Lisa Marie Bernardo

A Systematic Review of the Effects of Pilates Method of Exercise in Healthy People

OBJECTIVE To evaluate evidence for the effectiveness of the Pilates method of exercise (PME) in healthy people. DATA SOURCES Published research was identified by searching Science Direct, MEDLINE, PubMed, SPORTDiscus, PEDro, Cochrane Central Register of Controlled Trials, CINAHL, and Web of Science. STUDY SELECTION Research studies published from inception to May 7, 2011 were selected for evaluation. Two reviewers independently applied the inclusion criteria to selected potential studies. Studies were included if they were published in a peer-reviewed journal, written in the English language, conducted as a randomized controlled trial (RCT) or quasi-RCT in healthy people, had an inactive and/or exercise control group(s), included key study outcomes, and used the PME as the study intervention in at least 1 study arm. DATA EXTRACTION Two reviewers independently extracted data (study, design, subjects, intervention, key outcomes results), applied the Physiotherapy Evidence Database (PEDro) scale to assess the method quality of selected studies, and determined the strength of the evidence using the best evidence synthesis grading system. DATA SYNTHESIS Sixteen studies met the inclusion criteria. PEDro scale values ranged from 3 to 7 (mean, 4.1), indicating a low level of scientific rigor. The outcomes studied most often were flexibility, muscular endurance, strength, and postural alignment. The PME appears to be effective in improving flexibility (strong evidence), dynamic balance (strong evidence), and muscular endurance (moderate evidence) in healthy people. CONCLUSIONS There was strong evidence to support the use of the PME at least to the end of training to improve flexibility and dynamic balance and moderate evidence to enhance muscular endurance. Future RCTs should focus on the components of blinding, concealed allocation, subject adherence, intention-to-treat analysis, and follow-up designs.

A comparison of dog bite injuries in younger and older children treated in a pediatric emergency department.

Objective Dog bites account for a significant number of traumatic injuries in the pediatric population that often require medical treatment. Although agent, host, and environmental characteristics of dog bites have been well documented, no attempt has been made to compare these characteristics by patient age group. The purpose of this study is to determine if differences exist in agent, host, and environmental characteristics among younger (≤6 y) and older (>7 y) patients treated in a pediatric emergency department (ED) for dog bites. Findings from our study could be used to develop age-specific strategies for dog bite prevention. Theoretical Framework The epidemiologic triad of agent/host/environment formed the theoretical framework. Methods The study setting was the ED at Children’s Hospital of Pittsburgh. Patients were enrolled between 1999 and 2000 and were identified through a review of ED records (n = 386) of children sustaining dog bites. Records were abstracted with a researcher-designed and validated form for agent (eg, breed, number of biting dogs, owner, rabies status), host (eg, age, gender, number and location of bites, treatment), and environmental (eg, bite month and time, bite location, events leading to the bite, ZIP code) characteristics. Data were analyzed using descriptive and inferential statistical tests. Results Children younger than 6 years constituted 52.8% (n = 204) of the sample. As compared with older children, a higher proportion of younger children were bitten by their family dog (χ2 = 27.64, P = 0.001) whose rabies shots were up to date (χ2 = 12.08, P = 0.034). A higher proportion of younger children were bitten on the face (χ2 = 49.54, P = 0.000) and were bitten in their own homes (χ2 = 16.075, P = 0.013). Implications for Nursing Practice Young children frequently sustain dog bites from their family dog in their own homes. Injuries typically involve severe lacerations to the face. Prevention strategies for young children include close supervision of child–dog interactions.

Utilization of 3-month yoga program for adults at high risk for type 2 diabetes: a pilot study.

Various modes of physical activity, combined with dieting, have been widely recommended to prevent or delay type 2 diabetes. Among these, yoga holds promise for reducing risk factors for type 2 diabetes by promoting weight loss, improving glucose levels and reducing blood pressure and lipid levels. This pilot study aimed to assess the feasibility of implementing a 12-week yoga program among adults at high risk for type 2 diabetes. Twenty-three adults (19 Whites and 4 non-Whites) were randomly assigned to the yoga intervention group or the educational group. The yoga group participated in a 3-month yoga intervention with sessions twice per week and the educational group received general health educational materials every 2 weeks. All participants completed questionnaires and had blood tests at baseline and at the end of 3 months. Effect sizes were reported to summarize the efficacy of the intervention. All participants assigned to the yoga intervention completed the yoga program without complication and expressed high satisfaction with the program (99.2%). Their yoga session attendance ranged from 58.3 to 100%. Compared with the education group, the yoga group experienced improvements in weight, blood pressure, insulin, triglycerides and exercise self-efficacy indicated by small to large effect sizes. This preliminary study indicates that a yoga program would be a possible risk reduction option for adults at high risk for type 2 diabetes. In addition, yoga holds promise as an approach to reducing cardiometabolic risk factors and increasing exercise self-efficacy for this group.

