Volitional Pursed Lips Breathing in Patients With Stable Chronic Obstructive Pulmonary Disease Improves Exercise Capacity.

Volitional pursed lips breathing in patients with stable chronic obstructive pulmonary disease improves exercise capacity.

Filed under: Rehab Centers

Chron Respir Dis. 2012 Nov 13;
Bhatt SP, Luqman-Arafath TK, Gupta AK, Mohan A, Stoltzfus JC, Dey T, Nanda S, Guleria R

Pursed lips breathing (PLB) is used by a proportion of patients with chronic obstructive pulmonary disease (COPD) to alleviate dyspnea. It is also commonly used in pulmonary rehabilitation. Data to support its use in patients who do not spontaneously adopt PLB are limited. We performed this study to assess the acute effects of PLB on exercise capacity in nonspontaneously PLB patients with stable COPD. We performed a randomized crossover study comparing 6-min walk test (6MWT) at baseline without PLB with 6WMT using volitional PLB. Spirometry, maximal inspiratory and expiratory mouth pressures, and diaphragmatic excursion during tidal and vital capacity breathing using B-mode ultrasonography were measured at baseline and after 10 min of PLB. A Visual Analog Scale (VAS) assessed subjective breathlessness at rest, after 6MWT and after 6MWT with PLB. p ? 0.01 was considered significant. Mean ± SD age of patients was 53.1 ± 7.4 years. Forced expiratory volume in 1second was 1.1 ± 0.4 L/min (38.4 ± 13.2% predicted). Compared with spontaneous breathing, all but one patient with PLB showed a significant increment in 6MW distance (+34.9 ± 26.4 m; p = 0.002). There was a significant reduction in respiratory rate post 6MWT with PLB compared with spontaneous breathing (-4.4 ± 2.8 per minute; p = 0.003). There was no difference in VAS scores. There was a significant correlation between improvement in 6MWT distance and increase in diaphragmatic excursion during forced breathing. The improvement was greater in patients who had poorer baseline exercise performance. PLB has an acute benefit on exercise capacity. Sustained PLB or short bursts of PLB may improve exercise capacity in stable COPD.
HubMed – rehab

Effectiveness of intra-articular hyaluronic acid for ankle osteoarthritis treatment- a systematic review and meta-analysis.

Filed under: Rehab Centers

Arch Phys Med Rehabil. 2012 Nov 10;
Chang KV, Hsiao MY, Chen WS, Wang TG, Chien KL

OBJECTIVE: s: To explore the effectiveness and safety of hyaluronic acid (HA) administration for ankle osteoarthritis (OA) and to investigate the effects of variations in HA regimens on treatment responses. DATA SOURCES: Electronic databases including PubMed and Scopus were searched from January 1995 to June 2012. STUDY SELECTION: We included randomized controlled trials or prospective cohort studies that employed intra-articular HA to treat ankle OA. Four randomized controlled trials, one comparative and four single arm prospective studies were identified, comprising 354 PARTICIPANTS: Data extraction: We determined effect sizes for selected studies by extracting pain scores from ankle OA or visual analogue scales before and after HA or reference treatments. Meta-regression was implemented to determine whether outcomes were modified by variations in HA regimens. DATA SYNTHESIS: The pooled effect size of improvement scores from baseline was 2.01 (95% CI, 1.27-2.75), whereas the values of comparisons with reference treatments including saline, exercise and arthroscopy reduced to 0.85 (95% CI, -0.13 to 1.83). The placebo effect of the injection procedure accounted for 87% of the observed efficacy of HA treatment. The meta-regression indicated that the molecular weight was not associated with the magnitude of pain relief, but increases in total doses and 39 active ingredients administered might result in better outcome. Conversely, increases in injection volumes might cause a reduction of effect sizes. Regarding the side effects, the use of extremely high molecular weight HA frequently caused early post-injection pain. CONCLUSION: Intra-articular HA administration can significantly reduce pain in ankle OA compared with the condition before treatment, and is likely superior to reference therapy. We recommend using multiple doses with an appropriate injection volume to achieve maximum effectiveness.
HubMed – rehab

Community Participation Measures for People with Disabilities: A Systematic Review of Content from an ICF perspective.

