共查询到10条相似文献,搜索用时 171 毫秒
1.
Fisher BE Wu AD Salem GJ Song J Lin CH Yip J Cen S Gordon J Jakowec M Petzinger G 《Archives of physical medicine and rehabilitation》2008,89(7):1221-1229
Fisher BE, Wu AD, Salem GJ, Song J, Lin C-H, Yip J, Cen S, Gordon J, Jakowec M, Petzinger G. The effect of exercise training in improving motor performance and corticomotor excitability in people with early Parkinson's disease.
Objectives
To obtain preliminary data on the effects of high-intensity exercise on functional performance in people with Parkinson's disease (PD) relative to exercise at low and no intensity and to determine whether improved performance is accompanied by alterations in corticomotor excitability as measured through transcranial magnetic stimulation (TMS).Design
Cohort (prospective), randomized controlled trial.Setting
University-based clinical and research facilities.Participants
Thirty people with PD, within 3 years of diagnosis with Hoehn and Yahr stage 1 or 2.Interventions
Subjects were randomized to high-intensity exercise using body weight-supported treadmill training, low-intensity exercise, or a zero-intensity education group. Subjects in the 2 exercise groups completed 24 exercise sessions over 8 weeks. Subjects in the zero-intensity group completed 6 education classes over 8 weeks.Main Outcome Measures
Unified Parkinson's Disease Rating Scales (UPDRS), biomechanic analysis of self-selected and fast walking and sit-to-stand tasks; corticomotor excitability was assessed with cortical silent period (CSP) durations in response to single-pulse TMS.Results
A small improvement in total and motor UPDRS was observed in all groups. High-intensity group subjects showed postexercise increases in gait speed, step and stride length, and hip and ankle joint excursion during self-selected and fast gait and improved weight distribution during sit-to-stand tasks. Improvements in gait and sit-to-stand measures were not consistently observed in low- and zero-intensity groups. The high-intensity group showed lengthening in CSP.Conclusions
The findings suggest the dose-dependent benefits of exercise and that high-intensity exercise can normalize corticomotor excitability in early PD. 相似文献2.
Background
Returning home from hospital after an acute myocardial infarction [AMI] can be a period of vulnerability both for the patient and his/her partner. This study focuses on the time immediately after discharge.Aims
The aim of this study was to describe the patient's and his/her partner's experiences after hospital discharge following AMI.Methods
15 couples took part in individual interviews, 4-8 weeks after discharge. Data were analysed using qualitative content analysis.Results
The results are presented by means of three themes, ‘at home in one's own home’, ‘at home within oneself’ and ‘having normality in sight’, comprising ten categories that describe the experiences of both the patient and his/her partner.Conclusions
The patients as well as partners described the period after discharge from hospital comprising ambitions of feeling safety in their home, an inner sense of security and seeking normalisation. The results of this study could be useful for nurses when planning for patient discharge. During hospitalization nurses can prepare both the patient and their partner for what to expect when the patient returns home. 相似文献3.
Steele BG Belza B Cain KC Coppersmith J Lakshminarayan S Howard J Haselkorn JK 《Archives of physical medicine and rehabilitation》2008,89(3):404-412
Steele BG, Belza B, Cain KC, Coppersmith J, Lakshminarayan S, Howard J, Haselkorn JK. A randomized clinical trial of an activity and exercise adherence intervention in chronic pulmonary disease.
Objectives
To evaluate the effectiveness of an exercise adherence intervention to maintain daily activity, adherence to exercise, and exercise capacity over 1 year after completion of an outpatient pulmonary rehabilitation program.Design
A 2-group, experimental design was used with randomization into intervention and usual care groups.Setting
Outpatient pulmonary rehabilitation program in a university-affiliated medical center.Participants
One hundred six subjects (98 men; 98 with chronic obstructive pulmonary disease) with a mean age of 67 years and chronic lung disease.Intervention
Twelve-week adherence intervention (weekly phone calls and home visit) including counseling on establishing, monitoring, and problem-solving in maintaining a home exercise program.Main Outcome Measures
Primary outcomes included daily activity (accelerometer), exercise adherence (exercise diary), and exercise capacity (six-minute walk test). All measures were performed at baseline, after the pulmonary rehabilitation program (8wk), after the adherence intervention (20wk), and at 1 year.Results
A rank-based analysis of covariance showed less decline at 20 weeks in exercise adherence (intervention mean, +3min; control mean, −13min; P=.015) and exercise capacity (intervention mean, −10.7m; control mean, −35.4m; P=.023). There were no differences in daily activity at 20 weeks or any differences in any primary variable at 1 year.Conclusions
The intervention enhanced exercise adherence and exercise capacity in the short term but produced no long-term benefit. These findings are in part attributed to the disappointing measurement characteristics of the accelerometer used to measure daily activity. The intervention was acceptable to participants. Further study is needed to fashion interventions that have more persistent benefit. 相似文献4.
