Effects of abdominal binding on field-based exercise responses in Paralympic athletes with cervical spinal cord injury

Effects of abdominal binding on field-based exercise responses in Paralympic athletes with cervical spinal cord injury.

Christopher R. West, Ian G. Campbell, Victoria L. Goosey-Tolfrey, Barry S. Mason, Lee M. Romer

Abstract

Abdominal binding has been shown to improve resting cardiorespiratory function in individuals with

cervical SCI, but it is not yet clear whether this approach improves the exercise response.

Objectives: To determine the effects of abdominal binding on parameters relating to wheelchair sports performance in highly-trained athletes with cervical SCI.

Design: Repeated-measures field-based study.

Methods: Ten Paralympic wheelchair rugby players with motor-complete SCI (C5–C7) completed a series of exercise tests in two conditions (bound and unbound). The following parameters were assessed: agility and acceleration/deceleration performance; cardiorespiratory function and gross efficiency during submaximal wheelchair propulsion; anaerobic performance and propulsion kinematics during a 30s Wingate test; repeated sprint performance during a 10 × 20 m test; and aerobic performance during a repeated 4 min push test.

Results: Compared to unbound, 6 of 17 field-based performance measures changed significantly with binding. Time to complete the acceleration/deceleration test decreased (p = 0.005), whereas distances covered during the repeated 4 min push test increased (p < 0.043). Binding elicited significant reductions in minute ventilation during submaximal wheelchair propulsion (p = 0.040) as well as blood lactate accumulation and limb discomfort during the second set of the repeated 4 min push test (p = 0.012 and 0.022). There were no statistically significant effects of binding on any other variable.

Conclusions: Abdominal binding improves some important measures of field-based performance in highly-trained athletes with cervical SCI. The changes may be attributable, at least in part, to improvements in trunk stability, ventilatory efficiency and/or haemodynamics.

Source.

Obesity and the role of adipose tissue in inflammation and metabolism

Obesity and the role of adipose tissue in inflammation and metabolism

Andrew S Greenberg and Martin S Obin

Abstract

Recent discoveries, notably of the hormones leptin and adiponectin, have revised the notion that adipocytes are simply a storage depot for body energy. Instead, adipocytes are also endocrine organs, with multiple metabolic roles in regulating whole-body physiology. Small adipocytes in lean individuals promote metabolic homeostasis; the enlarged adipocytes of obese individuals recruit macrophages and promote inflammation and the release of a range of factors that predispose toward insulin resistance. Exercise activates the AMP-activated protein kinase (AMPK) in muscle and other tissues, a pathway that increases fat oxidation and glucose transport. Importantly, the adipocyte hormones leptin and adiponectin also activate AMPK; remarkably, the same pathway is activated by certain antidiabetic agents such as thiazolidinediones. Increasingly, our understanding of the adipocyte as an endocrine organ is leading to new insights into obesity and health.

The American Journal of Clinical Nutrition source.

Dietary patterns in relation to quality-adjusted life years

Dietary patterns in relation to quality-adjusted life years in the EPIC-NL cohort

Heidi P. Fransen, Joline W.J. Beulens, Anne M. May, Ellen A. Struijk, Jolanda M.A. Boer, G. Ardine de Wit, N. Charlotte Onland-Moret, Yvonne T. van der Schouw, H. Bas Bueno-de-Mesquit, Jeljer Hoekstr, Petra H.M. Peeters.

Abstract

Background

Dietary patterns have been associated with the incidence or mortality of individual non-communicable diseases, but their association with disease burden has received little attention.

Objective

The aim of our study was to relate dietary patterns to health expectancy using quality-adjusted life years (QALYs) as outcome parameter.

Methods

Data from the EPIC-NL study were used, a prospective cohort study of 33,066 healthy men and women aged 20-70 years at recruitment. A lifestyle questionnaire and a validated food frequency questionnaire were administered at study entry (1993-1997). Five dietary patterns were studied three a priori patterns (the modified Mediterranean Diet Score (mMDS), the WHO-based Healthy Diet Indicator (HDI) and the Dutch Healthy Diet index (DHD-index)) and two a posteriori data-based patterns. QALYs were used as a summary health measure for healthy life expectancy, combining a person’s life expectancy with a weight reflecting loss of quality of life associated with having chronic diseases.

