Objetivo: avaliar o efeito de um programa de reabilitação sobre a capacidade física de pacientes integrantes de um programa de reabilitação pós-infecção por SARS-CoV-2. Métodos: estudo observacional ...de incidência retrospectiva, com amostra de prontuários de pacientes >18 anos, participantes do programa de reabilitação pós-COVID-19 no Centro de Reabilitação da PUCRS. Foram extraídos dados demográficos, antropométricos e de testes funcionais, incluindo o teste da caminhada dos seis minutos (TC6) e o teste de sentar e levantar (TSL), antes e depois do programa. O programa foi composto por treinamento aeróbico e resistido, duas vezes por semana, totalizando 16 sessões. O treinamento aeróbico foi conduzido na esteira com duração de 30 minutos, sendo avaliada frequência cardíaca, saturação, pressão arterial e escala de Borg (dispneia e cansaço em membros inferiores). O treino resistido foi realizado após o teste de repetição máxima (1RM) com a carga variando entre 50-80% de 1RM, durante 30 minutos. Resultados: foram incluídos 13 pacientes, com média de idade de 51,0±16,4 anos. Ao comparar os resultados pré e pós-reabilitação, encontramos diferenças significativas na distância percorrida no TC6, sendo de 480,5±91,3 metros pré e 722,1±235,9 metros após a intervenção (p<0,001), bem como no percentual do previsto, sendo 87,5±18,8 pré e 130,7±43,5 após (p=0,001). Além disso, ao analisar o TSL, verificou-se uma redução significativa no tempo, de 12,3±4,7 segundos pré-programa para 8,8±2,2 após (p=0,005). Conclusão: o programa de reabilitação apresentou impacto positivo na capacidade física de pacientes que integraram o programa de reabilitação pós-infecção por SARS-CoV-2.
To improve preoperative risk stratification in lung cancer lobectomy by identifying and comparing optimal thresholds for peak oxygen uptake (VO2peak) presented as weight-indexed and percent of ...predicted values, respectively.
This was a longitudinal cohort study including national registry data on patients scheduled for cancer lobectomy that used available data from preoperative cardiopulmonary exercise testing. The measured VO2peak was indexed by body mass (mL/kg/min) and also compared with 2 established reference equations (Wasserman-Hansen and Study of Health in Pomerania, respectively). By receiver operating characteristic analysis, a lower 90% specificity and an upper 90% sensitivity threshold were determined for each measure, in relation to the outcome of any major complication or death. For each measure and based on these thresholds, patients were categorized as low risk, intermediate risk, or high risk. The frequency of complications was compared between groups using χ2.
The frequency of complications differed significantly between the proposed low-, intermediate-, and high-risk groups when using % predicted Study of Health in Pomerania (5%, 21%, 35%, P = .007) or % predicted Wasserman-Hansen (5%, 25%, 35%, P = .002) but not when using the weight-indexed VO2peak groups (7%, 23%, 15%, P = .08). Nonsignificant differences were found using the threshold <15 mL/kg/min (P = .34).
This study showed that weight-indexed VO2peak was of less use as a marker of risk at the lower range of exercise capacity, whereas % predicted VO2peak was associated with a continuously increasing risk of major complications, also at the lower end of exercise capacity. As identifying subjects at high risk of complications is important, % predicted VO2peak is therefore preferable.
