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Keep Them in the Game: Screening for Cardiovascular Disease and Diabetes in Aging Athletes 让他们在比赛中:筛选心血管疾病和糖尿病的老年运动员
Pub Date : 2020-10-19 DOI: 10.1097/CPT.0000000000000148
Becca Jordre, Brody W. Brisk, William E. Schweinle
Purpose: This observational cross-sectional study of aging athletes aims to (1) compare the prevalence of cardiovascular disease (CVD) and diabetes in aging athletes to the general population, (2) describe anthropometric values of aging athletes, (3) investigate the influence of cardiovascular sport competition on these measures, and (4) address any predictive value of evaluated measures. Methods: Health and sport history, blood pressure, waist circumference (WC), waist-to-hip ratio, and body mass index (BMI) were collected on 2351 aging athletes. Results: Aging athletes showed a significantly lower prevalence of CVD and diabetes than the general population. Athletes demonstrated BMI in the overweight range, WC in a healthy range, and waist-to-hip ratio in a healthy range for women but just over risk thresholds for men. Average blood pressure was near stage 1 hypertension. Waist circumference and waist-to-hip ratio were superior predictors of disease in the population. Cardiovascular athletes showed a lower disease risk and overall superior anthropometric values than other aging athletes. Conclusion: Aging athletes demonstrate a relatively low prevalence of CVD and diabetes despite demonstrating some anthropometric measurements over risk thresholds. Measures of central adiposity seem best for predicting disease in this population.
目的:这项针对老年运动员的观察性横断面研究旨在(1)将老年运动员的心血管疾病(CVD)和糖尿病患病率与普通人群进行比较,(2)描述老年运动员的人体测量值,(3)调查心血管运动竞赛对这些测量的影响,以及(4)解决评估测量的任何预测价值。方法:收集2351名老年运动员的健康和运动史、血压、腰围、腰臀比和体重指数。结果:老年运动员心血管疾病和糖尿病的患病率明显低于普通人群。运动员的BMI在超重范围内,WC在健康范围内,女性的腰臀比在健康范围,但略高于男性的风险阈值。平均血压接近高血压1期。腰围和腰臀比是人群疾病的主要预测因素。心血管病运动员比其他年龄较大的运动员表现出更低的疾病风险和更高的人体测量值。结论:尽管一些人体测量结果超过了风险阈值,但老年运动员的心血管疾病和糖尿病患病率相对较低。测量中心性肥胖似乎是预测这一人群疾病的最佳方法。
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引用次数: 1
Physical Therapy Interventions for a Patient Requiring Prolonged Intubation Due to Severe COVID-19: A Case Study 重症COVID-19患者需要长时间插管的物理治疗干预:一个案例研究
Pub Date : 2020-10-19 DOI: 10.1097/CPT.0000000000000153
K. Black, Carly Walters
There is little published information available to guide the acute care physical therapist in caring for acutely ill patients with COVID-19. Significant debility after prolonged stays in the intensive care unit can make rehabilitation more difficult. In this case, a 54-year-old man spent 1 month on mechanical ventilation before initiating therapies. Despite his poor medical prognosis, intensive therapies were initiated—including cardiopulmonary interventions, therapeutic exercise, and neuromuscular re-education. The patient displayed profound improvement andwas able to discharge to an inpatient rehabilitation facility. (CardiopulmPhys Ther J. 2021;32:S28–S31)
指导急性护理物理治疗师护理COVID-19急性患者的公开信息很少。在重症监护病房长时间停留后明显的虚弱会使康复更加困难。在本例中,一名54岁的男性在开始治疗前使用了1个月的机械通气。尽管他的医疗预后很差,但还是开始了强化治疗,包括心肺干预、治疗性运动和神经肌肉再教育。患者表现出显著的改善,并能够出院到住院康复机构。[j] .中华心血管病杂志;2011;32(5):528 - 531。
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引用次数: 0
Rehabilitation of Patients Presenting With Coronavirus Disease-19 and Hemiparesis: A Case Series 冠状病毒病-19和偏瘫患者的康复:一系列病例
Pub Date : 2020-10-15 DOI: 10.1097/CPT.0000000000000154
J. Jordan, J. Rice, Shane Bassett, Jessica Lazore, D. Weeks
