The Effect of Continuous Heat Wraps on Balance and Gait in the Elderly

Background: In an ageing geriatric population, tremor and poor balance become more pronounced and can lead to falls. Falls are the leading cause of mortality in this population. Continuous heat wraps have been shown to increase tissue flexibility. It was the purpose of this study to examine the effects of heat on balance and gait in the elderly with impaired mobility. Subjects: Twenty people with impaired mobility (assessed as a score of more than 4 on the “Stepping On” questionnaire) were tested with a balance platform after using ThermaCare continuous heat wraps on their legs and knees for 6 days. Data was collected at day 0 (before heat) and day 7. The average age was 60.3+/-8.3 years. The loss in mobility could not be due to pain killers or other drugs the person was taking that may reduce mobility. Half of the subjects started with a week of heat treatment and half were no heat controls. At the end of the first arm, there was a one week washout and the groups were reversed. Methods: Balance was assessed on a custom made balance platform during 8 different balance tasks lasting 10 seconds each and presented at random. Tremor was measured during the balance tasks at 8 and 24 Hertz. Gait was assessed by the “timed up and go” test. Results: Muscle tremor was reduced; balance and gait were significantly improved, after 6 sessions of heat application on the legs. Conclusion: As per the literature, this improvement in balance should reduce the chance of falls in this population

Evidence-Based Use of Cold for Plantar Fasciitis

Objective The purpose of this study was to examine the effect of cold applied the night before or in the morning on pain and symptoms of plantar fasciitis. Design Experimental study. Methods Thirty subjects with plantar fasciitis were recruited for this study. Subjects with plantar fasciitis either had no intervention, cold applied (20 minutes) at night before bed, or 20 minutes in the morning upon wakening. Plantar fascia tenderness and pain were evaluated. There were ten subjects in each group. Measures included visual analog scale, plantar facial thickness via high resolution ultrasound, algometer measure, and range of motion of the ankle and foot. There were 3 groups of 10 subjects, control (no intervention), cold the night before bed, and cold in the morning before rising. Results The greatest relief of symptoms was cold used at bedtime the night before the measurements. Cold used in the morning was not as effective as cold used in the evening before bed. Cold use reduced the thickness of the plantar fascia and irritation. There was a 13% reduction in plantar fascia thickness with cold the night before (p\u3c0.05), a 44% reduction in pain and an 86 % increase in the force that could be applied to the bottom of the foot without pain (p\u3c0.05). Conclusions Cold applied for 20 minutes prior bedtime is effective for reduced symptomology caused by plantar fascia inflammation

Can eccentric exercise of the lower limb be made more efficiently, a pilot study

Abstract Background: Eccentric Exercise has been shown to be more effective in building muscle and healing damaged tissue than concentric or isometric exercise. It has also been shown to be effective in increasing motor control. But the duration of therapeutic exercise in physical therapy is limited by insurance to 30-60 minutes a day. Objectives: Four standard therapy eccentric exercises of the lower limbs were compared (toe raise, ball exercise, side lying eccentric exercise and incline board exercise) to a trainer called the BTE Eccentron to see if the efficiency of exercise could be increased using one exercise session to meet or beat the four individual exercises. Subjects and Methods: The study examined eight randomly selected participants with no known medical conditions (neurological or orthopedic) that would preclude their participation (age=24.1+/-2.1 years height=168.9+/-6.4 cm BMI=23.2+/-3.2). EMG was used to assess muscle recruitment in each exercise. The muscles studies were the gastrocnemius, hamstring, hip adductors, and quadriceps muscles. Results: Muscle use on the eccentron was almost double that of the other exercises. Thus, making therapy more efficient. One single exercise bout showed more muscle activation during eccentric exercise than the other four exercises, with an average muscle use almost 4 times higher on the eccentron. Conclusion: The Eccentron offers a considerable advantage for clinical treatment making exercise and neuromuscular training more efficient

The Effect of ThermaCare Heat Wraps on Balance and Mobility in Seniors with Impaired Gait - A Cross Over Study

To examine if the use of heat at home can result in better quality and safer mobility in the elderly with gait and balance impairments. Setting: Randomized longitudinal cross over study design in a clinical setting. Methods: 20 people with impaired mobility (assessed as a score of more than 4 on the Stepping On questionnaire) were tested with a multi-camera gait analysis system, a treadmill with pressure sensors, a balance platform and the timed up and go and walking speed tests before and after using ThermaCare continuous heat wraps on their legs and knees for 6 days at 4 hours per day. The loss in mobility could not be due to pain killers or other drugs that reduced mobility. Results: Muscle tremor was reduced, mobility of the joints was improved, balance was significantly improved, and gait was improved after 6 sessions of heat application on the legs. As per the literature, this should reduce the chance of falls in this population. Conclusion: Using continuous heat wraps may be an important adjunct for improving gait in the elderly with gait impairments

The Effect of BMI on Oxygen Saturation at Rest and During Mild Walking

Eighty one subjects were examined for the relationship between BMI, body fat, arterial oxygen saturation and arterial PO2 with the subjects at rest and after 5 minutes of walking on a treadmill ergometer at 3 mph at a 3% grade. They had BMIs between 19 and 50. All subjects were free of cardiovascular disease and had normal blood pressure making it safe for them to participate in mild exercise. They were all able to walk for at least 10 minutes without cardiovascular complications and were not taking any medications that altered the autonomic nervous system. The age was between 22 and 68. The results showed that above a BMI of about 30, there was an inverse relationship between BMI and oxygen saturation in fingertip blood (correlation -0.81.

