive. Aim: The aim of this study was to examine the feasibility and effects of such training in BC patients during clinical treatment on maximal muscle strength and functional performance. Methods: Thirty patients (46 ± 9 yr) with stage I-III BC were randomized to training group (TG) or control group (CG). TG performed MST twice a week for 3 months and CG followed prescribed BC treatment without strength training. TG performed four sets of four repetitions (4×4) of dynamic leg press with an emphasis on the maximal mobilization of force in the concentric action and with a progressively adjusted intensity corresponding to 85%–90% of one repetition maximum (1RM). Results: After the MST period, TG displayed significant 25 ± 7 kg (23%) increase in leg press 1RM ( P = 0.001). The strength improvements led to a significant increase in 6 minute walk distance (8%), 30-second chair test (23%), stair climb test (17%), and to a significant increase in walking performance of (8%) measured on an incremental treadmill test to exhaustion. In 3 months' posttest CG displayed significant 10 ± 8 kg (9%) decrease in 1RM ( P = 0.006). Reduced muscle strength leg to a significant decrease in 6 minute walk distance (6%), 30-second chair test (14%), stair climb test by (8%), and walking performance reduced significantly by (17%). Significant changes from pre to 3 months' posttest were observed between TG and CG in all functional performance measured variables. Conclusion: Maximal strength training was feasible during treatment and increased maximal muscle strength in BC patients. Increased strength led to improved functional performance after 24 training sessions each lasting only 20 min. Our results suggest that application of MST could accompany clinical training as a part of the treatment of BC patients. This training form showed excellent improvements in physical function tests and, thus should be implemented as a part of the breast cancer rehabilitation programs.
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Sugianto, Antonius, Ngesti Yuwono, and Kristianus Satriawan. "PERANCANGAN KURSI TANGGA MENGGUNAKAN METODE QUALITY FUNCTION DEPLOYMENT." Jurnal Muara Sains, Teknologi, Kedokteran dan Ilmu Kesehatan 4, no. 2 (October 29, 2020): 229. http://dx.doi.org/10.24912/jmstkik.v4i2.7968.
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Limited space in carrying out activities demanded the availability of furniture that has multifunctional. The purpose of this research is to design a multi-functional Stair Chair. The method used is Quality Function Deployment. The Quality Function Deployment method is used to obtain the product variables desired by most prospective users so that expected design results can fulfill the consumer's wishes. Existing product variables are the description of the main aspects of designing a product i.e. function, shape, construction and material. The main aspects of this design should be considered in order to produce a product design that meets the criteria in designing the correct furniture techniques. The understanding of the importance of ergonomics and anthropometry is indispensable for the main purpose of product design that is appropriate to the wishes of consumers can be fulfilled. Comfort and security become something the parameters must be met. Suitability of the size of furniture with users should be noticed for comfort in use can be fulfilled. Application method of Quality Function Deployment recommends that the development of stair seat products should be aware of the variable needs of consumers who have high weight, namely using strong raw materials, using raw materials that are durable, Using a maximum construction of 2 types, the system of fix assembly. Keywords: design; ladder chair; multi function; quality function deployment ABSTRAKKeterbatasan ruang dalam melaksanakan aktivitas menuntut tersedianya furnitur yang memiliki multifungsi. Tujuan penelitian ini merancang Kursi Tangga yang memiliki multi fungsi. Metode yang digunakan adalah Quality Function Deployment. Metode Quality Function Deployment digunakan untuk mendapatkan variabel produk yang diinginkan oleh sebagian besar calon pemakai sehingga diharapkan hasil perancangan dapat memenuhi keinginan konsumen. Variabel produk yang ada merupakan penjabaran dari aspek utama dalam merancang sebuah produk yaitu fungsi, bentuk, konstruksi dan bahan. Aspek utama dalam perancangan ini harus diperhatikan agar menghasilkan rancangan produk yang memenuhi kriteria dalam teknik mendesain furniture yang benar. Pemahaman akan pentingnya ergonomi dan antropometri sangat diperlukan agar tujuan utama perancangan produk yang sesuai dengan keinginan konsumen dapat terpenuhi. Kenyamanan dan keamanan menjadi sesuatu parameter yang harus dipenuhi. Kesesuaian ukuran furniture dengan pengguna harus diperhatikan agar kenyamanan dalam pemakaian dapat terpenuhi. Aplikasi metode Quality Function Deployment merekomendasikan bahwa pengembangan produk Kursi Tangga harus memperhatikan variabel kebutuhan konsumen yang memiliki bobot tinggi yaitu menggunakan bahan baku yang kuat, menggunakan bahan baku yang awet, menggunakan konstruksi maksimal 2 jenis, sistem perakitan mati.
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Dowsey, Michelle M., Marcus Pandy, Tony J. Young, Hans Gray, Shangyuanye Guan, and Peter F. Choong. "A blinded, three-arm randomised trial assessing joint function and measuring three-dimensional knee joint kinematics in individuals six months after a total knee joint replacement; comparing a medially stabilised design, to standard fixed bearing conventional designs – posterior stabilising and cruciate retaining." International Journal of Clinical Trials 5, no. 1 (January 23, 2018): 37. http://dx.doi.org/10.18203/2349-3259.ijct20180129.
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<p class="abstract"><strong>Background:</strong> No randomised trial exists to assess the relative prosthetic performance of three fixed bearing total knee joint replacement construct designs through clinical functional outcomes and biomechanical gait analysis at six months after the index procedure.</p><p class="abstract"><strong>Methods:</strong> The design of a double blinded, prospective, randomised trial with three parallel patient groups is presented. Patients reviewed in consultant clinic with radiographic and clinical diagnosis of osteoarthritis of the knee, with the condition deemed severe enough to require a total knee joint replacement (TKJR) are eligible. Subjects enrolled in the trial are randomised to one of the three TKJR construct designs approximately ten days prior to scheduled date of surgery. Each subject is then followed up for at least twelve months. Repeated measure of Analysis of Variance (ANOVA), and Analysis of Covariance (ANCOVA) will be utilised to uncover any clinical functional differences in each trial group in each time interval.</p><p class="abstract"><strong>Results:</strong> Differences in clinical functional scores at each time interval compared to pre-intervention, as well as between group differences in clinical functional scores at each time interval will be examined. At six months after the operation, biomechanical measurements of joint motion, ground reaction forces, and muscle electromyographic (EMG) activity will be recorded simultaneously from each subject for four test conditions: level walking, stair ascent, stair descent, and chair rise.</p><p><strong>Conclusions: </strong>This randomised trial is designed to better understand the relationships between the clinical functional outcomes and replaced knee kinematics in three fixed bearing total knee replacement construct designs at six months postoperatively.</p>
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Rayes, Angeles Bonal Rosell, Claudio Andre B. de Lira, Ricardo B. Viana, Ana A. Benedito-Silva, Rodrigo L. Vancini, Naryana Mascarin, and Marilia S. Andrade. "The effects of Pilates vs. aerobic training on cardiorespiratory fitness, isokinetic muscular strength, body composition, and functional tasks outcomes for individuals who are overweight/obese: a clinical trial." PeerJ 7 (February 28, 2019): e6022. http://dx.doi.org/10.7717/peerj.6022.