Introduction: The novel coronavirus disease-19 (COVID-19) has many unique features in its presentation. One increasingly noted symptom is the incidence of hypercoagulability which may lead to ischemic stroke. Physical therapists (PTs) are an integral component of the medical team and contribute to the early identification of stroke-like symptoms in patients with COVID-19. Case Presentation: This case series will describe the rehabilitation process of 3 patients who survived critical illness due to COVID-19 and had secondary complications including right hemiparesis while in critical care. Patients received rehabilitation by PTs and occupational therapists on average 6 times per week with interventions focused on recovery of strength, functionalmobility, neurological re-education, and cognition. Themobility status was assessedwith the Perme Intensive Care Unit Mobility Score. Conclusion: Patients who present with COVID-19 need careful screening for neurological impairment. Conventionalmeans to diagnose stroke, such as radiological imaging, canbe difficult to obtain in these unique circumstances because of infection control measures. Physical therapists can assist in early identification of neurological impairment in the absence of traditional diagnostic methods through identification of deficits in abilities such as mobility and balance. (Cardiopulm Phys Ther J. 2021;32:S22–S27)
简介:新型冠状病毒病-19(新冠肺炎)在表现上有许多独特的特点。一个越来越明显的症状是高凝状态的发生率,这可能导致缺血性中风。理疗师(PT)是医疗团队不可或缺的组成部分,有助于早期识别新冠肺炎患者的中风样症状。病例介绍:本病例系列将描述3名患者的康复过程,他们在新冠肺炎危重症中幸存下来,并在重症监护期间出现包括右偏瘫在内的继发并发症。患者平均每周接受6次PT和职业治疗师的康复治疗,干预重点是力量恢复、功能移动、神经再教育和认知。用Perme重症监护室活动能力评分评估活动能力状况。结论:新冠肺炎患者需要仔细筛查神经功能损害。由于感染控制措施,在这些独特的情况下,很难获得常规的中风诊断方法,如放射学成像。在缺乏传统诊断方法的情况下,理疗师可以通过识别行动和平衡等能力缺陷来帮助早期识别神经损伤。(Cardiopulm Phys Ther J.2021;32:S22–S27)
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引用次数: 0
Safety and Efficacy of Early Ambulation on an Alternative Oxygen Delivery Device for Patients Receiving Bedside Heated Humidified High-Flow Nasal Cannula Therapy 床边加热加湿高流量鼻插管治疗患者早期可选供氧装置的安全性和有效性
Pub Date : 2020-10-15 DOI: 10.1097/CPT.0000000000000147
Shane Bassett, J. Jordan, D. Weeks
Purpose: Patients in the intensive care unit (ICU) receiving heated humidified high-flow nasal cannula (HHFNC) therapy for acute respiratory failure have limited ambulation distance due to restrictions in supplying HHFNC away from bedside. This study investigated the safety and efficacy of transitioning patients requiring HHFNC to a portable high-flow oxygen (HFO2) device for ambulation. Methods: Twenty-three patients with acute respiratory failure participated in this prospective longitudinal observational study. Three diagnostic groups were formed (cardiac n = 8; pulmonary n = 11; and other n = 4). Initial aerobic tolerance was established through bedside marching on HHFNC, then participants transitioned to HFO2 for ambulation. During each phase, vital signs were monitored. Results: No differences were found among diagnostic groups or sexes during ambulation for blood pressure, heart rate (HR), respiratory rate (RR), oxygen saturation (SpO2), or the Borg dyspnea scale (BDS) (all P > .05). Outcomes during marching and ambulation differed from outcomes at rest and during recovery for HR, RR, SpO2, and BDS (all P < .001). Transitory adverse events during ambulation included anxiety (n = 2), hypotension (n = 1), and arrhythmia (n = 2). Conclusions: Results indicate it is safe and efficacious for patients in the ICU with acute respiratory failure requiring HHFNC to ambulate on HFO2 under the supervision of a physical therapist.