The Effect of an 8-Minute Yoga Breathing Program on Fitness, Weight Loss and Breathing Capacity

This was a single blinded randomized study with an intervention group and a control group to examine a modification in lifestyle and an 8-minute exercise session each day to lose weight. Fifty-seven female subjects participated. Subjects underwent girth measurements at the umbilicus, hips, thigh and upper arm; weight, height (for BMI), body fat, heart rate, blood pressure, abdominal strength, leg strength, arm strength, sedentary O2 saturation, treadmill challenged O2 saturation, resting metabolism (which includes fat metabolism), and lung capacity. Measures were repeated at baseline and the end of the 6-week period. During the 6-week period, they followed a healthy recommended diet with high volumes of vegetables and fruit and 8 minutes of exercise each day. In the investigational group, the average weight loss was 4.85 KG over the 6-week period, BMI was reduced 1.79 at the end of the 6 weeks, a significant loss (p\u3c0.01). Body fat in this group was reduced by 5.87 percent, the average girth at the showed an average loss in circumference of 5.9 cm over the 6-week period. For the hip, the average loss in circumference was 6.28 cm, for the thigh the average loss in circumference in the investigational group was 5.0 cm, and for the upper arm reduced girth by 2.61 cm. For strength for the investigational group, for the abdominals the increase was 11.3 Kg, for the leg it was 6.0 kg and for the arm it was 4.8 kg. All of these increases were significant (p\u3c0.01). The basal metabolic rate, in the investigational group after the 6 weeks increased to 31.1 cc/kg lean body mass. The fat burning doubled in the investigational group. In conclusion, subjects slept better, had high oxygen saturation and better strength and excellent weight and fat loss with this program

Effect of Heat, Cold, and Pressure on the Transverse Carpal Ligament and Median Nerve: A Pilot Study

Background: This study quantified the effects of heat, cold, and pressure on the median nerve and transverse carpal ligament in subjects without carpal tunnel syndrome. Material/Methods: Subjects were individuals ages 20–50 who had no symptoms of carpal tunnel disease. Imaging ultrasound was used to measure the clearance around the median nerve, transverse ligament elasticity, nerve conduction velocity, thickness of the carpal ligament, and area of the median nerve. Pressure was applied to the carpal ligament to assess the effects of increasing pressure on these structures. On 3 separate days, 10 subjects had ThermaCare heat or cold packs applied, for either 60 or 120 minutes for heat or 20 minutes for cold, to the palmer surface of the hand. Results: Tissue changes were recorded as a response to pressure applied at 0, 5, 10, and 20 N. The size of the nerve and ligaments were not significantly altered by pressure with the hand at room temperature and after cold exposure. After heat, the nerve, ligaments, and tendons showed significantly more elasticity. Conclusions: Application of cold to the hand may reduce compression of the carpal ligament and nerve

Reference Serum Chemistry and Hematological Values for Spinal Cord Injured Patients

Serum chemistry and hematological values from 220 traumatic spinal cord injured patients (157 male and 63 female between the ages of 15-47, with greater than six months from injury) were compiled via chart review. Traumatic spinal cord injured patient’s reference ranges were determined and compared with the general population reference ranges. Reference ranges within the spinal cord population were compared by age, gender, level of injury and chronicity of injury. The reference ranges determined for all groups within this spinal cord population fall within the reference ranges of the general population. This supports recent research which suggests that a decrease in high density lipids is not a consequence of spinal cord injury and that reference values listed on laboratory reports are representative of the spinal cord population. Keywords: spinal cord injury, hematology, serum chemistr

Effect of Monophasic Pulsed Current on Heel Pain and Functional Activities Caused by Plantar Fasciitis

Background: Plantar fasciitis (PF) is a soft tissue disorder considered to be one of the most common causes of inferior heel pain. The aim of this study was to investigate the effect of monophasic pulsed current (MPC) and MPC coupled with plantar fascia-specific stretching exercises (SE) on the treatment of PF. Material and Methods: Forty-four participants (22 women and 22 men, with a mean age of 49 years) diagnosed with PF were randomly assigned to receive MPC (n=22) or MPC coupled with plantar fascia-specific SE (n=22). Prior to and after 4 weeks of treatment, participants underwent baseline evaluation; heel pain was evaluated using a visual analogue scale (VAS), heel tenderness threshold was quantified using a handheld pressure algometer (PA), and functional activities level was assessed using the Activities of Daily Living subscale of the Foot and Ankle Ability Measure (ADL/FAAM). Results: Heel pain scores showed a significant reduction in both groups compared to baseline VAS scores (P Conclusions: This trial showed that MPC is useful in treating inferior heel symptoms caused by PF

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely