bluuebunny/crossref_metadata_2025 huggingface dataset:
The Effect of Bone-Loading Exercise on Bone Mineral Density in Women Following Treatment for Breast Cancer: A Systematic Review and Meta-analysis
Authors: Zerzan Sarah , Smoot Betty , Lee Jeannette Q. , Lui Andrew , Allen Diane D.
Published: July 2018

Purpose:

The purpose of this systematic review and meta-analysis was to synthesize the current literature on the effects of bone-loading exercise on bone mineral density (BMD) in women after treatment of breast cancer (BC).

Methods:

PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Physiotherapy Evidence Database (PEDro), and Web of Science databases were searched through March 31, 2016. A combination of MeSH terms and key words was used: (physical therapy OR physiotherapy OR resistance training OR weight training OR aerobic OR exercise) AND (bone density OR osteoporosis) AND breast cancer. Search terms for PEDro were as follows: (breast cancer AND bone breast cancer) and (breast cancer AND osteoporosis). Studies included were experimental studies that compared any type of bone-loading exercise intervention with a comparison group and reported dual-energy x-ray absorptiometry for assessment of BMD of the lumbar spine and/or proximal femur (femoral neck, trochanter, and/or total hip). Between-group BMD effect sizes and 95% confidence intervals (CIs) were calculated for each study (bone-loading exercise vs usual care/non–bone-loading exercise) and pooled across studies. Risk of bias in and across studies was addressed using the PEDro scale.

Results:

Five randomized controlled studies were included. Pooled effect sizes were statistically significant, favoring the bone-loading exercise group for proximal femur (d = 0.15; 95% CI, 0.03-0.28) and for lumbar spine BMD (d = 0.14; 95% CI, 0.01-0.27).

Conclusion:

Results provide modest evidence that bone-loading exercise interventions have statistically and clinically significant effects on proximal femur and lumbar spine BMD in women treated for BC. Further research is warranted to determine the most effective types and intensities of exercise for improving BMD in BC survivors.
Description of a Community-Based Exercise Program for Children With Cancer: A Sustainable, Safe, and Feasible Model
Authors: Chamorro Viña Carolina , Guilcher Gregory M.T. , Schulte Fiona , De Vries Alexander , Schwanke Jenna , Culos-Reed Susan Nicole
Published: July 2018

Background:

Physical activity has emerged as a promising intervention to decrease the severity of cancer side effects. To date, only a few community-based exercise programs have been described in the literature. Of these, none have been designed to be sustainable and available as programs for pediatric cancer survivors on an ongoing basis.

Methods:

This article aims to describe a safe, feasible, and sustainable community-based exercise program for children with cancer. The program is offered to children on/off treatment and their siblings, between 3 and 18 years old. A multidisciplinary team developed this evidence-based program, and it is facilitated by trained volunteers. A parent survey was conducted to evaluate the quality of the program.

Results:

The PEER (Pediatric cancer patients and survivors Engaging in Exercise for Recovery) program is a safe, feasible, and sustainable community-based exercise program for children with cancer. From the parent satisfaction survey, all of the parents would strongly recommend the PEER program to other families.

Conclusion:

PEER provides an example of a community-based exercise program that has a strong pedagogical focus, is evidence-based, and is individualized, safe, feasible, and sustainable for children with cancer. On the basis of the benefit of exercise described in the literature, we believe this model of an evidence-based community intervention might decrease the burden of cancer side effects and promote the reintegration of children affected by cancer into physical activity programming in their community.
Results of a Pilot Yoga Intervention to Improve Pediatric Cancer Patients' Quality of Life and Physical Activity and Parents' Well-being
Authors: Orsey Andrea D. , Park Crystal L. , Pulaski Regan , Shankar Nilani L. , Popp Jill M. , Wakefield Dorothy
Published: July 2018

Background and Purpose:

Yoga is increasingly proving beneficial in improving distress, pain, physical activity, and health-related quality of life (QOL) in adult patients with cancer, but few studies have examined the efficacy of yoga therapy for pediatric patients with cancer. We aimed to study the feasibility and preliminary efficacy of a yoga intervention for pediatric cancer patients in active treatment and for their families.

Methods:

We conducted 2 separate studies: (1) a survey of 20 patients and parents regarding preferences (eg, convenient days and times), experiences, and expectations regarding yoga (including barriers and positive expectancies); and (2) an 8-week single-arm clinical trial of a yoga intervention in 10 children and their family members. Targeted outcomes of the clinical trial were patients' fatigue, QOL, and physical activity. Secondary outcomes were caregivers' well-being (QOL and burden).

Results:

Study 1 demonstrated fairly high levels of interest from patients and family members. Study 2 demonstrated improved patients' and parents' QOL pre- to post–yoga intervention.

Conclusions:

Parents and patients found the intervention highly acceptable. Conducting the intervention in the context of active cancer treatment proved feasible. Despite limited statistical power, QOL of patients doing yoga improved. Our findings support the notion that yoga for pediatric cancer patients during active treatment is feasible and potentially helpful in improving both patients' and parents' well-being.
Respiratory Muscle Training Improves Exercise Performance and Quality of Life in Cancer Survivors: A Pilot Study
Authors: Ray Andrew D. , Williams Brian T. , Mahoney Martin C.
Published: July 2018

Background:

Respiratory muscle weakness represents one of the potential mechanisms contributing to exertional dyspnea and reduced exercise performance in lung and breast cancer survivors.

