Search

Copyright of Acta Universitatis Palackianae Olomucensis. Gymnica is the property of Palacky University in Olomouc and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Early identification of individuals at risk of developing heart failure (HF) may improve poor prognosis. A dominant sympathetic activity is common in HF and associated with worse outcomes; however, less is known about the autonomic balance before HF., Hypothesis: A low frequency/high frequency (L-F/H-F) ratio, index of heart rate variability, and marker of the autonomic balance predict the development of HF and may improve the performance of the HF prediction model when added to traditional cardiovascular (CV) risk factors., Methods: Individuals in the PIVUS (Prospective Investigation of the Vasculature in Uppsala Seniors) study (n = 1016, all aged 70 years) were included. Exclusion criteria were prevalent HF, electrocardiographic QRS duration ≥130 millisecond, major arrhythmias, or conduction blocks at baseline. The association between the L-F/H-F ratio and incident HF was assessed using Cox proportional hazard analysis. The C-statistic evaluated whether adding the L-F/H-F-ratio to traditional CV risk factors improved the discrimination of incident HF., Results: HF developed in 107/836 study participants during 15 years of follow-up. A nonlinear, inverse association between the L-F/H-F ratio and incident HF was mainly driven by an L-F/H-F ratio of <30. The association curve was flat for higher values (hazard ratio, HR for the total curve = 0.78 [95% confidence interval, CI: 0.69-0.88, p < .001]; HR = 2 for L-F/H-F ratio = 10). The traditional prediction model improved by 3.3% (p < .03) when the L-F/H-F ratio was added., Conclusions: An L-F/H-F ratio of <30 was related to incident HF and improved HF prediction when added to traditional CV risk factors., (© 2024 The Authors. Clinical Cardiology published by Wiley Periodicals LLC.)

Background: Early identification of patients at risk of congestive heart failure (HF) may alter their poor prognosis. The aim was therefore to test whether simple electrocardiographic variables, the P-wave and PR-interval, could predict incident HF., Methods: The PIVUS (Prospective Investigation of the Vasculature in Uppsala Seniors) study (1016 individuals all aged 70 years, 50% women) was used to identify predictors of HF. Subjects with prevalent HF, QRS duration ≥ 130 ms, atrial tachyarrhythmias, implanted pacemaker/defibrillator, second- and third-degree atrioventricular block or delta waves at baseline were excluded. Cox proportional hazard analysis was used to relate the PR interval, P-wave duration (Pdur) and amplitude (Pamp), measured in lead V1, to incident HF. Adjustment was performed for gender, RR-interval, beta-blocking agents, systolic blood pressure, body mass index and smoking., Results: Out of 836 subjects at risk, 107 subjects were diagnosed with HF during a follow-up of 15 years. In the multivariate analysis, there was a strong U-shaped correlation between Pdur in lead V1 and incident HF ( P = 0.0001) which was significant for a Pdur < 60 ms [HR = 2.75; 95% CI: 1.87-4.06, at Pdur 40 ms] but not for prolonged Pdur. There was no significant relationship between incident HF and the PR-interval or the Pamp. A Pdur < 60 ms improved discrimination by 3.7% when added to the traditional risk factors including sex, RR-interval, beta-blocking agents, systolic blood pressure, BMI and smoking ( P = 0.048)., Conclusions: A short Pdur, an easily measured parameter on the ECG, may potentially be a useful marker of future HF, enabling its early detection and prevention, thus improving outcomes., (© 2022 JGC All rights reserved; www.jgc301.com.)

The infection rate associated with cardiac implantable electronic devices has increased over the past decades. A recent study found the prevalence of infection after cardiac resynchronization therapy to be more than tenfold higher than reported to the national registry. Risk factors for infection can be host-, procedure-, or device-related, the most important being recent manipulation of the device. Perioperative contamination is the most frequent source, but leads can also be secondarily infected from bacteremia, most commonly with staphylococci. Patients with pocket infection often present with erythema and swelling over the pocket, whereas systemic infection usually produces fever and, in its most severe form, endocarditis. Parenteral empiric antimicrobial therapy should be initiated after drawing blood cultures and followed by transesophageal echocardiogram. Management also includes prompt device extraction, followed by a reevaluation of the indication before reimplantation. Education of operators, related personnel, and referring physicians, prevention of modifiable risk factors, and accurate reporting to national registries are critical actions to limit complications.

