Evidence supporting the utilization of surface EMG (sEMG) of extra-diaphragmatic muscles for moni... more Evidence supporting the utilization of surface EMG (sEMG) of extra-diaphragmatic muscles for monitoring of mechanical ventilation (MV) assistance is unclear. The purpose of this review was to assess the quality of literature available on using extra-diaphragmatic sEMG as an assessment technique of respiratory responses during MV. Methods: Studies using sEMG of extra-diaphragmatic respiratory muscles during MV were selected by two independent researchers after performing a database search of PubMed, CINAHL, GOOGLE SCHOLAR. Exclusion criteria were studies of patients with neuromuscular disorders, receiving neuromuscular blocking agents, receiving non-invasive MV, using needle EMG, and studies written in languages other than English. Quality of identified studies was assessed with the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2). This study is registered with PROSPERO, number (CRD42018081341).
Study design: Systematic literature review. Objectives: The primary aims of this study were to ev... more Study design: Systematic literature review. Objectives: The primary aims of this study were to evaluate the methodological quality of exercise intervention studies in adults with spinal cord injuries (SCIs); and to classify the reported outcome measures according to the International Classification of Functioning, Disability and Health (ICF). Methods: Electronic searches of PubMed, CINAHL, SPORTDiscus, PsychINFO, Scopus and the Cochrane Center Register of Controlled Trials from 2001 to 2011 were performed. Selected studies were evaluated for methodological quality using the Downs and Black checklist. Outcome measures were extracted and linked to categories of the ICF using standardized linking rules. Results: Two-hundred forty abstracts were retrieved, 57 studies met eligibility criteria. The mean methodological quality score was 14.7 ± 3.2 out of 28 on the Downs and Black checklist. Three-hundred seventy four outcome measures were extracted with 333 concepts linked to 35 second-level ICF categories across the four components. Conclusion: Studies of exercise interventions for adults with SCI included in this review are generally low in methodological quality, primarily reporting outcomes related to the Body Functions and Body Structures components of the ICF. It is recommended that studies employ more vigorous methodological designs to reduce bias and confounding, and include outcome measures targeting more categories in the Activities and Participation component so as to reflect the potential benefits of exercise on health and functioning in this population.
Entry-level DPT students, who were enrolled in either one of two 3-credit patient/client manageme... more Entry-level DPT students, who were enrolled in either one of two 3-credit patient/client management courses (i.e., Basic Skills and Cardiopulmonary) over two academic years (2012 and 2013), participated in this study. Of the 132 students in these courses, 115 completed the questionnaire (87% response rate). There were 85 first-year students from the Basic Skills course (43 first year students in 2012 and 42 in 2013) and 30 second-year students from the Cardiopulmonary course (2012). All participants experienced TBL for the first time in their DPT curriculum. The Student Perceptions of TBL scale is a 15-item instrument with two subscales: “preference for TBL” (8 items) and “preference for teamwork” (7 items). Each item was rated on a 5-point Likert-type scale: strongly disagree = -2, disagree = -1, neutral = 0, agree = 1, and strongly agree = 2, with a higher positive score indicating a more favourable perception toward TBL and teamwork
Background. Bed rest and immobility in patients on mechanical ventilation and/or in an intensive ... more Background. Bed rest and immobility in patients on mechanical ventilation and/or in an intensive care unit (ICU) have detrimental effects. Studies in medical ICUs show that early mobilization is safe, does not increase cost, and can be associated with decreased ICU and hospital length of stay (LOS). Objective. Assess the effects of an early mobilization protocol (EMP) on complication rates, ventilator days, and ICU and hospital LOS for patients admitted to a trauma and burn ICU (TBICU). Design. A retrospective cohort study of a interdisciplinary quality-improvement program. Methods. Pre- and post-EMP patient data from the trauma registry for 2,176 patients admitted to the TBICU between May 2008 and April 2010 were compared. Results. No adverse events were reported related to the EMP. After adjusting for age and injury severity, there was a decrease in airway, pulmonary, and vascular complications (including pneumonia and DVT) post-EMP. Ventilator days, TBICU and
Background Despite evidence of exercise benefits to lung function, adherence to routine exercise ... more Background Despite evidence of exercise benefits to lung function, adherence to routine exercise in adults with cystic fibrosis (CF) is low. The incorporation of interactive virtual reality video exergame activities in home-based programs as an incentive may help improve motivation and adherence to exercise. This proposed study will attempt to improve the physical fitness and respiratory function of sedentary adults with CF by engaging them in a Nintendo Wii Fit Plus™ home-based exercise program. Methods A single group pretest-posttest design will be used to examine the immediate (12-weeks) and long-term effect (24-weeks) of a home-based exergame program on improving pulmonary-related function (physical fitness and respiratory function) in sedentary adults with CF. Participants will receive a one-time orientation to the Wii Fit Plus, and will be requested to use it to exercise according to the recommended guidelines 3 times a week for 30 min in the following 24 weeks. Monthly phone ...
