Psychosomatic aspects of chronic low back pain syndrome

The purpose of the study was to determine the relationships between emotional distress and pain syndrome, its characteristic parameters and impact on the quality of life in patients with chronic low back pain. The study included 110 patients, mean age 44.2 ± 8.0 years, with clinical diagnosis of lumbar spine disk pathology with chronic low back pain syndrome. The results showed that the studied patients differed by their emotional state. Emotional distress was associated with high intensity and specific symptoms of low back pain syndrome. Musculoskeletal dysfunction was associated with both physical and psychoemotional factors. The interaction of chronic low back pain syndrome complexity and biopsyhosocial factors is shown by a correlation between cytokines IL- 10 and IL-8 level in blood serum and both pain intensity and duration, characteristics of emotional and physical status, and level of physical activities.publishersversionPeer reviewe

Nordic Walking or Traditional Walking in Patients With Intermittent Claudication: A Critical Review

Regular exercises can improve walking distance and reduce physical impairment in patients with intermittent claudication. The objective of the research is to summarise and analyse the existing proof about the comparative effectiveness of Nordic walking and traditional walking in the improvement of health indicators in patients with intermittent claudication. Methods: The following online databases were used as sources for data collection: Ebsco, Sience Direct, Clinical Key, ProQuest, Scopus. The selection of works of research was performed on the basis of key words “Nordic walking”, “intermittent claudication”, “walking with poles”, “Nordic walking and walking and intermittent claudication” and the year of publishing (that is, from 2005 till 2015). Inclusion criteria met four works of research that were included in the critical analysis. Results and conclusions: There is no proof about the superiority of the Nordic walking programme over traditional walking (and there exist indications about the superiority of the traditional walking programme) in the improvement of helath indicators, but patients with intermittent claudication feel less discomfort during Nordic walking and they can cover a longer distance by using poles

Activity of Scapular Muscles : Comparison of Open and Closed Kinetic Chain Exercises

The function of the shoulder region and cervical spine are regulated by the motor control of the scapula. It is important to selectively activate weak muscles and minimally involve tense muscles to improve scapular motor control. The objective of this study was to compare the activity of scapular muscles and the intramuscular balance during various open and closed kinetic chain exercises. Methods: This study included 20 female sedentary office workers. A surface electromyography was used to analyze the activity of the scapular muscle in the correct exercise starting position and during 6 different exercises. Additionally, the optimal intramuscular balance was examined. Results and conclusions: Open kinetic chain exercises is more suitable than closed kinetic chain exercises for training scapular active stability. Horizontal shoulder abduction with external rotation (scapula retraction and internal rotation) while in the prone position was optimal and could be recommended (as well as its modifications with a resistance band) for training programs to improve scapula active stability.publishersversionPeer reviewe

Individualized home-based exercise program for idiopathic pulmonary arterial hypertension patients : A preliminary study

Publisher Copyright: © 2019, ČKS.Background: Exercise-based rehabilitation has been proved as a benefi cial additional non-pharmacological treatment in patients with stable pulmonary arterial hypertension (PAH). Majority of studies include hospital-based supervised programs. To improve patient accessibility to this important intervention and long-term efect the research on home-based programs is warranted. The purpose of our study was to evaluate the adherence, safety, training efects of 12-week individualized home-based exercise program in patients with idiopathic PAH. Methods: This was a prospective pilot uncontrolled interventional study. Six patients with iPAH confi rmed by right-heart catheterization from the Latvian PAH registry were selected. A 12-week exercise program adaptable for each patient's functional state and home environment was created. The program included muscle strength training, respiratory, aerobic exercise and neuro-muscular relaxation techniques, self-control monitoring, weekly phone control and on-site re-assessment by physiotherapist were parts of the program to ensure both individualized adjustments and proper execution, and to maximize clinical safety. The primary outcome measures for training efects were exercise capacity, breathing pattern and quality of life, for adherence days of performance, for safety any event of "alarm sign" indicators during exercising, incomplete recovery, worsening of PH symptoms. Results: The results showed a rather high degree of adherence to the prescribed exercise regimen (in average 92.5%). No adverse events were observed during the course of the program. The results proved the importance of ensuring optimal self-control skills both for objective measures and subjective symptoms. The 6-minute walking test (6MWT) results show that the developed program signifi cantly improves exercise capacity (mean improvement 39 ± 17.5 m). In four participants (66.7%) the minimum clinically important diference (MCID) for 6MWT distance in PAH patients was observed (25-33 m). Signifi cant improvement in chest excursions confi rm changes in breathing pattern suggesting better engagement of diaphragm during breathing after the program. Results did not show signifi cant improvements in either SF-36 survey domain. However, half of the participants reached MCID (11%) after the program at the physical health subscales. Conclusion: The results of this preliminary study prove that the created individualized home-based exercise program is safe, easily followed and allows progression in exercise intensity and improves physical functional state in clinically stable iPAH patients. This study hypothesis supports the need for RCT to continue research and approve the results.publishersversionPeer reviewe

