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.

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.

Read the rest.

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

Is it time to put electrophysical agents back in the physical therapy toolbox?

It’s time to smash the myths about electrophysical agents (EPAs) and put them back in the physical therapy toolbox where they belong. That will be the message from one of the profession’s leading names in EPA research, in an agenda-setting session at the WCPT Congress in May.

Here is also another beatiful website on electrotherapy.

American Cancer Society Guidelines on Nutrition and Physical Activity for Cancer Prevention

American Cancer Society Guidelines on Nutrition and Physical Activity for Cancer Prevention.

ACS Guidelines on Nutrition and Physical Activity for Cancer Prevention

Download Printable Version [PDF]

Full details of the ACS guidelines ranging from whole grains, fats, alcohol, and daily goals for exercise—to the lifestyle changes that may help prevent breast, colon and other specific cancers.

• American Cancer Society Guidelines on Nutrition and Physical Activity for Cancer Prevention
• Summary of the ACS Guidelines on Nutrition and Physical Activity
• ACS Guidelines for Nutrition and Physical Activity
• Food additives, safety, and organic foods
• Diet and activity factors that affect risks for certain cancers
• Common questions about diet and cancer

Exercise interventions on health-related quality of life for people with cancer during active treatment

Exercise interventions on health-related quality of life for people with cancer during active treatment.

Mishra SI1, Scherer RW, Snyder C, Geigle PM, Berlanstein DR, Topaloglu O.

Cochrane Database Syst Rev. 2012 Aug 15;8:CD008465. doi: 10.1002/14651858.CD008465.pub2.

Spinal Cord Injury Rehabilitation Evidence

• Over 3500 articles reviewed
• 1400+ articles rated
• 107 Outcome Measures assessed (Download for Free)
• 80+ researchers, clinicians and trainees from 5 different countries involved in updating the key topic areas in SCIRE, including New Chapters on Economic Evaluation of Spinal Cord Injury and Sexual and Reproductive Health and SCI

http://www.scireproject.com/

Clinical Epidemiology and Biostatistics

A wonderful article that explains briefly and simply the terms that every health professional should know either in the clinical or in the laboratory setting on Clinical Epidemiology and Biostatistics

Clinical Epidemiology and Biostatistics: A Primer for Orthopaedic Surgeons

BY MININDER S. KOCHER, MD, MPH, AND DAVID ZURAKOWSKI, PHD

Investigation performed at Harvard Medical School, Harvard School of Public Health, Boston, Massachusetts

COPYRIGHT © 2004 BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED

Physiopedia: open access research

More and more research is being brought out from behind cost ineffective paywalls and being made available at low cost or for free. Open access journals make it easy for us to access new research and are listed below:

http://www.physio-pedia.com/Open_Access_Research

Physiotherapy in the Intensive Care Unit

Physiotherapy in the Intensive Care Unit

R Gosselink, B Clerckx, C Robbeets, T Vanhullebusch, G Vanpee, J Segers

Netherlands Journal of Critical Care

Abstract: Physiotherapists are involved in the management of patients with critical illness. Physiotherapy assessment is focused on physical deconditioning and related problems (muscle weakness, joint stiffness, impaired functional exercise capacity, physical inactivity) and respiratory conditions (retained airway secretions, atelectasis and respiratory muscle weakness) to identify targets for physiotherapy. Evidence-based targets for physiotherapy are deconditioning, impaired airway clearance, atelectasis, (re-)intubation avoidance and weaning failure. Early physical activity and mobilisation are essential in the prevention, attenuation or reversion of physical deconditioning related to critical illness. A variety of modalities for exercise training and early mobility are evidence-based and must be implemented depending on the stage of critical illness, co-morbid conditions and cooperation of the patient. The physiotherapist should be responsible for implementing mobilization plans and exercise prescription and make recommendations for progression of these plans, jointly with medical and nursing staff.