There is an increasing focus on health promotion in physical therapist research and practice. A c... more There is an increasing focus on health promotion in physical therapist research and practice. A clinical model (Health-Focused Physical Therapy Model) was developed for identifying major steps in the delivery of health promotion focusing on adoption of healthy lifestyle behaviors. One of the primary steps within this model is the design and delivery of behavior change interventions. Such interventions involve coordinated sets of activities that target change in a specific pattern of unhealthy behavior (eg, physical inactivity, smoking). This Perspective contends that the science and practice of behavior change interventions can be significantly advanced in the field of physical therapy (implementation science) through the integration of behavior change frameworks and techniques within the context of an experimental medicine approach for health behavior change. This perspective presents the integration of the Theoretical Domains Framework, the Behavior Change Wheel, including the Cap...
natomy is commonly taught using didactic lectures, emphasizing clinically relevant facts and guid... more natomy is commonly taught using didactic lectures, emphasizing clinically relevant facts and guiding students through the body by cadaveric dissection with the help of atlases and clinical cadaveric images.1-3 Students are expected to independently study from recommended atlases and textbooks. This general didactic approach has been substantially improved with wider availability and more reliance on models, imaging, simulation and online tools2,4-6 to enhance the learning experience. In addition, team-, problemand case-based learning strategies (TBL, PBL and CBL)1,4,712 are being adopted at many institutions to make learning more interactive. Although the importance of multimodal teaching has been widely recognized and assessed, the didactic tools of anatomy education are in need of overhauling and updating, especially in regard to keeping up with the pace of technology and the tech savviness of today’s average student. A challenge is the widespread belief among optometry students t...
Cystic fibrosis (CF) is an inherited, multi-system, life-limiting disease characterized by a prog... more Cystic fibrosis (CF) is an inherited, multi-system, life-limiting disease characterized by a progressive decline in lung function, which accounts for the majority of CF-related morbidity and mortality. Inspiratory muscle training (IMT) has been proposed as a rehabilitative strategy to treat respiratory impairments associated with CF. However, despite evidence of therapeutic benefits in healthy and other clinical populations, the routine application of IMT in CF can neither be supported nor refuted due to the paucity of methodologically rigorous research. Specifically, the interpretation of available studies regarding the efficacy of IMT in CF is hampered by methodological threats to internal and external validity. As such, it is important to highlight the inherent risk of bias that differences in patient characteristics, IMT protocols, and outcome measurements present when synthesizing this literature prior to making final clinical judgments. Future studies are required to identify the characteristics of individuals who may respond to IMT and determine whether the controlled application of IMT can elicit meaningful improvements in physiological and patient-centered clinical outcomes. Given the equivocal evidence regarding its efficacy, IMT should be utilized on a case-by-case basis with sound clinical reasoning, rather than simply dismissed, until a rigorous evidence-based consensus has been reached.
