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Marie Ellstrom Engh - One of the best experts on this subject based on the ideXlab platform.
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can pelvic floor Muscle Training reverse pelvic organ prolapse and reduce prolapse symptoms an assessor blinded randomized controlled trial
American Journal of Obstetrics and Gynecology, 2010Co-Authors: Ingeborg Hoff Braekken, Memona Majida, Marie Ellstrom EnghAbstract:Objective The aim of this study was to investigate the effectiveness of pelvic floor Muscle Training in reversing pelvic organ prolapse and alleviating symptoms. Study Design This assessor-blinded, parallel group, randomized, controlled trial conducted at a university hospital and a physical therapy clinic randomly assigned 109 women with prolapse stages I, II, and III to pelvic floor Muscle Training (n = 59) or control (n = 50). Both groups received lifestyle advices and learned "the Knack." In addition, pelvic floor Muscle Training comprised individual physical therapy sessions and home exercise. Student t test, Mann-Whitney U test, odds ratio, and effect size were used to compare groups. Results Eleven (19%) women in the pelvic floor Muscle Training group improved 1 Pelvic Organ Prolapse Quantification System stage vs 4 (8%) controls ( P = .035). Compared with controls, the pelvic floor Muscle Training group elevated the bladder (difference: 3.0 mm; 95% confidence interval, 1.5–4.4; P P = .022) and reduced frequency and bother of symptoms compared with controls. Conclusion Pelvic floor Muscle Training is without adverse effects and can be used as treatment for prolapse.
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morphological changes after pelvic floor Muscle Training measured by 3 dimensional ultrasonography a randomized controlled trial
Obstetrics & Gynecology, 2010Co-Authors: Ingeborg Hoff Braekken, Memona Majida, Marie Ellstrom EnghAbstract:OBJECTIVE:To investigate morphological and functional changes after pelvic floor Muscle Training in women with pelvic organ prolapse.METHODS:This randomized controlled trial was conducted at a university hospital and a physical therapy clinic. One hundred nine women with pelvic organ prolapse stages
Rik Gosselink - One of the best experts on this subject based on the ideXlab platform.
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inspiratory Muscle Training reduces diaphragm activation and dyspnea during exercise in copd
Journal of Applied Physiology, 2018Co-Authors: Daniel Langer, Casey E Ciavaglia, Azmy Faisal, Katherine A Webb, Alberto J Neder, Rik Gosselink, Sauwaluk DachaAbstract:In patients with COPD and low maximal inspiratory pressures, inspiratory Muscle Training (IMT) may be associated with improvement of dyspnea, but the mechanisms for this are poorly understood. This...
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preoperative inspiratory Muscle Training to prevent postoperative pulmonary complications in patients undergoing esophageal resection prepare study study protocol for a randomized controlled trial
Trials, 2014Co-Authors: Karin Valkenet, Rik Gosselink, Jaap C A Trappenburg, Meindert N Sosef, Jerome Willms, Camiel Rosman, Heleen Pieters, Joris J Scheepers, Saskia C De Heus, John V ReynoldsAbstract:Esophageal resection is associated with a high incidence of postoperative pneumonia. Respiratory complications account for almost half of the readmissions to the critical care unit. Postoperative complications can result in prolonged hospital stay and consequently increase healthcare costs. In cardiac surgery a preoperative inspiratory Muscle Training program has shown to prevent postoperative pneumonia and reduce length of hospital stay. While in some surgical centers inspiratory Muscle Training is already used in the preoperative phase in patients undergoing esophageal resection, the added value of this intervention on the reduction of pulmonary complications has not yet been investigated in large surgical populations other than cardiac surgery in a randomized and controlled study design. The effect of a preoperative inspiratory Muscle Training program on the incidence of postoperative pneumonia in patients undergoing esophageal resection will be studied in a single blind multicenter randomized controlled trial (the PREPARE study). In total 248 patients (age >18 years) undergoing esophageal resection for esophageal cancer will be included in this study. They are randomized to either usual care or usual care with an additional inspiratory Muscle Training intervention according to a high-intensity protocol which is performed with a tapered flow resistive inspiratory loading device. Patients have to complete 30 dynamic inspiratory efforts twice daily for 7 days a week until surgery with a minimum of 2 weeks. The starting Training load will be aimed to be 60% of maximal inspiratory pressure and will be increased based on the rate of perceived exertion. The main study endpoint is the incidence of postoperative pneumonia. Secondary objectives are to evaluate the effect of preoperative inspiratory Muscle Training on length of hospital stay, duration of mechanical ventilation, incidence of other postoperative (pulmonary) complications, quality of life, and on postoperative respiratory Muscle function and lung function. The PREPARE study is the first multicenter randomized controlled trial to evaluate the hypothesis that preoperative inspiratory Muscle Training leads to decreased pulmonary complications in patients undergoing esophageal resection. NCT01893008 .