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Background Some studies have been conducted to verify the effects of Pilates for individuals who are obese, but conclusive results are not yet available due to methodological concerns. The present study aims to verify and compare the effects of Pilates and aerobic training on cardiorespiratory fitness, isokinetic muscular strength, body composition, and functional task outcomes for individuals who are overweight/obese. Methods Of the sixty participants, seventeen were allocated to the control group, since the intervention protocol (Pilates or walking sessions) was during their working hours. The remaining 44 participants were randomly allocated to one of two experimental groups (Pilates (n = 22)) or aerobic groups (n = 21).The Pilates and aerobic groups attended 60-min exercise sessions, three times per week for 8 weeks. The aerobic group performed walking training at a heart rate corresponding to the ventilatory threshold. The Pilates group performed exercises on the floor, resistance apparatus, and 1-kg dumbbells. The control group received no intervention. All volunteers were evaluated at the beginning and end of the intervention. The following assessments were conducted: food intake, cardiorespiratory maximal treadmill test, isokinetic strength testing, body composition and anthropometry, abdominal endurance test, trunk extensor endurance test, flexibility test and functional (stair and chair) tests. Results There was no significant difference pre- and post-intervention in calorie intake [F(2, 57) = 0.02744, p = 0.97)]. A significant improvement in oxygen uptake at ventilatory threshold (p = 0.001; d = 0.60), respiratory compensation point (p = 0.01; d = 0.48), and maximum effort (p = 0.01; d = 0.33) was observed only in the Pilates group. Isokinetic peak torque for knee flexor and extensor muscles did not change for any groups. Lean mass (p = 0.0005; d = 0.19) and fat mass (p = 0.0001; d = 0.19) improved only in the Pilates group. Waist and hip circumference measurements decreased similarly in both experimental groups. Abdominal test performance improved more in the Pilates group (p = 0.0001; d = 1.69) than in the aerobic group (p = 0.003; d = 0.95). Trunk extensor endurance and flexibility improved only in the Pilates group (p = 0.0003; d = 0.80 and p = 0.0001; d = 0.41, respectively). The Pilates group showed greater improvement on the chair and stair tests (p = 0.0001; d = 1.48 and p = 0.003; d = 0.78, respectively) than the aerobic group (p = 0.005; d = 0.75 and p = 0.05; d = 0.41, respectively). Conclusion Pilates can be used as an alternative physical training method for individuals who are overweight or obese since it promotes significant effects in cardiorespiratory fitness, body composition, and performance on functional tests.
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Adusumilli, Gautam, Solomon Eben Joseph, Michael A. Samaan, Brooke Schultz, Tijana Popovic, Richard B. Souza, and Sharmila Majumdar. "iPhone Sensors in Tracking Outcome Variables of the 30-Second Chair Stand Test and Stair Climb Test to Evaluate Disability: Cross-Sectional Pilot Study." JMIR mHealth and uHealth 5, no. 10 (October 27, 2017): e166. http://dx.doi.org/10.2196/mhealth.8656.
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da Cunha de Sá-Caputo, Danúbia, Redha Taiar, Adérito Seixas, Borja Sanudo, Anelise Sonza, and Mario Bernardo-Filho. "A Proposal of Physical Performance Tests Adapted as Home Workout Options during the COVID-19 Pandemic." Applied Sciences 10, no. 14 (July 10, 2020): 4755. http://dx.doi.org/10.3390/app10144755.
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Social isolation and physical distancing measures, such as quarantine, local confinement, lockdown and isolation, aim to slow the spread of the coronavirus disease (COVID-19). This condition is necessary; however, sedentary behaviors are stimulated. The aim of this manuscript is to propose simple home-based exercises that everyone, considering their individual limitations, could perform. Moreover, individuals might monitor their performance daily. Feasible and useful home-based exercise strategies, to counter-balance the negative impact of the sedentary lifestyle during confinement, will stimulate the population to perform some exercises wherever possible. For this, home-based exercises were proposed based on physical tests, such as a stair climb test, balance test, single-leg-stance-test, gait speed, five-chair stand, free walking, free run, six-minute walk test, timed up and go, sit-and-reach, fingertip-to-floor test, and free physical exercises. It is important to consider that when the individual is performing the test, physical exercise is also being done. In conclusion, several exercises that consider the clinical conditions of the individuals and can reduce their sedentary behavior, considering COVID-19 confinement, are suggested to improve the population’s quality of life.
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Afrin Urme, Nadia, Fabiha Alam, and Nusrat Jahan. "Effectiveness of Specific Lumbar Stabilization Exercise for LBP among Postpartum Women: A Quasi-Experimental Study." Journal of Advanced Academic Research 8, no. 1 (June 22, 2021): 79–95. http://dx.doi.org/10.3126/jaar.v8i1.39065.
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Background: Postpartum back pain is common, with up to 75% of women experiencing back pain immediately following birth due to ligament laxity and postural changes. Besides the lack of pelvic floor muscles strength, urine leakage problem during coughing and sneezing also arises in this condition. The purpose of this study was to explore the effect of stabilization exercise (SE) and Kegel exercise. Objective: To evaluate the pain intensity in rest and different functional activities before and after introducing spinal stabilization exercises in postpartum women with low back pain and also find out the effect of Kegel exercise. Study Design: A Quasi-Experimental (one group) pretest-posttest design was used. Methodology: 27 patients who were fulfill inclusion criteria within this study period with postpartum low back pain, attended at Gynecological and Women's Health unit, CRP, Mirpur, Dhaka was purposively chosen to conduct the study. Spinal stabilization exercise was applied to the participants to find out the effectiveness of this exercise. Kegel exercise was also introduced who have urine leakage problem among 27 patients. Participants received the exercise for 45 minutes, 2 times a week & total 6 weeks. Besides this they performed the exercises at home 5 times a day also. A numeric pain rating scale was used to measure pain intensity in different functional activities such as swiping, squatting, chair sitting, heavy weight lifting, walking, and journey by bus or rickshaw, and stair climbing. Pain score was analyzed by calculating the "Wilcoxon Signed Ranked Test". Results: Results showed that relative improvement occurs in all participants in the experimental group. Pain scores on numeric pain rating Scale on different functional activities such as during toilet sitting, stair climbing, walking, during weight lifting, were relatively reduced which was also statistically significant (p≤ .05). Participants who have a urine leakage problem also recover from this problem. Conclusions: Lumbar stabilization exercises has effect on reducing pain and improving functional activities, and to solve the urine leakage problem Kegel exercise effective.
