Unnamed: 0
int64 0
2.02k
| ReviewID
int64 9.47M
32.4M
| Target_x
stringlengths 50
2.79k
| Background_x
stringlengths 68
3.52k
⌀ | Unnamed: 0_x
int64 0
49k
| PMID
int64 6.99k
32.6M
| Title
stringlengths 8
300
| Abstract
stringlengths 7
10.4k
| Unnamed: 0_y
int64 0
2.02k
| Target_y
stringlengths 50
2.79k
| Background_y
stringlengths 68
3.52k
⌀ |
|---|---|---|---|---|---|---|---|---|---|---|
2,010 | 30,591,077 |
Results Based on consistent evidence from studies that were rated as moderate or strong , there is good evidence that military weight management interventions are effective in improving body composition for duration s of up to 12 months .
Effective interventions are more likely to be high intensity ( have a greater number of sessions ) , are more often delivered by specialists , and use theoretical base/behavioral change techniques and a st and ardized guideline .
Dietary interventions can potentially reduce total fat and saturated fat intake .
Dietary interventions that target the kitchen staff and /or increase the availability of healthy food are more likely to be effective in the short term .
The results regarding military physical fitness interventions were inconclusive .
Conclusion Despite limitations such as the diversity and heterogeneity of the included interventions , outcome measurements , and follow-up duration , this systematic review found good evidence that weight management interventions are effective , especially in terms of weight loss .
|
Background Research has been conducted to assess the effectiveness of weight management , dietary and physical activity interventions in military setting s. However , a recent and comprehensive overview is lacking .
The aim of this systematic review is to examine the evidence and describe key components of effective interventions in terms of improving body composition , dietary behaviors , and physical activity among active-duty military personnel .
| 48,800 | 12,775,172 |
Use of the stages of change model in improving nutrition and exercise habits in enlisted Air Force men.
|
Thirty-nine U.S. Air Force enlisted men participated in a r and omized controlled study that evaluated an experimental program design ed to enhance fitness . Subjects were assigned to either a treatment ( access to the program ) or control ( no access to program ) group for 6 months . To improve treatment group fitness ( as measured by VO2 , subjects received individually tailored information ( based on a behavior change model ) via the Internet to encourage adoption of positive diet and exercise behaviors . Results showed no significant effect in improving fitness in treatment . However , significant effects were observed for secondary outcomes such as weight ( controls , + 1.0 kg vs. treatment , -2.2 kg , p < 0.05 ) , body mass index ( + 0.3 kg/m2 vs. -0.7 kg/m2 , p < 0.05 ) , and percent body fat ( + 0.6 % vs. -1.5 % , p < 0.001 ) . The data suggest that the individually tailored exercise information was not effective in encouraging sufficient exercise intensity to impact fitness . However , the dietary tailored information appears to have encouraged the adoption of more positive nutritional practice s as demonstrated by the beneficial effects reflected in secondary outcomes
| 2,010 |
Results Based on consistent evidence from studies that were rated as moderate or strong , there is good evidence that military weight management interventions are effective in improving body composition for duration s of up to 12 months .
Effective interventions are more likely to be high intensity ( have a greater number of sessions ) , are more often delivered by specialists , and use theoretical base/behavioral change techniques and a st and ardized guideline .
Dietary interventions can potentially reduce total fat and saturated fat intake .
Dietary interventions that target the kitchen staff and /or increase the availability of healthy food are more likely to be effective in the short term .
The results regarding military physical fitness interventions were inconclusive .
Conclusion Despite limitations such as the diversity and heterogeneity of the included interventions , outcome measurements , and follow-up duration , this systematic review found good evidence that weight management interventions are effective , especially in terms of weight loss .
|
Background Research has been conducted to assess the effectiveness of weight management , dietary and physical activity interventions in military setting s. However , a recent and comprehensive overview is lacking .
The aim of this systematic review is to examine the evidence and describe key components of effective interventions in terms of improving body composition , dietary behaviors , and physical activity among active-duty military personnel .
|
2,010 | 30,591,077 |
Results Based on consistent evidence from studies that were rated as moderate or strong , there is good evidence that military weight management interventions are effective in improving body composition for duration s of up to 12 months .
Effective interventions are more likely to be high intensity ( have a greater number of sessions ) , are more often delivered by specialists , and use theoretical base/behavioral change techniques and a st and ardized guideline .
Dietary interventions can potentially reduce total fat and saturated fat intake .
Dietary interventions that target the kitchen staff and /or increase the availability of healthy food are more likely to be effective in the short term .
The results regarding military physical fitness interventions were inconclusive .
Conclusion Despite limitations such as the diversity and heterogeneity of the included interventions , outcome measurements , and follow-up duration , this systematic review found good evidence that weight management interventions are effective , especially in terms of weight loss .
|
Background Research has been conducted to assess the effectiveness of weight management , dietary and physical activity interventions in military setting s. However , a recent and comprehensive overview is lacking .
The aim of this systematic review is to examine the evidence and describe key components of effective interventions in terms of improving body composition , dietary behaviors , and physical activity among active-duty military personnel .
| 48,801 | 20,102,855 |
Efficacy of a meal-replacement program for promoting blood lipid changes and weight and body fat loss in US Army soldiers.
|
Excess weight is associated with negative health outcomes . Meal replacements are effective in promoting favorable body composition changes in civilian population s ; however , their efficacy with military service members who have unique lifestyles is unknown . The objective of this r and omized controlled trial was to determine the efficacy of the Army 's education-based weight-management program , " Weigh to Stay , " with and without meal replacements for improving blood lipids , and to promote weight and body fat loss in overweight US Army soldiers . Soldiers ( n=113 ; 76 males/37 females ) attending Weigh to Stay at Fort Bragg , NC , in 2006/2007 were r and omized to Weigh to Stay only or a commercially available meal-replacement program ( two meal replacements per day ) in conjunction with Weigh to Stay , and followed until Army body fat st and ards were met or for 6 months if st and ards were not met . Study completers ( n=46 ) in both treatment groups lost weight ( Weigh to Stay : -2.7+/-4.3 kg ; meal replacers : -3.8+/-3.5 kg ) and fat mass ( Weigh to Stay , -2.7+/-3.2 kg ; meal replacers : -2.9+/-2.5 kg ) , and improved high-density lipoprotein cholesterol concentrations ( Weigh to Stay : 13+/-9 mg/dL [ 0.34+/-0.23 mmol/L ] ; meal replacers : 8+/-7 mg/dL [ 0.21+/-0.18 mmol/L ] ; P<0.05 ) ; however , no between-group differences were observed . Attrition was lower ( P=0.009 ) and success in meeting body fat st and ards tended to be higher ( P=0.06 ) for the meal replacers vs Weigh to Stay participants . Intent-to-treat analysis demonstrated that meal replacers lost more weight ( 1.2+/-0.5 kg ) , percent body fat ( 1.0%+/-0.4 % ) , and fat mass ( 0.8+/-0.4 kg ) compared to Weigh to Stay volunteers ( P<0.05 ) . Our findings suggest that meal replacement use can be recommended as a potential adjunct strategy to Weigh to Stay
| 2,010 |
Results Based on consistent evidence from studies that were rated as moderate or strong , there is good evidence that military weight management interventions are effective in improving body composition for duration s of up to 12 months .
Effective interventions are more likely to be high intensity ( have a greater number of sessions ) , are more often delivered by specialists , and use theoretical base/behavioral change techniques and a st and ardized guideline .
Dietary interventions can potentially reduce total fat and saturated fat intake .
Dietary interventions that target the kitchen staff and /or increase the availability of healthy food are more likely to be effective in the short term .
The results regarding military physical fitness interventions were inconclusive .
Conclusion Despite limitations such as the diversity and heterogeneity of the included interventions , outcome measurements , and follow-up duration , this systematic review found good evidence that weight management interventions are effective , especially in terms of weight loss .
|
Background Research has been conducted to assess the effectiveness of weight management , dietary and physical activity interventions in military setting s. However , a recent and comprehensive overview is lacking .
The aim of this systematic review is to examine the evidence and describe key components of effective interventions in terms of improving body composition , dietary behaviors , and physical activity among active-duty military personnel .
|
2,010 | 30,591,077 |
Results Based on consistent evidence from studies that were rated as moderate or strong , there is good evidence that military weight management interventions are effective in improving body composition for duration s of up to 12 months .
Effective interventions are more likely to be high intensity ( have a greater number of sessions ) , are more often delivered by specialists , and use theoretical base/behavioral change techniques and a st and ardized guideline .
Dietary interventions can potentially reduce total fat and saturated fat intake .
Dietary interventions that target the kitchen staff and /or increase the availability of healthy food are more likely to be effective in the short term .
The results regarding military physical fitness interventions were inconclusive .
Conclusion Despite limitations such as the diversity and heterogeneity of the included interventions , outcome measurements , and follow-up duration , this systematic review found good evidence that weight management interventions are effective , especially in terms of weight loss .
|
Background Research has been conducted to assess the effectiveness of weight management , dietary and physical activity interventions in military setting s. However , a recent and comprehensive overview is lacking .
The aim of this systematic review is to examine the evidence and describe key components of effective interventions in terms of improving body composition , dietary behaviors , and physical activity among active-duty military personnel .
| 48,802 | 22,717,217 |
Efficacy of orlistat 60 mg on weight loss and body fat mass in US Army soldiers.
|
A higher body mass index is associated with exercise-related injuries and increased risk for musculoskeletal and connective tissue disorders , which are relevant to military personnel . Studies show the efficacy of orlistat 60 mg for promoting weight and body fat loss in civilians ; however , its efficacy among predominantly young , male soldiers is unknown . This study 's objective was to examine the effect of a 6-month , st and ard education-based weight-management program with and without orlistat 60 mg on changes in weight and body fat in overweight soldiers . Data were collected for this r and omized , controlled trial from March 2008 to November 2010 at Fort Bragg , NC . Participants were enrolled in an education-based weight management program ( n=435 ; 75 % men ) and were r and omized to placebo or orlistat 60 mg , three capsules daily with meals . All participants were recommended to maintain a reduced-energy , low-fat diet . Among study completers ( 14 % retention rate ; placebo n=22 , orlistat n=35 ) members of both groups lost significant weight from baseline ( placebo -3.0±5.2 kg ; orlistat -3.2±4.7 kg ; P<0.01 ) , but only the orlistat group lost fat mass ( -2.5±3.9 kg ; P<0.001 ) , whereas the placebo group lost lean mass ( -1.4±2.7 kg ; P < 0.01 ) . An intent-to-treat analysis ( ? 1 follow-up body weight measure ) demonstrated that the orlistat group lost more fat mass vs the placebo group ( -1.3±2.9 kg vs ? 0.6±1.8 kg , respectively ; P<0.05 ) , but less lean mass ( -0.2±2.0 kg vs -0.8±1.8 kg , respectively ; P<0.01 ) . Orlistat 60 mg may be an effective adjunct to an education-based weight management program in a mostly young , male soldier population
| 2,010 |
Results Based on consistent evidence from studies that were rated as moderate or strong , there is good evidence that military weight management interventions are effective in improving body composition for duration s of up to 12 months .
Effective interventions are more likely to be high intensity ( have a greater number of sessions ) , are more often delivered by specialists , and use theoretical base/behavioral change techniques and a st and ardized guideline .
Dietary interventions can potentially reduce total fat and saturated fat intake .
Dietary interventions that target the kitchen staff and /or increase the availability of healthy food are more likely to be effective in the short term .
The results regarding military physical fitness interventions were inconclusive .
Conclusion Despite limitations such as the diversity and heterogeneity of the included interventions , outcome measurements , and follow-up duration , this systematic review found good evidence that weight management interventions are effective , especially in terms of weight loss .
|
Background Research has been conducted to assess the effectiveness of weight management , dietary and physical activity interventions in military setting s. However , a recent and comprehensive overview is lacking .
The aim of this systematic review is to examine the evidence and describe key components of effective interventions in terms of improving body composition , dietary behaviors , and physical activity among active-duty military personnel .
|
2,010 | 30,591,077 |
Results Based on consistent evidence from studies that were rated as moderate or strong , there is good evidence that military weight management interventions are effective in improving body composition for duration s of up to 12 months .
Effective interventions are more likely to be high intensity ( have a greater number of sessions ) , are more often delivered by specialists , and use theoretical base/behavioral change techniques and a st and ardized guideline .
Dietary interventions can potentially reduce total fat and saturated fat intake .
Dietary interventions that target the kitchen staff and /or increase the availability of healthy food are more likely to be effective in the short term .
The results regarding military physical fitness interventions were inconclusive .
Conclusion Despite limitations such as the diversity and heterogeneity of the included interventions , outcome measurements , and follow-up duration , this systematic review found good evidence that weight management interventions are effective , especially in terms of weight loss .
|
Background Research has been conducted to assess the effectiveness of weight management , dietary and physical activity interventions in military setting s. However , a recent and comprehensive overview is lacking .
The aim of this systematic review is to examine the evidence and describe key components of effective interventions in terms of improving body composition , dietary behaviors , and physical activity among active-duty military personnel .
| 48,803 | 19,331,705 |
Association between folate intake from different food sources in Norway and homocysteine status in a dietary intervention among young male adults.
|
The aim of the present investigation was to study the effect of a dietary intervention which combined nutrition information with increased availability of vegetables , fruits and wholegrain bread . The effect of the intervention was determined by changes in the intake of vegetables , fruits , wholegrain bread and estimated nutrients . Furthermore , the study investigated whether changes in relative contribution from different food sources of folate were related to changes in the concentration of plasma total homocysteine ( p-tHcy ) . The 5-month intervention study included 376 male recruits from the Norwegian National Guard , Vaernes ( intervention group ) and 105 male recruits from the Norwegian National Guard , Heggelia ( control group ) . The study result ed in an increase in the total consumption of vegetables , fruits , berries and juice ( P < 0.001 ) and of wholegrain bread ( P < 0.001 ) . The participants in the intervention group showed a higher increase in the intake of dietary fibre ( P < 0.001 ) and folate ( P < 0.001 ) compared with the control group . The relative contribution of folate intake from fruits , vegetables and wholegrain bread was higher in the intervention group compared with the control group ( P < 0.001 for all ) . The increased intake of folate from wholegrain bread was inversely associated with a reduced concentration of p-tHcy ( P = 0.017 ) . In summary , the dietary intervention result ed in an increased intake of vegetables , fruits and wholegrain bread and a subsequent increase in folate intake from these food components . Reduction in the concentration of p-tHcy was significantly related to an increased folate intake due to an increased consumption of wholegrain bread
| 2,010 |
Results Based on consistent evidence from studies that were rated as moderate or strong , there is good evidence that military weight management interventions are effective in improving body composition for duration s of up to 12 months .
Effective interventions are more likely to be high intensity ( have a greater number of sessions ) , are more often delivered by specialists , and use theoretical base/behavioral change techniques and a st and ardized guideline .
Dietary interventions can potentially reduce total fat and saturated fat intake .
Dietary interventions that target the kitchen staff and /or increase the availability of healthy food are more likely to be effective in the short term .
The results regarding military physical fitness interventions were inconclusive .
Conclusion Despite limitations such as the diversity and heterogeneity of the included interventions , outcome measurements , and follow-up duration , this systematic review found good evidence that weight management interventions are effective , especially in terms of weight loss .
|
Background Research has been conducted to assess the effectiveness of weight management , dietary and physical activity interventions in military setting s. However , a recent and comprehensive overview is lacking .
The aim of this systematic review is to examine the evidence and describe key components of effective interventions in terms of improving body composition , dietary behaviors , and physical activity among active-duty military personnel .
|
2,010 | 30,591,077 |
Results Based on consistent evidence from studies that were rated as moderate or strong , there is good evidence that military weight management interventions are effective in improving body composition for duration s of up to 12 months .
Effective interventions are more likely to be high intensity ( have a greater number of sessions ) , are more often delivered by specialists , and use theoretical base/behavioral change techniques and a st and ardized guideline .
Dietary interventions can potentially reduce total fat and saturated fat intake .
Dietary interventions that target the kitchen staff and /or increase the availability of healthy food are more likely to be effective in the short term .
The results regarding military physical fitness interventions were inconclusive .
Conclusion Despite limitations such as the diversity and heterogeneity of the included interventions , outcome measurements , and follow-up duration , this systematic review found good evidence that weight management interventions are effective , especially in terms of weight loss .
|
Background Research has been conducted to assess the effectiveness of weight management , dietary and physical activity interventions in military setting s. However , a recent and comprehensive overview is lacking .
The aim of this systematic review is to examine the evidence and describe key components of effective interventions in terms of improving body composition , dietary behaviors , and physical activity among active-duty military personnel .
| 48,804 | 22,545,373 |
Effects of an Eight Week Military Training Program on Aerobic Indices and Psychomotor Function
|
This study assessed the effects of eight weeks of military training on aerobic fitness indices , military skills and neuropsychological function . Thirty five ( n=35 ) male Irish Defence Forces personnel , divided into training ( n=20 ) and control ( n=15 ) subgroups , completed tests of military aptitude ( Kim ’s games , judging distance , fire order , map reading , weapon assembly ) and neuropsychological function ( Symbol digit modalities test ( SDMT ) , Trail making test , Stroop test and grooved pegboard test ) pre- and post-intervention . The repeated measures study design sought to account for any learning effect . Participants also completed a 10 km route march , a two mile run and three by 20 m shuttle run tests at both time points to quantify changes in fitness variables . The training sub-group significantly ( P<0.001 ) improved mean 20 m shuttle-run distance and consequently estimated VO2 max pre- to post-intervention ( 49.8±1.0 vs. 52.4±0.9 mL.kg-1.min-1 ) . Two mile run time was not significantly improved . Mean % HRmax during the 10 km route march was significantly higher in both training ( P<0.001 ) and control ( P<0.01 ) sub-groups post-intervention ( 71±1 and 83±1 % ) compared to pre-intervention ( 65±1 and 77±1 % ) . However , the training sub-group conducted the route march at a significantly faster speed on the second occasion . Military training significantly improved performance in 3/18 neuropsychological test components and 2/12 military skills test components . Training significantly improved ability to estimate both short ( error ; 36±6 vs. 12±1 % ) and intermediate ( error ; 72±12 vs. 11±3 % ) distances post-intervention . The training sub-group significantly ( P<0.01 ) improved SDMT score and mean Trail 1 time pre- to post-intervention ( 58.0±2.8 vs. 69.5±3.4 ; 18.1±0.8 vs. 14.4±0.8s , respectively ) . In Part 3 of the Stroop test , time mediated a significant ( P<0.05 ) and selective improvement in the training sub-group ( 51.3±3.2 vs. 63.8±5.4 ) . In conclusion , aerobic fitness and a minority of neuropsychological and military skills tests improved following 8 weeks of military training
| 2,010 |
Results Based on consistent evidence from studies that were rated as moderate or strong , there is good evidence that military weight management interventions are effective in improving body composition for duration s of up to 12 months .
Effective interventions are more likely to be high intensity ( have a greater number of sessions ) , are more often delivered by specialists , and use theoretical base/behavioral change techniques and a st and ardized guideline .
Dietary interventions can potentially reduce total fat and saturated fat intake .
Dietary interventions that target the kitchen staff and /or increase the availability of healthy food are more likely to be effective in the short term .
The results regarding military physical fitness interventions were inconclusive .
Conclusion Despite limitations such as the diversity and heterogeneity of the included interventions , outcome measurements , and follow-up duration , this systematic review found good evidence that weight management interventions are effective , especially in terms of weight loss .
|
Background Research has been conducted to assess the effectiveness of weight management , dietary and physical activity interventions in military setting s. However , a recent and comprehensive overview is lacking .
The aim of this systematic review is to examine the evidence and describe key components of effective interventions in terms of improving body composition , dietary behaviors , and physical activity among active-duty military personnel .
|
2,010 | 30,591,077 |
Results Based on consistent evidence from studies that were rated as moderate or strong , there is good evidence that military weight management interventions are effective in improving body composition for duration s of up to 12 months .
Effective interventions are more likely to be high intensity ( have a greater number of sessions ) , are more often delivered by specialists , and use theoretical base/behavioral change techniques and a st and ardized guideline .
Dietary interventions can potentially reduce total fat and saturated fat intake .
Dietary interventions that target the kitchen staff and /or increase the availability of healthy food are more likely to be effective in the short term .
The results regarding military physical fitness interventions were inconclusive .
Conclusion Despite limitations such as the diversity and heterogeneity of the included interventions , outcome measurements , and follow-up duration , this systematic review found good evidence that weight management interventions are effective , especially in terms of weight loss .
|
Background Research has been conducted to assess the effectiveness of weight management , dietary and physical activity interventions in military setting s. However , a recent and comprehensive overview is lacking .
The aim of this systematic review is to examine the evidence and describe key components of effective interventions in terms of improving body composition , dietary behaviors , and physical activity among active-duty military personnel .
| 48,805 | 19,778,751 |
Adherence and weight loss outcomes associated with food-exercise diary preference in a military weight management program.
|
The more consistently someone records their food intake the more likely they are to lose weight . We hypothesized that subjects who kept track via their preferred method would demonstrate higher adherence and therefore improved outcomes compared to those who used a non-preferred method . Participants were r and omly assigned to use a paper , PDA , or Web-based diary and classified as " Preferred " if they used their preferred method and " Non-Preferred " if they did not . Days adherent to diary use were collected for 12 weeks . Weight , % body fat , waist circumference , and self-efficacy scores were measured at baseline , 6 and 12 weeks . Thirty nine participants completed the 12 week study . Fifty nine percent were male . The mean age was 35 and mean baseline BMI was 33 kg/m(2 ) ( + /-3.5 ) . Forty four % ( n=17 ) used their " Preferred " diary method and 56 % ( n=22 ) did not . Participants who used their preferred diary were more adherent to recording both food intake ( 64.2 % vs. 43.4 % , p=.015 ) and exercise ( 60.6 % vs. 31.2 % , p=.001 ) . Though no difference was seen between groups on weight management outcomes , these results suggest that diary preference affects adherence to diary use
| 2,010 |
Results Based on consistent evidence from studies that were rated as moderate or strong , there is good evidence that military weight management interventions are effective in improving body composition for duration s of up to 12 months .
Effective interventions are more likely to be high intensity ( have a greater number of sessions ) , are more often delivered by specialists , and use theoretical base/behavioral change techniques and a st and ardized guideline .
Dietary interventions can potentially reduce total fat and saturated fat intake .
Dietary interventions that target the kitchen staff and /or increase the availability of healthy food are more likely to be effective in the short term .
The results regarding military physical fitness interventions were inconclusive .
Conclusion Despite limitations such as the diversity and heterogeneity of the included interventions , outcome measurements , and follow-up duration , this systematic review found good evidence that weight management interventions are effective , especially in terms of weight loss .
|
Background Research has been conducted to assess the effectiveness of weight management , dietary and physical activity interventions in military setting s. However , a recent and comprehensive overview is lacking .
The aim of this systematic review is to examine the evidence and describe key components of effective interventions in terms of improving body composition , dietary behaviors , and physical activity among active-duty military personnel .
|
2,010 | 30,591,077 |
Results Based on consistent evidence from studies that were rated as moderate or strong , there is good evidence that military weight management interventions are effective in improving body composition for duration s of up to 12 months .
Effective interventions are more likely to be high intensity ( have a greater number of sessions ) , are more often delivered by specialists , and use theoretical base/behavioral change techniques and a st and ardized guideline .
Dietary interventions can potentially reduce total fat and saturated fat intake .
Dietary interventions that target the kitchen staff and /or increase the availability of healthy food are more likely to be effective in the short term .
The results regarding military physical fitness interventions were inconclusive .
Conclusion Despite limitations such as the diversity and heterogeneity of the included interventions , outcome measurements , and follow-up duration , this systematic review found good evidence that weight management interventions are effective , especially in terms of weight loss .
|
Background Research has been conducted to assess the effectiveness of weight management , dietary and physical activity interventions in military setting s. However , a recent and comprehensive overview is lacking .
The aim of this systematic review is to examine the evidence and describe key components of effective interventions in terms of improving body composition , dietary behaviors , and physical activity among active-duty military personnel .
| 48,806 | 20,444,314 |
Long-term sustainability of a worksite canteen intervention of serving more fruit and vegetables.
|
OBJECTIVE To analyse the 5-year sustainability of a worksite canteen intervention of serving more fruit and vegetables ( F&V ) . DESIGN Average F&V consumption per customer per meal per day was assessed in five worksite canteens by weighing F&V served and subtracting waste . Data were collected by the canteen staff during a 3-week continuous period and compared to data from the same five canteens measured at baseline , at end point and at 1-year follow-up . The intervention used a participatory and empowering approach , self-monitoring and networking among the canteen staff , management and a consultant . The method focused on providing ideas for increased F&V for lunch , making environmental changes in the canteens by giving access to tasteful and healthy food choices and reducing the availability of unhealthy options . SETTING Five Danish worksites serving from 50 to 500 meals a day : a military base , an electronic component distributor , a bank , a town hall and a waste-h and ling facility . SUBJECTS Worksite canteen managers , canteen staff . RESULTS Four of the five worksite canteens were able to either maintain the intervention or even increase the consumption of F&V. The average increase from baseline to 5-year follow-up was 95 g per customer per meal per day ( 18 , 144 , 66 , 105 and 141 g , respectively ) . On average , the five canteens at the long-term follow-up had an F&V consumption of 208 g/meal per customer . CONCLUSIONS The present study indicates that sustainability of F&V is possible in worksites where the participatory and empowering approach , self-monitoring , environmental change , dialogue with suppliers and networking among worksite canteens are applied
| 2,010 |
Results Based on consistent evidence from studies that were rated as moderate or strong , there is good evidence that military weight management interventions are effective in improving body composition for duration s of up to 12 months .
Effective interventions are more likely to be high intensity ( have a greater number of sessions ) , are more often delivered by specialists , and use theoretical base/behavioral change techniques and a st and ardized guideline .
Dietary interventions can potentially reduce total fat and saturated fat intake .
Dietary interventions that target the kitchen staff and /or increase the availability of healthy food are more likely to be effective in the short term .
The results regarding military physical fitness interventions were inconclusive .
Conclusion Despite limitations such as the diversity and heterogeneity of the included interventions , outcome measurements , and follow-up duration , this systematic review found good evidence that weight management interventions are effective , especially in terms of weight loss .
|
Background Research has been conducted to assess the effectiveness of weight management , dietary and physical activity interventions in military setting s. However , a recent and comprehensive overview is lacking .
The aim of this systematic review is to examine the evidence and describe key components of effective interventions in terms of improving body composition , dietary behaviors , and physical activity among active-duty military personnel .
|
2,010 | 30,591,077 |
Results Based on consistent evidence from studies that were rated as moderate or strong , there is good evidence that military weight management interventions are effective in improving body composition for duration s of up to 12 months .
Effective interventions are more likely to be high intensity ( have a greater number of sessions ) , are more often delivered by specialists , and use theoretical base/behavioral change techniques and a st and ardized guideline .
Dietary interventions can potentially reduce total fat and saturated fat intake .
Dietary interventions that target the kitchen staff and /or increase the availability of healthy food are more likely to be effective in the short term .
The results regarding military physical fitness interventions were inconclusive .
Conclusion Despite limitations such as the diversity and heterogeneity of the included interventions , outcome measurements , and follow-up duration , this systematic review found good evidence that weight management interventions are effective , especially in terms of weight loss .
|
Background Research has been conducted to assess the effectiveness of weight management , dietary and physical activity interventions in military setting s. However , a recent and comprehensive overview is lacking .
The aim of this systematic review is to examine the evidence and describe key components of effective interventions in terms of improving body composition , dietary behaviors , and physical activity among active-duty military personnel .
| 48,807 | 10,023,731 |
The impact of a shipboard weight control program.
|
OBJECTIVE The specific aim was to determine whether a multifaceted approach to weight loss and physical readiness could be implemented onboard a deployed combatant ship of the U.S. Navy . RESEARCH METHODS AND PROCEDURES Thirty-nine men ( 31+/-6 years old , mean+/-st and ard deviation ) assigned to the USS ENTERPRISE ( CVN 65 ) during a 6-month Mediterranean deployment who had failed their previous Physical Readiness Test due to excessive body weight ( 108+/-11 kg overweight ) were r and omly assigned to nutrition , cognitive-behavioral obesity treatment plus exercise or to the Navy 's usual treatment ( control ) , which is exercise alone . RESULTS Outcomes for the treatment group were significantly better than the controls , with 8.6+/-5.0 vs. 5.0+/-4.1 kg weight loss , 8 % vs. 5 % reduction in original body weight , and body fat loss of 7 % vs. 5 % . Triglycerides declined significantly greater in the treatment group than the controls ( 145 mg/dL to 109 mg/dL vs. 146 mg/dL to 145 mg/dL , p<0.05 ) , whereas depression and eating behaviors significantly improved among treated men . Problematic environmental factors were the limited variety of heart healthy foods in the galley , short meal breaks , and long mess hall lines that led to eating snacks from vending machines and frequent port calls . DISCUSSION Although greater weight loss than would be expected of a Navy usual care group diluted the treatment effect , the treated men still fared significantly better . The physical readiness implication of this research has the potential to impact Navy health promotion programs and policy , the health and well-being of its personnel , and the Navy 's ability to meet mission requirements
| 2,010 |
Results Based on consistent evidence from studies that were rated as moderate or strong , there is good evidence that military weight management interventions are effective in improving body composition for duration s of up to 12 months .
Effective interventions are more likely to be high intensity ( have a greater number of sessions ) , are more often delivered by specialists , and use theoretical base/behavioral change techniques and a st and ardized guideline .
Dietary interventions can potentially reduce total fat and saturated fat intake .
Dietary interventions that target the kitchen staff and /or increase the availability of healthy food are more likely to be effective in the short term .
The results regarding military physical fitness interventions were inconclusive .
Conclusion Despite limitations such as the diversity and heterogeneity of the included interventions , outcome measurements , and follow-up duration , this systematic review found good evidence that weight management interventions are effective , especially in terms of weight loss .
|
Background Research has been conducted to assess the effectiveness of weight management , dietary and physical activity interventions in military setting s. However , a recent and comprehensive overview is lacking .
The aim of this systematic review is to examine the evidence and describe key components of effective interventions in terms of improving body composition , dietary behaviors , and physical activity among active-duty military personnel .
|
2,010 | 30,591,077 |
Results Based on consistent evidence from studies that were rated as moderate or strong , there is good evidence that military weight management interventions are effective in improving body composition for duration s of up to 12 months .
Effective interventions are more likely to be high intensity ( have a greater number of sessions ) , are more often delivered by specialists , and use theoretical base/behavioral change techniques and a st and ardized guideline .
Dietary interventions can potentially reduce total fat and saturated fat intake .
Dietary interventions that target the kitchen staff and /or increase the availability of healthy food are more likely to be effective in the short term .
The results regarding military physical fitness interventions were inconclusive .
Conclusion Despite limitations such as the diversity and heterogeneity of the included interventions , outcome measurements , and follow-up duration , this systematic review found good evidence that weight management interventions are effective , especially in terms of weight loss .
|
Background Research has been conducted to assess the effectiveness of weight management , dietary and physical activity interventions in military setting s. However , a recent and comprehensive overview is lacking .
The aim of this systematic review is to examine the evidence and describe key components of effective interventions in terms of improving body composition , dietary behaviors , and physical activity among active-duty military personnel .
| 48,808 | 18,188,080 |
Obesity and Presenteeism: The Impact of Body Mass Index on Workplace Productivity
|
Objective : To examine whether obesity is associated with increased presenteeism ( health-related limitations at work ) . Methods : R and omly selected manufacturing employees ( n = 341 ) were assessed via height and weight measures , demographic survey , wage data , and the Work Limitations Question naire . The Work Limitations Question naire measures productivity on four dimensions . Analyses of variance and analyses of covariance were computed to identify productivity differences based on body mass index ( BMI ) . Results : Moderately or extremely obese workers ( BMI ≥35 ) experienced the greatest health-related work limitations , specifically regarding time needed to complete tasks and ability to perform physical job dem and s. These workers experienced a 4.2 % health-related loss in productivity , 1.18 % more than all other employees , which equates to an additional $ 506 annually in lost productivity per worker . Conclusions : The relationship between BMI and presenteeism is characterized by a threshold effect , where extremely or moderately obese workers are significantly less productive than mildly obese workers
| 2,010 |
Results Based on consistent evidence from studies that were rated as moderate or strong , there is good evidence that military weight management interventions are effective in improving body composition for duration s of up to 12 months .
Effective interventions are more likely to be high intensity ( have a greater number of sessions ) , are more often delivered by specialists , and use theoretical base/behavioral change techniques and a st and ardized guideline .
Dietary interventions can potentially reduce total fat and saturated fat intake .
Dietary interventions that target the kitchen staff and /or increase the availability of healthy food are more likely to be effective in the short term .