Purpose/Objective:

Pilot study of a respiratory muscle training (RMT) program to improve exercise capacity and quality of life (QOL) and reduce dyspnea in breast and lung cancer survivors.

Methods:

Participants performed 3 sets of 15 repetitions against spring-loaded inspiratory and expiratory valves, 3 days per week, for 4 weeks, with weekly increases in resistance. Maximal expiratory (MEP) and inspiratory pressures (MIP), exercise tests (

JOURNAL/reonc/04.03/01893697-201704000-00007/7FSM1/v/2023-08-24T150842Z/r/image-gif

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2peak, submaximal cycling endurance at 70% of peak, and Six-Minute Walk Test [6MWT]) along with questionnaires (Baseline Dyspnea Index and SF-36 [36-Item Short Form Health Survey]) were completed pre- and post-RMT.

Design:

Single-arm pilot study.

Setting:

University research and academic medical center.

Patients:

Lung and breast cancer survivors with the presence of mild-to-moderate dyspnea symptoms not attributed to cardiopulmonary disease.

Results:

Post-RMT, MIP and MEP increased 29% ± 21% and 34% ± 32%, respectively (P < .001). Submaximal endurance time (16.9 ± 7.4 minutes vs 31.4 ± 7.7 minutes, P = .001), the distance covered in the 6MWT (427 ± 84 m vs 471 ± 95 m, P = .005), dyspnea index (6.4 ± 1.0 vs 7.6 ± 1.3, P = .02), and QOL (total 85.3 ± 9.4 vs 97.8 ± 12.7, P = .014) were all significantly improved post-RMT.

Limitations:

Limited sample size and short duration of follow-up.

Conclusions:

These preliminary results support the continued investigation of a respiratory muscle-training program to improve respiratory muscle strength, exercise performance, and QOL, as well as to decrease dyspnea symptoms among cancer survivors.
Effects of an Individualized Aerobic Exercise Program in Individuals With a Brain Tumor Undergoing Inpatient Rehabilitation: A Feasibility Study
Authors: Ayotte Sarah L. , Harro Cathy C.
Published: July 2018

Background/Objective:

To investigate the feasibility of aerobic exercise training in patients with brain tumors and its effects on aerobic function, strength, fatigue, and functional outcomes.

Methods:

Design: Prospective study, single cohort design. Setting: Phase 1: inpatient rehabilitation hospital; phase 2: outpatient setting. Patients: Patients with primary or metastatic brain tumors. Twenty qualified participants enrolled, 16 participants (9 men, 7 women; mean age = 56.6 years) completed phase 1. One participant completed phase 2. Intervention: Individualized aerobic training on a recumbent cycle ergometer. Phase 1: 5 days per week; phase 2: 3 days per week. Training goal was 20 minutes of continuous cycling at moderate intensity for a duration of 6 weeks including phase 1 and phase 2. Measurements: Aerobic capacity (graded submaximal cycling test), Six-Minute Walk Test (6MWT), Functional Independence Measure, lower-extremity composite strength, and the Functional Assessment of Chronic Illness Therapy–Fatigue; measures were assessed pretraining, at inpatient discharge, and posttraining. Feasibility determined by (1) adherence to training program, (2) training responsiveness, and (3) ability to achieve training goals.

Results:

Statistically significant changes in all outcome measures found during phase 1, with moderate gains in aerobic capacity and the 6MWT. All participants reached the training goal of 20 minutes of continuous cycling at moderate intensity and adherence to 5 training sessions per week in phase 1. No adverse events reported.

Limitations:

Lack of a control group and limited participation in phase 2; therefore, training responsiveness assessed only during inpatient phase.

Conclusion:

Study supports the feasibility and effectiveness of an individualized aerobic exercise program for individuals with brain tumors.
Oncology Section EDGE Task Force on Urogenital Cancer Outcomes: Clinical Measures of Lymphedema—A Systematic Review
Authors: Cohn Joy C. , Geyer Hannah , Lee Jeannette , Fisher Mary Insana
Published: July 2018

Background:

Valid and reliable tools to assess lymphedema are necessary to accurately evaluate status and to objectively document and measure the results of interventions. Understanding the advantages and disadvantages of each measure can inform the clinician's choice of the appropriate tool to be used in the clinic or research setting.

Purpose:

To identify reliable and valid measurement techniques that are sensitive to change for assessing edema volume or soft tissue change in the lower extremities or genital region of patients with lymphedema.

Methods:

A systematic review of the literature was conducted to assess the published psychometric properties and clinical feasibility of each method identified. Task Force members independently reviewed each measure using the Cancer EDGE Rating Form.

Results:

Both water displacement and circumferential measurement methods by tape measure were rated as Highly Recommended to quantify lower-extremity limb volume. Water displacement was determined to be the criterion standard by which all other assessments of volume are benchmarked. Both optoelectric volumetry and bioelectric impedance analysis were rated as Recommended, and ultrasound was rated Not Recommended.