Claire L. Boswell-Ruys Daina L. Sturnieks Lisa A. Harvey Catherine Sherrington James W. Middleton Stephen R. Lord 《Archives of physical medicine and rehabilitation》2009,90(9):1571-1577
Boswell-Ruys CL, Sturnieks DL, Harvey LA, Sherrington C, Middleton JW, Lord SR. Validity and reliability of assessment tools for measuring unsupported sitting in people with a spinal cord injury.
Objectives
To develop simple tests to assess the abilities of people with spinal cord injury (SCI) to sit unsupported and to assess the construct validity and test-retest reliability of these tests.Design
Cross-sectional comparisons, convenience sample.Setting
Biomechanical laboratory.Participants
People (N=30) with SCI between the C6 and the L2 level of 2 months to 37 years duration before assessment. The sample was stratified by impairment level (at T8) and time since injury (1y postinjury).Interventions
Not applicable.Main Outcome Measures
On 2 separate occasions, participants performed tests that measured the distance of upper-body sway and maximal torso leaning, errors made during a coordinated stability task, timed dressing/undressing of the upper body and alternating arm reaching, and percentage change in seated upper body/arm reaching.Results
All tests showed good construct validity in that they distinguished between participants with higher (C6-T7) and lower (T8-L2) level impairments (P<.05) and between participants with acute (≤1y) and chronic (>1y) lesions (P<.05). The tests also showed good to excellent test-retest reliability (intraclass correlation coeffiecient3,1 range, .51-.91).Conclusions
These simple and quick-to-administer tests have both construct validity and test-retest reliability. They would be appropriate for research and clinical purposes to quantify the abilities of people with SCI to sit unsupported. 相似文献5.
Sze PC Cheung WH Lam PS Lo HS Leung KS Chan T 《Archives of physical medicine and rehabilitation》2008,89(7):1329-1334
Sze P-C, Cheung W-H, Lam P-S, Lo HS-D, Leung K-S, Chan T. The efficacy of a multidisciplinary falls prevention clinic with an extended step-down community program.
Objective
To investigate the efficacy of a falls prevention clinic and a community step-down program in reducing the number of falls among community-dwelling elderly at high risk of fall.Design
Prospective cohort.Setting
Community.Participants
Community-dwelling elderly (N=200) were screened for risk of fall; 60 were identified as being at high risk and were referred to the intervention program.Intervention
Twelve sessions of a once-a-week falls prevention clinic, including fall evaluation, balance training, home hazard management program, and medical referrals, were provided in the first 3 months. The community step-down program, including falls prevention education, a weekly exercise class, and 2 home visitations, was provided in the following 9 months.Main Outcome Measures
Fall rate, injurious fall, and its associated medical consultation were recorded during the intervention period and the year before intervention. Balance tests included the Berg Balance Scale (BBS), Sensory Organization Test, and limits of stability test; fear of falling, as evaluated using the Activities-specific Balance Confidence (ABC) scale, was measured at baseline and after the training in the falls prevention clinic.Results
Significant reductions in fall rate (74%), injurious falls (43%), and fall-associated medical consultation (47%) were noted. Significant improvement in balance scores (BBS, P<.001; endpoint excursion in limits of stability test, P=.004) and fear of falling (ABC scale, P=.001) was shown.Conclusions
The programs in the falls prevention clinic were effective in reducing the number of falls and injurious falls. The community step-down programs were crucial in maintaining the intervention effects of the falls prevention clinic. 相似文献6.
Objective
To evaluate, through two studies, the factor structure, inter-rater agreement, and test-retest and inter-rater reliability of the Sport Injury Rehabilitation Adherence Scale (SIRAS).Design
Repeated measures design in both Study 1 (video evaluation) and Study 2 (clinical evaluation).Setting
University department (Study 1) and outpatient physiotherapy department (Study 2).Participants
Sixty physiotherapists and physiotherapy students in Study 1 and 45 patients undergoing physiotherapy treatment for a musculoskeletal injury in Study 2.Intervention
In Study 1, participants rated the adherence of a simulated videotaped patient demonstrating high, moderate and low adherence during rehabilitation. In Study 2, two physiotherapists rated the adherence of patients at two consecutive rehabilitation sessions.Main outcome measure
The SIRAS.Results
In Study 1, principal components analysis confirmed a single factor for the SIRAS, and inter-rater agreement values ranged from 0.87 to 0.93. In Study 2, inter-rater and test-retest reliability coefficients ranged from 0.76 [95% confidence interval (CI) 0.54 to 0.83] to 0.89 (95% CI 0.79 to 0.95), and from 0.63 (95% CI 0.36-0.82) to 0.76 (95% CI 0.55-0.88), respectively.Conclusion
The SIRAS is a reliable measure with high inter-rater agreement when used to evaluate clinic-based adherence to physiotherapy rehabilitation for musculoskeletal injury. 相似文献7.
