Physiological impairment in mild COPD

Chronic obstructive pulmonary disease (COPD) is a common and often progressive inflammatory disease of the airways, alveoli and microvasculature that is both preventable and treatable. It is well established that smokers with mild airway obstruction, as spirometrically defined, represent the vast majority of patients with COPD, yet this population has not been extensively studied. An insidious preclinical course means that mild COPD is both underdiagnosed and undertreated. In this context, recent studies have confirmed that even patients with mild COPD can have extensive physiological impairment, which contributes to poor perceived health status compared with non‐smoking healthy controls. This review describes the heterogeneous pathophysiology that can exist in COPD patients with only mild airway obstruction on spirometry. It exposes the compensatory adaptations that develop in such patients to ensure that the respiratory system fulfils its primary task of maintaining adequate pulmonary gas exchange for the prevailing metabolic demand. It demonstrates that adaptations such as increased inspiratory neural drive to the diaphragm due to combined effects of increased mechanical loading and chemostimulation underscore the increased dyspnoea and exercise intolerance in this population. Finally, based on available evidence, we present what we believe is a sound physiological rationale for earlier diagnosis in this population.     

Elder Abuse

The detection, treatment and prevention of elder abuse, although of concern to health care professionals, has not received over the past several years the attention it merits. While social service and health care dollars for elders decline or are redistributed, elder abuse may be on the upswing. As physical and occupational therapists move into home health care settings they are in opportune positions to detect instances of elder abuse and facilitate remedial or preventive services. This article reviews the current problem of elder abuse and describes some roles for the allied health professional in addressing the need.     

Effect of aging on treadmill exercise induced theta power in the rat

The effects of aging on the electroencephalogram (EEG) power spectra of 8- and 60-week-old Wistar–Kyoto rats were examined during the waking baseline and treadmill exercise. Using continuous and simultaneous recordings of EEG and electromyogram signals, this study demonstrated that the alpha (10–13 Hz), theta (6–10 Hz), and delta (0.5–4 Hz) powers of the EEG were significantly lower in older rats as compared with young rats during the waking baseline. In the young rats, treadmill exercise resulted promptly in a higher alpha power, higher theta power, and higher theta power percentage as compared with the waking baseline. In the aged rats, treadmill exercise only resulted in a higher theta power and higher theta power percentage. During the treadmill exercise, however, the aged rats still showed a significantly lower exercise-evoked theta power change than the young rats. These results suggested that aging is accompanied by lower EEG activities during waking and this also is accompanied by an attenuated response of the brain to exercise in the rat.     

Measuring the Actual Levels and Patterns of Physical Activity/Inactivity of Adults with Intellectual Disabilities

Background Lack of regular physical activity is a significant risk to health. The aim of this study was to objectively measure the levels and patterns of activity of adults with intellectual disabilities, to inform the design of studies aimed at increasing activity and health in this population. Materials and Methods Interviews were conducted with 62 community‐based adults with mild to moderate intellectual disabilities at the start and at the end of a 7‐day period of physical activity/inactivity measurement using an activity monitor. Results Forty‐one (66%) participants wore the activity monitor at least 5 days. Of these, only 11 (27%) achieved the recommended 10 000 steps per day, and only six (15%) were achieving the recommended ≥30 min of moderate/vigorous activity at least 5 days per week. Conclusions Adults with mild to moderate learning disabilities have low levels of physical activity.     

Retraining motor control of abdominal muscles among elite cricketers with low back pain

The purpose of this study was to document the effect of a staged stabilization training program on the motor control of the anterolateral abdominal muscles in elite cricketers with and without low back pain (LBP). Changes in the cross‐sectional area of the trunk, the thickness of the internal oblique and transversus abdominis (TrA) muscles and the shortening of the TrA muscle in response to an abdominal drawing‐in task were measured at the start and completion of a 13‐week cricket training camp. Measures were performed using ultrasound imaging and magnetic resonance imaging. Participants from the group with LBP underwent a stabilization training program that involved performing voluntary contractions of the multifidus, TrA and pelvic floor muscles, while receiving feedback from ultrasound imaging. By the end of the training camp, the motor control of cricketers with LBP who received the stabilization training improved and was similar to that of the cricketers without LBP.     