The results regarding military physical fitness interventions were inconclusive .
Conclusion Despite limitations such as the diversity and heterogeneity of the included interventions , outcome measurements , and follow-up duration , this systematic review found good evidence that weight management interventions are effective , especially in terms of weight loss .
|
Background Research has been conducted to assess the effectiveness of weight management , dietary and physical activity interventions in military setting s. However , a recent and comprehensive overview is lacking .
The aim of this systematic review is to examine the evidence and describe key components of effective interventions in terms of improving body composition , dietary behaviors , and physical activity among active-duty military personnel .
|
2,010 | 30,591,077 |
Results Based on consistent evidence from studies that were rated as moderate or strong , there is good evidence that military weight management interventions are effective in improving body composition for duration s of up to 12 months .
Effective interventions are more likely to be high intensity ( have a greater number of sessions ) , are more often delivered by specialists , and use theoretical base/behavioral change techniques and a st and ardized guideline .
Dietary interventions can potentially reduce total fat and saturated fat intake .
Dietary interventions that target the kitchen staff and /or increase the availability of healthy food are more likely to be effective in the short term .
The results regarding military physical fitness interventions were inconclusive .
Conclusion Despite limitations such as the diversity and heterogeneity of the included interventions , outcome measurements , and follow-up duration , this systematic review found good evidence that weight management interventions are effective , especially in terms of weight loss .
|
Background Research has been conducted to assess the effectiveness of weight management , dietary and physical activity interventions in military setting s. However , a recent and comprehensive overview is lacking .
The aim of this systematic review is to examine the evidence and describe key components of effective interventions in terms of improving body composition , dietary behaviors , and physical activity among active-duty military personnel .
| 48,809 | 23,356,124 |
Effect of an accelerometer on body weight and fitness in overweight and obese active duty soldiers.
|
This study evaluated whether using a web-linked accelerometer , plus m and atory physical training , is associated with various weight- and fitness-related outcomes in overweight/obese active duty soldiers . Soldiers who failed the height/weight st and ards of the Army Physical Fitness Test ( APFT ) were r and omized to use a Polar FA20 accelerometer device ( polar accelerometer group [ PA ] , n = 15 ) or usual care ( UC , n = 13 ) for 6 months . Both groups received 1.5 hours of lifestyle instruction . We collected data at baseline , 2 , 4 , and 6 months , and evaluated group differences in temporal changes in study outcomes . At 6 months , 1/28 subjects ( UC ) passed the APFT height/weight st and ards . There were no group differences in changes in weight ( PA : -0.1 kg vs. UC : + 0.3 kg ; p = 0.9 ) , body fat ( PA : -0.9 % vs. UC : -1.1 % ; p = 0.9 ) , systolic blood pressure ( PA : + 1.3 mm Hg vs. UC : -2.1 mm Hg ; p = 0.2 ) , diastolic blood pressure ( PA : + 3.8 mm Hg vs. UC : -2.4 mm Hg ; p = 0.3 ) , or resting heart rate in beats per minute ( bpm ) ( PA : + 7.8 bpm vs. UC : + 0.1 bpm ; p = 0.2 ) . These results suggest that using an accelerometer with web-based feedback capabilities plus m and atory physical training does not assist in significant weight loss or ability to pass the APFT height/weight st and ards among overweight/obese soldiers
| 2,010 |
Results Based on consistent evidence from studies that were rated as moderate or strong , there is good evidence that military weight management interventions are effective in improving body composition for duration s of up to 12 months .
Effective interventions are more likely to be high intensity ( have a greater number of sessions ) , are more often delivered by specialists , and use theoretical base/behavioral change techniques and a st and ardized guideline .
Dietary interventions can potentially reduce total fat and saturated fat intake .
Dietary interventions that target the kitchen staff and /or increase the availability of healthy food are more likely to be effective in the short term .
The results regarding military physical fitness interventions were inconclusive .
Conclusion Despite limitations such as the diversity and heterogeneity of the included interventions , outcome measurements , and follow-up duration , this systematic review found good evidence that weight management interventions are effective , especially in terms of weight loss .
|
Background Research has been conducted to assess the effectiveness of weight management , dietary and physical activity interventions in military setting s. However , a recent and comprehensive overview is lacking .
The aim of this systematic review is to examine the evidence and describe key components of effective interventions in terms of improving body composition , dietary behaviors , and physical activity among active-duty military personnel .
|
2,010 | 30,591,077 |
Results Based on consistent evidence from studies that were rated as moderate or strong , there is good evidence that military weight management interventions are effective in improving body composition for duration s of up to 12 months .
Effective interventions are more likely to be high intensity ( have a greater number of sessions ) , are more often delivered by specialists , and use theoretical base/behavioral change techniques and a st and ardized guideline .
Dietary interventions can potentially reduce total fat and saturated fat intake .
Dietary interventions that target the kitchen staff and /or increase the availability of healthy food are more likely to be effective in the short term .
The results regarding military physical fitness interventions were inconclusive .
Conclusion Despite limitations such as the diversity and heterogeneity of the included interventions , outcome measurements , and follow-up duration , this systematic review found good evidence that weight management interventions are effective , especially in terms of weight loss .
|
Background Research has been conducted to assess the effectiveness of weight management , dietary and physical activity interventions in military setting s. However , a recent and comprehensive overview is lacking .
The aim of this systematic review is to examine the evidence and describe key components of effective interventions in terms of improving body composition , dietary behaviors , and physical activity among active-duty military personnel .
| 48,810 | 22,001,689 |
The efficacy and cost-effectiveness of a community weight management intervention: a randomized controlled trial of the health weight management demonstration.
|
PURPOSE The study investigated the efficacy and cost-effectiveness of a cognitive-behavioral weight management program , complemented by an interactive Web site and brief telephone/e-mail coaching . METHODS In 2006 - 2007 , 1755 overweight , non-active-duty TRICARE beneficiaries were r and omized to one of three conditions with increasing intervention intensity : written material s and basic Web access ( RCT 1 ) , plus an interactive Web site ( RCT 2 ) , plus brief telephone/e-mail coaching support ( RCT 3 ) . The study assessed changes in weight , blood pressure , and physical activity from baseline to 6 , 12 , and 15 - 18 months . ( Study retention was 31 % at 12 months . ) Average and incremental cost-effectiveness and cost-offset analyses were conducted . RESULTS Participants experienced significant weight loss ( -4.0 % , -4.0 % , and -5.3 % , respectively , in each RCT group after 12 months and -3.5 % , -3.8 % , and -5.1 % , respectively , after 15 to 18 months ) , increased physical activity , and decreased blood pressure . Cost-effectiveness ratios were $ 900 to $ 1100/ quality -adjusted life year ( QALY ) for RCT 1 and RCT 2 and $ 1900/QALY for RCT 3 . The cost recovery period to the government was 3 years for RCTs 1 and 2 and 6 years for RCT 3 . CONCLUSION A relatively inexpensive cognitive-behavioral weight management intervention improved patient outcomes . Extrapolation of savings for the entire TRICARE population would significantly reduce direct medical costs
| 2,010 |
Results Based on consistent evidence from studies that were rated as moderate or strong , there is good evidence that military weight management interventions are effective in improving body composition for duration s of up to 12 months .
Effective interventions are more likely to be high intensity ( have a greater number of sessions ) , are more often delivered by specialists , and use theoretical base/behavioral change techniques and a st and ardized guideline .
Dietary interventions can potentially reduce total fat and saturated fat intake .
Dietary interventions that target the kitchen staff and /or increase the availability of healthy food are more likely to be effective in the short term .
The results regarding military physical fitness interventions were inconclusive .
Conclusion Despite limitations such as the diversity and heterogeneity of the included interventions , outcome measurements , and follow-up duration , this systematic review found good evidence that weight management interventions are effective , especially in terms of weight loss .
|
Background Research has been conducted to assess the effectiveness of weight management , dietary and physical activity interventions in military setting s. However , a recent and comprehensive overview is lacking .
The aim of this systematic review is to examine the evidence and describe key components of effective interventions in terms of improving body composition , dietary behaviors , and physical activity among active-duty military personnel .
|
2,010 | 30,591,077 |
Results Based on consistent evidence from studies that were rated as moderate or strong , there is good evidence that military weight management interventions are effective in improving body composition for duration s of up to 12 months .
Effective interventions are more likely to be high intensity ( have a greater number of sessions ) , are more often delivered by specialists , and use theoretical base/behavioral change techniques and a st and ardized guideline .
Dietary interventions can potentially reduce total fat and saturated fat intake .
Dietary interventions that target the kitchen staff and /or increase the availability of healthy food are more likely to be effective in the short term .
The results regarding military physical fitness interventions were inconclusive .
Conclusion Despite limitations such as the diversity and heterogeneity of the included interventions , outcome measurements , and follow-up duration , this systematic review found good evidence that weight management interventions are effective , especially in terms of weight loss .
|
Background Research has been conducted to assess the effectiveness of weight management , dietary and physical activity interventions in military setting s. However , a recent and comprehensive overview is lacking .
The aim of this systematic review is to examine the evidence and describe key components of effective interventions in terms of improving body composition , dietary behaviors , and physical activity among active-duty military personnel .
| 48,811 | 7,594,122 |
Use of the Food Guide Pyramid and US Dietary Guidelines to improve dietary intake and reduce cardiovascular risk in active-duty Air Force members.
|
OBJECTIVE To determine whether adoption of dietary patterns consistent with the US Dietary Guidelines for Americans and the Food Guide Pyramid , combined with exercise training , result in significant reductions in cardiovascular risk compared with a regimen of exercise therapy alone . DESIGN A r and omized trial to compare the effects of exercise alone ( n = 17 ) with the effects of exercise and dietary intervention ( n = 15 ) . SETTING McClellan Air Force Base medical clinic ( Sacramento , Calif ) . SUBJECTS Thirty-two members of the Air Force ( 20 men and 12 women ) were recruited at the time they entered a 90-day fitness improvement program . Mean age was 32 years . INTERVENTION All subjects participated in a 90-day fitness program . Half of the group received individualized dietary counseling using the Food Guide Pyramid as a primary educational tool . MAIN OUTCOME MEASURES Changes in body mass index , plasma lipids and lipoprotein levels , aerobic capacity , and dietary intake were selected to evaluate the effectiveness of the intervention . STATISTICAL ANALYSES PERFORMED Outcome measures were evaluated by analysis of variance . A paired t test was performed to compare changes in food-group servings and food-group fat intake from baseline values for the exercise-plus-diet group . RESULTS Percentage of energy from fat decreased from 39 % to 23 % for the exercise-plus-diet group , and servings from each of the food groups changed to reflect current guidelines . This group also had significant reductions in body mass index , total cholesterol level , and low-density lipoprotein level : 2 % ( P = .0001 ) , 9 % ( P = .003 ) , and 13 % ( P = .005 ) , respectively . No change was observed for the exercise-only group . Additionally , a significant improvement in maximum oxygen consumption ( P = .01 ) of 38 % ( vs 14 % for the control group ) was achieved . CONCLUSIONS Dietary modification in accordance with the Food Guide Pyramid and the US Dietary Guidelines results in significant reductions in known cardiovascular risk factors and improves the response to exercise training
| 2,010 |
Results Based on consistent evidence from studies that were rated as moderate or strong , there is good evidence that military weight management interventions are effective in improving body composition for duration s of up to 12 months .
Effective interventions are more likely to be high intensity ( have a greater number of sessions ) , are more often delivered by specialists , and use theoretical base/behavioral change techniques and a st and ardized guideline .
Dietary interventions can potentially reduce total fat and saturated fat intake .
Dietary interventions that target the kitchen staff and /or increase the availability of healthy food are more likely to be effective in the short term .
The results regarding military physical fitness interventions were inconclusive .
Conclusion Despite limitations such as the diversity and heterogeneity of the included interventions , outcome measurements , and follow-up duration , this systematic review found good evidence that weight management interventions are effective , especially in terms of weight loss .
|
Background Research has been conducted to assess the effectiveness of weight management , dietary and physical activity interventions in military setting s. However , a recent and comprehensive overview is lacking .
The aim of this systematic review is to examine the evidence and describe key components of effective interventions in terms of improving body composition , dietary behaviors , and physical activity among active-duty military personnel .
|
2,010 | 30,591,077 |
Results Based on consistent evidence from studies that were rated as moderate or strong , there is good evidence that military weight management interventions are effective in improving body composition for duration s of up to 12 months .
Effective interventions are more likely to be high intensity ( have a greater number of sessions ) , are more often delivered by specialists , and use theoretical base/behavioral change techniques and a st and ardized guideline .
Dietary interventions can potentially reduce total fat and saturated fat intake .
Dietary interventions that target the kitchen staff and /or increase the availability of healthy food are more likely to be effective in the short term .
The results regarding military physical fitness interventions were inconclusive .
Conclusion Despite limitations such as the diversity and heterogeneity of the included interventions , outcome measurements , and follow-up duration , this systematic review found good evidence that weight management interventions are effective , especially in terms of weight loss .
|
Background Research has been conducted to assess the effectiveness of weight management , dietary and physical activity interventions in military setting s. However , a recent and comprehensive overview is lacking .
The aim of this systematic review is to examine the evidence and describe key components of effective interventions in terms of improving body composition , dietary behaviors , and physical activity among active-duty military personnel .
| 48,812 | 21,634,310 |
A pedometer-based intervention to improve physical activity, fitness, and coronary heart disease risk in National Guard personnel.
|
To compare the effects of a pedometer-based behavioral intervention ( Fitness for Life [ FFL ] program ) and a traditional high-intensity fitness ( TRAD ) program on physical activity ( PA ) , Army Physical Fitness Test ( APFT ) , and coronary heart disease risk factors in Army National Guard members who failed the APFT 2-mile run . From a pool of 261 Army National Guard , a total of 156 were r and omized to TRAD or FFL for 24 weeks consisting of a 12-week progressive conditioning program followed by 12 weeks of maintenance . For both groups , the total APFT score and 2-mile run time/score improved from baseline to 12 weeks ( FFL : down 7.4 % , p = 0.03 ; TRAD : down 5 % , p = 0.08 ) but at 24 weeks they had regressed toward baseline . PA improved modestly and coronary risk profile changed minimally in both groups . A pedometer-based exercise intervention had results similar to a high-intensity program for improving PA , APFT , and 2-mile run times/score . Neither group sustained the improved run times over the 12 weeks of maintenance
| 2,010 |
Results Based on consistent evidence from studies that were rated as moderate or strong , there is good evidence that military weight management interventions are effective in improving body composition for duration s of up to 12 months .
Effective interventions are more likely to be high intensity ( have a greater number of sessions ) , are more often delivered by specialists , and use theoretical base/behavioral change techniques and a st and ardized guideline .
Dietary interventions can potentially reduce total fat and saturated fat intake .
Dietary interventions that target the kitchen staff and /or increase the availability of healthy food are more likely to be effective in the short term .
The results regarding military physical fitness interventions were inconclusive .
Conclusion Despite limitations such as the diversity and heterogeneity of the included interventions , outcome measurements , and follow-up duration , this systematic review found good evidence that weight management interventions are effective , especially in terms of weight loss .
|
Background Research has been conducted to assess the effectiveness of weight management , dietary and physical activity interventions in military setting s. However , a recent and comprehensive overview is lacking .
The aim of this systematic review is to examine the evidence and describe key components of effective interventions in terms of improving body composition , dietary behaviors , and physical activity among active-duty military personnel .
|
2,010 | 30,591,077 |
Results Based on consistent evidence from studies that were rated as moderate or strong , there is good evidence that military weight management interventions are effective in improving body composition for duration s of up to 12 months .
Effective interventions are more likely to be high intensity ( have a greater number of sessions ) , are more often delivered by specialists , and use theoretical base/behavioral change techniques and a st and ardized guideline .
Dietary interventions can potentially reduce total fat and saturated fat intake .
Dietary interventions that target the kitchen staff and /or increase the availability of healthy food are more likely to be effective in the short term .
The results regarding military physical fitness interventions were inconclusive .
Conclusion Despite limitations such as the diversity and heterogeneity of the included interventions , outcome measurements , and follow-up duration , this systematic review found good evidence that weight management interventions are effective , especially in terms of weight loss .
|
Background Research has been conducted to assess the effectiveness of weight management , dietary and physical activity interventions in military setting s. However , a recent and comprehensive overview is lacking .
The aim of this systematic review is to examine the evidence and describe key components of effective interventions in terms of improving body composition , dietary behaviors , and physical activity among active-duty military personnel .
| 48,813 | 18,201,641 |
Weight management using the internet a randomized controlled trial.
|
BACKGROUND Most weight-loss research targets obese individuals who desire large weight reductions . However , evaluation of weight-gain prevention in overweight individuals is also critical as most Americans become obese as a result of a gradual gain of 1 - 2 pounds per year over many years . METHOD This study evaluated the efficacy of an Internet-based program for weight-loss and weight-gain prevention with a two-group , prospect i ve , r and omized controlled trial . A military medical research center with a population of 17,000 active-duty military personnel supplied 446 overweight individuals ( 222 men ; 224 women ) with a mean age of 34 years and a mean BMI of 29 . Recruitment and study participation occurred 2003 - 2005 and data were analyzed in 2006 . Participants were r and omly assigned to receive the 6-month behavioral Internet treatment ( BIT , n=227 ) or usual care ( n=224 ) . Change in body weight , BMI , percent body fat , and waist circumference ; presented as group by time interactions , were measured . RESULTS After 6 months , completers who received BIT lost 1.3 kg while those assigned to usual care gained 0.6 kg ( F((df=366))=24.17 ; I<0.001 ) . Results were similar for the intention-to-treat model . BIT participants also had significant changes in BMI ( -0.5 vs + 0.2 kg/m(2 ) ; F((df=366))=24.58 ) ; percent body fat ( -0.4 vs + 0.6 % ; F((df=366))=10.45 ) ; and waist circumference ( -2.1 vs -0.4 cm ; F((df=366))=17.09 ) ; p<0.001 for all . CONCLUSIONS Internet-based weight-management interventions result in small amounts of weight loss , prevent weight gain , and have potential for widespread dissemination as a population health approach . TRIAL REGISTRATION NCT00417599
| 2,010 |
Results Based on consistent evidence from studies that were rated as moderate or strong , there is good evidence that military weight management interventions are effective in improving body composition for duration s of up to 12 months .
Effective interventions are more likely to be high intensity ( have a greater number of sessions ) , are more often delivered by specialists , and use theoretical base/behavioral change techniques and a st and ardized guideline .
Dietary interventions can potentially reduce total fat and saturated fat intake .
Dietary interventions that target the kitchen staff and /or increase the availability of healthy food are more likely to be effective in the short term .
The results regarding military physical fitness interventions were inconclusive .
Conclusion Despite limitations such as the diversity and heterogeneity of the included interventions , outcome measurements , and follow-up duration , this systematic review found good evidence that weight management interventions are effective , especially in terms of weight loss .
|
Background Research has been conducted to assess the effectiveness of weight management , dietary and physical activity interventions in military setting s. However , a recent and comprehensive overview is lacking .
The aim of this systematic review is to examine the evidence and describe key components of effective interventions in terms of improving body composition , dietary behaviors , and physical activity among active-duty military personnel .
|
2,010 | 30,591,077 |
Results Based on consistent evidence from studies that were rated as moderate or strong , there is good evidence that military weight management interventions are effective in improving body composition for duration s of up to 12 months .
Effective interventions are more likely to be high intensity ( have a greater number of sessions ) , are more often delivered by specialists , and use theoretical base/behavioral change techniques and a st and ardized guideline .
Dietary interventions can potentially reduce total fat and saturated fat intake .
Dietary interventions that target the kitchen staff and /or increase the availability of healthy food are more likely to be effective in the short term .
The results regarding military physical fitness interventions were inconclusive .
Conclusion Despite limitations such as the diversity and heterogeneity of the included interventions , outcome measurements , and follow-up duration , this systematic review found good evidence that weight management interventions are effective , especially in terms of weight loss .
|
Background Research has been conducted to assess the effectiveness of weight management , dietary and physical activity interventions in military setting s. However , a recent and comprehensive overview is lacking .
The aim of this systematic review is to examine the evidence and describe key components of effective interventions in terms of improving body composition , dietary behaviors , and physical activity among active-duty military personnel .
| 48,814 | 16,808,141 |
A low-intensity intervention to prevent annual weight gain in active duty Air Force members.
|
Elevated body weight among active duty Air Force ( ADAF ) members is a substantial and growing problem , and typically results from gaining small amounts of weight each year over many years . We design ed a strategy to prevent annual weight gain in ADAF members using self-directed behavior change booklets followed by weekly e-mails about diet and physical activity for a year . The intervention was universally offered to ADAF members meeting selection criteria at five U.S. Air Force bases ( n = 3,502 ) ; members at 60 other U.S. Air Force bases served as controls ( n = 65,089 ) . The intervention was completely effective at preventing weight gain in a subgroup of men ( those above the lowest three ranks , with baseline weight above maximum allowable ) and in women , while controls continued to gain weight . Since the intervention did not require personalized contact , this approach has promise for large-scale population -based efforts aim ed at preventing weight gain in working adults
| 2,010 |
Results Based on consistent evidence from studies that were rated as moderate or strong , there is good evidence that military weight management interventions are effective in improving body composition for duration s of up to 12 months .
Effective interventions are more likely to be high intensity ( have a greater number of sessions ) , are more often delivered by specialists , and use theoretical base/behavioral change techniques and a st and ardized guideline .
Dietary interventions can potentially reduce total fat and saturated fat intake .
Dietary interventions that target the kitchen staff and /or increase the availability of healthy food are more likely to be effective in the short term .
The results regarding military physical fitness interventions were inconclusive .
Conclusion Despite limitations such as the diversity and heterogeneity of the included interventions , outcome measurements , and follow-up duration , this systematic review found good evidence that weight management interventions are effective , especially in terms of weight loss .
|
Background Research has been conducted to assess the effectiveness of weight management , dietary and physical activity interventions in military setting s. However , a recent and comprehensive overview is lacking .
The aim of this systematic review is to examine the evidence and describe key components of effective interventions in terms of improving body composition , dietary behaviors , and physical activity among active-duty military personnel .
|
2,010 | 30,591,077 |
Results Based on consistent evidence from studies that were rated as moderate or strong , there is good evidence that military weight management interventions are effective in improving body composition for duration s of up to 12 months .
Effective interventions are more likely to be high intensity ( have a greater number of sessions ) , are more often delivered by specialists , and use theoretical base/behavioral change techniques and a st and ardized guideline .
Dietary interventions can potentially reduce total fat and saturated fat intake .
Dietary interventions that target the kitchen staff and /or increase the availability of healthy food are more likely to be effective in the short term .
The results regarding military physical fitness interventions were inconclusive .
Conclusion Despite limitations such as the diversity and heterogeneity of the included interventions , outcome measurements , and follow-up duration , this systematic review found good evidence that weight management interventions are effective , especially in terms of weight loss .
|
Background Research has been conducted to assess the effectiveness of weight management , dietary and physical activity interventions in military setting s. However , a recent and comprehensive overview is lacking .
The aim of this systematic review is to examine the evidence and describe key components of effective interventions in terms of improving body composition , dietary behaviors , and physical activity among active-duty military personnel .
| 48,815 | 8,857,219 |
A comprehensive weight-loss program for soldiers.
|
A weight-loss treatment program for active duty military personnel is discussed and evaluated . The Fat Loss and Exercise Program at U.S. Army Hospital , Bremerhaven , Germany , consisted of a 3-week inpatient treatment program and 6 months of weekly outpatient follow-up . The program combined a multidisciplinary team approach to the treatment of obesity -- psychology , internal medicine , nursing , nutrition care , and physical therapy . Patients showed a significant weight and body fat loss [ F(2,90 ) = 52.91 and 65.85 , p < 0.001 , respectively ] from the initiation of treatment ( mean = 205.9 pounds , 28.91 % ) to the end of the inpatient program ( mean = 192.8 pounds , 25.97 % ) with maintenance over 6 months ( mean = 190.4 pounds , 25.03 % ) . Changes in cholesterol levels by treatment phase are also discussed . Results demonstrate positive increases in high-density lipoprotein at each phase . These results support a comprehensive , multidisciplinary inpatient treatment of obesity within the military
| 2,010 |
Results Based on consistent evidence from studies that were rated as moderate or strong , there is good evidence that military weight management interventions are effective in improving body composition for duration s of up to 12 months .
Effective interventions are more likely to be high intensity ( have a greater number of sessions ) , are more often delivered by specialists , and use theoretical base/behavioral change techniques and a st and ardized guideline .
Dietary interventions can potentially reduce total fat and saturated fat intake .
Dietary interventions that target the kitchen staff and /or increase the availability of healthy food are more likely to be effective in the short term .
The results regarding military physical fitness interventions were inconclusive .
Conclusion Despite limitations such as the diversity and heterogeneity of the included interventions , outcome measurements , and follow-up duration , this systematic review found good evidence that weight management interventions are effective , especially in terms of weight loss .
|
Background Research has been conducted to assess the effectiveness of weight management , dietary and physical activity interventions in military setting s. However , a recent and comprehensive overview is lacking .
The aim of this systematic review is to examine the evidence and describe key components of effective interventions in terms of improving body composition , dietary behaviors , and physical activity among active-duty military personnel .
|
2,010 | 30,591,077 |
Results Based on consistent evidence from studies that were rated as moderate or strong , there is good evidence that military weight management interventions are effective in improving body composition for duration s of up to 12 months .
Effective interventions are more likely to be high intensity ( have a greater number of sessions ) , are more often delivered by specialists , and use theoretical base/behavioral change techniques and a st and ardized guideline .
Dietary interventions can potentially reduce total fat and saturated fat intake .
Dietary interventions that target the kitchen staff and /or increase the availability of healthy food are more likely to be effective in the short term .
The results regarding military physical fitness interventions were inconclusive .
Conclusion Despite limitations such as the diversity and heterogeneity of the included interventions , outcome measurements , and follow-up duration , this systematic review found good evidence that weight management interventions are effective , especially in terms of weight loss .
|
Background Research has been conducted to assess the effectiveness of weight management , dietary and physical activity interventions in military setting s. However , a recent and comprehensive overview is lacking .
The aim of this systematic review is to examine the evidence and describe key components of effective interventions in terms of improving body composition , dietary behaviors , and physical activity among active-duty military personnel .
| 48,816 | 23,787,560 |
Obesity Intervention During a Work Health Promotion: The Obesity Intervention Program of the German Military Forces
|
Objectives : The aim of the Obesity Intervention Program of the German Army was to enhance physical activity levels , to adjust diet behavior , and to reduce risk factors in out patients over a period of 24 months . Methods : The data of the participants in the outpatient intervention from 2003 till 2011 were analyzed . Results : In total , 665 participants took part . All examined parameters were improved by the intervention , already in the second follow-up , significant for all parameters . A total of 12.2 % of all patients reduced their body weight by 5 % , and 8.4 % by 10 % . Conclusions : A significant improvement in all examined parameters was found . With respect to the fact that the participants of this Obesity Intervention Program were only military servicemen and servicewomen , it should be tested if the program can be transferred on work health promotions outside the military
| 2,010 |
Results Based on consistent evidence from studies that were rated as moderate or strong , there is good evidence that military weight management interventions are effective in improving body composition for duration s of up to 12 months .
Effective interventions are more likely to be high intensity ( have a greater number of sessions ) , are more often delivered by specialists , and use theoretical base/behavioral change techniques and a st and ardized guideline .
Dietary interventions can potentially reduce total fat and saturated fat intake .
Dietary interventions that target the kitchen staff and /or increase the availability of healthy food are more likely to be effective in the short term .
The results regarding military physical fitness interventions were inconclusive .
Conclusion Despite limitations such as the diversity and heterogeneity of the included interventions , outcome measurements , and follow-up duration , this systematic review found good evidence that weight management interventions are effective , especially in terms of weight loss .
|
Background Research has been conducted to assess the effectiveness of weight management , dietary and physical activity interventions in military setting s. However , a recent and comprehensive overview is lacking .
The aim of this systematic review is to examine the evidence and describe key components of effective interventions in terms of improving body composition , dietary behaviors , and physical activity among active-duty military personnel .
|
2,010 | 30,591,077 |
Results Based on consistent evidence from studies that were rated as moderate or strong , there is good evidence that military weight management interventions are effective in improving body composition for duration s of up to 12 months .
Effective interventions are more likely to be high intensity ( have a greater number of sessions ) , are more often delivered by specialists , and use theoretical base/behavioral change techniques and a st and ardized guideline .
Dietary interventions can potentially reduce total fat and saturated fat intake .
Dietary interventions that target the kitchen staff and /or increase the availability of healthy food are more likely to be effective in the short term .
The results regarding military physical fitness interventions were inconclusive .
Conclusion Despite limitations such as the diversity and heterogeneity of the included interventions , outcome measurements , and follow-up duration , this systematic review found good evidence that weight management interventions are effective , especially in terms of weight loss .
|
Background Research has been conducted to assess the effectiveness of weight management , dietary and physical activity interventions in military setting s. However , a recent and comprehensive overview is lacking .
The aim of this systematic review is to examine the evidence and describe key components of effective interventions in terms of improving body composition , dietary behaviors , and physical activity among active-duty military personnel .
| 48,817 | 20,370,312 |
Economic evaluation of an Internet-based weight management program.
|
OBJECTIVE To determine whether a behavioral Internet treatment ( BIT ) program for weight management is a viable , cost-effective option compared with usual care ( UC ) in a diverse sample of overweight ( average body mass index = 29 kg/m2 ) , healthy adults ( mean age = 34 years ) serving in the US Air Force . STUDY DESIGN Two-group parallel r and omized controlled trial . METHODS Participants were r and omly assigned into 2 groups : UC ( n = 215 ) and UC plus BIT ( n = 227 ) . Baseline and 6-month assessment s were included in the analyses . Primary outcome measures ( changes in body weight , percent body fat , and waist circumference ) and secondary outcome measures ( Weight Efficacy Lifestyle [ WEL ] question naire ) were included in an incremental cost-effectiveness analysis ( ICEA ) model . Costs were computed using the perspective of an agency wanting to replicate the intervention . Sensitivity analyses were performed to measure the robustness of models . RESULTS Overall cost for BIT intervention was $ 11,178.40 , or $ 49.24 per BIT participant . Total staff-time cost was $ 14.03 per BIT participant . Intervention cost was $ 25.92 per kilogram of weight loss and $ 28.96 per centimeter of waist-circumference loss . The cost was $ 37.88 for each additional point gained on the WEL subscale , where increasing scores indicate increased confidence in managing social pressures to eat . CONCLUSIONS The BIT program is a cost-effective choice for weight management . It may cost more initially , but it results in long-term cost savings . Such cost-effective , Internet-based behavioral interventions for weight management could provide a valuable tool for preventive care aim ed at improving individual and societal health
| 2,010 |
Results Based on consistent evidence from studies that were rated as moderate or strong , there is good evidence that military weight management interventions are effective in improving body composition for duration s of up to 12 months .
Effective interventions are more likely to be high intensity ( have a greater number of sessions ) , are more often delivered by specialists , and use theoretical base/behavioral change techniques and a st and ardized guideline .
Dietary interventions can potentially reduce total fat and saturated fat intake .
Dietary interventions that target the kitchen staff and /or increase the availability of healthy food are more likely to be effective in the short term .
The results regarding military physical fitness interventions were inconclusive .
Conclusion Despite limitations such as the diversity and heterogeneity of the included interventions , outcome measurements , and follow-up duration , this systematic review found good evidence that weight management interventions are effective , especially in terms of weight loss .
|
Background Research has been conducted to assess the effectiveness of weight management , dietary and physical activity interventions in military setting s. However , a recent and comprehensive overview is lacking .
The aim of this systematic review is to examine the evidence and describe key components of effective interventions in terms of improving body composition , dietary behaviors , and physical activity among active-duty military personnel .
|
2,010 | 30,591,077 |
Results Based on consistent evidence from studies that were rated as moderate or strong , there is good evidence that military weight management interventions are effective in improving body composition for duration s of up to 12 months .
Effective interventions are more likely to be high intensity ( have a greater number of sessions ) , are more often delivered by specialists , and use theoretical base/behavioral change techniques and a st and ardized guideline .
Dietary interventions can potentially reduce total fat and saturated fat intake .
Dietary interventions that target the kitchen staff and /or increase the availability of healthy food are more likely to be effective in the short term .
The results regarding military physical fitness interventions were inconclusive .
Conclusion Despite limitations such as the diversity and heterogeneity of the included interventions , outcome measurements , and follow-up duration , this systematic review found good evidence that weight management interventions are effective , especially in terms of weight loss .
|
Background Research has been conducted to assess the effectiveness of weight management , dietary and physical activity interventions in military setting s. However , a recent and comprehensive overview is lacking .