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preoperative inspiratory Muscle Training to prevent postoperative pulmonary complications in patients undergoing esophageal resection prepare study study protocol for a randomized controlled trial
Trials, 2014Co-Authors: Karin Valkenet, Rik Gosselink, Jaap C A Trappenburg, Meindert N Sosef, Jerome Willms, Camiel Rosman, Heleen Pieters, Joris J Scheepers, Saskia C De Heus, John V ReynoldsAbstract:Background: Esophageal resection is associated with a high incidence of postoperative pneumonia. Respiratory complications account for almost half of the readmissions to the critical care unit. Postoperative complications can result in prolonged hospital stay and consequently increase healthcare costs. In cardiac surgery a preoperative inspiratory Muscle Training program has shown to prevent postoperative pneumonia and reduce length of hospital stay. While in some surgical centers inspiratory Muscle Training is already used in the preoperative phase in patients undergoing esophageal resection, the added value of this intervention on the reduction of pulmonary complications has not yet been investigated in large surgical populations other than cardiac surgery in a randomized and controlled study design. Methods/Design: The effect of a preoperative inspiratory Muscle Training program on the incidence of postoperative pneumonia in patients undergoing esophageal resection will be studied in a single blind multicenter randomized controlled trial (the PREPARE study). In total 248 patients (age >18 years) undergoing esophageal resection for esophageal cancer will be included in this study. They are randomized to either usual care or usual care with an additional inspiratory Muscle Training intervention according to a high-intensity protocol which is performed with a tapered flow resistive inspiratory loading device. Patients have to complete 30 dynamic inspiratory efforts twice daily for 7 days a week until surgery with a minimum of 2 weeks. The starting Training load will be aimed to be 60% of maximal inspiratory pressure and will be increased based on the rate of perceived exertion. The main study endpoint is the incidence of postoperative pneumonia. Secondary objectives are to evaluate the effect of preoperative inspiratory Muscle Training on length of hospital stay, duration of mechanical ventilation, incidence of other postoperative (pulmonary) complications, quality of life, and on postoperative respiratory Muscle function and lung function. (Continued on next page)
Hakan Alfredson - One of the best experts on this subject based on the ideXlab platform.