Conclusion:

The Urogenital Cancer EDGE Task Force highly recommends water displacement and circumferential tape measurement for use as reliable methods for assessment and documentation of change of limb volume in this patient population. Early detection of subclinical lower-extremity lymphedema in this patient population remains challenging, as there is no “index” limb that can be proven to be uninvolved in a patient population with documented pelvic node dissection/irradiation. No articles were found to support valid and reliable genital lymphedema volume measurement.
Best Practices for Public Policies for Palliative Care Physical Therapy: A Critical Review of the Literature
Authors: Baldwin Amber , Wilson Christopher
Published: July 2018

Background and Purpose:

In comparison with the volume of patients living with a chronic disease or life-threatening illness, there remains insufficient availability and affordability of both palliative care (PC) and physical therapy (PT) services. The purpose of this critical review of the literature was to examine the factors impacting integration of PT within PC and identify opportunities to improve public policy initiatives to facilitate integration of PT and PC.

Methods:

Peer-reviewed articles regarding PT within PC as it relates to public policy and health care reform were retrieved through a critical review of the literature.

Results:

Twenty articles were identified and synthesized that described a variety of aspects of the effect of public policy and health care reform on the integration of PT and PC.

Discussion:

The evidence for the importance of PT in PC stems from multiple factors such as better symptom management, reduction in cost, decreased length of stay, fewer hospital readmissions, improved patient/provider satisfaction, and an increase in quality of life. Further integration of PT within PC and the associated benefits are heavily influenced by choices made in public policy.

Conclusion:

Public policies that should be addressed include regulation reform of payment and reimbursement, modernization of legislation for access and referrals to PT, institutional support of education for key PT and PC stakeholders, and increased funding for support of PT involvement in PC.
Physical Therapy–Based Interventions Improve Balance, Function, Symptoms, and Quality of Life in Patients With Chemotherapy-Induced Peripheral Neuropathy: A Systematic Review
Authors: Brayall Patrick , Donlon Erin , Doyle Lisa , Leiby Renee , Violette Katelyn
Published: July 2018

Background:

Chemotherapy-induced peripheral neuropathy (CIPN) involves damage to peripheral nerves. It can cause weakness, loss of dexterity, pain, sensory disturbances, and decreased ankle proprioception. These impairments lead to decreased balance, increased risk of falls, difficulty with activities of daily living, and difficulty walking at home and in the community. These functional limitations also contribute to decreased quality of life (QOL) and participation restrictions. There is a lack of evidence related to physical therapy (PT) interventions and outcomes in patients with CIPN.

Objective:

To systematically review the evidence to determine whether adults with CIPN benefit from PT interventions to improve balance, function, and QOL.

Methods:

A database search was performed in January 2017 for articles dated in the last 15 years. Search terms used were as follows: chemotherapy, peripheral, neuropathy, prevalence, management, falling, strength, and balance training. This yielded 300 studies, with another 98 studies found through other methods. Inclusion criteria were as follows: adults with diagnosis of CIPN, balance or functional mobility issues due to CIPN, and studies involving PT interventions. Articles were excluded if they were pharmacological intervention based, if they did not include patients with documented CIPN, and if they did not involve PT interventions. Articles were appraised using the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) criteria. A total of 5 articles met the criteria, including 3 experimental studies and 2 randomized control trials, and were included in this review.

Results:

Lower limb closed kinetic chain exercises showed a decrease in tingling sensation, decrease in pain, and improved balance. Interactive sensor-based balance training showed increasing tandem stance balance with eyes open. Studies involving strength and endurance training showed positive effects for balance, lower extremity strength, function, and QOL, as measured using the McGill QOL Questionnaire and the European Organization for Research and Treatment in Cancer Quality-of-Life Questionnaire (EORTC QLQ-C30).

Conclusion:

PT interventions are beneficial for individuals with CIPN demonstrating improved static and dynamic balance, increased lower extremity strength, and reduction in CIPN symptoms such as pain and paresthesia. This could lead to a decreased risk of falls and has been shown to correlate to an improved QOL. Larger sample sizes, more specific outcome measures and interventions, and better defined inclusion criteria will further inform best practice with this patient population.
Clinical Implementation of the Clinical Practice Guidelines for Diagnosing Upper-Quadrant Lymphedema Secondary to Cancer
Authors: Perdomo Marisa , Ryans Kathryn , Levenhagen Kimberly , Davies Claire C. , Gilchrist Laura
Published: July 2018

Background:

The Oncology Section of the APTA recently published a clinical practice guideline (CPG) for diagnosing secondary upper-quadrant lymphedema (SUQL) related to cancer. Application of any CPGs may be challenging depending upon clinical setting, patient population, and clinical expertise.

Purpose:

The purpose of this article is to assist the clinician in integrating the evidence from the CPG into clinical practice. The authors present the recommendations from the CPG using a systematic approach that will enable integration of the appropriate diagnostic tools for SUQL based on presentation and stage during the patient evaluation.