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Saeterbakken, Atle Hole, Hilde Bremseth Bårdstu, Anine Brudeseth, and Vidar Andersen. "Effects of Strength Training on Muscle Properties, Physical Function, and Physical Activity among Frail Older People: A Pilot Study." Journal of Aging Research 2018 (June 3, 2018): 1–11. http://dx.doi.org/10.1155/2018/8916274.
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The aim of this study was to determine the effects of a 10-week strength training intervention on isometric strength, rate of force development (RFD), physical function (stair climbing, rising from a chair, and preferred and maximal walking speed), and physical activity among frail elderly people receiving home-care services. Thirty participants were randomly assigned (by sex) to a control group (CON) or a strength training group (ST) performing a supervised training programme using elastic bands, box-lifting, and body weight exercises twice per week. Twenty-three participants were selected to complete the study (age 84.9 ± 6.1 years). For the ST, only improvement in muscle properties was the peak RFD in leg extension (p=0.04). No significant differences were observed in muscle properties for the control group (CON) (p=0.16–1.00) or between groups (p=0.39–1.00). There were no changes within and between the groups in physical function (p=0.12–0.19) or physical activity levels (p=0.06–0.73). The results of this pilot study did not demonstrate greater improvements in muscle properties and physical function and improved physical activity after attending a home-based resistance program compared to physical activity advise; however, larger population studies should examine these findings. This trial is registered with ISRCTN10967873.
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Villafaina, Santos, Yolanda Borrega-Mouquinho, Juan Pedro Fuentes-García, Daniel Collado-Mateo, and Narcis Gusi. "Effect of Exergame Training and Detraining on Lower-Body Strength, Agility, and Cardiorespiratory Fitness in Women with Fibromyalgia: Single-Blinded Randomized Controlled Trial." International Journal of Environmental Research and Public Health 17, no. 1 (December 24, 2019): 161. http://dx.doi.org/10.3390/ijerph17010161.
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The aim of this study was to analyze the effects of a 24 week exergame intervention and 24 weeks of detraining on lower-limb strength, agility, and cardiorespiratory fitness in women with fibromyalgia (FM). It was performed as a single-blinded randomized controlled trial of 55 women with FM. University facilities were used. The 24 week exergame intervention was focused on mobility, postural control, upper- and lower-limb coordination, aerobic fitness, and strength. Participants performed 120 min of exergaming per week, which was divided into two sessions. Twenty-four weeks after the end of the intervention, participants were re-evaluated. A chair–stand test, 10 step stair test, and six-minute walk test were conducted to assess lower-body strength, agility, and cardiorespiratory fitness, respectively. The exergame intervention significantly improved lower-limb strength and cardiorespiratory fitness. However, no significant effects on agility were observed. After the detraining period, lower-limb strength and agility returned to their baseline level, but improvements in cardiorespiratory fitness were sustained over time. Exergaming was therefore shown to be beneficial for physical fitness in people with FM. However, exergames had to be played regularly to maintain the benefits. This long-term intervention (24 weeks) may have changed the lifestyle of women with FM, which could explain why cardiorespiratory fitness improvements remained after the detraining period. Future research should focus on lifestyle changes after long-term interventions.
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Bishop, E. L., G. Kuntze, and J. L. Ronsky. "Effect of a tri compartment unloader knee brace on knee moments and quadriceps activity during a chair rise and lower and stair descent in individuals with knee osteoarthritis." Osteoarthritis and Cartilage 28 (April 2020): S243—S244. http://dx.doi.org/10.1016/j.joca.2020.02.390.
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Kılıç, Filiz, Arzu Demirgüç, Saniye Aydoğan Arslan, Esra Dilek Keskin, and Müyesser Aras. "The effect of aerobic exercise training on postmenopausal patients with knee osteoarthritis." Journal of Back and Musculoskeletal Rehabilitation 33, no. 6 (November 11, 2020): 995–1002. http://dx.doi.org/10.3233/bmr-191712.
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BACKGROUND: Knee osteoarthritis (OA) is a common musculoskeletal problem encountered in the postmenopausal period. OBJECTIVE: This study aimed to determine the impact of aerobic exercise on functional limitation, exercise tolerance, and performance tests in postmenopausal women with knee OA. METHODS: A total of 50 women (aged between 48–78) with grade 2–3 knee OA according to the Kellgren-Lawrence radiographic scale were enrolled. OA-specific physical performance tests (40 m Fast-Paced Walk Test (40mFPWT), 30 s Chair Stand Test (30sCST), Stair Climb Test (9-step SCT)), six-minute walk test (6MWT), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and Visual Analogue Scale (VAS) were performed. Fifty patients were randomized to either the treatment or control groups. The treatment group received an additional aerobic exercise training along with a combined physiotherapy program for six weeks. The aerobic exercise program was carried out by the same physiotherapist every weekday (five days) for six weeks. The control group only received a combined physiotherapy program for six weeks. RESULTS: The post-treatment comparisons of the two groups yielded similar SCT results (p> 0.05), while VAS scores, the results of all performance tests, WOMAC scores, and the distance covered in 6MWT were significantly higher in the treatment group (p< 0.05). CONCLUSIONS: Consequently, this study provides an insight into the efficacy of the aerobic exercise program applied along with a combined physiotherapy program in postmenopausal women with knee OA.
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Krut, S., Ch Azevedo Coste, and P. Chabloz. "Secure Microprocessor-Controlled Prosthetic Leg for Elderly Amputees: Preliminary Results." Applied Bionics and Biomechanics 8, no. 3-4 (2011): 385–98. http://dx.doi.org/10.1155/2011/308973.
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We introduce a new prosthetic leg design, adapted to elderly trans-femoral amputees. Technical progress in prosthesis design mainly concerns active individuals. An important number of elderly amputees are not very mobile, tire easily, present reduced muscle strength, and have difficulties managing their balance. Therefore, the needs and characteristics of this specific population are very different from those of younger ones and the prosthetic solutions are not adapted. Our artificial knee has been designed to fulfill the specific requirements of this population in terms of capabilities, transfer assistance, security, intuitiveness, simplicity of use, and types of physical activity to be performed. We particularly focused our efforts on ensuring safe and secure stand-to-sit transfers. We developed an approach to control the different states of the prosthetic joint (blocked, free, resistant), associated with different physical activities. Amputee posture and motion are observed through a single multi-axis force sensor embedded in the prosthesis. The patient behaves naturally, while the controller analyses his movements in order to detect his intention to sit down. The detection algorithm is based on a reference pattern, calibrated individually, to which the sensor data are compared, and submitted to a set of tests allowing the discrimination of the intention to sit down from other activities. Preliminary validation of the system has been performed in order to verify the applicability of the prosthesis to different tasks: walking, standing, sitting down, standing up, picking up an object from a chair, slope and stair climbing.