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new regimen for eccentric calf Muscle Training in patients with chronic insertional achilles tendinopathy results of a pilot study
British Journal of Sports Medicine, 2008Co-Authors: Per Jönsson, Hakan Alfredson, Martin Fahlstrom, Kerstin Sunding, Jill CookAbstract:New regimen for eccentric calf Muscle Training in patients with chronic insertional Achilles tendinopathy : results of a pilot-study
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chronic achilles tendon pain treated with eccentric calf Muscle Training
Knee Surgery Sports Traumatology Arthroscopy, 2003Co-Authors: Martin Fahlstrom, Per Jönsson, Ronny Lorentzon, Hakan AlfredsonAbstract:Injuries involving the Achilles tendon and manifested as chronic tendon pain are common, especially among recreational athletes. In a pilot study on a small group of patients with chronic painful mid-portion Achilles tendinosis, eccentric calf-Muscle Training was shown to give good clinical results. The aim of this prospective study was to investigate if the previously achieved good clinical results could be reproduced in a larger group of patients, and also to investigate the effects of eccentric calf-Muscle Training in patients with chronic insertional Achilles tendon pain. Seventy-eight consecutive patients, having chronic painful Achilles tendinosis at the mid-portion (2–6 cm level) in a total of 101 tendons (55 unilateral and 23 bilateral), and thirty consecutive patients with chronic insertional Achilles tendon pain in 31 tendons (29 unilateral and one bilateral) were treated with eccentric calf-Muscle Training for 12 weeks. Most patients were recreational athletes. Evaluation of the amount of tendon pain during activity was recorded on a visual analogue scale (VAS), before and after treatment. In 90 of the 101 Achilles tendons (89%) with chronic painful mid-portion Achilles tendinosis, treatment was satisfactory and the patients were back on their pre-injury activity level after the 12-week Training regimen. In these patients, the amount of pain during activity, registered on the VAS-scale (mean±SD), decreased significantly from 66.8±19.4 to 10.2±13.7. On the contrary, in only ten of the tendons (32%) with chronic insertional Achilles tendon pain was treatment satisfactory, with a significant decrease on the VAS-scale (mean±SD), from 68.3±7.0 to 13.3±13.2. Our conclusion is that treatment with eccentric calf-Muscle Training produced good clinical results in patients with chronic painful mid-portion Achilles tendinosis, but not in patients with chronic insertional Achilles tendon pain.
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Heavy-load eccentric calf Muscle Training for the treatment of chronic achilles tendinosis
American Journal of Sports Medicine, 1998Co-Authors: Hakan Alfredson, Tom Pietilä, Per Jönsson, Ronny LorentzonAbstract:We prospectively studied the effect of heavy-load eccentric calf Muscle Training in 15 recreational athletes (12 men and 3 women; mean age, 44.3 +/- 7.0 years) who had the diagnosis of chronic Achilles tendinosis (degenerative changes) with a long duration of symptoms despite conventional nonsurgical treatment. Calf Muscle strength and the amount of pain during activity (recorded on a visual analog scale) were measured before onset of Training and after 12 weeks of eccentric Training. At week 0, all patients had Achilles tendon pain not allowing running activity, and there was significantly lower eccentric and concentric calf Muscle strength on the injured compared with the noninjured side. After the 12-week Training period, all 15 patients were back at their preinjury levels with full running activity. There was a significant decrease in pain during activity, and the calf Muscle strength on the injured side had increased significantly and did not differ significantly from that of the noninjured side. A comparison group of 15 recreational athletes with the same diagnosis and a long duration of symptoms had been treated conventionally, i.e., rest, nonsteroidal antiinflammatory drugs, changes of shoes or orthoses, physical therapy, and in all cases also with ordinary Training programs. In no case was the conventional treatment successful, and all patients were ultimately treated surgically. Our treatment model with heavy-load eccentric calf Muscle Training has a very good short-term effect on athletes in their early forties.
Per Jönsson - One of the best experts on this subject based on the ideXlab platform.
