Effects of endurance, resistance and neuro-muscular electrical stimulation trainings to the anthropometric and functional mobility domains in elderly

Background and aims There\u2019s the need to increase physical activity engagement to promote healthy ageing. Different training protocols elicit different morpho-functional effects: the comprehension of the related assessment tests is a key to improve the specific proposals and to monitor adequately the adaptations. We aimed to identify the functional adaptation processes basing on different training protocols. Methods 40 healthy elderly (28 males and 12 females, 70.7 \ub1 4.39 y) were randomly divided into 4 groups: endurance, resistance, Neuro-Muscular Electrical Stimulation and control, trained for 12 weeks andex-post evaluated on anthropometric and functional domains. Results We found: significant effect for gender, time and time 7 protocols for Five Times Sit-to-Stand Test and Timed Up-and-Go test. Post-hoc analyses revealed effect for resistance and Neuro-Muscular Electrical Stimulation on Five Times Sit-to-Stand Test, and for endurance and Neuro-Muscular Electrical Stimulation on Timed Up-and-Go test. Correlations and factorial analysis linked Five Times Sit-to-Stand Test and Timed Up-and-Go test on the functional domain. Conclusions Medium-term physical interventions significantly modified functional characteristics of elderly. We found no ex-post effect on anthropometric parameters. The two functional tests are based on different underlying domains, our data therefore suggest to use both of them to specifically evaluate the training-induced functional adaptations in elderly. Our results promote the usefulness of evidence-based trainin

Estimation of the stress related to conservative scoliosis therapy: an analysis based on BSSQ questionnaires

BACKGROUND: Adolescent girls treated with a brace for scoliosis are submitted to prolonged stress related to both the disease and the therapy. Currently proposed quality of life questionnaires are focused on the outcome of therapy. Bad Sobernheim Stress Questionnaire (BSSQ) enables monitoring of patients being under treatment with a brace or exercises. The aim of the study was to assess the stress level in conservatively managed scoliotic girls using BSSQ. MATERIALS AND METHODS: 111 girls, aged 14,2 ± 2,2 years, mean Cobb angle of the primary curve 42,8° ± 17,0° and mean Bunnell angle of 11,4° ± 4,5° were examined with two versions of BSSQ (Deformity and Brace). The analysis considered the type of treatment, curve location, correlation of the total score with age, Cobb angle and Bunnell rotation angle. RESULTS: The BSSQ Deformity revealed the median of 17 points in patients managed with exercises (from 4 to 24 points), 18 in patients managed with a brace (from 8 to 24 points) and 12 in patients before surgery (from 3 to 21 points). Braced patients who completed both questionnaires (n = 50) revealed significantly higher score with BSSQ Deformity (median = 18) comparing to BSSQ Brace (median = 9). There was a correlation between the total score of BSSQ Deformity and the Cobb angle (r = -0,34), Bunnell primary curve rotation (r = -0,34) and Bunnell sum of rotation (r = -0,33) but not with the age of patients. CONCLUSION: Scoliotic adolescents managed with exercises and brace suffered little stress from the deformity. The brace increased the level of stress over the stress induced by the deformity. The stress level correlated with clinical deformity (Bunnell angle), radiological deformity (Cobb angle) and the type of treatment (exercises, bracing, surgery). Bad Sobernheim Stress Questionnaires are simple and helpful in the management of girls treated conservatively for idiopathic scoliosis

Brace related stress in scoliosis patients – Comparison of different concepts of bracing

<p>Abstract</p> <p>Background</p> <p>The BSSQbrace questionnaire has been shown to be reliable with good internal consistency and reproducibility estimating the stress scoliosis patients have whilst wearing their brace. Eight questions are provided focussing on this topic. A max. score of 24 can be achieved (from 0 for most stress to 24 for no stress). The subdivision of the score values is: 0–8 (strong stress), 9–16 (medium stress) and 17–24 (little stress).</p> <p>Study design</p> <p>Two BSSQbrace questionnaires have been posted to 65 patients under brace treatment from our Cheneau light data base. All patients had another kind of brace prior to the Cheneau light. The patients have been asked to rate their stress level using one questionnaire for the current brace and the other for the previous one.</p> <p>Results</p> <p>63 Patients (59 girls and 4 boys) returned their fully completed questionnaires (average age 13,6 years, average Cobb angle 43,7 degrees). Stress level in the previous brace was 11,04 and in the Cheneau light(r) 13,87. The differences were highly significant in the t-test; t = -4,67; p < 0,001.</p> <p>Conclusion</p> <p>The use of the Cheneau light^®brace leads to reduced stress and/or impairment for the patients under treatment compared to heavier brace models used so far.</p

Effect of Deutetrabenazine on Chorea Among Patients With Huntington Disease A Randomized Clinical Trial

Importance Deutetrabenazine is a novel molecule containing deuterium, which attenuates CYP2D6 metabolism and increases active metabolite half-lives and may therefore lead to stable systemic exposure while preserving key pharmacological activity. Objective To evaluate efficacy and safety of deutetrabenazine treatment to control chorea associated with Huntington disease. Design, Setting, and Participants Ninety ambulatory adults diagnosed with manifest Huntington disease and a baseline total maximal chorea score of 8 or higher (range, 0-28; lower score indicates less chorea) were enrolled from August 2013 to August 2014 and randomized to receive deutetrabenazine (n = 45) or placebo (n = 45) in a double-blind fashion at 34 Huntington Study Group sites. Interventions Deutetrabenazine or placebo was titrated to optimal dose level over 8 weeks and maintained for 4 weeks, followed by a 1-week washout. Main Outcomes and Measures Primary end point was the total maximal chorea score change from baseline (the average of values from the screening and day-0 visits) to maintenance therapy (the average of values from the week 9 and 12 visits) obtained by in-person visits. This study was designed to detect a 2.7-unit treatment difference in scores. The secondary end points, assessed hierarchically, were the proportion of patients who achieved treatment success on the Patient Global Impression of Change (PGIC) and on the Clinical Global Impression of Change (CGIC), the change in 36-Item Short Form– physical functioning subscale score (SF-36), and the change in the Berg Balance Test. Results Ninety patients with Huntington disease (mean age, 53.7 years; 40 women [44.4%]) were enrolled. In the deutetrabenazine group, the mean total maximal chorea scores improved from 12.1 (95% CI, 11.2-12.9) to 7.7 (95% CI, 6.5-8.9), whereas in the placebo group, scores improved from 13.2 (95% CI, 12.2-14.3) to 11.3 (95% CI, 10.0-12.5); the mean between-group difference was –2.5 units (95% CI, –3.7 to –1.3) (P < .001). Treatment success, as measured by the PGIC, occurred in 23 patients (51%) in the deutetrabenazine group vs 9 (20%) in the placebo group (P = .002). As measured by the CGIC, treatment success occurred in 19 patients (42%) in the deutetrabenazine group vs 6 (13%) in the placebo group (P = .002). In the deutetrabenazine group, the mean SF-36 physical functioning subscale scores decreased from 47.5 (95% CI, 44.3-50.8) to 47.4 (44.3-50.5), whereas in the placebo group, scores decreased from 43.2 (95% CI, 40.2-46.3) to 39.9 (95% CI, 36.2-43.6), for a treatment benefit of 4.3 (95% CI, 0.4 to 8.3) (P = .03). There was no difference between groups (mean difference of 1.0 unit; 95% CI, –0.3 to 2.3; P = .14), for improvement in the Berg Balance Test, which improved by 2.2 units (95% CI, 1.3-3.1) in the deutetrabenazine group and by 1.3 units (95% CI, 0.4-2.2) in the placebo group. Adverse event rates were similar for deutetrabenazine and placebo, including depression, anxiety, and akathisia. Conclusions and Relevance Among patients with chorea associated with Huntington disease, the use of deutetrabenazine compared with placebo resulted in improved motor signs at 12 weeks. Further research is needed to assess the clinical importance of the effect size and to determine longer-term efficacy and safety

A.C.T.I.V.E. AGEING (Adapted Controlled Training Individualised through Verification in the Elderly): an innovative comprehensive multifactorial evaluation for the planning and monitoring of Adapted Physical Activity in the elderl

Purpose: The project A.C.T.I.V.E. AGEING herein presented is part of an extended ambitious interdisciplinary, multifactorial project started by our group. The project aims to bring back to more active and physically efficient life, elderly people. The general framework is to build individualised adapted physical activities (APA) to contrast sedentary lifestyle, sarcopenia and low-grade chronic inflammatory status (Inflammaging) to prevent immobility syndrome in the elderly. Individualised APA for the elderly is necessary to avoid the overwhelming physical-psychological stress that could lead to failure with reduced functional efficiency, increased pain, subsequent lack of motivation and abandonment of training programmes. Methods: To achieve the \u2018\u2018proper individualised APA\u2019\u2019 and to monitor its effect on the elderly a number of quantitative measurements are planned: 1. Anthropometry including plicometry and measurement of circumferences. 2. Battery of Validated Functional Tests: a. Five Times Sit-to-Stand Test (FTSST) and Timed Up-andGo test (TUG). b. Maximal Voluntary Contraction (MVC) of quadriceps. 3. Comprehensive Multifactorial Biomechanical Analysis (CMBA) of full 3D skeleton Posture and Movement using new technological Opto-Electronic tereophotogrammetric devices in conjunction with Baropodometric and Surface Electro-Myographic devices [1, 2]. 4. Bio-histo-chemical analysis through muscle biopsy to measure exercise-associated muscle structure changes. Twenty participants (age 71.77 \ub1 4.06 years) were subdivided randomly into 2 groups: controls (n.10 subjects no APA); resistance training APA supplemented with neuro-muscular electrical stimulation (10 subjects). Two-way ANOVA for repeated measures was used to analyse differences between groups and over pre (T0)-and post (T1) after 12 weeks APAs. Results: The groups presented no differences at T0, while as expected the APA group showed improvements at T1 in: FTSST, TUG, MVC, CMBA and in muscle structure. Conversely, 12 weeks period of APA revealed to be insufficient to find significant changes in anthropometry. All participants reported an optimal compliance with planned level of APA. Conclusions: The described general framework proved to be effective to plan and monitor \u2018\u2018proper individualised APA\u2019\u2019. It demonstrates the importance to collect multifactorial data and integrate them into a unique framework, providing a real added value in the detailed comprehension of functional and biomechanical phenomena