Shweta Shenoy

Effect of different cuff widths on the motor nerve conduction of the median nerve: an experimental study

BackgroundA bloodless operative field is considered mandatory for most surgical procedures on the upper and lower extremity. This is accomplished by using either an Esmarch bandage or a pneumatic tourniquet, but a number of complications are associated with both. Nerve palsy is one of the most frequently encountered complications of this procedure. Wider cuffs have been found to cause reduced risk of tourniquet induced injury to the underlying soft tissues than the narrower ones due to the fact that lower occlusion pressures are caused by the former. To address and investigate this question, conduction in the median nerve has been measured proximal to tourniquet as well as distal to the tourniquet. Parameters of nerve conduction measured are nerve conduction velocity, latency and amplitude.MethodsSphygmomanometer cuffs with widths 14 cm and 7 cm were applied to the upper extremities of 20 healthy, normotensive volunteers (9 males and 11 females with age ranging from 22 to 27). Systolic blood pressure was measured first and then the cuff was inflated to about 20–30 mm Hg above it and was kept inflated for 15 minutes. Recordings were done prior to, for the period of tourniquet inflation, and following release of the tourniquet.ResultsNerve conduction was found to be more severely affected by the 14 cm cuff than the 7 cm cuff.ConclusionWider cuffs resulted in more severe changes in the nerve. This brings us to the conclusion that though lower inflation pressures are required for the occlusion of the blood supply using wider cuffs, the nerve conduction is more severely affected by the wider ones. Both electrophysiological changes and occlusion pressure should be kept in mind while choosing the width of the cuff.

Effects of Withania somnifera (Ashwagandha) and Terminalia arjuna (Arjuna) on physical performance and cardiorespiratory endurance in healthy young adults.

Introduction: Several medicinal plants have been described to be beneficial for cardiac ailments in Ayurveda like Ashwagandha and Arjuna. Ashwagandha-categorised as Rasayanas, and described to promote health and longevity and Arjuna primarily for heart ailments. coronary artery disease, heart failure, hypercholesterolemia, anginal pain and can be considered as a useful drug for coronary artery disease, hypertension and ischemic cardiomyopathy. Objective: There are no scientific clinical studies showing effect of both these drugs on exercise performance after regular administration when given as supplements The present study was therefore designed and performed to assess the effects of Withania somnifera (Ashwagandha) and Terminalia arjuna (Arjuna) individually and as a combination on maximum velocity, average absolute and relative Power, balance, maximum oxygen consumption (VO2 max) and blood pressure in humans. Materials and Methods: Forty normal healthy. Subjects (either sex, mean age 20.6 ± 2.5yrs and mean Body Mass Index 21.9 ± 2.2) were recruited after written informed consent was obtained. Institutional Ethics Committee permission was also obtained. Thirty participants were assigned to experimental group of which 10 received standardized root extracts of Withania somnifera, 10 received standardized bark extract of Terminalia arjuna and the rest of the 10 received standardized root extract of Withania somnifera in addition to bark extract of Terminalia arjuna both. Both the drugs were given in the form of capsules (dosage 500mg/day for both the drugs). Ten participants received placebo (capsules filled with flour). All the subjects continued the regimen for 8 weeks. All variables were assessed before and after the course of drug administration Observations: Our study showed that Withania somnifera increased velocity, power and VO2 max whereas Terminalia arjuna increased VO2 max and lowered resting systolic blood pressure. When given in combination, the improvement was seen in all parameters except balance and diastolic blood pressure. Conclusion: Withania somnifera may therefore be useful for generalized weakness and to improve speed and lower limb muscular strength and neuro-muscular co-ordination. Terminalia arjuna may prove useful to improve cardio-vascular endurance and lowering systolic blood pressure. Both drugs appear to be safe for young adults when given for mentioned dosage and duration.

Effectiveness of an aerobic walking program using heart rate monitor and pedometer on the parameters of diabetes control in Asian Indians with type 2 diabetes

AIMS To analyze the effects of 8 weeks of aerobic walking using a heart rate monitor (HRM) and pedometer for monitoring exercise intensity on glycemic outcomes, fasting blood glucose (FBG), cardiovascular fitness and well-being in type 2 diabetes patients. METHODS Forty adults with type 2 diabetes were randomly allocated to an 8-week supervised program of walking using heart rate monitor and pedometer (group A=20) and control group (group B=20). All outcomes were determined at baseline and after the 8-week training period. RESULTS The exercise training program resulted in a 9.7% (P<0.05) improvement in group A. Fasting blood glucose level decreased significantly by 37% in group A (P<0.05). Body mass index (BMI) ratio decreased by 3.9% in group A and increased by 2.2% in group B. General well-being (GWB) improved by 28.8% (P<0.05) in the exercising group and there was an improvement in all parameters associated with cardiovascular health. CONCLUSION Monitoring an exercise program using a heart rate monitor and pedometer was effective and decreased the level of HbA1c, FBG, BMI and improved general well-being. Further using HRM helped us to attribute all improvements to the exercise intensity that we used in our study.