目的:在重症监护病房(ICU)接受加热加湿高流量鼻插管(HHFNC)治疗急性呼吸衰竭的患者,由于在床边提供高流量鼻插管的限制,其行走距离有限。本研究探讨了将需要HHFNC的患者转移到便携式高流量供氧(HFO2)装置行走的安全性和有效性。方法:23例急性呼吸衰竭患者参与了这项前瞻性纵向观察研究。分为3个诊断组(心脏组8例;肺n = 11;等n = 4)。通过床边在HHFNC上行走建立初始有氧耐量,然后参与者过渡到HFO2进行行走。在每个阶段监测生命体征。结果:各诊断组和性别在活动时血压、心率(HR)、呼吸频率(RR)、血氧饱和度(SpO2)和Borg呼吸困难量表(BDS)均无差异(P < 0.05)。行军和活动期间的结果与休息和恢复期间的HR、RR、SpO2和BDS的结果不同(均P < 0.001)。行走过程中的短暂性不良事件包括焦虑(n = 2)、低血压(n = 1)和心律失常(n = 2)。结论:结果表明,ICU急性呼吸衰竭患者需要HHFNC在物理治疗师的监督下使用HFO2行走是安全有效的。
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引用次数: 2
Metabolic and Cardiovascular Effects of Body Weight Support Treadmill Walking in Healthy Adults 体重支持在跑步机上行走对健康成人代谢和心血管的影响
Pub Date : 2020-10-01 DOI: 10.1097/cpt.0000000000000137
R. Zant, W. Colchagoff, M. Kunish, Tamara Kunz, Mark Marshall, S. McDermott, Trevor Myers, Byron Sunga
PURPOSE: The use of body weight support treadmill (BWST) training for rehabilitation of patients with brain injuries, as well as musculoskeletal and neuromuscular impairments, is an emerging clinical treatment method. Because of the limited evidence of physiological stress of BWST training, the purpose of this study was to describe the metabolic and cardiovascular response to varying levels of BWST walking in healthy adult subjects. METHODS: A total of 21 subjects (10 females; 34+6.7 yr; 74.6+14.3 kg; 170.8+6.9 cm; 26.1+5.3 kg/m) provided their informed consent to participate in three 5-minute walking trials at a self-selected treadmill speed, with body weight support (BWS) of 0, 15, and 30%. Test order was randomized for each subject. Subjects rested for a minimum of 5 minutes between each trial, and did not begin a subsequent trial until HR was verified to be < 5 bpm of HR rest. Mean HR (12-lead ECG), BP (auscultation), oxygen uptake (continuous indirect calorimetry), and RPE (Borg ratio scale) were determined from the last 3 minutes of each trial. Mean values for all variables were assessed for difference between trials using repeated measures analysis of variance (SPSS ver. 24, New York, NY). RESULTS: At rest, HR was 78.2+11.5 bp and BP was 121.2+7.9 / 76.9+8.0 mmHg. Mean walking speed of subjects was 64.2 m/min. HR and systolic BP significantly (p<0.05) increased from rest to exercise at all BWS levels, with no significant difference in diastolic BP seen from rest to exercise at all BWS levels. There was no statistical difference among levels of BWS for HR, BP, RPE, oxygen uptake, respiratory exchange ratio, respiratory rate, tidal volume, and METs. CONCLUSIONS: Metabolic and cardiovascular responses to treadmill walking at 3 levels of BWS (0, 15, 30%) were similar in apparently healthy adult subjects.