Exercise and physical activity have been recommended since the 1970s as important aspects of care... more Exercise and physical activity have been recommended since the 1970s as important aspects of care for people with cystic fibrosis (CF). Benefits of an active lifestyle for these patients include improved pulmonary function, functional capacity, and quality of life and also decreased mortality. However, there are not currently any guidelines available to CF care centers regarding the type, amount or frequency of exercise, or habitual physical activity that should be performed to achieve these benefits. In addition, there is no guidance available about adapting physical activity and exercise for different ages or comorbidities common to CF. This document presents evidence-based recommendations from an international group of experts in the area of exercise for CF to guide practitioners toward the goal of regular, appropriate habitual physical activity, exercise and sports for all patients with CF. As lifespan for people with CF increases, it is important that regular physical activity is incorporated as part of daily care for a lifetime.
Physical activity (PA) and exercise have become an accepted and valued component of cystic fibros... more Physical activity (PA) and exercise have become an accepted and valued component of cystic fibrosis (CF) care. Regular PA and exercise can positively impact pulmonary function, improve physical fitness, and enhance health-related quality of life (HRQoL). However, motivating people to be more active is challenging. Supervised exercise programs are expensive and labour intensive, and adherence falls off significantly once supervision ends. Unsupervised or partially supervised programs are less costly and more flexible, but compliance can be more problematic. The primary objective of this study is to evaluate the effects of a partially supervised exercise intervention along with regular motivation on forced expiratory volume in 1 s (FEV) at 6 months in a large international group of CF patients. Secondary endpoints include patient reported HRQoL, as well as levels of anxiety and depression, and control of blood sugar. It is planned that a total of 292 patients with CF 12 years and olde...
Sleep Slow Oscillations (SSOs), paradigmatic EEG markers of cortical bistability (alternation bet... more Sleep Slow Oscillations (SSOs), paradigmatic EEG markers of cortical bistability (alternation between cellular downstates and upstates), and sleep spindles, paradigmatic EEG markers of thalamic rhythm, are two hallmarks of sleeping brain. Selective thalamic lesions are reportedly associated to reductions of spindle activity and its spectrum~14 Hz (sigma), and to alterations of SSO features. This apparent, parallel behavior suggests that thalamo-cortical entrainment favors cortical bistability. Here we investigate temporally-causal associations between thalamic sigma activity and shape, topology, and dynamics of SSOs. We recorded sleep EEG and studied whether spatio-temporal variability of SSO amplitude, negative slope (synchronization in downstate falling) and detection rate are driven by cortical-sigma-activity expression (12-18 Hz), in 3 consecutive 1 s-EEG-epochs preceding each SSO event (Baselines). We analyzed: (i) spatial variability, comparing maps of baseline sigma power and of SSO features, averaged over the first sleep cycle; (ii) event-by-event shape variability, computing for each electrode correlations between baseline sigma power and amplitude/slope of related SSOs; (iii) eventby-event spreading variability, comparing baseline sigma power in electrodes showing an SSO event with the homologous ones, spared by the event. The scalp distribution of baseline sigma power mirrored those of SSO amplitude and slope; event-by-event variability in baseline sigma power was associated with that in SSO amplitude in fronto-central areas; within each SSO event, electrodes involved in cortical bistability presented higher baseline sigma activity than those free of SSO. In conclusion, spatio-temporal variability of thalamocortical entrainment, measured by background sigma activity, is a reliable estimate of the cortical proneness to bistability.
Background: The aim of this position statement was to inform the choice of physical activity tool... more Background: The aim of this position statement was to inform the choice of physical activity tools for use within CF research and clinical settings. Methods: A systematic review of physical activity tools to explore evidence for reliability, validity, and responsiveness. Narrative answers to "four key questions" on motion sensors, questionnaires and diaries were drafted by the core writing team and then discussed at the Exercise Working Group in ECFS Lisbon 2013. Results and summary: Our current position is that activity monitors such as SenseWear or ActiGraph offer informed choices to facilitate a comprehensive assessment of physical activity, and should as a minimum report on dimensions of physical activity including energy expenditure, step count and time spent in different intensities and sedentary time. The DigiWalker pedometer offers an informed choice of a comparatively inexpensive method of obtaining some measurement of physical activity. The HAES represents an informed choice of questionnaire to assess physical activity. There is insufficient data to recommend the use of one diary over another. Future research should focus on providing additional evidence of clinimetric properties of these and new physical activity assessment tools, as well as further exploring the added value of physical activity assessment in CF.