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new regimen for eccentric calf Muscle Training in patients with chronic insertional achilles tendinopathy results of a pilot study
British Journal of Sports Medicine, 2008Co-Authors: Per Jönsson, Hakan Alfredson, Martin Fahlstrom, Kerstin Sunding, Jill CookAbstract:New regimen for eccentric calf Muscle Training in patients with chronic insertional Achilles tendinopathy : results of a pilot-study
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chronic achilles tendon pain treated with eccentric calf Muscle Training
Knee Surgery Sports Traumatology Arthroscopy, 2003Co-Authors: Martin Fahlstrom, Per Jönsson, Ronny Lorentzon, Hakan AlfredsonAbstract:Injuries involving the Achilles tendon and manifested as chronic tendon pain are common, especially among recreational athletes. In a pilot study on a small group of patients with chronic painful mid-portion Achilles tendinosis, eccentric calf-Muscle Training was shown to give good clinical results. The aim of this prospective study was to investigate if the previously achieved good clinical results could be reproduced in a larger group of patients, and also to investigate the effects of eccentric calf-Muscle Training in patients with chronic insertional Achilles tendon pain. Seventy-eight consecutive patients, having chronic painful Achilles tendinosis at the mid-portion (2–6 cm level) in a total of 101 tendons (55 unilateral and 23 bilateral), and thirty consecutive patients with chronic insertional Achilles tendon pain in 31 tendons (29 unilateral and one bilateral) were treated with eccentric calf-Muscle Training for 12 weeks. Most patients were recreational athletes. Evaluation of the amount of tendon pain during activity was recorded on a visual analogue scale (VAS), before and after treatment. In 90 of the 101 Achilles tendons (89%) with chronic painful mid-portion Achilles tendinosis, treatment was satisfactory and the patients were back on their pre-injury activity level after the 12-week Training regimen. In these patients, the amount of pain during activity, registered on the VAS-scale (mean±SD), decreased significantly from 66.8±19.4 to 10.2±13.7. On the contrary, in only ten of the tendons (32%) with chronic insertional Achilles tendon pain was treatment satisfactory, with a significant decrease on the VAS-scale (mean±SD), from 68.3±7.0 to 13.3±13.2. Our conclusion is that treatment with eccentric calf-Muscle Training produced good clinical results in patients with chronic painful mid-portion Achilles tendinosis, but not in patients with chronic insertional Achilles tendon pain.
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Heavy-load eccentric calf Muscle Training for the treatment of chronic achilles tendinosis
American Journal of Sports Medicine, 1998Co-Authors: Hakan Alfredson, Tom Pietilä, Per Jönsson, Ronny LorentzonAbstract:We prospectively studied the effect of heavy-load eccentric calf Muscle Training in 15 recreational athletes (12 men and 3 women; mean age, 44.3 +/- 7.0 years) who had the diagnosis of chronic Achilles tendinosis (degenerative changes) with a long duration of symptoms despite conventional nonsurgical treatment. Calf Muscle strength and the amount of pain during activity (recorded on a visual analog scale) were measured before onset of Training and after 12 weeks of eccentric Training. At week 0, all patients had Achilles tendon pain not allowing running activity, and there was significantly lower eccentric and concentric calf Muscle strength on the injured compared with the noninjured side. After the 12-week Training period, all 15 patients were back at their preinjury levels with full running activity. There was a significant decrease in pain during activity, and the calf Muscle strength on the injured side had increased significantly and did not differ significantly from that of the noninjured side. A comparison group of 15 recreational athletes with the same diagnosis and a long duration of symptoms had been treated conventionally, i.e., rest, nonsteroidal antiinflammatory drugs, changes of shoes or orthoses, physical therapy, and in all cases also with ordinary Training programs. In no case was the conventional treatment successful, and all patients were ultimately treated surgically. Our treatment model with heavy-load eccentric calf Muscle Training has a very good short-term effect on athletes in their early forties.
Margalit Weiner - One of the best experts on this subject based on the ideXlab platform.