The aim of this systematic review is to examine the evidence and describe key components of effective interventions in terms of improving body composition , dietary behaviors , and physical activity among active-duty military personnel .
| 48,818 | 27,007,300 |
Effects of an energy balance educational intervention and the COPE cognitive behavioral therapy intervention for Division I U.S. Air Force Academy female athletes
|
Background and purpose : Female athletes struggle harder than male athletes to lose body fat and maintain a leaner physique . The purpose of this study was to determine the effects of an educational and cognitive behavioral therapy (CBT)‐based intervention on knowledge , body composition , anxiety , stress , and nutritional intake . Methods : A r and omized controlled trial was conducted with 153 female athletes from the U.S. Air Force Academy ( USAFA ) . Participants were assigned to one of three groups : ( a ) a combined energy balance and CBT‐based intervention ( E1 ) ; ( b ) a CBT‐based intervention alone ( E2 ) ; and ( c ) a control group ( C ) . Main outcomes included a DXA scan for body composition , a knowledge test , the GAD‐7 for anxiety , the brief inventory of perceived stress ( BIPS ) for stress , and a 24‐h food recall . Findings : Significant improvement on knowledge of energy balance occurred in all three groups E1 ( p < .001 ) , E2 , and C ( p < .05 ) . Significant reductions in percentage of body fat occurred in E1 ( p < .001 ) and E2 ( p < .05 ) . There also were significant reductions in the percent of fat consumed by E1 ( p < .05 ) and saturated fat consumed by both E1 and E2 ( p < .05 ) . The control group only demonstrated a significant increase in stress as measured by the BIPS ( p < .05 ) . Conclusions : A combined energy balance and CBT‐based intervention improves knowledge and body fat . Implication s : The importance to assess knowledge , anxiety , stress , nutrition intake , and percentage of body fat in female athletes and to deliver evidence ‐based interventions to improve their health outcomes
| 2,010 |
Results Based on consistent evidence from studies that were rated as moderate or strong , there is good evidence that military weight management interventions are effective in improving body composition for duration s of up to 12 months .
Effective interventions are more likely to be high intensity ( have a greater number of sessions ) , are more often delivered by specialists , and use theoretical base/behavioral change techniques and a st and ardized guideline .
Dietary interventions can potentially reduce total fat and saturated fat intake .
Dietary interventions that target the kitchen staff and /or increase the availability of healthy food are more likely to be effective in the short term .
The results regarding military physical fitness interventions were inconclusive .
Conclusion Despite limitations such as the diversity and heterogeneity of the included interventions , outcome measurements , and follow-up duration , this systematic review found good evidence that weight management interventions are effective , especially in terms of weight loss .
|
Background Research has been conducted to assess the effectiveness of weight management , dietary and physical activity interventions in military setting s. However , a recent and comprehensive overview is lacking .
The aim of this systematic review is to examine the evidence and describe key components of effective interventions in terms of improving body composition , dietary behaviors , and physical activity among active-duty military personnel .
|
2,011 | 21,251,757 |
That is , persons with acute or subacute LBP appear to vary in the levels of physical activity independent of their pain-related disability .
Persons with chronic LBP with high levels of disability are also likely to have low levels of physical activity .
Persons with acute or subacute back pain appear to vary in the levels of physical activity independent of disability .
Persons with chronic back pain with high levels of disability will likely have low levels of physical activity
|
It is often assumed that patients with pain-related disability due to low back pain ( LBP ) will have reduced physical activity levels , but recent studies have provided results that challenge this assumption .
The aim of our systematic review was to examine the relationship between physical activity and disability in LBP .
| 48,819 | 2,409,320 |
Motor control or graded activity exercises for chronic low back pain? A randomised controlled trial
|
Background Chronic low back pain remains a major health problem in Australia and around the world . Unfortunately the majority of treatments for this condition produce small effects because not all patients respond to each treatment . It appears that only 25–50 % of patients respond to exercise . The two most popular types of exercise for low back pain are grade d activity and motor control exercises . At present however , there are no guidelines to help clinicians select the best treatment for a patient . As a result , time and money are wasted on treatments which ultimately fail to help the patient . Methods This paper describes the protocol of a r and omised clinical trial comparing the effects of motor control exercises with a grade d activity program in the treatment of chronic non specific low back pain . Further analysis will identify clinical features that may predict a patient 's response to each treatment . One hundred and seventy two participants will be r and omly allocated to receive either a program of motor control exercises or grade d activity . Measures of outcome will be obtained at 2 , 6 and 12 months after r and omisation . The primary outcomes are : pain ( average pain intensity over the last week ) and function ( patient-specific functional scale ) at 2 and 6 months . Potential treatment effect modifiers will be measured at baseline . Discussion This trial will not only evaluate which exercise approach is more effective in general for patients will chronic low back pain , but will also determine which exercise approach is best for an individual patient . Trial registration
| 2,011 |
That is , persons with acute or subacute LBP appear to vary in the levels of physical activity independent of their pain-related disability .
Persons with chronic LBP with high levels of disability are also likely to have low levels of physical activity .
Persons with acute or subacute back pain appear to vary in the levels of physical activity independent of disability .
Persons with chronic back pain with high levels of disability will likely have low levels of physical activity
|
It is often assumed that patients with pain-related disability due to low back pain ( LBP ) will have reduced physical activity levels , but recent studies have provided results that challenge this assumption .
The aim of our systematic review was to examine the relationship between physical activity and disability in LBP .
|
2,011 | 21,251,757 |
That is , persons with acute or subacute LBP appear to vary in the levels of physical activity independent of their pain-related disability .
Persons with chronic LBP with high levels of disability are also likely to have low levels of physical activity .
Persons with acute or subacute back pain appear to vary in the levels of physical activity independent of disability .
Persons with chronic back pain with high levels of disability will likely have low levels of physical activity
|
It is often assumed that patients with pain-related disability due to low back pain ( LBP ) will have reduced physical activity levels , but recent studies have provided results that challenge this assumption .
The aim of our systematic review was to examine the relationship between physical activity and disability in LBP .
| 48,820 | 9,885,030 |
Effects of a Three-Month Active Rehabilitation Program on Psychomotor Performance of Lower Limbs in Subjects with Low Back Pain: A Controlled Study with a Nine-Month Follow-up
|
Proper psychomotor performance is needed in work and in activities of daily living , but among subjects with low back pain this area has been studied Little . The present purpose was to evaluate the effect and permanence of a 3-mo . physical exercise program on the psychomotor performance of lower limbs in subjects with low back pain . The associations between psychomotor performance and intensity of low back pain and subjective disability were also evaluated . 90 subjects with nonspecific , subacute low back pain were assigned to one of the three groups : one given three months intensive training , one home exercise , or the control group . Four measurement sessions were made during the 1-yr . study . Psychomotor speed of lower limbs was analyzed with Choice Reaction Time , Movement Time , and Total Response Time . Flight Time of a vertical static jump was also measured . Muscle strength was assessed with conventional methods from trunk , lower limbs , and h and . Intensity of Current Back Pain was analyzed with the Borg scale . Subjective disability was evaluated with the Oswestry Index . Analysis showed that muscle strength and back pain intensity had associations with psychomotor performance but subjective disability or physical activity did not affect it noticeably . There were no changes in Choice Reaction Time , but Total Response Time and Movement Time decreased and Flight Time increased for all subjects . In the first postintervention measurement the home exercise group had significantly lower Movement Time than the intensively trained group . Back Pain Intensity decreased in both exercise groups for those subjects whose psychomotor performance values were below the mean value for the sample
| 2,011 |
That is , persons with acute or subacute LBP appear to vary in the levels of physical activity independent of their pain-related disability .
Persons with chronic LBP with high levels of disability are also likely to have low levels of physical activity .
Persons with acute or subacute back pain appear to vary in the levels of physical activity independent of disability .
Persons with chronic back pain with high levels of disability will likely have low levels of physical activity
|
It is often assumed that patients with pain-related disability due to low back pain ( LBP ) will have reduced physical activity levels , but recent studies have provided results that challenge this assumption .
The aim of our systematic review was to examine the relationship between physical activity and disability in LBP .
|
2,011 | 21,251,757 |
That is , persons with acute or subacute LBP appear to vary in the levels of physical activity independent of their pain-related disability .
Persons with chronic LBP with high levels of disability are also likely to have low levels of physical activity .
Persons with acute or subacute back pain appear to vary in the levels of physical activity independent of disability .
Persons with chronic back pain with high levels of disability will likely have low levels of physical activity
|
It is often assumed that patients with pain-related disability due to low back pain ( LBP ) will have reduced physical activity levels , but recent studies have provided results that challenge this assumption .
The aim of our systematic review was to examine the relationship between physical activity and disability in LBP .
| 48,821 | 2,777,147 |
Does physical activity change predict functional recovery in low back pain? Protocol for a prospective cohort study
|
Background Activity advice and prescription are commonly used in the management of low back pain ( LBP ) . Although there is evidence for advising patients with LBP to remain active , facilitating both recovery and return to work , to date no research has assessed whether objective measurements of free living physical activity ( PA ) can predict outcome , recovery and course of LBP . Methods An observational longitudinal study will investigate PA levels in a cohort of community-dwelling working age adults with acute and sub-acute LBP . Each participant 's PA level , functional status , mood , fear avoidance behaviours , and levels of pain , psychological distress and occupational activity will be measured on three occasions during for 1 week periods at baseline , 3 months , and 1 year . Physical activity levels will be measured by self report , RT3 triaxial accelerometer , and activity recall question naires . The primary outcome measure of functional recovery will be the Rol and Morris Disability Question naire ( RMDQ ) . Free living PA levels and changes in functional status will be quantified in order to look at predictive relationships between levels and changes in free living PA and functional recovery in a LBP population . Discussion This research will investigate levels and changes in activity levels of an acute LBP cohort and the predictive relationship to LBP recovery . The results will assess whether occupational , psychological and behavioural factors affect the relationship between free living PA and LBP recovery . Results from this research will help to determine the strength of evidence supporting international guidelines that recommend restoration of normal activity in managing LBP.Trial registration [ Clinical Trial Registration Number , ACTRN12609000282280
| 2,011 |
That is , persons with acute or subacute LBP appear to vary in the levels of physical activity independent of their pain-related disability .
Persons with chronic LBP with high levels of disability are also likely to have low levels of physical activity .
Persons with acute or subacute back pain appear to vary in the levels of physical activity independent of disability .
Persons with chronic back pain with high levels of disability will likely have low levels of physical activity
|
It is often assumed that patients with pain-related disability due to low back pain ( LBP ) will have reduced physical activity levels , but recent studies have provided results that challenge this assumption .
The aim of our systematic review was to examine the relationship between physical activity and disability in LBP .
|
2,011 | 21,251,757 |
That is , persons with acute or subacute LBP appear to vary in the levels of physical activity independent of their pain-related disability .
Persons with chronic LBP with high levels of disability are also likely to have low levels of physical activity .
Persons with acute or subacute back pain appear to vary in the levels of physical activity independent of disability .
Persons with chronic back pain with high levels of disability will likely have low levels of physical activity
|
It is often assumed that patients with pain-related disability due to low back pain ( LBP ) will have reduced physical activity levels , but recent studies have provided results that challenge this assumption .
The aim of our systematic review was to examine the relationship between physical activity and disability in LBP .
| 48,822 | 1,382,224 |
Active rehabilitation for chronic low back pain: Cognitive-behavioral, physical, or both? First direct post-treatment results from a randomized controlled trial [ISRCTN22714229]
|
Background The treatment of non-specific chronic low back pain is often based on three different models regarding the development and maintenance of pain and especially functional limitations : the deconditioning model , the cognitive behavioral model and the biopsychosocial model . There is evidence that rehabilitation of patients with chronic low back pain is more effective than no treatment , but information is lacking about the differential effectiveness of different kinds of rehabilitation . A direct comparison of a physical , a cognitive-behavioral treatment and a combination of both has never been carried out so far . Methods The effectiveness of active physical , cognitive-behavioral and combined treatment for chronic non-specific low back pain compared with a waiting list control group was determined by performing a r and omized controlled trial in three rehabilitation centers . Two hundred and twenty three patients were r and omized , using concealed block r and omization to one of the following treatments , which they attended three times a week for 10 weeks : Active Physical Treatment ( APT ) , Cognitive-Behavioral Treatment ( CBT ) , Combined Treatment of APT and CBT ( CT ) , or Waiting List ( WL ) . The outcome variables were self-reported functional limitations , patient 's main complaints , pain , mood , self-rated treatment effectiveness , treatment satisfaction and physical performance including walking , st and ing up , reaching forward , stair climbing and lifting . Assessment s were carried out by blinded research assistants at baseline and immediately post-treatment . The data were analyzed using the intention-to-treat principle . Results For 212 patients , data were available for analysis . After treatment , significant reductions were observed in functional limitations , patient 's main complaints and pain intensity for all three active treatments compared to the WL . Also , the self-rated treatment effectiveness and satisfaction appeared to be higher in the three active treatments . Several physical performance tasks improved in APT and CT but not in CBT . No clinical ly relevant differences were found between the CT and APT , or between CT and CBT . Conclusion All three active treatments were effective in comparison to no treatment , but no clinical ly relevant differences between the combined and the single component treatments were found
| 2,011 |
That is , persons with acute or subacute LBP appear to vary in the levels of physical activity independent of their pain-related disability .
Persons with chronic LBP with high levels of disability are also likely to have low levels of physical activity .
Persons with acute or subacute back pain appear to vary in the levels of physical activity independent of disability .
Persons with chronic back pain with high levels of disability will likely have low levels of physical activity
|
It is often assumed that patients with pain-related disability due to low back pain ( LBP ) will have reduced physical activity levels , but recent studies have provided results that challenge this assumption .
The aim of our systematic review was to examine the relationship between physical activity and disability in LBP .
|
2,011 | 21,251,757 |
That is , persons with acute or subacute LBP appear to vary in the levels of physical activity independent of their pain-related disability .
Persons with chronic LBP with high levels of disability are also likely to have low levels of physical activity .
Persons with acute or subacute back pain appear to vary in the levels of physical activity independent of disability .
Persons with chronic back pain with high levels of disability will likely have low levels of physical activity
|
It is often assumed that patients with pain-related disability due to low back pain ( LBP ) will have reduced physical activity levels , but recent studies have provided results that challenge this assumption .
The aim of our systematic review was to examine the relationship between physical activity and disability in LBP .
| 48,823 | 18,930,352 |
Efficacy of percutaneous electrical nerve stimulation and therapeutic exercise for older adults with chronic low back pain: A randomized controlled trial
|
Abstract Chronic low back pain ( CLBP ) in older adults may be disabling and therapeutically challenging , largely because of the inefficacy and /or morbidity associated with traditional pain treatment . We conducted a r and omized controlled trial in 200 men and women ⩾ age 65 with CLBP to evaluate the efficacy of percutaneous electrical nerve stimulation ( PENS ) with and without general conditioning and aerobic exercise ( GCAE ) , for reducing pain and improving physical function . Participants were r and omized to receive ( 1 ) PENS , ( 2 ) control‐PENS ( brief electrical stimulation to control for treatment expectancy ) , ( 3 ) PENS + GCAE , or ( 4 ) control‐PENS + GCAE , twice a week for 6 weeks . All four groups experienced significantly reduced pain ( range −2.3 to −4.1 on the McGill Pain Question naire short form ) , improved self‐reported disability ( range −2.1 to −3.0 on Rol and scale ) and improved gait velocity ( 0.04–0.07 m/s ) , sustained at 6 months . The GCAE groups experienced significantly fewer fear avoidance beliefs immediately post‐intervention and at 6 months than non‐GCAE groups . There were no significant side effects . Since brief electrical stimulation ( i.e. , control‐PENS ) facilitated comparably reduced pain and improved function at 6 months as compared with PENS , the exact dose of electrical stimulation required for analgesia can not be determined . GCAE was more effective than PENS alone in reducing fear avoidance beliefs , but not in reducing pain or in improving physical function
| 2,011 |
That is , persons with acute or subacute LBP appear to vary in the levels of physical activity independent of their pain-related disability .
Persons with chronic LBP with high levels of disability are also likely to have low levels of physical activity .
Persons with acute or subacute back pain appear to vary in the levels of physical activity independent of disability .
Persons with chronic back pain with high levels of disability will likely have low levels of physical activity
|
It is often assumed that patients with pain-related disability due to low back pain ( LBP ) will have reduced physical activity levels , but recent studies have provided results that challenge this assumption .
The aim of our systematic review was to examine the relationship between physical activity and disability in LBP .
|
2,011 | 21,251,757 |
That is , persons with acute or subacute LBP appear to vary in the levels of physical activity independent of their pain-related disability .
Persons with chronic LBP with high levels of disability are also likely to have low levels of physical activity .
Persons with acute or subacute back pain appear to vary in the levels of physical activity independent of disability .
Persons with chronic back pain with high levels of disability will likely have low levels of physical activity
|
It is often assumed that patients with pain-related disability due to low back pain ( LBP ) will have reduced physical activity levels , but recent studies have provided results that challenge this assumption .
The aim of our systematic review was to examine the relationship between physical activity and disability in LBP .
| 48,824 | 16,495,468 |
Characterizing the course of low back pain: a latent class analysis.
|
Underst and ing the course of back pain is important for clinicians and research ers , but analyses of longitudinal data from multiple time points are lacking . A prospect i ve cohort study of consecutive back pain consulters from five general practice s in the United Kingdom was carried out between 2001 and 2003 to identify groups defined by their pain pathways . Patients were sent monthly question naires for a year . Longitudinal latent class analysis was performed by using pain intensity scores for 342 consulters . Analysis yielded four clusters representing different pathways of back pain . Cluster 1 ( " persistent mild " ; n = 122 ) patients had stable , low levels of pain . Patients in cluster 2 ( " recovering " ; n = 104 ) started with mild pain , progressing quickly to no pain . Cluster 3 ( " severe chronic " ; n = 71 ) patients had permanently high pain . For patients in cluster 4 ( " fluctuating " ; n = 45 ) , pain varied between mild and high levels . Distinctive patterns for each cluster were maintained throughout follow-up . Clusters showed statistically significant differences in disability , psychological status , and work absence ( p < 0.001 ) . This is the first time , to the authors ' knowledge , that latent class analysis has been applied to longitudinal data on back pain patients . Identification of four distinct groups of patients improves underst and ing of the course of back pain and may provide a basis of classification for intervention
| 2,011 |
That is , persons with acute or subacute LBP appear to vary in the levels of physical activity independent of their pain-related disability .
Persons with chronic LBP with high levels of disability are also likely to have low levels of physical activity .
Persons with acute or subacute back pain appear to vary in the levels of physical activity independent of disability .
Persons with chronic back pain with high levels of disability will likely have low levels of physical activity
|
It is often assumed that patients with pain-related disability due to low back pain ( LBP ) will have reduced physical activity levels , but recent studies have provided results that challenge this assumption .
The aim of our systematic review was to examine the relationship between physical activity and disability in LBP .
|
2,011 | 21,251,757 |
That is , persons with acute or subacute LBP appear to vary in the levels of physical activity independent of their pain-related disability .
Persons with chronic LBP with high levels of disability are also likely to have low levels of physical activity .
Persons with acute or subacute back pain appear to vary in the levels of physical activity independent of disability .
Persons with chronic back pain with high levels of disability will likely have low levels of physical activity
|
It is often assumed that patients with pain-related disability due to low back pain ( LBP ) will have reduced physical activity levels , but recent studies have provided results that challenge this assumption .
The aim of our systematic review was to examine the relationship between physical activity and disability in LBP .
| 48,825 | 16,648,740 |
The Effectiveness of High-Intensity Versus Low-Intensity Back Schools in an Occupational Setting: A Pragmatic Randomized Controlled Trial
|
Study Design . R and omized controlled trial . Objectives . To compare high- and low-intensity back schools with usual care in occupational health care . Summary of Background Data . The content and intensity of back schools vary widely and the method ologic quality of r and omized controlled trials is generally weak . Until now , no back school has proven to be superior for workers sick-listed because of subacute nonspecific low back pain . Methods . Workers ( n = 299 ) sick-listed for a period of 3 to 6 weeks because of nonspecific low back pain were recruited by the occupational physician and r and omly assigned to a high-intensity back school , a low-intensity back school , or care as usual . Outcome measures were days until return to work , total days of sick-leave , pain , functional status , kinesiophobia , and perceived recovery and were assessed at baseline and at 3 and 6 months of follow-up . Principal analyses were performed according to the intention-to-treat principle . Results . We r and omly allocated 299 workers . Workers in the low-intensity back school returned to work faster compared with usual care and the high-intensity back school , with hazard ratios of 1.4 ( P = 0.06 ) and 1.3 ( P = 0.09 ) , respectively . The comparison between high-intensity back school and usual care result ed in a hazard ratio of 1.0 ( P = 0.83 ) . The median number of sick-leave days was 68 , 75 , and 85 in the low-intensity back school , usual care , and high-intensity back school , respectively . Beneficial effects on functional status and kinesiophobia were found at 3 months in favor of the low-intensity back school . No substantial differences on pain and perceived recovery were found between groups . Conclusions . The low-intensity back school was most effective in reducing work absence , functional disability , and kinesiophobia , and more workers in this group scored a higher perceived recovery during the 6-month follow-up
| 2,011 |
That is , persons with acute or subacute LBP appear to vary in the levels of physical activity independent of their pain-related disability .
Persons with chronic LBP with high levels of disability are also likely to have low levels of physical activity .
Persons with acute or subacute back pain appear to vary in the levels of physical activity independent of disability .
Persons with chronic back pain with high levels of disability will likely have low levels of physical activity
|
It is often assumed that patients with pain-related disability due to low back pain ( LBP ) will have reduced physical activity levels , but recent studies have provided results that challenge this assumption .
The aim of our systematic review was to examine the relationship between physical activity and disability in LBP .
|
2,011 | 21,251,757 |
That is , persons with acute or subacute LBP appear to vary in the levels of physical activity independent of their pain-related disability .
Persons with chronic LBP with high levels of disability are also likely to have low levels of physical activity .
Persons with acute or subacute back pain appear to vary in the levels of physical activity independent of disability .
Persons with chronic back pain with high levels of disability will likely have low levels of physical activity
|
It is often assumed that patients with pain-related disability due to low back pain ( LBP ) will have reduced physical activity levels , but recent studies have provided results that challenge this assumption .
The aim of our systematic review was to examine the relationship between physical activity and disability in LBP .
| 48,826 | 17,173,002 |
Low Back Pain in a General Population. Natural Course and Influence of Physical Exercise–A 5-Year Follow-up of the Musculoskeletal Intervention Center-Norrtälje Study
|
Study Design . A 5-year prospect i ve cohort study was conducted of men and women seeking care for a new period of low back pain ( LBP ) . Objectives . To study the natural course of pain and disability due to LBP during a 5-year follow-up period , and to investigate the possible influence of regular physical exercise on recovery . Summary of Background Data . LBP is major health problem , but its natural course is not very well studied . Several studies have investigated the role of physical exercise on LBP disorders , with inconsistent results . Methods . At baseline , a total of 790 subjects seeking care for LBP were interviewed about physical exercise during leisure time . Over 5 years , 3 follow-up assessment s were made by postal question naire . At all measuring points , pain intensity ratings and disability scores were compared between men and women , and among 3 exercise categories . Results . The pain intensity and disability scores were improved after 5 years for both men and women . The most prominent improvements occurred after 6 months , but less so thereafter . There were no significant differences between men and women with regard to individual changes at the 5-year follow-up concerning the pain intensity or disability scores . There were no significant differences , either for women or men , between low , median , or high intensity exercise groups regarding pain intensity or disability values for the individual change at the 5-year follow-up . Conclusions . Over a 5-year period , both men and women who had sought care for LBP reported a decrease in pain and disability ; however , only a few were fully restored . In this study , we found no effect of nonspecific physical exercise on recovery from LBP in men and women
| 2,011 |
That is , persons with acute or subacute LBP appear to vary in the levels of physical activity independent of their pain-related disability .
Persons with chronic LBP with high levels of disability are also likely to have low levels of physical activity .
Persons with acute or subacute back pain appear to vary in the levels of physical activity independent of disability .
Persons with chronic back pain with high levels of disability will likely have low levels of physical activity
|
It is often assumed that patients with pain-related disability due to low back pain ( LBP ) will have reduced physical activity levels , but recent studies have provided results that challenge this assumption .
The aim of our systematic review was to examine the relationship between physical activity and disability in LBP .
|
2,011 | 21,251,757 |
That is , persons with acute or subacute LBP appear to vary in the levels of physical activity independent of their pain-related disability .
Persons with chronic LBP with high levels of disability are also likely to have low levels of physical activity .
Persons with acute or subacute back pain appear to vary in the levels of physical activity independent of disability .
Persons with chronic back pain with high levels of disability will likely have low levels of physical activity
|
It is often assumed that patients with pain-related disability due to low back pain ( LBP ) will have reduced physical activity levels , but recent studies have provided results that challenge this assumption .
The aim of our systematic review was to examine the relationship between physical activity and disability in LBP .
| 48,827 | 14,734,329 |
Graded Activity for Low Back Pain in Occupational Health Care
|
Context Low back pain causes frequent disability and lost productive time . Contribution This r and omized trial compared a behavioral-oriented grade d activity program with usual care in 134 Dutch airline company workers who had missed work because of persistent low back pain . Grade d activity consisted of biweekly 1-hour exercise sessions with physiotherapists who emphasized operant-conditioning principles . Over 6 months of follow-up , participants in the grade d activity program missed 58 days of work , while participants receiving usual care missed 87 days . Implication s A behavioral-oriented grade d activity program returned participants with low back pain to work more often than did usual care . The Editors Nonspecific low back pain is an uncomfortable medical condition that causes frequent disability and absence from work . Most episodes of low back pain resolve fairly quickly and cause only short periods of absence from work . However , some workers with low back pain miss work for several days to weeks and are at risk for more permanent disability ( 1 ) . To reduce the individual and socioeconomic burden related to this absenteeism , we need effective intervention strategies in occupational health care setting s that promote safe and rapid return to work . One promising and often-advocated intervention strategy for workers with prolonged nonspecific low back pain is active rehabilitation that is directed toward return to normal activity and work ( 2 ) . Examples are grade d activity interventions that include physical exercise , application of operant-conditioning behavioral principals , and promotion of improved functioning and safe return to work even if pain persists ( 3 - 6 ) . In a r and omized , controlled trial , Lindstrm and colleagues ( 3 , 4 ) found that a grade d activity intervention reduced absence from work more than did traditional care in Swedish workers employed in the automobile industry . We investigate , in a second r and omized , controlled trial , whether absence from work because of low back pain is reduced more with grade d activity intervention than with traditional care in an occupational health care setting in the Netherl and s. Methods Study Design and Sample The study was a single-blind , r and omized , controlled trial in an occupational health services center ( KLM Health , Safety and Environment ) at Schiphol Airport , Amsterdam , the Netherl and s. The center provides occupational health services for all employees of a major Dutch airline ( KLM Royal Dutch Airlines ) . The source sample ( n = 20 000 ) consisted of workers who were employed in the following organizational units of the airline : baggage and aircraft turnaround services , passenger services , engineering and maintenance , cargo , and cabin and cockpit . Workers who were listed as absent from work because of low back pain were invited for a consultation with the occupational physician . Those who were thought to be eligible for inclusion were referred to the research assistant , who judged whether they met the inclusion criteria : full or partial absence from work because of nonspecific low back pain and low back pain symptoms with a minimum duration of 4 weeks in succession . The exclusion criteria were low back pain with radiation below the knee with signs of nerve-root compression ( 7 ) ; cardiovascular contraindications for physical activity , as checked according to the Physical Activities Readiness Question naire ( 8 , 9 ) ; any conflict between worker and employer with legal involvement ; or pregnancy . Workers who met the inclusion criteria were informed of the purpose and procedures of the study and were enrolled after giving informed consent . The Medical Ethical Committee of the VU University Medical Center , Amsterdam , the Netherl and s , approved the study . Treatment Allocation The participants were assigned to grade d activity or usual care on the basis of block r and omization , after prestratification for the organizational unit in the workplace from which they were recruited ( the 5 organizational units listed earlier ) and for the severity of pain symptoms ( scored on a scale of 0 to 10 ; severity scores were < 6 or 6 points ) . This result ed in a total of 10 strata . R and omized , permuted blocks of 4 allocations were generated for each stratum through a computer-generated r and om-sequence table . Opaque , sequentially numbered , sealed envelopes were prepared for each stratum by a research er who was not involved in enrolling the participants or assigning them to their groups . The envelopes contained a sheet of paper that indicated 1 of the 2 interventions . Participants learned their group assignments after a research assistant completed the baseline measurements and delivered the sealed envelopes . Blinding The research assistants who collected the data were blinded to the treatment allocation . All participants were repeatedly asked not to reveal any information about their treatment allocation . The participants and treatment providers were not blinded to treatment allocation . Interventions In the Dutch occupational health care system , occupational physicians guide disabled workers who are absent from work through their disability period . These occupational physicians are employed by occupational health services that are paid for by the companies . The occupational physicians adhere to back pain management strategies that consist of advising workers on ergonomics , prevention , and return-to-work schedules and advising and communicating with other stakeholders ( such as health care providers and representatives of the workplace ) . Disabled workers who participated in the present study were assigned to either grade d activity or usual care within the context of the Dutch occupational health care setting . Grade d Activity The intervention group received the usual guidance from the occupational physician about work-related problems and barriers to return to work as well as the grade d activity intervention supervised by a physiotherapist . Three physiotherapists who worked in a private practice at Schiphol Airport provided the treatment according to the grade d activity protocol . Two of those physiotherapists were also trained as manual therapists , and 1 was also a human movement scientist . Before the study , the physiotherapists had been specifically trained to treat patients with low back pain according to behavioral principles . A research physiotherapist who was experienced in treating patients with chronic pain in rehabilitation centers instructed the physiotherapists in three 2-hour sessions and practice d patienttherapist interactions with them through role-play . Before the study , the physiotherapists treated several patients according to the grade d activity protocol to gain more experience . The physiotherapists made audiotapes of the intervention sessions before and during the study period . The contents of these audiotapes were assessed and discussed with the research physiotherapist in 3 additional meetings . Furthermore , the physiotherapists summarized the treatment after each session , and research ers used these summaries to review the sessions . The same physiotherapist treated participants each time , except for temporary st and -in sessions that were supervised by colleagues because of holidays or other reasons . Specific therapists were not systematic ally selected to treat specific participants ; selection was based on pragmatic reasons , such as the time available in the work schedules of the physiotherapists or the days of treatment preferred by the participants . Table 1 presents the concept and content of the grade d activity intervention . The intervention consisted of 1-hour exercise sessions that participants attended twice per week until they returned completely to regular work or until the maximum therapy duration of 3 months was reached . At the start of the intervention , the physiotherapist inquired about the participant 's medical history and completed a brief physical examination consisting of flexion , extension , and lateroflexion of the lumbar spine and a brief screening for nerve-root pain ( 10 ) . The purpose of the physical examination was to confirm the diagnosis of benign , nonspecific low back pain and to reduce participants ' fears about any presumed underlying disease . The participants were reassured that despite the annoying pain , nothing was seriously wrong with their backs . Subsequently , the physiotherapist and participant decided on a set of general exercises and individually tailored exercises . Both types of exercises had to be performed during each session . The general exercises were aerobic exercises , such as cycling or rowing , and strengthening exercises for large muscle groups , and most were carried out in a gym while using exercise equipment . The strengthening exercises were a floor abdominal sit-up exercise , a dynamic back extension exercise , a leg-press exercise , a latissimus pull-down exercise , and st and ing up from a low chair . Participants in the grade d activity group had to perform not only these general exercises but also individually tailored exercises , which imitated physical tasks at work or difficult and painful activities of daily living . For example , a participant who reported back problems while lifting and moving suitcases from a luggage wagon into an airplane might be given an exercise to practice lifting and moving a suitcase with a certain number of repetitions . During the first 3 sessions , the maximal performance ( for example , the maximum number of repetitions ) was assessed for each exercise separately , and the average score for each exercise over the 3 sessions was used as a baseline value for specifying a gradually progressive exercise scheme . Subsequently , the participant was asked to propose a date for full return to regular work , which would consequently be the end point of the physical exercise program . Before returning to full regular work , participants could return to work with modified hours and duties . Advised by the physiotherapist , the participant
| 2,011 |
That is , persons with acute or subacute LBP appear to vary in the levels of physical activity independent of their pain-related disability .
Persons with chronic LBP with high levels of disability are also likely to have low levels of physical activity .
Persons with acute or subacute back pain appear to vary in the levels of physical activity independent of disability .
Persons with chronic back pain with high levels of disability will likely have low levels of physical activity
|
It is often assumed that patients with pain-related disability due to low back pain ( LBP ) will have reduced physical activity levels , but recent studies have provided results that challenge this assumption .