Results

The mean QALYs of the participants were 74.9 (standard deviation 4.4). A higher mMDS and HDI were associated with a longer life in good health. Participants who had a high mMDS score (6-9) had 0.17 [95% CI 0.05;0.30] more QALYs than participants with a low score (0-3), equivalent to a two months longer life in good health. Participants with a high HDI score also had more QALYs (0.15 [95% CI 0.03; 0.27]) than participants with a low HDI score.

Conclusion

A Mediterranean-type diet and the Healthy Diet Indicator were associated with approximately 2 months longer life in good health.

ScienceDierct source.

Physical therapy is boring -- play a game instead

You’ve just been injured, and you’re on the way home from an hour of physical therapy. The last thing you want to do on your own is confusing exercises that take too long to show results. TED Fellow Cosmin Mihaiu demos a fun, cheap solution that turns boring physical therapy exercises into a video game with crystal-clear instructions.

http://www.mirarehab.com/

Educational tool: Medbullets.com

Medbullets.com is an educational resource for medical students designed to evolve and improve over time through the communal efforts of those who use it as a learning resource. It is a simple but powerful concept.

Our Beliefs

Medbullets.com is built on the following core beliefs:

• Medical education can be improved and made more efficient.
• With proper incentives and guidance, medical students and recent medical graduates can and will produce high-quality USMLE review content that benefits themselves and their peers.
• Physicians and physicians-in-training should be rewarded fairly for their publishing contribution.

Wheelchair rugby - athletes testing

Last Saturday we tested the physical and sport specific skills of our athletes in the Dutch Wheelchair Rugby Talent Selection Team with Tom Paulson. Great experience and nice results.

Posted by Testcentrum CASA Reade on Tuesday, 19 May 2015

Last Saturday we tested the physical and sport specific skills of our athletes in the Dutch Wheelchair Rugby Talent Selection Team with Tom Paulson. Great experience and nice results.

Posted by Testcentrum CASA Reade on Tuesday, 19 May 2015

BMI calculator wrongly labelling thousands as obese, research shows, plus BMI and Spinal Cord Injuries

The BMI calculator used in the public health system to measure obesity rates is highly flawed and could be slapping a false fat label on thousands of Australians, new research has highlighted.

A study into the size and shape of women aged 18-44 has found that almost one-third of participants were miscalculated as obese using the BMI calculator alone, highlighting the need for body measurements, percentage body fat and muscle mass to be introduced into testing.

Read the rest.

Your waist measurement compares closely with your body mass index (BMI), and is often seen as a better way of checking your risk of developing a chronic disease.

Read the rest.

Measuring the waist circumference in people with a SCI should be done in supine position.

Being overweight is a common problem for people with spinal cord injury (SCI). Some research shows that two out of three people with SCI are overweight. Excess weight gained after SCI is difficult to lose, and it is hard to maintain weight over time and avoid putting on extra pounds. In part this is due to a reduced ability to move freely. The higher the injury, the more difficult it is to move, stay active, and exercise. A person with a cervical SCI will have more difficulty moving compared to someone with SCI in the lower spine. The same is true for the completeness of an injury. A person with an incomplete injury who is able to walk will likely burn more calories than a person who has a complete injury and uses a wheelchair full time.

Read the rest.

A review of body mass index and waist circumference as markers of obesity and coronary heart disease risk in persons with chronic spinal cord injury.

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Waist circumference is the best index for obesity-related cardiovascular disease risk in individuals with spinal cord injury.

Read the rest.

Dietary Animal and Plant Protein and Human Bone Health: A Whole Foods Approach

Dietary Animal and Plant Protein and Human Bone Health: A Whole Foods Approach

Linda K. Massey

Urinary calcium excretion is strongly related to net renal acid excretion. The catabolism of dietary protein generates ammonium ion and sulfates from sulfur-containing amino acids. Bone citrate and carbonate are mobilized to neutralize these acids, so urinary calcium increases when dietary protein increases. Common plant proteins such as soy, corn, wheat and rice have similar total S per g of protein as eggs, milk and muscle from meat, poultry and fish. Therefore increasing intake of purified proteins from either animal or plant sources similarly increases urinary calcium. The effects of a protein on urinary calcium and bone metabolism are modified by other nutrients found in that protein food source.