Conclusion:

Although this article provides the clinician with recommendations for integrating the CPG into their practice, it is beneficial for the clinician to refer back to the original CPG to understand its scope and limitations. The SUQL CPG was based on a review of the literature from 2000 to 2015. The authors acknowledge that some additional literature may have emerged since its development that may now either support or refute the use of some measures evaluated and recommended. Further collaborative research is needed between researchers and clinicians to develop and evaluate appropriate assessment and diagnostic tools to aid in early diagnosis of SUQL in body regions such as the trunk, breast, hand, head, and neck.
Translating Research to Practice Using a Team-Based Approach to Cancer Rehabilitation: A Physical Therapy and Exercise-Based Cancer Rehabilitation Program Reduces Fatigue and Improves Aerobic Capacity
Authors: Leach Heather J. , Covington Kelley R. , Pergolotti Mackenzi , Sharp Julia , Maynard Brooke , Eagan Jeffrey , Beasley Joanne
Published: July 2018

Background and Objective:

Intervention research has shown that exercise-based rehabilitation is safe and effective for reducing disease burden across the cancer continuum. However, the translation of this research to programs implemented in health care settings remains a challenge. This study describes the implementation of a physical therapy–based exercise program for patients who have been diagnosed with cancer and its effectiveness for reducing fatigue and improving aerobic capacity.

Methods:

Retrospective analysis of a single-group, pre/postprogram assessment for adult patients who have been diagnosed with cancer (N = 546). Six-Minute Walk Test (6MWT) measured aerobic capacity. Functional Assessment of Chronic Illness Therapy–Fatigue (FACIT-Fatigue) and Piper Fatigue Scale (PFS) measured fatigue. Paired-samples t tests examined changes in outcomes from pre- to postprogram assessments. Linear regression explored predictors of postprogram outcomes.

Results:

Participants were 63.7 ± 12.2 years old, diagnosed with breast (27.1%), hematological (15.4%), head and neck (12.6%), lung (12.3%), prostate (11%), colorectal (7.3%), or other (14.3%) cancers. For those who completed the postprogram measures (N = 169), FACIT-Fatigue scores improved (MΔ = +8.42 ± 9.2, t
79 = −8.21, P = .000), PFS scores improved (MΔ = −2.1 ± 2.0, t
81 = 9.5, P = .000), and 6MWT distance improved (MΔ = +42.9 ± 53.8 m, t
160 = −10.1, P = .000). Age (P = .034) and time since completing chemotherapy (P = .000) or radiation therapy (P = .014) was inversely associated with the 6MWT. Greater exercise session attendance was associated with higher PFS scores (P = .020).

Limitations:

Only 31% of participants completed postprogram assessments, and limited information was available regarding reasons for dropout/withdrawal.

Conclusions:

This study provides a real-world example of a cancer rehabilitation program implemented in a health care setting, which was successful in reducing fatigue and improving aerobic capacity.
Oncology Section EDGE Task Force on Cancer: Measures of Cancer-Related Fatigue—A Systematic Review
Authors: Fisher Mary Insana , Davies Claire , Lacy Hannah , Doherty Deborah
Published: July 2018

Background:

Cancer-related fatigue (CRF) is one of the most common side effects of cancer and cancer treatment. Being able to accurately screen for and assess CRF will improve access to and prescriptions for interventions. Valid and reliable measures to screen for and assess CRF need to be identified.

Purpose:

To identify and recommend reliable, valid, and clinically useful tools to screen for and assess CRF among those treated for cancer.

Methods:

A systematic review of the literature was conducted to assess the published psychometric properties and clinical feasibility of each method identified. Task force members independently reviewed each measure using the Cancer EDGE Rating Form.

Results:

Review of 136 studies resulted in recommendations for 14 questionnaires. Five unidimensional and 9 multidimensional questionnaires are recommended by the Oncology EDGE Task Force.

Conclusion:

The 10-point Numeric Rating Scale for Fatigue is best as a screening tool, whereas the Multidimensional Fatigue Symptom Inventory is a highly recommended multidimensional tool. Ease of screening can promote referral for interventions, whereas thorough assessment drives appropriate interventions.
Screening for Early Childhood Intervention in Oncology
Authors: Corr Angela Meyer , Thomas Kristin M.
Published: July 2018

Infants and toddlers (birth to 3 years of age) diagnosed with cancer are at a critical phase of development and are at greater risk for developmental delays due to this early adversity. Because of this risk, St. Jude Children's Research Hospital (SJCRH) developed an Early Childhood Clinic (ECC). Psychologists screen children using the Battelle Developmental Inventory, Second Edition (BDI-2). If physical and occupational therapy services are needed on the basis of the results of the BDI-2, the physical therapists and occupational therapists administer the Peabody Developmental Motor Scales, Second Edition (PDMS-2). If scores from the PDMS-2 display a delay in gross and/or fine motor skills, physical therapy and/or occupational therapy are initiated. At SJCRH, the psychologists in the ECC have screened 107 patients. Eighty-eight of the 107 patients (82%) were referred to physical therapy. Because 82% of patients who received a developmental screen are then referred to physical therapy, it appears beneficial to screen children younger than 3 years who have been diagnosed with a malignancy. The ECC at SJCRH is a program dedicated to improving quality of life for children and their families through hospital-based early intervention for chronically ill children. The ECC developed at SJCRH may be a model of care for pediatric oncology settings to encourage the development of age-appropriate motor skills while providing families with resources in home communities to further this development.
Physical and Edema Therapy Management of Amyloidosis in the Acute Care Setting: A Case Report
Authors: Boudreau Jennifer , Lagunilla Jane , Kotkiewicz Jean
Published: July 2018

Background and Purpose:

Currently, there are no formal guidelines describing rehabilitation interventions for those with amyloidosis. This case report explores the application of physical and edema therapy interventions, including external compression, for a patient with a diagnosis of light-chain (AL) amyloidosis and functionally limiting orthostatic hypotension in the acute care setting.