The differential effects of core stabilization exercise regime and conventional physiotherapy regime on postural control parameters during perturbation in patients with movement and control impairment chronic low back pain

BackgroundThe purpose of the present study was to examine the differential effect of core stability exercise training and conventional physiotherapy regime on altered postural control parameters in patients with chronic low back pain (CLBP). As heterogeneity in CLBP population moderates the effect of intervention on outcomes, in this study, interventions approaches were used based on sub-groups of CLBP.MethodsThis was an allocation concealed, blinded, sequential and pragmatic control trial. Three groups of participants were investigated during postural perturbations: 1) CLBP patients with movement impairment (n = 15, MI group) randomized to conventional physiotherapy regime 2) fifteen CLBP patients with control impairment randomized to core stability group (CI group) and 3) fifteen healthy controls (HC).ResultsThe MI group did not show any significant changes in postural control parameters after the intervention period however they improved significantly in disability scores and fear avoidance belief questionnaire work score (P < 0.05). The CI group showed significant improvements in Fx, Fz, and My variables (p < 0.013, p < 0.006, and p < 0.002 respectively with larger effect sizes: Hedgess g > 0.8) after 8 weeks of core stability exercises for the adjusted p values. Postural control parameters of HC group were analyzed independently with pre and post postural control parameters of CI and MI group. This revealed the significant improvements in postural control parameters in CI group compared to MI group indicating the specific adaptation to the core stability exercises in CI group. Though the disability scores were reduced significantly in CI and MI groups (p < 0.001), the post intervention scores between groups were not found significant (p < 0.288). Twenty percentage absolute risk reduction in flare-up rates during intervention was found in CI group (95% CI: 0.69-0.98).ConclusionsIn this study core stability exercise group demonstrated significant improvements after intervention in ground reaction forces (Fz, Mz; g > 0.8) indicating changes in load transfer patterns during perturbation similar to HC group.Trial registrationUTRN095032158-06012009423714

An electromyographic analysis of shoulder muscle activation during push-up variations on stable and labile surfaces

Background: Numerous exercises are used to strengthen muscles around the shoulder joint including the push-up and the push-up plus. An important consideration is the addition of surface instability in the form of swiss ball for rehabilitation and strength. The justification for the use of the swiss ball is based on its potential for increasing muscular demand required to maintain postural stability and for improving joint proprioception. Evidence for this is lacking in literature. Purpose of the Study: To compare the myoelectric amplitude of shoulder muscles during push-ups on labile and stable surface. Study Design: Same subject experimental study. Materials and Methods: Thirty healthy male subjects in the age group 20-30 years with a mean height of 173.65 cm (± SD 2.56) and a mean weight of 69.9 kg (±SD 0.2) were taken. Surface electromyogram was recorded from triceps, pectoralis major, serratus anterior and upper trapezius while performing push-up and push-up plus exercises, both on labile and stable surface. Results: Significant increase in muscle activity was observed in pectoralis major and triceps muscle (only during eccentric phase of elbow pushups), while serratus anterior and upper trapezius showed no change in activation level on swiss ball. Conclusion: The addition of a swiss ball is capable of influencing shoulder muscle activity during push-up variations, although the effect is task and muscle dependent.

Effect of Soy Isolate Protein and Resistance Exercises on Muscle Performance and Bone Health of Osteopenic/Osteoporotic Post-Menopausal Women

There are contradictory reports regarding the effect of soy protein isolate on bone health in menopause. The main objective of this study was to assess the influence of soy isolate protein intake and resistance exercises on isokinetic muscle strength, endurance, power, and bone health parameters in osteopenic/osteoporotic postmenopausal women. Sixty osteoporotic sedentary women (mean age 54.55 years) were randomly assigned to three groups: soy isolate protein (Group A), soy + exercise group (Group B), and control group (Group C). Group B performed supervised progressive resistance exercises 4 times/week for 12 weeks. Muscle performance was measured by isokinetic dynamometry, and bone health was measured by ultrasound densitometry. Analysis of variance showed significant bone and muscle strength gains (p < .05) both in Group A and B, with the improvements more pronounced in Group B. Significant muscle performance changes, after intervention, were evident and bone strength increases may parallel changes in muscle strength.

