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- Creators: Debussy, Claude, 1862-1918
ContributorsDebussy, Claude, 1862-1918 (Composer)
ContributorsDebussy, Claude, 1862-1918 (Composer)
ContributorsDebussy, Claude, 1862-1918 (Composer)
ContributorsDebussy, Claude, 1862-1918 (Composer)
ContributorsDebussy, Claude, 1862-1918 (Composer)
Description
Background: Heart failure is the leading cause of hospitalization in older adults and has the highest 30-day readmission rate of all diagnoses. An estimated 30 to 60 percent of older adults lose some degree of physical function in the course of an acute hospital stay. Few studies have addressed the role of posture and mobility in contributing to, or improving, physical function in older hospitalized adults. No study to date that we are aware of has addressed this in the older heart failure population.
Purpose: To investigate the predictive value of mobility during a hospital stay and patterns of mobility during the month following discharge on hospital readmission and 30-day changes in functional status in older heart failure patients.
Methods: This was a prospective observational study of 21 older (ages 60+) patients admitted with a primary diagnosis of heart failure. Patients wore two inclinometric accelerometers (rib area and thigh) to record posture and an accelerometer placed at the ankle to record ambulatory activity. Patients wore all sensors continuously during hospitalization and the ankle accelerometer for 30 days after hospital discharge. Function was assessed in all patients the day after hospital discharge and again at 30 days post-discharge.
Results: Five patients (23.8%) were readmitted within the 30 day post-discharge period. None of the hospital or post-discharge mobility measures were associated with readmission after adjustment for covariates. Higher percent lying time in the hospital was associated with slower Timed Up and Go (TUG) time (b = .08, p = .01) and poorer hand grip strength (b = -13.94, p = .02) at 30 days post-discharge. Higher daily stepping activity during the 30 day post-discharge period was marginally associated with improvements in SPPB scores at 30 days (b = <.001, p = .06).
Conclusion: For older heart failure patients, increased time lying while hospitalized is associated with slower walking time and poor hand grip strength 30 days after discharge. Higher daily stepping after discharge may be associated with improvements in physical function at 30 days.
Purpose: To investigate the predictive value of mobility during a hospital stay and patterns of mobility during the month following discharge on hospital readmission and 30-day changes in functional status in older heart failure patients.
Methods: This was a prospective observational study of 21 older (ages 60+) patients admitted with a primary diagnosis of heart failure. Patients wore two inclinometric accelerometers (rib area and thigh) to record posture and an accelerometer placed at the ankle to record ambulatory activity. Patients wore all sensors continuously during hospitalization and the ankle accelerometer for 30 days after hospital discharge. Function was assessed in all patients the day after hospital discharge and again at 30 days post-discharge.
Results: Five patients (23.8%) were readmitted within the 30 day post-discharge period. None of the hospital or post-discharge mobility measures were associated with readmission after adjustment for covariates. Higher percent lying time in the hospital was associated with slower Timed Up and Go (TUG) time (b = .08, p = .01) and poorer hand grip strength (b = -13.94, p = .02) at 30 days post-discharge. Higher daily stepping activity during the 30 day post-discharge period was marginally associated with improvements in SPPB scores at 30 days (b = <.001, p = .06).
Conclusion: For older heart failure patients, increased time lying while hospitalized is associated with slower walking time and poor hand grip strength 30 days after discharge. Higher daily stepping after discharge may be associated with improvements in physical function at 30 days.