Individually tailored 12-week home-based exercise program improves both physical capacity and sleep quality in patients with pulmonary arterial hypertension

Publisher Copyright: © 2021, ČKS.Background: Most patients with optimal PAH-targeted medical therapy suffer from clinical symptoms, reduced exercise tolerance and have a poor quality of life. The 2019 European Respiratory Society task force statement on physical exercise and rehabilitation in patients with severe, chronic PH suggests that individually adjusted and monitored exercise programs are likely to be safe for PH patients, who are clinically stable on medical therapy. Currently, the development of PAH-specific rehabilitation interventions is still in the research stage. We present the preliminary results of a more extensive study with the aim to show the effectiveness of a 12-week individualized, home-based exercise program in promoting physical capacity, quality of sleep and reducing signs of emotional distress in patients with PAH. Methods: This was a prospective randomized controlled interventional study. 16 PAH patients were included in the analysis. Training group underwent a complex training program, consisting of 12-week individually tailored home-based exercise training, education, self-control measures and tele-rehabilitation components. The program included muscle strength training, respiratory, aerobic exercise and relaxation techniques. Results: A statistically significant mean increase in 6MWT distance was observed for the training group (Δ = 51.7 ± 45.1 m). In six participants (66.7%) from the training group and two patients (28.6%) from the control group, the minimal clinically significant difference for 6MWT distance was observed (25–33 m). IPsubmax test results changed significantly in training group (Δ = 9.8 ± 4.7 cm H20). PSQI values sleep quality improved from poor to good in four (44.5%) patients from training group. HADS sub-scales scores values confirmed clinically important reduction of anxiety symptoms in both groups. Depression symptoms did not show clinically important changes. No adverse events were observed. Conclusion: The studied 12-week individually tailored home-based exercise program is effective in stable PAH patients by improving physical functional capacity, as well as sleep quality. Further studies are required to solidify the methodology of exercise programmes in the field of PAH. These are the preliminary results of ongoing study.publishersversionPeer reviewe

Individually Tailored Remote Physiotherapy Program Improves Participation and Autonomy in Activities of Everyday Life along with Exercise Capacity, Self-Efficacy, and Low-Moderate Physical Activity in Patients with Pulmonary Arterial Hypertension : A Randomized Controlled Study

Publisher Copyright: © 2022 by the authors. Licensee MDPI, Basel, Switzerland.Background and Objectives: Pulmonary arterial hypertension (PAH) is a rare, chronic, pro-gressive, and life-threatening disease; however, the appropriate target medical treatment today allows patients with PAH not only to survive but also to live a relatively normal life. However, patients face the challenge of adapting and maintaining a good quality of life, thus it is important to consider complex interventions related not only to medical treatment. Methods: This was a prospective, ran-domized, controlled, single-blind study. Twenty-one (21) patients diagnosed with PAH were included and randomly assigned to training or control group. All participants continued target medical therapy. Furthermore, TG underwent the individually tailored 12-week remote physiotherapy program. As a primary outcome measurement, the Impact on Participation and Autonomy Questionnaire (IPA) was used. Secondary outcome included aerobic capacity (6MWT), accelerometery and general self-efficacy (GSE). Data were collected at baseline, after 12 weeks and at follow-up 6 months after the beginning of the intervention. Results: A significant difference between the groups was found in the follow-up assessment on three of the four IPA subscales analyzed, AO, RF, and AI. The total IPA score decreased significantly in TG after the program, indicating an improved participation. In addition, in TG a significant increase in 6MWT results, daily time in low-or moderate-intensity physical activities, and GSE was observed. Conclusions: In summary, the individually tailored physiotherapy program inves-tigated added to stable target medical therapy in patients with PAH encourages improvement and prevents possible deterioration of perceived participation of patients in activities of their everyday life in the context of one’s health condition in the long term, along with improved exercise capacity and increased time spent in low-or moderate-intensity physical activities. Future studies are needed to develop and evaluate long-term intervention to support patients living with this rare, chronic, and life-threatening disease.publishersversionPeer reviewe

Individually tailored home-based physiotherapy program makes sustainable improvement in exercise capacity and daily physical activity in patients with pulmonary arterial hypertension

