The effect of instruction to synchronize over step frequency while walking with auditory cues on a treadmill

"Available online 16 January 2014"Walking to a pacing stimulus has proven useful in motor rehabilitation, and it has been suggested that spontaneous synchronization could be preferable to intentional synchronization. But it is still unclear if the paced walking effect can occur spontaneously, or if intentionality plays a role. The aim of this work is to analyze the effect of sound pacing on gait with and without instruction to synchronize, and with different rhythmic auditory cues, while walking on a treadmill. Firstly, the baseline step frequency while walking on a treadmill was determined for all participants, followed by experimental sessions with both music and footstep sound cues. Participants were split into two groups, with one being instructed to synchronize their gait to the auditory stimuli, and the other being simply told to walk. Individual auditory cues were generated for each participant: for each trial, cues were provided at the participant’s baseline walking frequency, at 5% and 10% above baseline, and at 5% and 10% below baseline. This study’s major finding was the role of intention on synchronization, given that only the instructed group synchronized their gait with the auditory cues. No differences were found between the effects of step or music stimuli on step frequency. In conclusion, without intention or cues that direct the individual’s attention, spontaneous gait synchronization does not occur during treadmill walking.This study was financed by the Portuguese Foundation for Science and Technology and FEDER (projects FCOMP-01-0124-FEDER-007560, FCOMP-01-0124-FEDER-022674, PEst-OE/ECI/UI4047/2011, PTDC/TRA/67859/2006 and PTDC/EEA-ELC/112137/2009), by the German Cluster of Excellence Hearing4all, and by the Academy of Finland project 13266239-Audiovisual Space

Cardiac Mass: Left Atrial Myxoma

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Ruptured Mitral Valve Aneurysm: A Rare Complication of Mitral Valve Endocarditis

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Cardiovascular rehabilitation in patients aged 70-year-old or older: benefits on functional capacity, physical activity and metabolic profile in younger vs. older patients

Background: The benefits of exercise-based cardiac rehabilitation (EBCR) programs in post-acute myocardial infarction (AMI) patients have been demonstrated. Our aim was to assess the impact of EBCR in ≥ 70-years-old vs. younger post-AMI patients. Methods: We retrospectively evaluated patients who underwent a supervised EBCR protocol, twice a week during 6-12 weeks. We evaluated changes in several outcomes based on pre- and post-CRP assessments. Results: Of a total of 1607 patients, 333 (21%) were ≥ 70-years-old. After the EBCR, an overall improvement on functional capacity, daily physical activity, lipid profile, body mass index, glycated hemoglobin (HbA1c), N-terminal pro-brain natriuretic peptide (NT-pro-BNP) and C-reactive protein was observed in both younger and older patients (P < 0.05). Older patients showed a smaller benefit on the increment of daily physical activity and lipid profile improvement, but a larger reduction in NT-pro-BNP. In the multivariate analysis, only improvements on daily physical activity and HbA1c were dependent on age. Conclusion: As their younger counterparts, older patients, significantly improved functional capacity, metabolic parameters and level of daily physical activity after EBCR.info:eu-repo/semantics/publishedVersio

Predictors of In-Hospital Mortality after Recovered Out-of-Hospital Cardiac Arrest in Patients with Proven Significant Coronary Artery Disease: A Retrospective Study

Introduction: Recovered Out-of-Hospital Cardiac Arrest (rOHCA) population is heterogenous. Few studies focused on outcomes in the rOHCA subgroup with proven significant coronary artery disease (SigCAD). We aimed to characterize this subgroup and study the determinants of in-hospital mortality. Methods: Retrospective study of consecutive rOHCA patients submitted to coronary angiography. Only patients with SigCAD were included. Results: 60 patients were studied, 85% were male, mean age was 62.6 ± 12.1 years. In-hospital mortality rate was 43.3%. Patients with diabetes and history of stroke were less likely to survive. Significant univariate predictors of in-hospital mortality were further analysed separately, according to whether they were present at hospital admission or developed during hospital evolution. At hospital admission, initial non-shockable rhythm, low-flow time>12min, pH4.75mmol/L were the most relevant predictors and therefore included in a score tested by Kaplan-Meyer. Patients who had 0/4 criteria had 100% chance of survival till hospital discharge, 1/4 had 77%, 2/4 had 50%, 3/4 had 25%. Patients with all 4 criteria had 0% survival. During in-hospital evolution, a pH2mmol/L at 24h, anoxic brain injury and persistent hemodynamic instability proved significant. Patients who had 0/4 of these in-hospital criteria had 100% chance of survival till hospital discharge, 1/4 had 94%, 2/4 had 47%, 3/4 had 25%. Patients with all 4 criteria had 0% survival. Contrarily, CAD severity and ventricular dysfunction didn't significantly correlate to the outcome. Conclusion: Classic prehospital variables retain their value in predicting mortality in the specific group of OHCA with SigCAD. In-hospital evolution variables proved to add value in mortality prediction. Combining these simple variables in risk scores might help refining prognostic prediction in these patients's subset.info:eu-repo/semantics/publishedVersio

Echocardiographic Assessment of Right Ventriculo-arterial Coupling: Clinical Correlates and Prognostic Impact in Heart Failure Patients Undergoing Cardiac Resynchronization Therapy

Background: Right ventriculo-arterial coupling (RV-PA) can be estimated by echocardiography using the ratio between tricuspid annular plane systolic excursion (TAPSE) and pulmonary artery systolic pressure (PASP) and it has prognostic value in the general heart failure (HF) population. We aimed to study the clinical correlates and prognostic value of RV-PA in HF patients undergoing cardiac resynchronization therapy (CRT). Methods: We retrospectively studied 70 HF patients undergoing CRT implantation. Results: RV-PA coupling was estimated by TAPSE/PASP ratio using baseline echocardiography. Non-response to CRT was defined as improvement of left ventricular ejection fraction < 5% in a follow-up echo 6-12 months after CRT. Those with lower TAPSE/PASP ratios (worse RV-PA coupling) had higher NT-proBNP concentrations and increased E/e' ratio. TAPSE/PASP ratio and PASP, but not TAPSE, predicted nonresponse to CRT with TAPSE/PASP ratio showing the best discriminative ability with a sensitivity of 76% and specificity of 71%. Among these parameters, PASP independently predicted all-cause mortality. Conclusions: RV-PA coupling estimated by TAPSE/PASP ratio was associated with established prognostic markers in HF. It numerically outperformed PASP and TAPSE in predicting the response to CRT. Our data suggest that this simple and widely available echocardiographic parameter conveys significant pathophysiological and prognostic meaning in HF patients undergoing CRT.info:eu-repo/semantics/publishedVersio

Otimizaçao do marcapasso na ressincronizaçao cardíaca: importância da ecocardiografia

A terapia de ressincronizaçao cardíaca (TRC) promove beneficios clínicos para a maior parte dos pacientes com insuficiência cardíaca refratária secundária a disfunçao ventricular esquerda importante e prolongada conduçao interventricular. Uma programaçao adequada do atraso atrioventricular pode ser também importante para maximizar a resposta da funçao ventricular esquerda. Vários métodos Doppler-ecocardiográficos têm sido relatados como de grande utilidade para determinaçao do intervalo atrioventricular (IAV) ideal. Esta revisao abordará os vários parâmetros Doppler-ecocardiográficos utilizados na programaçao do IAV ótimo em pacientes submetidos a TRC

Otimizaçao do marcapasso na ressincronizaçao cardíaca: importância da ecocardiografia

A terapia de ressincronizaçao cardíaca (TRC) promove beneficios clínicos para a maior parte dos pacientes com insuficiência cardíaca refratária secundária a disfunçao ventricular esquerda importante e prolongada conduçao interventricular. Uma programaçao adequada do atraso atrioventricular pode ser também importante para maximizar a resposta da funçao ventricular esquerda. Vários métodos Doppler-ecocardiográficos têm sido relatados como de grande utilidade para determinaçao do intervalo atrioventricular (IAV) ideal. Esta revisao abordará os vários parâmetros Doppler-ecocardiográficos utilizados na programaçao do IAV ótimo em pacientes submetidos a TRC

An Overview of the Environmental Applicability of Vermicompost: From Wastewater Treatment to the Development of Sensitive Analytical Methods

The use of vermicompost (humified material) for treating wastewaters, remediating polluted soils, improving agricultural productivity, protecting crop production, and developing sensitive analytical methods is reviewed here, covering the past 17 years. The main advantages of vermicompost, considering all applications covered in this paper, comprise (i) easy acquisition, (ii) low costs, (iii) structural, chemical, and biological characteristics responsible for exceptional adsorptive capacities as well as pollutant degradation, and (iv) the promotion of biocontrol. Specifically, for wastewater decontamination, a considerable number of works have verified the adsorption of toxic metals, but the application of vermicompost is still scarce for the retention of organic compounds. Problems related to the final disposal of enriched vermicompost (after treatment steps) are often found, in spite of some successful destinations such as organic fertilizer. For decontaminating soils, the use of vermicompost is quite scarce, mainly for inorganic pollutants. In agricultural productivity and biocontrol, vermicompost imparts remarkable benefits regarding soil aggregation, plant nutrition, and the development of beneficial microorganisms against phytopathogens. Finally, the use of vermicompost in sensitive analytical methods for quantifying toxic metals is the newest application of this adsorbent