Medications
Henry J. Woodford in Essential Geriatrics, 2022
The risk of muscle adverse effects due to statin therapy is controversial. In clinical practice, 10–25% of people taking statins report muscle problems but this has not been found in clinical trials.65 In RCTs, muscle problems almost equally affected both the statin and placebo arms. The reporting of adverse effects in clinical trials may be inaccurate due to varying definitions of statin-related muscle problems, reliance on serum creatine kinase (CK) concentrations or through not systematically looking for muscle adverse effects. But it is likely that the frequency is over-estimated in clinical practice. On the other hand, frail older people are at higher risk of adverse drug events and even mild muscle symptoms, that are worse on exertion, could lead to reduced physical activity, with its own detrimental effects. In combination with sarcopenia this could have greater functional impact.
Modern Rehabilitation Techniques for COVID-19
Wenguang Xia, Xiaolin Huang in Rehabilitation from COVID-19, 2021
For severe and critically severe patients, the recommended activities are as follows (pay attention to preventing the tubes connecting patients from disconnecting during the whole activity process, and monitor vital signs throughout the whole activity process). Exercise intensity: patients with poor physical strength can reduce the intensity of exertion. With time or activity range maintained, they are just required to complete the movement. Exercise frequency: once or twice a day. Exercise time: the total training time should not exceed 30 minutes each time to avoid the aggravation of fatigue. Exercise types: first, regularly turning over and moving on the bed, siting up from the bed, transferring from the bed to the chair, sitting on the chair, standing up and walking on the spot, carrying out these exercises step by step in this order. Second, active/passive range of motion training. Third, for patients with sedation or cognitive impairment or biological constraints, passive lower limbs function bicycle ergometer, passive range of motion (PROM), and stretch and neuromuscular electrical stimulation (Table 5.1) are recommended.
Exercise Prescription for Apparently Healthy Individuals and for Special Populations
James M. Rippe in Lifestyle Medicine, 2019
Depending on the type and extent of disability, proper physical activity may improve physical fitness and functional abilities and may reduce a person’s risk for cardiometabolic diseases. The range of disabilities (cerebral palsy, spinal cord injury, stroke, etc.) is too wide to permit a thorough discussion of exercise prescription for each disability here. However, a few points are important to remember across many conditions. For example, disabilities resulting in autonomic impairment will yield abnormal cardiovascular responses to exercise and impaired thermoregulation. Therefore, perceived exertion may be a better gauge of exercise intensity, and special precautions should be taken to prevent hyper- or hypothermia. In addition, adaptions in equipment or clothing may be needed to help persons with particular disabilities perform common exercises. For example, persons with impaired gripping ability may benefit from Velcro gloves when performing resistance exercises or arm ergometry. Shorter bouts of physical activity spread throughout the day may be necessary for persons with very low physical tolerance.
Influence of home-based pulmonary rehabilitation program among people with interstitial lung disease: A pre-post study
Published in Physiotherapy Theory and Practice, 2023
Revati Amin, K Vaishali, G. Arun Maiya, Aswini Kumar Mohapatra, Vishak Acharya, R. Vani Lakshmi
All the participants were educated regarding the precautions and risk factors which they needed to look out for during the home-based exercise regimen. Patients were instructed how to evaluate physical exertion by tracking pulse rate, oxygen saturation, or using the rate of perceived exertion scale, in addition to how to choose suitable attire and footwear for exercise, choosing an open and non-slippery environment to perform the exercises and how to perform warm-up, cool-down exercises. In case of muscle soreness and pain, they were advised to apply ice at the site of pain. In case of increased symptoms such as breathlessness and fatigue, they were advised to monitor their oxygen saturation using a pulse oximeter and were advised to rest. They were asked to notify the investigators in case of worsening of symptoms or any kind of injury. During exercise therapy, participants receiving long-term oxygen therapy (LTOT) received an oxygen dose of 15–18 hours per day that was identical to the standard treatment (Khor et al., 2019).
Treatment of non-sports related concussion in adolescents following an irritability algorithmic approach: a case series
Published in Physiotherapy Theory and Practice, 2022
Kelly Hardesty, Zachary Walston, Lindsay Walston, Dale Yake, Tye Marr
Physiological exertion interventions were assessed using resting heart rate and age-predicted maximum heart rate at varying intensities for a desired outcome. Many studies support emerging evidence for early return to physical activity following concussion management, compared to physical and cognitive rest (Chan et al., 2018; Grabowski et al., 2017; Grool et al., 2016; Kurowski et al., 2017; Leddy et al., 2019). A randomized-controlled trial by Chan et al. (2018) assessed a 6-week sub-symptom threshold aerobic training program in addition to visualization and coordination exercises. Aerobic training resulted in symptom exacerbations in 30% of participants that subsided within 24 hours; none-the-less active rehabilitation was associated with greater symptom reduction than “Treatment as Usual” defined as return-to-play advice, return-to-school facilitation, and psychiatric consultation. In addition, Kurowski et al. (2017) demonstrated a significantly greater rate of improvement in sub-symptom threshold aerobic training compared to a full body-stretching program, which did not affect cardiovascular function. Participants in this case series were physiologically progressed by increases in 5–10 bpm per week within sub-symptom threshold tolerance and a targeted percentage of heart rate max in accordance with the algorithm presented in Table 3.
Replacing sitting with light-intensity physical activity throughout the day versus 1 bout of vigorous-intensity exercise: similar cardiometabolic health effects in multiple sclerosis. A randomised cross-over study
Published in Disability and Rehabilitation, 2022
Ine Nieste, Wouter M. A. Franssen, Bernard M. F. M. Duvivier, Jan Spaas, Hans H. C. M. Savelberg, Bert O. Eijnde
During the screening visit, study eligibility and subject characteristics (gender, age, anthropometrics, EDSS score, MS duration, and medication intake) were assessed and a resting electrocardiogram was taken. After medical approval for maximal exercise testing by a trained professional, a maximal cardiopulmonary exercise test (CPET) was performed. During the activity regimens, PA and SB, exercise intensity, and perceived exertion were measured. After an overnight fast (12 h) following the fourth day of each activity regimen, CM health outcomes were assessed (cfr. 'cardiometabolic health' below). The analysis of outcomes was performed without knowledge of activity regimens. All participants provided written informed consent before participation. The study protocol was approved by the Medical Ethical Committee of Hasselt University (Hasselt, Belgium) and the Maria Hospital North Limburg (Pelt, Belgium), was conducted in accordance with the principles of the Declaration of Helsinki (2013), and is registered at clinical-trials.gov as NCT03919058.
Related Knowledge Centers
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- Musculoskeletal System
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- Volition
- Musculoskeletal System
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- Rating of Perceived Exertion
- Psychological Inertia