The aim of our systematic review was to examine the relationship between physical activity and disability in LBP .
|
2,011 | 21,251,757 |
That is , persons with acute or subacute LBP appear to vary in the levels of physical activity independent of their pain-related disability .
Persons with chronic LBP with high levels of disability are also likely to have low levels of physical activity .
Persons with acute or subacute back pain appear to vary in the levels of physical activity independent of disability .
Persons with chronic back pain with high levels of disability will likely have low levels of physical activity
|
It is often assumed that patients with pain-related disability due to low back pain ( LBP ) will have reduced physical activity levels , but recent studies have provided results that challenge this assumption .
The aim of our systematic review was to examine the relationship between physical activity and disability in LBP .
| 48,828 | 11,576,740 |
The role of fear-avoidance beliefs in acute low back pain: relationships with current and future disability and work status
|
& NA ; Fear‐avoidance beliefs have been identified as an important psychosocial variable in patients with chronic disability doe to low back pain . The importance of fear‐avoidance beliefs for individuals with acute low back pain has not been explored . Seventy‐eight subjects with work‐related low back pain of less than 3 weeks ' duration were studied . Measurements of pain intensity , physical impairment , disability , nonorganic signs and symptoms , and depression were taken at the initial evaluation . Fear‐avoidance beliefs were measured with the work and physical activity subscales of the Fear‐avoidance Beliefs Question naire . Disability and work status were re‐assessed after 4 weeks of physical therapy . Patterns of correlation between fear‐avoidance beliefs and other concurrently‐measured variables were similar to those reported in patients with chronic low back pain . Fear‐avoidance beliefs did not explain a significant amount of the variability in initial disability levels after controlling for pain intensity and physical impairment . Fear‐avoidance beliefs about work were significant predictors of 4‐week disability and work status even after controlling for initial levels of pain intensity , physical impairment , and disability , and the type of therapy received . Fear‐avoidance beliefs are present in patients with acute low back pain , and may be an important factor in explaining the transition from acute to chronic conditions . Screening for fear‐avoidance beliefs may be useful for identifying patients at risk of prolonged disability and work absence
| 2,011 |
That is , persons with acute or subacute LBP appear to vary in the levels of physical activity independent of their pain-related disability .
Persons with chronic LBP with high levels of disability are also likely to have low levels of physical activity .
Persons with acute or subacute back pain appear to vary in the levels of physical activity independent of disability .
Persons with chronic back pain with high levels of disability will likely have low levels of physical activity
|
It is often assumed that patients with pain-related disability due to low back pain ( LBP ) will have reduced physical activity levels , but recent studies have provided results that challenge this assumption .
The aim of our systematic review was to examine the relationship between physical activity and disability in LBP .
|
2,011 | 21,251,757 |
That is , persons with acute or subacute LBP appear to vary in the levels of physical activity independent of their pain-related disability .
Persons with chronic LBP with high levels of disability are also likely to have low levels of physical activity .
Persons with acute or subacute back pain appear to vary in the levels of physical activity independent of disability .
Persons with chronic back pain with high levels of disability will likely have low levels of physical activity
|
It is often assumed that patients with pain-related disability due to low back pain ( LBP ) will have reduced physical activity levels , but recent studies have provided results that challenge this assumption .
The aim of our systematic review was to examine the relationship between physical activity and disability in LBP .
| 48,829 | 20,591,572 |
The course of chronic and recurrent low back pain in the general population
|
& NA ; Using latent class analysis ( LCA ) , a previous study on patients attending primary care identified four courses of low back pain ( LBP ) over the subsequent 6 months . To date , no studies have used longitudinal pain recordings to examine the “ natural ” course of recurrent and chronic LBP in a population ‐based sample of individuals . This study examines the course of LBP in the general population and elaborates on the stability and criterion‐related validity of the clusters derived . A r and om sample of 400 individuals reporting LBP in a population ‐based study was asked to complete a comprehensive question naire at the start and end of the year 's survey , and 52 weekly pain diaries in between . The latter were analyzed using LCA . 305 individuals returned more than 50 % of the diaries . Four clusters were identified ( severe persistent , moderate persistent , mild persistent , and fluctuating ) . The clusters differed significantly with regards to pain and disability . Assessment of cluster stability showed that a considerable proportion of patients in the “ fluctuating ” group changed their classification over time . Three of the four clusters describing the typical course of pain matched the clusters described previously for patients in primary care . Due to the population ‐based design , this study achieves , for the first time , a close insight into the “ natural ” course of chronic and recurrent low back pain , including individuals that did not necessarily visit the general practitioner . The findings will help to underst and better the nature of this pain in the general population
| 2,011 |
That is , persons with acute or subacute LBP appear to vary in the levels of physical activity independent of their pain-related disability .
Persons with chronic LBP with high levels of disability are also likely to have low levels of physical activity .
Persons with acute or subacute back pain appear to vary in the levels of physical activity independent of disability .
Persons with chronic back pain with high levels of disability will likely have low levels of physical activity
|
It is often assumed that patients with pain-related disability due to low back pain ( LBP ) will have reduced physical activity levels , but recent studies have provided results that challenge this assumption .
The aim of our systematic review was to examine the relationship between physical activity and disability in LBP .
|
2,011 | 21,251,757 |
That is , persons with acute or subacute LBP appear to vary in the levels of physical activity independent of their pain-related disability .
Persons with chronic LBP with high levels of disability are also likely to have low levels of physical activity .
Persons with acute or subacute back pain appear to vary in the levels of physical activity independent of disability .
Persons with chronic back pain with high levels of disability will likely have low levels of physical activity
|
It is often assumed that patients with pain-related disability due to low back pain ( LBP ) will have reduced physical activity levels , but recent studies have provided results that challenge this assumption .
The aim of our systematic review was to examine the relationship between physical activity and disability in LBP .
| 48,830 | 20,227,640 |
Treatment-based subgroups of low back pain: a guide to appraisal of research studies and a summary of current evidence.
|
There has been a recent increase in research evaluating treatment-based subgroups of non-specific low back pain . The aim of these sub-classification schemes is to identify subgroups of patients who will respond preferentially to one treatment as opposed to another . Our article provides accessible guidance on to how to interpret this research and determine its implication s for clinical practice . We propose that studies evaluating treatment-based subgroups can be interpreted in the context of a three-stage process : ( 1 ) hypothesis generation-proposal of clinical features to define subgroups ; ( 2 ) hypothesis testing-a r and omised controlled trial ( RCT ) to test that subgroup membership modifies the effect of a treatment ; and ( 3 ) replication-another RCT to confirm the results of stage 2 and ensure that findings hold beyond the specific original conditions . At this point , the bulk of research evidence in defining subgroups of patients with low back pain is in the hypothesis generation stage ; no classification system is supported by sufficient evidence to recommend implementation into clinical practice
| 2,011 |
That is , persons with acute or subacute LBP appear to vary in the levels of physical activity independent of their pain-related disability .
Persons with chronic LBP with high levels of disability are also likely to have low levels of physical activity .
Persons with acute or subacute back pain appear to vary in the levels of physical activity independent of disability .
Persons with chronic back pain with high levels of disability will likely have low levels of physical activity
|
It is often assumed that patients with pain-related disability due to low back pain ( LBP ) will have reduced physical activity levels , but recent studies have provided results that challenge this assumption .
The aim of our systematic review was to examine the relationship between physical activity and disability in LBP .
|
2,011 | 21,251,757 |
That is , persons with acute or subacute LBP appear to vary in the levels of physical activity independent of their pain-related disability .
Persons with chronic LBP with high levels of disability are also likely to have low levels of physical activity .
Persons with acute or subacute back pain appear to vary in the levels of physical activity independent of disability .
Persons with chronic back pain with high levels of disability will likely have low levels of physical activity
|
It is often assumed that patients with pain-related disability due to low back pain ( LBP ) will have reduced physical activity levels , but recent studies have provided results that challenge this assumption .
The aim of our systematic review was to examine the relationship between physical activity and disability in LBP .
| 48,831 | 16,813,479 |
Effects of two 4-week proprioceptive neuromuscular facilitation programs on muscle endurance, flexibility, and functional performance in women with chronic low back pain.
|
BACKGROUND AND PURPOSE Improving functional performance in patients with chronic low back pain is of primary importance . The purpose of this study was to examine the effects of 2 proprioceptive neuromuscular facilitation ( PNF ) programs on trunk muscle endurance , flexibility , and functional performance in subjects with chronic low back pain ( CLBP ) . SUBJECTS Eighty-six women ( 40.2+/-11.9 [ mean+/-SD ] years of age ) who had complaints of CLBP were r and omly assigned to 3 groups : rhythmic stabilization training , combination of isotonic exercises , and control . METHODS Subjects trained with each program for 4 weeks with the aim of improving trunk stability and strength . Static and dynamic trunk muscle endurance and lumbar mobility were measured before , at the end of , and 4 and 8 weeks after training . Disability and back pain intensity also were measured with the Oswestry Index . RESULTS Multivariate analysis of variance indicated that both training groups demonstrated significant improvements in lumbar mobility ( 8.6%-24.1 % ) , static and dynamic muscle endurance ( 23.6%-81 % ) , and Oswestry Index ( 29.3%-31.8 % ) measurements . DISCUSSION AND CONCLUSION Static and dynamic PNF programs may be appropriate for improving short-term trunk muscle endurance and trunk mobility in people with CLBP
| 2,011 |
That is , persons with acute or subacute LBP appear to vary in the levels of physical activity independent of their pain-related disability .
Persons with chronic LBP with high levels of disability are also likely to have low levels of physical activity .
Persons with acute or subacute back pain appear to vary in the levels of physical activity independent of disability .
Persons with chronic back pain with high levels of disability will likely have low levels of physical activity
|
It is often assumed that patients with pain-related disability due to low back pain ( LBP ) will have reduced physical activity levels , but recent studies have provided results that challenge this assumption .
The aim of our systematic review was to examine the relationship between physical activity and disability in LBP .
|
2,011 | 21,251,757 |
That is , persons with acute or subacute LBP appear to vary in the levels of physical activity independent of their pain-related disability .
Persons with chronic LBP with high levels of disability are also likely to have low levels of physical activity .
Persons with acute or subacute back pain appear to vary in the levels of physical activity independent of disability .
Persons with chronic back pain with high levels of disability will likely have low levels of physical activity
|
It is often assumed that patients with pain-related disability due to low back pain ( LBP ) will have reduced physical activity levels , but recent studies have provided results that challenge this assumption .
The aim of our systematic review was to examine the relationship between physical activity and disability in LBP .
| 48,832 | 14,638,564 |
The long-term effects of a self-management program for inner-city primary care patients with acute low back pain.
|
BACKGROUND We evaluated the effect of a self-management program for low-income primary care patients with acute low back pain ( ALBP ) from inner-city neighborhood health centers . METHODS We conducted a r and omized controlled trial of a self-management program compared with usual care at university-affiliated neighborhood health centers and an emergency department of an inner-city public teaching hospital . We enrolled 211 patients who visited a physician for ALBP ( < 90 days ' duration ) . The self-management program consisted of 3 group sessions and telephone follow-up that focused on underst and ing back pain , increasing physical activity , and dealing with fears and frustrations . RESULTS At baseline , 4 months , and 12 months , blinded interviewers assessed back pain physical function ( Rol and Disability Question naire ) , health status ( Arthritis Impact Measurement Scales ) , self-efficacy , and time spent in physical activity . Compared with patients receiving usual care , intervention patients reported significantly better scores on the Rol and Disability Question naire ( P = .009 ) , mental functioning ( P = .009 ) , self-efficacy to manage ALBP ( P = .03 ) , time spent in physical activity ( P = .047 ) , and reduced fears of movement/reinjury ( P = .005 ) after 12 months . CONCLUSION A self-management program can improve and maintain functional status , mental functioning , and self-efficacy to manage future symptoms for 1 year among primary care patients with ALBP living in the urban , inner city
| 2,011 |
That is , persons with acute or subacute LBP appear to vary in the levels of physical activity independent of their pain-related disability .
Persons with chronic LBP with high levels of disability are also likely to have low levels of physical activity .
Persons with acute or subacute back pain appear to vary in the levels of physical activity independent of disability .
Persons with chronic back pain with high levels of disability will likely have low levels of physical activity
|
It is often assumed that patients with pain-related disability due to low back pain ( LBP ) will have reduced physical activity levels , but recent studies have provided results that challenge this assumption .
The aim of our systematic review was to examine the relationship between physical activity and disability in LBP .
|
2,011 | 21,251,757 |
That is , persons with acute or subacute LBP appear to vary in the levels of physical activity independent of their pain-related disability .
Persons with chronic LBP with high levels of disability are also likely to have low levels of physical activity .
Persons with acute or subacute back pain appear to vary in the levels of physical activity independent of disability .
Persons with chronic back pain with high levels of disability will likely have low levels of physical activity
|
It is often assumed that patients with pain-related disability due to low back pain ( LBP ) will have reduced physical activity levels , but recent studies have provided results that challenge this assumption .
The aim of our systematic review was to examine the relationship between physical activity and disability in LBP .
| 48,833 | 18,438,894 |
Graded activity for workers with low back pain: who benefits most and how does it work?
|
OBJECTIVE To identify subgroups of workers absent from work due to low back pain who are more or less likely to return to work earlier as a result of a grade d activity intervention , and to investigate whether this intervention is effective in reducing pain-related fears and if so , whether these reductions in pain-related fears mediate return to work . METHODS A subgroup analysis was conducted on data from a previous r and omized controlled trial of 134 Dutch airline workers , which found that a behaviorally-oriented grade d activity intervention was more effective than usual care in stimulating return to work . The subgroup analyses added interaction terms to a Cox regression model that described the relationship between treatment allocation and return to work over 12 months of followup . Furthermore , we studied the effects of grade d activity on pain-related fears and added variables indicating a reduction in pain-related fears to the model in order to investigate their influence on return to work . RESULTS Statistically significant interactions were found for disability , fear-avoidance beliefs about physical activity , and fear-avoidance beliefs about work . No indication was found that the reduction in pain-related fears in the grade d activity group mediated more favorable return-to-work results in this group . CONCLUSION Workers who perceive their disability to be moderate and workers with moderate scores for fear-avoidance beliefs return to work more rapidly as a result of the grade d activity intervention than workers with higher scores . The return to work of workers receiving the grade d activity intervention is possibly independent from the reductions in pain-related fears caused by this intervention
| 2,011 |
That is , persons with acute or subacute LBP appear to vary in the levels of physical activity independent of their pain-related disability .
Persons with chronic LBP with high levels of disability are also likely to have low levels of physical activity .
Persons with acute or subacute back pain appear to vary in the levels of physical activity independent of disability .
Persons with chronic back pain with high levels of disability will likely have low levels of physical activity
|
It is often assumed that patients with pain-related disability due to low back pain ( LBP ) will have reduced physical activity levels , but recent studies have provided results that challenge this assumption .
The aim of our systematic review was to examine the relationship between physical activity and disability in LBP .
|
2,011 | 21,251,757 |
That is , persons with acute or subacute LBP appear to vary in the levels of physical activity independent of their pain-related disability .
Persons with chronic LBP with high levels of disability are also likely to have low levels of physical activity .
Persons with acute or subacute back pain appear to vary in the levels of physical activity independent of disability .
Persons with chronic back pain with high levels of disability will likely have low levels of physical activity
|
It is often assumed that patients with pain-related disability due to low back pain ( LBP ) will have reduced physical activity levels , but recent studies have provided results that challenge this assumption .
The aim of our systematic review was to examine the relationship between physical activity and disability in LBP .
| 48,834 | 18,212,032 |
Sequentially allocated clinical trial of rhythmic stabilization exercises and TENS in women with chronic low back pain
|
Objective : To examine the effectiveness of rhythmic stabilization exercises and transcutaneous electrical nerve stimulation ( TENS ) and their combination in treating women with chronic low back pain . Design : Sequentially allocated , single-blinded and controlled study , with a two-month follow-up . Setting : The data were collected in a patient rehabilitation setting . Subjects : A total of 92 women ( 34—46 years old ) with chronic low back pain were studied . Interventions : Sequential allocation was undertaken into four groups : ` rhythmic stabilization ' ( n=23 ) , ` rhythmic stabilization — TENS ' ( n=23 ) , TENS ( n=23 ) , and a placebo group ( n = 23 ) . Each programme lasted for four weeks . All outcome measures were assessed prior to , immediately after , four weeks and eight weeks post intervention . Main measures : Data were obtained on functional disability , pain intensity , trunk extension range of motion , dynamic endurance of trunk flexion and static endurance of trunk extension . Results : A total of 88 patients provided two-month follow-up data . The ` rhythmic stabilization ' and the ` rhythmic stabilization — TENS ' groups displayed statistically significant ( P<0.05 ) improvements in functional disability and pain intensity ( ranging from 21.2 to 42.8 % ) , trunk extension range of motion ( ranging from 6.5 to 25.5 % ) , dynamic endurance of trunk flexion and static endurance of trunk extension ( ranging from 13.5 to 74.3 % ) compared with the remaining groups . Conclusions : The rhythmic stabilization programmes result ed in more gains in women with chronic low back pain regarding the present outcome variables compared with the other groups ; therefore , its application in female chronic low back pain patients aged 34—46 years is recommended
| 2,011 |
That is , persons with acute or subacute LBP appear to vary in the levels of physical activity independent of their pain-related disability .
Persons with chronic LBP with high levels of disability are also likely to have low levels of physical activity .
Persons with acute or subacute back pain appear to vary in the levels of physical activity independent of disability .
Persons with chronic back pain with high levels of disability will likely have low levels of physical activity
|
It is often assumed that patients with pain-related disability due to low back pain ( LBP ) will have reduced physical activity levels , but recent studies have provided results that challenge this assumption .
The aim of our systematic review was to examine the relationship between physical activity and disability in LBP .
|
2,012 | 25,639,643 |
Longer duration of electrocardiographic monitoring after cryptogenic stroke is associated with a greater detection of AF .
|
BACKGROUND Atrial fibrillation ( AF ) is a major cause of stroke .
Although st and ard investigations after an event include electrocardiographic monitoring , the optimal duration to detect AF is unclear .
We performed a systematic review and meta- analysis to determine whether the duration of electrocardiographic monitoring after an ischemic event is related to the detection of AF .
| 48,835 | 22,871,678 |
Continuous Stroke Unit Electrocardiographic Monitoring Versus 24-Hour Holter Electrocardiography for Detection of Paroxysmal Atrial Fibrillation After Stroke
|
Background and Purpose — Cardioembolism in paroxysmal atrial fibrillation ( pxAF ) is a frequent cause of ischemic stroke . Sensitive detection of pxAF after stroke is crucial for adequate secondary stroke prevention ; the optimal diagnostic modality to detect pxAF on stroke units is unknown . We compared 24-hour Holter electrocardiography ( ECG ) with continuous stroke unit ECG monitoring ( CEM ) for pxAF detection . Methods — Patients with acute ischemic stroke or transient ischemic attack were prospect ively enrolled . After a 12-channel ECG on admission , all patients received 24-hour Holter ECG and CEM . Additionally , ECG monitoring data underwent automated analysis using dedicated software to identify pxAF . Patients with a history of atrial fibrillation or with atrial fibrillation on the admission ECG were excluded . Results — Four hundred ninety-six patients ( median age , 69 years ; 61.5 % male ) fulfilled all inclusion criteria ( ischemic stroke : 80.4 % ; transient ischemic attack : 19.6 % ) . Median stroke unit stay lasted 88.8 hours ( interquartile range , 65.0–122.0 ) . ECG data for automated CEM analysis were available for a median time of 64.0 hours ( 43.0–89.8 ) . Paroxysmal AF was documented in 41 of 496 patients ( 8.3 % ) . Of these , Holter detected pxAF in 34.1 % ; CEM in 65.9 % ; and automated CEM in 92.7 % . CEM and automated CEM detected significantly more patients with pxAF than Holter ( P<0.001 ) , and automated CEM detected more patients than CEM ( P<0.001 ) . Conclusions — Automated analysis of CEM improves pxAF detection in patients with stroke on stroke units compared with 24-hour Holter ECG . The comparative usefulness of prolonged or repetitive Holter ECG recordings requires further evaluation
| 2,012 |
Longer duration of electrocardiographic monitoring after cryptogenic stroke is associated with a greater detection of AF .
|
BACKGROUND Atrial fibrillation ( AF ) is a major cause of stroke .
Although st and ard investigations after an event include electrocardiographic monitoring , the optimal duration to detect AF is unclear .
We performed a systematic review and meta- analysis to determine whether the duration of electrocardiographic monitoring after an ischemic event is related to the detection of AF .
|
2,012 | 25,639,643 |
Longer duration of electrocardiographic monitoring after cryptogenic stroke is associated with a greater detection of AF .
|
BACKGROUND Atrial fibrillation ( AF ) is a major cause of stroke .
Although st and ard investigations after an event include electrocardiographic monitoring , the optimal duration to detect AF is unclear .
We performed a systematic review and meta- analysis to determine whether the duration of electrocardiographic monitoring after an ischemic event is related to the detection of AF .
| 48,836 | 3,262,405 |
Detection of atrial high-rate events by continuous Home Monitoring: clinical significance in the heart failure–cardiac resynchronization therapy population
|
Aims Uncertainty exists over the importance of device-detected short- duration atrial arrhythmias . Continuous atrial diagnostics , through home monitoring ( HM ) technology ( BIOTRONIK , Berlin , Germany ) , provides a unique opportunity to assess frequency and quantity of atrial fibrillation ( AF ) episodes defined as atrial high-rate events ( AHRE ) . Methods and results Prospect i ve data from 560 heart failure ( HF ) patients ( age 67 ± 10 years , median ejection fraction 27 % ) patients with a cardiac resynchronization therapy ( CRT ) device capable of HM from two multi-centre studies were analysed . Atrial high-rate events burden was defined as the duration of mode switch in a 24-h period with atrial rates of > 180 beats for at least 1 % or total of 14 min per day . The primary endpoint was incidence of a thromboembolic ( TE ) event . Secondary endpoints were cardiovascular death , hospitalization because of AF , or worsening HF . Over a median 370-day follow-up AHRE occurred in 40 % of patients with 11 ( 2 % ) patients developing TE complications and mortality rate of 4.3 % ( 24 deaths , 16 with cardiovascular aetiology ) . Compared with patients without detected AHRE , patients with detected AHRE>3.8 h over a day were nine times more likely to develop TE complications ( P= 0.006 ) . The majority of patients ( 73 % ) did not show a temporal association with the detected atrial episode and their adverse event , with a mean interval of 46.7 ± 71.9 days ( range 0–194 ) before the TE complication . Conclusion In a high-risk cohort of HF patients , device-detected atrial arrhythmias are associated with an increased incidence of TE events . A cut-off point of 3.8 h over 24 h was associated with significant increase in the event rate . Routine assessment of AHRE should be considered with other data when assessing stroke risk and considering anti-coagulation initiation and should also prompt the optimization of cardioprotective HF therapy in CRT patients
| 2,012 |
Longer duration of electrocardiographic monitoring after cryptogenic stroke is associated with a greater detection of AF .
|
BACKGROUND Atrial fibrillation ( AF ) is a major cause of stroke .
Although st and ard investigations after an event include electrocardiographic monitoring , the optimal duration to detect AF is unclear .
We performed a systematic review and meta- analysis to determine whether the duration of electrocardiographic monitoring after an ischemic event is related to the detection of AF .
|
2,012 | 25,639,643 |
Longer duration of electrocardiographic monitoring after cryptogenic stroke is associated with a greater detection of AF .
|
BACKGROUND Atrial fibrillation ( AF ) is a major cause of stroke .
Although st and ard investigations after an event include electrocardiographic monitoring , the optimal duration to detect AF is unclear .
We performed a systematic review and meta- analysis to determine whether the duration of electrocardiographic monitoring after an ischemic event is related to the detection of AF .
| 48,837 | 19,426,887 |
Intermittent atrial fibrillation may account for a large proportion of otherwise cryptogenic stroke: a study of 30-day cardiac event monitors.
|
INTRODUCTION Despite extensive inpatient workup including telemetry monitoring , a significant proportion of stroke is classified as cryptogenic at hospital discharge . It is possible that a significant proportion of cryptogenic stroke is a result of intermittent atrial fibrillation ( AF ) . Thirty-day cardiac event monitors ( 30-DEM ) may increase the rate of AF detection compared with st and ard investigations that include a combination of electrocardiography , cardiac telemetry , and short-term Holter monitoring . METHODS Charts were review ed of patients who were admitted to a university stroke center or who were evaluated in the outpatient clinic during a 9-month period to determine whether the cause of stroke was cryptogenic . As a matter of protocol , such patients typically underwent 30-DEM and the results of such monitoring were documented along with the duration of inpatient cardiac monitoring if relevant . RESULTS In all , 218 patients with a diagnosis of ischemic stroke or transient ischemic attack were identified . Of the strokes , 36 ( 16.5 % ) were classified as cryptogenic . Twenty patients with cryptogenic stroke or transient ischemic attack were evaluated with 30-DEM . Four ( 20 % ) were found to have AF , and all 4 patients were treated with warfarin . CONCLUSION The 30-DEM changed the medical treatment of 20 % of patients with otherwise cryptogenic stroke because of the detection of intermittent AF despite no detection of AF on electrocardiography and inpatient telemetry monitoring in the majority of patients . Further prospect i ve studies of extended cardiac event monitors in the setting of cryptogenic stroke are warranted
| 2,012 |
Longer duration of electrocardiographic monitoring after cryptogenic stroke is associated with a greater detection of AF .
|
BACKGROUND Atrial fibrillation ( AF ) is a major cause of stroke .
Although st and ard investigations after an event include electrocardiographic monitoring , the optimal duration to detect AF is unclear .
We performed a systematic review and meta- analysis to determine whether the duration of electrocardiographic monitoring after an ischemic event is related to the detection of AF .
|
2,012 | 25,639,643 |
Longer duration of electrocardiographic monitoring after cryptogenic stroke is associated with a greater detection of AF .
|
BACKGROUND Atrial fibrillation ( AF ) is a major cause of stroke .
Although st and ard investigations after an event include electrocardiographic monitoring , the optimal duration to detect AF is unclear .
We performed a systematic review and meta- analysis to determine whether the duration of electrocardiographic monitoring after an ischemic event is related to the detection of AF .
| 48,838 | 17,585,079 |
Frequent Atrial Premature Beats Predict Paroxysmal Atrial Fibrillation in Stroke Patients: An Opportunity for a New Diagnostic Strategy
|
Background and Purpose — For patients having suffered ischemic stroke , the current diagnostic strategies often fail to detect atrial fibrillation as a potential cause of embolic events . The aim of the study was to identify paroxysmal atrial fibrillation in stroke patients . We hypothesized that patients with frequent atrial premature beats ( APBs ) recorded in 24-hour ECG will show more often atrial fibrillation when followed by repeated long-term ECG recordings than patients without or infrequent APBs . Methods — 127 patients with acute ischemic stroke and without known AF were enrolled in a prospect i ve study to detect paroxysmal AF . Patients were stratified according to the number of APBs recorded in a 24-hour ECG ( ≥70 APBs versus < 70 APBs ) . Subsequently , they all underwent serial 7-day event-recorder monitoring at 0 , 3 , and 6 months . Results — Serial extended ECG monitoring identified AF in 26 % of patients with frequent APBs but only in 6.5 % when APBs were infrequent ( P=0.0021 ) . A multivariate analysis showed that the presence of frequent APBs in the initial 24-hour ECG was the only independent predictor of paroxysmal AF during follow-up ( odds ratio 6.6 , 95 % confidence intervals 1.6 to 28.2 , P=0.01 ) . Conclusions — In patients with acute ischemic stroke , frequent APBs ( ≥70/24 hours ) are a marker for individuals who are at greater risk to develop or have paroxysmal AF . For such patients , we propose a diagnostic workup with repeated prolonged ECG monitoring to diagnose paroxysmal AF
| 2,012 |
Longer duration of electrocardiographic monitoring after cryptogenic stroke is associated with a greater detection of AF .
|
BACKGROUND Atrial fibrillation ( AF ) is a major cause of stroke .
Although st and ard investigations after an event include electrocardiographic monitoring , the optimal duration to detect AF is unclear .
We performed a systematic review and meta- analysis to determine whether the duration of electrocardiographic monitoring after an ischemic event is related to the detection of AF .
|
2,012 | 25,639,643 |
Longer duration of electrocardiographic monitoring after cryptogenic stroke is associated with a greater detection of AF .
|
BACKGROUND Atrial fibrillation ( AF ) is a major cause of stroke .
Although st and ard investigations after an event include electrocardiographic monitoring , the optimal duration to detect AF is unclear .
We performed a systematic review and meta- analysis to determine whether the duration of electrocardiographic monitoring after an ischemic event is related to the detection of AF .
| 48,839 | 24,130,137 |
Improved Detection of Silent Atrial Fibrillation Using 72-Hour Holter ECG in Patients With Ischemic Stroke: A Prospective Multicenter Cohort Study
|
Background and Purpose — Adequate diagnosis of atrial fibrillation ( AF ) , including paroxysmal AF , is an important part of stroke workup . Prolonged ECG monitoring may improve the detection of paroxysmal , previously undiagnosed AF ( unknown AF ) . Therefore , we evaluated systematic 72-hour Holter ECG monitoring to detect unknown AF for the workup of patients with stroke . Methods — Unselected survivors of a stroke or transient ischemic attack ( TIA ) without known AF were enrolled in a prospect i ve , multicenter cohort study of 72-hour Holter ECG monitoring in 9 German secondary and tertiary stroke centers between May 2010 and January 2011 . In addition to st and ardized workup of stroke pathogenesis according to the German Stroke Unit protocol , all patients underwent 72-hour Holter ECG monitoring directly after admission . All ECGs were central ly analyzed by 2 independent observers . We determined the proportion of unknown AF and compared the detection rates of 72- and 24-hour monitoring . Results — A total of 1135 patients were enrolled ( mean age , 67 years [ SD , 13.1 years ] , 45 % women , 29 % TIA ) . Unknown AF was detected in 49 out of 1135 patients ( 4.3 % , [ 95 % confidence interval , 3.4–5.2 % ] ) by 72-hour ECG monitoring . Unknown AF was diagnosed in 29 patients ( 2.6 % ) within the first 24 hours of ECG monitoring , and in 20 more patients only by 72 hours of ECG monitoring . The number needed to screen by 72-hour ECG was 55 patients ( 95 % confidence interval [ 35–123 ] ) for each additional AF diagnosis . Patients with unknown AF were significantly older and had more often a history of previous stroke . Patients with unknown AF were equally distributed within categories of pathogenesis according to Trial of Org 10172 in Acute Stroke Treatment ( TOAST ) classification . Conclusions — In unselected survivors of stroke or TIA , 72-hour ECG monitoring is feasible and improves the detection rate of silent paroxysmal AF
| 2,012 |
Longer duration of electrocardiographic monitoring after cryptogenic stroke is associated with a greater detection of AF .
|
BACKGROUND Atrial fibrillation ( AF ) is a major cause of stroke .
Although st and ard investigations after an event include electrocardiographic monitoring , the optimal duration to detect AF is unclear .
We performed a systematic review and meta- analysis to determine whether the duration of electrocardiographic monitoring after an ischemic event is related to the detection of AF .
|
2,012 | 25,639,643 |
Longer duration of electrocardiographic monitoring after cryptogenic stroke is associated with a greater detection of AF .
|
BACKGROUND Atrial fibrillation ( AF ) is a major cause of stroke .
Although st and ard investigations after an event include electrocardiographic monitoring , the optimal duration to detect AF is unclear .
We performed a systematic review and meta- analysis to determine whether the duration of electrocardiographic monitoring after an ischemic event is related to the detection of AF .
| 48,840 | 3,826,055 |
Cost-effectiveness of 7-day-Holter monitoring alone or in combination with transthoracic echocardiography in patients with cerebral ischemia
|
Abstract Background and purpose Prolonged Holter monitoring of patients with cerebral ischemia increases the detection rate of paroxysmal atrial fibrillation ( PAF ) ; this leads to improved antithrombotic regimens aim ed at preventing recurrent ischemic strokes . The aim of this study was to compare a 7-day-Holter monitoring ( 7-d-Holter ) alone or in combination with prior selection via transthoracic echocardiography ( TTE ) to a st and ard 24-h-Holter using a cost-utility analysis . Methods Lifetime cost , quality -adjusted life years ( QALY ) , and incremental cost-effectiveness ratios ( ICER ) were estimated for a cohort of patients with acute cerebral ischemia and no contraindication to oral anticoagulation . A Markov model was developed to simulate the long-term course and progression of cerebral ischemia considering the different diagnostic algorithms ( 24-h-Holter , 7-d-Holter , 7-d-Holter after pre selection by TTE ) . Clinical data for these algorithms were derived from the prospect i ve observational Find-AF study ( IS RCT N 46104198 ) . Results Predicted lifelong discounted costs were 33,837 € for patients diagnosed by the 7-d-Holter and 33,852 € by the st and ard 24-h-Holter . Cumulated QALYs were 3.868 for the 7-d-Holter compared to 3.844 for the 24-h-Holter . The 7-d-Holter dominated the 24-h-Holter in the base-case scenario and remained cost-effective in extensive sensitivity analysis of key input parameter with a maximum of 8,354 € /QALY gained . Pre selecting patients for the 7-d-Holter had no positive effect on the cost-effectiveness . Conclusions A 7-d-Holter to detect PAF in patients with cerebral ischemia is cost-effective . It increases the detection which leads to improved antithrombotic regimens ; therefore , it avoids recurrent strokes , saves future costs , and decreases quality of life impairment . Pre selecting patients by TTE does not improve cost-effectiveness
| 2,012 |
Longer duration of electrocardiographic monitoring after cryptogenic stroke is associated with a greater detection of AF .
|
BACKGROUND Atrial fibrillation ( AF ) is a major cause of stroke .
