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Recipient management before transplantation
Published in Wickii T. Vigneswaran, Edward R. Garrity, John A. Odell, LUNG Transplantation, 2016
Gundeep S. Dhillon, David Weill
Patients with advanced lung disease can develop decreased exercise tolerance secondary to their ventilatory limitations, skeletal muscle dysfunction, and symptoms associated with their underlying lung disease, such as cough, dyspnea, and fatigue.24 Patients awaiting a lung transplant can be markedly inactive, with major parts of their waking hours devoted to sitting (54%) and lying (15%).25,26 Studies of patients with idiopathic pulmonary fibrosis (IPF) and CF have documented that the 6-minute walk distance (6MWD) predicts survival in patients awaiting a lung transplant.27,28 Candidates’ functional status and exercise capacity as measured by 6MWD are associated with waiting list and posttransplant survival. This effect has been described in all lung disease groups.29 An improvement in exercise tolerance achieved by pulmonary rehabilitation may result in improved clinical outcomes before and after lung transplantation.30 Both interval and continuous training are effective in improving exercise capacity in patients listed for lung transplantation.31,32 Similarly, Nordic walking has been shown to be safe, feasible, and effective in patients awaiting lung transplantation.33 Transplant candidates’ access to formal pulmonary rehabilitation programs may be limited by financial or geographic constraints. If feasible, patients should be strongly encouraged to participate in formal exercise programs. Alternatively, they should be encouraged to remain physically active and be provided with educational resources to develop their own home-based exercise regimen. Additionally, their overall exercise tolerance and level of debility should be closely monitored.
Bone Health
Published in Carolyn Torkelson, Catherine Marienau, Beyond Menopause, 2023
Carolyn Torkelson, Catherine Marienau
Chi walking blends the health benefits of walking with the core principles of Tai Chi to deliver maximum physical, mental, and spiritual fitness. Becoming a better walker does not depend on how fast or how far you can walk but on how well you can listen to your body and respond to its needs. Chi walking can be ideal for women as they age because it encourages good body mechanics, improves balance, and engages the core. A quick explanation: Begin by aligning your posture, making sure your spine is long, tall, and straight. Set your feet hip-width apart and parallel and soften your knees. Then, engage your core by leveling your pelvis. Do this by placing a hand on your belly with your thumb at your naval and your fingers just above your pubic bone, and gently activating the pelvic muscles under your fingers so that your pelvis tilts. Your body weight is always centered over your leading foot, so that movement begins from your center, and the bulk of the work is done by your core muscles rather than your feet and legs. This enhances balance and lessens the risk of falling or injury. Next, move forward by leading with your upper body, in balance over your stepping foot, rather than leading with your legs. Choose which direction you are going before you start, so that all parts are moving in the same direction. Keep moving forward, with your posture straight, your core engaged, and your upper body balanced over your lower body. Mindfully complete the first four steps so that your forward movement has balance, purpose, and direction. Watching a YouTube video is helpful to see this in action.Nordic walking is a type of total body walking done with walking poles that are similar to ski poles. It has been done in Scandinavian countries for years, and now an estimated 12 million Europeans are Nordic walkers. This full-body workout helps to engage the core and upper-body muscles, which in turn support posture and stability. Getting into a walking rhythm can increase the exertion of walking by 40%, as well as being a form of moving meditation. Nordic walking can be done even in winter months, by yourself or in a group as a social activity—what a fun way to benefit from a daily walking routine.
Minimal clinically important difference of the King’s Parkinson’s disease Pain Scale
Published in Disability and Rehabilitation, 2023
Ghorban Taghizadeh, Seyed-Mohammad Fereshtehnejad, Sepideh Goudarzi, Shamsi Jamali, Maryam Mehdizadeh
Each intervention session was carried out for 70 min and consisted of (1) 10-min warm-up, with light stretches and movement of trunk and limbs; (2) 20-min strength training including light weight-bearing, isometric and isotonic exercises for the trunk and limbs (arm extensors and flexors, knee extensors and flexors, hip extensors and flexors, and ankle extensors and flexors, as in several jumping; (3) 30-min balance exercises and Nordic walking, the first consisting of multidirectional stepping and postural transitions, compensatory postural adjustments (rapid unpredictable changes in posture) as well as instructions to maintain attention during tasks, rapid walking (at a heart rate of 65–80% of the maximal heart rate based on the subject's age) and the latter (Nordic walking) including opening of the hands, diagonal sequence, and planting of the poles; and eventually (4) 10-min cool-down [12–14].
Dynamic balance and gait speed improve in persons with Parkinson´s disease after Lee Silverman Voice Treatment (LSVT)-BIG training: a single subject experimental design study
Published in European Journal of Physiotherapy, 2020
Tale Tangen Kleppang, Lone Jørgensen
Previously, six studies have examined the effect of LSVT-BIG on either gait alone, or on both balance and gait [17–22]. A randomised trial, including 60 participants, compared LSVT-BIG training with either group training of Nordic walking or with domestic, non-supervised exercises [17]. The LSVT-BIG group improved significantly more than the other two groups with regard to the Timed Up and Go (TUG) test, and significantly more than the domestic home training group regarding the gait speed. Another randomised study, including 42 participants, compared the standard protocol of LSVT-BIG training to a shorter protocol of LSVT-BIG exercises [18]. Both groups showed equal improvement in gait speed, endurance and TUG. Furthermore, in a non-controlled trial, including 18 participants, a significant improvement was seen in stride length after LSVT-BIG intervention [19]. Similarly, a case-report with three participants found improvements in both balance and gait as per Functional Reach Test (FRT), Functional Gait Assessment (FGA) and TUG [21]. In contrast, another small study including eight participants did not see significant changes in gait speed and TUG [20]. Recently, a study using a more comprehensive measurement of balance (the Berg Balance Assessment (BBA)), in addition to measurements of gait (gait speed and FGA), reported that eight of the nine participants with mild symptoms had improved their performance in at least one of these measurements after LSVT-BIG intervention [22].
Effects of concurrent exercise on cardiometabolic status during perimenopause: the FLAMENCO Project
Published in Climacteric, 2018
I. Coll-Risco, M. Borges-Cosic, P. Acosta-Manzano, D. Camiletti-Moirón, P. Aranda, V. A. Aparicio
Other studies have seen similar improvements in fasting glucose after Nordic walking combined with a 1500-kcal diet, showing better results than with diet alone20 in overweight and obese postmenopausal women. The same trend was observed after 6-week resistance training in postmenopausal women21. Furthermore, the LDL-C reduction observed in our exercise group matches a review of previous studies22, as diet alone was not as efficient in the reduction of LDL-C. Similarly, the borderline significance observed for the changes in HDL-C, increasing in the exercise group and decreasing in the counseling group, also concurs with previous findings10,22, emphasizing the importance of an exercise-based plan, as diet counseling alone could not attenuate the usual reduction found in HDL-C during menopausal transition2. Therefore, future studies analyzing the benefits of a combined counseling plus exercise intervention during perimenopause may lead to interesting and complementary findings.