A B C D E F G H I J K L M N O P Q R S T U V W X Y Z All
Sundaram, Balasubramanian
- Slow Breathing Training on Cardio-respiratory Control and Exercise Capacity in Persons with Essential Hypertension - a Randomized Controlled Trial
Authors
1 Srinivas College of Physiotherapy and Research Centre, Pandeshwar, Mangalore -1, IN
Source
Indian Journal of Physiotherapy & Occupational Therapy-An International Journal, Vol 6, No 2 (2012), Pagination: 17-21Abstract
Background
In Persons with Hypertension there is Decreased Exercise Tolerance and Elevated Total Peripheral Resistance Due to Autonomic Imbalance. Slow Breathing Improves Autonomic Imbalance by Reducing Sympathetic overactivity in Hypertensive Patients.
Aim
To Find the Effect of Slow Breathing Training on Cardiorespiratory Control and Exercise Capacity in Patients with Essential Hypertension.
Setting
Medicine Out-patient Department of a Tertiary Care Hospital. Design Randomized Controlled Trial. Methods forty Persons with Essential Hypertension of Age Group 35 - 60 Years were Recruited and Randomly Allocated in to 2 Groups; Experimental Group (n=20), who Received Slow Breathing Exercises Twice a Week for 4 Weeks along with Pharmacological Treatment and Control Group (n=20), who Received Pharmacological Treatment Alone. after 4 Weeks, Persons in both the Groups were Measured for Outcome Variables Like Submaximal Exercise Capacity by Using 6 Minute Walk Test (6 Mwd), Systolic Blood Pressure (sbp), Diastolic Blood Pressure (dbp), Heart Rate(hr) and Respiratory Rate (rr). Results a Statistically Significant Difference was Found in Exercise Group between Pre and Post Intervention for all the Outcome Variables, whereas for Control Group no Significant Difference was Found between Pre and Post Intervention. between the Exercise and Control Group, a Statistically Significant Difference was Found for the Variables, Hr (p =0.009), Sbp (p =0.012), Dbp (p =0.000) and Rr (p =0.000), but there was no Significant Difference in Mean Difference of 6 Mwd (95% Ci = -4.443, 2.543; P =0.585) between the Groups.
Conclusion
Slow Breathing Training Significantly Improves Cardiorespiratory Control but it Fails to Improve the Exercise Capacity in Patients with Essential Hypertension.
Keywords
Slow Breathing Exercises, Blood Pressure, Autonomic Imbalance, Exercise Tolerance, Sympathetic OveractivityReferences
- Aram V Chobanian, George L Bakris, Henry R Black, William C Cushman, Lee A Green, Joseph L Izzo et al,. The National High Blood Pressure Education Program Coordinating Committee. The seventh Report of Joint National Committee on prevention, detection, evaluation and treatment of High Blood pressure. The JNC-VII report. JAMA 2003; 289(19).
- Ellen A. Hillegass, H. Steven Sadowsky. Essential of Cardiopulmonary Physical Therapy. 2nd ed. Saunders an imprint of Elsevier; 2001. p. 286-287.
- Shyamal Kumar Das, Kalyan Sanyal, Arindam Basu. Study of urban community survey in India: growing trend of high prevalence of hypertension in a developing country. Int J Med Sci 2005;2:70-78.
- Suzuki S, Ohta T. Non-pharmacological treatment of hypertension in the elderly. Nippon Rinhso 2005;63(6):1010-5.
- Chacko N. Joseph, Cesare Porta, Gaia Casucci, nadia Casiraghi, Mara Maffeis, Marco Rossi, Luciano Bernardi. Slow breathing improves arterial baroreflex sensitivity and decreases blood pressure in essential hypertension. Hypertension 2005;46:714-718.
- Somers VK, Mark AL, Abboud FM. Potentiation of sympathetic nerve responses to hypoxia in borderline hypertensive subjects. Hypertension 1988;11:608-612.
- Pitt O. Lim, Robert J. MacFadyen, Peter B.M. Clarkson, Thomas M. MacDonald. Impaired exercise tolerance in hypertensive patients. Annals of Internal medicine 1996;124(1):41-55.
