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1.

Purpose

To determine if 30 minutes of Nintendo Wii Sports boxing provides cardiorespiratory benefits and contributes to the daily exercise recommendations for healthy young adults.

Methods

Twenty healthy 23- to 27-year-olds participated in two sessions to measure maximum heart rate (HRmax) via a treadmill test and heart rate (HR) response to 30 minutes of Wii Sports boxing. Heart rate in beats per minute (bpm) was measured continuously, and exercise intensity during each minute of play was stratified as a percentage of HRmax. Mixed designs analysis of variance (ANOVA) and Pearson product moment correlations were used to analyze the data.

Results

Mean (SD) HR response to boxing was 143 (15) bpm or 77.5% (10.0%) of HRmax. The mean HR response for experienced participants was significantly lower than inexperienced participants, P = .007. The ANOVA revealed a significant interaction between experience and time spent at various intensities, P = .009. Experienced participants spent more time in light to vigorous intensities, inexperienced participants in moderate to very hard intensities. Fitness was not correlated with mean HR response to boxing, P = .49.

Conclusion

Thirty minutes of Nintendo Wii Sports boxing provides a moderate to vigorous aerobic response in healthy young adults and can contribute to daily recommendations for physical activity.Key Words: exergaming, cardiorespiratory training, active video games  相似文献   

2.

Purpose

Reduced cardiovascular fitness post-stroke may negatively impact recovery. There is little information regarding exercise testing performance and cardiorespiratory response to an aerobic exercise intervention in subacute stroke. The purpose of this study was to examine cardiorespiratory response in subacute stroke after an 8-week aerobic exercise intervention using a total body recumbent stepper (TBRS).

Methods

Nine individuals with mean age 61.2 (SD 4.7) years and mean 66.7 (SD 41.5) days post-stroke completed the exercise intervention. Participants had a mean Fugl-Meyer score of 100.3 (SD 29.3). Outcome measures were obtained at baseline and postintervention. A peak exercise test using a TBRS assessed oxygen consumption, heart rate, and minute ventilation. Participants completed an 8-week exercise intervention on a recumbent stepper 3 times per week at a prescribed heart rate intensity.

Results

Submaximal VO2 was significantly lower from baseline to postintervention with a main effect of Study Visit (F1,8 = 8.5, p = 0.02). Heart rate was not significantly different pre- to postintervention. Minute ventilation exhibited no main effect of Study Visit or Test Minute.

Conclusion

Moderate-high intensity aerobic exercise in subacute stroke appears to be beneficial for improving cardiovascular outcomes during submaximal performance of an exercise test.Key Words: oxygen uptake, cerebrovascular accident, cardiovascular fitness, submaximal exercise  相似文献   

3.

Purpose

The aim of this study was to investigate the effects of mobilization on respiratory and hemodynamic parameters in critically ill obese patients.

Methods

Critically ill obese patients (n = 31) were included in this retrospective study. Data were collected from patients’ files and physiotherapy records of mobilization sessions. Heart rate (HR), systolic/diastolic/mean blood pressure, respiratory rate (RR), and percutaneous oxygen saturation (SpO2) were recorded. Cardiorespiratory parameters were collected just prior to the mobilization, just after the completion of the mobilization and after 5 minutes recovery period. Respiratory reserve was calculated before and after the mobilization.

Results

A total of 37 mobilization sessions in 31 obese patients (mean age: 63.3 years, mean BMI: 32.2 kg/m2) who received physiotherapy were analyzed. Respiratory rate increased significantly after the completion of the mobilization compared to initial values (p < 0.05). SpO2 significantly increased (p < 0.05) and all other parameters remained similar (p > 0.05) compared to initial values after the recovery period. Mobilization resulted in a significant increase in respiratory reserve (p < 0.05).

Conclusion

Early mobilization in intensive care unit promotes respiratory reserve in obese patients. We found that mobilization can be performed safely in critically ill obese patients if cardiorespiratory parameters are continuously monitored.Key Words: obesity, mobilization, critically ill patients, physiotherapy  相似文献   

4.
5.

Purpose

To determine the opinions and attitudes toward exercise in people with chronic obstructive pulmonary disease (COPD) who had completed a randomised controlled trial of 12-months maintenance exercise.

Methods

Participants were eligible for recruitment to the maintenance exercise study if they had COPD and had completed an 8-week pulmonary rehabilitation program. They were randomized into an Intervention Group (IG) that consisted of once weekly, supervised hospital-based maintenance exercise plus home exercise for 12 months or a Control Group that undertook unsupervised home maintenance exercise for 12 months. At the end of the 12 months, participants completed a survey consisting of 23 questions using a visual analogue scale (VAS) of 100 mm.