European Journal of Cardiovascular Prevention & Rehabilitation, 2006
Conclusion Lower limb-dominant exercise training causes remodelling of peripheral arteries, suppl... more Conclusion Lower limb-dominant exercise training causes remodelling of peripheral arteries, supplying active and inactive vascular beds, but not central arteries in type 2 diabetes. Keywords Intima-media thickness • Cardiovascular risk • Exercise training • Arterial remodelling Abbreviations BA Brachial artery CA Carotid artery CV Coefficient of variation HDL High-density lipoprotein LDL Low-density lipoprotein ROI Region of interest SD Standard deviation SE Standard error SFA Superficial femoral artery Abstract Objective Little is known about the impact of exercise training on conduit artery wall thickness in type 2 diabetes. We examined the local and systemic impact of exercise training on superficial femoral (SFA), brachial (BA), and carotid artery (CA) wall thickness in type 2 diabetes patients and controls. Methods Twenty patients with type 2 diabetes and 10 ageand sex-matched controls performed an 8-week training study involving lower limb-based combined aerobic and resistance exercise training. We examined the SFA to study the local effect of exercise, and also the systemic impact of lower limb-based exercise training on peripheral (i.e. BA) and central (i.e. CA) arteries. Wall thickness (WT), diameter and wall:lumen(W:L)-ratios were examined using automated edge detection of ultrasound images. Results Exercise training did not alter SFA or CA diameter in type 2 diabetes or controls (all P > 0.05). BA diameter was increased after training in type 2 diabetes, but not in controls. Exercise training decreased WT and W:L ratio Communicated by Massimo Pagani.
Evidence supporting the utilization of surface EMG (sEMG) of extra-diaphragmatic muscles for moni... more Evidence supporting the utilization of surface EMG (sEMG) of extra-diaphragmatic muscles for monitoring of mechanical ventilation (MV) assistance is unclear. The purpose of this review was to assess the quality of literature available on using extra-diaphragmatic sEMG as an assessment technique of respiratory responses during MV. Methods: Studies using sEMG of extra-diaphragmatic respiratory muscles during MV were selected by two independent researchers after performing a database search of PubMed, CINAHL, GOOGLE SCHOLAR. Exclusion criteria were studies of patients with neuromuscular disorders, receiving neuromuscular blocking agents, receiving non-invasive MV, using needle EMG, and studies written in languages other than English. Quality of identified studies was assessed with the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2). This study is registered with PROSPERO, number (CRD42018081341).
Study design: Systematic literature review. Objectives: The primary aims of this study were to ev... more Study design: Systematic literature review. Objectives: The primary aims of this study were to evaluate the methodological quality of exercise intervention studies in adults with spinal cord injuries (SCIs); and to classify the reported outcome measures according to the International Classification of Functioning, Disability and Health (ICF). Methods: Electronic searches of PubMed, CINAHL, SPORTDiscus, PsychINFO, Scopus and the Cochrane Center Register of Controlled Trials from 2001 to 2011 were performed. Selected studies were evaluated for methodological quality using the Downs and Black checklist. Outcome measures were extracted and linked to categories of the ICF using standardized linking rules. Results: Two-hundred forty abstracts were retrieved, 57 studies met eligibility criteria. The mean methodological quality score was 14.7 ± 3.2 out of 28 on the Downs and Black checklist. Three-hundred seventy four outcome measures were extracted with 333 concepts linked to 35 second-level ICF categories across the four components. Conclusion: Studies of exercise interventions for adults with SCI included in this review are generally low in methodological quality, primarily reporting outcomes related to the Body Functions and Body Structures components of the ICF. It is recommended that studies employ more vigorous methodological designs to reduce bias and confounding, and include outcome measures targeting more categories in the Activities and Participation component so as to reflect the potential benefits of exercise on health and functioning in this population.