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McGibbon, Chris A. "A biomechanical model for encoding joint dynamics: applications to transfemoral prosthesis control." Journal of Applied Physiology 112, no. 9 (May 1, 2012): 1600–1611. http://dx.doi.org/10.1152/japplphysiol.01251.2011.
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This paper presents and tests a framework for encoding joint dynamics into energy states using kinematic and kinetic knee joint sensor data and demonstrates how to use this information to predict the future energy state (torque and velocity requirements) of the joint without a priori knowledge of the activity sequence. The intended application is for enhancing micro-controlled prosthetics by making use of the embedded sensory potential of artificial limbs and classical mechanical principles of a prosthetic joint to report instantaneous energy state and most probable next energy state. When applied to the knee during preferred and fast speed walking in 8 human subjects (66 preferred-speed trials and 50 fast-speed trials), it was found that joint energy states could be consistently sequenced (75% consensus) according to mechanical energy transference conditions and subsequences appeared to reflect the stability and energy dissipation requirements of the knee during gait. When simple constraints were applied to the energy transfer input conditions (their signs), simulations indicated that it was possible to predict the future energy state with an accuracy of >80% when 2% cycle in advance (∼20 ms) of the switch and >60% for 4% (∼40 ms) in advance. This study justifies future research to explore whether this encoding algorithm can be used to identify submodes of other human activity that are relevant to TFP control, such as chair and stair activities and their transitions from walking, as well as unexpected perturbations.
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Lacroix, André, Reto W. Kressig, Thomas Muehlbauer, Yves J. Gschwind, Barbara Pfenninger, Othmar Bruegger, and Urs Granacher. "Effects of a Supervised versus an Unsupervised Combined Balance and Strength Training Program on Balance and Muscle Power in Healthy Older Adults: A Randomized Controlled Trial." Gerontology 62, no. 3 (December 9, 2015): 275–88. http://dx.doi.org/10.1159/000442087.
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Background: Losses in lower extremity muscle strength/power, muscle mass and deficits in static and particularly dynamic balance due to aging are associated with impaired functional performance and an increased fall risk. It has been shown that the combination of balance and strength training (BST) mitigates these age-related deficits. However, it is unresolved whether supervised versus unsupervised BST is equally effective in improving muscle power and balance in older adults. Objective: This study examined the impact of a 12-week BST program followed by 12 weeks of detraining on measures of balance and muscle power in healthy older adults enrolled in supervised (SUP) or unsupervised (UNSUP) training. Methods: Sixty-six older adults (men: 25, women: 41; age 73 ± 4 years) were randomly assigned to a SUP group (2/week supervised training, 1/week unsupervised training; n = 22), an UNSUP group (3/week unsupervised training; n = 22) or a passive control group (CON; n = 22). Static (i.e., Romberg Test) and dynamic (i.e., 10-meter walk test) steady-state, proactive (i.e., Timed Up and Go Test, Functional Reach Test), and reactive balance (e.g., Push and Release Test), as well as lower extremity muscle power (i.e., Chair Stand Test; Stair Ascent and Descent Test) were tested before and after the active training phase as well as after detraining. Results: Adherence rates to training were 92% for SUP and 97% for UNSUP. BST resulted in significant group × time interactions. Post hoc analyses showed, among others, significant training-related improvements for the Romberg Test, stride velocity, Timed Up and Go Test, and Chair Stand Test in favor of the SUP group. Following detraining, significantly enhanced performances (compared to baseline) were still present in 13 variables for the SUP group and in 10 variables for the UNSUP group. Conclusion: Twelve weeks of BST proved to be safe (no training-related injuries) and feasible (high attendance rates of >90%). Deficits of balance and lower extremity muscle power can be mitigated by BST in healthy older adults. Additionally, supervised as compared to unsupervised BST was more effective. Thus, it is recommended to counteract intrinsic fall risk factors by applying supervised BST programs for older adults.
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S Jorge, Ana E., Lucas O Dantas, Paula R. M S Serrão, Francisco Alburquerque-Sendín, and Tania F. Salvini. "Photobiomodulation therapy associated with supervised therapeutic exercises for people with knee osteoarthritis: a randomised controlled trial protocol." BMJ Open 10, no. 6 (June 2020): e035711. http://dx.doi.org/10.1136/bmjopen-2019-035711.
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BackgroundPhysical exercise, a cornerstone of the conservative management of knee osteoarthritis (KOA), is exhaustively recommended by important clinical guidelines. A strength therapeutic exercise program (STEP) relieves pain, improves physical function and ultimately ameliorates quality of life (QoL). Furthermore, photobiomodulation (PBM) has been used as an adjunct treatment for people with KOA; however, there are still controversial recommendations regarding its use on this population. Thus, we hypothesised that PBM, when associated with a STEP protocol on patients with KOA, could induce better clinical outcomes than a STEP protocol alone.Methods and analysisThe study is a 6-month triple-blind placebo-controlled randomised clinical trial with intention-to-treat analysis. The trial will include 120 people with clinic and radiographic signs of KOA. The intervention consists of a supervised STEP and PBM protocols conducted over an 8-week intervention period. Assessments are performed at baseline, right after treatment, and 3-month and 6-month follow-up periods. The primary clinical outcome is pain intensity according to a 10 cm Visual Analogue Scale. Secondary outcomes are the global Western Ontario & McMaster Universities Osteoarthritis Index; QoL assessed by the 36-item Short-Form health survey questionnaire; and performance-based physical parameters assessed by the 30 s chair stand test; the stair climb test; and the 40 m fast-paced walk test.Ethics and disseminationThe trial was approved by the Human Research Ethics Committee of the Federal University of São Carlos, São Paulo, Brazil (REC no 2.016.122). Results will be published in peer-reviewed journals.Trial registration numberBrazilian Clinical Trials Registry (U1111-1215-6510).
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Khan, Saad Jawaid, Soobia Saad Khan, Juliana Usman, Abdul Halim Mokhtar, and Noor Azuan Abu Osman. "Orthoses versus gait retraining: Immediate response in improving physical performance measures in healthy and medial knee osteoarthritic adults." Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine 234, no. 7 (May 27, 2020): 749–57. http://dx.doi.org/10.1177/0954411920924525.