Post‐exercise aortic hemodynamic responses to low‐intensity resistance exercise with and without vascular occlusion

High‐intensity resistance exercise may acutely increase arterial stiffness. Vascular occlusion (VO) acutely decreases arterial stiffness. The purpose of this study was to evaluate acute aortic hemodynamic responses to low‐intensity resistance exercise (LIRE) with slow eccentric movement with and without VO. Twenty‐three young healthy subjects (12 women and 11 men) were randomized into three trials: seated control (CON), LIRE (six sets at 40% one repetition maximum), and LIRE with VO. Vascular measurements were assessed before, immediately (post1), and 30 min after (post30) each trial. There were significant (P<0.05) time effects and trial‐by‐time interactions such that the changes were greater after the LIRE trials compared with CON. Aortic blood pressure [systolic (～10 mmHg) and diastolic (～5 mmHg)], heart rate (～23 b.p.m.), and the first (～10 mmHg) and second systolic peak (～9 mmHg) increased, whereas time to reflection decreased (～15 ms) at post1. All measurements returned to baseline at post30, except aortic augmentation index (AIx), which decreased ～5% after the LIRE trials compared with CON. Increases in cardiovascular variables immediately after the LIRE trials were mild and short lasting. Our results indicate that LIRE acutely decreases AIx 30 min after exercise cessation. The use of moderate intermittent VO during LIRE does not produce additional post‐exercise vascular effects.     

Single nucleotide polymorphisms in the myostatin (MSTN) and muscle creatine kinase (CKM) genes are not associated with elite endurance performance

Maximal oxygen uptake (VO_2max) is one of the most important determinants of elite endurance performance. VO_2max is determined by a whole range of genetic and environmental factors. Single nucleotide polymorphisms (SNPs) in muscle myostatin (MSTN) and creatine kinase (CKM) genes are candidates for VO_2max and skeletal muscle performance phenotypes. Common MSTN (rs3791783, rs11681628 and rs7570532) and CKM (rs344816, rs10410448, rs432979, rs1133190, rs7260359, rs7260463 and rs4884) SNPs, selected from HapMap CEU data in order to tag the genetic variability of the proteins, were genotyped in 316 male Caucasian elite endurance athletes and 304 sedentary controls from the Genathlete study. Association with elite endurance performance was determined by logistic regression analysis. The P‐value for statistical significance was set at <0.01. None of the SNPs or haplotypes showed a significant association with elite endurance status. We conclude that common variants of MSTN and CKM genes do not play a role in attaining high‐level endurance performance in Caucasian populations.     

Cerebral hemodynamic reactions to low-intensity physical exercise

Cerebral hemodynamic reactions to light physical exercise increasing stepwise on a bicycle ergometer were studied in healthy young male subjects. Hemodynamic parameters were measured by transcranial Doppler ultrasonography from the middle cerebral artery (MCA) before the start of the study and during the last few seconds of each exercise step. Cerebral hemodynamic reactions to physical exercise were characterized by a significant increase in systolic blood flow rate in the middle cerebral artery only at exercise levels of about 0.25 W/kg body weight (90 rpm at 0 W/kg) with no further increase in the blood flow rate with increases in loading to 0.5 W/kg body weight. The mechanism stabilizing blood flow rate in the cerebral arteries as physical exercise increased and, thus, the mechanism of cerebral circulatory autoregulation consisted of a arterial pressure-dependent increase in regional cerebral vascular resistance. The threshold at which the cerebral blood flow rate autoregulatory mechanism was triggered in normal subjects corresponded to a loading of about 0.25 W/kg and a systolic arterial pressure of about 140–145 mmHg. Translated from Rossiiskii Fiziologicheskii Zhurnal imeni I. M. Sechenova, Vol. 94, No. 7, pp. 790–798, July, 2008.