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BackgroundPridopidine is a well-tolerated, oral Sigma-1 receptor (S1R) agonist. Human PET imaging shows pridopidine 45 mg bid, the dose currently evaluated in PROOF-HD, has selective and robust S1R ...occupancy. In preclinical HD models, S1R activation by pridopidine enhances multiple cellular processes impaired in HD, leading to neuroprotection. In the PRIDE-HD Ph2 trial, pridopidine 45 mg bid showed a beneficial effect vs placebo (Δ0.87, p=0.0032) on Total Functional Capacity (TFC) at Week 52. TFC is a regulatory-accepted, validated scale for clinical progression of HD. Post-hoc analysis shows this effect is driven by early HD patients (TFC7-13) (Δ1.16, p=0.0003). Responder analysis demonstrates that pridopidine reduced the probability of TFC worsening by 80% (p=0.002).AimEvaluate the efficacy and safety of pridopidine 45 mg bid on TFC in early HD.DesignPROOF-HD is a 65-week, double-blind, placebo-controlled, global Ph3 trial assessing pridopidine 45 mg bid in early HD patients. Primary endpoint is change from baseline to week 65 in TFC. Secondary endpoints include proportion of patients with no TFC decline and changes to week 65 in Q-Motor, Total Motor Score (TMS) and the composite UHDRS. Plasma neurofilament (NfL) levels are an exploratory endpoint. PROOF-HD completed enrollment of 499 patients ahead of schedule in Oct 2021. As of June 16th, 2022, low dropout (23/499, 4.6%) and treatment discontinuations (19/499, 3.8%) confirm pridopidine’s favorable tolerability and safety profile. In February 2022, an independent safety monitoring committee reported no safety signals of concern, and recommended PROOF-HD continue as planned. Results are expected in early 2023.
Chronic low back pain (LBP) is a prevalent condition in older adults, being identified as a cause of disability in this population. Despite ir validity and reliability, the functional capacity tests ...are not often administered in patients with LBP but provide useful information related to mobility. A measurement property of the functional capacity tests that has not been investigated extensively in the LBP field is the resiveness, such as the capacity to detect changes during the intervention.
To determine the responsiveness of three functional capacity tests, the Timed Up and Go test, the 4-meter Walk test, the 5 times Sit to Stand test, and to compare with the responsiveness of the Roland Morris Disability Questionnaire (RMDQ) in older adults with chronic LBP undergoing an 8-week intervention.
This is a responsiveness study with measurement before and after an 8-week intervention. It was prospectively registered at the Brazilian Registry of Clinical Trials (RBR-9prhzng). Patients with nonspecific LBP (age ≥60) were recruited. The functional capacity tests and the RMDQ were administered at baseline and after 8 weeks. The intervention followed the recommendations from clinical practice guidelines for the management of nonspecific LBP: The responsiveness was determined by calculating the effect size (ES), correlation analysis, and the analysis of the Receiver Operating Characteristic (ROC) Curve to calculate the area under the curve (AUC).
118 older adults with chronic LBP were recruited. The RMDQ was the most responsiveness measure, followed by the Sit to Stand test. The ES for the RMDQ was large (ES= -0,74; 95%IC: -0,56; -0,92), whereas the 5 Times Sit to Stand test presented a small effect (EF= -0,45, 95%CI: - 0,26; -0,64). The Timed UP and Go test and the 4-meter Walk test small ESs (ES< 0,25). The 5 Times Sit to Stand test was the only one to show a fair correlation (0,25 < r <0,50) with RMDQ. The ROC analysis, only the RMDQ showed AUC values above the cut-off point of 0,70.
The RMDQ was responsive to an 8-week lumbar stabilization program in older adults with chronic LBP. The 5 Times Sit to Stand test was the most responsive but presented limitations with regard to the capacity to discriminate patients who recovered from those who did not recover. A possible explanation for the lack of responsiveness foto the tests may be due to the nature of the intervention, which was not focused on increasing ability and balance, components that are necessarily assessed by functional capacity tests.
Functional capacity tests are widely used to assess mobility and balance in older adults. Only the 5 Times Sit to Stand test was considered to able to detect changes in older adults who underwent an 8-week intervention program. The RMDQ was more responsive than any of the functional capacity tests.