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The conservative techniques of treating knee osteoarthritis (kOA) include wearing orthoses such as knee braces and laterally wedged insoles and applying gait modification techniques such as toe-in gait and toe-out gait. This study aimed at assessing the immediate effects of these techniques in improving physical function of healthy and kOA participants. Five Osteoarthritis Research Society International (OARSI) recommended performance-based tests were randomly applied to measure physical function: (1) 30-second chair stand test (30CST), (2) 40-m (4 × 10) fast-paced walk test (40FPW), (3) stair climb test (SCT), (4) timed up and go test (TUGT) and (5) 6-minute walk test (6MWT) during a single-visit on 20 healthy and 20 kOA patients (age: 59.5 ± 7.33 and 61.5 ± 8.63 years, BMI: 69.95 ± 9.86 and 70.45 ± 8.80 kg/m2). The interventions included natural gait, toe-out gait, toe-in gait, laterally wedged insoles and knee brace. Analysis was performed through repeated-measures ANOVA and independent sample t-test. 30CST and TUGT showed no significant differences for the five test conditions ( p > 0.05). Toe-out showed profound effects via pairwise comparison in impairing the physical function while knee brace improved it during 40FPW, SCT and 6MWT. In general, all the tested conservative techniques except laterally wedged insoles had immediate effects on physical performance measures in both healthy and medial knee osteoarthritis participants. The valgus knee brace improved the parameters the most, while toe-out gait impaired them the most. Future studies can develop strategies for improving gait retraining methods on the basis of issues identified by this study.
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Baldwin, Jennifer N., Marnee J. McKay, Joshua Burns, Claire E. Hiller, Elizabeth J. Nightingale, and Niamh Moloney. "What are the similarities and differences between healthy people with and without pain?" Scandinavian Journal of Pain 18, no. 1 (January 26, 2018): 39–47. http://dx.doi.org/10.1515/sjpain-2017-0156.
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Abstract Background and aims: Knowledge of pain characteristics among the healthy population or among people with minimal pain-related disability could hold important insights to inform clinical practice and research. This study investigated pain prevalence among healthy individuals and compared psychosocial and physical characteristics between adults with and without pain. Methods: Data were from 1,000 self-reported healthy participants aged 3–101 years (1,000 Norms Project). Single-item questions assessed recent bodily pain (“none” to “very severe”) and chronic pain (pain every day for 3 months in the previous 6 months). Assessment of Quality of Life (AQoL) instrument, New Generalised Self-Efficacy Scale, International Physical Activity Questionnaire, 6-min walk test, 30-s chair stand and timed up-and-down stairs tests were compared between adults with and without pain. Results: Seventy-two percent of adults and 49% of children had experienced recent pain, although most rated their pain as mild (80% and 87%, respectively). Adults with recent pain were more likely to be overweight/obese and report sleep difficulties, and had lower self-efficacy, AQoL mental super dimension scores and sit-to-stand performance, compared to adults with no pain (p<0.05). Effect sizes were modest (Cohen’s d=0.16–0.39), therefore unlikely clinically significant. Chronic pain was reported by 15% of adults and 3% of children. Adults with chronic pain were older, more likely to be overweight/obese, and had lower AQoL mental super dimension scores, 6-min walk, sit-to-stand and stair-climbing performance (p<0.05). Again, effect sizes were modest (Cohen’s d=0.25–0.40). Conclusions: Mild pain is common among healthy individuals. Adults who consider themselves healthy but experience pain (recent/chronic) display slightly lower mental health and physical performance, although these differences are unlikely clinically significant. Implications: These findings emphasise the importance of assessing pain-related disability in addition to prevalence when considering the disease burden of pain. Early assessment of broader health and lifestyle risk factors in clinical practice is emphasised. Avenues for future research include examination of whether lower mental health and physical performance represent risk factors for future pain and whether physical activity levels, sleep and self-efficacy are protective against chronic pain-related disability.
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Pontes, Nayara Silva, Germanna Medeiros Barbosa, Hugo Jário Almeida Silva, Rodrigo Scattone Silva, Clécio Gabriel Souza, Caio Alano de Almeida Lins, and Marcelo Cardoso de Souza. "Effects of dry cupping on pain, function and quality of life in women with knee osteoarthritis: a protocol for a sham-controlled randomised trial." BMJ Open 10, no. 12 (December 2020): e039857. http://dx.doi.org/10.1136/bmjopen-2020-039857.
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IntroductionKnee osteoarthritis (KOA) is the most common cause of pain and disability worldwide. Dry cupping has been used as non-pharmacological approach to control pain and improve physical function. However, there is a lack of high-quality scientific evidence regarding its effects on this condition. This protocol describes a sham-controlled, randomised and simple blind study that aims to evaluate the effect of dry cupping on pain, function and quality of life in women with KOA.Methods and analysisSixty-two women diagnosed with KOA, based on American College of Rheumatology clinical criteria, and aged from 50 to 75 years, will be randomly distributed into two groups (31 per group): real and sham dry cupping. Both applications will occur with acrylic cups around the knee. The intervention will last 15 min, two times a week over six consecutive weeks, for a total of 12 sessions. Both groups will be assessed at four different times: before the intervention (T0), after 3 weeks intervention (T3), at the end of the protocol (T6) and 4 weeks after the interventions (follow-up: T10). The primary outcome will be pain intensity (Numerical Pain Rating Scale), and secondary outcomes will be knee-related health status (Western Ontario and McMaster Universities Osteoarthritis Index), functional capacity (8-step stair climb test, 40-metre fast-paced walk test and 30-second chair stand test), quality of life (Short-Form 36) and global perceived effect.Ethics and disseminationThis protocol was approved by the UFRN/FACISA Ethics Committee (number 3.737.688). The study results will be disseminated to the participants and submitted to a peer-reviewed journal and scientific meetings.Trial registration numberNCT04331158.
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Ogura Dantas, Lucas, Ana Elisa Serafim Jorge, Paula Regina Mendes da Silva Serrão, Francisco Aburquerque-Sendín, and Tania de Fatima Salvini. "Cryotherapy associated with tailored land-based exercises for knee osteoarthritis: a protocol for a double-blind sham-controlled randomised trial." BMJ Open 10, no. 6 (June 2020): e035610. http://dx.doi.org/10.1136/bmjopen-2019-035610.
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IntroductionThere is an unmet need to develop tailored therapeutic exercise protocols applying different treatment parameters and modalities for individuals with knee osteoarthritis (KOA). Cryotherapy is widely used in rehabilitation as an adjunct treatment due to its effects on pain and the inflammatory process. However, disagreement between KOA guidelines remains with respect to its recommendation status. The aim of this study is to verify the complementary effects of cryotherapy when associated with a tailored therapeutic exercise protocol for patients with KOA.Methods and analysisThis study is a sham-controlled randomised trial with concealed allocation and intention-to-treat analysis. Assessments will be performed at baseline and immediately following the intervention period. To check for residual effects of the applied interventions, 3-month and 6-month follow-up assessments will be performed. Participants will be community members living with KOA divided into three groups: (1) the experimental group that will receive a tailored therapeutic exercise protocol followed by a cryotherapy session of 20 min; (2) the sham control group that will receive the same regimen as the first group, but with sham packs filled with dry sand and (3) the active treatment control group that will receive only the therapeutic exercise protocol. The primary outcome will be pain intensity according to a Visual Analogue Scale. Secondary outcomes will be the Western Ontario & McMaster Universities Osteoarthritis Index; the Short-Form Health Survey 36; the 30-s Chair Stand Test; the Stair Climb test; and the 40-m fast-paced walk test.Ethics and disseminationThe trial was approved by the Institutional Ethics Committee of Federal University of São Carlos, São Paulo, Brazil. Registration approval number: CAAE: 65966617.9.0000.5504. The results will be published in peer-reviewed journals.Trial registration numberNCT03360500
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Taaffe, Dennis R., Robert U. Newton, Nigel Spry, David J. Joseph, and Daniel A. Galvão. "Responsiveness to Resistance-Based Multimodal Exercise Among Men With Prostate Cancer Receiving Androgen Deprivation Therapy." Journal of the National Comprehensive Cancer Network 17, no. 10 (October 2019): 1211–20. http://dx.doi.org/10.6004/jnccn.2019.7311.
