Postural Strategy and Back Muscle Oxygenation During Inspiratory Muscle Loading.

Postural Strategy and Back Muscle Oxygenation During Inspiratory Muscle Loading.

Med Sci Sports Exerc. 2013 Mar 6;
Janssens L, Pijnenburg M, Claeys K, McConnell A, Troosters T, Brumagne S

PURPOSE: Most healthy individuals show a multi-segmental control strategy during challenging standing conditions, whereas others show a rigid ankle-steered strategy which is assumed as suboptimal. Respiratory demanding tasks exert a perturbing effect on balance, although the underlying mechanisms remain poorly understood. The purpose of this study was to investigate whether inspiratory resistive loading (IRL) affects postural strategy, back muscle oxygenation and blood volume during postural control. METHODS: We assessed the acute effects of increased respiratory effort by measuring center of pressure displacement in 12 healthy individuals during upright standing on an unstable support surface, whilst breathing against an IRL. Simultaneous ankle and back muscle vibration was used to evaluate the proprioceptive strategy (multi-segmental versus ankle-steered) during postural control. Back muscles oxygenation and blood volume were assessed using near-infrared spectroscopy (NIRS) (tissue oxygenation index (TOI), deoxyhaemoglobin (HHb), oxyhaemoglobin (O2Hb) and combined haemoglobin (cHb)). RESULTS: An increased proprioceptive gain at the ankles and decreased gain at the back was observed after ~7 minutes of IRL. Retrospectively, the group was subdivided based on participants’ dominant proprioceptive use during baseline postural control. During IRL the anklesteered group showed an increased reliance on ankle proprioception, compared to a multisegmental group (-5.9±3.1cm and 1.0±1.9cm, respectively, p< 0.05). TOI, HHb, O2Hb and cHb declined progressively in the ankle-steered group during the IRL (from baseline (100%) to -1%, -1%, -45% and -18% respectively, p< 0.05), whereas no decline was found in the multisegmental group (from baseline (100%) to 134%, 82%, 129% and 153%, respectively, p> 0.05). CONCLUSIONS: Individuals who adopted an ankle-steered strategy during IRL showed a progressive decline in back muscle oxygenation and blood volume. In contrast, IRL did not affect back muscle oxygenation and blood volume in individuals who showed a multi-segmental strategy in upright standing. HubMed – rehab


Low-Volume, High-intensity Interval Training in Patients with Coronary Artery Disease.

Med Sci Sports Exerc. 2013 Mar 6;
Currie KD, Dubberley JB, McKelvie RS, Macdonald MJ

Purpose: Isocaloric interval exercise training programs have been shown to elicit improvements in numerous physiological indices in patients with coronary artery disease (CAD). Low-volume high-intensity interval exercise training (HIT) is effective in healthy populations; however its effectiveness in cardiac rehabilitation has not been established. This study compared the effects of 12-weeks of HIT, and higher-volume moderate-intensity endurance exercise (END), on brachial artery flow-mediated dilation (FMD) and cardiorespiratory fitness (VO2peak) in patients with CAD. Methods: Twenty-two patients with documented CAD were randomized into HIT (n=11) or END (n=11) based on pre-training FMD. Both groups attended 2 supervised sessions per week for 12-weeks. END performed 30-50 minutes of continuous cycling at 58% peak power output (PPO), while HIT performed 10, 1-minute intervals at 89% PPO separated by 1-minute intervals at 10% PPO per session. Results: Relative FMD was increased post-training (END: 4.4 ± 2.6% vs. 5.9 ± 3.6%; HIT: 4.6 ± 3.6% vs. 6.1 ± 3.4%, p?0.001 pre- vs. post-training) with no differences between groups. A training effect was also observed for relative VO (END: 18.7 ± 5.7 ml·kg·min vs. 22.3 ± 6.1 ml·kg·min; HIT: 19.8 ± 3.7 ml·kg·min vs. 24.5 ± 4.5 ml·kg·min, p<0.001 for pre- vs. post-training), with no group differences. Conclusions: Low-volume high-intensity interval exercise training provides an alternative to the current, more time intensive prescription for cardiac rehabilitation. HIT elicited similar improvements in fitness and FMD as END, despite differences in exercise duration and intensity. HubMed – rehab


Evaluation of mean platelet volume (MPV) levels in patients with synovitis associated with knee osteoarthritis.

Platelets. 2013 Mar 7;
Balbaloglu O, Korkmaz M, Yolcu S, Karaaslan F, Beceren NG

Platelet count, C-reactive protein (CRP) and neutrophile countings are markers those reflect the inflammatory response. Mean platelet volume (MPV) is a simple indicator of platelet size and has been known to be a marker of platelet activity. Some platelet markers, including MPV, have been investigated to have relation with inflammation. MPV is inversely correlated with inflammation in inflammatory bowel diseases, rheumatoid arthritis, and ankylosing spondylitis, as shown in the previous studies. In this study, we aimed to investigate the levels of MPV in patients with synovitis of knee osteoarthritis. 147 patients diagnosed with synovitis associated to osteoarthritis, 191 patients with knee osteoarthritis, and 121 patients between the same age range who did not have joint complaints (control group), totally 459 participants were included to our study. MPV results of these groups were compared. We found a significant difference between the patient group with synovitis associated with osteoarthritis of knee and patients with knee osteoarthritis in MPV blood level (p?HubMed – rehab


[Usefulness of preemptive anticoagulation in patients with suspected pulmonary embolism].

Rev Med Suisse. 2013 Feb 6; 9(372): 306-8, 310
Blondon M, Le Gal G, Aujesky D, Righini M, Perrier A

The usefulness of anticoagulation in patients with suspected non-massive pulmonary embolism (PE) is uncertain. We recently published a decision analysis model suggesting a benefit for preemptive anticoagulation in patients with an intermediate or high probability of PE, even with short diagnostic delays (0-3 h). In case of a low probability of PE, the decision to treat or not could partly rely on the expected diagnostic delay. Once the diagnosis is confirmed, achieving rapidly therapeutic anticoagulation levels decreases future thrombotic complications. HubMed – rehab