Although st and ard investigations after an event include electrocardiographic monitoring , the optimal duration to detect AF is unclear .
We performed a systematic review and meta- analysis to determine whether the duration of electrocardiographic monitoring after an ischemic event is related to the detection of AF .
|
2,012 | 25,639,643 |
Longer duration of electrocardiographic monitoring after cryptogenic stroke is associated with a greater detection of AF .
|
BACKGROUND Atrial fibrillation ( AF ) is a major cause of stroke .
Although st and ard investigations after an event include electrocardiographic monitoring , the optimal duration to detect AF is unclear .
We performed a systematic review and meta- analysis to determine whether the duration of electrocardiographic monitoring after an ischemic event is related to the detection of AF .
| 48,841 | 20,966,415 |
Enhanced Detection of Paroxysmal Atrial Fibrillation by Early and Prolonged Continuous Holter Monitoring in Patients With Cerebral Ischemia Presenting in Sinus Rhythm
|
Background and Purpose Diagnosis of paroxysmal atrial fibrillation is difficult but highly relevant in patients presenting with cerebral ischemia yet free from atrial fibrillation on admission . Early initiation and prolongation of continuous Holter monitoring may improve diagnostic yield compared with the st and ard of care including a 24-hour Holter recording . Methods — In the observational Find-AF trial ( IS RCT N 46104198 ) , consecutive patients presenting with symptoms of cerebral ischemia were included . Patients free from atrial fibrillation at presentation received 7-day Holter monitoring . Results — Two hundred eighty-one patients were prospect ively included . Forty-four ( 15.7 % ) had atrial fibrillation documented by routine electrocardiogram on admission . All remaining patients received Holter monitors at a median of 5.5 hours after presentation . In those 224 patients who received Holter monitors but had no previously known paroxysmal atrial fibrillation , the detection rate with early and prolonged ( 7 days ) Holter monitoring ( 12.5 % ) was significantly higher than for any 24-hour ( mean of 7 intervals : 4.8 % , P=0.015 ) or any 48-hour monitoring interval ( mean of 6 intervals : 6.4 % , P=0.023 ) . Of those 28 patients with new atrial fibrillation on Holter monitoring , 15 ( 6.7 % ) had been discharged without therapeutic anticoagulation after routine clinical care ( ie , with data from 24-hour Holter monitoring only ) . Detection rates were 43.8 % or 6.3 % for short supraventricular runs of ≥10 beats or prolonged episodes ( < 5 hours ) of atrial fibrillation , respectively . Diagnostic yield appeared to be only slightly and not significantly increased during the first 3 days after the index event . Conclusions — Prolongation of Holter monitoring in patients with symptoms of cerebral ischemic events increases the rate of detection of paroxysmal atrial fibrillation up to Day 7 , leading to a relevant change in therapy in a substantial number of patients . Early initiation of monitoring does not appear to be crucial . Hence , prolonged Holter monitoring ( ≥7 days ) should be considered for all patients with unexplained cerebral ischemia
| 2,012 |
Longer duration of electrocardiographic monitoring after cryptogenic stroke is associated with a greater detection of AF .
|
BACKGROUND Atrial fibrillation ( AF ) is a major cause of stroke .
Although st and ard investigations after an event include electrocardiographic monitoring , the optimal duration to detect AF is unclear .
We performed a systematic review and meta- analysis to determine whether the duration of electrocardiographic monitoring after an ischemic event is related to the detection of AF .
|
2,012 | 25,639,643 |
Longer duration of electrocardiographic monitoring after cryptogenic stroke is associated with a greater detection of AF .
|
BACKGROUND Atrial fibrillation ( AF ) is a major cause of stroke .
Although st and ard investigations after an event include electrocardiographic monitoring , the optimal duration to detect AF is unclear .
We performed a systematic review and meta- analysis to determine whether the duration of electrocardiographic monitoring after an ischemic event is related to the detection of AF .
| 48,842 | 23,121,252 |
Predictors of newly diagnosed atrial fibrillation in cryptogenic stroke: a cohort study.
|
BACKGROUND AND PURPOSE A significant proportion of cryptogenic ischaemic strokes are due to paroxysmal atrial fibrillation ( AF ) . As paroxysmal AF appears to inexorably progress to persistent or permanent AF , this study with long-term follow-up was design ed to establish the profile of patients who developed AF after hospital discharge . METHODS All patients with cryptogenic ischaemic stroke over a 1-year period were included ( n = 164 ) . Patients were prospect ively followed up at the outpatient clinic . Information on long-term outcome included the presence of newly diagnosed AF ( NDAF ) . A specific NDAF assessment was performed at least 2 years after the index stroke using a structured telephone interview . Baseline clinical , laboratory , and echocardiographic data of these patients were retrospectively recorded . Independent predictive factors were then used to produce a predictive grading score for NDAF , derived by logistic regression analysis . RESULTS With a median follow-up of 854 days , 22 cases of NDAF ( 13 % ) were observed . On multivariate analysis , factors associated with NDAF were age ≥72 years ( two points ) , history of coronary artery disease ( one point ) or stroke ( one point ) , and left atrial area ≥16 cm(2 ) ( two points ) ( total score ranging from 0 to 6 ) . Patients with a score ≤1 point did not have NDAF during follow-up . CONCLUSIONS In cryptogenic ischaemic stroke , the NDAF score can be used to target patients at high risk of developing AF after hospital discharge , as a score of 0 - 1 was highly predictive of the absence of NDAF during follow-up . These results need to be confirmed in prospect i ve studies
| 2,012 |
Longer duration of electrocardiographic monitoring after cryptogenic stroke is associated with a greater detection of AF .
|
BACKGROUND Atrial fibrillation ( AF ) is a major cause of stroke .
Although st and ard investigations after an event include electrocardiographic monitoring , the optimal duration to detect AF is unclear .
We performed a systematic review and meta- analysis to determine whether the duration of electrocardiographic monitoring after an ischemic event is related to the detection of AF .
|
2,012 | 25,639,643 |
Longer duration of electrocardiographic monitoring after cryptogenic stroke is associated with a greater detection of AF .
|
BACKGROUND Atrial fibrillation ( AF ) is a major cause of stroke .
Although st and ard investigations after an event include electrocardiographic monitoring , the optimal duration to detect AF is unclear .
We performed a systematic review and meta- analysis to determine whether the duration of electrocardiographic monitoring after an ischemic event is related to the detection of AF .
| 48,843 | 22,236,222 |
Subclinical atrial fibrillation and the risk of stroke.
|
BACKGROUND One quarter of strokes are of unknown cause , and sub clinical atrial fibrillation may be a common etiologic factor . Pacemakers can detect sub clinical episodes of rapid atrial rate , which correlate with electrocardiographically documented atrial fibrillation . We evaluated whether sub clinical episodes of rapid atrial rate detected by implanted devices were associated with an increased risk of ischemic stroke in patients who did not have other evidence of atrial fibrillation . METHODS We enrolled 2580 patients , 65 years of age or older , with hypertension and no history of atrial fibrillation , in whom a pacemaker or defibrillator had recently been implanted . We monitored the patients for 3 months to detect sub clinical atrial tachyarrhythmias ( episodes of atrial rate > 190 beats per minute for more than 6 minutes ) and followed them for a mean of 2.5 years for the primary outcome of ischemic stroke or systemic embolism . Patients with pacemakers were r and omly assigned to receive or not to receive continuous atrial overdrive pacing . RESULTS By 3 months , sub clinical atrial tachyarrhythmias detected by implanted devices had occurred in 261 patients ( 10.1 % ) . Sub clinical atrial tachyarrhythmias were associated with an increased risk of clinical atrial fibrillation ( hazard ratio , 5.56 ; 95 % confidence interval [ CI ] , 3.78 to 8.17 ; P<0.001 ) and of ischemic stroke or systemic embolism ( hazard ratio , 2.49 ; 95 % CI , 1.28 to 4.85 ; P=0.007 ) . Of 51 patients who had a primary outcome event , 11 had had sub clinical atrial tachyarrhythmias detected by 3 months , and none had had clinical atrial fibrillation by 3 months . The population attributable risk of stroke or systemic embolism associated with sub clinical atrial tachyarrhythmias was 13 % . Sub clinical atrial tachyarrhythmias remained predictive of the primary outcome after adjustment for predictors of stroke ( hazard ratio , 2.50 ; 95 % CI , 1.28 to 4.89 ; P=0.008 ) . Continuous atrial overdrive pacing did not prevent atrial fibrillation . CONCLUSIONS Sub clinical atrial tachyarrhythmias , without clinical atrial fibrillation , occurred frequently in patients with pacemakers and were associated with a significantly increased risk of ischemic stroke or systemic embolism . ( Funded by St. Jude Medical ; ASSERT Clinical Trials.gov number , NCT00256152 . )
| 2,012 |
Longer duration of electrocardiographic monitoring after cryptogenic stroke is associated with a greater detection of AF .
|
BACKGROUND Atrial fibrillation ( AF ) is a major cause of stroke .
Although st and ard investigations after an event include electrocardiographic monitoring , the optimal duration to detect AF is unclear .
We performed a systematic review and meta- analysis to determine whether the duration of electrocardiographic monitoring after an ischemic event is related to the detection of AF .
|
2,012 | 25,639,643 |
Longer duration of electrocardiographic monitoring after cryptogenic stroke is associated with a greater detection of AF .
|
BACKGROUND Atrial fibrillation ( AF ) is a major cause of stroke .
Although st and ard investigations after an event include electrocardiographic monitoring , the optimal duration to detect AF is unclear .
We performed a systematic review and meta- analysis to determine whether the duration of electrocardiographic monitoring after an ischemic event is related to the detection of AF .
| 48,844 | 15,228,390 |
Holter monitoring in the diagnosis of stroke mechanism.
|
BACKGROUND Atrial fibrillation ( AF ) , an important and treatable cause of ischaemic stroke , can occur as a sustained or a paroxysmal arrhythmia . Continuous cardiac rhythm monitoring ( Holter monitoring ) is often performed in stroke patients to identify paroxysmal AF , which is an indication for warfarin anti-coagulation in this patient population . AIM The aim of this study was to assess the clinical utility of Holter monitoring in detecting occult AF in patients with possible cardioembolic stroke . METHODS The medical records of ischaemic stroke patients consecutively hospitalized at a single academic centre during a one-year period were review ed . Data regarding patient demographics , stroke characteristics , electrocardiography and echocardiography results and duration and findings of Holter monitoring were abstract ed . The primary outcome was yield of newly diagnosed AF on Holter monitoring . RESULTS Of 465 consecutive patients admitted with a diagnosis of new ischaemic stroke , 210 underwent Holter monitoring . The mean duration of monitoring was 22.8 + /- 4.0 h. Previously undiscovered AF was -identified in five cases ( 2.4 % ) , all of which represented non-rheumatic AF . In three cases , the Holter test was negative despite AF documented on an admission electro-cardiogram . CONCLUSIONS Holter monitoring can identify occult paroxysmal AF , assisting targeted secondary prevention in patients with new ischaemic stroke . However , the st and ard 24-h duration of monitoring probably under-estimates the prevalence of paroxysmal AF in this population . Prospect i ve studies are indicated to evaluate the value of longer monitoring periods in stroke population
| 2,012 |
Longer duration of electrocardiographic monitoring after cryptogenic stroke is associated with a greater detection of AF .
|
BACKGROUND Atrial fibrillation ( AF ) is a major cause of stroke .
Although st and ard investigations after an event include electrocardiographic monitoring , the optimal duration to detect AF is unclear .
We performed a systematic review and meta- analysis to determine whether the duration of electrocardiographic monitoring after an ischemic event is related to the detection of AF .
|
2,012 | 25,639,643 |
Longer duration of electrocardiographic monitoring after cryptogenic stroke is associated with a greater detection of AF .
|
BACKGROUND Atrial fibrillation ( AF ) is a major cause of stroke .
Although st and ard investigations after an event include electrocardiographic monitoring , the optimal duration to detect AF is unclear .
We performed a systematic review and meta- analysis to determine whether the duration of electrocardiographic monitoring after an ischemic event is related to the detection of AF .
| 48,845 | 12,511,758 |
Admitting Acute Ischemic Stroke Patients to a Stroke Care Monitoring Unit Versus a Conventional Stroke Unit: A Randomized Pilot Study
|
Background and Purpose — Pathophysiological considerations and observational studies indicate that elevated body temperature , hypoxia , hypotension , and cardiac arrhythmias in the acute phase of ischemic stroke may aggravate brain damage and worsen outcome . Methods — Both units were organized with the same st and ard care and multidisciplinary approach to nursing and rehabilitation . A blinded observer assessed functional outcome at 3 months with the modified Rankin scale ( mRS ) and Barthel Index ( BI ) . End points were ( 1 ) poor outcome , defined as either mRS ≥4 or BI < 60 or the need for institutional care and ( 2 ) mortality . Results — Fifty-four patients meeting the inclusion criteria were r and omized . The groups were well matched for baseline characteristics , stroke subtype , stroke severity , vascular risk factors , and prognostic factors . Poor outcome was seen in 7 ( 25.9 % ) patients in the SCMU group and in 13 ( 48.1 % ) in the SU group ( P = 0.16 ) . Mortality was lower in the SCMU group than in the SU group ( 1 [ 3.7 % ] vs 7 [ 25.9 % ] ; odds ratio , 0.11 [ 95 % CI , 0.02 to 0.96 ] , P = 0.05 ) . Conclusions — This pilot study suggests that admission of acute stroke patients to an SCMU may reduce mortality and poor outcome . A larger trial is required to confirm these findings
| 2,012 |
Longer duration of electrocardiographic monitoring after cryptogenic stroke is associated with a greater detection of AF .
|
BACKGROUND Atrial fibrillation ( AF ) is a major cause of stroke .
Although st and ard investigations after an event include electrocardiographic monitoring , the optimal duration to detect AF is unclear .
We performed a systematic review and meta- analysis to determine whether the duration of electrocardiographic monitoring after an ischemic event is related to the detection of AF .
|
2,012 | 25,639,643 |
Longer duration of electrocardiographic monitoring after cryptogenic stroke is associated with a greater detection of AF .
|
BACKGROUND Atrial fibrillation ( AF ) is a major cause of stroke .
Although st and ard investigations after an event include electrocardiographic monitoring , the optimal duration to detect AF is unclear .
We performed a systematic review and meta- analysis to determine whether the duration of electrocardiographic monitoring after an ischemic event is related to the detection of AF .
| 48,846 | 3,734,596 |
Age-dependent yield of screening for undetected atrial fibrillation in stroke patients: the Find-AF study
|
Diagnosis of paroxysmal atrial fibrillation ( AF ) in stroke patients is challenging , but highly clinical ly relevant . The percentage of stroke patients with permanent AF increases with age , but limited data are available for the age-dependent yield of paroxysmal AF by Holter monitoring . Patients with acute cerebral ischemia were included into the prospect i ve observational Find-AF study . Patients free from AF at presentation received 7 day Holter monitoring . We calculated the percentage of otherwise undetected paroxysmal AF and the number needed to screen for age groups under 60 years , and in 5 year clusters from the age of 60 up to 85 and older . 272 patients were included , 43 ( 15.8 % ) had AF at admission , 33 patients with paroxysmal AF were identified by 7 day Holter ( n = 29 ) or medical history ( n = 4).The yield of 7 day Holter ECG clearly increased with older age ( p = 0.004 ) : < 60 years : 5 % , 60–64 years : 5 % , 65–69 years : 7 % , 70–74 years : 11 % , 75–79 years : 13 % , 80–84 years : 25 % , ≥85 years : 39 % . The number needed to screen ( NNS ) to find one patient with paroxysmal AF decreased with age : ≤60 years : 18 , 60–64 years : 20 , 65–69 years : 14 , 70–74 years : 9 , 75–79 years : 8 , 80–84 years : 4 , ≥85 years : 3 , respectively . In patients < 65 years , all AF cases were detected by Holter ECG . The percentage of paroxysmal AF in stroke patients increases with age . The 7 day Holter ECG is most efficient in elderly patients
| 2,012 |
Longer duration of electrocardiographic monitoring after cryptogenic stroke is associated with a greater detection of AF .
|
BACKGROUND Atrial fibrillation ( AF ) is a major cause of stroke .
Although st and ard investigations after an event include electrocardiographic monitoring , the optimal duration to detect AF is unclear .
We performed a systematic review and meta- analysis to determine whether the duration of electrocardiographic monitoring after an ischemic event is related to the detection of AF .
|
2,012 | 25,639,643 |
Longer duration of electrocardiographic monitoring after cryptogenic stroke is associated with a greater detection of AF .
|
BACKGROUND Atrial fibrillation ( AF ) is a major cause of stroke .
Although st and ard investigations after an event include electrocardiographic monitoring , the optimal duration to detect AF is unclear .
We performed a systematic review and meta- analysis to determine whether the duration of electrocardiographic monitoring after an ischemic event is related to the detection of AF .
| 48,847 | 22,871,679 |
Detection of Paroxysmal Atrial Fibrillation by 30-Day Event Monitoring in Cryptogenic Ischemic Stroke: The Stroke and Monitoring for PAF in Real Time (SMART) Registry
|
Background and Purpose — Patients with cryptogenic ischemic stroke may have undetected paroxysmal atrial fibrillation ( PAF ) . We established the Stroke and Monitoring for PAF in Real Time ( SMART ) Registry to determine the yield of 30-day outpatient PAF monitoring in cryptogenic ischemic stroke . Methods — The SMART Registry was a 3-year , prospect i ve multicenter registry of 239 patients with cryptogenic ischemic stroke undergoing 30-day outpatient autotriggered PAF detection in Kaiser Permanente Northern California . Results — In intention-to-monitor analysis , PAF was detected in 29 of 239 patients ( 12.1 % ; 95 % CI , 8.6%–16.9 % ) . After retrospective chart review was performed , a new diagnosis of PAF was confirmed in 26 of 236 patients ( 11.0 % ; 95 % CI , 7.6%–15.7 % ) . The majority of detected PAF events were asymptomatic ; only 6 of 98 recorded PAF events ( 6.1 % ) were patient-triggered or associated with symptoms . Conclusions — -Approximately 1 in every 9 patients with cryptogenic ischemic stroke was found to have new PAF within 30 days . Routine monitoring in this population should be strongly considered
| 2,012 |
Longer duration of electrocardiographic monitoring after cryptogenic stroke is associated with a greater detection of AF .
|
BACKGROUND Atrial fibrillation ( AF ) is a major cause of stroke .
Although st and ard investigations after an event include electrocardiographic monitoring , the optimal duration to detect AF is unclear .
We performed a systematic review and meta- analysis to determine whether the duration of electrocardiographic monitoring after an ischemic event is related to the detection of AF .
|
2,012 | 25,639,643 |
Longer duration of electrocardiographic monitoring after cryptogenic stroke is associated with a greater detection of AF .
|
BACKGROUND Atrial fibrillation ( AF ) is a major cause of stroke .
Although st and ard investigations after an event include electrocardiographic monitoring , the optimal duration to detect AF is unclear .
We performed a systematic review and meta- analysis to determine whether the duration of electrocardiographic monitoring after an ischemic event is related to the detection of AF .
| 48,848 | 2,921,065 |
Unexpected low prevalence of atrial fibrillation in cryptogenic ischemic stroke: a prospective study
|
Purpose Ischemic stroke is a frequent pathology with high rate of recurrence and significant morbidity and mortality . There are several causes of stroke , affecting prognosis , outcomes , and management , but in many cases , the etiology remains undetermined . We hypothesized that atrial fibrillation was involved in this pathology but underdiagnosed by st and ard methods . The aim of the study was to determine the incidence of atrial fibrillation in cryptogenic ischemic stroke by using continuous monitoring of the heart rate over several months . The secondary objective was to test the value of atrial vulnerability assessment in predicting spontaneous atrial fibrillation . Methods and results We prospect ively enrolled 24 patients under 75 years of age , 15 men and 9 women of mean age 49 years , who within the last 4 months had experienced cryptogenic stroke diagnosed by clinical presentation and brain imaging and presumed to be of cardioembolic mechanism . All causes of stroke were excluded by normal 12-lead ECG , 24-h Holter monitoring , echocardiography , cervical Doppler , hematological , and inflammatory tests . All patients underwent electrophysiological study . Of the patients , 37.5 % had latent atrial vulnerability , and 33.3 % had inducible sustained arrhythmia . Patients were secondarily implanted with an implantable loop recorder to look for spontaneous atrial fibrillation over a mean follow-up interval of 14.5 months . No sustained arrhythmia was found . Only one patient had non-significant episodes of atrial fibrillation . Conclusion In this study , symptomatic atrial fibrillation or AF with fast ventricular rate has not been demonstrated by the implantable loop recorder in patients under 75 years with unexplained cerebral ischemia . The use of this device should not be generalized in the systematic evaluation of these patients . In addition , this study attests that the assessment of atrial vulnerability is poor at predicting spontaneous arrhythmia in such patients
| 2,012 |
Longer duration of electrocardiographic monitoring after cryptogenic stroke is associated with a greater detection of AF .
|
BACKGROUND Atrial fibrillation ( AF ) is a major cause of stroke .
Although st and ard investigations after an event include electrocardiographic monitoring , the optimal duration to detect AF is unclear .
We performed a systematic review and meta- analysis to determine whether the duration of electrocardiographic monitoring after an ischemic event is related to the detection of AF .
|
2,012 | 25,639,643 |
Longer duration of electrocardiographic monitoring after cryptogenic stroke is associated with a greater detection of AF .
|
BACKGROUND Atrial fibrillation ( AF ) is a major cause of stroke .
Although st and ard investigations after an event include electrocardiographic monitoring , the optimal duration to detect AF is unclear .
We performed a systematic review and meta- analysis to determine whether the duration of electrocardiographic monitoring after an ischemic event is related to the detection of AF .
| 48,849 | 22,308,240 |
A Structured Reading Algorithm Improves Telemetric Detection of Atrial Fibrillation After Acute Ischemic Stroke
|
Background and Purpose — Anticoagulation is a highly effective secondary prevention in patients with cardioembolic stroke and atrial fibrillation/flutter ( AF ) . However , the condition remains underdiagnosed , because paroxysmal AF may be missed by diagnostic tests in the acute phase . In this study , the sensitivity of AF detection was assessed for serial electrocardiographic recordings and continuous stroke unit telemetric monitoring with or without a structured algorithm to analyze telemetric data ( SEA-AF ) . Methods — Three hundred forty-six consecutive patients with acute ischemic stroke were prospect ively included and subjected to st and ard telemetric monitoring . In addition , telemetric data were separately analyzed following SEA-AF , consisting of a structured evaluation of episodes with high risk for AF and a chronological beat-to-beat screening of the full registration . Serial electrocardiograms were conducted in 24-hour intervals . Results — Median effective telemetry monitoring time was 75.5 hours ( interquartile range 64–86 hours ) . Overall , AF was diagnosed in 119 of 346 patients ( 34.4 % ) . The structured reading algorithm was the most sensitive method to detected AF . Conventional telemetry and serial electrocardiographic assessment s were less effective . However , only 35 % of patients with previously documented paroxysmal AF and negative baseline electrocardiogram demonstrated AF episodes during monitoring . Conclusions — Continuous stroke unit telemetry using SEA-AF shows a significantly higher detection rate for AF compared with daily electrocardiographic assessment s and st and ard telemetry without structured reading . The low overall probability to detect paroxysmal AF with either method during the first days after stroke demonstrates the urgent need for complementary diagnostic strategies such as long-term monitoring and frequent follow-up assessment s. Clinical Trial Registration — URL : www . clinical trials.gov . Unique identifier : NCT01177748
| 2,012 |
Longer duration of electrocardiographic monitoring after cryptogenic stroke is associated with a greater detection of AF .
|
BACKGROUND Atrial fibrillation ( AF ) is a major cause of stroke .
Although st and ard investigations after an event include electrocardiographic monitoring , the optimal duration to detect AF is unclear .
We performed a systematic review and meta- analysis to determine whether the duration of electrocardiographic monitoring after an ischemic event is related to the detection of AF .
|
2,012 | 25,639,643 |
Longer duration of electrocardiographic monitoring after cryptogenic stroke is associated with a greater detection of AF .
|
BACKGROUND Atrial fibrillation ( AF ) is a major cause of stroke .
Although st and ard investigations after an event include electrocardiographic monitoring , the optimal duration to detect AF is unclear .
We performed a systematic review and meta- analysis to determine whether the duration of electrocardiographic monitoring after an ischemic event is related to the detection of AF .
| 48,850 | 20,723,645 |
Comparison of detection of arrhythmias in patients with chronic heart failure secondary to non-ischemic versus ischemic cardiomyopathy by 1 versus 7-day holter monitoring.
|
The purpose of this study was to compare the diagnostic sensitivity of 1-day Holter monitoring versus 7-day Holter monitoring ( 7DH ) to detect atrial and ventricular arrhythmias in a population of stable patients with chronic heart failure and left ventricular dysfunction . Sixty-three consecutive stable patients with chronic heart failure with left ventricular ejection fractions < or = 50 % were included . Blood sample s were obtained , the Minnesota Living With Heart Failure Question naire was administered , and echocardiography , 6-minute walk tests , and 7DH were performed at enrollment . The mean ejection fraction was 35.8 + /- 9.8 % , and the mean age was 55.5 + /- 13.9 years . Seven-day Holter monitoring did not significantly increase the detection of nonsustained atrial tachycardia or atrial fibrillation . In contrast , the incidence of nonsustained ventricular tachycardia increased in nonischemic patients from 35.1 % on day 1 to 54.1 % on day 7 ( p = 0.01 ) . In ischemic patients , the sensitivity increased from 11.5 % to 46.2 % ( p = 0.004 ) . Two patients without nonsustained ventricular tachycardia on day 1 had episodes of 13 and 16 beats on days 3 and 6 of monitoring . In patients with left ventricular ejection fractions > 35 % and N-terminal-pro-brain natriuretic peptide levels < 1,000 pg/ml , no episodes of nonsustained ventricular tachycardia were detected on day 1 in nonischemic and ischemic patients , but 7DH detected 3 new patients in each group . In conclusion , 7DH clearly improves the detection and allows a better characterization of ventricular arrhythmic episodes but seems to be less useful for supraventricular events
| 2,012 |
Longer duration of electrocardiographic monitoring after cryptogenic stroke is associated with a greater detection of AF .
|
BACKGROUND Atrial fibrillation ( AF ) is a major cause of stroke .
Although st and ard investigations after an event include electrocardiographic monitoring , the optimal duration to detect AF is unclear .
We performed a systematic review and meta- analysis to determine whether the duration of electrocardiographic monitoring after an ischemic event is related to the detection of AF .
|
2,012 | 25,639,643 |
Longer duration of electrocardiographic monitoring after cryptogenic stroke is associated with a greater detection of AF .
|
BACKGROUND Atrial fibrillation ( AF ) is a major cause of stroke .
Although st and ard investigations after an event include electrocardiographic monitoring , the optimal duration to detect AF is unclear .
We performed a systematic review and meta- analysis to determine whether the duration of electrocardiographic monitoring after an ischemic event is related to the detection of AF .
| 48,851 | 24,963,566 |
Atrial fibrillation in patients with cryptogenic stroke.
|
BACKGROUND Atrial fibrillation is a leading preventable cause of recurrent stroke for which early detection and treatment are critical . However , paroxysmal atrial fibrillation is often asymptomatic and likely to go undetected and untreated in the routine care of patients with ischemic stroke or transient ischemic attack ( TIA ) . METHODS We r and omly assigned 572 patients 55 years of age or older , without known atrial fibrillation , who had had a cryptogenic ischemic stroke or TIA within the previous 6 months ( cause undetermined after st and ard tests , including 24-hour electrocardiography [ ECG ] ) , to undergo additional noninvasive ambulatory ECG monitoring with either a 30-day event-triggered recorder ( intervention group ) or a conventional 24-hour monitor ( control group ) . The primary outcome was newly detected atrial fibrillation lasting 30 seconds or longer within 90 days after r and omization . Secondary outcomes included episodes of atrial fibrillation lasting 2.5 minutes or longer and anticoagulation status at 90 days . RESULTS Atrial fibrillation lasting 30 seconds or longer was detected in 45 of 280 patients ( 16.1 % ) in the intervention group , as compared with 9 of 277 ( 3.2 % ) in the control group ( absolute difference , 12.9 percentage points ; 95 % confidence interval [ CI ] , 8.0 to 17.6 ; P<0.001 ; number needed to screen , 8) . Atrial fibrillation lasting 2.5 minutes or longer was present in 28 of 284 patients ( 9.9 % ) in the intervention group , as compared with 7 of 277 ( 2.5 % ) in the control group ( absolute difference , 7.4 percentage points ; 95 % CI , 3.4 to 11.3 ; P<0.001 ) . By 90 days , oral anticoagulant therapy had been prescribed for more patients in the intervention group than in the control group ( 52 of 280 patients [ 18.6 % ] vs. 31 of 279 [ 11.1 % ] ; absolute difference , 7.5 percentage points ; 95 % CI , 1.6 to 13.3 ; P=0.01 ) . CONCLUSIONS Among patients with a recent cryptogenic stroke or TIA who were 55 years of age or older , paroxysmal atrial fibrillation was common . Noninvasive ambulatory ECG monitoring for a target of 30 days significantly improved the detection of atrial fibrillation by a factor of more than five and nearly doubled the rate of anticoagulant treatment , as compared with the st and ard practice of short- duration ECG monitoring . ( Funded by the Canadian Stroke Network and others ; EMBRACE Clinical Trials.gov number , NCT00846924 . )
| 2,012 |
Longer duration of electrocardiographic monitoring after cryptogenic stroke is associated with a greater detection of AF .
|
BACKGROUND Atrial fibrillation ( AF ) is a major cause of stroke .
Although st and ard investigations after an event include electrocardiographic monitoring , the optimal duration to detect AF is unclear .
We performed a systematic review and meta- analysis to determine whether the duration of electrocardiographic monitoring after an ischemic event is related to the detection of AF .
|
2,012 | 25,639,643 |
Longer duration of electrocardiographic monitoring after cryptogenic stroke is associated with a greater detection of AF .
|
BACKGROUND Atrial fibrillation ( AF ) is a major cause of stroke .
Although st and ard investigations after an event include electrocardiographic monitoring , the optimal duration to detect AF is unclear .
We performed a systematic review and meta- analysis to determine whether the duration of electrocardiographic monitoring after an ischemic event is related to the detection of AF .
| 48,852 | 23,899,913 |
Noninvasive Cardiac Event Monitoring to Detect Atrial Fibrillation After Ischemic Stroke: A Randomized, Controlled Trial
|
Background and Purpose — Atrial fibrillation ( AF ) elevates risk of recurrent stroke but is incompletely identified by st and ard investigation after stroke , though detection rates correlate with monitoring duration . We hypothesized that 7 days of noninvasive cardiac-event monitoring early after stroke would accelerate detection of AF and thus uptake of effective therapy . Methods — We performed a pragmatic r and omized trial with objective outcome assessment among patients presenting in sinus rhythm with no AF history , within 7 days of ischemic stroke symptom onset . Patients were r and omized to st and ard practice investigations ( SP ) to detect AF , or SP plus additional monitoring ( SP-AM ) . AM comprised 7 days of noninvasive cardiac-event monitoring reported by an accredited cardiac electrocardiology laboratory . Primary outcome was detection of AF at 14 days . Results — One-hundred patients were enrolled from 2 centers . Within 14 days of stroke , sustained paroxysms of AF were detected in 18 % of patients undergoing SP-AM versus 2 % undergoing SP ( P<0.05 ) . Paroxysms of any- duration were detected in 44 % of patients undergoing SP-AM versus 4 % undergoing SP ( P<0.001 ) . These differences persisted at 90 days . Anticoagulant therapy was commenced within 14 days in 16 % of SP-AM patients versus none r and omized to SP ( P<0.01 ) . This difference persisted to 90 days ( 22 % versus 6 % ; P<0.05 ) . Conclusions — Routine noninvasive cardiac-event monitoring after acute stroke enhances detection of paroxysmal AF and early anticoagulation . Extended monitoring should be offered to all eligible patients soon after acute stroke . Guidelines on investigation for AF in stroke patients could be strengthened . Clinical Trial Registration — URL : http://www.controlled-trials.com/is rct n/. Unique identifier : IS RCT N97412358
| 2,012 |
Longer duration of electrocardiographic monitoring after cryptogenic stroke is associated with a greater detection of AF .
|
BACKGROUND Atrial fibrillation ( AF ) is a major cause of stroke .