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Background: Androgen deprivation therapy (ADT) in the management of prostate cancer (PCa) results in an array of adverse effects, and exercise is one strategy to counter treatment-related musculoskeletal toxicities. This study assessed the prevalence of exercise responsiveness in men with PCa undergoing ADT in terms of body composition, muscle strength, and physical function. Methods: Prospective analyses were performed in 152 men (aged 43–90 years) with PCa receiving ADT who were engaged in resistance exercise combined with aerobic or impact training for 3 to 6 months. Whole-body lean mass and fat mass (FM), trunk FM, and appendicular skeletal muscle were assessed with dual x-ray absorptiometry; upper and lower body muscle strength were assessed with the one-repetition maximum; and physical function was assessed with a battery of tests (6-m usual, fast, and backward walk; 400-m walk; repeated chair rise; stair climb). Results: Significant improvements were seen (P<.01) in lean mass (0.4±1.4 kg [range, −2.8 to +4.1 kg]), appendicular skeletal muscle (0.2±0.8 kg [range, −1.9 to +1.9 kg]), and all measures of muscle strength (chest press, 2.9±5.8 kg [range, −12.5 to +37.5 kg]; leg press, 29.2±27.6 kg [range, −50.0 to +140.0 kg]) and physical function (from −0.1±0.5 s [range, +1.3 to −2.1 s] for the 6-m walk; to −8.6±15.2 s [range, +25.2 to −69.7 s] for the 400-m walk). An increase in FM was also noted (0.6±1.8 kg [range, −3.6 to +7.3 kg]; P<.01). A total of 21 men did not exhibit a favorable response in at least one body composition component, 10 did not experience improved muscle strength, and 2 did not have improved physical function. However, all patients responded in at least one of the areas, and 120 (79%) favorably responded in all 3 areas. Conclusions: Despite considerable heterogeneity, most men with PCa receiving ADT responded to resistance-based multimodal exercise, and therefore our findings indicate that this form of exercise can be confidently prescribed to produce beneficial effects during active treatment.
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Reid, Julie C., France Clarke, Deborah J. Cook, Alexander Molloy, Jill C. Rudkowski, Paul Stratford, and Michelle E. Kho. "Feasibility, Reliability, Responsiveness, and Validity of the Patient-Reported Functional Scale for the Intensive Care Unit: A Pilot Study." Journal of Intensive Care Medicine 35, no. 12 (January 22, 2019): 1396–404. http://dx.doi.org/10.1177/0885066618824534.
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Background: Although many performance-based measures assess patients’ physical function in intensive care unit (ICU) survivors, to our knowledge, there are no patient-reported ICU rehabilitation-specific measures assessing function. We developed the Patient-Reported Functional Scale-ICU (PRFS-ICU), which measures patients’ perceptions of their ability to perform 6 activities (rolling, sitting edge of bed, sit-to-stand and bed-to-chair transfers, ambulation, and stair climbing). Each item is scored from 0 (unable) to 10 (able to perform at pre-ICU level) to a maximum of 60. Objectives: Estimate the feasibility, reliability, responsiveness, and validity of the PRFS-ICU. Methods: This was a substudy of TryCYCLE, a single-center, prospective cohort examining the safety and feasibility of early in-bed cycling with mechanically ventilated patients (NCT01885442). To determine feasibility, we calculated the number of patients with at least 1 PRFS-ICU assessment during their hospital stay. To assess reliability, 2 raters blinded to each other’s assessments administered the PRFS-ICU within 24-hours of each other. We calculated the intraclass correlation coefficient (ICC; 95% confidence interval [CI]), standard error of measurement (SEM, 95% CI), and minimal detectable change (MDC90). To assess validity, we estimated convergent validity of the PRFS-ICU with the Functional Status Score for ICU (FSS-ICU), Medical Research Council Sum Score (MRC-SS), Physical Function Test for ICU (PFIT-s), Katz Index of Independence in Activities of Daily Living (Katz ADLs), and a pooled index using Pearson's correlation coefficient ( r, 95% CI). Results: Feasibility: 20 patients completed a PRFS-ICU assessment. Reliability and responsiveness: 16 patients contributed data. The ICC, SEM, and MDC90 were 0.91 (0.76, 0.97), 4.75 (3.51, 7.35), and 11.04 points, respectively. Validity: 19 patients contributed data and correlations were ( r [95% CI]): FSS-ICU (0.40 [−0.14, 0.76]), MRC-SS (0.51 [0.02, 0.80]), PFIT-s (0.43 [−0.13, 0.78]), Katz ADLs (0.53 [0.10, 0.79]), and pooled index (0.48 [−0.14, 0.82]). Conclusions: Our pilot work suggests the PRFS-ICU may be a useful tool to assess and monitor patients’ perceptions of function over time.
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Bennell, Kim, Fiona Dobson, and Rana Hinman. "Measures of physical performance assessments: Self-Paced Walk Test (SPWT), Stair Climb Test (SCT), Six-Minute Walk Test (6MWT), Chair Stand Test (CST), Timed Up & Go (TUG), Sock Test, Lift and Carry Test (LCT), and Car Task." Arthritis Care & Research 63, S11 (November 2011): S350—S370. http://dx.doi.org/10.1002/acr.20538.
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Yelamarthi, Nagendra Gowtham Rayudu, Raghu Yelavarthi, and Rajashekhar Tati. "Assessment of functional mobility and body mass index among patients with a total knee replacement: a retrospective study in Indian population." International Journal of Research in Orthopaedics 5, no. 4 (June 27, 2019): 687. http://dx.doi.org/10.18203/issn.2455-4510.intjresorthop20192685.