- Carolyn Kisner, Lynn Allen Colby. Therapeutic Exercise Foundation and Techniques. 4th ed. New Delhi: JAYPEE Brothers; 2003. p. 749-750.
- Bernardi L, Spadacinin G, Bellwon J, Hajric R, Roskamm H, Frey AW. Effect of breathing rate on oxygen saturation and exercise performance in chronic heart failure. Lancet 1998 May 2;351(9112):1299-300.
- Carlos Hermano da Justa Pinheiro, Renato Antonio Ribeiro Medeiros, Denise Goncalves Moura Pinheiro, Maria de Jesus Ferreira Marinho. Spontaneous respiratory modulation improves cardiovascular control in essential hypertension. Arq. Bras. Cardiol 2007;88(6).
- Luciano Bernardi, Cesare Porta, Lucia Spicuzza, Jerzy Bellwon, Giammario Spadacini, Axel W. Frey, Leata Y.C. Yeung, John E. Sanderson, Roberto Pedretti, Roberto Tramarin. Slow breathing increases arterial baroreflex sensitivity in patients with chronic heart failure. Circulation;105;143-145.
- Bernardi L, Gabutti A, Porta C, Spicuzza L. Slow breathing reduces chemoreflex to hypoxia and hypercapnia, and increases baroreflex sensitivity. J Hypertens 2001;19(12):2221-9.
- Montano N, Cogliati C, Porta A, Pagani M, Malliani A, Narkiewicz K, Abboud FM, Birkett C, Somers VK. Central vagotonic effects of atropine modulate spectral oscillations of sympathetic nerve activity. Circulation 1998;98:1294- 1399.
- Somers VK, Mark AL, Abboud FM. Interaction of baroreceptor and chemoreceptor reflex control of sympathetic nerve activity in normal humans. J Clin Invest 1991;87:1953-75.
- ATS statement: guidelines for the six-minute walk test. Am J Respir Crit Care Med 2002 Jul 1;166(1):111-7.
- Gordon H. Guyatt, Michael H. Sullivan, Penelope J. Thompson, Ernest L. Fallen, Steward O. Pugsley, D. Wayne Taylor, Leslie B. Berman. The 6 minute walk: a new measure of exercise capacity in patients with chronic heart failure. Can Med Assoc J 1985 April 15;132.
- Postural Stability during Seven Different Standing Tasks in Persons with Chronic Low Back Pain - A Cross-sectional Study
Authors
1 Srinivas College of Physiotherapy and Research Centre, Pandeshwar, Mangalore, IN
Source
Indian Journal of Physiotherapy & Occupational Therapy-An International Journal, Vol 6, No 2 (2012), Pagination: 22-27Abstract
Background
Proprioceptive impairments reflected by poor joint position sense have been identified in persons with Low Back Pain (LBP) and thus leading to impaired postural control.
Aim
To evaluate the postural stability during seven different standing tasks in persons with CLBP compared to persons without LBP.
Setting
Movement Science Lab.
Design
Cross-sectional study.
Methods and Material
A force plate was used to measure the Centre of Pressure (COP) excursion in antero-posterior (A-P) and medial-lateral (M-L) directions in persons with CLBP (n = 20) and normal subjects (n = 20) for 7 different standing tasks with eyes opened and closed.
Statistical Analysis
Independent t test and Mann - Whitney U test were used based on the normality assumption for comparing the COP excursion between CLBP and normal subjects.
Results
The CLBP group showed statistically significant increase in COP excursion for normal standing with eyes opened (NSEO) [P = 0.000], normal standing with eyes closed (NSEC) [95% CI = 0.39, 0.66; P = 0.000], tandem standing with eyes opened (TSEO) [P = 0.000], tandem standing with eyes closed (TSEC) [P = 0.000], foam standing with eyes opened (FSEO) [P = 0.0001], foam standing with eyes closed (FSEC) [95% CI = 0.56,1.05; P = 0.000], and one leg standing (OLS) [95% CI = 0.07,0.47; P = 0.010] as compared to normal subjects.
Conclusion
There was an increase in postural sway among the persons with CLBP compared to that of the normal individuals in all the 7 different standing tasks.
