Changes in pulmonary function during the early years after inpatient rehabilitation in persons with spinal cord injury: a prospective cohort study.

Objective: To describe changes in pulmonary function (PF) during the 5 years after inpatient rehabilitation in persons with spinal cord injury (SCI) and to study potential determinants of change.

Design: Prospective cohort study.

Setting: Eight rehabilitation centers with specialized SCI units.

Comparison of respiratory muscle training methods in individuals with motor and sensory complete tetraplegia: a randomized controlled trial.

Objective: To compare the effects of inspiratory resistance training and isocapnic hyperpnoea vs incentive spirometry (placebo) on respiratory function, voice, thorax mobility and quality of life in individuals with tetraplegia.

Design: Randomized controlled trial.

Patients/methods: A total of 24 individuals with traumatic, complete tetraplegia (C5-C8, American Spinal Injury Association (ASIA) Impairment Scale; AIS A) were randomly assigned to 1 of 3 groups.

Co-occurrence of cardiovascular and prothrombotic risk factors in women with a history of preeclampsia.

Objective: Formerly preeclamptic women are at increased risk for remote cardiovascular and thrombotic diseases. We studied co-occurrence of cardiovascular and prothrombotic risk factors within a cohort of formerly preeclamptic women and tested if prevalence of these risk profiles related to onset of preeclampsia in previous pregnancy.

Methods: We evaluated 1,297 nonpregnant formerly preeclamptic women (6-12 months postpartum) for the presence of four risk profiles: circulatory risk profile (hypertension or latent hypertension [low plasma volume, increased vascular resistance, or both]; metabolic syndrome (World Health Organization criteria); thrombophilia (factor V Leiden, prothrombin mutation, or protein C or S deficiency); and hyperhomocysteinemia.

Impact of age and sex on carotid and peripheral arterial wall thickness in humans.

Background: Although previous studies have reported age-related wall thickening in carotid arteries, it is not clear whether this is a systemic phenomenon which is also apparent in peripheral conduit arteries or whether conduit wall thickness (WT) changes occur to a similar degree in men and women.

Aim: To determine whether sex modifies the impact of ageing on WT or wall-to-lumen ratio (W:L) in atherosclerosis-prone (i.e.

The identification of genetic pathways involved in vascular adaptations after physical deconditioning versus exercise training in humans.

Physical inactivity and exercise training result in opposite adaptations of vascular structure. However, the molecular mechanisms behind these adaptations are not completely understood. We used a unique study design to examine both vascular characteristics of the superficial femoral artery (using ultrasound) and gene expression levels (from a muscle biopsy) in human models for physical deconditioning and exercise training.

Expression of genes involved in fatty acid transport and insulin signaling is altered by physical inactivity and exercise training in human skeletal muscle.

Physical deconditioning is associated with the development of chronic diseases, including type 2 diabetes and cardiovascular disease. Exercise training effectively counteracts these developments, but the underlying mechanisms are largely unknown. To gain more insight into these mechanisms, muscular gene expression levels were assessed after physical deconditioning and after exercise training of the lower limbs in humans by use of gene expression microarrays.

Impact of physical fitness and daily energy expenditure on sleep efficiency in young and older humans.

Background: Physical activity is known to influence sleep efficiency. Relatively little is known about the relationship between physical activity and sleep efficiency in young and older humans and the impact of exercise training on sleep efficiency in healthy older individuals.

Objectives: To determine the relationship between physical fitness and daily energy expenditure with sleep efficiency in young and older subjects, and assess the effect of 12-month exercise training on sleep efficiency in healthy older participants.

Maximal exercise performance in patients with postcancer fatigue.

Purpose: The aim of this study is to examine whether physical fitness of severely fatigued and non-fatigued cancer survivors, as measured by maximal exercise performance, is different between both groups and, if so, whether this difference can be explained by differences in physical activity, self-efficacy regarding the exercise test, and/or social support.

Methods: Severely fatigued (n = 20) and sex- and age-matched non-fatigued (n = 20) disease-free cancer survivors, who completed treatment for a malignant, solid tumor at least 1 year earlier, participated in this case-control study. Maximal oxygen consumption was measured during an incremental cycling exercise test.