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prophylactic inspiratory Muscle Training in patients undergoing coronary artery bypass graft
World Journal of Surgery, 1998Co-Authors: P Weiner, Fawaz Zeidan, D Zamir, Benny Pelled, J Waizman, Marinella Beckerman, Margalit WeinerAbstract:Pulmonary complications after cardiac surgery are a leading cause of postoperative morbidity and mortality. Respiratory Muscle weakness may contribute to the postoperative pulmonary abnormalities. We hypothesized that: (1) there is a decrease in inspiratory Muscle strength (PImax at residual volume) and endurance (Pmpeak/PImax) following coronary artery bypass graft (CABG); (2) this weakness is associated with reduced pulmonary function tests (PFTs), impaired gas exchange, and a higher rate of pulmonary complications; and (3) prophylactic inspiratory Muscle Training (IMT) can prevent those changes. Eighty-four candidates for CABG, with ages ranging from 33 to 82 years, were evaluated prior to operation and randomized into two groups: 42 patients underwent IMT using a threshold trainer for 30 min/day for 2 weeks, 1 month before operation (group A); 42 patients served as a control group and underwent sham Training (group B). There was a significant decrease in respiratory Muscle function, PFTs, and gas exchange in the control group following CABG, whereas these parameters remained similar to those before entering the study in the Training group. The differences between the groups were statistically significant. In addition, 11 (26%) patients in the control group but only 2 (5%) in the Training group needed postsurgical mechanical ventilation longer than 24 hours. CABGs have a significant deteriorating effect on inspiratory Muscle function, PFTs, and arterial blood gases. The decrease in these parameters can be prevented by prophylactic inspiratory Muscle Training, which may also prevent postsurgical pulmonary complications.
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the effect of incentive spirometry and inspiratory Muscle Training on pulmonary function after lung resection
The Journal of Thoracic and Cardiovascular Surgery, 1997Co-Authors: P Weiner, Margalit Weiner, D Zamir, J Waizman, Abraham Man, Marinella Rabner, Rasmi Magadle, Yoel GreiffAbstract:Abstract Background: A predicted postoperative forced expiratory volume in 1 second (FEV 1 ) of less than 800 ml or 40% of predicted is a common criterion for exclusion of patients from lung resection for cancer. Usually, the predicted postoperative lung function is calculated according to a formula based on the number of lung segments that will be resected. Incentive spirometry and specific inspiratory Muscle Training are two maneuvers that have been used to enhance lung expansion and inspiratory Muscle strength in patients with chronic obstructive pulmonary disease and after lung operation. Methods: Thirty-two patients with chronic obstructive pulmonary disease who were candidates for lung resection were randomized into two groups: 17 patients received specific inspiratory Muscle Training and incentive spirometry, 1 hour per day, six times a week, for 2 weeks before and 3 months after lung resection (group A) and 15 patients were assigned to the control group and received no Training (group B). Results: Inspiratory Muscle strength increased significantly in the Training group, both before and 3 months after the operation. In group B, the predicted postoperative FEV 1 value consistently underestimated the actual postoperative FEV 1 by approximately 70 ml in the lobectomy subgroup and by 110 ml in the pneumonectomy subgroup. In group A, the actual postoperative FEV 1 was higher than the predicted postoperative FEV 1 by 570 ml in the lobectomy subgroup and by 680 ml in the pneumonectomy subgroup of patients. Conclusions: In patients undergoing lung resection the simple calculation of predicted postoperative FEV 1 underestimates the actual postoperative FEV 1 by a small fraction. Lung functions can be increased significantly when incentive spirometry and specific inspiratory Muscle Training are used before and after operation. (J Thorac Cardiovasc Surg 1997;113:552-7)
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inspiratory Muscle Training in patients with bronchial asthma
Chest, 1992Co-Authors: P Weiner, Yair Azgad, Rasem Ganam, Margalit WeinerAbstract:In patients with asthma, the respiratory Muscles have to overcome the increased resistance while they become progressively disadvantaged by hyperinflation. We hypothesized that increasing respiratory Muscle strength and endurance with specific inspiratory Muscle Training (SIMT) would result in improvement in asthma symptoms in patients with asthma. Thirty patients with moderate to severe asthma were recruited into 2 groups; 15 patients received SIMT (group A) and 15 patients were assigned to the control group (group B) and got sham Training in a double-blind group-comparative trial. The Training was performed using a threshold inspiratory Muscle trainer. Subjects of both groups trained five times a week, each session consisted of ½-h Training, for six months. Inspiratory Muscle strength, as expressed by the PImax at RV, increased significantly, from 84.0 ± 4.3 to 107.0 ± 4.8 cm H2O (p