Funding Information: The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The study did not receive funding but was financially supported by Pauls Stradins Clinical University Hospital Scientific Institute (provision of IMT devices) and the Latvian Rare Diseases Research Foundation along with Beurer Company (provision of pulse oximeters). Publisher Copyright: © The Author(s), 2022.BACKGROUND: Pulmonary arterial hypertension (PAH) is a rare, chronic, progressive, and life-threatening cardiopulmonary disease. This study investigated the impact of an individually tailored 12 weeks home-based physiotherapy program in PAH patients, with the aim to evaluate change in exercise capacity and daily physical activity level. METHODS: This was an analysis of secondary outcomes from a prospective, randomized, controlled intervention study. Twenty-one participants were recruited from the Latvian PH registry based on inclusion criteria and randomized in a training group (TG) and control group (CG). Both groups continued a medical target therapy, but for TG, the individually tailored home-based physiotherapy program was added including physical exercises, relaxation, self-control, education, and supervision with telehealth elements. Outcomes included a 6-min walk test (6MWT) (m) and daily physical activity based on accelerometry results assessed at baseline, after 12 weeks, and at follow-up 6 months after commencement of intervention. RESULTS: 6MWT distance significantly (p 33 m) increased within TG after 12 weeks (51.8 m, 95% CI = 25.7-77.9 m, Cohen's d = 1.7) and at follow-up (75.5 m, 95% CI = 46.1-104.8 m, Cohen's d = 2.1). A significant difference in 6MWT results between the groups at 12 weeks and follow-up was approved. In TG, low-intensity activities significantly (p < 0.05) increased both after 12 weeks (Cohen's d = 1.6) and at follow-up (Cohen's d = 1.2), moderate-intensity activities significantly (p < 0.05) increased at follow-up (Cohen's d = 1.3), and no significant improvements were present in CG. CONCLUSION: The individually tailored 12 weeks home-based physiotherapy program comprising comprehensive physical exercise training, relaxation, self-control skills training, and education, added to stable medical target therapy and supervised by physiotherapist through telehealth elements, is effective in improving exercise capacity and increasing daily time in low or moderate physical activities 6 months after commencement of the intervention in patients with PAH.publishersversionPeer reviewe

Aaerobic Capacity of Health Care Students at Riga Stradinš University

Aerobic capacity (AC) is one of health indicators that characterise the functional status of heart, blood vessels, respiratory and other bodily systems. Aerobic capacity depends on several factors: the health conditions, gender, age and the level of physical activities. Students spend many hours in a sitting position in lectures, libraries, when preparing homework, as well as when watching the TV and sitting by the computer. As a result students’ work abilities decrease and the health conditions deteriorate. Health care specialists should be physically active, not only for the sake of their well-being and health conditions, but also they should to be able to motivate their clients to have an active lifestyle.Objective of the research. The objective of the research is to explore aerobic capacity of healthcare students and analyse it within the context of the respective age group population. Aerobic capacity was determined for 730 students (517 women and 213 men in the age group from18 to 30 years) by applying the veloergometry test of the World Health Organisation (WHO) and using veloergometersMonarkErgomedik 839E. Pursuant to the WHO test results during the studies aerobic capacity indicators deteriorated for the majority of students.

Hronisku muguras lejasdaļas sāpju pacientu analīze biopsihosociālā modeļa ietvaros. Promocijas darba kopsavilkums

Research was carried out at RSU Faculty of Rehabilitation Department of Rehabilitation, and RSU Department of Psychosomatic Medicine and Psychotherapy; Rehabilitation centre „Ligatne”. Defence: on November 14, 2011, at 14.00 p.m. on the open meeting of the Promotional Council of the Theoretical Medicine disciplines of Riga Stradiņš University in Riga, at Dzirciema Street 16, in the Hippocrates lecture-hall

Analysis of Chronic Low Back Pain Patients in the Framework of Biopsichosocial Model. Summary of the Doctoral Thesis

Promocijas darbs izstrādāts Rīgas Stradiņa universitātes Rehabilitācijas fakultātes Rehabilitācijas katedrā un Psihosomatiskās medicīnas un psihoterapijas katedrā; SIA Rehabilitācijas centrā Līgatne. Aizstāvēšana: Rīgas Stradiņa universitātes Teorētiskās medicīnas promocijas padomes atklātajā sēdē 2011. gada 14.novembrī plkst. 14.00 Rīgas Stradiņa universitātes Hipokrāta auditorijā, Rīgā, Dzirciema ielā 16