Data Elements for Emergency Department Systems, Release 1.0 (DEEDS): A Summary Report

See editorial, p 274. Variations in the way that data are entered in emergency department record systems impede the use of ED records for direct patient care and deter their reuse for many other legitimate purposes. To foster more uniform ED data, the Centers for Disease Control and Preventions National Center for Injury Prevention and Control is coordinating a public-private partnership that has developed recommended specifications for many observations, actions, instructions, conclusions, and identifiers that are entered in ED records. The partnerships initial product, Data Elements for Emergency Department Systems, Release 1.0 (DEEDS), is intended for use by individuals and organizations responsible for ED record systems. If the recommended specifications are widely adopted, then problems-such as data incompatibility and high costs of collecting, linking, and using data-can be substantially reduced. The collaborative effort that led to DEEDS, Release 1.0 sets a precedent for future review and revision of the initial recommendations. [DEEDS Writing Committee: Data Elements for Emergency Department Systems, Release 1.0 (DEEDS): A summary report. Ann Emerg Med February 1998;31:264-273.].

Self-esteem and optimism in rural youth: Gender differences

Abstract Aim: To identify and describe gender-related differences in the self-esteem and optimism levels of rural adolescents. Background: Self-esteem and optimism have been broadly examined and are associated with health-practices, social interaction, attachment, resiliency, and personal identity. Information describing the relationship of self-esteem and optimism as it relates to gender is limited. Methods: Using a cross-sectional survey design, students (N = 193) from three high-schools in rural Pennsylvania, USA completed the Rosenberg Self-Esteem Scale and the Optimism Scale-Life Orientation Test-Revised as part of a National Institute of Health, National Institute of Nursing Research funded study. Results: Both instruments’ mean scores were in the range of average for this population, with females scoring lower than males in both self-esteem (p < 0.0001) and optimism (p < 0.0001). The results of this study have nursing implications for evidenced based interventions that target self-esteem and optimism. Attention to self-esteem and optimism in female youth is recommended.

The LUNAR project: A description of the population of individuals who seek health care at emergency departments.

INTRODUCTION Although little information exists about the consumers of emergency services and their illness behaviors, such information is essential for decision making by providers, administrators, and policy makers. The purpose of the LUNAR Project was to describe the population of individuals who seek health care at emergency departments. METHODS After they attended a training course, 90 emergency nurses served as site coordinators in 89 emergency departments in 35 states. A standardized protocol was used to collect data retrospectively from 140 randomly selected patient records at each site. The final sample included 12,422 ED patients. RESULTS Overall, 52% of the patient visits were for nonurgent care, 40% were for urgent care, and 8% were for emergent care. Most visits occurred between 10 AM and 8 PM and peaked at 6 PM. Children and younger adults were the largest consumers of services, primarily for nonurgent care. The most frequent reasons for visits were fever, chest pain, and abdominal pain, and the most common discharge diagnoses were middle ear infection, chest pain, and acute upper respiratory infection. DISCUSSION The profile of ED patients showed a need for new types of services to provide nonurgent care and new interventions for preventing illnesses and injuries commonly treated in the emergency department.

Effects of Pilates-Based Exercise on Life Satisfaction, Physical Self-Concept and Health Status in Adult Women

The objective of this study was to determine the effect of Pilates-based mat exercises on life satisfaction, perception of appreciation by other people, perception of physical appearance, perception of functionality, total physical self-concept, and perception of health status in healthy women. A randomized controlled trial was conducted in Évora, Portugal, in 2008, in which 62 healthy adult women were randomized to a Pilates-based mat (experimental group) (n = 38, mean age ± SD, 41.08 ± 6.64 years) or a control group (n = 24, mean age ± SD, 40.25 ± 7.70 years). Experimental group participants performed the Initial Mat of Body Control Pilates twice per week, 60-minutes per session. Repeated measurements were performed at baseline, 3 months and 6 months. No significant differences between the two groups were observed in life satisfaction, perception of appreciation by other people, perception of physical appearance, perception of functionality, total physical self-concept, and perception of health status at three time point measures (baseline, after 3 months, and after 6 months). No significant differences were observed in the control group over time. The experimental group showed significant improvements between baseline and six months in life satisfaction (p = .04), perception of appreciation by other people (p = .002), perception of physical appearance (p = .001), perception of functionality (p = .01), total physical self-concept (p = .001), perception of health status (p = .013) and between three and six months in life satisfaction (p = .002), perception of appreciation by other people (p = .05), perception of physical appearance (p = .001), perception of functionality (p = .02), and total physical self-concept (p = .001). Life satisfaction, perception of appreciation by other people, perception of physical appearance, perception of functionality, total physical self-concept and perception of health status may improve after 6 months of Pilates-based mat exercise.

