Britta Lindström

Effects on leg muscular performance from whole-body vibration exercise : a systematic review.

The purpose of this study was to investigate the effects on leg muscular performance from whole‐body vibration exercise. Literature search was performed on the databases Pubmed, Cinahl, ISI web of science (Sci‐expanded, SSCI) and Embase (Rehab & Physical Med). Rating of 19 relevant studies was performed (14 on long‐term exercise and five on short‐term exercise) using a score system for the methodological quality. Several randomized‐controlled trial studies of high to moderate quality show similar improvements from long‐term regimen on muscular performance in the legs after a period of whole‐body vibration exercise. As there were few studies on short‐term exercise and as they had no control groups, the same convincing improvements regarding muscular performance were not achieved. Preliminarily, there is strong to moderate evidence that long‐term whole‐body vibration exercise can have positive effects on the leg muscular performance among untrained people and elderly women. There is no clear evidence for effects on muscular performance after short‐term vibration stimuli.

The effects of preexercise stretching on muscular soreness, tenderness and force loss following heavy eccentric exercise

The present study sought to investigate the effects of preexercise stretching on delayed onset muscle soreness (DOMS), i.e. soreness, tenderness and loss of muscle force, that usually occurs after strenuous or unaccustomed eccentric exercise. Ten female volunteers performed 10 sets of 10 maximal isokinetic eccentric contractions for knee flexion with both legs after a 5‐min ergometer cycling warm‐up. Prior to the exercise for one leg, randomly chosen, 4×20 s of static stretching for the hamstring muscle group was implemented. Rated soreness, tenderness on algometer pressure and loss of maximal eccentric contractile force was evaluated preexercise and 24, 48 and 96 h postexercise. The exercise bout produced severe DOMS, with parameters peaking and troughing at 48 h postexercise. However, no significant differences were found, regarding any of the parameters, when comparing stretched and nonstretched legs. The present study thus suggests that preexercise static stretching has no preventive effect on the muscular soreness, tenderness and force loss that follows heavy eccentric exercise.

Positive attitudes and preserved high level of motor performance are important factors for return to work in younger persons after stroke : a national survey

OBJECTIVE Significant numbers of younger persons with stroke should be given the opportunity to return to work. The aim of this study was to investigate factors of importance for return to work among persons after first ever stroke, in the age range 18-55 years. METHODS A questionnaire was sent to all persons who had experienced a first ever stroke, 18-55 years of age, registered in the Swedish national quality register for stroke care, Riks-Stroke. Of the 1068 who answered the questionnaire, 855 (539 men and 316 women) were in paid employment before their stroke, and were included in this study. RESULTS Sixty-five percent returned to work and, of these, an equal proportion were men and women. Significant factors associated with return to work were the perceived importance of work (odds ratio (OR) 5.10), not perceiving themselves as a burden on others (OR 3.33), support from others for return to work (OR 3.66), retaining the ability to run a short distance (OR 2.77), and higher socioeconomic codes (OR 2.12). A negative association was found between those rehabilitated in wards intended for younger persons and return to work (OR 0.37). CONCLUSION External support from others, and positive attitudes towards return to work, were factors associated with successful return to work after stroke. Contrary to what was expected, independence in personal activities of daily living and cognitive factors were not associated with return to work to the same extent as persistent higher level of physical functions, such as ability to run a short distance.

Life satisfaction in younger individuals after stroke: different predisposing factors among men and women.