Background and Objective:Adolescent idiopathic scoliosis is one of the complex and common deformities of the spine. It is a condition that can cause a lot of pain and discomfort for individuals and ...has consequences and complications. There are different exercises and approaches for correction of this deformity, such as Schroth exercise. In this regard, the purpose of this study was to investigate the effect of corrective exercises on Cobb angle, flexibility, functional capacity, and quality of life of adolescents with idiopathic scoliosis. Materials and Methods:This controlled clinical trial with pre-test and post-test design was performed on 24 adolescents with idiopathic scoliosiswho were randomly divided into control and experimental groups. Cobb angle, flexibility, and functional capacity were measured by X-ray imaging, flexibility box, and six-minute walk test, respectively. The collected data were statistically analyzed in SPSS software (version 23) using a mixed-design analysis of variance with repeated measures. It must be noted that a p-value of 0.05 was considered statistically significant. Results:Based on the results, after 10 weeks of Schroth exercises, there was a significant difference in the exercise group regarding the reduction of Cobb angle as well as the increase of flexibility and functional capacity. However, no significant difference was observed in the control group from pre-test to post-test (P≤0.05). Conclusion:According to the results, it can be concluded that the Schroth exercise program that involves the whole motor chain can effectively decrease the lateral curvature angle of patients with idiopathicscoliosis. Therefore, this type of exercise can be useful to use to treat people with Idiopathic scoliosisdeformity.
Patients with schizophrenia suffer from physical health conditions, culminating in reduced physical functioning with enormous costs for patients and society. Although aerobic endurance and skeletal ...muscle strength, typically reduced in this population, relate to cognition and function, no study has explored their respective contributions to performance of functional skills and everyday tasks.
In a cross-sectional study, 48 outpatients (28/20 men/women; 35 ± 11(SD) years) with schizophrenia spectrum disorders (ICD-10; F20–25) were administered the UCSD Performance-based Skills Assessment-Brief (UPSA-B; functional skills), Specific Level of Functioning (SLOF; functional performance) and the Positive and Negative Syndrome (PANSS) scale. Peak oxygen uptake (V̇O2peak) was assessed along with leg press maximal muscle strength (1RM) and mechanical power.
UPSA-B performance was associated with V̇O2peak (r = 0.28,p < 0.05), accounting for 8 % (p < 0.05) of shared variance, but was unrelated to 1RM and mechanical power. The SLOF physical functioning domain was associated with V̇O2peak (r = 0.30,p < 0.05) and 1RM (r = 0.24,p < 0.05), while SLOF personal care (r = 0.27,p < 0.05) and activities (r = 0.30,p < 0.05) were related only to V̇O2peak. Hierarchical regression analyses revealed that while V̇O2peak and age combined to account for 20 % (p < 0.05) of the variance in physical functioning, the contribution of 1RM was eliminated after adjusting for age. V̇O2peak and negative symptoms combined predicted 24 % and 35 % of the variance in personal care and activities, respectively. UPSA-B scores did not add to the prediction of SLOF scores.
Although V̇O2peak and 1RM both relate to functional outcomes, the combination of V̇O2peak, age, and negative symptoms exert the greatest detrimental influence on functional performance beyond skills deficits.
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PURPOSETo investigate the efficacy of a 12-week combined functional anaerobic and strength training program on neuromuscular properties and functional capacity in young adults with spastic-type CP.
...METHODS17 young adults (21±4 years, 9 males, GMFCS I=11, II=6) were randomized to 12 weeks, 3 sessions per week, of high intensity functional anaerobic and progressive resistance training of the lower limbs (n=8), or a waitlist control group (n=9). Pre- and post-training plantar flexor and tibialis anterior muscle volumes and composition, passive and active plantar flexor muscle properties, and functional capacity outcomes were assessed.
RESULTSThe training group had higher values compared to the control group (adjusted mean difference) at 12-weeks formore- and less-impaired total plantar flexor and tibialis anterior muscle volumes; maximum isometric plantar flexion strength; muscle power sprint test peak power; agility shuttle time; composite functional strength score; and six-minute walk test distance. The change in total plantar flexor muscle volume was associated with the change in plantar flexor muscle strength. There were relationships between the change in plantar flexor muscle strength and change in functional capacity outcomes (functional strength; six-minute walk test).
CONCLUSIONSCombined functional anaerobic and strength training increased muscle size, strength and functional capacity in young adults with CP. The addition of anaerobic training to progressive resistance training programs assists in the transfer to improved functional capacity.