Results

Forty-eight participants completed the 12 month study and 36 participants (75%) completed the survey [IG mean (SD): age 65 (8) years, FEV1 58 (20) % predicted; CG: age 66 (8) years, FEV1 67 (17) % predicted]. No between group difference was found for the importance of exercise, the benefits of the program or the importance of support from the physiotherapist. However, the IG reported exercising more regularly, having more enjoyment of being involved in the maintenance exercise program, greater benefit in general well-being, and better physical fitness.

Conclusions

At the completion of the 12 month exercise study, the survey results showed that all participants reported positive attitudes towards both supervised and unsupervised maintenance exercise programs, with the IG reporting greater benefits.Key Words: COPD, survey, maintenance exercise program  相似文献   

6.

Purpose

Large therapeutic rolls (LTR) and balls are popular rehabilitation tools and have also been advertised as cardiovascular training devices. The aim of this study was to determine if individuals of varying fitness levels would reach aerobic training levels by evidence-based standards as described in American College of Sports Medicine (ACSM) publications.

Methods

Fourteen volunteers performed a maximal exercise test and on subsequent days, two submaximal exercise tests on the LTR (LTR-A and -B). LTR-A consisted of four 5-minute stages of exercise at progressive intensity levels. LTR-B included 20 minutes of continuous exercise. Oxygen consumption (VO2) and heart rate (HR) during exercise on the LTR were compared with ACSM recommended standards.

Results

The average (range) peak intensity achieved during LTR-A was 66.8% (51.7-82.7%) of maximal VO2 reserve (VO2R) and 82.9% (70.7%-91.2%) of maximal heart rate (HRmax). During LTR-B, HR and VO2 of all participants was maintained at moderate exercise intensity and averaged 56% of VO2R and 78% of HRmax during the 20 minute exercise period.

Conclusions

These findings suggest that individuals with a wide range of aerobic fitness are able to reach and maintain aerobic training levels with appropriate exercise on a large therapeutic roll or ball.Key Words: large therapeutic roll, Swiss Ball, aerobic exercise, exercise intensity  相似文献   

7.
8.

Purpose

Performing exercise tests in patients with an implantable cardioverter defibrillator (ICD) presents specific challenges because of susceptibility to ventricular arrhythmias during maximal levels of exertion. The purpose of this paper is to outline the exercise testing protocol from the Anti-Arrhythmic Effects of Exercise after an ICD trial and to report baseline test results and safety outcomes using the protocol.

Methods and Results

Maximal cardiopulmonary exercise testing was performed to assess levels of physical fitness as part of a randomized trial of walking exercise in patients with ICDs. Subjects were randomized after baseline testing to aerobic exercise plus usual care or usual care alone. A modified Balke treadmill exercise test was used and specific ICD programming procedures were implemented to avoid unnecessary shocks, which included programming off ventricular tachycardia (VT) therapies during testing. To date, 161 baseline tests have been performed. One ventricular fibrillation (VF) cardiac arrest occurred following completion of an exercise test and three tests were stopped by the investigators due to nonsustained ventricular tachycardia. Eleven subjects were not able to achieve maximum exercise, defined as reaching an anaerobic threshold (AT) at baseline testing. There have been no deaths as a result of exercise testing.

Conclusions

Symptom-limited maximal exercise testing can be performed safely and effectively in patients with ICDs for both primary and secondary prevention indications. Specific strategies for ICD programming and preparation for treating ventricular arrhythmias needs to be in place before exercise testing is performed.Key Words: implanted cardioverter defibrillator, exercise testing, treadmill protocol  相似文献   

9.
10.

Purpose

The purpose of this review is to evaluate the literature related to mobilization of the critically ill patient with an emphasis on functional outcomes and patient safety.

Methods

We searched the electronic databases of PubMed, CINAHL, Medline (Ovid), and The Cochrane Library for a period spanning 2000–2011. Articles used in this review included randomized and nonrandomized clinical trials, prospective and retrospective analyses, and case series in peer-reviewed journals. Sackett''s Levels of Evidence were used to classify the current literature to evaluate the strength of the outcomes reported.

Results

Fifteen studies met inclusion criteria and were reviewed. According to Sackett''s Levels of Evidence, 9 studies were level 4 evidence, one study was level 3, 4 studies were level 2, and one study was level one evidence. Ten studies pertained to patient safety/feasibility and 10 studies pertained to functional outcomes with 5 fitting into both categories.

Conclusion

A search of the scientific literature revealed a limited number of studies that examined the mobilization of critically ill patients in the intensive care unit. However, literature that does exist supports early mobilization and physical therapy as a safe and effective intervention that can have a significant impact on functional outcomes.Key Words: mobilization, exercise, intensive care unit, critical illness, physical therapy  相似文献   

11.
12.