OBJECT To describe self-reported life satisfaction of younger persons after stroke and to investigate differences between men and women and factors associated with life satisfaction. DESIGN A cross-sectional study. METHODS Subjects were all persons after stroke, aged 18-55 years, registered in the Swedish National Quality Register for Stroke Care. A questionnaire was completed by 1068 individuals 8-36 months after stroke. Perceived Life Satisfaction was measured with LiSat-9. RESULTS Less than half of the participants were satisfied with life as a whole. For women, significant associations were found between not being satisfied with life as a whole and haemorrhage (odds ratio (OR) 4.00) as well as a deteriorated ability to concentrate (OR 2.11). For men, significant associations were found to be not having a significant other (OR 3.17), not working (OR 2.26) and deteriorated ability to concentrate (OR 2.04). CONCLUSION There were different factors for being satisfied with life as a whole between men and women, indicating a need for a more gender-specific rehabilitation than is currently used. The impact that deteriorated ability to concentrate has on life satisfaction is an important finding that needs to be considered in the rehabilitation process of younger patients after stroke.

Low‐load/high‐repetition elastic band resistance training in patients with COPD: a randomized, controlled, multicenter trial

High‐repetitive resistance training (RT) is recommended to increase peripheral muscular endurance in healthy adults; however, the effects of RT with this design on exercise capacity and health‐related quality of life (HRQOL) in patients with chronic obstructive pulmonary disease (COPD) is unknown. The study aimed to investigate if low‐load/high‐repetition elastic band RT could improve functional capacity, muscular function, endurance cycle capacity or HRQOL in patients with COPD.

What is the benefit of a high-intensive exercise program on health-related quality of life and depression after stroke? A randomized controlled trial

Abstract The aim of the study was to evaluate the impact of a high-intensive exercise program containing high-intensive functional exercises implemented to real-life situations together with group discussions on falls and security aspects in stroke subjects with risk of falls. This was a pre-specified secondary outcome for this study. For evaluation, Short Form-36 (SF-36) health-related quality of life (HRQoL) and the Geriatric Depression Scale-15 (GDS-15) were used. This was a single-center, single-blinded, randomized, controlled trial. Consecutive ≥55 years old stroke patients with risk of falls at 3–6 months after first or recurrent stroke were randomized to the intervention group (IG, n=15) or to the control group (CG, n=19) who received group discussion with focus on hidden dysfunctions but no physical fitness training. The 5-week high-intensive exercise program was related to an improvement in the CG in the SF-36 Mental Component Scale and the Mental Health subscale at 3 months follow-up compared with baseline values while no improvement was seen in the IG at this time. For the SF-36 Physical Component Scale, there was an improvement in the whole study group at 3 and 6 months follow-up compared with baseline values without any significant changes between the IG and CG. The GDS-15 was unchanged throughout the follow-up period for both groups. Based on these data, it is concluded that high-intensive functional exercises implemented in real-life situations should also include education on hidden dysfunctions after stroke instead of solely focus on falls and safety aspects to have a favorable impact on HRQoL.

Perceived impaired physical and cognitive functions after stroke in men and women between 18 and 55 years of age – a national survey

Purpose. We describe self-reported consequences for physical and cognitive functions, detect possible gender differences, and find factors that were associated with deteriorated physical function in younger stroke patients, independent in their personal activities of daily life. Methods. This study involved all first ever stroke patients, aged 18–55 years, registered in the Swedish national quality register for stroke. A questionnaire was answered by 1068 patients 8–36 months after the stroke. Changes were sought in physical and cognitive functions as compared with the pre-stroke condition. Results. Eight hundred and sixty-seven patients (83%) were independent in personal activities of daily life. Significant differences between men and women were found: deteriorated physical ability was reported by 56–71% of the men and 65–79% of the women; deteriorated cognitive function was reported by 48–57% of the men and 57–68% of the women. Many patients (70% men, 77% women) reported that they had received insufficient information about physical exertion. Significant associations were found between deteriorated physical function and deteriorated cognitive function as well as fear of physical exertion. Conclusions. Deterioration was found in physical and cognitive functions greater in women then in men. Insecurity regarding physical exertion existed indicating that younger stroke patients might need information directly aimed at physical functioning and more gender specific than today. This study has raised the awareness that there also might be gender differences in other fields, which needs further studies.

