Frontal Plane Instability Following Rapid Voluntary Stepping: Effects of Age and a Concurrent Cognitive Task.

Frontal Plane Instability Following Rapid Voluntary Stepping: Effects of Age and a Concurrent Cognitive Task.

J Gerontol A Biol Sci Med Sci. 2013 May 16;
Kurz I, Berezowski E, Melzer I

BACKGROUND: Quick step execution may prevent falls when balance is lost. Lateral steps often emerge as a consequence of frontal plane instability arising after the first rapid step. In this study, we suggest a new analysis, focusing on the variability of the frontal plane fluctuations of center of pressure (CoP), that is, mediolateral instability, and their changes over time during and immediately following rapid voluntary stepping in older and younger adults in single- and dual-task conditions. This may be useful in understanding age-related alterations in the locomotor control system. METHODS: Seventeen older adults, who live independently in the community, and 16 younger adults performed rapid forward voluntary stepping under single- and dual-task conditions. The average mediolateral CoP fluctuations, that is, the average distance the CoP travels from side to side in the frontal plane over time, standard deviation, and the coefficient of variation of mediolateral CoP fluctuation were extracted and calculated from CoP data during and immediately following rapid voluntary stepping using a force plate. RESULTS: We found an age-related increase in the coefficient of variation that represents the variability of frontal plane fluctuations and no significant differences in the average and standard deviations of frontal plane fluctuations. Cognitive task had no influence on measures of frontal plane fluctuations in both age groups. CONCLUSION: The study showed frontal plane instability during and immediately following rapid stepping in older persons. This may be a factor contributing to lateral balance loss and the large number of lateral falls seen in the older population. HubMed – rehab


Effect of Dietary Restriction and Exercise on Lower Extremity Tissue Compartments in Obese, Older Women: A Pilot Study.

J Gerontol A Biol Sci Med Sci. 2013 May 16;
Manini TM, Buford TW, Lott DJ, Vandenborne K, Daniels MJ, Knaggs JD, Patel H, Pahor M, Perri MG, Anton SD

BACKGROUND: Accumulating evidence suggests that both dietary restriction and exercise (DR + E) should be incorporated in weight loss interventions to treat obese, older adults. However, more information is needed on the effects to lower extremity tissue composition-an important consideration for preserving mobility in older adults. METHODS: Twenty-seven sedentary women (body mass index: 36.3±5.4kg/m(2); age: 63.6±5.6 yrs) were randomly assigned to 6 months of DR + E or a health education control group. Thigh and calf muscle, subcutaneous adipose tissue (SAT), and intermuscular adipose tissue (IMAT) size were determined using magnetic resonance imaging. Physical function was measured using a long-distance corridor walk and knee extension strength. RESULTS: Compared with control, DR + E significantly reduced body mass (-6.6±3.7kg vs. control: -0.05±3.5kg; p < .01). Thigh and calf muscle volumes responded similarly between groups. Within the DR + E group, adipose tissue was reduced more in the thigh than in the calf (p < .04). Knee extension strength was unaltered by DR + E, but a trend toward increased walking speed was observed in the DR + E group (p = .09). Post hoc analyses showed that reductions in SAT and IMAT within the calf, but not the thigh, were associated with faster walking speed achieved with DR + E (SAT: r = -0.62; p = .01; IMAT: r = -0.62; p = .01). CONCLUSIONS: DR + E preserved lower extremity muscle size and function and reduced regional lower extremity adipose tissue. Although the magnitude of reduction in adipose tissue was greater in the thigh than the calf region, post hoc analyses demonstrated that reductions in calf SAT and IMAT were associated with positive adaptations in physical function. HubMed – rehab


Exploring positive adjustment in people with spinal cord injury.

