Podium Session H

ABSTRACT:

This presentation will examine the need for and benefits of Physical Therapy (PT) intervention for the treatment of underactive pelvic floor conditions such as pelvic organ prolapse (POP) and urinary incontinence (UI). The topics of discussion will comprise of explanation of risk factors and demographics for pelvic floor dysfunction. Additionally, methods to evaluate patients with pelvic floor dysfunction and components of a pelvic floor PT assessment will be introduced. And lastly, research-supported interventions for treatment like pelvic floor muscle training and therapeutic modalities will be considered. It is important for healthcare providers and the public to be aware of the signs, symptoms, and treatments available of both POP and UI because they have the potential to cause a significant psychosocial burden on patients including decrease in quality of life, self-perception of body image, and decreased activity levels for those affected. Utilization of pelvic floor PT has the potential to decrease healthcare costs and the need for surgical intervention while at the same time improving patient satisfaction and objective outcomes.

ABSTRACT:

Individuals with Down syndrome (DS) have reduced aerobic capacity (VO­_2peak) and exercise tolerance. Previous studies have attributed this exercise intolerance to autonomic dysfunction and cardiovascular limitations, but individuals with DS might also have less efficient respiration (pulmonary and/or mitochondrial). Physiologic measures that represent this efficiency are oxygen uptake efficiency slope (OUES) and the ventilatory equivalent for carbon dioxide (V_E/VCO₂ slope) , where lower OUES and/or higher V_E/VCO₂ slope indicate less efficient respiration. Investigating OUES and V_E/VCO₂ slope obtained during maximal exercise testing could therefore provide valuable insight into the etiology of exercise intolerance of individuals with DS.

PURPOSE: To determine if OUES and V_E/VCO₂ slope are different between individuals with and without DS.

METHODS: Cardiopulmonary exercise tests were performed in healthy adults with and without DS to assess VO_2peak, OUES and V_E/VCO₂ slope. Breath-by-breath data was obtained through indirect calorimetry and 15-second epoch data from start of the test until VO_2peak was used to determine OUES and V_E/VCO₂ slope.

RESULTS: Individuals with DS (n=21) had lower OUES than those without DS (n=30, 1945.7 ± 413.7 vs. 2549.9 ± 736.2, respectively, p<0.001). Individuals with and without DS had similar V_E/VCO₂ slope (30.3 ± 3.1 and 31.1 ± 3.7, respectively, p=0.463).

CONCLUSION: Unexpectedly, individuals with DS had lower OUES but similar V_E/VCO₂ slope compared to their peers without DS. While more information is needed to completely elucidate the implications of these findings, this does suggest that exercise intolerance in individuals with DS may be related to some limitation in pulmonary or mitochondrial respiration.

ABSTRACT:

INTRODUCTION: Heart rate (HR) is an important physiological variable, allowing athletes and exercise scientists the ability to measure and track intensity during exercise. There are two types of technology used to measure HR, photoplethysmography (PPG) and electrocardiography (ECG). Both technologies have been around for decades and have been important innovations for biosensors, fitness trackers, and wearable technology. PPG devices use light-based optical sensors to determine the rate of blood flow, and thereby HR. Whereas ECG devices monitor the electrical signals produced by the heart. DISCUSSION: Our lab group has tested a variety of HR devices using both types of technology in walking, trail running, biking, and other exercise modalities. While the devices tend to do well under certain circumstances, they perform poorly under other circumstances. These devices are limited in their effectiveness and appropriate use-case by their accuracy. Wrist-based PPG devices are suitable for rest and light exercise, they are not suitable for high-intensity exercise. For high intensity exercise, or modalities with increased movement, the devices should utilize more robust means of securing the device to the body. Or use ECG technology that is resistant to errors due to movement. There are statistical tests to help determine the validity (accuracy) and therefore use-cases of these devices. While common agreement is beginning to emerge as to what tests are appropriate to determine validity, a universal agreement on validity thresholds has yet to be established. CONCLUSION: Thus, we propose a tiered validity threshold to determine validity and appropriate use-cases in wearable technology.

ABSTRACT:

Elevated risk of falling in individuals with lower limb amputation remains an issue that threatens this population. Literature has shown that when individuals with transfemoral amputation being tripped, they exhibited distinct recovery strategy side to side. However, the non-prosthetic versus prosthetic side trip recovery mechanism remains unclear in persons with transtibial amputation.

Twelve individuals were recruited. All participants walked on a side-by-side dual belt instrumented treadmill. Perturbations with small and large accelerations were applied to the non-prosthetic leg (SNP & LNP) and prosthetic leg (SP & LP). The recovery responses were quantified by peak trunk flexion angle. Three events were identified including perturbation onset (Onset), contralateral limb contact (Contra On; when the contralateral limb makes the first ground contact), and ipsilateral limb contact (Ipsi On; when the tripped limb once again makes the first ground contact). Duration from Onset to Contra On, from Onset to Ipsi On, and from Contra On to Ipsi On were calculated.

There were no significant differences in peak trunk flexion angle. The duration Onset-Contra On were longer when the NP limb was perturbed. It indicated that it took longer time for them to use the prosthetic limb to make the forward recovery step. However, the duration Onset-Ipsi On was not significantly different side to side. This may be due to the significantly shorter duration Contra On-Ipsi On in NP conditions, indicating that the second step of recovery making be the NP limb was sped up to achieve an overall stable recovery time Onset-Ipsi On.