Although st and ard investigations after an event include electrocardiographic monitoring , the optimal duration to detect AF is unclear .
We performed a systematic review and meta- analysis to determine whether the duration of electrocardiographic monitoring after an ischemic event is related to the detection of AF .
|
2,012 | 25,639,643 |
Longer duration of electrocardiographic monitoring after cryptogenic stroke is associated with a greater detection of AF .
|
BACKGROUND Atrial fibrillation ( AF ) is a major cause of stroke .
Although st and ard investigations after an event include electrocardiographic monitoring , the optimal duration to detect AF is unclear .
We performed a systematic review and meta- analysis to determine whether the duration of electrocardiographic monitoring after an ischemic event is related to the detection of AF .
| 48,853 | 20,160,169 |
Performance of a New Leadless Implantable Cardiac Monitor in Detecting and Quantifying Atrial Fibrillation Results of the XPECT Trial
|
Background —Current methods for detecting atrial fibrillation ( AF ) have limited diagnostic yield . Continuous monitoring with automatic arrhythmia detection and classification may improve detection of symptomatic and asymptomatic AF and subsequent patient treatment . The study purpose was to quantify the performance of the first implantable leadless cardiac monitor ( ICM ) with dedicated AF detection capabilities . Methods and Results — Patients ( n=247 ) with an implanted ICM ( Reveal XT , Medtronic Inc , Minneapolis , Minn ) who were likely to present with paroxysmal AF were selected . A special Holter device stored 46 hours of subcutaneously recorded ECG , ICM markers , and 2 surface ECG leads . The ICM automatic arrhythmia classification was compared with the core laboratory classification of the surface ECG . Of the 206 analyzable Holter recordings collected , 76 ( 37 % ) contained at least 1 episode of core laboratory classified AF . The sensitivity , specificity , positive predictive value , and negative predictive value for identifying patients with any AF were 96.1 % , 85.4 % , 79.3 % , and 97.4 % , respectively . The AF burden measured with the ICM was very well correlated with the reference value derived from the Holter ( Pearson coefficient=0.97 ) . The overall accuracy of the ICM for detecting AF was 98.5 % . Conclusions —In this ICM validation study , the dedicated AF detection algorithm reliably detected the presence or absence of AF and the AF burden was accurately quantified . The ICM is a promising new diagnostic and monitoring tool for the clinician to treat AF patients independently of symptoms . Long-term studies are needed to evaluate the clinical benefits of the technology . Clinical Trial Registration — clinical trials.gov Identifier NCT00680927
| 2,012 |
Longer duration of electrocardiographic monitoring after cryptogenic stroke is associated with a greater detection of AF .
|
BACKGROUND Atrial fibrillation ( AF ) is a major cause of stroke .
Although st and ard investigations after an event include electrocardiographic monitoring , the optimal duration to detect AF is unclear .
We performed a systematic review and meta- analysis to determine whether the duration of electrocardiographic monitoring after an ischemic event is related to the detection of AF .
|
2,012 | 25,639,643 |
Longer duration of electrocardiographic monitoring after cryptogenic stroke is associated with a greater detection of AF .
|
BACKGROUND Atrial fibrillation ( AF ) is a major cause of stroke .
Although st and ard investigations after an event include electrocardiographic monitoring , the optimal duration to detect AF is unclear .
We performed a systematic review and meta- analysis to determine whether the duration of electrocardiographic monitoring after an ischemic event is related to the detection of AF .
| 48,854 | 10,456,638 |
Impact of long-term ECG recording on the detection of paroxysmal atrial fibrillation in patients after an acute ischemic stroke.
|
An ECG recording time of 24 hours has a low yield to detect atrial arrhythmias in patients after an acute ischemic stroke . The present study investigated whether a recording time of 72 instead of 24 hours detects paroxysmal atrial fibrillation in more patients . The study prospect ively included 82 consecutive patients 2 - 3 weeks after an acute ischemic stroke . All patients had sinus rhythm in the resting ECGs and no history of atrial fibrillation or flutter . The frequency of atrial fibrillation was assessed after 24 , 48 , and 72 hours of ambulatory ECG monitoring . An ECG monitoring time of 72 hours documented paroxysmal atrial fibrillation in five ( 6 % ) patients . The episode of paroxysmal atrial fibrillation occurred in only one patient within 24 hours . The other patients had their first episode of atrial fibrillation between 24 and 48 hours ( n = 2 ) and between 48 and 72 hours ( n = 2 ) . These five patients were older ( age = 70 + /- 5 years ) , whereas the mean age of the remaining patients was 59 + /- 13 years . All five patients had cardiovascular disease in comparison to 36 of 77 patients and reported palpitations in comparison to 6 of 77 of the remaining patients . In conclusion , ambulatory ECG monitoring over 72 hours detected after the first recording day four of five patients in whom paroxysmal atrial fibrillation could be documented for the first time . The 72-hour recording time improved , compared to the 24-hour period , the detection of paroxysmal atrial fibrillation in patients after an ischemic stroke . It seems to be more efficient to perform prolonged ECG recording mainly in older patients with a cardiovascular disease and /or a history of palpitations
| 2,012 |
Longer duration of electrocardiographic monitoring after cryptogenic stroke is associated with a greater detection of AF .
|
BACKGROUND Atrial fibrillation ( AF ) is a major cause of stroke .
Although st and ard investigations after an event include electrocardiographic monitoring , the optimal duration to detect AF is unclear .
We performed a systematic review and meta- analysis to determine whether the duration of electrocardiographic monitoring after an ischemic event is related to the detection of AF .
|
2,012 | 25,639,643 |
Longer duration of electrocardiographic monitoring after cryptogenic stroke is associated with a greater detection of AF .
|
BACKGROUND Atrial fibrillation ( AF ) is a major cause of stroke .
Although st and ard investigations after an event include electrocardiographic monitoring , the optimal duration to detect AF is unclear .
We performed a systematic review and meta- analysis to determine whether the duration of electrocardiographic monitoring after an ischemic event is related to the detection of AF .
| 48,855 | 23,791,469 |
Paroxysmal atrial fibrillation in cryptogenic stroke: a case-control study.
|
BACKGROUND It is unclear if brief episodes of paroxysmal atrial fibrillation ( PAF ) detected by prolonged cardiac monitoring are an occult of cause of cryptogenic strokes ( CS ) . We compared the incidence of PAF in patients with CS and patients with stroke of known cause ( SKC ) using prolonged ambulatory cardiac monitoring . METHODS We prospect ively enrolled patients within 3 months of ischemic stroke to undergo noninvasive cardiac monitoring for 3 weeks . Primary end point was PAF detection independently confirmed by 2 blinded cardiologists . RESULTS The study consisted of 132 patients , 66 had CS and 66 had SKC . Episodes of PAF were detected in 16 of 64 ( 25 % ) patients with CS and 9 of 64 ( 14 % ) patients with SKC ( P=.12 ) . Duration and number of PAF episodes , PAF burden , and time of first PAF detection did not differ significantly between the 2 groups ( P>.05 for all ) . In patients younger than 65 years , PAF was more common in the CS group ( 22 % versus 3 % ; P=.07 ) , whereas in patients 65 years or older , the rates of detection were similar ( 27 % in CS versus 25 % in SKC ; P=.9 ) . Among patients younger than 65 years with embolic imaging pattern , PAF was only observed in the CS group ( 21 % versus 0 % ; P=.03 ) . CONCLUSIONS Very short episodes of PAF are common in patients with CS and with SKC , but their pathogenic significance is unclear . Predominance of PAF in younger patients with CS and embolic infa rct pattern suggests a causative role in these cases . More research is needed before prolonged cardiac rhythm monitoring can be recommended to guide anticoagulation in CS patients
| 2,012 |
Longer duration of electrocardiographic monitoring after cryptogenic stroke is associated with a greater detection of AF .
|
BACKGROUND Atrial fibrillation ( AF ) is a major cause of stroke .
Although st and ard investigations after an event include electrocardiographic monitoring , the optimal duration to detect AF is unclear .
We performed a systematic review and meta- analysis to determine whether the duration of electrocardiographic monitoring after an ischemic event is related to the detection of AF .
|
2,012 | 25,639,643 |
Longer duration of electrocardiographic monitoring after cryptogenic stroke is associated with a greater detection of AF .
|
BACKGROUND Atrial fibrillation ( AF ) is a major cause of stroke .
Although st and ard investigations after an event include electrocardiographic monitoring , the optimal duration to detect AF is unclear .
We performed a systematic review and meta- analysis to determine whether the duration of electrocardiographic monitoring after an ischemic event is related to the detection of AF .
| 48,856 | 23,192,756 |
Pilot Randomized Trial of Outpatient Cardiac Monitoring After Cryptogenic Stroke
|
Background and Purpose — Observational studies indicate that outpatient cardiac monitoring detects previously undiagnosed atrial fibrillation ( AF ) in 5 % to 20 % of patients with recent stroke . However , it remains unknown whether the yield of monitoring exceeds that of routine clinical follow-up . Methods — In a pilot trial , we r and omly assigned 40 patients with cryptogenic ischemic stroke or high-risk transient ischemic attack to wear a Cardionet mobile cardiac outpatient telemetry monitor for 21 days or to receive routine follow-up alone . After thorough investigation , we excluded patients with documented AF or other apparent stroke pathogenesis . We contacted patients and their physicians at 3 months and at 1 year to ascertain any diagnoses of AF or recurrent stroke or transient ischemic attack . Results — The baseline characteristics of our cohort broadly matched those of previous observational studies of monitoring after stroke . In the monitoring group , patients wore monitors for 64 % of the assigned days , and 25 % of patients were not compliant at all with monitoring . No patient in either study arm received a diagnosis of AF . Cardiac monitoring revealed AF in zero patients ( 0 % ; 95 % confidence interval , 0%–17 % ) , brief episodes of atrial tachycardia in 2 patients ( 10 % ; 95 % confidence interval , 1%–32 % ) , and nonsustained ventricular tachycardia in 2 patients ( 10 % ; 95 % confidence interval , 1%–32 % ) . Conclusions — In the first reported r and omized trial of cardiac monitoring after cryptogenic stroke , the rate of AF detection was lower than expected , incidental arrhythmias were frequent , and compliance with monitoring was suboptimal . Our findings highlight the challenges of prospect ively identifying stroke patients at risk for harboring paroxysmal AF and ensuring adequate compliance with cardiac monitoring . Clinical Trial Registration — URL : http:// clinical trials.gov . Unique Identifier :
| 2,012 |
Longer duration of electrocardiographic monitoring after cryptogenic stroke is associated with a greater detection of AF .
|
BACKGROUND Atrial fibrillation ( AF ) is a major cause of stroke .
Although st and ard investigations after an event include electrocardiographic monitoring , the optimal duration to detect AF is unclear .
We performed a systematic review and meta- analysis to determine whether the duration of electrocardiographic monitoring after an ischemic event is related to the detection of AF .
|
2,012 | 25,639,643 |
Longer duration of electrocardiographic monitoring after cryptogenic stroke is associated with a greater detection of AF .
|
BACKGROUND Atrial fibrillation ( AF ) is a major cause of stroke .
Although st and ard investigations after an event include electrocardiographic monitoring , the optimal duration to detect AF is unclear .
We performed a systematic review and meta- analysis to determine whether the duration of electrocardiographic monitoring after an ischemic event is related to the detection of AF .
| 48,857 | 21,895,885 |
Continuous monitoring versus HOLTER ECG for detection of atrial fibrillation in patients with stroke.
|
BACKGROUND AND PURPOSE Detection of atrial fibrillation is of vital importance because oral anticoagulation decreases the risk of a stroke by 64 % . Current st and ards for stroke unit treatment require continuous electrocardiogram ( ECG ) monitoring for at least 24 h. Additionally , a 24-h HOLTER ECG ( HOLTER ) should be performed in selected patients . It remains unclear whether continuous monitoring at the bedside is equivalent to HOLTER for the detection of atrial fibrillation . Furthermore , we investigate how many additional patients with paroxysmal atrial fibrillation can be identified as a result of a longer duration of continuous monitoring . METHODS In this study , we prospect ively compared the detection rates of HOLTER and 24-h monitoring at the Stroke Unit at the University of Heidelberg over a period of 9 months . Continuous monitoring was analyzed by trained nurses , HOLTER by cardiologists . RESULTS We included 370 patients with ischemic stroke or transient ischemic attack ( TIA ) in our study . Of these , 192 patients underwent HOLTER . Previously unknown atrial fibrillation was detected in 44 patients , 13 patients had no atrial fibrillation in baseline ECG , but atrial fibrillation was detected by continuous monitoring . In two patients , the HOLTER showed atrial fibrillation ; both patients had also been detected by continuous monitoring . Median time to detection of the atrial fibrillation during continuous monitoring was 43 h after hospitalization . CONCLUSION In this study , use of HOLTER does not give any additional benefit in comparison with continuous monitoring with intermittent analysis by trained staff alone . The median detection time of 43 h emphasizes the importance of longer continuous monitoring
| 2,012 |
Longer duration of electrocardiographic monitoring after cryptogenic stroke is associated with a greater detection of AF .
|
BACKGROUND Atrial fibrillation ( AF ) is a major cause of stroke .
Although st and ard investigations after an event include electrocardiographic monitoring , the optimal duration to detect AF is unclear .
We performed a systematic review and meta- analysis to determine whether the duration of electrocardiographic monitoring after an ischemic event is related to the detection of AF .
|
2,012 | 25,639,643 |
Longer duration of electrocardiographic monitoring after cryptogenic stroke is associated with a greater detection of AF .
|
BACKGROUND Atrial fibrillation ( AF ) is a major cause of stroke .
Although st and ard investigations after an event include electrocardiographic monitoring , the optimal duration to detect AF is unclear .
We performed a systematic review and meta- analysis to determine whether the duration of electrocardiographic monitoring after an ischemic event is related to the detection of AF .
| 48,858 | 22,349,706 |
Optimal timing and duration of continuous electrocardiographic monitoring for detecting atrial fibrillation in stroke patients.
|
BACKGROUND Several studies have suggested that after ischemic stroke , continuous electrocardiographic ( ECG ) monitoring ( CEM ) increases the atrial fibrillation ( AF ) detection rate . However , optimal CEM terms of use are not clear . The aim of our study was to evaluate the usefulness of CEM in detecting AF and define optimal terms of the use of CEM . METHODS We prospect ively enrolled consecutive patients with acute ischemic stroke who were admitted to the stroke unit without AF on baseline ECG . We compared 2 strategies of AF detection : the first using CEM and the second with routine clinical practice ( 24-hour Holter ECG and additional ECGs ) . Adjusted odds ratios for the association between AF diagnosis and the use of CEM stratified by monitoring duration were calculated using multivariate logistic regression analysis . RESULTS Of the 1166 patients included , 220 ( 18.87 % ) had AF on baseline ECG and were excluded . Of the 946 remaining patients , 592 underwent CEM . The prevalence of AF using CEM was 12.50 % compared 2.26 % using the routine strategy . After adjustment ( demographic data , vascular risk factors , and National Institutes of Health Stroke Scale scores ) , using CEM increased 5.29 fold the odds of finding AF ( 95 % confidence interval [ CI ] 2.43 - 11.55 ) compared to the routine strategy . The adjusted odds ratio ( 9.82 ; 95 % CI 3.01 - 32.07 ) was maximum for the first day of monitoring and decreased later . Beyond 5 days , CEM usefulness was not significantly higher than the routine strategy . CONCLUSIONS We suggest that in order to enhance the detection rate of AF , CEM could be generalized in the stroke unit . It must be started early in patients with acute stroke and prolonged over a minimum of 4 days
| 2,012 |
Longer duration of electrocardiographic monitoring after cryptogenic stroke is associated with a greater detection of AF .
|
BACKGROUND Atrial fibrillation ( AF ) is a major cause of stroke .
Although st and ard investigations after an event include electrocardiographic monitoring , the optimal duration to detect AF is unclear .
We performed a systematic review and meta- analysis to determine whether the duration of electrocardiographic monitoring after an ischemic event is related to the detection of AF .
|
2,012 | 25,639,643 |
Longer duration of electrocardiographic monitoring after cryptogenic stroke is associated with a greater detection of AF .
|
BACKGROUND Atrial fibrillation ( AF ) is a major cause of stroke .
Although st and ard investigations after an event include electrocardiographic monitoring , the optimal duration to detect AF is unclear .
We performed a systematic review and meta- analysis to determine whether the duration of electrocardiographic monitoring after an ischemic event is related to the detection of AF .
| 48,859 | 15,143,959 |
Diagnostic and therapeutic impact of ambulatory electrocardiography in acute stroke.
|
UNLABELLED Detection of paroxysmal atrial fibrillation ( PAF ) in patients with recent ischemic stroke or TIA suggests a cardioembolic etiology and leads to initiation of oral anticoagulation in suitable c and i date s. We assessed the diagnostic and therapeutic impact of adding ambulatory electrocardiography ( 24 hr ECG ) to a st and ardised ischemic stroke workup . METHODS We measured the frequency of detection of PAF in consecutive stroke patients who underwent 24 hr ECG that was not diagnosed clinical ly or on a st and ard 12-lead ECG . RESULTS One hundred forty five ischemic stroke patients were included . 24 hr ECG was obtained in 136 patients ( 93.8 % ) . Clinical ly unsuspected PAF was detected on 24 hr ECG in 7 patients ( 5.1 % ) . The secondary prevention measure changed from antiplatelet agents to oral anticoagulation in 6 of 7 patients . CONCLUSION Our findings suggest that ambulatory electrocardiography is a valuable diagnostic tool in the workup of stroke patients . Further prospect i ve studies are needed to identify , subtypes of patients in whom the yield of ambulatory electrocardiography is higher
| 2,012 |
Longer duration of electrocardiographic monitoring after cryptogenic stroke is associated with a greater detection of AF .
|
BACKGROUND Atrial fibrillation ( AF ) is a major cause of stroke .
Although st and ard investigations after an event include electrocardiographic monitoring , the optimal duration to detect AF is unclear .
We performed a systematic review and meta- analysis to determine whether the duration of electrocardiographic monitoring after an ischemic event is related to the detection of AF .
|
2,012 | 25,639,643 |
Longer duration of electrocardiographic monitoring after cryptogenic stroke is associated with a greater detection of AF .
|
BACKGROUND Atrial fibrillation ( AF ) is a major cause of stroke .
Although st and ard investigations after an event include electrocardiographic monitoring , the optimal duration to detect AF is unclear .
We performed a systematic review and meta- analysis to determine whether the duration of electrocardiographic monitoring after an ischemic event is related to the detection of AF .
| 48,860 | 22,249,917 |
96 hours ECG monitoring for patients with ischemic cryptogenic stroke or transient ischaemic attack
|
Atrial fibrillation ( AF ) is intermittent in 30 % of patients with cardioembolic stroke and , therefore , might not be seen in a single st and ard ECG recording . The aim of this study was to evaluate if prolonged ECG monitoring ( 96 h ) finds episodes of intermittent AF beyond the 24 h ECG monitoring in patients with cryptogenic stroke or transient ischemic attack ( TIA ) . We prospect ively evaluated consecutive patients affected by cryptogenic stroke or TIA who had sinus rhythm on a 12-lead ECG on admission , and during ECG monitoring performed in the acute phase ( for at least 24 h ) . Patients had continuous 96 h Holter ECG monitoring within 30 days from stroke onset . 114 patients were included in the study ( mean age 63.1 ± 15.1 , 59 males ) . AF was found in 29 patients ( 24.3 % ) . In 20 patients , AF was found in the first 24 h of recording , and in nine patients after 24 h. In addition , several other dysrhythmias such as supraventricular ectopic activity ( 33 ) , ventricular tachycardia ( 10 ) , sinus pause ( 4 ) and sinus-atrial block ( 1 ) were found . In patients with cryptogenic stroke or TIA , 96 h ECG monitoring detected a high rate of AF . One-third of AF was seen beyond 24 h of ECG monitoring
| 2,012 |
Longer duration of electrocardiographic monitoring after cryptogenic stroke is associated with a greater detection of AF .
|
BACKGROUND Atrial fibrillation ( AF ) is a major cause of stroke .
Although st and ard investigations after an event include electrocardiographic monitoring , the optimal duration to detect AF is unclear .
We performed a systematic review and meta- analysis to determine whether the duration of electrocardiographic monitoring after an ischemic event is related to the detection of AF .
|
2,012 | 25,639,643 |
Longer duration of electrocardiographic monitoring after cryptogenic stroke is associated with a greater detection of AF .
|
BACKGROUND Atrial fibrillation ( AF ) is a major cause of stroke .
Although st and ard investigations after an event include electrocardiographic monitoring , the optimal duration to detect AF is unclear .
We performed a systematic review and meta- analysis to determine whether the duration of electrocardiographic monitoring after an ischemic event is related to the detection of AF .
| 48,861 | 24,189,453 |
Atrial fibrillation and paroxysmal atrial fibrillation detection in patients with acute ischemic stroke.
|
BACKGROUND Studies about continuous electrocardiographic ( ECG ) monitoring in detection of paroxysmal atrial fibrillation ( PAF ) in Asian patients with acute ischemic stroke are very limited . We looked for the prevalence and associated factors of atrial fibrillation ( AF ) and PAF in Thai patients with acute ischemic stroke . METHODS In all , 204 patients with acute ischemic stroke were prospect ively included . Snapshot 12-lead ECG and continuous ECG monitoring for at least the first 24 hours were performed . Multivariate analyses were performed to find out the associated factors of AF and PAF . RESULTS AF was diagnosed in 31 patients ( 15 % ) and PAF in 15 patients ( 7 % ) . Twelve and 3 patients with PAF were diagnosed by continuous ECG monitoring and snapshot 12-lead ECG , respectively . Mean duration of continuous ECG monitoring and mean time to detect PAF were 55 and 23 hours , respectively . Multivariate analysis revealed that age of 70 years or older ( odds ratio [ OR ] 3.52 , 95 % confidence interval [ CI ] 1.68 - 7.35 , P = .001 ) and heart diseases ( OR 4.26 , 95 % CI 1.14 - 15.95 , P = .031 ) were associated with AF and PAF . CONCLUSIONS AF/PAF was one of the common causes of ischemic stroke in Thai patients . Most PAF was detected by continuous ECG monitoring . Snapshot 12-lead ECG and continuous ECG monitoring should be recommended in all patients with acute ischemic stroke
| 2,012 |
Longer duration of electrocardiographic monitoring after cryptogenic stroke is associated with a greater detection of AF .
|
BACKGROUND Atrial fibrillation ( AF ) is a major cause of stroke .
Although st and ard investigations after an event include electrocardiographic monitoring , the optimal duration to detect AF is unclear .
We performed a systematic review and meta- analysis to determine whether the duration of electrocardiographic monitoring after an ischemic event is related to the detection of AF .
|
2,012 | 25,639,643 |
Longer duration of electrocardiographic monitoring after cryptogenic stroke is associated with a greater detection of AF .
|
BACKGROUND Atrial fibrillation ( AF ) is a major cause of stroke .
Although st and ard investigations after an event include electrocardiographic monitoring , the optimal duration to detect AF is unclear .
We performed a systematic review and meta- analysis to determine whether the duration of electrocardiographic monitoring after an ischemic event is related to the detection of AF .
| 48,862 | 20,598,970 |
Cryptogenic Stroke and underlying Atrial Fibrillation (CRYSTAL AF): design and rationale.
|
BACKGROUND Patients with atrial fibrillation ( AF ) are at increased risk for ischemic stroke . In patients who have suffered a stroke , screening for AF is routinely performed only for a short period after the stroke as part of the evaluation for possible causes . If AF is detected after an ischemic stroke , oral anticoagulation therapy is recommended for secondary stroke prevention . In 25 % to 30 % of stroke patients , the stroke mechanism can not be determined ( cryptogenic stroke ) . The incidence of paroxysmal AF undetected by short-term monitoring in patients with cryptogenic stroke is unknown , but has important therapeutic implication s on patient care . The optimum monitoring duration and method of AF detection after stroke are unknown . The purpose of this study is to evaluate the incidence of AF and time to AF detection in patients with cryptogenic stroke using an insertable cardiac monitor . STUDY DESIGN The CRYSTAL AF trial is a r and omized prospect i ve study to evaluate a novel approach to long-term monitoring for AF detection in patients with cryptogenic stroke . Four hundred fifty cryptogenic stroke patients ( by definition , without a history of AF ) will be enrolled at approximately 50 sites in Europe , Canada , and the United States . Patients will be r and omized in a 1:1 fashion to st and ard arrhythmia monitoring ( control arm ) or implantation of the subcutaneous cardiac monitor ( Reveal XT ; Medtronic , Inc , Minneapolis , MN ) ( continuous monitoring arm ) . OUTCOMES The primary end point is time to detection of AF within 6 months after stroke . The clinical follow-up period will be at least 12 months . Study completion is expected at the end of 2012
| 2,012 |
Longer duration of electrocardiographic monitoring after cryptogenic stroke is associated with a greater detection of AF .
|
BACKGROUND Atrial fibrillation ( AF ) is a major cause of stroke .
Although st and ard investigations after an event include electrocardiographic monitoring , the optimal duration to detect AF is unclear .
We performed a systematic review and meta- analysis to determine whether the duration of electrocardiographic monitoring after an ischemic event is related to the detection of AF .
|
2,012 | 25,639,643 |
Longer duration of electrocardiographic monitoring after cryptogenic stroke is associated with a greater detection of AF .
|
BACKGROUND Atrial fibrillation ( AF ) is a major cause of stroke .
Although st and ard investigations after an event include electrocardiographic monitoring , the optimal duration to detect AF is unclear .
We performed a systematic review and meta- analysis to determine whether the duration of electrocardiographic monitoring after an ischemic event is related to the detection of AF .
| 48,863 | 19,699,858 |
Multicenter randomized study of anticoagulation guided by remote rhythm monitoring in patients with implantable cardioverter-defibrillator and CRT-D devices: Rationale, design, and clinical characteristics of the initially enrolled cohort The IMPACT study.
|
Atrial fibrillation and atrial flutter are common cardiac arrhythmias associated with an increased risk of stroke in patients with additional risk factors . Anticoagulation ameliorates stroke risk , but because these arrhythmias may occur intermittently without symptoms , initiation of prophylactic therapy is often delayed until electrocardiographic documentation is obtained . The IMPACT study is a multicenter , r and omized trial of remote surveillance technology in patients with implanted dual-chamber cardiac resynchronization therapy defibrillator ( CRT-D ) devices design ed to test the hypothesis that initiation and withdrawal of oral anticoagulant therapy guided by continuous ambulatory monitoring of the atrial electrogram improve clinical outcomes by reducing the combined rate of stroke , systemic embolism , and major bleeding compared with conventional clinical management . For those in the intervention group , early detection of atrial high-rate episodes ( AHRE ) generates an automatic alert to initiate anticoagulation based on patient-specific stroke risk stratification . Subsequently , freedom from AHRE for predefined periods prompts withdrawal of anticoagulation to avoid bleeding . Patients in the control arm are managed conventionally , the anticoagulation decision prompted by incidental detection of atrial fibrillation or atrial flutter during routine clinical follow-up . The results will help define the clinical utility of wireless remote cardiac rhythm surveillance and help establish the critical threshold of AHRE burden warranting anticoagulant therapy in patients at risk of stroke . In this report , we describe the study design and baseline demographic and clinical features of the initial cohort ( 227 patients )
| 2,012 |
Longer duration of electrocardiographic monitoring after cryptogenic stroke is associated with a greater detection of AF .
|
BACKGROUND Atrial fibrillation ( AF ) is a major cause of stroke .
Although st and ard investigations after an event include electrocardiographic monitoring , the optimal duration to detect AF is unclear .
We performed a systematic review and meta- analysis to determine whether the duration of electrocardiographic monitoring after an ischemic event is related to the detection of AF .
|
2,012 | 25,639,643 |
Longer duration of electrocardiographic monitoring after cryptogenic stroke is associated with a greater detection of AF .
|
BACKGROUND Atrial fibrillation ( AF ) is a major cause of stroke .
Although st and ard investigations after an event include electrocardiographic monitoring , the optimal duration to detect AF is unclear .
We performed a systematic review and meta- analysis to determine whether the duration of electrocardiographic monitoring after an ischemic event is related to the detection of AF .
| 48,864 | 20,720,410 |
Detection of Paroxysmal Atrial Fibrillation in Acute Stroke Patients
|
Background : Atrial fibrillation ( AF ) is a frequent cause of stroke , but detecting paroxysmal AF ( pAF ) poses a challenge . We investigated whether continuous bedside ECG monitoring in a stroke unit detects pAF more sensitively than 24-hour Holter ECG , and tested whether examining RR interval dynamics on short-term ECG recordings using an automated screening algorithm ( ASA ) for pAF detection is a useful tool to predict the risk of pAF outside periods of manifest AF . Methods : Patients > 60 years with acute ischemic stroke or transient ischemic attacks ( TIA ) were prospect ively enrolled unless initial ECG revealed AF or they had a history of paroxysmal or persistent AF . ASA was performed on 1- to 2-hour ECG recordings in the emergency room and patients were classified into 5 risk categories for pAF . All patients underwent continuous bedside ECG monitoring for > 48 h. Additionally , 24-hour Holter ECG was performed . Results : 136 patients were enrolled ( median age : 72 years , male : 58.8 % ) . In 29 ( 21.3 % ) , pAF was newly diagnosed by continuous bedside ECG monitoring . pAF increased with age ( p = 0.031 ) . Median time to first pAF detection on continuous bedside ECG monitoring was 36 h. In 16 patients , pAF was detected by continuous bedside ECG monitoring prior to the performance of 24-hour Holter ECG . Thirteen of the remaining patients were pAF positive on continuous bedside ECG monitoring , but 24-hour Holter detected only 3 patients . Accordingly , the sensitivity of 24-hour Holter was 0.23 . Sensitivity of higher-risk categories of ASA compared to continuous bedside ECG monitoring was 0.72 , and specificity 0.63 . Conclusion : Continuous bedside ECG monitoring is more sensitive than 24-hour Holter ECG for pAF detection in acute stroke/TIA patients . Screening patients for pAF outside AF episodes using ASA requires further development
| 2,012 |
Longer duration of electrocardiographic monitoring after cryptogenic stroke is associated with a greater detection of AF .
|
BACKGROUND Atrial fibrillation ( AF ) is a major cause of stroke .
Although st and ard investigations after an event include electrocardiographic monitoring , the optimal duration to detect AF is unclear .
We performed a systematic review and meta- analysis to determine whether the duration of electrocardiographic monitoring after an ischemic event is related to the detection of AF .
|
2,012 | 25,639,643 |
Longer duration of electrocardiographic monitoring after cryptogenic stroke is associated with a greater detection of AF .
|
BACKGROUND Atrial fibrillation ( AF ) is a major cause of stroke .
Although st and ard investigations after an event include electrocardiographic monitoring , the optimal duration to detect AF is unclear .
We performed a systematic review and meta- analysis to determine whether the duration of electrocardiographic monitoring after an ischemic event is related to the detection of AF .
| 48,865 | 24,816,310 |
Twenty-eight day Holter monitoring is poorly tolerated and insensitive for paroxysmal atrial fibrillation detection in cryptogenic stroke.
|
This pilot study in a prospect i ve cohort of 20 cryptogenic stroke patients showed that a significant proportion has paroxysmal atrial fibrillation undetected by 24-h Holter monitoring . However , longer monitoring with 28-day Holter was poorly tolerated and still insufficiently sensitive for paroxysmal atrial fibrillation detection . Further studies are urgently needed to eluci date the optimal timing , method and duration of cardiac rhythm monitoring following ischaemic stroke
| 2,012 |
Longer duration of electrocardiographic monitoring after cryptogenic stroke is associated with a greater detection of AF .
|
BACKGROUND Atrial fibrillation ( AF ) is a major cause of stroke .
Although st and ard investigations after an event include electrocardiographic monitoring , the optimal duration to detect AF is unclear .