Cardiac implantable electronic devices (CIED) are potentially life-saving treatments for several cardiac conditions, but are not without risk. Despite dissemination of recommended strategies for prevention of device infections, such as administration of antibiotics before implantation, infection rates continue to rise resulting in escalating health care costs. New trials conveying important steps for better prevention of device infection and an EHRA consensus paper were recently published. This document will review the role of various preventive measures for CIED infection, emphasizing the importance of adhering to published recommendations. The document aims to provide guidance on how to prevent CIED infections in clinical practice by considering modifiable and non-modifiable risk factors that may be present pre-, peri-, and/or post-procedure., (Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2021. For permissions, please email: journals.permissions@oup.com.)

Background: The study aimed to compare characteristics of postural sway and shape of anteroposterior spinal curvatures in faller and non-faller elderly women., Material and Methods: The study enrolled 265 women aged 51-82 years (mean: 66.2) who were physically fit and free from conditions affecting sensorimotor function. Balance was assessed by stabilographic method. Changes in the location of the centre of the force of foot pressure on the ground were registered over 20-second periods with the subjects standing still with eyes open and closed. Measures of variability in the COP signal were analysed together the viscoelastic parameters of the mathematical model in the standing position. Assessment of the shape of anteroposterior spinal curvatures was conducted by photogrammetric method. Indices of the degree of thoracic kyphosis and lumbar lordosis were analysed., Results: The group of women who had experienced at least one fall during the year displayed: a) with regard to body balance, a significantly larger range, variability and velocity of body sway in the sagittal plane and increased suppression of postural oscillations in the frontal plane; b) with regard to body posture, more pronounced forward inclination of the trunk, more marked thoracic kyphosis and a smaller degree of lumbar lordosis., Conclusions: Fallers demonstrate poorer body balance in the standing position and poorer body posture than non-fallers.

Background: It is known that women with osteoporosis display only slight deficits in postural control. However, a condition that often co-exists with OP is osteoarthritis (OA), which has been shown to significantly compromise balance. To establish reasonable inclusion criteria for balance assessment of women with OP and investigate if specific treatment regimens are necessary for those subjects, it is important to evaluate the differences in postural control and postural strategies between the two groups., Material and Method: We compared postural sway in quiet standing measured by the parameters of the center-of-pressure (COP) signals, recorded on a force plate, of 30 women with osteoporosis and 27 women with coexisting mild osteoarthritis., Results: Our results indicated that the latter subjects had higher COP sway in the sagittal compared with the frontal plane, while the former subjects had similar sway in both planes. Subjects with both conditions relied more on vision to preserve postural stability compared with subjects with osteoporosis alone, and they also appeared to compensate further with a higher frequency of their body oscillations., Conclusions: 1. Even mild symptoms of osteoarthritis may affect balance and misrepresent the observed postural behavior in stabilographic studies. 2. The indications for the treatment regimens of.

Background. The co-occurrence of kyphotic posture and low bone density in elderly women has never been completely explained. The aim of our study was to assess postural changes (the shape of spinal curvatures) in elderly women with advanced spinal osteoporosis. Material and methods. We examined 62 women (32 with osteoporosis and 30 with normal BMD) 52 to 84 years of age. The photogrammetric method based on the moiré phenomenon was used to measure the spinal contour (kyphosis and lordosis), and DEXA was employed to assess bone mineral density (BMD) at the lumbar spine level. Results. The group with osteoporosis had significantly greater kyphosis (p<0.05) than the group without osteoporosis; however, we found a correlation between the BMD and the parameters of the spinal contour. In the group of women with osteoporosis, the BMI was significantly correlated with the lumbar lordosis angle (p<0.01), the compensation index (p<0.01), and the BMD (p<0.01), and it was also highly correlated with the inclination angle of the lumbosacral spinal segment (p<0.001). Another significant correlation occurred between the lumbosacral spinal segment inclination angle and height loss (p<0.05). A weak correlation was observed between age and the inclination angle of the upper thoracic spinal segment (p<0.05). Conclusion. The observed changes in body posture in women with osteoporosis result primarily from enlargement of the upper section of thoracic kyphosis.