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<p class="abstract"><strong>Background:</strong> Obesity is associated with an increased risk of osteoarthritis, and the incidence of obese patients requiring a total knee replacement (TKR) has increased in recent years. A high body mass index (BMI) may influence post‐TKR rehabilitation outcomes. The aim of the present study was to assess the effects of obesity on functional mobility outcomes following post‐TKR rehabilitation in Asian patients where BMI was not as high as those reported in similar studies performed other countries other than Asian.</p><p class="abstract"><strong>Methods:</strong> A total of 100 patients were categorized as normal weight (n=11), overweight (n=10), class I obese (n=28), or class II obese (n=32), class III obese (n=19). Patients were retrospectively followed up for 6 months after undergoing TKR followed by 2 months of active rehabilitation. Outcome measures were recorded at baseline and at the 2‐month and 6‐month follow-up assessments and included the Western Ontario and McMaster Universities Osteoarthritis Index and the following tests: functional reach, single‐leg stance, ten‐meter walk, timed up and go, chair rise, and stair climbing.<strong></strong></p><p class="abstract"><strong>Results:</strong> A 4×3 (group×time) repeated‐measures analysis of variance showed significant improvement in all of the outcome measures for all of the BMI groups at the 2‐month and 6‐month follow-up assessments (p<0.05 for all). No significant intergroup differences at the 2‐month and 6‐month follow-up assessments were observed for any of the mobility measures except the functional reach and single‐leg stance (p<0.05).</p><p class="abstract"><strong>Conclusions:</strong> Patients with class II/III obesity benefit from early post‐TKR outpatient rehabilitation and respond well. Also, the patients with lower BMIs showed significant improvements and patients with a high BMI might require additional balance-based exercises in their post-TKR rehabilitation protocols.</p>
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Andersen, Høgni Hammershaimb, Marta Kramer Mikkelsen, Ida Lundager, Cecilia Margareta Lund, Julia Sidenius Johansen, Anders Vinther, Carsten Bogh Juhl, Bo Zerahn, Anne-Mette Ragle, and Dorte Lisbet Nielsen. "Exercise in older women with breast cancer during systemic therapy: study protocol of a randomised controlled trial (BREACE)." BMJ Open 10, no. 10 (October 2020): e038674. http://dx.doi.org/10.1136/bmjopen-2020-038674.
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IntroductionExercise interventions have been widely investigated in patients with cancer and demonstrate beneficial effects. However, intervention studies that include older women with breast cancer exercising during medical treatment are scarce. Hence, the aim of this study is to investigate the effect of a 12-week exercise-based intervention in older women (≥65 years) with breast cancer receiving (neo)adjuvant or first-line or second-line systemic therapy.Methods and analysisThis is a single-centre, two-armed randomised controlled trial. We anticipate including 100 patients, who will be randomised 1:1 to exercise-based intervention or control stratified by treatment setting ((neo)adjuvant or metastatic) and treatment (chemotherapy or endocrine therapy + cyclin-dependent kinase (CDK) 4/6 inhibitors). The intervention group will receive standard oncological treatment and a 12-week supervised exercise-based intervention comprising a progressive resistance exercise programme two times per week, a protein supplement after exercise and a home-based walking programme based on daily step counts. The control group will receive standard oncological treatment. Assessments will be performed at baseline and 6, 12 and 24 weeks after start of the intervention. Primary outcome is physical function, measured by the 30-second Chair Stand Test. Secondary outcomes are feasibility (compliance and adherence to intervention), objective and patient-reported functional measures (6-meter and 10-meter gait speed; 6-min Walk Test; Handgrip Strength; Stair Climb Test; Physical Activity Questionnaire), symptom burden and well-being (MD Anderson Symptom Inventory; Hospital Anxiety and Depression Scale), quality of life (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core-30 and B23), body composition (dual-energy X-ray absorptiometry scan), side effects, inflammatory biomarkers, hospitalisation and survival.Ethics and disseminationThe protocol was reviewed and accepted by the Scientific Ethics Review Committee of the Capital Region of Denmark, 17 June 2018 (VEK ref.: H-18021013). Trial results will be submitted for publication in a peer-reviewed journal and presented on conferences, in oncology wards, exercise centres in municipalities and patient organisations, ensuring dissemination to relevant stakeholders.Trial registration numberhttps://clinicaltrials.gov/ on 3 September 2018. Identifier: NCT03656731.
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Gasmallah, Safa Alturafi, Mohammed Nafi Mohammed Nafi, and Mustafa Etegani. "Direct Detection of Mycobacterium Tuberculosis in Sputum by Polymerase Chain Reaction and Zieh-Neelsen Stain." Indian Journal of Applied Research 4, no. 7 (October 1, 2011): 438–40. http://dx.doi.org/10.15373/2249555x/july2014/138.
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Moon, Hoi Ri, Cheol Ho Choi, and Myunghyun Paik Suh. "A Stair-Shaped Molecular Silver(0) Chain." Angewandte Chemie 120, no. 44 (October 20, 2008): 8518–21. http://dx.doi.org/10.1002/ange.200803465.
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Moon, Hoi Ri, Cheol Ho Choi, and Myunghyun Paik Suh. "A Stair-Shaped Molecular Silver(0) Chain." Angewandte Chemie International Edition 47, no. 44 (October 20, 2008): 8390–93. http://dx.doi.org/10.1002/anie.200803465.
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Ogura, Shinji, Masahiro Akimoto, Aki Sakurai, Chisako Ito, Yuriko Fujita, Yoshinobu Aisa, and Tomonori Nakazato. "The Clinical Impact of Modified Barthel Index in Elderly Patients over 60 Years with Diffuse Large B-Cell Lymphoma." Blood 134, Supplement_1 (November 13, 2019): 4119. http://dx.doi.org/10.1182/blood-2019-125573.