Filed under: Rehab Centers

Arch Phys Med Rehabil. 2012 Nov 10;
Chang FH, Coster WJ, Helfrich CA

OBJECTIVE: To identify instruments that measure community participation in people with disabilities and to evaluate which domains, to what extent, and how precisely they address this construct. The review aims to provide information to guide selection of community participation instruments and to identify limitations of existing measures. DATA SOURCES: A systematic search was performed in PubMed, CINHAL and PsychINFO in February and March 2012. The latest systematic reviews and references of searched articles were also reviewed to check for measures that were not identified in the initial search. STUDY SELECTION: Instruments were included if they: 1) were a self-report questionnaire; 2) measured community participation, participation, or community integration; 3) measured actual participation (rather than subjective experience); 4) had available information on the instrument content and measurement properties; 5) were designed for adults; 6) were applicable for all disabled populations. DATA EXTRACTION: Instruments were obtained from identified full-text articles, reference lists or websites. Two researchers independently reviewed each selected instrument to determine which of their items measure community participation. These items were then classified using nine community participation domains from the ICF to reflect each instrument’s domain coverage. DATA SYNTHESIS: 17 instruments were identified as containing community participation items, two of which were 100% comprised of community participation items. The rest of the instruments included 8.7% to 73.1% items measuring community participation. The domain coverage varied from 3 to 8 domains across the instruments. CONCLUSIONS: None of the 17 instruments covered the full breadth of community participation domains, but each addressed community participation to some extent. New instruments that evaluate community participation more comprehensively will be needed in the future.
HubMed – rehab

Physical strain of walking relates to activity level in adults with cerebral palsy.

Filed under: Rehab Centers

Arch Phys Med Rehabil. 2012 Nov 10;
Slaman J, Bussmann J, van der Slot WM, Stam HJ, Roebroeck ME, van den Berg-Emons RJ

OBJECTIVE: To gain insight into underlying mechanisms of inactive lifestyles among adults with spastic bilateral CP with a focus on aerobic capacity, oxygen consumption, and physical strain during walking at preferred walking speed, as well as fatigue. DESIGN: Cross sectional SETTING: University hospital PARTICIPANTS: Thirty-six adults, aged 25-45 years, with spastic bilateral cerebral palsy, walking with (n=6) or without, (n=30) walking aids. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Physical strain during walking was defined as oxygen uptake during walking, expressed as percentage of peak aerobic capacity. Participants with spastic bilateral CP walked their preferred walking speed while oxygen uptake was measured using a portable gas analyzer. Peak aerobic capacity was measured during maximal cycle ergometry. An accelerometry-based Activity Monitor measured total daily walking time. Regression analyses were performed to assess the relation between aerobic capacity, oxygen uptake and physical strain of walking on the one hand and total daily walking time on the other hand. RESULTS: Neither aerobic capacity nor oxygen uptake during walking was related to total daily walking time (r2=0.29, p=0.10 and r2=0.27, p=0.16). Physical strain of walking at preferred walking speed was inversely related to total daily walking time (r2=0.44, p<0.01). CONCLUSION: Physical strain during walking is moderately related to total daily walking time, implying that people with high physical strain during walking at preferred walking speed likely walk less in daily life. HubMed – rehab

Demi Moore Checks Into Rehab – The actress has reportedly check into Cirque Lodge rehab center in Utah after being hospitalized for seizure-like symptoms. DEMI MOORE HAS REPORTEDLY TAKEN THE NEXT STEP IN THE HEALING PROCESS, AND CHECKED INTO THE RITZ OF REHAB CENTERS…CIRCQUE LODGE IN UTAH. A SOURCE TELLS E ONLINE, DEMI ENTERED THE TREATMENT CENTER AFTER BEING HOSPITALIZED FOR SEIZURE-LIKE SYMPTOMS. “She’s on total lockdown and only talking to a small group of people,” THE SOURCE SAYS, ADDING THAT THE 49-YEAR-OLD IS BEING TREATED FOR BOTH SUBSTANCE ABUSE AND AN EATING DISORDER CIRQUE LODGE HAS A HISTORY OF CELEB CLIENTELE INCLUDING LINDSAY LOHAN AND MARY KATE OLSEN. DAYS AFTER HER HOSPITALIZATION DEMI REPORTEDLY GATHERED HER BELONGINGS AND SECRETLY LEFT FOR UTAH. THE SOURCE SAID It became clear to her that her way of coping with her stress was not working and she needed more help DESPITE EARLIER REPORTS THAT DEMI’S EXES BRUCE WILLIS AND ASHTON KUTCHER VISITED HER AT HER LOS ANGELES HOME THIS WEEK…,THE ACTRESS HAS BEEN IN UTAH THE ENTIRE TIME.

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