J Health Psychol. 2013 May 16;
Dibb B, Ellis-Hill C, Donovan-Hall M, Burridge JH, Rushton D

This study explored adjustment in people with spinal cord injury; data from four focus groups are presented. Thematic analysis revealed four themes, managing goals and expectations, comparison with others, feeling useful and acceptance, showing participants positively engaged in life, positively interpreted social comparison information and set realistic goals and expectations. These positive strategies show support for adjustment theories, such as the Cognitive Adaptation Theory, the Control Process Theory and Response Shift Theory. These results also provide insight into the adjustment process of a person with spinal cord injury and may be useful in tailoring support during rehabilitation. HubMed – rehab


The 6-minute walk test and other endpoints in Duchenne muscular dystrophy: Longitudinal natural history observations over 48 weeks from a multicenter study.

Muscle Nerve. 2013 May 16;
McDonald CM, Henricson EK, Abresch RT, Florence J, Eagle M, Gappmaier E, Glanzman AM, , Spiegel R, Barth J, Elfring G, Reha A, Peltz S

Introduction: Duchenne muscular dystrophy (DMD) subjects ?5 years with nonsense mutations were followed for 48 weeks in a multicenter, randomized, double-blind, placebo-controlled trial of ataluren. Placebo arm data (N=57) provide insight into the natural history of the 6-minute walk test (6MWT) and other endpoints. Methods: Evaluations performed every 6 weeks included the 6 minute walk distance (6MWD), timed function tests (TFTs), and quantitative strength using hand-held myometry. Results: Baseline age (?7 years), 6MWD, and selected TFT performance, are strong predictors of decline in ambulation (? 6MWD) and time to 10% worsening in 6MWD. A baseline 6MWD of <350 meters was associated with greater functional decline, and loss of ambulation was only seen in those with baseline 6MWD <325 meters. Only 1/42 (2.3%) subjects able to stand from supine lost ambulation. Discussion: Findings confirm the clinical meaningfulness of the 6MWD as the most accepted primary clinical endpoint in ambulatory DMD trials. © 2013 Wiley Periodicals, Inc. HubMed – rehab


Testing for boosting at the paralympic games: policies, results and future directions.

Br J Sports Med. 2013 May 16;
Blauwet CA, Benjamin-Laing H, Stomphorst J, Van de Vliet P, Pit-Grosheide P, Willick SE

BACKGROUND: ‘Boosting’ is defined as the intentional induction of autonomic dysreflexia (AD) by athletes with a spinal cord injury (SCI) at or above the level of T6 for the purpose of improving sports performance. Boosting has been shown to confer up to a 9.7% improvement in race time. Additionally, to compete in a hazardous dysreflexic state, whether intentional or unintentional, would present an extreme health risk to the athlete. For these reasons, the International Paralympic Committee strictly bans the practice of boosting, and has developed a protocol to test for its presence. METHODS: Testing was performed at three major international Paralympic events. Education regarding the dangers of AD was provided to athletes and team staff. Testing was conducted on athletes from the relevant sport classes: Athletics (wheelchair racing classes T51/T52/T53) and Handcycling (H1). Key parameters included the athlete’s demographics (gender, country of origin), classification and blood pressure measurements. An extremely elevated blood pressure was considered to be a proxy maker for AD, and a systolic blood pressure of ?180 mm Hg was considered a positive test. RESULTS: A total of 78 tests for the presence of AD were performed during the three games combined. No athlete tested positive. The number of athletes tested, by classification, was: 6 in Athletics T51, 47 in Athletics T52, 9 in Athletics T53 and 16 in Handcycling H1. Of those tested, the average systolic and diastolic blood pressures were 135 mm Hg (range 98-178) and 82 mm Hg (range 44-112), respectively. All athletes were compliant with testing. No athletes were withdrawn from competition due to the presence of AD. DISCUSSION: Testing for the presence of AD in paralympic athletes with SCI prior to competition has been carried out for the first time at three major international paralympic competitions. There have been no positive tests thus far. Knowledge gained during these early testing experiences will be used to guide ongoing refinement of the testing protocol and the development of further educational initiatives. HubMed – rehab



?????? – ?????? Structured settlements Mesothelioma Acne Life Insurance Asbestos Bextra Bankruptcy Car Insurance Dental Plans Private Jets Debt Consolidation Credit C…