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Standing Positions (standing + position)
Selected AbstractsAsymptomatic leukocyturia and the autonomic nervous system in womenGERIATRICS & GERONTOLOGY INTERNATIONAL, Issue 2 2009Yoshimasa Igari Background: The present study sought to investigate the relationship between asymptomatic leukocyturia (ASL) and autonomic nervous function by power spectral analysis of the R-R intervals in women. Methods: One hundred and forty-two female outpatients aged 23,91 years were studied. We regarded ASL to be present if two consecutive samples were found to have 10 or more leukocytes/high-power field at ×400 magnification in a centrifuged midstream urine sample. The R-R intervals of all subjects were measured by the wavelet transform analysis system. This system detected R-R variation data distributed in two bands: low-frequency power (LF) (0.04,0.15 Hz) and high-frequency power (HF) (0.15,0.40 Hz). The ratio of LF to HF (LF/HF) was also determined. Post-void residual urine volume was measured using an automated, compact 3-D ultrasound device. Results: The patients with ASL had diabetes mellitus more frequently than those without ASL. Residual urine volume was significantly higher in the former than in the latter, while the HF values in both a recumbent position and a standing position were significantly lower in the former than in the latter (P = 0.003, P = 0.001, respectively). However, there were no significant differences in LF or LF/HF values in either a recumbent or a standing position between the two groups. The HF values in both a recumbent position and in a standing position were independent indicators of ASL, even after adjustment for age, diabetes mellitus and residual urine volume. Conclusion: The present study reveals the relationship between ASL and impairment of the parasympathetic nervous system in women. [source] High prevalence of orthostatic hypotension and its correlation with potentially causative medications among elderly veteransJOURNAL OF CLINICAL PHARMACY & THERAPEUTICS, Issue 2 2005I. O. Poon PharmD BCPS CGP Summary Background:, Orthostatic hypotension (OH) is defined as a reduction of systolic blood pressure of at least 20 mmHg, or diastolic blood pressure of at least 10 mmHg from a sitting to a standing position. It is a common physical finding among older adults and associated with significant morbidity and mortality. Use of medications that have the potential to induce OH, particularly concomitant use of several of such medications, is a major factor for the development of OH. Objectives:, To describe the prevalence of symptomatic and asymptomatic OH in veterans aged 75 years and older attending a geriatric clinic, and to assess the association between OH and the number of potentially causative medications used. Methods:, Charts of all patients who attended a VA geriatric clinic (Michael E. DeBakey VA Medical Center) during the period of 1 June 2002 to 1 June 2003 were reviewed retrospectively for (i) the use of potentially causative medications, i.e. medications that were reported to cause OH in at least 1% of the general population and that were available in the VA formulary, (ii) the presence or absence of OH, and (iii) the presence or absence of symptomatic OH. Patients with primary autonomic dysfunction, Parkinson's disease, and patients who were unable to stand, or who had no assessment for both sitting and standing blood pressure for other reasons were excluded. Results:, A total of 505 individual patients attended the clinic during the study period, and 342 patients fit the inclusion criteria. About 189 of these patients (55%) had OH. Among patients with OH, 61 patients (33%) were symptomatic, including 52 patients who had falls. The prevalence of OH in patients receiving zero, one, two, and three or more potentially causative medications was 35, 58, 60 and 65% respectively. Receiving hydrochlorothiazide was associated with the highest prevalence of OH (65%), followed by receiving lisinopril (60%), trazodone (58%), furosemide (56%) and terazosin (54%). Conclusion:, The prevalence of OH is very high in older veterans and significantly related to the number of concurrent causative medications used. Providers should be educated to reduce the amount of potentially causative medications in the elderly and better assess patients in which use of such medications is necessary to avoid symptomatic