Effects of eight-week supplementation of Ashwagandha on cardiorespiratory endurance in elite Indian cyclists

Background: Cycling is an endurance sport relying mainly on aerobic capacity to provide fuel during long-duration cycling events. Athletes are constantly searching for new methods to improve this capacity through various nutritional and ergogenic aids.s Purpose: The aim of the study was to find out the effect of Ashwagandha on the cardiorespiratory endurance capacity, that is, aerobic capacity of elite Indian cyclists. Materials and Methods: Forty elite (elite here refers to the participation of the athlete in at least state-level events) Indian cyclists were chosen randomly and were equally divided into experimental and placebo groups. The experimental group received 500 mg capsules of aqueous roots of Ashwagandha twice daily for eight weeks, whereas the placebo group received starch capsules. Outcome Measures: The baseline treadmill test for the cyclists were performed to measure their aerobic capacity in terms of maximal aerobic capacity (VO2 max), metabolic equivalent, respiratory exchange ratio (RER), and total time for the athlete to reach his exhaustion stage. After eight weeks of supplementation, the treadmill test was again performed and results were obtained. Results: There was significant improvement in the experimental group in all parameters, whereas the placebo group did not show any change with respect to their baseline parameters. There was significant improvement in the experimental group in all parameters, namely, VO2 max (t = 5.356; P < 0.001), METS (t = 4.483; P < 0.001), and time for exhaustion on treadmill (t = 4.813; P < 0.001) in comparison to the placebo group which did not show any change with respect to their baseline parameters. Conclusion: Ashwagandha improved the cardiorespiratory endurance of the elite athletes.

Effect of progressive pedometer based walking intervention on quality of life and general well being among patients with type 2 diabetes

BackgroundTo determine the effectiveness of two goal setting pedometer based walking program for people with type 2 diabetes, one employing supervised exercise group with pedometer and the other employing self reported group with pedometer.MethodsA total of 102 type 2 diabetic outpatients (28 women, 74 men) between the age of 40-70 years were recruited and randomly allocated into 3 groups: supervised exercise group with pedometer (Group A), self reported exercise group with pedometer (Group B) and a control group (Group C) for 16 weeks. Subjects were asked to respond to the Audit of Diabetes Dependent Quality of Life (ADDQoL) and well being questionnaire at two occasions i.e. 0 week and after 16 weeks of intervention. Paired t test were used within the groups to compare Mean ± SD for all the parameters at baseline and at the end of 16 weeks. Differences between the groups were compared using analysis of variance (ANOVA). Statistical difference was further analyzed by Post hoc analysis using Bonferroni method.ResultsThe item “Freedom to eat” had the highest negative impact among all the subgroups. Other domains that were adversely affected by diabetes are ‘leisure activity’, ’do physically’, ‘physical appearance’, ‘self confidence’, ‘future’ and ‘financial situation’. In the group A significant reduction were noted among all the items except long distance journey (p<0.05). In the group B participants experienced reduction among all the domains except long distance journey, sex life and living condition.ConclusionPedometer determined activity has the potential to improve the quality of life. Supervised Walking using a pedometer was found more effective in improving quality of life and general wellbeing for Asian Indians with type 2 diabetes.Clinical trial registry India (CTRI)[CTRI/2012/10/003034].

Peak Torque and IEMG Activity of Quadriceps Femoris Muscle at Three Different Knee Angles in a Collegiate Population

The coordinated activities of the four heads of the quadriceps femoris muscle results in knee extension. It is still a matter of debate as to whether the different heads of the quadriceps can be activated differentially by the central nervous system at different joint angles. This study aimed to investigate the influence of different angles of knee joint on the activation level of the vastus medialis oblique (VMO), vastus lateralis (VL) and rectus femoris (RF) using electromyographic activity during maximal voluntary isometric contraction (MVIC) and occurrence of peak torque measurement. Forty healthy subjects (20 males, 20 females) participated in the study. The peak torque for the dominant leg was measured using HUR5340 leg extension/curl with simultaneous recording of MVIC of the VMO, VL and RF using surface electromyography (SEMG). Test angles were presented randomly in 30° increments from 30° to 90° of knee flexion. To get peak torque, each subject performed maximal contraction of 10 seconds at each test angle and the myoelectrical activity was recorded simultaneously. The results illustrated that peak torque occurred at 60° for the entire group, including males ( F = 39.654, p F = 32, p F = 14.665, p F = 22.40, p

Intravascular haemolysis during prolonged running on asphalt and natural grass in long and middle distance runners

Abstract Surface features such as uneven playing surfaces, low impact absorption capacity and inappropriate friction/traction characteristics are connected with injury prevalence whereas force impact during foot strike has been suggested to be an important mechanism of intravascular haemolysis during running. We aimed to evaluate intravascular haemolysis during running and compare the effect of running on two different types of surfaces on haemolysis. We selected two surfaces (asphalt and grass) on which these athletes usually run. Participants were randomly assigned to group A (asphalt) or group B (grass) with 10 athletes in each group. Each athlete completed one hour of running at the calculated target heart rate (60–70%). Venous blood samples were collected before and immediately after running. We measured unconjugated bilirubin (UBR) (mg · dl−1), lactate dehydrogenase (LDH) (μ · ml−1), haemoglobin (g · l−1) and serum ferritin (ng · ml−1) as indicators of haemolysis. Athletes who ran on grass demonstrated an increase in the haematological parameters (UBR: P < 0.01, LDH: P < 0.05) when compared to athletes who ran on asphalt (UBR: P < 0.05, LDH: P = 0.241). Our findings indicate that intravascular haemolysis occurs significantly after prolonged running. Furthermore, we conclude that uneven grass surface results in greater haemolysis compared to asphalt road.