目的:使用体重支持跑步机(BWST)训练对脑损伤、肌肉骨骼和神经肌肉损伤患者进行康复,是一种新兴的临床治疗方法。由于BWST训练的生理压力证据有限,本研究的目的是描述健康成年受试者对不同水平的BWST行走的代谢和心血管反应。方法:共有21名受试者(10名女性;34+6.7岁;74.6+14.3公斤;170.8+6.9厘米;26.1+5.3公斤/米)提供知情同意书,以自行选择的跑步机速度参加三项5分钟步行试验,体重支持率(BWS)分别为0%、15%和30%。每个受试者的测试顺序是随机的。受试者在每次试验之间至少休息5分钟,直到HR被证实<5 bpm,才开始后续试验。从每次试验的最后3分钟开始测定平均HR(12导联心电图)、BP(听诊)、摄氧量(连续间接量热法)和RPE(博格比量表)。使用重复测量方差分析(SPSS ver.24,纽约,NY)评估所有变量的平均值,以确定试验之间的差异。结果:静息时HR为78.2+11.5bp,bp为121.2+7.9/76.9+8.0mmHg。受试者的平均步行速度为64.2m/min。在所有BWS水平下,从休息到运动,HR和收缩压显著增加(p<0.05),而在所有BWS水平下,休息到运动的舒张压没有显著差异。BWS的HR、BP、RPE、摄氧量、呼吸交换率、呼吸频率、潮气量和METs水平之间没有统计学差异。结论:在明显健康的成年受试者中,在3个BWS水平(0、15、30%)下,对跑步机行走的代谢和心血管反应相似。
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引用次数: 1
Validity of the Global Physical Activity Questionnaire in Older Adults With Chronic Obstructive Pulmonary Disease: Results From the National Health and Nutrition Examination Survey 全球体育活动问卷在老年慢性阻塞性肺病患者中的有效性:来自全国健康和营养检查调查的结果
Pub Date : 2020-10-01 DOI: 10.1097/cpt.0000000000000127
S. Gore, A. Goldberg, M. Huang, M. Shoemaker, J. Blackwood
the design, analysis, drafting, and revisions of this manuscript. Purpose: The Global Physical Activity Questionnaire (GPAQv2) is widely used and one of the only national surveillance measures recommended by the World Health Organization for physical activity (PA) assessment globally. No studies to date have examined the validity of GPAQv2 in older adults with chronic obstructive pulmonary disease (COPD). This observational study examined its construct validity using population-based data. Methods: Individuals aged 65 years and older with COPD, interviewed in the National Health and Nutrition Examination Survey (NHANES) between years 2007 and 2012 were included. GPAQv2-derived PA was compared with constructs of lung function, shortness of breath, and the diagnosis of COPD. Results: The GPAQv2 was not found to be a significant predictor of COPD status (odds ratio 5 1.00, 95% confidence interval: 0.99, 1.00) when controlling for relevant covariates. Age and smoking status emerged as the strongest predictors of COPD. Total PA was neither significantly associated with shortness of breath nor lung function. Conclusions: Older adults with chronic conditions such as COPD represent a unique subset of population discrete from the healthier counterparts. Given the importance of GPAQv2 as the only widely accepted population surveillance tool, future studies exploring its validity in this subset of individuals with COPD using different constructs and objective reference standards are needed. (Cardiopulm Phys Ther J. 2020;31:159 – 166)
这篇手稿的设计、分析、起草和修订。目的:全球身体活动问卷(GPAQv2)被广泛使用,是世界卫生组织在全球范围内推荐的唯一用于身体活动(PA)评估的国家监测措施之一。迄今为止,还没有研究检验GPAQv2在老年慢性阻塞性肺疾病(COPD)患者中的有效性。本观察性研究使用基于人群的数据来检验其结构效度。方法:纳入2007 - 2012年全国健康与营养调查(NHANES)访谈的65岁及以上COPD患者。将gpaqv2衍生的PA与肺功能、呼吸短促和COPD诊断进行比较。结果:在控制相关协变量时,GPAQv2不是COPD状态的显著预测因子(优势比为1.00,95%置信区间为0.99,1.00)。年龄和吸烟状况是COPD的最强预测因子。总PA与呼吸短促和肺功能均无显著相关性。结论:患有慢性疾病(如COPD)的老年人代表了与健康人群不同的一个独特的人群子集。鉴于GPAQv2作为唯一被广泛接受的人群监测工具的重要性,未来需要使用不同的结构和客观参考标准来探索其在COPD患者这一亚群中的有效性。[j] .中华心血管病杂志,2020;31(1):159 - 166。
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引用次数: 2
Use of AM-PAC “6 Click” Scores to Predict Discharge Location Post-hospitalization in Adults With Cardiovascular Disease: A Retrospective Cohort Study 使用AM-PAC“6点击”评分预测成人心血管疾病患者住院后出院地点:一项回顾性队列研究