Entry-level DPT students, who were enrolled in either one of two 3-credit patient/client manageme... more Entry-level DPT students, who were enrolled in either one of two 3-credit patient/client management courses (i.e., Basic Skills and Cardiopulmonary) over two academic years (2012 and 2013), participated in this study. Of the 132 students in these courses, 115 completed the questionnaire (87% response rate). There were 85 first-year students from the Basic Skills course (43 first year students in 2012 and 42 in 2013) and 30 second-year students from the Cardiopulmonary course (2012). All participants experienced TBL for the first time in their DPT curriculum. The Student Perceptions of TBL scale is a 15-item instrument with two subscales: “preference for TBL” (8 items) and “preference for teamwork” (7 items). Each item was rated on a 5-point Likert-type scale: strongly disagree = -2, disagree = -1, neutral = 0, agree = 1, and strongly agree = 2, with a higher positive score indicating a more favourable perception toward TBL and teamwork
Background. Bed rest and immobility in patients on mechanical ventilation and/or in an intensive ... more Background. Bed rest and immobility in patients on mechanical ventilation and/or in an intensive care unit (ICU) have detrimental effects. Studies in medical ICUs show that early mobilization is safe, does not increase cost, and can be associated with decreased ICU and hospital length of stay (LOS). Objective. Assess the effects of an early mobilization protocol (EMP) on complication rates, ventilator days, and ICU and hospital LOS for patients admitted to a trauma and burn ICU (TBICU). Design. A retrospective cohort study of a interdisciplinary quality-improvement program. Methods. Pre- and post-EMP patient data from the trauma registry for 2,176 patients admitted to the TBICU between May 2008 and April 2010 were compared. Results. No adverse events were reported related to the EMP. After adjusting for age and injury severity, there was a decrease in airway, pulmonary, and vascular complications (including pneumonia and DVT) post-EMP. Ventilator days, TBICU and
Background Despite evidence of exercise benefits to lung function, adherence to routine exercise ... more Background Despite evidence of exercise benefits to lung function, adherence to routine exercise in adults with cystic fibrosis (CF) is low. The incorporation of interactive virtual reality video exergame activities in home-based programs as an incentive may help improve motivation and adherence to exercise. This proposed study will attempt to improve the physical fitness and respiratory function of sedentary adults with CF by engaging them in a Nintendo Wii Fit Plus™ home-based exercise program. Methods A single group pretest-posttest design will be used to examine the immediate (12-weeks) and long-term effect (24-weeks) of a home-based exergame program on improving pulmonary-related function (physical fitness and respiratory function) in sedentary adults with CF. Participants will receive a one-time orientation to the Wii Fit Plus, and will be requested to use it to exercise according to the recommended guidelines 3 times a week for 30 min in the following 24 weeks. Monthly phone ...
There is an increasing focus on health promotion in physical therapist research and practice. A c... more There is an increasing focus on health promotion in physical therapist research and practice. A clinical model (Health-Focused Physical Therapy Model) was developed for identifying major steps in the delivery of health promotion focusing on adoption of healthy lifestyle behaviors. One of the primary steps within this model is the design and delivery of behavior change interventions. Such interventions involve coordinated sets of activities that target change in a specific pattern of unhealthy behavior (eg, physical inactivity, smoking). This Perspective contends that the science and practice of behavior change interventions can be significantly advanced in the field of physical therapy (implementation science) through the integration of behavior change frameworks and techniques within the context of an experimental medicine approach for health behavior change. This perspective presents the integration of the Theoretical Domains Framework, the Behavior Change Wheel, including the Cap...