Reduced satellite cell numbers with spinal cord injury and aging in humans.

Introduction: Both sarcopenia and spinal cord injury (SCI) are characterized by the loss of skeletal muscle mass and function. Despite obvious similarities in atrophy between both models, differences in muscle fiber size and satellite cell content may exist on a muscle fiber type-specific level.

Methods: In the present study, we compared skeletal muscle fiber characteristics between wheelchair-dependent young males with SCI (n = 8, 32 ± 4 yr), healthy elderly males (n = 8, 75 ± 2 yr), and young controls (n = 8, 31 ± 3 yr).

Unexplained first trimester recurrent pregnancy loss and low venous reserves.

Background: More than half of recurrent pregnancy loss (RPL) remains unexplained. We hypothesized that women with a history of unexplained RPL (URPL) have low venous reserve.

Methods: Case-control study in 12 women with a history of URPL, 11 healthy nulliparous controls and 12 primiparous controls with a history of uncomplicated pregnancy.

Prediction models and development of an easy to use open-access tool for measuring lung function of individuals with motor complete spinal cord injury.

Objective: To develop statistical models to predict lung function and respiratory muscle strength from personal and lesion characteristics of individuals with motor complete spinal cord injury.

Design: Cross-sectional, multi-centre cohort study.

Subjects: A total of 440 individuals with traumatic, motor complete spinal cord injury, time post-injury ≥ 6 months, lesion level C4-T12, underwent measurements of lung function and respiratory muscle strength.

Physiological and neurophysiological determinants of postcancer fatigue: design of a randomized controlled trial.

Background: Postcancer fatigue is a frequently occurring, severe, and invalidating problem, impairing quality of life. Although it is possible to effectively treat postcancer fatigue with cognitive behaviour therapy, the nature of the underlying (neuro)physiology of postcancer fatigue remains unclear. Physiological aspects of fatigue include peripheral fatigue, originating in muscle or the neuromuscular junction; central fatigue, originating in nerves, spinal cord, and brain; and physical deconditioning, resulting from a decreased cardiopulmonary function.

The influence of concentration/meditation on autonomic nervous system activity and the innate immune response: a case study.

Objective: In this case study, we describe the effects of a particular individual's concentration/meditation technique on autonomic nervous system activity and the innate immune response. The study participant holds several world records with regard to tolerating extreme cold and claims that he can influence his autonomic nervous system and thereby his innate immune response.

Methods: The individual's ex vivo cytokine response (stimulation of peripheral blood mononuclear cells with lipopolysaccharide [LPS]) was determined before and after an 80-minute full-body ice immersion during which the individual practiced his concentration/meditation technique.

Reproducibility of assessing rib cage mobility from computed tomography images.

Background: Rib cage mobility decreases in various health conditions, for example neuromuscular diseases. A decrease in rib cage mobility reduces respiratory function and therefore increases the risk of respiratory complications. To evaluate the effects of interventions aiming at increasing rib cage mobility, changes should be calculated from measurements before and after such interventions.

Impaired endothelial function and blood flow in repetitive strain injury.

Repetitive Strain Injury (RSI) is a disabling upper extremity overuse injury that may be associated with pathophysiological changes in the vasculature. In this study we investigated whether RSI is associated with endothelial dysfunction and impaired exercise-induced blood flow in the affected forearm. 10 patients with RSI (age, 40.

Time course of arterial remodelling in diameter and wall thickness above and below the lesion after a spinal cord injury.

Physical inactivity in response to a spinal cord injury (SCI) represents a potent stimulus for conduit artery remodelling. Changes in conduit artery characteristics may be induced by the local effects of denervation (and consequent extreme inactivity below the level of the lesion), and also by systemic adaptations due to whole body inactivity. Therefore, we assessed the time course of carotid (i.

Conduit diameter and wall remodeling in elite athletes and spinal cord injury.

Purpose: This study aimed to investigate localized and systemic effects of chronic exercise and inactivity on conduit artery remodeling in humans.