Pub Date : 2020-10-01 DOI: 10.1097/cpt.0000000000000128
N. Fernandez, S. Gore, Samantha K. Benson, J. Blackwood
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引用次数: 4
Sit Less for Successful Aging Pilot Study: Feasibility of an Intervention to Reduce Sedentary Time in Older Adults in Independent Living Communities. 少坐对成功衰老的初步研究:减少独立生活社区老年人久坐时间干预的可行性。
Pub Date : 2020-10-01 DOI: 10.1097/cpt.0000000000000126
Andrea L Hergenroeder, Bethany Barone Gibbs, Mary P Kotlarczyk, Subashan Perera, Tyler Quinn, Valerie Shuman, Jennifer S Brach, Robert J Kowalsky
{"title":"Sit Less for Successful Aging Pilot Study: Feasibility of an Intervention to Reduce Sedentary Time in Older Adults in Independent Living Communities.","authors":"Andrea L Hergenroeder,&nbsp;Bethany Barone Gibbs,&nbsp;Mary P Kotlarczyk,&nbsp;Subashan Perera,&nbsp;Tyler Quinn,&nbsp;Valerie Shuman,&nbsp;Jennifer S Brach,&nbsp;Robert J Kowalsky","doi":"10.1097/cpt.0000000000000126","DOIUrl":"https://doi.org/10.1097/cpt.0000000000000126","url":null,"abstract":"","PeriodicalId":72526,"journal":{"name":"Cardiopulmonary physical therapy journal","volume":"31 4","pages":"142-151"},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8059591/pdf/nihms-1540426.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38827716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Editorial 编辑
Pub Date : 2020-10-01 DOI: 10.1097/cpt.0000000000000150
S. Collins
{"title":"Editorial","authors":"S. Collins","doi":"10.1097/cpt.0000000000000150","DOIUrl":"https://doi.org/10.1097/cpt.0000000000000150","url":null,"abstract":"","PeriodicalId":72526,"journal":{"name":"Cardiopulmonary physical therapy journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/cpt.0000000000000150","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41568637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Optimizing Outcomes With Physical Therapy Treatment for IndividuALs Surviving an Intensive Care Units Admission for COVID-19 (OPTImAL)—A Protocol for a Single Center Prospective Study 优化新冠肺炎重症监护病房住院IndividuAL患者的物理治疗结果(OPTIAL)-单中心前瞻性研究方案
Pub Date : 2020-09-10 DOI: 10.1097/CPT.0000000000000156
K. Mayer, Angela K. Steele, Rajan R. Joshi, Melissa K. Soper, E. Dupont-Versteegden, P. Morris, Ashley A. Montgomery, S. Parry
Kirby P. Mayer, DPT, PhD; Angela K. Steele, PT, ACSM-CEP; Rajan R. Joshi, MD; Melissa K. Soper, APRN; Esther E. DupontVersteegden, PhD; Peter E. Morris, MD; Ashley A. Montgomery, MD; Selina M. Parry, PT, PhD Department of Physical Therapy, College of Health Sciences, University of Kentucky, Lexington, KY Pulmonary Rehabilitation, Division of Pulmonary, Critical Care and Sleep Medicine, College of Medicine, University of Kentucky, Lexington, KY Division of Pulmonary, Critical Care and Sleep Medicine, College of Medicine, University of Kentucky, Lexington, KY Department of Physiotherapy, School of Health Sciences, The University of Melbourne, Melbourne, Australia
Kirby P.Mayer,理学博士;Angela K.Steele,PT,ACSM-CEP;Rajan R.Joshi,医学博士;Melissa K.Soper,APRN;Esther E.DupontVersteegden,博士;Peter E.Morris,医学博士;Ashley A.Montgomery,医学博士;Selina M.Parry,PT,肯塔基大学列克星敦分校健康科学学院物理治疗博士,肯塔基州列克星敦大学医学院肺、重症监护和睡眠医学部肺康复,肯塔基州莱克星敦大学,KY澳大利亚墨尔本大学健康科学学院物理治疗系
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引用次数: 4
期刊
Cardiopulmonary physical therapy journal
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