Objectives
Acquired brain injury (ABI) requires an extended recovery time and residual signs may be observed years after discharge. Supervised home-based motor training may present a viable option for continuing treatment of adult patients, but little information is available on home-based treatment in children. This study assessed the feasibility of home practice in children with ABI (1 or more years post-trauma). The efficacy of the programme was also evaluated.Design
A non-randomised, self-control study with control and intervention periods.Setting
Home-based exercise programme.Participants
Nineteen children (mean age 12.5 ± 3.1 years).Interventions
A 4-week daily training programme of step-up and sit-stand-sit exercises.Main outcome measures
Feasibility was assessed by the number of participants who completed the programme. Efficacy was evaluated at different stages using 10-metre walking and 2-minute walking tests, and the balance subitems of the Bruininks-Oseretsky Test of Motor Proficiency. An energy expenditure index was calculated for walking. Performance scores were used to assess balance.Results
Nine participants completed the study. The mean number of training sessions was 22 ± 8 of the 30 sessions originally scheduled. Major differences were noted between the experimental stages. Walking speed, endurance and balance improved significantly during the intervention period.Conclusions
Continuing exercising at home may be a feasible and efficient option for a considerable proportion of ABI children who are compliant with a simple but challenging exercise programme. A randomised controlled trial with a larger sample is now required. 相似文献8.
Susan B. Williams Caroline A. Brand Keith D. Hill Susan B. Hunt Helen Moran 《Archives of physical medicine and rehabilitation》2010,91(1):106-114
Williams SB, Brand CA, Hill KD, Hunt SB, Moran H. Feasibility and outcomes of a home-based exercise program on improving balance and gait stability in women with lower-limb osteoarthritis or rheumatoid arthritis: a pilot study.
Objective
To evaluate the feasibility and gait stability and balance outcomes of a 4-month individualized home exercise program for women with arthritis.Design
Pre-post interventional study.Setting
General community.Participants
Women (N=49) (volunteers) with lower-limb osteoarthritis or lower-limb rheumatoid arthritis were enrolled. Only 39 subjects were eligible and completed the study.Intervention
After completion of the initial assessment, all participants received home balance exercises from an experienced physiotherapist based on assessment findings and exercises available from commercially available kits. All measures were repeated 4 months later.Main Outcome Measures
Falls risk (Falls Risk of Older People—Community Setting) and balance measures.Results
Thirty-nine women (mean age, 69.3y; 95% confidence interval, 65.7-72.9) completed the 4-month program. At baseline, 64% of participants reported falling in the preceding 12 months, and the average falls risk (Falls Risk of Older People—Community Setting) score was 14.5, with 42% rated as moderate risk (16-23). Participants achieved improved performance on most balance and related measures after the exercise program, including falls risk (P=.01), activity levels (P=.015), fear of falling (P=.022), functional reach test (P=.001), rising index for sit to stand (P=.001), step width in walking (P=.001), and body mass index (P=.006).Conclusions
An individualized balance training home exercise program is feasible for older women with osteoarthritis or rheumatoid arthritis and may improve stability during walking and other functional activities. 相似文献9.
Gillian Yeowell 《Physiotherapy》2010,96(3):257-263
Objective
To gain an insight into the needs of female Pakistani service users in relation to physiotherapy.Design
A qualitative research design was utilised, drawing on ethnographic traditions and including ethnographic interviews. The interviews were transcribed and the data were analysed using thematic analysis.Setting
A venue of the service user's own choosing in one geographical area of the North west of England.Participants
Six, Pakistani, Muslim female patients who had recently received physiotherapy from a range of specialisms. Five participants came to the UK from Pakistan, and one participant of Pakistani heritage came to the UK from East Africa. An interpreter was used in four of the six interviews.Findings
Four main themes emerged from data analysis: issues of gender; language issues including the subthemes of crosscultural communication, time and materials; role of exercise; and acquiescence.Conclusions
It appears that physiotherapy provision for female patients with Pakistani backgrounds may be failing to meet their needs, which may affect compliance. In order to address these issues, culturally competent health care needs to be provided and the following points are worthy of consideration:- •
- offering service users the choice of gender of therapist and, where appropriate, the provision of single-sex exercise group sessions;
- •
- longer appointment times for service users where English is not their first language, and the recruitment of bilingual therapists. Written instructions, in English, with pictures should be provided;
- •
- therapists should have some understanding of the culture of their local community to enable them to incorporate the patient's culture into their management; and
- •
- there may be a need to explore service provision where a high proportion of female Pakistani service users are failing to attend physiotherapy appointments.
10.
Ballaz L Fusco N Crétual A Langella B Brissot R 《Archives of physical medicine and rehabilitation》2008,89(11):2162-2166
Ballaz L, Fusco N, Crétual A, Langella B, Brissot R. Peripheral vascular changes after home-based passive leg cycle exercise training in people with paraplegia: a pilot study.