Case Description:

A 52-year-old man with a diagnosis of immunoglobulin AL amyloidosis presented to the acute care setting with progressed orthostatic hypotension, bilateral lower extremity edema, and episodes of syncope. The patient spent 17 days in the inpatient setting and received physical therapy (PT) and edema therapy through the inpatient lymphedema service. Rehabilitation focused on exercise, compression, and behavioral and educational interventions over the course of 9 PT sessions and 7 edema therapy sessions.

Outcomes:

Before interventions, the patient was unable to safely ambulate at home due to syncope. He progressed to being able to ambulate 1560 ft with seated rests. The patient demonstrated decreased limb circumferential measurements, improved performance on the 6-Minute Walk Test, improved ability to self-manage orthostatic hypotension and edema, and increased participation in activities of daily living.

Discussion:

The combination of physical and edema therapy services may have compensated for orthostatic hypotension and improved standing tolerance. The patient's blood urea nitrogen and brain natriuretic peptide levels may have improved because of the application of external compression. Overall, the patient experienced decreased limb size, increased exercise tolerance, decreased syncopal episodes, and improved quality of life without changes in pharmacologic management or adverse events.
Emotional Influences on Cognitive Processing in Fibromyalgia Patients With Different Depression Levels
Authors: Sitges Carolina , González-Roldán Ana M. , Duschek Stefan , Montoya Pedro
Published: July 2018

Objectives:

Comorbid symptoms in fibromyalgia (FM) syndrome, such as mood disorders and cognitive dysfunction, may lead to greater functional impairment than pain itself. This study aimed to unravel the modulating role of depression in response execution and inhibition in FM using an emotional go/no-go task.

Materials and Methods:

In total, 17 FM patients with low depression, 18 FM patients with high depression, and 18 pain-free controls were included. Pain, happy, and neutral faces were pseudorandomly presented, and participants were asked to respond to male faces (go trials) by pressing a button, and to inhibit their responses if female faces were presented (no-go trials).

Results:

FM patients with high depression showed lower positive affect scores, higher negative affect and pain vigilance scores, and slower reaction times, than FM patients with low depression and pain-free controls. Both subgroups of FM patients also rated pain faces as more arousing than pain-free controls. The lack of group differences in our electrophysiological data, neither in N200 nor in P300 amplitudes, seems to indicate that there was no significant impairment in response execution in response inhibition due to pain.

Discussion:

Taken together, these results add evidence to the notion that depression is associated with higher affective dysregulation and deficit of information-processing speed in FM. Furthermore, our data suggest that pain induces a bias to pain-related information, but the absence of significant group differences in event-related potential amplitudes, calculated with analyses of covariance (ANCOVA) (with pain intensity), seem to show that pain intensity is not a predictor for cognitive dysfunctions.
Arthroscopic Elbow Contracture Release in the Pediatric Patient
Authors: Andelman Steven M. , Walsh Amanda L. , Sochol Kristen M. , Rubenstein William M. , Hausman Michael R.
Published: July 2018

Background:

Elbow contracture is a sequelae of elbow trauma in pediatric patients. Arthroscopic contracture release has been shown to provide equivalent results to open contracture release with less associated morbidity and complications in the adult population. However, open contracture release is still commonly utilized in pediatric patients. The goal of this study is to determine the clinical results and safety profile of arthroscopic elbow contracture release in the pediatric population.

Methods:

A retrospective review of all patients 18 years of age and younger who underwent arthroscopic elbow contracture release was performed. Demographic statistics, indication for surgery, preoperative and postoperative flexion-extension and pronation-supination range of motion, and all complications were recorded and analyzed.

Results:

Twenty-five patients were identified as having undergone 29 arthroscopic elbow contracture releases. The most common index injury was elbow contracture after radial head fracture. The flexion-extension arc of motion improved from 93.0±39.9 degrees to 128.0±19.2 degrees for a total improvement of 35.2 degrees (P=0.0002), whereas the pronation-supination arc of motion improved from 141.0±58.6 degrees to 153±49.3 degrees for a total improvement of 12.2 degrees (P=0.097). There were 7 total complications.

Conclusions:

Arthroscopic elbow contracture release allows for restoration of range of motion with an acceptable safety profile and can be considered as a less invasive alternative to open contracture release in the pediatric population.

