Physiospot CardioRespiratory

Physiospot Redirect

All of our Physiospot blogs can now be found together at www.physiospot.com

You will need to sign up to the new RSS feeds and email updates to continue receiving regular updates on all the latest clinically relevant research.

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New Year, New Start!

With the expansion in the number of Physispot blogs available in 2007 it has become quite a large task to continually juggle them all and is not conducive to an effective service for our readers. We have therefore made the decision to amalgamate all the blogs into one place at www.physiospot.com.  Whilst you will be able to read all the  articles that have been selected as clinically relevant and posted we have developed separate areas of the site for research in different clinical areas. 

By making the management process more efficient not only will we be able to devote more time to actually posting articles but it will also provide a number of additional benefits:

• Each clinical area can be easily accessed from the navigation bar at the top of each page, no more flicking between different blogs.
• Articles can be tagged with more than one clinical area thereby adding more articles to each individual clinical area.
• The search function will search across all clinical areas so that you will be looking for what you need amongst all the articles posted.
• More easily keep up-to-date with recent additions in multiple clinicl areas by freely subscribing to one or more of our update options.
• Authors can easily work in more than one clinical area which may be useful for their own professional development and evidence based practice.

There is one small inconvenience to our readers which can be easily overcome.  As of today the email alerts and feeds for all the old physispot blogs will cease to function.  You will need to sign up again to receive the update alerts that you are interested in.  Go to the update options page to sign up now for your RSS feed and Email Alerts.  You can also download our toolbar to receive updates straight to your desktop and follow us on Twitter from this page.

We hope that all our readers are happy with the developments and that you enjoy the site and continue to find it useful, had we not done this we may not have been able to carry on with the juggling!  Visit the new site at www.physiospot.com

Estimating maximum work rate during incremental cycle ergometry testing from six-minute walk distance in patients with chronic obstructive pulmonary disease.

Hill K, Jenkins SC, Cecins N, Philippe DL, Hillman DR, Eastwood PR.

The authors of this study set out to develop a predictive equation which would allow estimation of the maximum work rate (Wmax) achieved during an incremental cycle ergometry test from the measurement of 6-minute walk distance (6MWD) and its derivative, 6-minute walk work, which is the product of 6MWD and body weight.

They found that Wmax could be estimated from equations based on measurements of 6MWD or 6-minute walk work. The estimate of Wmax derived from either equation could provide a basis on which to prescribe cycle ergometry training work rates that comply with the current guidelines for pulmonary rehabilitation

Archives of Physical Medicine and Rehabilitation. 2008;89(9):1782-7

Link to Abstract

Control of separation in sternal instability by supportive devices: a comparison of an adjustable fastening brace, compression garment, and sports tape.

El-Ansary D, Waddington G, Adams R.

Support from sports tape, a compression garment, and an adjustable fastening brace was assessed by an ultrasound-based measure of sternal separation contingent on movement and by self-report measures of comfort, pain, feeling of support, ease of upper-limb movement, and ease of breathing in 15 patients with sternal instability after a median sternotomy.

The results showed that for both sternal separation and self-report data, some support was better than no support, a supportive device worn on the body was better than sports tape, and wearing an adjustable fastening brace was better than a compression garment. The effects of wearing the different supportive devices on visual analog scale ratings of comfort, pain, support, ease of breathing, and movement mirrored the results obtained for sternal separation.

Archives of Physical Medicine and Rehabilitation. 2008;89(9):1775-81

Link to Abstract

A single session of Acu-TENS increases FEV1 and reduces dyspnoea in patients with chronic obstructive pulmonary disease: a randomised, placebo-controlled trial

Lau KSL and Jones AYM

Forty-six ambulatory patients with a mean age of 75 years, with stage I or II chronic obstructive pulmonary disease, and with no previous experience of TENS or acupuncture were included in the study. The experimental group received a treatment of 45 minutes of Acu-TENS, while the control group received placebo-TENS with identical electrode placement.

The experimental group had an increased FEV1 and decreased dyspnoea scores when compared to the control group. Acu-TENS may be a useful non-invasive adjunctive intervention in the management of dyspnoea in patients with chronic obstructive
pulmonary disease.

Australian Journal of Physiotherapy 2008; 54: 179–184

Link to Abstract

Skeletal muscle weakness, exercise tolerance and physical activity in adults with Cystic Fibrosis.

Troosters T, Langer D, Vrijsen B, Segers J, Wouters K, Janssens W, Gosselink R, Decramer M, Dupont L.

The aim of this study was to investigate the prevalence of muscle weakness and the importance of physical inactivity in CF and its relation to exercise tolerance and muscle strength. In a study group of 64 adult patients with CF and 20 age-matched controls exercise tolerance, skeletal and respiratory muscle strength were assessed. Quadriceps muscle weakness was present in 56% of the patients. Peak oxygen consumption and six minute walking distance was below normal in 89% and 75% of patients, respectively. Respiratory muscle strength was normal.

The authors conclude that skeletal muscle weakness and exercise intolerance are prevalent in CF. Although physical inactivity is a significant factor contributing to exercise tolerance and skeletal muscle force in adults with Cystic Fibrosis, the impairments in muscle strength and six minute walk distance are in excess to that expected from physical inactivity only.

European Respiratory Journal 2009; 33:99-106

Link to Abstract

Taking a Break!

With a couple of e-learning projects that require some dedicated time, I will be taking a break from writing on the CPDspot and Physiospot blogs for the rest of November and December.  There may continue to be some posts from our other authors but I will be going quiet until the New Year.  When I return in 2009 I will be refreshed and ready to get writing again.  I will also have had some time to consider some of the ideas for new projects that have been mulling around for a while now, so you can expect some exciting developments next year.

Rehabilitation for Hospital Associated Deconditioning.

Kortebein P. This article reviews the current state of knowledge regarding the rehabilitation of patients with hospital associated deconditioning including terminology, epidemiology, etiology, current rehabilitation recommendations, and future areas of research. Despite the prevalence of hospital associated deconditioning, there is a paucity of research examining the functional recovery and rehabilitation of these patients. The available evidence to date indicates that acute inpatient rehabilitation seems to be effective for improving function in patients with hospital associated deconditioning. American Journal of Physical Medicine and Rehabilitation. 2008 Aug 6. (Epub ahead of print)

Analysis of bedside entertainment services' effect on post cardiac surgery physical activity: a prospective, randomised clinical trial.

Papaspyros S, Uppal S, Khan SA, Paul S, O'Regan DJ. The aim of this study was to compare the level of postoperative physical activity and length of in-hospital stay of patients undergoing cardiac surgery depending on whether they had access to bedside entertainment services (BES) or not. Pedometers were used to quantify postoperative physical activity for 5 days. On average, patients with no access to BES walked more than those with BES access. Patients with no access to BES were 84% more likely to walk higher number of steps than patients with access to BES. On average, participants with access to BES were likely to stay longer in hospital, than participants with no access to BES. This study suggests that bedside entertainment systems may have an adverse effect on post cardiac surgery patient ambulation and may contribute to an increase in hospital stay. European Journal of Cardiothoracic Surgery 2008 Aug 13. (Epub ahead of print)