Keywords
Postural Control, Postural Steadiness, Postural Sway, Balance, COP ExcursionReferences
- Frymoyer JW. Back pain and sciatica. N Engl J Med 1988;318:291-300.
- Elaine Thomas, Alan J Silman, Peter R Croft, Ann C Papageorgiou, Malcolm I V Jayson and Gary J Macfarlane. Predicting who develops chronic low back pain in primary care: a prospective study. BMJ 1999;318:1662-7.
- Abenhaim L, Suisa S, Rossignol M. Risk of recurrence of occupational back pain over three year follow up. Brit J Ind Med 1988 Dec;45(12):829-33.
- Adams MA, Mannion AF, Dolan P. Personal risk factors for first-time low back pain. Spine 1999;23:2497-2505.
- Van der Heijden GJMG, Beurskens AJHM, Koes BW, et al. De resultaten van een pilot study. Ned T Fysiotherapie 1991;101:37–43.
- Ji RR, Woolf CJ. Neuronal plasticity and signal transduction in nociceptive neurons: implications for the initiation and maintenance of pathological pain. Neurobiol Dis 2001;8(1):1–10.
- Boal RW, Gillette RG. Central neuronal plasticity, low back pain and spinal manipulative therapy. J Manipulative Physiol Ther 2004;27(5):314–26.
- Coderre TJ, Katz J, Vaccarino AL, Melzack R. Contribution of central neuroplasticity to pathological pain: review of clinical and experimental evidence. Pain 1993;52(3): 259– 85.
- Woolf CJ, Salter MW. Neuronal plasticity: increasing the gain in pain. Science 2000;288(5472):1765–9.
- Bolay H, Moskowitz MA. Mechanisms of pain modulation in chronic syndromes. Neurology 2002;59(5 Suppl. 2):S2–7. Hanke TA, Rogers MW. Reliability of ground reaction force measurements during dynamic transitions from bipedal to single-limb stance in healthy adults. Phys Ther 1992;72:810- 816.
- Ikeda H, Heinke B, Ruscheweyh R, Sandkuhler J. Synaptic plasticity in spinal lamina I projection neurons that mediate hyperalgesia. Science 2003;299(5610):1237–40.
- Gebhart GF. Descending modulation of pain. Neurosci Biobehav Rev 2004;27(8):729–37.
- Hanke TA, Rogers MW. Reliability of ground reaction force measurements during dynamic transitions from bipedal to single-limb stance in healthy adults. Phys Ther 1992;72:810- 816.
- Irrgang JJ, Whitney SL, Cox ED. Balance and proprioceptive training for rehabilitation of the lower extremity. J Sport Rehabil 1994;3:68-83.
- Newton RA. Joint receptor contributions to reflexive and kinesthetic responses. Phys Ther 1992;62:22-29.
- Prieto TE, Myklebust JB, Myklebust BM. Characterization and modeling of postural steadiness in the elderly: a review. IEEE Trans Rehabil Eng 1993;1:26-34.
- Brocklehurst JC, Robertson D, James-Groom P. Clinical correlated of sway in old age -sensory modalities. Age Ageing 1982;11:1-10.
- Lichtenstein MJ, Shields SL, Shiavi RG, Burger MC. Clinical determinants of biomechanics platform measures of balance in aged women. J Am Geriatr Soc 1988 Nov;36(11):996- 1002.
- Overstall W, Exton-Smith AN, Imms FJ, Johnson AL. Falls in the elderly related to postural balance. BMJ 1977;1:287-95.
- Mientjes MI, Frank JS. Balance in chronic low back pain patients compared to healthy people under various conditions in upright standing. Clin Biomech 1999;14:710– 716.
- Carolyn Richardson, Paul Hodges, Julie Hides. Therapeutic exercise for lumbopelvic stabilization. 2nd ed. China: Churchill Livingstone; 2004. p. 16,20,143.
- Brumagne S, Cordo P, Verschueren S. Proprioceptive weighting changes in persons with low back pain and elderly persons during upright standing. Neurosci Lett 2004;366:63–66.