Level of Evidence:

Level IV.
A Novel Technique for Correcting Radial Length and Translation in Distal Radius Fractures
Authors: Wang William L. , Tosti Rick
Published: July 2018

We describe a novel technique in correcting distal radius fractures deformed with significant shortening or coronal plane translation in both the acute or chronic setting. The technique involves using a modified push-pull device to assist the surgeon in correcting length and/or translation of the articular block without the use additional hardware outside of the volar plate.
Dynamic Angiogenic Switch as Predictor of Response to Chemotherapy-Bevacizumab in Patients With Metastatic Colorectal Cancer
Authors: Cubillo Antonio , Álvarez-Gallego Rafael , Muñoz Manuel , Pond Gregory , Perea Sofía , Sánchez Gema , Martin María , Rodríguez-Pascual Jesús , Garralda Elena , Vega Estela , de Vicente Emilio , Quijano Yolanda , Muñoz César , Ugidos Lisardo , Toledo Rodrigo A. , Hidalgo Manuel
Published: July 2018

Background:

Previous studies have shown that metastatic colorectal carcinoma (mCRC) patients treated with bevacizumab, experience variation in the plasma levels of angiogenesis growth factors and related cytokines, called angiogenic switch (AS). The aim of the present study was to analyze the relationship between AS and the clinical response during standard chemotherapy-bevacizumab treatment.

Patients and Methods:

Patients with Eastern Cooperative Oncology Group 0-1 mCRC were eligible. Patients received treatment with standard dose capecitabine plus either oxaliplatin or irinotecan and bevacizumab for 6 cycles. Initial treatment was followed by maintenance therapy with bevacizumab plus capecitabine until progression. Plasma levels of angiogenic-related cytokines (hepatocyte growth factor, placental growth factor, macrophage chemoattractant protein-3, MM-9, eotaxin, basic fibroblast growth factor, and interleukin 18) were prospectively analyzed at baseline and every 8 weeks. Progression-free survival (PFS) was calculated using the Kaplan-Meier method.

Results:

A total of 71 patients were enrolled. AS was observed in 45 patients (63.4%), 28 of whom experienced AS at the first evaluation after treatment start. Disease control, which includes partial/complete response and stable disease, was seen in 96% of AS patients (43/45), but only in 15/26 (58%) for the remaining patients without evidence of AS (P<0.001). The median PFS of AS patients was 11.4 months (95% confidence interval, 8.6-15.8) versus 8.3 months for patients without AS (95% confidence interval, 5.6-16.4; P=0.04).

Conclusions:

Chemotherapy plus Bevacizumab combination in mCRC patients results in dynamic changes in plasma cytokines, which is associated with better disease control and longer PFS. These new findings support continuing studying AS as a potential marker of angiogenesis inhibitor effectiveness.
Time Course of Exercise Training–Induced Muscle Strength Changes in Type 2 Diabetes
Authors: Mathis Ruth Ann , Taylor J. David , Fletcher James P. , Rainey Jacquie , Cade W. Todd , Bandy William D.
Published: July 2018

Purpose:

To investigate longitudinal muscle strength changes in response to exercise training in people with type 2 diabetes.

Methods:

Twenty-one people with type 2 diabetes were randomly allocated to either a moderate or high-intensity exercise training group with the only difference between the groups being the prescribed exercise training intensity. Muscle strength (8 repetition maximum in kilograms) was measured weekly for 12 weeks using the chest press, leg press, row, and knee extension exercises. Muscle strength was expressed as the sum of 8 repetition maximum scores for each exercise.

Results:

Linear mixed models indicated significant gains in muscle strength (P < .001) in both groups and no significant difference in gains in muscle strength (P = .47) between the groups. Pooled data from both groups indicated significant improvement in muscle strength (P < .05) week-to-week beginning after week 1 and continued until week 9.

Conclusion:

Participation in either a moderate or high-intensity exercise training program can result in similar gains in muscle strength for people with type 2 diabetes. Muscle strength improvements can occur on a weekly basis for the first 8 weeks of exercise training, with a plateau in gains occurring at week 9 through week 12.
Cardiovascular and Pulmonary Research: The Year (2016) in Review
Authors: Ricard Paul E. H. , Cahalin Lawrence P.
Published: July 2018

Practitioners need access to and the ability to openly discuss advanced in practice and concepts as they apply to the practice of cardiovascular and pulmonary physical therapy (PT). Lack of accessibility to research literature, limited personal time, or insufficient knowledge to adequately review the breadth of literature published each year can hinder this process. This article provides an overview of cardiovascular and pulmonary research published in 2016 that the authors believe most important and relevant or speak to the volume or trend of current topics in the clinical practice of cardiovascular and pulmonary PT. Several key sections are used to describe selected articles and are followed by brief overview of clinical relevance of this material presented at the 2017 Combined Sections Meeting in San Antonio, Texas.
Objective Improvement in Daily Physical Activity in Heart Failure Remains Elusive: A Systematic Review
Authors: Shoemaker Michael J. , Tresh Thomas , Hart Jack , Wood Tiffany
Published: July 2018

Purpose:

The purpose was to comprehensively review the literature for exercise- and psychosocial-based rehabilitation interventions for improving daily physical activity (PA) in patients with heart failure (HF).

Methods:

A search of the PubMed/MEDLINE, CINAHL, ProQuest Medical, PsycINFO, and Web of Science databases was conducted. Articles were included if they (1) were written in English, (2) included subjects with HF, (3) assessed physical or psychosocial rehabilitation interventions to improve daily PA, and (4) measured daily PA qualitatively or quantitatively. Case reports, non–peer-reviewed research, and articles without full text available were excluded. Two authors completed the screening independently, and conflicts were resolved by a third author.

