Physical activity interventions to improve daily walking activity in cancer survivors

Background Cancer patients may benefit from physical exercise programs. It is unclear, however, how sustained levels of physical activity are best achieved in this population. A systematic review was performed to summarize the current evidence of the effect of physical activity interventions on daily walking activity enhancement in cancer survivors, and to review the literature for its methodological quality. Methods A search in Medline, PEDro and the Cochrane databases was performed for English literature citations (randomized controlled trials; `RCTs`). In a first step, one reviewer abstracted data from the included studies on patients, physical activity interventions and outcomes. Two independent reviewers reviewed the methodological quality of these studies. Data were pooled using random-effects calculations. Results Our search identified 201 citations. Five RCTs that reported changes in daily step activity over time were identified, and were reviewed for methodological quality and substantive results. The median score across studies for methodological quality based on the PEDro criteria was 8. These 5 RCTs evaluated 660 participants with a mean age of 53.6 (SD 4.2) years. The mean change in daily step activity for patients with a physical exercise intervention was 526 daily steps (SD 537), with a range from -92 to 1299 daily steps. The data of three studies reporting the effect of combined physical activity and counseling on daily walking activity in breast cancer survivors were pooled, however; the I2 was 79%, indicating statistical heterogeneity between the three trials. Conclusion The 5 RCTs reviewed were of good methodological quality. Together they suggest that combined physical activity and counseling improves daily step activity in (breast) cancer survivors. Studies that define a step goal appear to be more effective in improving daily walking activity than studies that do not do so. However, the current results should be interpreted with caution because of the observed clinical and statistical heterogeneity. Future studies are warranted to evaluate the effects of goal targeted physical activity, with or without counseling, on daily walking in various cancer populations

THE STATUS OF NONINVASIVE FUNCTIONAL ELECTRICAL

Abstract-This paper reviews of status of noninvasive (transcutaneous) functional electrical stimulation (FES) for the purpose of independent ambulation by spinal-cord injured (SCI) patients having complete thoracic-level spinal cord lesions, namely, patients having neither motor function nor sensation in their lower extremities. The paper reviews FES system design principles, criteria for patients admissibility to FES ambulation programs and training procedures. It provides data on ambulation performance and on subsequent medical benefits to patients who use a trascutaneous FES system. It also considers problems relating to system adoption and long term system use. Furthermore, the paper discusses regulatory approval and reimbursement aspects concerning the noninvasive FES systems for ambulation by paraplegics. The paper also compares non-invasive FES as with implanted FES systems and with long-leg braced hybrid systems for ambulation purposes, thoracic level SCI patients

Recognition and prediction of individual and combined muscular activation modes via surface EMG analysis

The paper discusses how recognition of individual and combined muscular activation modes (functions) and the prediction of intended such modes can be accomplished by identifying parameters of noninvasive surface EMG signals. It outlines the mathematical analysis of surface EMG signal to facilitate such recognition and related prediction, including recognition of intention (in terms of attempts) to activate motor functions from the EMG, without accessing the CNS itself, in cases where a patient, say, a high-level amputee does not have the final-activation muscles and joints. The EMG activity thus allows to interpret and recognize CNS commands from minute variations in the parameters of surface EMG signals that record changes in the firing of motor neurons triggering contractions in related muscle fibers. We note that although in popular media this is sometimes referred to as detection of “thoughts”, no thoughts are detected, but only motor-outcomes of thoughts as found in the EMG signal. Examples of concrete cases where such recognition or prediction were accomplished in the author’s lab and in devices that came out of that lab, are given as are references to these in the literature over the last 35 years

Principles of artificial neural networks. 3rd edition

Singaporexviii, 363 p.: bibl. ref., index; 25 c