For example, the high amount of calcium in milk compensates for urinary calcium losses generated by milk protein. Similarly, the high potassium levels of plant protein foods, such as legumes and grains, will decrease urinary calcium. The hypocalciuric effect of the high phosphate associated with the amino acids of meat at least partially offsets the hypercalciuric effect of the protein. Other food and dietary constituents such as vitamin D, isoflavones in soy, caffeine and added salt also have effects on bone health. Many of these other components are considered in the potential renal acid load of a food or diet, which predicts its effect on urinary acid and thus calcium. “Excess” dietary protein from either animal or plant proteins may be detrimental to bone health, but its effect will be modified by other nutrients in the food and total diet.

The Journal of Nutrition source.

Association between being overweight and health related quality of life

The associations between overweight, weight change and health related quality of life: Longitudinal data from the Stockholm Public Health Cohort 2002–2010

N. Döring, J. de Munter, F. Rasmussen.

Abstract

Objective

Cross-sectional studies have shown that people with obesity and overweight report lower health related quality of life (HRQoL). With a lack of longitudinal studies, this study aims to assess the association between eight-year weight change and HRQoL measured by the EQ-5D instrument and to investigate whether the association differs with regard to baseline body mass index (BMI).

Method

A population-based survey was conducted among a random sample of 31,182 individuals from Stockholm County aged 18–84 years in 2002 and reassessed in 2010 and supplemented by record linkage with regional and national registers. Multivariate Poisson regression and linear regression were conducted with adjustments for socio-demographic and health-related variables and baseline BMI category as effect modifier for the association between weight change and HRQoL.

Results

Individuals with overweight and obesity respectively have 0.014 and 0.039 lower EQ-5D indexes compared to those being normal weight. Over the eight-year follow-up, 17.6% gained moderately (≥ 5% body weight) and 13.9% gained heavily (≥ 10% body weight) in weight. In the fully adjusted analysis, heavy weight gain was associated with a significantly lower overall EQ-5D index and an increased risk of reporting impairment in all but one EQ-5D dimensions irrespective of baseline BMI category. Weight reduction had no significant preventive effect.

Conclusion

Next to obesity status itself, weight gain leads to impairment in HRQoL irrespective of BMI category at baseline while eight year weight loss seems not to have the reversed effect on HRQoL, emphasizing the importance of primary prevention of weight gain.

ScienceDirect Source

Pilates exercise for elderly

The effects of Pilates exercise training on physical fitness and wellbeing in the elderly: A systematic review for future exercise prescription.

V. Bulloa, M. Bergamina, S. Gobboa, J.C. Sieverdesb, M. Zaccariaa, D. Neunhaeuserera, A. Ermolaoa

Abstract

This systematic review aims to summarize the effects of Pilates exercise training (PET) in elderly population on physical fitness, balance and fall prevention, and its effects on mood states, quality of life and independence in the daily living activities.

Methods

Keyword “Pilates” associated with “elderly”, “aging” and “old subjects” were identified as terms for the literature research in MEDLINE, Embase, PubMed, Scopus, PsycINFO and SPORTDiscus. Only studies published in peer-reviewed journals written in English language were considered. A meta-analysis was performed and effect sizes (ES) calculated.

Results

10 studies were identified (6 RCTs and 4 uncontrolled trials); age ranged from 60 to 80 years. Overall, PET showed large ES to improve muscle strength (ES = 1.23), walking and gait performances (ES = 1.39), activities of daily living, mood states and quality of life (ES = 0.94), moderate to high effect on dynamic balance (ES = 0.77), small effects on static balance (ES = 0.34) and flexibility (ES = 0.31), while a small effect on cardio-metabolic outcomes (ES = 0.07).

Conclusions

PET should be taken into account as a way to improve quality of life in the elderly, due to the imparted benefits of fall prevention, physical fitness, and mood states. In this context, physicians might include PET as a tool for exercise prescriptions for the elderly.

ScienceDirect Source