natomy is commonly taught using didactic lectures, emphasizing clinically relevant facts and guid... more natomy is commonly taught using didactic lectures, emphasizing clinically relevant facts and guiding students through the body by cadaveric dissection with the help of atlases and clinical cadaveric images.1-3 Students are expected to independently study from recommended atlases and textbooks. This general didactic approach has been substantially improved with wider availability and more reliance on models, imaging, simulation and online tools2,4-6 to enhance the learning experience. In addition, team-, problemand case-based learning strategies (TBL, PBL and CBL)1,4,712 are being adopted at many institutions to make learning more interactive. Although the importance of multimodal teaching has been widely recognized and assessed, the didactic tools of anatomy education are in need of overhauling and updating, especially in regard to keeping up with the pace of technology and the tech savviness of today’s average student. A challenge is the widespread belief among optometry students t...
Cystic fibrosis (CF) is an inherited, multi-system, life-limiting disease characterized by a prog... more Cystic fibrosis (CF) is an inherited, multi-system, life-limiting disease characterized by a progressive decline in lung function, which accounts for the majority of CF-related morbidity and mortality. Inspiratory muscle training (IMT) has been proposed as a rehabilitative strategy to treat respiratory impairments associated with CF. However, despite evidence of therapeutic benefits in healthy and other clinical populations, the routine application of IMT in CF can neither be supported nor refuted due to the paucity of methodologically rigorous research. Specifically, the interpretation of available studies regarding the efficacy of IMT in CF is hampered by methodological threats to internal and external validity. As such, it is important to highlight the inherent risk of bias that differences in patient characteristics, IMT protocols, and outcome measurements present when synthesizing this literature prior to making final clinical judgments. Future studies are required to identify the characteristics of individuals who may respond to IMT and determine whether the controlled application of IMT can elicit meaningful improvements in physiological and patient-centered clinical outcomes. Given the equivocal evidence regarding its efficacy, IMT should be utilized on a case-by-case basis with sound clinical reasoning, rather than simply dismissed, until a rigorous evidence-based consensus has been reached.
Exercise and physical activity have been recommended since the 1970s as important aspects of care... more Exercise and physical activity have been recommended since the 1970s as important aspects of care for people with cystic fibrosis (CF). Benefits of an active lifestyle for these patients include improved pulmonary function, functional capacity, and quality of life and also decreased mortality. However, there are not currently any guidelines available to CF care centers regarding the type, amount or frequency of exercise, or habitual physical activity that should be performed to achieve these benefits. In addition, there is no guidance available about adapting physical activity and exercise for different ages or comorbidities common to CF. This document presents evidence-based recommendations from an international group of experts in the area of exercise for CF to guide practitioners toward the goal of regular, appropriate habitual physical activity, exercise and sports for all patients with CF. As lifespan for people with CF increases, it is important that regular physical activity is incorporated as part of daily care for a lifetime.
Physical activity (PA) and exercise have become an accepted and valued component of cystic fibros... more Physical activity (PA) and exercise have become an accepted and valued component of cystic fibrosis (CF) care. Regular PA and exercise can positively impact pulmonary function, improve physical fitness, and enhance health-related quality of life (HRQoL). However, motivating people to be more active is challenging. Supervised exercise programs are expensive and labour intensive, and adherence falls off significantly once supervision ends. Unsupervised or partially supervised programs are less costly and more flexible, but compliance can be more problematic. The primary objective of this study is to evaluate the effects of a partially supervised exercise intervention along with regular motivation on forced expiratory volume in 1 s (FEV) at 6 months in a large international group of CF patients. Secondary endpoints include patient reported HRQoL, as well as levels of anxiety and depression, and control of blood sugar. It is planned that a total of 292 patients with CF 12 years and olde...