Results:

One thousand four hundred sixty-two unique records were identified, and of these, 47 were selected for full-text review. Ultimately 15 were included: 13 randomized controlled trials and 2 case series, published from 1999 to 2016. No studies using only exercise interventions resulted in objective increases in daily PA. All 3 studies using only psychosocial interventions resulted in an increase, but only 1 of these used an objective measure and that study was a case series. One study using a combination of exercise and psychosocial interventions showed an objective increase in daily PA, but that result was not replicated later in a similar study.

Conclusions:

Exercise interventions alone do not result in improvement in daily PA in patients with HF. Further investigation concerning psychosocial interventions, with objective outcome measurement, is warranted.
Fitness Fatness Index and Residual-Specific Mortality
Authors: Frith Emily , Loprinzi Paul D.
Published: July 2018

Purpose:

A fitness fatness index (FFI) was recently (2016) developed, with FFI calculated as cardiorespiratory fitness divided by waist-to-height ratio. This FFI algorithm includes easily-assessed patient health parameters that physical therapists can readily determine. Residual-specific mortality (deaths not from the 9 major causes) is more prevalent than each of the 9 major causes of death. No study has evaluated the association of FFI on residual mortality risk, which was this study's purpose.

Methods:

Data from the 1999 to 2006 National Health and Nutrition Examination Survey were used, with follow-up through 2011. Among the 9974 participants, 162 died of residual mortality over the follow-up period; median follow-up period was 105 months (interquartile range: 81–129).

Results:

In a Cox proportional hazard model, for every 1 FFI increase, participants had a 9% reduced hazard of residual-specific death (hazard ratio = 0.91; 95% confidence interval: 0.87–0.95; P < .001).

Conclusions:

This novel study presents evidence of an inverse association between FFI on residual-specific mortality. Physical therapists can use this algorithm to further assess their patient's current and future health status.
Description and Comparison of Preseason and Postseason Blood Pressure Measures Among Collegiate Athletes: A Prospective Observational Study
Authors: Arena Sara , LaBelle Lauren , Larsen Jennifer , Palomino Lia , Hew-Butler Tamara , Peterson Edward
Published: July 2018

Purpose:

Growing evidence suggests that suboptimal blood pressure (BP) measures among professional athletes parallel rates among nonathletes; however, BP measures among collegiate athletes of varied sports or the relationship of this measure to body mass index (BMI) has not been reported. The primary purpose of this study is to describe and compare preseason and postseason BP measures among collegiate athletes of varied sports and sexes. A secondary purpose is to describe correlations between a BP measurement and BMI during the course of a competitive season.

Methods:

A prospective observational study using a sample of convenience assessed resting BP and BMI of athletes from men's soccer, cross country, and swimming; and women's volleyball, cross country, and swimming at one Division I university. Blood pressure measures were further classified as elevated, stage 1, or stage 2 hypertensive (HTN) using previously established criteria. Descriptive statistics reported athlete demographics, BP, and BMI. A pairwise t test compared and determined differences in preseason and postseason BP. Correlations of BP with BMI were examined. Statistical significance was set at P ≤ .05.

Results:

Seventy-four athletes met preseason and postseason inclusion criteria. Preseason and postseason right-sided BP assessment identified 10.8% (n = 8), 5.4% (n = 4), and 1.3% (n = 1) and then 17.6% (n = 13), 17.6% (n = 13), and 1.3% (n = 1) athletes to have Elevated, stage 1 HTN, and stage 2 HTN measures, respectively. All BP measures demonstrated significant preseason to postseason increases (P = .001) in all sports with significantly higher BP increases in men compared with women. Furthermore, positive correlations between systolic BP and BMI were identified.

Conclusions:

Elevated and HTN BP measures were identified among collegiate athletes. Although significant increases in BP over time were detected, causative factors warrant further examination; however, increase in BMI may be a contributing factor. Findings of this study support routine BP assessment by physical therapists serving the collegiate athlete population.
Association between metabolic profiles in urine and bone mineral density of pre- and postmenopausal Chinese women
Authors: Yu Lisha , Qi Huanhuan , An Guohua , Bao Jun , Ma Bo , Zhu Jianwei , Ouyang Gang , Zhang Pengling , Fan Hongwei , Zhang Qi
Published: July 2018

Objective:

In the present study, we aimed to characterize the pathological development of menopausal osteoporosis, as well as to explore potential biomarkers and metabolic pathways involved in osteoporosis.

Methods:

Urine samples from 322 female participants categorized by menopause status and different bone conditions were collected and analyzed based on a gas chromatography–mass spectrometry (GC–MS) approach. Multivariate and univariate statistical analyses were carried out for urinary metabolomic profile characterization and comparison.

Results:

Seventeen metabolites in the low bone mineral density (BMD) groups were clearly differentiated from those in normal BMD groups. Among these 17 differentiating metabolites, taurine, β-alanine, and 5-hydroxycaproic acid were found to be potential biomarkers of osteoporosis. The taurine metabolic pathway and the β-alanine metabolic pathway were found to be related to menopause and bone loss.

