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To evaluate the cardiovascular response during head-out water immersion, underwater treadmill gait, and land treadmill gait in stroke patients.
Ten stroke patients were recruited for underwater and land treadmill gait sessions. Each session was 40 minutes long; 5 minutes for standing rest on land, 5 minutes for standing rest in water or on treadmill, 20 minutes for treadmill walking in water or on land, 5 minutes for standing rest in water or on treadmill, and 5 minutes for standing rest on land. Blood pressure (BP) and heart rate (HR) were measured during each session. In order to estimate the cardiovascular workload and myocardial oxygen demand, the rate pressure product (RPP) value was calculated by multiplying systolic BP (SBP) by HR.
SBP, DBP, mean BP (mBP), and RPP decreased significantly after water immersion, but HR was unchanged. During underwater and land treadmill gait, SBP, mBP, DBP, RPP, and HR increased. However, the mean maximum increases in BP, HR and RPP of underwater treadmill walking were significantly lower than that of land treadmill walking.
Stroke patients showed different cardiovascular responses during water immersion and underwater gait as opposed to standing and treadmill-walking on land. Water immersion and aquatic treadmill gait may reduce the workload of the cardiovascular system. This study suggested that underwater treadmill may be a safe and useful option for cardiovascular fitness and early ambulation in stroke rehabilitation.
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Method 14 healthy people performed cardiopulmonary exercise test by means of Bruce protocol. The omnidirectional PATs were placed onto the right wrist and ankle, and the temperature sensing PATs were placed onto the right arm and lower leg. Simultaneous measurement of body motion was continuously recorded during cardiopulmonary exercise test. Then we checked total calorie expenditure and duration above moderated intensity activity (＞3 METs) from each PATs and gas analyzer.
Results Total calorie expenditures of PAT were significantly underestimated than gas analyzer, except the temperature sensing PAT applied onto the leg, but all of them showed significant correlation. The duration above moderate intensity activity of the PAT did not show significant difference comparing with gas analyzer, except the omnidirectional PAT applied onto the arm, but all of them showed significant correlation.
Conclusion Both omnidirectional PATs and temperature sensing PATs could estimate the total calorie expenditure and the duration above moderate intensity activity. But it is necessary to apply exercise-specific protocol to PAT to enhance the accuracy of estimating energy expenditure during periods of exercise.
Method: Sciatic nerve of seventy rats was compressed with haemostatic forceps. The experimental group was divided into 4 subgroups according to the intensity and duration of injury: group 1, first degree compression for 5 seconds; group 2, first degree for 30 seconds; group 3, third degree for 5 seconds; and group 4, third degree for 30 seconds. Treadmill exercise was done for either 30 minutes or 2 hours a day, 5 days a week for 4 weeks. Histochemical study of soleus was done before nerve compression and 1 week, 4 weeks after compression.
Results: The fiber diameter of soleus was larger in the experimental group at 4 weeks (p＜0.05). The intensity of injury had greater impact on the recovery of fiber diameter than the duration. Thirty minute exercise was seen to have a earlier recovery of fiber diameter than 2 hours.
Conclusion: These results may provide the basic data to clarify the neurological recovery in relation to the severity of injury, and to help establishing adequate duration of exercise after nerve damage.
Objective: To evaluate the effects of local triamcinolone (TAC) injection and weight bearing on healing process of the injured Achilles tendon.
Method: The right Achilles tendons in 54 rats, Sprague- Dawley (about 200 g), were each sutured after transection and allocated into three groups according to the amount of the local injection of TAC (none, 0.25 mg, and 1.25 mg respectively), and subsequently each group divided into three subgroups by the type of weight bearing {normal weight bearing (NWB), treadmill exercise (7∼8 m/min, 10 min/day) from day 7 for 7 days, and hind limb immobilization respectively}. On 15th day rats were sacrificed, and then diameters of both injured and uninjured tendon, numbers of fibroblasts on injured tissues and
the percentage of matured fibroblasts by microscopy were evaluated.
Results: The diameter of the hypertrophied neotendon in groups injected with TAC 1.25 mg was significantly decreased, but not in the others. There were no differences in numbers of fibroblast. As the amount of TAC increased in groups done with NWB and treadmill exercise, the percentages of matured fibroblasts significantly decreased.
Conclusion: The local TAC injection on acute tendon injuries had deleterious effects on healing process of tendon, and follow- up study about the types of weight bearing is needed. (J Korean Acad Rehab Med 2002; 26: 215-222)
Objective: The goal of this study was to determine the efficacy of caudal epidural injection in relieving pseudoclaudication of patients with lumbar spinal stenosis.
Method: Fifteen patients with a spinal stenosis which was confirmed by the magnetic resonance imaging(MRI) studies, received a caudal epidural steroid injection of triamcinolone acetate 120 mg, in a solution mixed with 2 ml of 1% lidocaine, and 15 ml of normal saline.
Results: The visual analogue scales checked at 1 hour prior to injection, 1 hour postinjection, and 1 month postinjection were 8.1⁑0.8, 3.7⁑1.7, and 6.4⁑1.9, respectively.
The exercise tolerance on the treadmill with 0o ramp inclination and 1.8 km/h speed was measured at 1 hour prior to injection, 1 hour postinjection, and 1 month postinjection. The time intervals to the first symptom of the pseudoclaudication were 2.3⁑0.8 minutes, 6.5⁑0.7 minutes, and 4.6⁑1.9 minutes, respectively.
Conclusion: In our study, the caudal epidural injection offered a significant short-term relief for the pseudoclaudication. Also it appeared to be a reasonable therapeutic option among patients with lumbar spinal stenosis after 1 month postinjection.
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