Purpose

Following a cardiac event patients are at risk for deficits in mobility and function. However, measures of physical performance are not commonly used and have not been extensively studied in patients enrolled in cardiac rehabilitation. The purpose of this study was to determine the reliability and the minimal detectable change (MDC) of gait speed, 5 times sit to stand (5 STS) and hand grip strength for individuals enrolled in cardiac rehabilitation.

Methods

Forty-nine individuals enrolled in phase II or III cardiac rehabilitation participated in the study. Gait speed, 5 STS, and hand grip strength were measured over two sessions held on the same day. Intraclass correlation coefficient was used to determine reliability and MDC95 was calculated to measure responsiveness.

Results

All 3 measures showed high reliability (ICC for gait speed = 0.96, 5 STS = 0.87, right hand grip strength = 0.97, left hand grip strength = 0.97). The MDC95 for gait speed was 0.16 meters/second, 3.12 seconds for 5 STS, 5.2 kilograms for right and 5.1 kilograms for left hand grip strength.

Conclusion

Gait speed, 5 STS, and hand grip strength are reliable and responsive measures for patients in cardiac rehabilitation. Findings support their use in clinical practice and future cardiac rehabilitation studies.Key Words: cardiac rehabilitation, gait speed, sit to stand  相似文献   

13.

Introduction

There are limited data describing mobility interventions provided to patients with femoral catheters. The purpose of this study was to examine the incidence of femoral catheter related adverse effects during physical therapy (PT) sessions in a cardiovascular intensive care unit (ICU).

Methods

This was a prospective, observational study and included patients with at least one femoral catheter. Data were collected after each PT session.

Results

There were 77 subjects with a total of 92 femoral catheters (50 arterial, 15 central venous, and 27 dialysis) treated. A total of 210 separate PT sessions occurred with 630 mobility activities including sitting on side of bed, standing at the bedside, transfers to stretcher chair or regular chair, and walking. There were no catheter related mechanical or thrombotic complications during any of the PT sessions.

Conclusions

Physical therapy sessions, including standing and walking were feasible and safe in cardiovascular ICU patients with femoral catheters who met the criteria for mobility interventions. The results from this study support the hypothesis that early mobilization in patients with femoral catheters is important to minimize functional decline and provide evidence that the presence of femoral catheters alone should not be a reason to limit progressive mobility interventions.Key Words: physical therapy, ICU, early mobilization, femoral catheter  相似文献   

14.
15.

PURPOSE

The primary purpose of this study was to investigate 6-minute walk test (6MWT) performance in young children who were normal weight (NW) and overweight (OW).

METHODS

Seventy children, 5-9 years of age, participated in this study. The 6MWT was performed on an indoor walkway. Heart rate (HR), blood pressure (BP), and oxygen saturation (SaO2) were measured. A self-reported physical activity questionnaire was completed by a parent/guardian. Data were analyzed with independent t tests, ANOVA, correlation analyses, and logistic regression.

RESULTS

The systolic BP values were higher in the children who were OW compared with their NW peers (resting mean 104.1 (8.9) mmHg vs. 97.5 (7.8) mmHg, P < 0.05; post-6WMT: mean 118.4 (10.78) mmHg vs. 109.9 (9.1) mmHg, P < 0.05). The SaO2 values were lower in the children who were OW compared to their NW counterparts (resting: mean 97.2 (1.1) % vs. 98.0 (1.0) %, P < 0.05; post-6WMT: mean 96.8 (1.0) % vs. 97.7 (1.0) %, P < 0.05).

CONCLUSIONS

The children who were OW had higher systolic BP and lower SaO2 levels at rest and post-6WMT. More research is needed to determine if these differences contribute to children who are OW having difficulty performing exercise.Key Words: obesity, children, exercise capacity  相似文献   

16.

Purpose

The study purpose was to assess perceptions of physical therapists (PTs) regarding the role of physical therapy in cardiovascular disease (CVD) prevention.

Methods

A 25-item survey, validated by expert cardiovascular/pulmonary (CVP) PTs, was sent electronically to 2,673 PTs. Each item represented an element of clinical practice behavior: education of CVD/risk factors (EDCVD), administration of primary CVD prevention (PRECVD), identifying underlying CVD/risk factors (IDCVD), monitoring CV status in patients with CVD (MONCVD). Responses were assigned numeric values (strongly agree = 5 to strongly disagree = 1), and mean element scores were analyzed.