OH. [source] Waist circumference percentiles for 7- to 15-year-old Australian childrenACTA PAEDIATRICA, Issue 9 2005Joey C. Eisenmann Abstract Aim: The purpose of this study was to develop age- and sex-specific reference values for waist circumference using data obtained from Australian children and adolescents. Methods: Subjects were 8439 7-to-15 y olds (4277 males and 4162 females) who participated in the 1985 Australian Health and Fitness Survey. Waist circumference (WC) was measured in the standing position at the level of the umbilicus to the nearest 0.1 cm using a constant tension tape. Descriptive statistics for each whole-year age group (e.g., 10.0,10.99 y, etc.) within sex were calculated. Construction of the smoothed centile curves was performed using the LMS method. Results: Mean WC increases in both males and females, with the values being similar between males and females prior to age 11 y, after which values are slightly higher in males. The range of values varied by age and sex groups but approximated 30,60 cm. Smoothed percentile curves and percentile values for the 5th, 10th, 25th, 50th, 75th, 90th, and 95th percentiles are presented for boys and girls. WC increases with age in boys and girls, and boys have higher values than girls at nearly every age-specific percentile. Conclusions: These data can be added to the existing international reference values for WC of children and adolescents which should be used to create international cut-off points similar to those for the body mass index (BMI). Future studies should consider the immediate and long-term consequences of an elevated WC in children and also examine the interaction of BMI and WC on chronic disease risk factors. [source] Myofascial Trigger Points, Neck Mobility, and Forward Head Posture in Episodic Tension-Type HeadacheHEADACHE, Issue 5 2007César Fernández-de-las-Peñas PT Objective.,To assess the differences in the presence of trigger points (TrPs) in head and neck muscles, forward head posture (FHP) and neck mobility between episodic tension-type headache (ETTH) subjects and healthy controls. In addition, we assess the relationship between these muscle TrPs, FHP, neck mobility, and several clinical variables concerning the intensity and the temporal profile of headache. Background.,TTH is a headache in which musculoskeletal disorders of the craniocervical region might play an important role in its pathogenesis. Design.,A blinded, controlled pilot study. Methods.,Fifteen ETTH subjects and 15 matched controls without headache were studied. TrPs in both upper trapezius, both sternocleidomastoids, and both temporalis muscles were identified according to Simons and Gerwin diagnostic criteria (tenderness in a hypersensible spot within a palpable taut band, local twitch response elicited by snapping palpation, and elicited referred pain with palpation). Side-view pictures of each subject were taken in both sitting and standing positions, in order to assess FHP by measuring the craniovertebral angle. A cervical goniometer was employed to measure neck mobility. All measures were taken by a blinded assessor. A headache diary was kept for 4 weeks in order to assess headache intensity, frequency, and duration. Results.,The mean number of TrPs for each ETTH subject was 3.7 (SD: 1.3), of which 1.9 (SD: 0.9) were active, and 1.8 (SD: 0.9) were latent. Control subjects only had latent TrPs (mean: 1.5; SD: 1). TrP occurrence between the 2 groups was significantly different for active TrPs (P < .001), but not for latent TrPs (P > .05). Differences in the distribution of TrPs were significant for the right upper trapezius muscles (P= .04), the left sternocleidomastoid (P= .03), and both temporalis muscles (P < .001). Within the ETTH group, headache intensity, frequency, and duration outcomes did not differ depending on TrP activity, whether the TrP was active or latent. The craniovertebral angle was smaller, ie, there was a greater FHP, in ETTH patients than in healthy controls for both sitting and standing positions (P < .05). ETTH subjects with active TrPs in the analyzed muscles had a greater FHP than those with latent TrPs in both sitting and standing positions, though differences were only significant for certain muscles. Finally, ETTH patients also showed lesser neck mobility than healthy controls in the total range of motion as well as in half-cycles (except for cervical extension), although neck mobility