Conclusions:

Based on the GC–MS metabolomic platform, four typical pathological phases during the progression of postmenopausal osteoporosis were described. Several differentiating metabolites and metabolic pathways were found to be closely related to the pathology of postmenopausal osteoporosis. Our results provided a solid foundation for further studies on early diagnosis and pathomechanistic evaluation.
Difference in carotid intima-media thickness between pre and postmenopausal women
Authors: Ieamtairat Piyamas , Soontrapa Sukree , Kaewrudee Srinaree , Promsorn Julaluck , Takong Wittawat , Somboonporn Woraluk
Published: July 2018

Objectives:

To examine whether carotid intima-media thickness (CIMT), the prevalence of increased CIMT, and the presence of carotid plaque differ according to menopausal status.

Methods:

In this analytical cross-sectional study, we enrolled 61 premenopausal women and 61 postmenopausal women. We matched the two groups for age. Participants were classified as either premenopausal or postmenopausal according to menstrual history and follicular-stimulating hormone level. Two skilled radiologists measured CIMT and carotid plaque in all participants by using B-mode ultrasound.

Results:

The mean age was 49.25 ± 2.0 years. The mean number of years since menopause in the postmenopausal group was 1.9 ± 0.92 years. After adjusted analysis, the mean CIMT of the common carotid artery of postmenopausal women was significantly higher than that of premenopausal women, with a mean difference of 0.068 mm (95% confidence interval 0.023, 0.113). There was no significant association between number of years since menopause and mean CIMT. Although the prevalence of increased CIMT and the presence of carotid plaque were significantly higher in the postmenopausal group than in the premenopausal group according to crude analysis, this difference was not statistically significant after adjusted analysis. Multiple linear regression analysis for assessing potential risk factors for the alteration of mean CIMT showed that only menopausal status and body mass index were independently associated factors.

Conclusions:

Our findings indicate that postmenopausal status is a significant factor of high mean CIMT. These findings add to the growing evidence showing that menopause transition is a critical period for subclinical atherosclerosis development.
Depression and Anxiety in Heart Failure: A Review
Authors: Celano Christopher M. , Villegas Ana C. , Albanese Ariana M. , Gaggin Hanna K. , Huffman Jeff C.
Published: July 2018

Learning objectives

After participating in this activity, learners should be better able to:

• Identify the relationships between depression, anxiety, and heart failure (HF).

• Assess methods for accurately diagnosing depression and anxiety disorders in patients with HF.

• Evaluate current evidence for treatment of anxiety and depression in patients with HF.

Background

In patients with heart failure (HF), depression and anxiety disorders are common and associated with adverse outcomes such as reduced adherence to treatment, poor function, increased hospitalizations, and elevated mortality. Despite the adverse impact of these disorders, anxiety and depression remain underdiagnosed and undertreated in HF patients.

Methods

We performed a targeted literature review to (1) identify associations between depression, anxiety, and HF, (2) examine mechanisms mediating relationships between these conditions and medical outcomes, (3) identify methods for accurately diagnosing depression and anxiety disorders in HF, and (4) review current evidence for treatments of these conditions in this population.

Results

Both depression and anxiety disorders are associated with the development and progression of HF, including increased rates of mortality, likely mediated through both physiologic and behavioral mechanisms. Given the overlap between cardiac and psychiatric symptoms, accurately diagnosing depression or anxiety disorders in HF patients can be challenging. Adherence to formal diagnostic criteria and utilization of a clinical interview are the best courses of action in the evaluation process. There is limited evidence for the efficacy of pharmacologic and psychotherapy in patients with HF. However, cognitive-behavioral therapy has been shown to improve mental health outcomes in patients with HF, and selective serotonin reuptake inhibitors appear safe in this cohort.

Conclusions

Depression and anxiety disorders in HF patients are common, underrecognized, and linked to adverse outcomes. Further research to improve detection and develop effective treatments for these disorders in HF patients is badly needed.
Compassion and Loving-Kindness Meditation: An Overview and Prospects for the Application in Clinical Samples
Authors: Graser Johannes , Stangier Ulrich
Published: July 2018

Objectives

This article presents a brief overview of the empirical evidence of well-established mindfulness interventions and an in-depth review of less-established compassion-based interventions (CBIs) and loving-kindness meditation (LKM). Definitions, cognitive and physiological mechanisms, and methods of assessment are discussed.

Method

A literature review using the databases Google Scholar, PsycINFO, and PubMed was conducted.

Results

Whereas the efficacy of mindfulness-based stress reduction and mindfulness-based cognitive therapy has been documented in many trials, only seven randomized, controlled trials have been completed on CBIs and LKM. In these trials, CBIs were effective in treating psychotic disorders, affective disorders with psychotic features, major depressive disorder, eating disorders, and patients with suicide attempts in the past year; LKM was effective in treating chronic pain; and a combination of both was effective for borderline personality disorder. A larger number of nonrandomized studies indicate that CBIs and LKM may be effective in treating a wide range of clinical conditions, including depression, anxiety disorders, chronic pain, and posttraumatic stress disorder.

Conclusions

Further studies are needed to confirm the promising effects of CBIs and LKM. Preliminary evidence suggests that both approaches might be beneficial across various clinical populations. Future studies need to clarify whether these approaches might be options as stand-alone treatments or as adjuncts or augmentation of evidence-based methods in psychotherapy.