Adipose Tissue Differs and Correlates to Carbohydrate Metabolism and Proinflammatory Adipokines by Level of Spinal Cord Injury

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Effects of Exercise Environment and Protocol Intensity on the Efficacy of Rehabilitation Care for Patients with Huntington’s Disease: A Comprehensive Review

International Journal of Exercise Science 12(3): 456-470, 2019. Huntington’s disease (HD) is a neurodegenerative disease caused by astrogliosis of the putamen and caudate nucleus. Motor symptoms include progressive chorea, leading to deficits in gait, motor function, and quality of life. While many studies have examined the effects of therapeutic exercise on these factors in individuals with HD, the efficacy of such protocols has yet to be analyzed. Purpose: The purpose of this review is to analyze trends in efficacy reported by studies examining the effects of exercise on motor function, gait quality, and quality of life in individuals with HD. Methods: A literature search was performed by the primary author in September 2017. Databases include PubMed, Google Scholar Article Library, and The Cochran Article Library. Results: Though there is intrinsic variability between studies, therapeutic outcomes can be compared between settings and protocols. The increases in exercise duration/frequency and utilization of multiple supervised rehabilitation modalities in clinical/intensive inpatient-based programs resulted in greater function and psychological improvements in individuals with HD compared to those in the home/community-based programs. However, the adherence rates of high-intensity, multi-disciplinary protocols are lower than less intensive regimens. Conclusion: The results of this review suggest that rehabilitation exercise protocols held in a clinical and moderately intensive inpatient setting may provide the greatest functional and psychological outcomes for those with HD as evidenced by consistent patient benefit and high adherence rates. Furthermore, the high physical and time demands of high-intensity protocols may make them less practical than less intensive protocols, though more study is needed for confirmation

Mathematical models of supersonic and intersonic crack propagation in linear elastodynamics

This paper presents mathematical models of supersonic and intersonic crack propagation exhibiting Mach type of shock wave patterns that closely resemble the growing body of experimental and computational evidence reported in recent years. The models are developed in the form of weak discontinuous solutions of the equations of motion for isotropic linear elasticity in two dimensions. Instead of the classical second order elastodynamics equations in terms of the displacement field, equivalent first order equations in terms of the evolution of velocity and displacement gradient fields are used together with their associated jump conditions across solution discontinuities. The paper postulates supersonic and intersonic steady-state crack propagation solutions consisting of regions of constant deformation and velocity separated by pressure and shear shock waves converging at the crack tip and obtains the necessary requirements for their existence. It shows that such mathematical solutions exist for significant ranges of material properties both in plane stress and plane strain. Both mode I and mode II fracture configurations are considered. In line with the linear elasticity theory used, the solutions obtained satisfy exact energy conservation, which implies that strain energy in the unfractured material is converted in its entirety into kinetic energy as the crack propagates. This neglects dissipation phenomena both in the material and in the creation of the new crack surface. This leads to the conclusion that fast crack propagation beyond the classical limit of the Rayleigh wave speed is a phenomenon dominated by the transfer of strain energy into kinetic energy rather than by the transfer into surface energy, which is the basis of Griffiths theory

Underwater Treadmill Training After Neural-Paralytic Injury

Background: Patients with neural-paralytic conditions, such as spinal cord injury (SCI) and stroke, often experience the partial or complete inability to produce a stable, voluntary gait pattern as a result of some level of paralysis. These individuals also have deficiencies in balance, step initiation, muscle strength, walking speed and cardiovascular function. The use of an aquatic environment can provide additional benefits to the rehabilitation process compared to overground gait therapies. Research in aquatic gait therapy for individuals post-SCI and stroke has shown improvements in balance, leg strength, muscle spasticity, walking performance, pulmonary function, cardiovascular response, and quality of life. Recent gait rehabilitation research has focused on combining a therapeutic aquatic environment with the known benefits of treadmill based gait training. Purpose: This review presents research performed on the gait restorative effects of UTT for adults with neural-paralytic injuries, including SCI and stroke. Results: In the limited amount of published literature, underwater treadmill training (UTT) has demonstrated the ability to enhance balance, leg strength, gait performance and cardiovascular performance of individuals with neural-paralytic conditions. Conclusion: The results reported by the studies in this review show that UTT may be a useful rehabilitation modality for improving cardiovascular health, mobility, balance, and strength for individuals with neural-paralytic conditions. Further studies examining the efficacy of UTT for individuals with neural-paralytic injury is however needed to justify integration of UTT protocols into conventional rehabilitation care plans

Efficacy of Underwater Treadmill Training As a Complimentary Gait Restorative Therapy For Spinal Cord Injured Individual: A Case Report

Background: Walking on an underwater treadmill has been shown to improve balance, strength, cardiac performance, and overall mobility in individuals with incomplete spinal cord injury (iSCI). However, little is known about the extent to which an individual with iSCI can regain stepping ability when using underwater treadmill training (UTT). This case report examines the functional effects of a combined UTT exercise protocol and supplemental overground exercise training program on the recovery of independent stepping ability in an individual with iSCI. Methods: A twenty-four year old male with C4-C5 motor and sensory incomplete tetraplegia completed two separate progressive UTT protocols of twelve and thirteen weeks, respectively. Steps taken with the aid of a trainer (aided) and steps taken without trainer assistance (unaided) were recorded. Results: Over the course of both UTT protocols, the subject regained the ability to walk in an aquatic environment. After only six weeks of inability to complete an unaided step, the participant regained independent stepping ability and was able to average over 1100 unaided steps underwater per UTT session by the end of the training. Conclusion: The present case study suggests that underwater treadmill training may be a safe and effective therapy for the re-elicitation of independent stepping ability for individuals with iSCI, and play a complimentary role as part of a more comprehensive therapy program