Physiotherapy at a distance: a controlled study of rehabilitation at home after a shoulder joint operation:

We explored the benefit of video communication in home rehabilitation after shoulder joint replacement and compared it to referral for physiotherapy in the conventional way. A total of 22 patients were included in the study. The intervention group (n = 10) had training at home under the supervision of a physiotherapist at the hospital using videoconferencing. The control group (n = 12) had physiotherapy training in a conventional way in their home town. All patients had the same postoperative, three-phase-programme for two months. The outcome measures were a Visual Analogue Scale (VAS) for pain, range of motion (ROM), shoulder function ability (Constant score and SRQ-S) and health-related quality of life (SF-36). Questions about areas of priority for improvement and general satisfaction with the shoulder were also included. The telemedicine group received a greater number of treatments compared to the control group. After the intervention, there were significant improvements in VAS-pain, Constant score and SRQ-S for both groups. The telemedicine group improved significantly more in all three measurements than the control group (P < 0.001 for all). When changes from baseline to follow-up were compared, the telemedicine group improved significantly more in terms of decrease in pain (P = 0.004) and vitality (P = 0.001) than the control group. Despite some limitations, there seem to be clear benefits from physiotherapy at a distance with a telemedicine technique that allows patients to obtain access to physiotherapy at home.

What is the benefit of a high intensive exercise program? A randomized controlled trial

Abstract The aim of the study was to evaluate a high intensive exercise program in stroke subjects with risk of falls regarding balance, activities of daily life, falls efficacy, number of falls and lifestyle activities. The intervention program contained high intensity functional exercises (HIFE) implemented to real-life situations together with education on falls and security aspects. This was a single-center, single-blinded, randomized controlled trial. Consecutive >55-year-old patients with risk of falls were enrolled and randomized 3–6 months after first or recurrent stroke to the intervention group (IG, n=15) or to the control group (CG, n=19) who received group discussions about hidden dysfunctions after stroke. Outcomes were Berg Balance Scale (BBS) primarily, Barthel Index (BI), Falls Efficacy Scale – International (FES-I) and number of falls secondarily and Frenchay Activities Index last 3 months (FAI-3) tertially. Assessments were done at baseline, post-intervention, 3- and 6-month follow-up by two physiotherapists and one nurse blinded to group allocation. Generalized Estimating Equations with Repeated-measure statistics were used to analyze the data. There were no significant differences between the IG and the CG regarding balance (BBS). BI at 6 months and FES-I post-intervention and 3 months follow-up showed significant improvement in the IG compared with the CG (p<0.05). Number of falls and FAI-3 were without significant change. This study suggests that our program consisting of HIFE implemented in real-life situations together with educational discussions may improve performance of everyday life activities and improve falls efficacy in stroke subjects with risk of falls.

Weighted Belt Exercise for Frail Older Women Following Hip Fracture - A Single Subject Design

The aim was to investigate the possibility of increasing lower limb strength, dynamic balance and gait speed in frail older women with residual mobility problems following hip fracture by using a combined and functional training programme with a weighted belt. Three women aged 78-82 participated in this repeated single-subject experimental design study. The intervention phase consisted of a 10-week functional weight-bearing exercise programme performed twice a week. Main outcome measures were assessed twice a week during baseline and intervention phases. Graphic analyses showed substantial improvements in dynamic balance and gait speed, related to the intervention, in all three subjects. During intervention phase, gait speed improved by 16-38% and step test performance (dynamic balance) by 36-67%. The subjects also increased weight load in the belt by 25-80%. No progress was seen regarding isometric knee extension muscle strength, and the control variable, isometric hand-grip strength, remained unchanged. However, dynamic strength (one-repetition maximum in leg press, tested before and after intervention) showed substantial increase. Subjects experienced strong improvement and reported no discomfort. In conclusion, functional training with a weighted belt may be suitable for older women to alleviate mobility problems following hip fracture.