We performed a systematic review and meta- analysis to determine whether the duration of electrocardiographic monitoring after an ischemic event is related to the detection of AF .
|
2,012 | 25,639,643 |
Longer duration of electrocardiographic monitoring after cryptogenic stroke is associated with a greater detection of AF .
|
BACKGROUND Atrial fibrillation ( AF ) is a major cause of stroke .
Although st and ard investigations after an event include electrocardiographic monitoring , the optimal duration to detect AF is unclear .
We performed a systematic review and meta- analysis to determine whether the duration of electrocardiographic monitoring after an ischemic event is related to the detection of AF .
| 48,866 | 17,903,944 |
Detection of atrial fibrillation in patients with acute stroke.
|
Atrial fibrillation ( AF ) and paroxysmal AF ( PAF ) are common causes of stroke which may not be detected by a single electrocardiogram ( EKG ) . We conducted a prospect i ve study to determine if 48 hours of telemetry monitoring increased the rate of detection of AF in patients with acute stroke and thus identified patients requiring anticoagulation . One hundred and fifty consecutive patients with acute ischemic stroke were placed on telemetry monitoring for 48 hours . Thirty-five patients had AF related strokes . There were 12 patients with AF related stroke who did not have a previous history of AF and were found to have AF following the stroke . Six of these 12 patients were found to have AF on their admission EKG . The remaining six patients had normal admission EKGs and were diagnosed with AF only during telemetry monitoring for 48 hrs . Patients with AF were older , had larger strokes , which were more likely to be non-lacunar , than patients without AF . Our study suggests that AF is sometimes undiagnosed until a stroke occurs . Improved methods of detection of AF are needed in high-risk patients for primary stroke prevention . Patients older than 65 years of age with non-lacunar strokes should have 48 hours of telemetry monitoring to detect previously undiagnosed AF
| 2,012 |
Longer duration of electrocardiographic monitoring after cryptogenic stroke is associated with a greater detection of AF .
|
BACKGROUND Atrial fibrillation ( AF ) is a major cause of stroke .
Although st and ard investigations after an event include electrocardiographic monitoring , the optimal duration to detect AF is unclear .
We performed a systematic review and meta- analysis to determine whether the duration of electrocardiographic monitoring after an ischemic event is related to the detection of AF .
|
2,012 | 25,639,643 |
Longer duration of electrocardiographic monitoring after cryptogenic stroke is associated with a greater detection of AF .
|
BACKGROUND Atrial fibrillation ( AF ) is a major cause of stroke .
Although st and ard investigations after an event include electrocardiographic monitoring , the optimal duration to detect AF is unclear .
We performed a systematic review and meta- analysis to determine whether the duration of electrocardiographic monitoring after an ischemic event is related to the detection of AF .
| 48,867 | 24,963,567 |
Cryptogenic stroke and underlying atrial fibrillation.
|
BACKGROUND Current guidelines recommend at least 24 hours of electrocardiographic ( ECG ) monitoring after an ischemic stroke to rule out atrial fibrillation . However , the most effective duration and type of monitoring have not been established , and the cause of ischemic stroke remains uncertain despite a complete diagnostic evaluation in 20 to 40 % of cases ( cryptogenic stroke ) . Detection of atrial fibrillation after cryptogenic stroke has therapeutic implication s. METHODS We conducted a r and omized , controlled study of 441 patients to assess whether long-term monitoring with an insertable cardiac monitor ( ICM ) is more effective than conventional follow-up ( control ) for detecting atrial fibrillation in patients with cryptogenic stroke . Patients 40 years of age or older with no evidence of atrial fibrillation during at least 24 hours of ECG monitoring underwent r and omization within 90 days after the index event . The primary end point was the time to first detection of atrial fibrillation ( lasting > 30 seconds ) within 6 months . Among the secondary end points was the time to first detection of atrial fibrillation within 12 months . Data were analyzed according to the intention-to-treat principle . RESULTS By 6 months , atrial fibrillation had been detected in 8.9 % of patients in the ICM group ( 19 patients ) versus 1.4 % of patients in the control group ( 3 patients ) ( hazard ratio , 6.4 ; 95 % confidence interval [ CI ] , 1.9 to 21.7 ; P<0.001 ) . By 12 months , atrial fibrillation had been detected in 12.4 % of patients in the ICM group ( 29 patients ) versus 2.0 % of patients in the control group ( 4 patients ) ( hazard ratio , 7.3 ; 95 % CI , 2.6 to 20.8 ; P<0.001 ) . CONCLUSIONS ECG monitoring with an ICM was superior to conventional follow-up for detecting atrial fibrillation after cryptogenic stroke . ( Funded by Medtronic ; CRYSTAL AF Clinical Trials.gov number , NCT00924638 . )
| 2,012 |
Longer duration of electrocardiographic monitoring after cryptogenic stroke is associated with a greater detection of AF .
|
BACKGROUND Atrial fibrillation ( AF ) is a major cause of stroke .
Although st and ard investigations after an event include electrocardiographic monitoring , the optimal duration to detect AF is unclear .
We performed a systematic review and meta- analysis to determine whether the duration of electrocardiographic monitoring after an ischemic event is related to the detection of AF .
|
2,012 | 25,639,643 |
Longer duration of electrocardiographic monitoring after cryptogenic stroke is associated with a greater detection of AF .
|
BACKGROUND Atrial fibrillation ( AF ) is a major cause of stroke .
Although st and ard investigations after an event include electrocardiographic monitoring , the optimal duration to detect AF is unclear .
We performed a systematic review and meta- analysis to determine whether the duration of electrocardiographic monitoring after an ischemic event is related to the detection of AF .
| 48,868 | 20,498,434 |
Detection of paroxysmal atrial fibrillation with transtelephonic EKG in TIA or stroke patients
|
Background : Paroxysmal atrial fibrillation ( PAF ) may remain underdiagnosed after stroke , as suggested by long- duration EKG monitoring . Here we report the sensitivity of transtelephonic EKG monitoring ( TTM ) for detection of PAF in patients following a recent stroke or TIA and a negative 24-hour Holter . Methods : We analyzed data from 98 consecutive patients with TTM and noncardioembolic TOAST stroke ( n = 78 ) or TIA ( n = 20 ) . Most were cryptogenic events ( 82 % ) . Patients started TTM 0.8 months ( interquartile range 0.4–2.5 ) after the indexed event and r and omly recorded about 1 EKG per day for 1 month . Univariate and multivariate analyses were run to identify PAF predictors . Results : Seventeen PAF episodes were detected in 9.2 % ( 9/98 ) of the patients . The estimated duration of PAF episodes ranged from 4 to 72 hours . Two predictors were identified : premature atrial ectopic beats ( more than 100 ) in 24-hour routine Holter ( odds ratio [ OR ] = 11.0 ; 95 % confidence interval [ CI ] 1.9–62 ; p = 0.007 ) and nonlacunar anterior circulation DWI hypersignals ( OR = 9.9 ; 95 % CI 1.1–90.6 ; p = 0.04 ) . The PAF detection rate varied from 42.6 % for patients meeting both criteria to 0 % for patients with neither of them . Conclusions : Transtelephonic EKG monitoring increases detection rate of paroxysmal atrial fibrillation in stroke and TIA patients whose 24-hour Holter result was negative , especially if they had frequent premature atrial ectopic beats , recent anterior circulation infa rct on MRI , or both
| 2,012 |
Longer duration of electrocardiographic monitoring after cryptogenic stroke is associated with a greater detection of AF .
|
BACKGROUND Atrial fibrillation ( AF ) is a major cause of stroke .
Although st and ard investigations after an event include electrocardiographic monitoring , the optimal duration to detect AF is unclear .
We performed a systematic review and meta- analysis to determine whether the duration of electrocardiographic monitoring after an ischemic event is related to the detection of AF .
|
2,013 | 28,629,898 |
The present study revealed that supplementation with ALA slightly but significantly decreased body weight and BMI .
Safe dosage for ALA is up to 1200 mg/day .
However , it seems that ALA can not be cost-effective .
|
BACKGROUND & AIMS Previous studies have supported positive roles of antioxidant supplements on weight-loss .
One antioxidant supplement is Alpha-lipoic acid .
However , recommending ALA as an anti-obesity supplement remains controversial .
Accordingly , the purpose of the present study was to perform a meta- analysis on the effects of ALA supplement on anthropometric indices among adult subjects .
| 48,869 | 25,594,166 |
Effects of α-lipoic acid and eicosapentaenoic acid in overweight and obese women during weight loss.
|
OBJECTIVE To evaluate the potential body weight-lowering effects of dietary supplementation with eicosapentaenoic acid ( EPA ) and α-lipoic acid separately or combined in healthy overweight/obese women following a hypocaloric diet . METHODS This is a short-term double-blind placebo-controlled study with parallel design that lasted 10 weeks . Of the r and omized participants , 97 women received the allocated treatment [ Control , EPA ( 1.3 g/d ) , α-lipoic acid ( 0.3 g/d ) , and EPA+α-lipoic acid ( 1.3 g/d+0.3 g/d ) ] , and 77 volunteers completed the study . All groups followed an energy-restricted diet of 30 % less than total energy expenditure . Body weight , anthropometric measurements , body composition , resting energy expenditure , blood pressure , serum glucose , and insulin and lipid profile , as well as leptin and ghrelin levels , were assessed at baseline and after nutritional intervention . RESULTS Body weight loss was significantly higher ( P<0.05 ) in those groups supplemented with α-lipoic acid . EPA supplementation significantly attenuated ( P<0.001 ) the decrease in leptin levels that occurs during weight loss . Body weight loss improved lipid and glucose metabolism parameters but without significant differences between groups . CONCLUSIONS The intervention suggests that α-lipoic acid supplementation alone or in combination with EPA may help to promote body weight loss in healthy overweight/obese women following energy-restricted diets
| 2,013 |
The present study revealed that supplementation with ALA slightly but significantly decreased body weight and BMI .
Safe dosage for ALA is up to 1200 mg/day .
However , it seems that ALA can not be cost-effective .
|
BACKGROUND & AIMS Previous studies have supported positive roles of antioxidant supplements on weight-loss .
One antioxidant supplement is Alpha-lipoic acid .
However , recommending ALA as an anti-obesity supplement remains controversial .
Accordingly , the purpose of the present study was to perform a meta- analysis on the effects of ALA supplement on anthropometric indices among adult subjects .
|
2,013 | 28,629,898 |
The present study revealed that supplementation with ALA slightly but significantly decreased body weight and BMI .
Safe dosage for ALA is up to 1200 mg/day .
However , it seems that ALA can not be cost-effective .
|
BACKGROUND & AIMS Previous studies have supported positive roles of antioxidant supplements on weight-loss .
One antioxidant supplement is Alpha-lipoic acid .
However , recommending ALA as an anti-obesity supplement remains controversial .
Accordingly , the purpose of the present study was to perform a meta- analysis on the effects of ALA supplement on anthropometric indices among adult subjects .
| 48,870 | 26,276,648 |
Alpha-lipoic acid reduces body weight and regulates triglycerides in obese patients with diabetes mellitus.
|
AIM To determine an influence of alpha-lipoic acid to reduction of body weight and regulation of total cholesterol concentration , triglycerides and glucose serum levels in obese patients with diabetes mellitus type 2 . METHODS A prospect i ve study includes two groups of obese patients with diabetes mellitus and signs of peripheral polyneuropathia : examined group ( 30 patients ; 15 females and 15 males ) , and control group ( 30 patients ; 12 females and 18 males ) . All were treated with metformin ( 850 - 1700 mg/day ) . Examined patients were additionally treated with alpha-lipoic acid 600 mg/day during 20 weeks . Body mass index and concentrations of total cholesterol , triglycerides and glucose in serum were compared before and after the treatment . RESULTS The group treated with 600 mg alpha-lipoic acid lost significantly more weight , and had lower triglyceride level than the control group . There were no significant differences in total cholesterol and glucose serum levels between the groups . CONCLUSION Alpha-lipoic acid of 600 mg/day treatment have influenced weight and triglycerides loss in obese patients with diabetes mellitus type 2 . It should be considered as an important additive therapy in obese patients with diabetes mellitus type 2
| 2,013 |
The present study revealed that supplementation with ALA slightly but significantly decreased body weight and BMI .
Safe dosage for ALA is up to 1200 mg/day .
However , it seems that ALA can not be cost-effective .
|
BACKGROUND & AIMS Previous studies have supported positive roles of antioxidant supplements on weight-loss .
One antioxidant supplement is Alpha-lipoic acid .
However , recommending ALA as an anti-obesity supplement remains controversial .
Accordingly , the purpose of the present study was to perform a meta- analysis on the effects of ALA supplement on anthropometric indices among adult subjects .
|
2,013 | 28,629,898 |
The present study revealed that supplementation with ALA slightly but significantly decreased body weight and BMI .
Safe dosage for ALA is up to 1200 mg/day .
However , it seems that ALA can not be cost-effective .
|
BACKGROUND & AIMS Previous studies have supported positive roles of antioxidant supplements on weight-loss .
One antioxidant supplement is Alpha-lipoic acid .
However , recommending ALA as an anti-obesity supplement remains controversial .
Accordingly , the purpose of the present study was to perform a meta- analysis on the effects of ALA supplement on anthropometric indices among adult subjects .
| 48,871 | 21,255,807 |
α-lipoic acid can improve endothelial dysfunction in subjects with impaired fasting glucose.
|
Several studies showed that impairment of endothelium-dependent arterial dilation ( EDAD ) exists in subjects with impaired fasting glucose ( IFG ) . The crucial mechanism of this endothelial dysfunction remains unclear . We hypothesized that oxidative stress may be partially responsible for the impairment in EDAD in subjects with IFG . Thus , the present study was design ed to assess whether the antioxidant α-lipoic acid can improve endothelial dysfunction in subjects with IFG . Sixty subjects with newly diagnosed IFG and 32 healthy individuals with normal glucose tolerance were enrolled . Subjects were r and omized into 2 groups : untreated experimental group ( n = 30 ) and α-lipoic acid treatment group ( n = 30 , α-lipoic acid 600 mg via intravenous infusion once a day for 3 weeks ) . We measured EDAD at baseline and after 3 weeks of intervention . At baseline , EDADs in α-lipoic acid and untreated experimental groups were 4.03 % and 4.14 % , respectively , which were significantly lower than that in controls ( 5.72 % ) ( P < .001 ) . After 3 weeks of intervention , there was a remarkable increase in EDAD ( reaching 5.10 % ; ΔEDAD , 26.5 % ) ( P < .01 ) and a significant decrease in plasma thiobarbituric acid reactive substances ( TBARS ) ( 29.1 % ) ( P < .05 ) in IFG subjects treated with α-lipoic acid . Endothelium-dependent arterial dilation and TBARS remained unchanged before and after intervention in the untreated experimental group . The absolute changes in EDAD showed a significant negative correlation with the changes in TBARS ( r = -0.444 , P = .014 ) . Our data showed that IFG subjects have impaired endothelial function and that antioxidant α-lipoic acid can improve endothelial function through a decrease of oxygen-derived free radicals
| 2,013 |
The present study revealed that supplementation with ALA slightly but significantly decreased body weight and BMI .
Safe dosage for ALA is up to 1200 mg/day .
However , it seems that ALA can not be cost-effective .
|
BACKGROUND & AIMS Previous studies have supported positive roles of antioxidant supplements on weight-loss .
One antioxidant supplement is Alpha-lipoic acid .
However , recommending ALA as an anti-obesity supplement remains controversial .
Accordingly , the purpose of the present study was to perform a meta- analysis on the effects of ALA supplement on anthropometric indices among adult subjects .
|
2,013 | 28,629,898 |
The present study revealed that supplementation with ALA slightly but significantly decreased body weight and BMI .
Safe dosage for ALA is up to 1200 mg/day .
However , it seems that ALA can not be cost-effective .
|
BACKGROUND & AIMS Previous studies have supported positive roles of antioxidant supplements on weight-loss .
One antioxidant supplement is Alpha-lipoic acid .
However , recommending ALA as an anti-obesity supplement remains controversial .
Accordingly , the purpose of the present study was to perform a meta- analysis on the effects of ALA supplement on anthropometric indices among adult subjects .
| 48,872 | 21,187,189 |
Effects of alpha-lipoic Acid on body weight in obese subjects.
|
PURPOSE alpha-lipoic acid is an essential cofactor for mitochondrial respiratory enzymes that improves mitochondrial function . We previously reported that alpha-lipoic acid markedly reduced body weight gain in rodents . The purpose of this study was to determine whether alpha-lipoic acid reduces body weight in obese human subjects . METHODS in this r and omized , double-blind , placebo-controlled , 20-week trial , 360 obese individuals ( body mass index [ BMI ] ≥ 30 kg/m(2 ) or BMI 27 - 30 kg/m(2 ) plus hypertension , diabetes mellitus , or hypercholesterolemia ) were r and omized to alpha-lipoic acid 1200 or 1800 mg/d or placebo . The primary end point was body weight change from baseline to end point . RESULTS the 1800 mg alpha-lipoic acid group lost significantly more weight than the placebo group ( 2.1 % ; 95 % confidence interval , 1.4 - 2.8 ; P<.05 ) . Urticaria and itching sensation were the most common adverse events in the alpha-lipoic acid groups , but these were generally mild and transient . CONCLUSION alpha-lipoic acid 1800 mg/d led to a modest weight loss in obese subjects . Alpha-lipoic acid may be considered as adjunctive therapy for obesity
| 2,013 |
The present study revealed that supplementation with ALA slightly but significantly decreased body weight and BMI .
Safe dosage for ALA is up to 1200 mg/day .
However , it seems that ALA can not be cost-effective .
|
BACKGROUND & AIMS Previous studies have supported positive roles of antioxidant supplements on weight-loss .
One antioxidant supplement is Alpha-lipoic acid .
However , recommending ALA as an anti-obesity supplement remains controversial .
Accordingly , the purpose of the present study was to perform a meta- analysis on the effects of ALA supplement on anthropometric indices among adult subjects .
|
2,013 | 28,629,898 |
The present study revealed that supplementation with ALA slightly but significantly decreased body weight and BMI .
Safe dosage for ALA is up to 1200 mg/day .
However , it seems that ALA can not be cost-effective .
|
BACKGROUND & AIMS Previous studies have supported positive roles of antioxidant supplements on weight-loss .
One antioxidant supplement is Alpha-lipoic acid .
However , recommending ALA as an anti-obesity supplement remains controversial .
Accordingly , the purpose of the present study was to perform a meta- analysis on the effects of ALA supplement on anthropometric indices among adult subjects .
| 48,873 | 17,298,711 |
Better dietary adherence and weight maintenance achieved by a long-term moderate-fat diet.
|
The objective of the present study was to determine the effects of a long-term moderate-fat diet ( 30 % energy from fat ) v. a low-fat one ( 20 % energy from fat ) on metabolic risks . The study was a r and omised , prospect i ve 14-month trial on overweight and obese patients ( eighty-nine overweight and obese men and women ) . The intervention was a moderate-fat diet ( 30 % energy ) or a low-fat diet ( 20 % energy ) . The main outcome measurements were change in body weight , waist circumference , LDL-cholesterol , HDL-cholesterol , total cholesterol , TAG , and systolic and diastolic blood pressure . Forty-five subjects on the moderate-fat diet and forty-four subjects on the low-fat one were studied . Characteristics of all r and omised participants were similar in both groups . After 7 months , the moderate- and low-fat diets had similar effects on cardiovascular risks . The moderate-fat diet was more successful after 14 months in reducing weight ( -5.0 ( SD 2.5 ) kg in the moderate-fat group v. -1.2 ( SD 1.1 ) kg in the low-fat one ; P < 0.0001 ) , waist circumference ( -5.5 ( SD 2.4 ) cm in the moderate-fat group v. - 2.3 ( SD 1.3 ) cm in the low-fat one ; P < 0.0001 ) , and other cardiovascular risk factors as well ( LDL , TAG , total cholesterol and systolic blood pressure ) . In conclusion , a moderate-fat energy-restricted diet in the long term might have more beneficial effects on weight maintenance and cardiovascular risk factors compared with a low-fat diet . Better dietary adherence with the moderate-fat diet may be the reason for its successful effects
| 2,013 |
The present study revealed that supplementation with ALA slightly but significantly decreased body weight and BMI .
Safe dosage for ALA is up to 1200 mg/day .
However , it seems that ALA can not be cost-effective .
|
BACKGROUND & AIMS Previous studies have supported positive roles of antioxidant supplements on weight-loss .
One antioxidant supplement is Alpha-lipoic acid .
However , recommending ALA as an anti-obesity supplement remains controversial .
Accordingly , the purpose of the present study was to perform a meta- analysis on the effects of ALA supplement on anthropometric indices among adult subjects .
|
2,013 | 28,629,898 |
The present study revealed that supplementation with ALA slightly but significantly decreased body weight and BMI .
Safe dosage for ALA is up to 1200 mg/day .
However , it seems that ALA can not be cost-effective .
|
BACKGROUND & AIMS Previous studies have supported positive roles of antioxidant supplements on weight-loss .
One antioxidant supplement is Alpha-lipoic acid .
However , recommending ALA as an anti-obesity supplement remains controversial .
Accordingly , the purpose of the present study was to perform a meta- analysis on the effects of ALA supplement on anthropometric indices among adult subjects .
| 48,874 | 21,908,204 |
Effects of alpha-lipoic acid supplementation on inflammation, oxidative stress, and serum lipid profile levels in patients with end-stage renal disease on hemodialysis.
|
OBJECTIVE We examined the effects of alpha-lipoic acid ( ALA ) supplementation on inflammation , oxidative stress , and serum lipid profile levels in hemodialysis ( HD ) patients . DESIGN This was a double-blinded , r and omized , placebo-controlled clinical trial . SETTING The present study involved HD centers in Tabriz , Iran . PATIENTS Participants included 63 patients with end-stage renal disease ( 43 men and 20 women ; age range : 22 - 79 years ) undergoing maintenance HD . INTERVENTION HD patients were r and omly assigned into the supplemented group ( n = 31 ) , receiving a daily dose of ALA ( 600 mg ) , or a control group ( n = 32 ) , receiving placebo for 8 weeks . MAIN OUTCOME MEASURES High sensitivity C-reactive protein ( hsCRP ) , malondialdehyde , total antioxidant status , total cholesterol , triglyceride , high-density lipoprotein cholesterol ( HDL-C ) , and low-density lipoprotein cholesterol ( LDL-C ) were measured at baseline and after 8 weeks of supplementation . RESULTS At the end of intervention , 11 patients were excluded from the study . HsCRP levels decreased by 18.7 % in the supplemented group after 8 weeks of supplementation , and the reduction was significant in comparison with the placebo group ( P < .05 ) ; this finding was also significant after adjusting for baseline values of hsCRP . The mean malondialdehyde and total antioxidant status levels did not change significantly in the 2 groups during the study . The mean high-density lipoprotein cholesterol concentrations increased significantly in the supplemented group at the end of the study ( P < .05 ) ; however , this improvement was not statistically significant as compared with the placebo group . No significant alterations were observed in the other lipid profile parameters within each group during the study . CONCLUSION ALA supplementation significantly reduced hsCRP levels , which is a risk factor for cardiovascular disease in HD patients
| 2,013 |
The present study revealed that supplementation with ALA slightly but significantly decreased body weight and BMI .
Safe dosage for ALA is up to 1200 mg/day .
However , it seems that ALA can not be cost-effective .
|
BACKGROUND & AIMS Previous studies have supported positive roles of antioxidant supplements on weight-loss .
One antioxidant supplement is Alpha-lipoic acid .
However , recommending ALA as an anti-obesity supplement remains controversial .
Accordingly , the purpose of the present study was to perform a meta- analysis on the effects of ALA supplement on anthropometric indices among adult subjects .
|
2,013 | 28,629,898 |
The present study revealed that supplementation with ALA slightly but significantly decreased body weight and BMI .
Safe dosage for ALA is up to 1200 mg/day .
However , it seems that ALA can not be cost-effective .
|
BACKGROUND & AIMS Previous studies have supported positive roles of antioxidant supplements on weight-loss .
One antioxidant supplement is Alpha-lipoic acid .
However , recommending ALA as an anti-obesity supplement remains controversial .
Accordingly , the purpose of the present study was to perform a meta- analysis on the effects of ALA supplement on anthropometric indices among adult subjects .
| 48,875 | 3,506,092 |
Effect of Soymilk Consumption on Waist Circumference and Cardiovascular Risks among Overweight and Obese Female Adults
|
Background : Soy milk replacement in the diet might have beneficial effects on waist circumference and cardiovascular risk factors for overweight and obese subjects . Therefore , we are going to determine the effects of soy milk replacements on the waist circumference and cardiovascular risk factors among overweight and obese female adults . Methods : In this crossover r and omized clinical trail , 24 over weight and obese female adults were on a diet with soy milk or the diet with cow 's milk for four weeks . In the diet with soy milk only one glass of soy milk ( 240 cc ) was replaced instead of one glass of cow 's milk ( 240 cc ) . Measurements were done according to the st and ard protocol . Results : Waist circumference reduced significantly following soy milk period ( mean percent change in soy milk period for waist circumference : -3.79 ± 0.51 vs. -1.78 ± 0.55 % ; P = 0.02 in the cow 's milk period ) . Blood pressure , weight , liver enzymes and glycemic control indices did not changed significantly after soy milk period compared to the cow 's milk period . Conclusion : Among over weight and obese patients , soy milk can play an important role in reducing waist circumference . However , soy milk replacement had no significant effects on weight , glycemic control indices , liver enzymes , fibrinogen and blood pressure in a short term trial
| 2,013 |
The present study revealed that supplementation with ALA slightly but significantly decreased body weight and BMI .
Safe dosage for ALA is up to 1200 mg/day .
However , it seems that ALA can not be cost-effective .
|
BACKGROUND & AIMS Previous studies have supported positive roles of antioxidant supplements on weight-loss .
One antioxidant supplement is Alpha-lipoic acid .
However , recommending ALA as an anti-obesity supplement remains controversial .
Accordingly , the purpose of the present study was to perform a meta- analysis on the effects of ALA supplement on anthropometric indices among adult subjects .
|
2,013 | 28,629,898 |
The present study revealed that supplementation with ALA slightly but significantly decreased body weight and BMI .
Safe dosage for ALA is up to 1200 mg/day .
However , it seems that ALA can not be cost-effective .
|
BACKGROUND & AIMS Previous studies have supported positive roles of antioxidant supplements on weight-loss .
One antioxidant supplement is Alpha-lipoic acid .
However , recommending ALA as an anti-obesity supplement remains controversial .
Accordingly , the purpose of the present study was to perform a meta- analysis on the effects of ALA supplement on anthropometric indices among adult subjects .
| 48,876 | 25,753,493 |
The effect of alpha-lipoic acid (ALA) supplementation on cardiovascular risk factors in men with chronic spinal cord injury: a clinical trial
|
Study design : A r and omized , double-blind , placebo-controlled clinical trial . Objective : To assess the effect of alpha-lipoic acid ( ALA ) supplementation on IL-6 , hs-CRP , FBS , anthropometric indices , food intake and blood pressure in male patients with chronic spinal cord injury ( SCI ) . Setting : Imam Khomeini Hospital , Tehran University of Medical Sciences , Tehran , Iran . Methods : Fifty-eight men with chronic SCI participated in the study . Participants were divided in two groups : one group received 600 mg of supplemental ALA ( n=28 ) and the other group received placebo ( n=30 ) for 12 weeks . At the beginning and end of the study , biochemical parameters , anthropometric indices , blood pressure and dietary intakes were measured . Dietary intake was measured using N4 software , and statistical analyses were carried out using SPSS16 . Results : No significant reduction was found in IL-6 ( P=0.97 ) and hs-CRP levels ( P=0.23 ) . There was significant reduction in fasting blood sugar ( P=0.001 ) , body weight ( P=0.001 ) , BMI ( P=0.001 ) , waist circumference ( P=0.001 ) and blood pressure ( P=0.001 ) . Dietary intake was significantly reduced , including fat ( P=0.001 ) , carbohydrate ( P=0.001 ) , protein ( P=0.002 ) and energy intakes ( P=0.001 ) . Conclusion : Lipoic acid supplementation had no significant effect on the measured inflammatory markers but it reduces fasting blood sugar , anthropometric parameters , food intake and blood pressure in men with chronic SCI
| 2,013 |
The present study revealed that supplementation with ALA slightly but significantly decreased body weight and BMI .
Safe dosage for ALA is up to 1200 mg/day .
However , it seems that ALA can not be cost-effective .
|
BACKGROUND & AIMS Previous studies have supported positive roles of antioxidant supplements on weight-loss .
One antioxidant supplement is Alpha-lipoic acid .
However , recommending ALA as an anti-obesity supplement remains controversial .
Accordingly , the purpose of the present study was to perform a meta- analysis on the effects of ALA supplement on anthropometric indices among adult subjects .
|
2,013 | 28,629,898 |
The present study revealed that supplementation with ALA slightly but significantly decreased body weight and BMI .
Safe dosage for ALA is up to 1200 mg/day .
However , it seems that ALA can not be cost-effective .
|
BACKGROUND & AIMS Previous studies have supported positive roles of antioxidant supplements on weight-loss .
One antioxidant supplement is Alpha-lipoic acid .
However , recommending ALA as an anti-obesity supplement remains controversial .
Accordingly , the purpose of the present study was to perform a meta- analysis on the effects of ALA supplement on anthropometric indices among adult subjects .
| 48,877 | 27,276,401 |
Adjunctive &agr;-lipoic acid reduces weight gain compared with placebo at 12 weeks in schizophrenic patients treated with atypical antipsychotics: a double-blind randomized placebo-controlled study
|
& agr;-Lipoic acid ( ALA ) has been reported to be effective in reducing body weight in rodents and obese patients . Our previous open trial showed that ALA may play a role in reducing weight gain in patients with schizophrenia on atypical antipsychotics . The present study evaluated the efficacy of ALA in reducing weight and BMI in patients with schizophrenia who had experienced significant weight gain since taking atypical antipsychotics . In a 12-week , double-blind r and omized placebo-controlled study , 22 overweight and clinical ly stable patients with schizophrenia were r and omly assigned to receive ALA or placebo . ALA was administered at 600–1800 mg , as tolerated . Weight , BMI , abdomen fat area measured by computed tomography , and metabolic values were determined . Adverse effects were also assessed to examine safety . Overall , 15 patients completed 12 weeks of treatment . There was significant weight loss and decreased visceral fat levels in the ALA group compared with the placebo group . There were no instances of psychopathologic aggravation or severe ALA-associated adverse effects . ALA was effective in reducing weight and abdominal obesity in patients with schizophrenia who had experienced significant weight gain since beginning an atypical antipsychotic regimen . Moreover , ALA was well tolerated throughout this study . ALA might play an important role as an adjunctive treatment in decreasing obesity in patients who take atypical antipsychotics
| 2,013 |
The present study revealed that supplementation with ALA slightly but significantly decreased body weight and BMI .
Safe dosage for ALA is up to 1200 mg/day .
However , it seems that ALA can not be cost-effective .
|
BACKGROUND & AIMS Previous studies have supported positive roles of antioxidant supplements on weight-loss .
One antioxidant supplement is Alpha-lipoic acid .
However , recommending ALA as an anti-obesity supplement remains controversial .
Accordingly , the purpose of the present study was to perform a meta- analysis on the effects of ALA supplement on anthropometric indices among adult subjects .
|
2,013 | 28,629,898 |
The present study revealed that supplementation with ALA slightly but significantly decreased body weight and BMI .
Safe dosage for ALA is up to 1200 mg/day .
However , it seems that ALA can not be cost-effective .
|
BACKGROUND & AIMS Previous studies have supported positive roles of antioxidant supplements on weight-loss .
One antioxidant supplement is Alpha-lipoic acid .
However , recommending ALA as an anti-obesity supplement remains controversial .
Accordingly , the purpose of the present study was to perform a meta- analysis on the effects of ALA supplement on anthropometric indices among adult subjects .
| 48,878 | 21,666,939 |
Effect of alpha-lipoic acid on blood glucose, insulin resistance and glutathione peroxidase of type 2 diabetic patients.
|
OBJECTIVE To examine the effects of alpha-lipoic acid ( ALA ) treatment over a period of 2 months on fasting blood glucose ( FBG ) , insulin resistance ( IR ) , and glutathione peroxidase ( GH-Px ) activity in type 2 diabetes ( T2DM ) patients . METHODS This study took place in Motahari Clinic , Shiraz , Iran , which is affiliated to Shiraz University of Medical Sciences from May to October 2006 . Type 2 DM patients ( n=57 ) were divided into 2 groups to receive either ALA ( 300 mg daily ) or placebo by systematic r and omization , and were followed-up for 8 weeks . After an overnight fasting and 2 hours after breakfast , patients ' blood sample s were drawn and tested for FBG , 2 hours PPG , serum insulin level , and GH-Px activity . RESULTS The result of the study showed a significant decrease in FBG and PPG levels , IR-Homeostasis Model Assessment ( IR-HOMA index ) and GH-Px level in the ALA group . The comparison of differences between FBG and IR at the beginning and at the end of study in the ALA treated group and the placebo group were also significant . CONCLUSION This study supports the use of ALA as an antioxidant in the care of diabetic patients
| 2,013 |
The present study revealed that supplementation with ALA slightly but significantly decreased body weight and BMI .