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[Introduction]Modified Barthel Index (MBI) is widely used to measure performance in activities in daily living (ADL), especially in elderly patients. MBI consists of 10 items: feeding, personal hygiene (grooming), bathing, dressing, toilet transfer, bladder control, bowel control, chair/bed transfers, stair climbing, and ambulation. A total score ranges from 0 to 20. MBI has been studied in several types of cancer which is correlated with prognosis. However, the prognostic role of MBI in diffuse large B-cell lymphoma is still unknown. The study aims to investigate the predictive role of MBI in elderly patients over 60 years with DLBCL. [Methods]This retrospective study included elderly DLBCL patients over 60 years treated at our institution between 2009 and 2018. MBI score of each patient was evaluated at diagnosis. Receiver operator characteristic (ROC) curve was used to generate a cut off value for MBI. Kaplan-Meier method and univariate, multivariate analysis by Cox proportional hazards model were performed to assess the prognostic influence of the factors including Stage, Revised International Prognostic Index score (R-IPI), Performance status (PS), Extra-nodal Site Involvement (ESI), Lactate Dehydrogenase (LDH), Soluble Interleukine-2Receptor (sIL-2R), Albumin, B symptoms and MBI. The study protocol was approved by the Institutional Review Board of Yokohama Municipal Citizen's Hospital, and it was carried out in accordance with the Declaration of Helsinki. [Results]A total of 187 patients were included in the analysis. There were 102 males and 85 females, with a median age of 77 (range: 61-93). The median follow-up time was 39 months. The optimal MBI cutoff value for predicting 3-year survival was determined by ROC analysis to be 14.Patients with low MBI scores (< 14) had significantly shorter overall survival (OS) than those with high MBI scores (≥ 14) (3-year OS, 14.2 % vs. 65.2 %, p < 0.001). Among 163 patients receiving chemotherapy, patients with low MBI scores had shorter OS than those with high MBI scores (3-year OS, 21.2 % vs. 66.4 %, p < 0.001). In multivariate analysis, parameters having independent adverse significance for OS were: Low MBI (< 14) (p < 0.001, HR 2.49), PS ( ≥ 2) (p=0.04, HR 1.84). [Conclusion]In the present study we demonstrated that Low MBI was deeply associated with poor outcome in elderly patients with DLBCL. In particular, our data proved that a low MBI is an independent prognostic factor for survival in elderly patients with DLBCL. These results suggest that Low MBI may have an important role in DLBCL and may be also a useful prognostic marker. Since our results are based on a small-sized analysis, further large prospective studies are warranted to verify this conclusion. Disclosures No relevant conflicts of interest to declare.
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Hax, Vanessa, Rafaela Cavalheiro do Espírito Santo, Leonardo Peterson dos Santos, Mirian Farinon, Marianne Schrader de Oliveira, Guilherme Levi Três, Andrese Aline Gasparin, et al. "Practical screening tools for sarcopenia in patients with systemic sclerosis." PLOS ONE 16, no. 1 (January 22, 2021): e0245683. http://dx.doi.org/10.1371/journal.pone.0245683.
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Introduction In view of the method of diagnosing sarcopenia being complex and considered to be difficult to introduce into routine practice, the European Working Group on Sarcopenia in Older People (EWGSOP) recommends the use of the SARC-F questionnaire as a way to introduce assessment and treatment of sarcopenia into clinical practice. Only recently, some studies have turned their attention to the presence of sarcopenia in systemic sclerosis (SSc).There is no data about performance of SARC-F and other screening tests for sarcopenia in this population. Objective To compare the accuracy of SARC-F, SARC-CalF, SARC-F+EBM, and Ishii test as screening tools for sarcopenia in patients with SSc. Methods Cross-sectional study of 94 patients with SSc assessed by clinical and physical evaluation. Sarcopenia was defined according to the revised 2019 EWGSOP diagnostic criteria (EWGSOP2) with assessments of dual-energy X-ray absorptiometry, handgrip strength, and short physical performance battery (SPPB). As case finding tools, SARC-F, SARC-CalF, SARC-F+EBM and Ishii test were applied, including data on calf circumference, body mass index, limitations in strength, walking ability, rising from a chair, stair climbing, and self reported number of falls in the last year. The screening tests were evaluated through receiver operating characteristic (ROC) curves. Standard measures of diagnostic accuracy were computed using the EWGSOP2 criteria as the gold standard for diagnosis of sarcopenia. Results Sarcopenia was identified in 15 (15.9%) patients with SSc by the EWGSOP2 criteria. Area under the ROC curve of SARC-F screening for sarcopenia was 0.588 (95% confidence interval (CI) 0.420–0.756, p = 0.283). The results of sensitivity, specificity, positive likelihood ratio (+LR), negative likelihood ratio (-LR) and diagnostic Odds Ratio (DOR) with the EWGSOP2 criteria as the gold standard were 40.0% (95% CI, 19.8–64.2), 81.0% (95% CI, 71.0–88.1), 2.11 (95% CI, 0.98–4.55), 0.74 (95% CI, 0.48–1.13) and 2.84 (95% CI, 0.88–9.22), respectively. SARC-CalF and SARC-F+EBM showed better sensitivity (53.3%, 95% CI 30.1–75.2 and 60.0%, 95% CI 35.7–80.2, respectively) and specificity (84.8%, 95% CI 75.3–91.1 and 86.1%, 95% CI 76.8–92.0, respectively) compared with SARC-F. The best sensitivity was obtained with the Ishii test (86.7%, 95% CI 62.1–96.3), at the expense of a small loss of specificity (73.4%, 95% CI 62.7–81.9). Comparing the ROC curves, SARC-F performed worse than SARC-CalF, SARC-F+EBM and Ishii test as a sarcopenia screening tool in this population (AUCs 0.588 vs. 0.718, 0.832, and 0.862, respectively). Direct comparisons between tests revealed differences only between SARC-F and Ishii test for sensitivity (p = 0.013) and AUC (p = 0.031). Conclusion SARC-CalF, SARC-F+EBM, and Ishii test performed better than SARC-F alone as screening tools for sarcopenia in patients with SSc. Considering diagnostic accuracy and feasibility aspects, SARC-F+EBM seems to be the most suitable screening tool to be adopted in routine care of patients with SSc.
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Dörfler, S., and Andrea Otto. "Friction Stir Welding of Light Weight Sandwich Materials." Advanced Materials Research 6-8 (May 2005): 607–14. http://dx.doi.org/10.4028/www.scientific.net/amr.6-8.607.
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Ever since its invention, friction stir welding has been of great interest for the joining of light weight materials. Due to joining in the solid state, friction stir welding inheres characteristic advantages that are unmatched by conventional fusion welding techniques. At the Chair of Manufacturing Technology friction stir welding is employed to develop a process chain for the production of highly load adapted car body components out of aluminum sheet metal and aluminum foam sandwich (AFS) by tailored blanking. In contrast to friction stir welding other materials, special measures have to be taken, since AFS comprises a layered material structure out of two solid aluminum sheet metal cover layers and a powder metallurgically produced core layer. After welding, the tailored blank is subjected to forming, foaming and a final laser cutting process. High temperature capability of the weld seam must be assured, hence foaming of the powder metallurgic core layer requires temperatures of up to 95% of core layer-solidus temperature. Therefore not only mechanical properties are revealed, but also temperature capability is assessed by differential scanning calorimetry (DSC). Additionally the weld seams are tested during foaming by the use of special specimen geometry. Due to the high deformation and temperature while welding and foaming, the metallurgical structure at the weld seam undergoes some modifications, which are subject to metallographic analysis and hardness testing. As an outlook, new material developments towards 6000 aluminum alloys as cover sheet materials will be discussed with regard to the process chain.
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Allegra, Giuseppe, Mario De Vitis, and Fabio Ganazzoli. "Chain collapse of star polymers." Die Makromolekulare Chemie, Theory and Simulations 2, no. 6 (November 1993): 829–49. http://dx.doi.org/10.1002/mats.1993.040020601.
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