did not seem to influence headache parameters. Conclusions.,Active TrPs in the upper trapezius, sternocleidomastoid, and temporalis muscles were more common in ETTH subjects than in healthy controls, although TrP activity was not related to any clinical variable concerning the intensity and the temporal profile of headache. ETTH patients showed greater FHP and lesser neck mobility than healthy controls, although both disorders were not correlated with headache parameters. [source] Trigger Points in the Suboccipital Muscles and Forward Head Posture in Tension-Type HeadacheHEADACHE, Issue 3 2006César Fernández-de-las-Peñas PT Objective.,To assess the presence of trigger points (TrPs) in the suboccipital muscles and forward head posture (FHP) in subjects with chronic tension-type headache (CTTH) and in healthy subjects, and to evaluate the relationship of TrPs and FHP with headache intensity, duration, and frequency. Background.,Tension-type headache (TTH) is a prototypical headache in which myofascial TrPs in the cervical and pericranial musculature can play an important role. Design.,A blinded, controlled pilot study. Methods.,Twenty CTTH subjects and 20 matched controls without headache participated. TrPs were identified by eliciting referred pain with palpation, and increased referred pain with muscle contraction. Side-view pictures of each subject were taken in sitting and standing positions, in order to assess FHP by measuring the craniovertebral angle. Both measures were taken by a blinded assessor. A headache diary was kept for 4 weeks in order to assess headache intensity, frequency, and duration. Results.,Sixty-five percent (13/20) CTTH subjects showed active TrPs and 35% (7/20) had latent TrPs in the suboccipital muscles. Six (30%) controls also had latent TrPs. Differences in the presence of suboccipital muscle TrPs between both the groups were significant for active TrPs (P < .001) but not for latent TrPs (P > .5). CTTH subjects with active TrPs reported a greater headache intensity and frequency than those with latent TrPs (P < .05). The degree of FHP was greater in CTTH subjects than in controls in both sitting and standing positions (P < .01). Within the CTTH group, there was a negative correlation between the craniovertebral angle and the frequency of headache (rs=,0.6, P < .01, in sitting position; rs=,0.5, P < .05, in standing position). CTTH subjects with active TrPs had a greater FHP than those with latent TrPs, though this difference was not significant. Conclusions.,Suboccipital active TrPs and FHP were associated with CTTH. CCTH subjects with active TrPs reported a greater headache intensity and frequency than those with latent TrPs. The degree of FHP correlated positively with headache duration, headache frequency, and the presence of suboccipital active TrPs. [source] Early Detection Of Diminished Baroreflex Sensitivity In Diabetic Patients Without Evidence Of Cardiovascular Autonomic NeuropathyJOURNAL OF THE PERIPHERAL NERVOUS SYSTEM, Issue 3 2000D Ziegler Diabetic cardiovascular autonomic neuropathy (CAN) carries an increased risk of mortality. Decreased baroreflex sensitivity (BRS) has been identified as a predictor of increased mortality following myocardial infarction. We evaluated spontaneous BRS in 39 healthy control subjects (C: age (mean ± SEM): 41.5 ± 1.9 years) and 116 diabetic patients (64% Type 1, 36% Type 2; age: 45.8 ± 1.4 years; diabetes duration: 16.9 ± 1.0 years; HbA1c: 9.2 ± 0.2%) using cross-spectral analysis between systolic blood pressure and heart rate in the low-frequency (LF) and high-frequency (HF) bands as well as time domain (sequence) analysis in the supine and standing positions over 10 min. According to previously suggested definitions based on autonomic function tests (AFTs), 36 patients had definite CAN (CAN+: 3 of 7 indices abnormal), 13 had borderline CAN (CAN[+]: 2 of 7 indices abnormal), and 64 had no evidence of CAN (CAN,: 1 of 7 indices abnormal). Maximum gain in cross-spectral LF band (standing) was significantly reduced in CAN, as compared with C (5.2 ± 0.4 vs. 7.2 ± 0.8 ms/mmHg, p < 0.05). Moreover, maximum gain in cross-spectral HF band was significantly lower in CAN, than in C (supine: 12.0 ± 1.2 vs. 17.9 ± 2.5 ms/mmHg, p < 0.05; standing: 4.9 ± 0.5 vs. 8.7 ± 1.0 ms/mmHg, p < 0.05). The slope of the regression line between defined increases or reductions in systolic blood pressure and R-R intervals