Does Pilates-Based Exercise Improve Postural Alignment in Adult Women?

A randomized, controlled trial was conducted to determine the effect of Pilates-based exercise on postural alignment. Seventy-four adult women (mean age ± SD, 34.9 ± 16.4 years) were randomized to a Pilates-based mat class (n = 40) or a control group (n = 34). Pilates-based exercise participants were taught the Initial Mat of Body Control Pilates for 6 months, twice a week, for 60 minutes per session; the control group received no exercise intervention. Repeated measurements were performed at baseline, 3 months, and 6 months of the frontal alignment of the thoracolumbar spine, shoulder, and pelvis, and sagittal alignment of the head and pelvis. No differences were found in either group, over time, on frontal alignment of the thoracolumbar spine and pelvis. The experimental group showed significant improvements in frontal alignment of the shoulder and sagittal alignment of the head and pelvis at 6 months. The Pilates-based exercise enhanced some parameters of the postural alignment of women, as measured by frontal alignment of the shoulder and sagittal alignment of the head and pelvis. The significant improvement in sagittal alignment of the head may imply that 6 months of Pilates-based exercise enhances sagittal alignment of the cervical or thoracic spine.

Dog bites in children admitted to Pennsylvania trauma centers

Dog bites are a major public health problem in the pediatric population, requiring emergency treatment for wound repair and possible hospitalization in a trauma center. Data from the Pennsylvania Trauma Outcome Study were analyzed, and the records of 183 pediatric dog bite patients from 1990 to 1995 were evaluated. Dog bites were found to constitute a very small proportion of the total pediatric admissions to Pennsylvania trauma centers; however, the findings were similar to other reported studies.

The effects of core and peripheral warming methods on temperature and physiologic variables in injured children

Introduction Injured children are at risk for thermoregulatory compromise, where temperature maintenance mechanisms are overwhelmed by severe injury, environmental exposure, and resuscitation measures. Adequate thermoregulation can be maintained, and heat loss can be prevented, by core (administration of warmed intravenous fluid) and peripheral (application of convective air warming) methods. It is not known which warming method is better to maintain thermoregulation and prevent heat loss in injured children during their trauma resuscitations. The purpose of this feasibility study was to compare the effects of core and peripheral warming measures on body temperature and physiologic changes in a small sample of injured children during their initial emergency department (ED) treatment. Methods A prospective, randomized experimental design was used. Eight injured children aged 3 to 14 years (mean = 6.87, SD = 3.44 ) treated in the ED of Children’s Hospital of Pittsburgh were enrolled. Physiologic responses (eg, heart rate, blood pressure, respiratory rate, arterial oxygen saturation, core, peripheral temperatures) and level of consciousness were continuously measured and recorded every 5 minutes to detect early thermoregulatory compromise and to determine the child’s response to warming. Data were collected throughout the resuscitation period, including transport to CT scan, the inpatient nursing unit, intensive care unit, operating room or discharge to home. Core warming was accomplished with the Hotline Fluid Warmer (Sims Level 1, Inc., Rockland, MA), and peripheral warming was accomplished with the Snuggle Warm Convective Warming System (Sims Level 1, Inc., Rockland, MA). Data were analyzed using descriptive and inferential statistics. Results There were no statistically significant differences between the two groups on age (t = −0.485,P= 0.645); weight (t = −0.005,P= 0.996); amount of prehospital intravenous (IV) fluid (t = 0.314,P= 0.766); temperature on ED arrival (t = 0.287,P= 0.784); total amount of infused IV fluid (t = −0.21,P= 0.8); and length of time from ED admission to hospital admission (t = −0.613,P= 0.56). There were no statistically significant differences between the two groups on RTS (t = −0.516,P= 0.633). When comparing the mean differences in temperature upon hospital admission, no statistically significant differences were found (t = −1.572,P= 0.167). There were no statistically significant differences between the two groups in tympanic [F(15) = 0.71,P= 0.44] and skin [F(15) = 0.06,P= 0.81] temperature measurements over time. Conclusion Core and peripheral warming methods appeared to be effective in preventing heat loss in this stable patient population. A reasonable next step would be to continue this trial in a larger sample of patients who are at greater risk for heat loss and subsequent hypothermia and to use a control group.