ContributorsFloegel, Theresa A (Author) / Buman, Matthew P (Thesis advisor) / Hooker, Steven (Committee member) / Dickinson, Jared (Committee member) / DerAnanian, Cheryl (Committee member) / McCarthy, Marianne (Committee member) / Arizona State University (Publisher)
Created2015
Description
Obesity impairs skeletal muscle maintenance and regeneration, a condition that can progressively lead to muscle loss, but the mechanisms behind it are unknown. Muscle is primarily composed of multinucleated cells called myotubes which are derived by the fusion of mononucleated myocytes. A key mediator in this process is the cellular fusion protein syncytin-1. This led to the hypothesis that syncytin-1 could be decreased in the muscle of obese/insulin resistant individuals. In contrast, it was found that obese/insulin resistant subjects had higher syncytin-1 expression in the muscle compared to that of the lean subjects. Across the subjects, syncytin-1 correlated significantly with body mass index, percent body fat, blood glucose and HbA1c levels, insulin sensitivity and muscle protein fractional synthesis rate. The concentrations of specific plasma fatty acids, such as the saturated fatty acid (palmitate) and monounsaturated fatty acid (oleate) are known to be altered in obese/insulin resistant humans, and also to influence the protein synthesis in muscle. Therefore, it was evaluated that the effects of palmitate and oleate on syncytin-1 expression, as well as 4E-BP1 phosphorylation, a key mechanism regulating muscle protein synthesis in insulin stimulated C2C12 myotubes. The results showed that treatment with 20 nM insulin, 300 µM oleate, 300 µM oleate +20 nM insulin and 300 µM palmitate + 300 µM oleate elevated 4E-BP1 phosphorylation. At the same time, 20 nM insulin, 300 µM palmitate, 300 µM oleate + 20 nM insulin and 300 µM palmitate + 300 µM oleate elevated syncytin-1 expression. Insulin stimulated muscle syncytin-1 expression and 4E-BP1 phosphorylation, and this effect was comparable to that observed in the presence of oleate alone. However, the presence of palmitate + oleate diminished the stimulatory effect of insulin on muscle syncytin-1 expression and 4E-BP1 phosphorylation. These findings indicate oleate but not palmitate increased total 4E-BP1 phosphorylation regardless of insulin and the presence of palmitate in insulin mediated C2C12 cells. The presence of palmitate inhibited the upregulation of total 4EB-P1 phosphorylation. Palmitate but not oleate increased syncytin-1 expression in insulin mediated C2C12 myotubes. It is possible that chronic hyperinsulinemia in obesity and/or elevated levels of fatty acids such as palmitate in plasma could have contributed to syncytin-1 overexpression and decreased muscle protein fractional synthesis rate in obese/insulin resistant human muscle.
ContributorsRavichandran, Jayachandran (Author) / Katsanos, Christos (Thesis advisor) / Coletta, Dawn (Committee member) / Dickinson, Jared (Committee member) / Arizona State University (Publisher)
Created2017
Description
Individuals fluent in sign language who have at least one deaf parent are considered native signers while those with non-signing, hearing parents are non-native signers. Musculoskeletal pain from repetitive motion is more common from non-natives than natives. The goal of this study was twofold: 1) to examine differences in upper extremity (UE) biomechanical measures between natives and non-natives and 2) upon creating a composite measure of injury-risk unique to signers, to compare differences in scores between natives and non-natives. Non-natives were hypothesized to have less favorable biomechanical measures and composite injury-risk scores compared to natives. Dynamometry was used for measurement of strength, electromyography for ‘micro’ rest breaks and muscle tension, optical motion capture for ballistic signing, non-neutral joint angle and work envelope, a numeric pain rating scale for pain, and the modified Strain Index (SI) as a composite measure of injury-risk. There were no differences in UE strength (all p≥0.22). Natives had more rest (natives 76.38%; non-natives 26.86%; p=0.002) and less muscle tension (natives 11.53%; non-natives 48.60%; p=0.008) for non-dominant upper trapezius across the first minute of the trial. For ballistic signing, no differences were found in resultant linear segment acceleration when producing the sign for ‘again’ (natives 27.59m/s2; non-natives 21.91m/s2; p=0.20). For non-neutral joint angle, natives had more wrist flexion-extension motion when producing the sign for ‘principal’ (natives 54.93°; non-natives 46.23°; p=0.04). Work envelope demonstrated the greatest significance when determining injury-risk. Natives had a marginally greater work envelope along the z-axis (inferior-superior) across the first minute of the trial (natives 35.80cm; non-natives 30.84cm; p=0.051). Natives (30%) presented with a lower pain prevalence than non-natives (40%); however, there was no significant difference in the modified SI scores (natives 4.70 points; non-natives 3.06 points; p=0.144) and no association between presence of pain with the modified SI score (r=0.087; p=0.680). This work offers a comprehensive analysis of all the previously identified UE biomechanics unique to signers and helped to inform a composite measure of injury-risk. Use of the modified SI demonstrates promise, although its lack of association with pain does confirm that injury-risk encompasses other variables in addition to a signer’s biomechanics.
ContributorsRoman, Gretchen Anne (Author) / Swan, Pamela (Thesis advisor) / Vidt, Meghan (Committee member) / Peterson, Daniel (Committee member) / Lockhart, Thurmon (Committee member) / Ofori, Edward (Committee member) / Arizona State University (Publisher)
Created2018
Description
This study investigated the effect of a small added load on postural stability in older adults. Sixteen healthy older adults (6 male, 10 female, age=72 ± 3.2y, height=172± 9.3 cm, weight=84± 7.6 kg) performed clinical measures of postural control with different loads placed on the shoulders (0%, 1% and 3% bodyweight). The functional reach test, comprising a forward, right and left lateral reach, along with COP data measured through the use of a force plate were the postural control measures utilized in this study. COP data used were COP sway velocity and COP mean sway area, in the form of a 95% confidence ellipse. During the COP trials, visual input (eyes open and eyes closed) and surface conditions (firm and foam) were varied to evaluate the effect of the loads under different conditions. Two trials of each measurement were performed for all tests, and participants were allowed rest intervals as needed. Anticipated results show a decreased reach distance of 8% in the forward direction, and a 7% decrease in the left and right lateral directions under a 1% bodyweight load. For expected results of COP velocity, there will be a 12% increase from baseline COP sway velocity in the 1% bodyweight condition. Anticipated results for COP sway area show a 39% increase in the eyes open firm surface, under a 1% bodyweight load, and a 40% increase under the 3% load. These expected results show a significant effect on postural control with a 1% and 3% bodyweight load placed on the shoulders of older adults. This information may be valuable in combatting the epidemic of falls seen among the elderly population, as part of an exercise program for improving balance and postural stability.
