Changes in Pulmonary Function During the Early Years After Inpatient Rehabilitation in Persons With Spinal Cord Injury: A Prospective Cohort Study.
Changes in pulmonary function during the early years after inpatient rehabilitation in persons with spinal cord injury: A prospective cohort study.
Filed under: Rehab Centers
Arch Phys Med Rehabil. 2013 Feb 14;
Postma K, Haisma JA, de Groot S, Hopman MT, Bergen MP, Stam HJ, Bussmann JB
OBJECTIVE: To describe changes in pulmonary function (PF) during the 5 years after inpatient rehabilitation in persons with spinal cord injury (SCI) and to study potential determinants of change. DESIGN: Prospective cohort study. SETTING: Eight rehabilitation centers with specialized SCI units. PARTICIPANTS: 180 persons with SCI. INTERVENTIONS: Not applicable MAIN OUTCOME MEASURES: PF was determined by forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1) as a percentage of the predicted value, at the start of rehabilitation, at discharge, and 1 and 5 years after discharge from inpatient rehabilitation. The population was divided into 3 subgroups based on whether their PF declined, stabilized or improved. RESULTS: FVC improved on average 5.1% over the whole period between discharge of inpatient rehabilitation and 5 years hereafter, but changes differed largely between persons. FVC declined in 14.9% of the population during the first year after discharge. During this year, body mass index (BMI), inspiratory muscle strength (MIP), change in peak power output, and change in peak oxygen uptake (VO2peak) differed significantly between subgroups. FVC declined in 28.3% of the population during the following 4 years, but no differences were found between the subgroups for this period. Subgroups based on changes in FEV1 only differed with respect to change in VO2peak the first year after discharge. CONCLUSIONS: In our study, many persons with SCI showed a beyond the normal age-related decline in PF during the 5 years after inpatient rehabilitation. Results suggest that a decline in PF during the first year after inpatient rehabilitation is associated with higher BMI, lower MIP and declined physical fitness.
HubMed – rehab
Effectiveness of pulmonary rehabilitation in exercise capacity and quality of life in chronic obstructive pulmonary disease patients with and without global fat-free mass depletion.
Filed under: Rehab Centers
Arch Phys Med Rehabil. 2013 Feb 14;
Berton DC, Silveira L, Da Costa CC, De Souza RM, Winter CD, Zimermann Teixeira PJ
OBJECTIVE: To investigate the effectiveness of pulmonary rehabilitation (PR) in exercise capacity and quality of life in patients with chronic obstructive pulmonary disease (COPD) with and without global fat-free mass (FFM) depletion. DESIGN: Retrospective case-control. SETTING: Outpatient clinic, university center. PARTICIPANTS: All COPD patients referred to the PR program were stratified according their FFM status measured by bioelectrical impedance. They were considered depleted if FFM index was ? 15 kg/m(2) in women and ? 16 kg/m(2) in men. From this initial sample, all depleted patients (n=31) composed the FFM depleted group. It was composed predominantly by females (68%) with a mean age of 64.4±7.3yrs and forced expiratory volume in 1 second (FEV(1)) of 33.6±13.2% predicted. Paired for sex and age, 32 non-depleted patients were selected from the initial sample to compose the non-depleted group. INTERVENTION: PR including whole-body and weight training during twelve weeks, three times/week. MAIN OUTCOME MEASURES: St. George Respiratory Questionnaire (SGRQ), 6-minute walk distance (6-MWD) and FFM evaluation applied before and after PR. RESULTS: Improvement in 6-MWD was similar in these two groups after PR. Both groups improved SGRQ, although the observed power was small and did not allow adequate comparison between depleted and non-depleted patients. There was no difference between groups in weight change whereas FFM tended to be greater in depleted patients. This increase had no correlation with 6-MWD or SGRQ. CONCLUSION: Benefits of PR to exercise capacity were similar comparing FFM depleted and non-depleted COPD patients. Although FFM change tended to be greater in depleted patients, this increase had no definite relation with clinical outcomes.
HubMed – rehab
Controlled delivery of mesenchymal stem cells and growth factors using nanofiber scaffold for tendon repair.
Filed under: Rehab Centers
Acta Biomater. 2013 Feb 13;
Manning CN, Schwartz AG, Liu W, Xie J, Havlioglu N, Sakiyama-Elbert SE, Silva MJ, Xia Y, Gelberman RH, Thomopoulos S
Outcomes after tendon repair are often unsatisfactory, despite improvements in surgical techniques and rehabilitation methods. Recent studies aimed at enhancing repair have targeted the paucicellular nature of tendon for enhancing repair; however, most approaches for delivering growth factors and cells have not been designed for dense connective tissues such as tendon. Therefore, we developed a scaffold capable of delivering growth factors and cells in a surgically manageable form for tendon repair. The growth factor PDGF-BB along with adipose-derived mesenchymal stem cells (ASCs) was incorporated into a heparin/fibrin-based delivery system (HBDS). This hydrogel was then layered with an electrospun nanofiber poly-lactic-co-glycolic acid (PLGA) backbone. The HBDS allowed for the concurrent delivery of PDGF-BB and ASCs in a controlled manner, while the PLGA backbone provided structural integrity for surgical handling and tendon implantation. In vitro studies verified that the cells remained viable, and that sustained growth factor release was achieved. In vivo studies in a large animal tendon model verified that the approach was clinically relevant, and that the cells remained viable in the tendon repair environment. Only a mild immunoresponse was seen at dissection, histologically, and at the mRNA level; fluorescently-labeled ASCs and the scaffold were found at the repair site 9 days post-operatively; and increased total DNA was observed in ASC-treated tendons. The novel layered scaffold has the potential for improving tendon healing due to its ability to deliver both cells and growth factors simultaneously in a surgically convenient manner.
HubMed – rehab
Reasoning and rehabilitation cognitive skills programme reduces verbal aggression in violent offenders with psychotic disorders.
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Evid Based Ment Health. 2013 Feb 16;
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