Methods: We recruited elite athletes engaged in predominantly lower limb (LL runners/cyclists, n = 10) or upper limb (UL canoe paddlers, n = 12) exercise and matched able-bodied, recreationally active, controls (C, n = 16). We also studied wheelchair controls (spinal cord injury, n = 9) and athletes (spinal cord injury, n = 1; spina bifida, n = 4).

Complete absence of evening melatonin increase in tetraplegics.

Individuals with a spinal cord injury (SCI), especially with tetraplegia, experience poor sleep quality, and this may be related to impaired control of circadian rhythmicity. Here, we examined the evening onset of melatonin secretion, an important hormone for the initiation of sleep, in people with a complete cervical (tetraplegia) and thoracic (paraplegia) SCI, and age- and sex-matched able-bodied control participants. Multiple samples of salivary melatonin were obtained during the evening hours and analyzed by ELISA methods in 10 control partcipants, 9 individuals with paraplegia, and 6 individuals with tetraplegia.

Bilateral changes in forearm oxygen consumption at rest and after exercise in patients with unilateral repetitive strain injury: a case-control study.

Study Design: Case-control study.

Objectives: To investigate whether oxygen consumption and blood flow at rest and after exercise are lower in the affected arm of patients with repetitive strain injury (RSI) compared to controls, and lower in the healthy nonaffected forearm within patients with unilateral RSI.

Background: RSI is considered an upper extremity overuse injury.

Cardiovascular responses during a submaximal exercise test in patients with Parkinson's disease.

Background: Patients with Parkinson's disease (PD) are physically less active than controls, and autonomic dysfunction may contribute to this sedentary lifestyle. Specifically, an altered cardiovascular response to physical effort may restrict physical activities.

Objective: To assess the cardiovascular responses to a submaximal exercise test in PD patients and controls, 546 sedentary PD patients and 29 sedentary healthy controls performed the Åstrand-Rhyming submaximal cycle exercise test.

Impaired fetal growth and low plasma volume in adult life.

Objective: To estimate whether normotensive women who were born small for gestational age have low plasma volume in adult life, which is associated with later chronic hypertension.

Methods: In 280 normotensive women with a history of hypertension in pregnancy, we recorded recalled gestational age and weight at birth and measured plasma volume (I-human serum albumin indicator dilution method). To correct for possible confounders, we recorded recent obstetric history and measured in each individual all constituents of the metabolic syndrome (World Health Organization criteria), sex hormones (progesterone and estradiol), renal function, and cardiac performance at rest (echocardiography).

Sex difference in fluid balance responses during prolonged exercise.

Maintaining a proper fluid balance is important during exercise as athletes are prone to develop dehydration during exercise. Although several factors may regulate the fluid balance, little is known about the role of sex during prolonged moderate-intensity exercise. Therefore, we compared body mass changes and fluid balance parameters in men vs women in a large heterogeneous group of participants during prolonged exercise.

The impact of obesity on cardiac troponin levels after prolonged exercise in humans.

Elevated cardiac troponin I (cTnI), a marker for cardiac damage, has been reported after high-intensity exercise in healthy subjects. Currently, little is known about the impact of prolonged moderate-intensity exercise on cTnI release, but also the impact of obesity on this response. 97 volunteers (55 men and 42 women), stratified for BMI, performed a single bout of walking exercise (30-50 km).

Short-term statin treatment does not prevent ischemia and reperfusion-induced endothelial dysfunction in humans.

Statins are known to have cholesterol-independent pleiotropic effects, such as upregulation of the enzyme ecto-5'-nucleotidase. These effects may contribute to the protective effect of statins against ischemia and reperfusion (IR). Interestingly, pleiotropic effects have been shown to differ between hydrophilic and lipophilic statins.

Exercise-induced cardiac troponin release: real-life clinical confusion.

Exercise training represents a successful and powerful strategy to prevent future cardiovascular disease. Paradoxically, performance of exercise is also associated with an increased risk of acute cardiac events. Accordingly, patients may present to hospital with cardiac symptoms following a bout of unaccustomed physical effort (e.