Sleep Slow Oscillations (SSOs), paradigmatic EEG markers of cortical bistability (alternation bet... more Sleep Slow Oscillations (SSOs), paradigmatic EEG markers of cortical bistability (alternation between cellular downstates and upstates), and sleep spindles, paradigmatic EEG markers of thalamic rhythm, are two hallmarks of sleeping brain. Selective thalamic lesions are reportedly associated to reductions of spindle activity and its spectrum~14 Hz (sigma), and to alterations of SSO features. This apparent, parallel behavior suggests that thalamo-cortical entrainment favors cortical bistability. Here we investigate temporally-causal associations between thalamic sigma activity and shape, topology, and dynamics of SSOs. We recorded sleep EEG and studied whether spatio-temporal variability of SSO amplitude, negative slope (synchronization in downstate falling) and detection rate are driven by cortical-sigma-activity expression (12-18 Hz), in 3 consecutive 1 s-EEG-epochs preceding each SSO event (Baselines). We analyzed: (i) spatial variability, comparing maps of baseline sigma power and of SSO features, averaged over the first sleep cycle; (ii) event-by-event shape variability, computing for each electrode correlations between baseline sigma power and amplitude/slope of related SSOs; (iii) eventby-event spreading variability, comparing baseline sigma power in electrodes showing an SSO event with the homologous ones, spared by the event. The scalp distribution of baseline sigma power mirrored those of SSO amplitude and slope; event-by-event variability in baseline sigma power was associated with that in SSO amplitude in fronto-central areas; within each SSO event, electrodes involved in cortical bistability presented higher baseline sigma activity than those free of SSO. In conclusion, spatio-temporal variability of thalamocortical entrainment, measured by background sigma activity, is a reliable estimate of the cortical proneness to bistability.
Background: The aim of this position statement was to inform the choice of physical activity tool... more Background: The aim of this position statement was to inform the choice of physical activity tools for use within CF research and clinical settings. Methods: A systematic review of physical activity tools to explore evidence for reliability, validity, and responsiveness. Narrative answers to "four key questions" on motion sensors, questionnaires and diaries were drafted by the core writing team and then discussed at the Exercise Working Group in ECFS Lisbon 2013. Results and summary: Our current position is that activity monitors such as SenseWear or ActiGraph offer informed choices to facilitate a comprehensive assessment of physical activity, and should as a minimum report on dimensions of physical activity including energy expenditure, step count and time spent in different intensities and sedentary time. The DigiWalker pedometer offers an informed choice of a comparatively inexpensive method of obtaining some measurement of physical activity. The HAES represents an informed choice of questionnaire to assess physical activity. There is insufficient data to recommend the use of one diary over another. Future research should focus on providing additional evidence of clinimetric properties of these and new physical activity assessment tools, as well as further exploring the added value of physical activity assessment in CF.
European Journal of Cardiovascular Prevention & Rehabilitation, 2006
Conclusion Lower limb-dominant exercise training causes remodelling of peripheral arteries, suppl... more Conclusion Lower limb-dominant exercise training causes remodelling of peripheral arteries, supplying active and inactive vascular beds, but not central arteries in type 2 diabetes. Keywords Intima-media thickness • Cardiovascular risk • Exercise training • Arterial remodelling Abbreviations BA Brachial artery CA Carotid artery CV Coefficient of variation HDL High-density lipoprotein LDL Low-density lipoprotein ROI Region of interest SD Standard deviation SE Standard error SFA Superficial femoral artery Abstract Objective Little is known about the impact of exercise training on conduit artery wall thickness in type 2 diabetes. We examined the local and systemic impact of exercise training on superficial femoral (SFA), brachial (BA), and carotid artery (CA) wall thickness in type 2 diabetes patients and controls. Methods Twenty patients with type 2 diabetes and 10 ageand sex-matched controls performed an 8-week training study involving lower limb-based combined aerobic and resistance exercise training. We examined the SFA to study the local effect of exercise, and also the systemic impact of lower limb-based exercise training on peripheral (i.e. BA) and central (i.e. CA) arteries. Wall thickness (WT), diameter and wall:lumen(W:L)-ratios were examined using automated edge detection of ultrasound images. Results Exercise training did not alter SFA or CA diameter in type 2 diabetes or controls (all P > 0.05). BA diameter was increased after training in type 2 diabetes, but not in controls. Exercise training decreased WT and W:L ratio Communicated by Massimo Pagani.
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Papers by John D Lowman