Background. Falls are a common and often devastating occurrence for the elderly in both home and institutional settings. The main purpose of our study was to assess disorders of postural stability in elderly patients undergoing health resort treatment, recruited at the sanatorium in Swieradów Zdrój, Poland. Material and methods. Thirty two older adults between the ages of 67 and 84 years were enrolled. All subjects completed a questionnaire pertaining to their fall history, subjective feeling of unsteadiness, activity level, medical status and use of assistive devices and/or medications. The Berg Balance Test (BBT), consisting of 14 functional subtests, was used to measure balance abilities and identify individuals with a higher risk of falling. Results. The mean score on the BBT for all these older adults was 42. The lowest number of points was obtained by those persons who showed all the risk factors for falls: postural instability, previous falls, and no physical activity (26 +/- 15.5). The highest number of points was obtained by persons who had only one risk factor (45.3 +/- 4.5) or no risk factors (49.5 +/- 5.8). 41% of our study group had a higher risk of falling (score 40), while in 19% of the patients the risk of incurring a fall was 100% (score 36). Conclusions. Among health resort patients over the age of 65, there is a decline in balance abilities and more propensity to fall. Testing of balance and fall prevention programs should become a standard part of the treatment program at health resorts for the elderly.

Background. The objective of our research was to assess the impact of physiotherapy on the frequency of intraarticular and intramuscular hemorrhages and on elbow and knee joint function, in hemophilic patients. Material and methods. We examined 22 boys, 6-14 years of age, suffering from hemophilia A. The research program included patient history in respect to intraarticular hemorrhages in elbows and knees before therapy, observation of intra-articular bleeding during physiotherapy, goniometric measurements of the range of movement in the elbow and knee, measurement of the circumference of the arm, forearm, thigh and calf, and momentum dynamometric measurements of the relative and absolute force of the flexors and extensors of the lower leg at the knee joints and of the forearm at the elbow joints, in static conditions. The treatment program included deficit coagulant agent replacement therapy, physiotherapy, and kinesitherapy. Results. The physiotherapy program we applied resulted in a considerable improvement in mobility, as well as increased muscle strength and mass. Conclusions. Our research showed that, due to the application of the appropriate replacement treatment, there was a decrease in the frequency and size of intraarticular hemorrhages, despite intense rehabilitation and physical activity.

Background. The aim of this study was to attempt the implementation of the method of mathematical modelling for motor properties estimation in children with idiopathic scoliosis on the process of keeping the balance in a standing position in the presence of mild disturbances. Material and methods. 42 children with idiopathic scoliosis (13-18 yr) and 40 healthy children were included into the study. Stabilography method was used to estimate body balance and the COP time series were recorded for subsequent analysis. Motor parameters of the evaluated individuals were determined based on the coefficient values of equation assessed through mathematics model. Results. The analysis of obtained calculated results showed that there are significant differences in meandered reaction induced by balance disturbation in a standing posture in evaluated patients. In scoliosis group there was a bigger loss of balance than in healthy children.The speed of loosing of balance after its deviation was slower and was dependent on the magnitude of the curvature angle. The bigger the angle values of the curvature the slower is the process of balance loss and at a lower speed and acceleration. And the time required for regaining the posture is prolonged. Conclusions. Standing posture of children with lateral curvature of the spine is more susceptible to balance disturbances and is characterised by worse stability. The reaction of nervous system to balance disturbances in scoliosis is visibly delayed and is characterised by lower impulsiveness.

Unsteadiness and increased postural sway predispose individuals with osteoporosis to falling. We examined this relationship from a biomechanical perspective using a viscoelastic model. Specifically, we investigated the center-of-pressure (COP) in quiet stance in 37 postmenopausal women (aged 42-79 years), diagnosed with osteopenia or osteoporosis and who engaged in a range of activity levels. Subjects stood on a force platform for two 20s intervals: one with eyes open (EO) and the other with eyes closed (EC). The COP signals were used to compute traditional measures of sway: standard deviation, range, and mean velocity. Based on the difference between the COP and its smoothed representation, we used the "COP minus center-of-mass" signal to compute selected properties of postural mechanics (stiffness and viscosity) and dynamics (frequency and damping) of stance. Sway variability and incidence of falls were not correlated even though our subjects displayed higher sway than age-matched subjects from other studies. Bone density was correlated with frequency in the mediolateral (ML) plane with EO (r=0.50, p<0.002). Irrespective of age, the decrease in postural frequency and increase in postural viscosity in the ML plane were determinants of imbalance and accounted for 18% and 8% of the variance, respectively. With EC, an additional 10% of the variance was contributed by the ML range. The increased ML viscosity was the sole predictor of falls accounting for 20% of the variance of the tendency to fall. Thus, ML frequency plays a fundamental role in preserving balance in that a low value is an important predictor of falls. Finally, although being physical activity may reduce sway, physical activity fails to improve poor postural strategies. To conclude, increases in viscosity and range elucidate further the unique strategy of ML body sway in individuals with osteopenia or osteoporosis and provide insight into how posture may be maintained by those who fear falling.