- Newcomer Karen L, Laskowski Edward R, Yu Bing, Johnson Jane C, An Kai-Nan. Differences in repositioning error among patients with low back pain compared with control subjects. Spine 2000 Oct 1;25(19):2488–2493.
- Hides JA, Richardson CA, Jull GA. Multifidus muscle recovery is not automatic after resolution of acute, firstepisode low back pain. Spine 1996;21:2763–2769.
- Hodges PW, Richardson CA. Inefficient muscular stabilization of the lumbar spine associated with low back pain: A motor control evaluation of transversus abdominis. Spine 1996;21:2640–2650.
- Henry SM, Hitt JR, Jones SL et al. Decreased limits of stability in response to postural perturbations in subjects with low back pain. Clin Biomech 2006;21:881–892.
- Cholewicki J, van Dieen JH, Arsenault AB. Muscle function and dysfunction in the spine. J Electromyogr Kinesiol 2003;13:303–304.
- Byl NN, Sinnott PL. Variations in balance and body sway in middle-aged adults: subjects with healthy backs compared with subjects with low-back dysfunction. Spine 1991;16:325–330.
- Simon Brumagne, Lotte Janssens, Stefanie Knapen, Kurt Claeys, Ege Suuden-Johanson. Persons with recurrent low back pain exhibit a rigid postural control strategy. Eur Spine J 2008;17:1177–1184.
- Brumagne S, Cordo P, Lysens R, Verschueren S, Swinnen S. The role of paraspinal muscle spindles in lumbosacral position sense in individuals with and without LBP. Spine 2000;25(8):989-994.
- Davis J.R., Campbell, A.D., Adkin, A.L., Carpenter, M.G. The relationship between fear of falling and human postural control. Gait and Posture 2008;29(2):275-279.
- Sibley, K.M., Carpenter, M.G., Perry, J.C., Frank, J.S. Effects of postural anxiety on the soleus H-reflex. Human Movement Science 2007;26(1):103-112.
- Maki, B. E., Holliday, P. J., & Topper, A. K. Fear of falling and postural performance in the elderly. Journal of Gerontology 1991;46:M123–M131.
- Michael L. Madigan, Bradley S. Davidson, Maury A. Nussbaum. Postural sway and joint kinematics during quiet standing are affected by lumbar extensor fatigue. Human Movement Science 2006;25:788–799.
- Della Volpe R, Popa T, Ginanneschi F, Spidalieri R, Mazzocchio R, Rossi A. Changes in coordination of postural control during dynamic stance in chronic low back pain patients. Gait Posture 2006;24:349–55.
- Prieto TE, Myklebust JB, Myklebust BM. Characterization and modeling of postural steadiness in the elderly: a review. IEEE Trans Rehabil Eng 1993;1:26-34.
- Carver S, Kiemel T, Jeka JJ Modeling the dynamics of sensory reweighting. Biol Cybern 2006;95:123–134.
- Carl G. Mattacola, Denise A. Lebsack, and David H. Perrin. Intertester Reliability of Assessing Postural Sway Using the Chattecx Balance System J Athl Train. 1995 September; 30(3):237-239, 241-242.
- Gill KP, Callaghan MJ. The measurement of lumbar proprioception in individuals with and without low back pain. Spine 1998;23:371–377.
- Mok NW, Brauer SG, Hodges PW. Hip strategy for balance control in quiet standing is reduced in people with low back pain. Spine 2004;29:E107–E112.
- Mazzocchio R, Scarfo GB, Mariottini A, Muzii VF, Palma L. Recruitment curve of the soleus H-reXex in chronic back pain and lumbosacral radiculopathy. BMC Musculoskelet Disord 2001;2:4.
- Luana Mann, Julio F. Kleinpaul, Antonio Renato Pereira Moro, Carlos Bolli Mota, Felipe P. Carpes, Effect of low back pain on postural stability in younger women: Influence of visual deprivation Journal of Bodywork & Movement Therapies 2009;6:7.
- Radebold A, Cholewicki J, Polzhofer GK, et al. Impaired postural control of the lumbar spine is associated with delayed muscle response times in patients with chronic idiopathic low back pain. Spine. 2001;26:724–730.