KSS Theses

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    Assessment of exercise capacity in an individual with LVAD explanation without heart transplantation
    (Wichita State University, 2007-08) Amick, Ryan Zackary; Rogers, Michael E.
    BACKGROUND: Left Ventricular Assist Device’s (LVAD) have become a viable treatment alternative to heart transplantation. While under LVAD support, some have shown significant recovery of native heart function allowing for the removal of the device. METHODOLOGY: The patient in this study was diagnosed with idiopathic dilated cardiomyopathy and demonstrated worsening heart failure over a five year period with a maximum left ventricular end diastolic diameter of 8.99 cm and an ejection fraction between 20-25%. Upon implantation of a LVAD, the patient’s central hemodynamic function returned to near normal and the device was removed. Four months post explanation a cycle ergometry graded exercise peak VO2 test was performed. Exercise began at 0 Watts and increased 25 Watts per 3 minute stage. 12 lead EKG was used to determine heart function. RESULTS: The patient showed improvement in peak aerobic capacity when compared to pre LVAD cardiopulmonary stress tests. VO2 increased from pre LVAD measures of 11.8ml•kg-1•min-1 to 17.0 ml•kg-1•min-1. Time to maximal exertion increased from 5 minutes 27seconds to 15 minutes. CONCLUSION: The results from this case study indicate that significant improvements in native heart function is possible with a period of mechanical unloading through LVAD support.
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    Effects of chest wall constriction on aerobic capacity during exercise
    (2005-12) Farmer, Kevin Lee; Patterson, Jeremy A.
    The aim of the present study was to determine whether a reduction in lung volume and chest wall movement using an externally applied thoracic constriction band over an eight-week training period, could improve aerobic capacity and running performance. Participants included 22 healthy, non-active adults (26 ± 4 year (mean ± SD)) who were studied over a period of eight weeks during which they participated in aerobic exercise for three days/week for 30 minutes/session at a moderate intensity estimated at 65% to 80% of their maximal exertion. Aerobic capacity (VO 2max ) and pulmonary lung function (FVC, FEV 1 , FEF 25-75% , PEF) were measured pre-, mid-, and post-eight weeks. Following the pre-testing, participants were randomly placed into one of two groups: (1) Chest Wall Restriction (CWR), or (2) a control group (Non-Chest Wall Restriction (NCWR)). The CWR Group performed the exercise sessions while wearing an elastic strap. Participants were encouraged to use a treadmill, elliptical machine, and/or stationary cycle in random order to complete the exercise session. Pulmonary lung function measures were not changed over the eight weeks for either group. At eight weeks, CWR and NCWR groups had significant increases in VO 2max (from 33.55 ± 6.48 to 37.78 ± 7.11 and 33.30 ± 10.39 to 35.99 ± 9.09 ml · min -1· kg -1 ± SD, respectively). However, a significant improvement of 11.0 ± 4.0% in aerobic capacity was observed in the experimental group at just four weeks compared to the control group (3.0 ± 6.0%, P < 0.05). These results suggest that the use of an externally applied thoracic constriction band during aerobic exercise assists in increasing aerobic capacity more rapidly than training without a band, because of the greater increase in VO 2max seen within the first four weeks for the CWR group compared to the NCWR group.
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    Effects of an eight-week hand exercise program on older women with osteoarthritis
    (2006-07) Hubele, Ella Suzanne; Rogers, Michael E.
    Osteoarthritis is a disease that causes decreases in hand function in the elderly adult and can lead to full disability of the hand. There is no clear cause of osteoarthritis of the hand, although injury and overuse can contribute to development of the disease. Traditional treatments include splinting, paraffin therapy, medications and, in severe cases, joint replacement. Nontraditional therapies include mobility training, therapeutic touch, acupuncture and exercise. The purpose of this study was to explore the non-traditional treatment of hand-strengthening exercise as a way to improve hand function. Specifically, this study evaluated the effects of an eightweek hand exercise program utilizing Hand Exercisers and FlexBars on hand grip strength and dexterity in 13 elderly women aged 70-85 (M=80.4, SD= +/- 4.25) who showed signs and symptoms of hand osteoarthritis, which are pain, stiffness and swelling.. Participants were evaluated before and after the exercise intervention for grip strength, pinch strength, range of motion of the trapeziometacarpal, metacarpophalangeal, interphalangeal and wrist joints, and were timed on a hand dexterity test that involved putting on and buttoning a shirt with ten 3/8th inch buttons. A repeated measures ANOVA was the mode of data analysis. Hand strength significantly improved (p<0.05), as both grip (19%) and pinch (26%) strength showed improvements. In range of motion testing, palmar flexion (12%), interphalangeal flexion (46%), metacarpophalangeal flexion (39%) and wrist extension (11%) showed significant improvements while palmar abduction (12%) and wrist flexion (8%) did not. Hand dexterity also improved as evidenced by a 24% decrease in the amount of time to button a shirt. Pain, stiffness and disability, as measured by the AUSCAN, also decreased significantly, with a 17.3% decrease in means. The results indicate that hand exercise programs can be used to increase hand function while decreasing the signs and symptoms in patients with hand osteoarthritis.
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