Abstract
Background and hypothesis
Recovery from psychosis is a complex phenomenon determined by an array of variables mutually impacting each other in a manner that is not fully understood. The aim ...of this study is to perform an approximated replication of a previous network analysis study investigating how different clinical aspects—covering psychopathology, cognition, personal resources, functional capacity, and real-life functioning—are interrelated in the context of schizophrenia-spectrum disorders.
Study design
A sample of 843 subjects from a multisite cohort study, with the diagnosis of a schizophrenia-spectrum disorder, was used to estimate a network comprising 27 variables. The connectivity and relative importance of the variables was examined through network analysis. We used a quantitative and qualitative approach to infer replication quality.
Study results
Functional capacity and real-life functioning were central and bridged different domains of the network, in line with the replicated study. Neurocognition, interpersonal relationships, and avolition were also key elements of the network, in close relation to aspects of functioning. Despite significant methodological differences, the current study could substantially replicate previous findings.
Conclusions
Results solidify the network analysis approach in the context of mental disorders and further inform future studies about key variables in the context of recovery from psychotic disorders.
•Mung bean protein (MBP) was hydrolyzed by five proteases.•Alcalase had a stronger hydrolytic ability to MBP than other proteases.•Five proteases hydrolysis significantly destroyed the α-helix and ...β-sheet of MBP.•Protamex, papain hydrolysates had stronger functional properties than others.•Alcalase hydrolysate exhibited stronger antioxidant activity than other hydrolysates.
This study aimed to investigate physicochemical, functional and antioxidant properties of mung bean protein (MBP) enzymatic hydrolysates (MBPEHs) by alcalase, neutrase, protamex, flavourzyme and papain. Physicochemical properties were evaluated by SDS-PAGE, particle size distribution, FTIR, ultraviolet visible and fluorescence spectrophotometries. ABTS, hydroxyl scavenging, Fe2+ chelating activity were used to evaluate antioxidant activity. Enzymolysis with five proteases decreased average particle size, α-helix, β-sheet, surface hydrophobicity of hydrolysates. Alcalase hydrolysate had the highest degree of hydrolysis (23.55%), absolute zeta potential (33.73 mV) and the lowest molecular weight (<10 kDa). Protamex and papain hydrolysates had higher foaming capacities, emulsification activity indexes, emulsion stability indexes (235.00%, 123.07 m2/g, 132.54 min; 200.10%, 105.39 m2/g, 190.67 min) than MBP (135.03%, 20.03 m2/g, 30.88 min). Alcalase hydrolysate demonstrated the lowest IC50 (mg/mL) in ABTS (0.12), hydroxyl (2.98), Fe2+ chelating (0.22). These results provide support for application of MBPEHs as foaming agent, emulsifier and antioxidant in food industry.
Emerging evidence has supported the idea that goal-directed prehabilitation is a promising approach to boost functional capacity in preoperative patients. However, its usefulness has not been tested ...in the hepatobiliary and pancreatic (HBP) field. The objective of this trial was to investigate the efficacy of goal-directed prehabilitation for improving functional capacity in patients who were planned to undergo major HBP operations.
This assessor-blinded, parallel-arm, randomized clinical trial recruited patients who were scheduled for major HBP surgeries for malignancy. Patients were randomly allocated into the step goal-directed prehabilitation (GOLD) group as the test group and into the conventional prehabilitation (CONV) group as the control group. Patients in the GOLD group participated in a walking prehabilitation program with an intergrading goal of the step count. Patients in the CONV group received standard physical and nutritional prehabilitation. The primary outcome was change in the 6-minute walking distance (6MWD), which ranged from the time before starting prehabilitation (baseline) to the time after completing prehabilitation (immediately before surgery).
Among 180 randomized patients, 144 patients were included in the primary analysis (73 patients in the CONV group and 71 patients in the GOLD group). The mean change in the 6MWD was 27 m in the CONV group and 31 m in the GOLD group (P = 0.633).
In patients undergoing major HBP surgeries for malignancies, a goal-directed prehabilitation program did not result in a significantly greater increase in functional capacity than did conventional prehabilitation. Registration number: UMIN000038791 (https://www.umin.ac.jp/).
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