was significantly reduced in CAN, compared to C (supine: 10.6 ± 0.7 vs. 14.2 ± 1.6 ms/mmHg, p < 0.05; standing: 5.6 ± 0.4 vs. 8.1 ± 0.7 ms/mmHg, p < 0.05). Similar differences were obtained when comparing the CAN, and CAN[+] groups, the latter showing significantly reduced BRS by both techniques (p < 0.05). In contrast, no such differences were noted when comparing the CAN[+] and CAN+ groups. In conclusion, reduced spontaneous baroreflex sensitivity is an early marker of autonomic dysfunction at a stage when autonomic function tests do not yet indicate the presence of CAN, while cases with borderline CAN show a degree of BRS abnormality that is comparable to the level seen in definite CAN. Prospective studies are needed to evaluate whether reduced BRS is a predictor of mortality in diabetic patients. [source] Clinical evaluation of pelvic floor muscle function in continent and incontinent womenNEUROUROLOGY AND URODYNAMICS, Issue 3 2004Annemie Devreese Abstract Aims The aim of the study was to investigate the reliability of a scoring system for the investigation of voluntary and reflex co-contractions of abdominal and pelvic floor muscles in lying, sitting, and standing positions in continent and incontinent women. Methods A visual inspection and digital (strength, tone, speed, and endurance) palpation scale was developed to measure the coordination of the lower abdominal and pelvic floor muscles. Inter-observer reliability of the scales was investigated in 40 continent and 40 incontinent women. Differences between the continent and incontinent group were analysed. Results Inter-observer reliability for the visual inspection scale showed kappa values between 0.91 and 1.00, for tone percentage of agreement ranged from 95 to 100% (superficial) and 95 to 98% (deep muscle). Weighted Kappa (Kw) varied from 0.77 to 0.95 for strength and 0.75 to 0.98 for the inward movement of superficial and deep pelvic floor muscles. Kw for coordination between the superficial and deep part of the pelvic floor muscles groups was from 0.87 to 0.88 and 0.97 to 1.00 for endurance and global speed of the pelvic floor contraction. The continent women exhibited significantly better coordination between the pelvic floor and lower abdominal muscles during coughing in all three positions. Also the superficial part of the inward movement, the feeling and the coordination of the pelvic floor muscles were significantly better in the continent group. Conclusions Visual inspection and digital tests are easy and reliable methods by which insight can be gained into the multi-muscular activity and coordination of the pelvic floor and lower abdominal muscles in continent and incontinent women. Neurourol. Urodynam. 23:190,197, 2004. © 2004 Wiley-Liss, Inc. [source] Noninvasive assessment of energy expenditure in childrenAMERICAN JOURNAL OF HUMAN BIOLOGY, Issue 5 2006Isabelle Sarton-Miller This study establishes an affordable, simple, and noninvasive method to assess energy expenditure (EE) in children, an underrepresented group. The method is based on regression modeling, where prediction of oxygen consumption (VO2), a proxy of EE, was deduced from heart rate (HR) and several variables that adjusted for interindividual variability. Limb activities (arms vs. legs) and posture (sitting vs. standing) were represented in the regression as dichotomous covariates. The order of activities and intensities was randomized. Seventy-four children (aged 7,10 years), raised at sea-level (Seattle, WA), comprised the sample. Anthropometric measures were taken, and VO2 and HR were measured for activities using the arms in sitting and standing positions (mixing and punching), as well as walking at different velocities on a treadmill. Repeated measures and least square regression estimation were used. HR, body mass, number of hours of physical activity per week (HPA), an interaction term between sitting and standing resting HR, and the two dichotomous variables, sex and limbs, were significant covariates; posture was not. Several equations were developed for various field uses. The equations were built from sea-level data, but ultimately this method could serve as a baseline for developing a similar approach in other populations, where noninvasive estimation of EE is imperative in order to gain a better understanding of children's energetic issues. Am. J. Hum. Biol. 18:600,609, 2006. © 2006 Wiley-Liss, Inc. [source] | ||||||||||