Folia medica
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Previous studies focusing on the changes of heart rate, systolic blood pressure and dyspnea caused by the six-minute (6MWT) and shuttle walking distance tests (ISWT) have produced conflicting data. The present study aims at comparing the cardiovascular and dyspnea responses to 6MWT and ISWT in patients with chronic obstructive pulmonary disease (COPD). Twenty patients with clinically stable COPD (age, 56 +/- 9 yrs; BMI, 27.8 +/- 7.7 kg.m(-2); FEV1%pred, 42 +/- 19%; mean +/- Sx) performed three 6MWTs and two ISWTs using standardised protocols. The distances walked in the third 6MWT and second ISWT were 458 +/- 105 and 365 +/- 116 m, respectively. There was a significant correlation between the distances covered in the two tests (r = 0.87; p < 0.001). The 6MWT and ISWT showed similar correlation coefficients with the Baseline Dyspnea Index (r = 0.86; p < 0.001 and r = 0.76; p < 0.001), the Clinical Symptom Scale (r= -0.72; p < 0.001 and r= -0.55; p = 0.011), FEV1 L (r = 0.36; NS and r = 0.30; NS), PImax (r = 0.59; p < 0.008 and r = 0.60; p = 0.001) and the mean pulmonary artery pressure, Doppler echocardiography (r= -0.51; p < 0.029 and r = -0.51; p = 0.032). Although the response to ISWT tended to be greater, we found no statistically significant differences between the two tests in the changes of heart rate (HR), systolic blood pressure (SBP) and dyspnea (Borg) (deltaHR, 17.9 +/- 13.4 vs 23.8 +/- 15.4; deltaSBP, 7.7 +/- 14.6 vs 13.0 +/- 17.0 and deltaBorg, 1.7 +/- 1.1 vs 2.2 +/- 0.9; NS). ⋯ The cardiovascular and dyspnea response caused by ISWT is greater (but statistically not significant) than that generated by 6MWT. The more limited the functional capacity of COPD patients the more similar the response generated by 6MWT and ISWT.
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Clinical Trial
Treatment of knee osteoarthritis by arthroscopic synovectomy and debridement of cartilage lesions--late results.
Osteoarthritis (OA) is accompanied by degeneration and destruction of the articular cartilage, development of inflammatory process in the synovial membrane and periarticular tissues. Despite the introduction of new modern medications, the articular inflammatory changes often progress and therapy gives only a transitory improvement. Arthroscopic synovectomy (AS) in knee OA combined with resection of the cartilage lesions is a mild operative procedure and is not associated with postoperative joint stiffness and necessity of continuous rehabilitation. ⋯ The patients were examined before the arthroscopy and followed-up in 1, 3 and 5 years after AS. For the clinical assessment the WOMAC test was used. The WOMAC functional index shows statistically significant improvement at 1 and 3 years (p < 0.0001), as well as at 5 years (p < 0.001) after AS. The WOMAC pain index was significantly reduced in the arthroscopic joint at 1 and 3 years (p < 0.0001). The good therapeutic result was maintained for 5 years (p < 0.001). The WOMAC joint stiffness index was improved to the greatest extent 1 and 3 years after AS (p < 0.0001). In the 5th year a favourable statistically significant improvement was preserved. The total WOMAC index showed a durable general functional improvement including 3 years after the AS. The AS was performed in advanced OA of the knee joint accompanied with a chronic synovitis, resistant to medical therapy and topical management. The functional therapeutic results from AS were very good and lasting even 5 years after the AS.