Physical Therapy EBP videos, advices, ideas - Physical Therapy Nation

Physical Therapy Nation is platform which facilitates the sharing of evidence based information worldwide among both physical therapy students and active clinicians. PT Nation is also a completely free evidence based video database of over 1,000 internally filmed videos. The video library is free to all student PTs and licensed clinicians. It includes instruction covering manual therapy techniques, examinations, special tests, and many specialty areas like vestibular therapy and orthotic casting and fabrication.

The goal of Physical Therapy Nation is to promote, enhance, and move the profession of PT forward by providing a free video focused resource to all clinicians.

www.PhysicalTherapyNation.com

European Multicenter Study about Spinal Cord Injury

EMSC is an internationally recognized and scientifically successful clinical spinal cord injury network.

Aim: Establishing a multi-center basis for future therapeutic interventions in human spinal cord injury.

Balgrist Spinal Cord Injury Center

The Spinal Cord Injury Center at the Balgrist University Hospital is an internationally acknowledged rehabilitation center for patients with spinal cord injury (SCI). It comprises a 40 beds clinical unit and is linked excellently with its research facilities, located in the same building.

The focus of our research is the optimization and further development of existing and new interventions for patients with a spinal cord injury (SCI). Patients with SCI report that their priorities for recovery are bladder and bowel management and hand function in patients with high cervical lesions. Both also the recovery of walking function is highly appreciated. Indeed, besides other interests, these topics are covered by our research groups.

Our research is in general focussed on how the central nervous system reacts to the condition after SCI by investigating plastic changes in the sensory – motor and autonomic nervous system within the brain and spinal cord. Furthermore, we are interested how training interventions could exploit this plasticity to improve the functional outcome and independence of the patient. One focus of our lab is, in collaboration with the SMS Lab (ETHZ) and Hocoma AG, to develop and/or improve rehabilitation robotics for the upper and lower extremity and investigate their effect on the functional independence of our patients. We are also involved in clinical studies investigating safety of the anti-NOGO antibody, which should increase plasticity and regeneration of the damaged spinal cord (more information).

Improvement in training strategies can only be performed if adequate and sensitive outcome measures are available. Therefore, we develop and test the ability of neurological, neuro-physiological and functional outcome measures to detect small changes in our patients, which is required for clinical studies, but also the relevance of these changes for the functional status of the patient. Indeed, we are the leading center in an international collaboration evaluating outcome measures (www.emsci.org).

Stroke Engine

Welcome to Stroke Engine, a site for individuals who have experienced stroke, their families and health professionals who work in the field of stroke rehabilitation. Stroke Engine has been developed with the support of the Canadian Stroke Network to support the use of evidence-based stroke rehabilitation in clinical practice. Stroke Engine is recognized for its scientific rigor by the Canadian Cochrane Center. We receive over 300,000 visitors each year including clinicians, researchers, academics, teachers, students, patients with stroke and their family/friends.

Physiotherapyjournal.com

Physiotherapy aims to publish original research and facilitate continuing professional development for physiotherapists and other health professions worldwide. Dedicated to the advancement of physiotherapy through publication of research and scholarly work concerned with, but not limited to, its scientific basis and clinical application, education of practitioners, management of services and policy. 

We are pleased to receive articles reporting original scientific research, systematic reviews or meta-analyses, theoretical or debate articles, brief reports and technical reports. All papers should demonstrate methodological rigour. 

In Practice 2025: what will future physiotherapy practice look like?

The Australian Physiotherapy Association engaged Nous Group to collaboratively explore the question: What will the Practice of the Future look like in 2025?

In commissioning this project, the APA sought to:

provide members with insights to guide individual practice development and strategic planning inform the APA’s strategic priorities and actions to achieve its future vision shape professional development programs that enable future growth of the profession.

Understanding research study designs

In order to find the best possible evidence, it helps to understand the basic designs of research studies. The following basic definitions and examples of clinical research designs follow the “levels of evidence.”