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  • 1.
    Ambrosio, Fabrisia
    et al.
    Department of Physical Medicine and Rehabilitation, University of Pittsburgh.
    Kadi, Fawzi
    Lexell, Jan
    Fitzgerald, F.K.
    Boninger, Michael
    Huard, Johnny
    The effect of muscle loading on skeletal muscle regenerative potential: an update of current research findings relating to aging and neuromuscular pathology2009Inngår i: American Journal of Physical Medicine & Rehabilitation, ISSN 0894-9115, E-ISSN 1537-7385, Vol. 88, nr 2, s. 145-155Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Skeletal muscle is a dynamic tissue with a remarkable ability to continuously respond to environmental stimuli. Among its adaptive responses is the widely investigated ability of skeletal muscle to regenerate after loading or injury or both. Although significant basic science efforts have been dedicated to better understand the underlying mechanism controlling skeletal muscle regeneration, there has been relatively little impact in the clinical approaches used to treat skeletal muscle injuries and wasting. The purpose of this review article is to provide an overview of the basic biology of satellite cell function in response to muscle loading and to relate these findings in the context of aging and neuromuscular pathology for the rehabilitation medicine specialist.

  • 2. Lexell, Jan
    et al.
    Downham, David Y
    Department of Rehabilitation, Lund University Hospital, Sweden.
    How to assess the reliability of measurements in rehabilitation2005Inngår i: American Journal of Physical Medicine & Rehabilitation, ISSN 0894-9115, E-ISSN 1537-7385, Vol. 84, nr 9, s. 719-23Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    To evaluate the effects of rehabilitation interventions, we need reliable measurements. The measurements should also be sufficiently sensitive to enable the detection of clinically important changes. In recent years, the assessment of reliability in clinical practice and medical research has developed from the use of correlation coefficients to a comprehensive set of statistical methods. In this review, we present methods that can be used to assess reliability and describe how data from reliability analyses can aid the interpretation of results from rehabilitation interventions.

  • 3. Lexell, Jan
    et al.
    Miller, Michael
    Department of Health Sciences, Lund University.
    Flansbjer, Ulla-Britt
    Department of Health Sciences, Lund University.
    Downham, David
    Department of Health Sciences, Lund University.
    Superimposed electrical stimulation: assessment of voluntary activation and perceived discomfort in healthy, moderately active older and younger women and men2006Inngår i: American Journal of Physical Medicine & Rehabilitation, ISSN 0894-9115, E-ISSN 1537-7385, Vol. 85, nr 12, s. 945-50Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: An inability of the nervous system to fully activate the muscle is one factor that can contribute to age-related muscle weakness. Superimposed electrical stimulation can be used to determine voluntary muscle activation (VA). The aim of this study was to assess VA of the quadriceps muscle in healthy older and younger subjects. DESIGN: Electrical stimulation causes moderate discomfort in younger subjects, but no study has assessed discomfort in older subjects. The quadriceps muscle in 20 moderately active older subjects (mean age, 75 yrs) and 12 younger subjects (mean age, 25 yrs) was stimulated during two maximal voluntary contractions using a 100-Hz pulse train. A visual analog scale for pain (VAS-pain) was used to evaluate discomfort. RESULTS: Ability to activate the quadriceps muscle was generally very high, and there was no significant difference between the older (mean, 0.96) and younger (mean, 0.98) subjects. Discomfort did not differ between the older (mean VAS-pain score, 41 mm) and younger (mean VAS-pain score, 37 mm) subjects. CONCLUSIONS: Our results indicate that healthy, moderately active older subjects have the ability to almost complete VA of the quadriceps muscle and that discomfort during electrical stimulation is generally moderate.

  • 4.
    Littbrand, Håkan
    et al.
    Umeå universitet.
    Stenvall, Michael
    Umeå universitet.
    Rosendahl, Erik
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Applicability and effects of physical exercise on physical and cognitive functions and activities of daily living among people with dementia: a systematic review2011Inngår i: American Journal of Physical Medicine & Rehabilitation, ISSN 0894-9115, E-ISSN 1537-7385, Vol. 90, nr 6, s. 495-518Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: The aim of this study was to systematically review the applicability (attendance, achieved intensity, adverse events) and effects of physical exercise on physical functions, cognitive functions, and activities of daily living among people with dementia.Design: Randomized controlled trials were identified in PubMed, the Cumulative Index to Nursing and Allied Health, the Allied and Complementary Medicine Database, and the Cochrane Library on August 30 and September 1, 2010, according to predefined inclusion criteria. Two reviewers independently extracted predetermined data and assessed methodologic quality.Results: A qualitative analysis was performed, including ten studies. Most participants were people with Alzheimer disease in residential care facilities. Four studies reached "moderate" methodologic quality, and six reached "low." The studies of moderate quality evaluated the effects of combined functional weight-bearing exercise, combined functional and nonfunctional exercise, and walking exercise.Conclusions: Among older people with Alzheimer disease in residential care facilities, combined functional weight-bearing exercise seems applicable for use regarding attendance and adverse events, and there is some evidence that exercise improves walking performance and reduces the decline in activities of daily living. Furthermore, there is some evidence that walking exercise performed individually reduces decline in walking performance, but adverse events need to be evaluated. Among older people with various types of dementia disorders who are staying in a hospital, there is some evidence that combined functional and nonfunctional exercise over 2 wks has no effect on mobility. It seems important that the interventions last for at least a few months and that the exercises are task-specific and are intended to challenge the individual's physical capacity. Among older people with unspecified dementia disorders in residential care facilities, there is some evidence that walking exercise performed at a self-selected speed has no effect on cognitive functions. Whether physical exercise can improve cognitive functions among people with dementia remains unclear because studies evaluating this have either been of low methodologic quality or used an intervention of presumably insufficient intensity. There is a need for more studies of high methodologic quality, especially among people with dementia disorders other than Alzheimer disease.

  • 5.
    Miller, Michael
    et al.
    Lunds universitet.
    Flansbjer, Ulla-Britt
    Lunds universitet.
    Lexell, Jan
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    Voluntary activation of the knee extensors in chronic poststroke subjects2009Inngår i: American Journal of Physical Medicine & Rehabilitation, ISSN 0894-9115, E-ISSN 1537-7385, Vol. 88, nr 4, s. 286-291Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: To assess the extent to which knee extensor muscle weakness in subjects with chronic mild to moderate poststroke hemiparesis is caused by a decreased voluntary activation. Design: Forty community dwelling and ambulant men and women (mean age, 59.8 +/- 5.5 yrs) with residual hemiparesis (19.2 +/- 8.5 mos poststroke) were tested. Torque measurements were performed on a computerized dynamometer and the superimposed electrical stimulation technique was used to assess voluntary activation of the knee extensors in both the paretic and the nonparetic lower limbs.Results: The mean voluntary activation ratio of the knee extensors in the nonparetic and paretic leg was 0.97 +/- 0.04 and 0.86 +/- 0.13, respectively. Subjects who had a greater relative weakness, implying a more pronounced poststroke impairment, also had lower voluntary activation ratios. The mean percentage difference in total torque between the nonparetic and the paretic knee extensors after the electrical stimulation was 36.4% +/- 17.0%.Conclusions: Paretic knee extensor muscle weakness in chronic poststroke subjects is only partially explained by a reduced voluntary activation ability, indicating that other neuromuscular structural or functional factors contribute to poststroke hemiparetic muscle weakness.

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