Results

Most of the 516 respondents were APTA Section members (34% CVP Section, 42% other Section membership) and worked in academia (53%). Items showing a high (> 95%) level of agreement included patient education of smoking (97%) and monitoring exercise intensity (99%), assessing exercise benefits (99%), clinically identifying obesity (97%) and hypertension (97%), and monitoring CV response to exercise (99%). Items failing to reach 80% overall agreement were patient education of CVD medications (79%) and blood chemistry (72%), and assessing CVD family history (75%), patient BMI (60%), and body composition (33%). Identifying underlying CVD (77.2%) was the only practice behavior failing to reach 80% agreement. Outpatient PTs agreed significantly less to all elements vs. academics, and to IDCVD vs. all PTs except home health.

Conclusions

Physical therapists support most CVD prevention behaviors, but not given elements of patient education and identifying underlying CVD/risk factors.Key Words: cardiovascular disease, primary disease prevention, secondary disease prevention  相似文献   

17.

Purpose

Recently there has been increased interest in early mobilization of critically ill patients. Proposed benefits include improvements in respiratory function, muscle wasting, intensive care unit (ICU), and hospital length of stay. We studied the frequency of early mobilization in our intensive care unit in order to identify barriers to early mobilization.

Methods

A 4-week prospective audit of 106 patients admitted to a mixed medical-surgical tertiary ICU (mean age 60 ± 20 years, mean APACHE II score 14.7 ± 7.8) was performed. Outcome measures included number of patient days mobilized, type of mobilization, adverse events, and reasons for inability to mobilize.

Results

Patients were mobilized on 176 (54%) of 327 patient days. Adverse events occurred in 2 of 176 mobilization episodes (1.1%). In 71 (47%) of the 151 patient days where mobilization did not occur, potentially avoidable factors were identified, including vascular access devices sited in the femoral region, timing of procedures and agitation or reduced level of consciousness.

Conclusions

Critically ill patients can be safely mobilized for much of their ICU stay. Interventions that may allow more patients to mobilize include: changing the site of vascular catheters, careful scheduling of procedures, and improved sedation management.Key Words: intensive care units, mobility, physical therapy  相似文献   

18.
19.

Purpose

Physical therapists (PTs) have a unique opportunity to intervene in the area of health promotion. However, no instrument has been validated to measure PTs’ views on health promotion in physical therapy practice. The purpose of this study was to evaluate the content validity and test-retest reliability of a health promotion survey designed for PTs.

Methods

An expert panel of PTs assessed the content validity of “The Role of Health Promotion in Physical Therapy Survey” and provided suggestions for revision. Item content validity was assessed using the content validity ratio (CVR) as well as the modified kappa statistic. Therapists then participated in the test-retest reliability assessment of the revised health promotion survey, which was assessed using a weighted kappa statistic.

Results

Based on feedback from the expert panelists, significant revisions were made to the original survey. The expert panel reached at least a majority consensus agreement for all items in the revised survey and the survey-CVR improved from 0.44 to 0.66. Only one item on the revised survey had substantial test-retest agreement, with 55% of the items having moderate agreement and 43% poor agreement.

Conclusions

All items on the revised health promotion survey demonstrated at least fair validity, but few items had reasonable test-retest reliability. Further modifications should be made to strengthen the validity and improve the reliability of this survey.Key Words: health promotion, physical therapy, validity, reliability  相似文献   

20.

Introduction

Although the life expectancy for patients with cystic fibrosis (CF) has increased dramatically in the preceding decades, often the final therapeutic option for patients with end-stage CF is lung transplantation. Prior to transplantation, patients with severe disease may require mechanical ventilation. Those refractory to mechanical ventilation may require extracorporeal membrane oxygenation (ECMO). The purpose of this case report is to describe the physical therapy management of a patient who received ECMO as a bridge to lung transplantation.

Case Presentation

A 16-year-old girl with severe acute respiratory failure due to a CF exacerbation eventually required ECMO to maintain adequate gas exchange. While on ECMO, she received physical therapy interventions ranging from therapeutic exercise, manual therapy, and integumentary protection techniques in addition to airway clearance techniques. Prior to her transplant, she was standing multiple times per day with moderate assistance, was sitting on the edge-of-bed, as well as taking steps to transfer to/from a chair. She successfully received a bilateral lung transplant after 8 days on ECMO.

Conclusion

Physical therapy interventions, including out-of-bed mobility, can be safely provided to patients on portable ECMO as a bridge to lung transplantation. These interventions were focused on preventing the negative sequelae of bed rest, increasing her strength and endurance, as well as improving her level of consciousness and psychological well being in preparation for lung transplantation.Key Words: extracorporeal membrane oxygenation, lung transplantation, physical therapy, exercise  相似文献   

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