ContributorsScherwinski, Eric (Author) / Dounskaia, Natalia (Thesis director) / Vidt, Meghan (Committee member) / Barrett, The Honors College (Contributor)
Created2016-05
Description
ABSTRACT
Background: Although aerobic exercise has been shown to improve the glycemic control of individuals with type 2 diabetes, a simple and effective approach to manage post-meal glycemic control remains less clear.
Purpose: This study examined the effect of 15-minute of post-meal aerobic exercise on the glycemic control and anxiety scores as compared with control trials in participants with and without type 2 diabetes.
Methods: Six adults volunteered to participate in the study (3 adults with type 2 diabetes, age = 44.33 ± 7.71; and 3 adults without type 2 diabetes, age = 31.67 ± 15.76). All participants received aerobic exercise intervention and control treatments. The aerobic exercise treatment was listening to upbeat music and dancing for 15-minutes, whereas the control participants ingested 1 gram of vitamin C 30-minutes post-meal. Glucose levels were measured at baseline, and the 10, and 15-minute mark in both exercise intervention and control conditions 30-minutes post-meal.
Results: There was a significant interaction between treatment and time on the change in glucose levels (P<0.001). There was a significant mean difference in change in glucose levels between exercise intervention and control conditions (P = 0.002). Change in glucose levels in exercise intervention was significantly decreased at 10-minute (-18 ± 4.35 vs. 1.67 ± 4.34, P = 0.009) and 15-minute (-24 ± 4.88 vs. 5.67 ± 4.88, P = 0.001) compared with control condition. Although there were no statistical differences in state anxiety scores between pre- and post-exercise intervention (p=0.42), there was a significant trend in the reduction of state anxiety scores in diabetic participants, as compared with healthy participants, after 15-minute exercise intervention (-8 vs. -1).
Conclusion: Aerobic exercise for 15-minute by dancing to music after a meal is an effective approach to controlling the blood glucose levels in type 2 diabetic and healthy persons.
Background: Although aerobic exercise has been shown to improve the glycemic control of individuals with type 2 diabetes, a simple and effective approach to manage post-meal glycemic control remains less clear.
Purpose: This study examined the effect of 15-minute of post-meal aerobic exercise on the glycemic control and anxiety scores as compared with control trials in participants with and without type 2 diabetes.
Methods: Six adults volunteered to participate in the study (3 adults with type 2 diabetes, age = 44.33 ± 7.71; and 3 adults without type 2 diabetes, age = 31.67 ± 15.76). All participants received aerobic exercise intervention and control treatments. The aerobic exercise treatment was listening to upbeat music and dancing for 15-minutes, whereas the control participants ingested 1 gram of vitamin C 30-minutes post-meal. Glucose levels were measured at baseline, and the 10, and 15-minute mark in both exercise intervention and control conditions 30-minutes post-meal.
Results: There was a significant interaction between treatment and time on the change in glucose levels (P<0.001). There was a significant mean difference in change in glucose levels between exercise intervention and control conditions (P = 0.002). Change in glucose levels in exercise intervention was significantly decreased at 10-minute (-18 ± 4.35 vs. 1.67 ± 4.34, P = 0.009) and 15-minute (-24 ± 4.88 vs. 5.67 ± 4.88, P = 0.001) compared with control condition. Although there were no statistical differences in state anxiety scores between pre- and post-exercise intervention (p=0.42), there was a significant trend in the reduction of state anxiety scores in diabetic participants, as compared with healthy participants, after 15-minute exercise intervention (-8 vs. -1).
Conclusion: Aerobic exercise for 15-minute by dancing to music after a meal is an effective approach to controlling the blood glucose levels in type 2 diabetic and healthy persons.
ContributorsSymons, Nicholas Payne (Author) / Lee, Chong (Thesis director) / Dickinson, Jared (Committee member) / Barrett, The Honors College (Contributor) / School of Life Sciences (Contributor) / W. P. Carey School of Business (Contributor)
Created2015-05