Safe dosage for ALA is up to 1200 mg/day .
However , it seems that ALA can not be cost-effective .
|
BACKGROUND & AIMS Previous studies have supported positive roles of antioxidant supplements on weight-loss .
One antioxidant supplement is Alpha-lipoic acid .
However , recommending ALA as an anti-obesity supplement remains controversial .
Accordingly , the purpose of the present study was to perform a meta- analysis on the effects of ALA supplement on anthropometric indices among adult subjects .
|
2,014 | 25,006,974 |
The results of this systematic review identify the consistent and prevalent indicators of concussion and their associations , derived from the strongest evidence in the published literature .
|
BACKGROUND Currently , there is no evidence -based definition for concussion that is being uniformly applied in clinical and research setting s. OBJECTIVE To conduct a systematic review of the highest- quality literature about concussion and to assemble evidence about the prevalence and associations of key indicators of concussion .
The goal was to establish an evidence -based foundation from which to derive , in future work , a definition , diagnostic criteria , and prognostic indicators for concussion .
| 48,879 | 16,816,151 |
The “Value Added” of Neurocognitive Testing after Sports-Related Concussion
|
Background Neurocognitive testing has been endorsed as a “ cornerstone ’ of concussion management by recent Vienna and Prague meetings of the Concussion in Sport Group . Neurocognitive testing is important given the potential unreliability of athlete self-report after injury . Relying only on athletes'ormalities after injury . Study Design Case control study ; Level of evidence , 3 . Methods High school and college athletes with a diagnosed concussion were tested 2 days after injury . Postinjury neurocognitive performance ( Immediate Postconcussion Assessment and Cognitive Testing ) and symptom ( postconcussion symptom ) scores were compared with preinjury ( baseline ) scores and with those of an agex and education-matched noninjured athlete control group . “ Abnormal ” test performance was determined statistically with Reliable Change Index scores . Results Sixty-four percent of concussed athletes reported a significant increase in symptoms , as judged by postconcussion symptom scores , compared with preinjury baseline at 2 days after injury . Eighty-three percent of the concussed sample demonstrated significantly poorer neurocognitive test results relative to their own baseline performance . The addition of neurocognitive testing result ed in a net increase in sensitivity of 19 % . Ninety-three percent of the sample had either abnormal neurocognitive test results or a significant increase in symptoms , relative to their own baseline ; 30 % of a control group demonstrated either abnormalities in neurocognitive testing or elevated symptoms , as judged by postconcussion symptom scores . For the concussed group , use of symptom and neurocognitive test results result ed in an increased yield of 29 % overreliance on symptoms alone . In contrast , 0 % of the control group had both symptoms and abnormal neurocognitive testing . Conclusion Reliance on patients ’ self-reported symptoms after concussion is likely to result in underdiagnosis of concussion and may result in premature return to play . Neurocognitive testing increases diagnostic accuracy when used in conjunction with self-reported symptoms
| 2,014 |
The results of this systematic review identify the consistent and prevalent indicators of concussion and their associations , derived from the strongest evidence in the published literature .
|
BACKGROUND Currently , there is no evidence -based definition for concussion that is being uniformly applied in clinical and research setting s. OBJECTIVE To conduct a systematic review of the highest- quality literature about concussion and to assemble evidence about the prevalence and associations of key indicators of concussion .
The goal was to establish an evidence -based foundation from which to derive , in future work , a definition , diagnostic criteria , and prognostic indicators for concussion .
|
2,014 | 25,006,974 |
The results of this systematic review identify the consistent and prevalent indicators of concussion and their associations , derived from the strongest evidence in the published literature .
|
BACKGROUND Currently , there is no evidence -based definition for concussion that is being uniformly applied in clinical and research setting s. OBJECTIVE To conduct a systematic review of the highest- quality literature about concussion and to assemble evidence about the prevalence and associations of key indicators of concussion .
The goal was to establish an evidence -based foundation from which to derive , in future work , a definition , diagnostic criteria , and prognostic indicators for concussion .
| 48,880 | 15,597,030 |
Visuomotor Response Time in Children With a Mild Traumatic Brain Injury
|
Objective Compare the visuomotor response times of children after a mild traumatic brain injury ( mTBI ) with those of noninjured children matched for age , sex , and premorbid level of physical activity . Design Prospect i ve cohort study . Setting Pediatric trauma center . Participants Thirty-eight children aged 7 to 16 years in each group . Children with mTBI had a mean Glasgow Coma Scale score of 14.8 and were considered normal on a neurological assessment carried out at the time of hospital discharge . Noninjured children were friends of those with mTBI . Intervention Assessment s of response time were conducted at 1 , 4 , and 12 weeks after mTBI and at corresponding time intervals for the control children . Main Outcome Measures The response speed subtest of the Bruininks-Oseretsky Test of Motor Proficiency ( BOTMP ) ; reaction and movement time for upper and lower extremities , for simple , choice , and reversed choice response time paradigms . Results Over the assessment period , children with mTBI performed worse than the control group only on the response speed subtest of the BOTMP . The mTBI children however tended to have slower movement times 1 week postinjury for the reversed choice response time paradigm for the lower extremities . Conclusions Some children with mTBI may have some problems in response time persisting until 12 weeks postinjury . Further research is required to better identify and underst and the severity of these problems and determine their impact , if any , on participation in physical activities
| 2,014 |
The results of this systematic review identify the consistent and prevalent indicators of concussion and their associations , derived from the strongest evidence in the published literature .
|
BACKGROUND Currently , there is no evidence -based definition for concussion that is being uniformly applied in clinical and research setting s. OBJECTIVE To conduct a systematic review of the highest- quality literature about concussion and to assemble evidence about the prevalence and associations of key indicators of concussion .
The goal was to establish an evidence -based foundation from which to derive , in future work , a definition , diagnostic criteria , and prognostic indicators for concussion .
|
2,014 | 25,006,974 |
The results of this systematic review identify the consistent and prevalent indicators of concussion and their associations , derived from the strongest evidence in the published literature .
|
BACKGROUND Currently , there is no evidence -based definition for concussion that is being uniformly applied in clinical and research setting s. OBJECTIVE To conduct a systematic review of the highest- quality literature about concussion and to assemble evidence about the prevalence and associations of key indicators of concussion .
The goal was to establish an evidence -based foundation from which to derive , in future work , a definition , diagnostic criteria , and prognostic indicators for concussion .
| 48,881 | 10,522,888 |
Brain activation during working memory 1 month after mild traumatic brain injury
|
Objective : To assess patterns of regional brain activation in response to varying working memory loads shortly after mild traumatic brain injury ( MTBI ) . Background : Many individuals complain of memory difficulty shortly after MTBI . Memory performance in these individuals can be normal despite these complaints . Methods : Brain activation patterns in response to a working memory task ( auditory n-back ) were assessed with functional MRI in 12 MTBI patients within 1 month of their injury and in 11 healthy control subjects . Results : Brain activation patterns differed between MTBI patients and control subjects in response to increasing working memory processing loads . Maximum intensity projections of statistical parametric maps in control subjects showed bifrontal and biparietal activation in response to a low processing load , with little additional increase in activation associated with the high load task . MTBI patients showed some activation during the low processing load task but significantly increased activation during the high load condition , particularly in the right parietal and right dorsolateral frontal regions . Task performance did not differ significantly between groups . Conclusion : MTBI patients differed from control subjects in activation pattern of working memory circuitry in response to different processing loads , despite similar task performance . This suggests that injury-related changes in ability to activate or to modulate working memory processing re sources may underlie some of the memory complaints after MTBI
| 2,014 |
The results of this systematic review identify the consistent and prevalent indicators of concussion and their associations , derived from the strongest evidence in the published literature .
|
BACKGROUND Currently , there is no evidence -based definition for concussion that is being uniformly applied in clinical and research setting s. OBJECTIVE To conduct a systematic review of the highest- quality literature about concussion and to assemble evidence about the prevalence and associations of key indicators of concussion .
The goal was to establish an evidence -based foundation from which to derive , in future work , a definition , diagnostic criteria , and prognostic indicators for concussion .
|
2,014 | 25,006,974 |
The results of this systematic review identify the consistent and prevalent indicators of concussion and their associations , derived from the strongest evidence in the published literature .
|
BACKGROUND Currently , there is no evidence -based definition for concussion that is being uniformly applied in clinical and research setting s. OBJECTIVE To conduct a systematic review of the highest- quality literature about concussion and to assemble evidence about the prevalence and associations of key indicators of concussion .
The goal was to establish an evidence -based foundation from which to derive , in future work , a definition , diagnostic criteria , and prognostic indicators for concussion .
| 48,882 | 19,284,234 |
Prediction of intracranial computed tomography findings in patients with minor head injury by using logistic regression.
|
OBJECT The aim of this study was to develop a decision rule for physicians in developing countries to identify patients with minor head injury who will benefit from emergency brain CT scanning . METHODS Three hundred eighteen patients with a history of blunt head trauma and a Glasgow Coma Scale ( GCS ) score > or= 13 who had presented within 12 hours of trauma underwent nonenhanced brain CT and were included in this prospect i ve study . Computed tomography findings that necessitated neurosurgical care ( either observation or intervention ) were considered as positive findings . Logistic regression was used to develop the decision rule . RESULTS Computed tomography scans were always normal in patients < 65 years old who did not have an obvious head wound , a raccoon sign , vomiting , memory deficit , or a decrease in their GCS score . Patients with 1 major criterion ( GCS score < 14 , raccoon sign , failure to remember the impact , age > 65 years , or vomiting ) or 2 minor criteria ( wound at the scalp or GCS score < 15 ) had an abnormal CT scan in 13 % of the cases . CONCLUSIONS The decision rule developed by the authors appears to be 100 % sensitive and 46 % specific for positive findings on brain CT and will , in developing countries , help clarify the decision to obtain scans
| 2,014 |
The results of this systematic review identify the consistent and prevalent indicators of concussion and their associations , derived from the strongest evidence in the published literature .
|
BACKGROUND Currently , there is no evidence -based definition for concussion that is being uniformly applied in clinical and research setting s. OBJECTIVE To conduct a systematic review of the highest- quality literature about concussion and to assemble evidence about the prevalence and associations of key indicators of concussion .
The goal was to establish an evidence -based foundation from which to derive , in future work , a definition , diagnostic criteria , and prognostic indicators for concussion .
|
2,014 | 25,006,974 |
The results of this systematic review identify the consistent and prevalent indicators of concussion and their associations , derived from the strongest evidence in the published literature .
|
BACKGROUND Currently , there is no evidence -based definition for concussion that is being uniformly applied in clinical and research setting s. OBJECTIVE To conduct a systematic review of the highest- quality literature about concussion and to assemble evidence about the prevalence and associations of key indicators of concussion .
The goal was to establish an evidence -based foundation from which to derive , in future work , a definition , diagnostic criteria , and prognostic indicators for concussion .
| 48,883 | 16,462,481 |
Examining Concussion Rates and Return to Play in High School Football Players Wearing Newer Helmet Technology: A Three-Year Prospective Cohort Study
|
OBJECTIVE : The purpose of this study was to compare concussion rates and recovery times for athletes wearing newer helmet technology compared to traditional helmet design . METHODS : This was a three-year , prospect i ve , naturalistic , cohort study . Participants were 2,141 high school athletes from Western Pennsylvania . Approximately half of the sample wore the Revolution helmet manufactured by Riddell , Inc. ( n = 1,173 ) and the remainder of the sample used st and ard helmets ( n = 968 ) . Athletes underwent computerized neurocognitive testing through the use of ImPACT at the beginning of the study . Following a concussion , players were reevaluated at various time intervals until recovery was complete . RESULTS : In the total sample , the concussion rate in athletes wearing the Revolution was 5.3 % and in athletes wearing st and ard helmets was 7.6 % [ & khgr;2 ( 1 , 2 , 141 ) = 4.96 , P < 0.027 ] . The relative risk estimate was 0.69 ( 95 % confidence interval = 0.499– 0.958 ) . Wearing the Revolution helmet was associated with approximately a 31 % decreased relative risk and 2.3 % decreased absolute risk for sustaining a concussion in this cohort study . The athletes wearing the Revolution did not differ from athletes wearing st and ard helmets on the mechanism of injury ( e.g. , head-to-head strike ) , on-field concussion markers ( e.g. , amnesia or loss of consciousness ) , or on-field presentation of symptoms ( e.g. , headaches , dizziness , or balance problems ) . CONCLUSION : Recent sophisticated laboratory research has better eluci date d injury biomechanics associated with concussion in professional football players . This data has led to changes in helmet design and new helmet technology , which appears to have beneficial effects in reducing the incidence of cerebral concussion in high school football players
| 2,014 |
The results of this systematic review identify the consistent and prevalent indicators of concussion and their associations , derived from the strongest evidence in the published literature .
|
BACKGROUND Currently , there is no evidence -based definition for concussion that is being uniformly applied in clinical and research setting s. OBJECTIVE To conduct a systematic review of the highest- quality literature about concussion and to assemble evidence about the prevalence and associations of key indicators of concussion .
The goal was to establish an evidence -based foundation from which to derive , in future work , a definition , diagnostic criteria , and prognostic indicators for concussion .
|
2,014 | 25,006,974 |
The results of this systematic review identify the consistent and prevalent indicators of concussion and their associations , derived from the strongest evidence in the published literature .
|
BACKGROUND Currently , there is no evidence -based definition for concussion that is being uniformly applied in clinical and research setting s. OBJECTIVE To conduct a systematic review of the highest- quality literature about concussion and to assemble evidence about the prevalence and associations of key indicators of concussion .
The goal was to establish an evidence -based foundation from which to derive , in future work , a definition , diagnostic criteria , and prognostic indicators for concussion .
| 48,884 | 21,574,719 |
The prospective course of postconcussion syndrome: the role of mild traumatic brain injury.
|
OBJECTIVE To investigate whether postconcussion syndrome ( PCS ) represents long-term sequelae associated with mild traumatic brain injury ( mTBI ) . METHODS Prospect i ve consecutive admissions to a Level 1 trauma hospital were assessed a mean 4.9 days and again 106.2 days post-injury . The final sample comprised 62 mTBI and 58 nonbrain injured trauma controls ( TC ) . Change or lack of change in individual PCS-like symptoms and PCS was examined . Multilevel logistic regression was used to analyze whether mTBI predicts 3-month PCS ( Time 2 ; T2 ) ; whether predictors of PCS ( within 14 days of injury , Time 1 ; T1 ) predict 3-month PCS , and how change in these predictors from T1 to T2 were associated with change in PCS status . Variables included demographic , injury-related , financial incentives , neuropsychological , and psychiatric disorder . RESULTS MTBI did not predict PCS . PCS was comparable ( T1 : mTBI : 40.3 % , TC : 50.0 % ; T2 : mTBI : 46.8 % , TC : 48.3 % ) . At T2 , 38.6 % were new cases of PCS ; between 30.8 % and 86.2 % reported either a new or more frequent symptom . A pre-injury depressive or anxiety disorder ( OR = 2.99 , 95 % CI [ 1.38 , 6.45 ] ) , and acute posttraumatic stress ( OR = 1.05 , 95 % CI [ 1.00 , 1.00 ] ) were early markers of PCS , regardless of mTBI . An interaction between time and posttraumatic stress disorder ( PTSD ) suggested the relationship between the severity of PTSD symptoms and PCS strengthened over time ( OR = 2.66 , 95 % CI [ 1.08 , 6.55 ] ) . Pain was related to PCS . Females were more likely than males to have PCS . CONCLUSION The data suggest the phenomenon of PCS in trauma patients does not show an association with mTBI
| 2,014 |
The results of this systematic review identify the consistent and prevalent indicators of concussion and their associations , derived from the strongest evidence in the published literature .
|
BACKGROUND Currently , there is no evidence -based definition for concussion that is being uniformly applied in clinical and research setting s. OBJECTIVE To conduct a systematic review of the highest- quality literature about concussion and to assemble evidence about the prevalence and associations of key indicators of concussion .
The goal was to establish an evidence -based foundation from which to derive , in future work , a definition , diagnostic criteria , and prognostic indicators for concussion .
|
2,014 | 25,006,974 |
The results of this systematic review identify the consistent and prevalent indicators of concussion and their associations , derived from the strongest evidence in the published literature .
|
BACKGROUND Currently , there is no evidence -based definition for concussion that is being uniformly applied in clinical and research setting s. OBJECTIVE To conduct a systematic review of the highest- quality literature about concussion and to assemble evidence about the prevalence and associations of key indicators of concussion .
The goal was to establish an evidence -based foundation from which to derive , in future work , a definition , diagnostic criteria , and prognostic indicators for concussion .
| 48,885 | 17,762,747 |
SEX DIFFERENCES IN NEUROPSYCHOLOGICAL FUNCTION AND POST‐CONCUSSION SYMPTOMS OF CONCUSSED COLLEGIATE ATHLETES
|
OBJECTIVE Our purpose was to determine whether sex differences exist with respect to post-concussion symptoms and neurocognitive function in concussed collegiate athletes . METHODS A prospect i ve dependent- sample cohort design was used to compare baseline and post-concussion neuropsychological test scores and endorsed symptoms as functions of serial post-concussion assessment with respect to time and sex . The Immediate Post-concussion Assessment and Cognitive Testing ( ImPACT ) battery was administered to a multicenter analysis group of 79 concussed athletes . This computerized neuropsychological test was given to the athletes during the preseason and , on average , 2 and 8 days postinjury . RESULTS Multivariate analyses revealed no significant between-group differences on baseline test performance with respect to sex on any of the ImPACT composite scores or on the total symptom score . Multivariate analyses of post-concussion data revealed a significant main effect of time on ImPACT scores , but no main effect of sex was identified , and no time-by-sex interaction existed . Post hoc analysis revealed that concussed female athletes performed significantly worse than concussed male athletes on visual memory tasks ( P = 0.001 ) , and analysis of endorsed post-concussion symptoms revealed that concussed men were significantly more likely than concussed women to report post-concussion symptoms of vomiting ( P = 0.001 ) and sadness ( P = 0.017 ) . Athletes ' scores were examined individually using the reliable-change methodology . At 2 days post-injury , 58 % of concussed athletes had one or more reliable incidents of performance decline or increases in symptom reporting . At 8 days post-concussion , 30 % of concussed athletes were still showing one or more reliable change from preseason values . CONCLUSIONS College athletes exhibit differences on visual memory composite scores and symptoms post-concussion as a function of sex . These data support the importance of evaluating neuropsychological status and post-concussion symptoms in concussed athletes . In addition , these data illustrate the importance of analyzing an individual athlete 's recovery pattern , because individual differences in recovery trajectories may be overshadowed by global norm-group comparisons
| 2,014 |
The results of this systematic review identify the consistent and prevalent indicators of concussion and their associations , derived from the strongest evidence in the published literature .
|
BACKGROUND Currently , there is no evidence -based definition for concussion that is being uniformly applied in clinical and research setting s. OBJECTIVE To conduct a systematic review of the highest- quality literature about concussion and to assemble evidence about the prevalence and associations of key indicators of concussion .
The goal was to establish an evidence -based foundation from which to derive , in future work , a definition , diagnostic criteria , and prognostic indicators for concussion .
|
2,014 | 25,006,974 |
The results of this systematic review identify the consistent and prevalent indicators of concussion and their associations , derived from the strongest evidence in the published literature .
|
BACKGROUND Currently , there is no evidence -based definition for concussion that is being uniformly applied in clinical and research setting s. OBJECTIVE To conduct a systematic review of the highest- quality literature about concussion and to assemble evidence about the prevalence and associations of key indicators of concussion .
The goal was to establish an evidence -based foundation from which to derive , in future work , a definition , diagnostic criteria , and prognostic indicators for concussion .
| 48,886 | 17,060,147 |
Symptoms and disability until 3 months after mild TBI
|
Objective : Examine frequency , character and course of symptoms until 3 months after MTBI and the relation between symptoms and disability . Methods : Prospect i ve cohort study of 122 consecutive patients with MTBI . Symptom assessment after 1 , 7 and 14 days and 3 months post-injury by use of Rivermead Post-concussional Question naire . Disability assessment by use of Rivermead Head Injury Follow-up Question naire . Results : Patients reporting one or more symptoms declined from 86 % on day 1 to 49 % 3 months post-injury , when 25 % also reported change in one or more domains of everyday activities . Poor memory , sleep disturbance and fatigue were most commonly reported . Symptom and disability scores were correlated ( τ = 0.60 ; p < 0.001 ) . Early symptom load correlated with late symptom load ( τ = 0.38 ; p < 0.01 ) . Conclusions : Symptoms gradually decline post-injury . Symptoms correlate with disability at 3 months . Patients with early high symptom load are at risk for developing persisting complaints
| 2,014 |
The results of this systematic review identify the consistent and prevalent indicators of concussion and their associations , derived from the strongest evidence in the published literature .
|
BACKGROUND Currently , there is no evidence -based definition for concussion that is being uniformly applied in clinical and research setting s. OBJECTIVE To conduct a systematic review of the highest- quality literature about concussion and to assemble evidence about the prevalence and associations of key indicators of concussion .
The goal was to establish an evidence -based foundation from which to derive , in future work , a definition , diagnostic criteria , and prognostic indicators for concussion .
|
2,014 | 25,006,974 |
The results of this systematic review identify the consistent and prevalent indicators of concussion and their associations , derived from the strongest evidence in the published literature .
|
BACKGROUND Currently , there is no evidence -based definition for concussion that is being uniformly applied in clinical and research setting s. OBJECTIVE To conduct a systematic review of the highest- quality literature about concussion and to assemble evidence about the prevalence and associations of key indicators of concussion .
The goal was to establish an evidence -based foundation from which to derive , in future work , a definition , diagnostic criteria , and prognostic indicators for concussion .
| 48,887 | 20,861,034 |
Exploring differences in computerized neurocognitive concussion testing between African American and White athletes.
|
The purpose of the current study was to explore potential differences in pre- and post-concussion performance on a computerized neurocognitive concussion test between African American and White high-school and collegiate student-athletes . A prospect i ve case-control design was used to compare baseline and 2- and 7-day post-concussion computerized neurocognitive performance and symptoms between 48 White and 48 African American athletes matched for age , gender , and concussion history . The Immediate Post-Concussion Assessment Cognitive Test ( ImPACT ) version 2.0 ( NeuroHealth System , LLC , Pittsburgh , PA , USA ) computer software program was used to assess neurocognitive function ( i.e. , verbal and visual memory , motor processing speed , and reaction time ) and concussion symptoms . Regardless of race/ethnicity , there were significant decrements in computerized neurocognitive performance and increased symptoms following a concussion for the entire sample . African Americans and Whites did not differ significantly on baseline or post-concussion verbal memory , visual memory , reaction time , and total reported symptoms . However , African American participants were 2.4 × more likely to have at least one clinical ly significant cognitive decline on ImPACT at 7 days post-concussion and scored lower at 7 days post-concussion compared with baseline on processing speed than White participants . The authors concluded that the baseline ImPACT test was culturally equivalent and construct valid for use with these two racial/ethnic groups . However , in contrast , the findings support deleterious performance for the African American athletes compared with the White athletes on the ImPACT post-concussion evaluation that is of critical clinical relevance and warrants further research
| 2,014 |
The results of this systematic review identify the consistent and prevalent indicators of concussion and their associations , derived from the strongest evidence in the published literature .
|
BACKGROUND Currently , there is no evidence -based definition for concussion that is being uniformly applied in clinical and research setting s. OBJECTIVE To conduct a systematic review of the highest- quality literature about concussion and to assemble evidence about the prevalence and associations of key indicators of concussion .
The goal was to establish an evidence -based foundation from which to derive , in future work , a definition , diagnostic criteria , and prognostic indicators for concussion .
|
2,014 | 25,006,974 |
The results of this systematic review identify the consistent and prevalent indicators of concussion and their associations , derived from the strongest evidence in the published literature .
|
BACKGROUND Currently , there is no evidence -based definition for concussion that is being uniformly applied in clinical and research setting s. OBJECTIVE To conduct a systematic review of the highest- quality literature about concussion and to assemble evidence about the prevalence and associations of key indicators of concussion .
The goal was to establish an evidence -based foundation from which to derive , in future work , a definition , diagnostic criteria , and prognostic indicators for concussion .
| 48,888 | 17,762,748 |
FUNCTIONAL BRAIN ABNORMALITIES ARE RELATED TO CLINICAL RECOVERY AND TIME TO RETURN‐TO‐PLAY IN ATHLETES
|
OBJECTIVE The relationship between athlete reports of symptoms , neurophysiological activation , and neuropsychological functioning is investigated in a sample of high school athletes . METHODS All athletes were evaluated using functional magnetic resonance imaging ( fMRI ) , a computer-based battery of neurocognitive tests , and a subjective symptom scale . Athletes were evaluated within approximately 1 week of injury and again after clinical recovery using all assessment modalities . RESULTS This study found that abnormal fMRI results during the first week of recovery predicted clinical recovery . As a group , athletes who demonstrated hyperactivation on fMRI scans at the time of their first fMRI scan demonstrated a more prolonged clinical recovery than athletes who did not demonstrate hyperactivation at the time of their first fMRI scan . CONCLUSION These results demonstrate the relationship between neurophysiological , neuropsychological , and subjective symptom data in a relatively large sample composed primarily of concussed high school athletes . fMRI represents an important evolving technology for the underst and ing of brain recovery after concussion and may help shape return-to-play guidelines in the future
| 2,014 |
The results of this systematic review identify the consistent and prevalent indicators of concussion and their associations , derived from the strongest evidence in the published literature .
|
BACKGROUND Currently , there is no evidence -based definition for concussion that is being uniformly applied in clinical and research setting s. OBJECTIVE To conduct a systematic review of the highest- quality literature about concussion and to assemble evidence about the prevalence and associations of key indicators of concussion .
The goal was to establish an evidence -based foundation from which to derive , in future work , a definition , diagnostic criteria , and prognostic indicators for concussion .
|
2,014 | 25,006,974 |
The results of this systematic review identify the consistent and prevalent indicators of concussion and their associations , derived from the strongest evidence in the published literature .
|
BACKGROUND Currently , there is no evidence -based definition for concussion that is being uniformly applied in clinical and research setting s. OBJECTIVE To conduct a systematic review of the highest- quality literature about concussion and to assemble evidence about the prevalence and associations of key indicators of concussion .
The goal was to establish an evidence -based foundation from which to derive , in future work , a definition , diagnostic criteria , and prognostic indicators for concussion .
| 48,889 | 22,673,263 |
Serum levels of ubiquitin C-terminal hydrolase distinguish mild traumatic brain injury from trauma controls and are elevated in mild and moderate traumatic brain injury patients with intracranial lesions and neurosurgical intervention
|
BACKGROUND : This study compared early serum levels of ubiquitin C-terminal hydrolase ( UCH-L1 ) from patients with mild and moderate traumatic brain injury ( TBI ) with uninjured and injured controls and examined their association with traumatic intracranial lesions on computed tomography ( CT ) scan ( CT positive ) and the need for neurosurgical intervention ( NSI ) . METHODS : This prospect i ve cohort study enrolled adult patients presenting to three tertiary care Level I trauma centers after blunt head trauma with loss of consciousness , amnesia , or disorientation and a Glasgow Coma Scale ( GCS ) score 9 to 15 . Control groups included normal uninjured controls and nonhead injured trauma controls presenting to the emergency department with orthopedic injuries or motor vehicle crash without TBI . Blood sample s were obtained in all trauma patients within 4 hours of injury and measured by enzyme-linked immunosorbent assay for UCH-L1 ( ng/mL ± st and ard error of the mean ) . RESULTS : There were 295 patients enrolled , 96 TBI patients ( 86 with GCS score 13–15 and 10 with GCS score 9–12 ) , and 199 controls ( 176 uninjured , 16 motor vehicle crash controls , and 7 orthopedic controls ) . The AUC for distinguishing TBI from uninjured controls was 0.87 ( 95 % confidence interval [ CI ] , 0.82–0.92 ) and for distinguishing those TBIs with GCS score 15 from controls was AUC 0.87 ( 95 % CI , 0.81–0.93 ) . Mean UCH-L1 levels in patients with CT negative versus CT positive were 0.620 ( ±0.254 ) and 1.618 ( ±0.474 ) , respectively ( p < 0.001 ) , and the AUC was 0.73 ( 95 % CI , 0.62–0.84 ) . For patients without and with NSI , levels were 0.627 ( 0.218 ) versus 2.568 ( 0.854 ; p < 0.001 ) , and the AUC was 0.85 ( 95 % CI , 0.76–0.94 ) . CONCLUSION : UCH-L1 is detectable in serum within an hour of injury and is associated with measures of injury severity including the GCS score , CT lesions , and NSI . Further study is required to vali date these findings before clinical application . LEVEL OF EVIDENCE : II , prognostic study
| 2,014 |
The results of this systematic review identify the consistent and prevalent indicators of concussion and their associations , derived from the strongest evidence in the published literature .
|
BACKGROUND Currently , there is no evidence -based definition for concussion that is being uniformly applied in clinical and research setting s. OBJECTIVE To conduct a systematic review of the highest- quality literature about concussion and to assemble evidence about the prevalence and associations of key indicators of concussion .
The goal was to establish an evidence -based foundation from which to derive , in future work , a definition , diagnostic criteria , and prognostic indicators for concussion .
|
2,014 | 25,006,974 |
The results of this systematic review identify the consistent and prevalent indicators of concussion and their associations , derived from the strongest evidence in the published literature .
|
BACKGROUND Currently , there is no evidence -based definition for concussion that is being uniformly applied in clinical and research setting s. OBJECTIVE To conduct a systematic review of the highest- quality literature about concussion and to assemble evidence about the prevalence and associations of key indicators of concussion .
The goal was to establish an evidence -based foundation from which to derive , in future work , a definition , diagnostic criteria , and prognostic indicators for concussion .
| 48,890 | 18,180,129 |
Clinical decision instruments for CT scan in minor head trauma.
|
Previous studies have presented conflicting results regarding the predictive value of various clinical symptoms and signs for performing computed tomography ( CT ) scan in minor head injury . Moreover , despite the presence in the literature of several similar publications regarding whether or not CT should be employed at the time of presentation of minor head injured patients , data regarding delayed CT are limited . The objective of this study was to determine whether high-risk criteria represent a significant indication for initial CT scan in patients with minor head trauma , and whether or not analysis using delayed CT scan is necessary in patients with high-risk criteria before being discharged . Patients presenting to the Emergency Department with minor head trauma between September 1 , 2003 and September 1 , 2004 were evaluated prospect ively . After being divided into two main groups , low- and high-risk , four separate sub-groups based on age were established . Initial spiral CT examination was done within 3 h of trauma on all patients in addition to a delayed control CT scan in those with high-risk criteria between 16 and 24 h after trauma . The difference between the high- and low-risk groups in terms of abnormal CT findings was statistically significant ( p < 0.0005 ) . Among high-risk patients there was a significant difference between patients with a Glasgow Coma Scale ( GCS ) score of 13 or 14 and those with a GCS score of 15 ( p < 0.0005 ) . The relationship between vomiting and abnormal CT scan was significant ( odds ratio 4.61 , 95 % confidence interval 2.20 - 9.64 , p = 0.0001 ) , and the relationship between abnormal CT scan and suspected skull fracture was also significant ( odds ratio 3.46 , 95 % confidence interval 1.52 - 7.91 , p = 0.0032 ) . No significant correlations between other high-risk criteria and abnormal CT scan were determined . The difference between initial and delayed CT scans in patients with high-risk criteria was not significant ( p = 0.161 ) . Low-risk patients with a GCS score of 15 may be discharged without initial CT scan being performed . Initial CT scan absolutely must be performed , however , on patients with GCS < or = 15 in the event of vomiting or suspected skull fracture , even if isolated . Even though the difference between initial and delayed CT scans in patients with high-risk criteria is not significant , it is our opinion that it is still prudent for delayed CT scan to be performed , particularly on patients whose GCS score does not rise to 15 , or decreases
| 2,014 |
The results of this systematic review identify the consistent and prevalent indicators of concussion and their associations , derived from the strongest evidence in the published literature .
|
BACKGROUND Currently , there is no evidence -based definition for concussion that is being uniformly applied in clinical and research setting s. OBJECTIVE To conduct a systematic review of the highest- quality literature about concussion and to assemble evidence about the prevalence and associations of key indicators of concussion .
The goal was to establish an evidence -based foundation from which to derive , in future work , a definition , diagnostic criteria , and prognostic indicators for concussion .
|
2,014 | 25,006,974 |
The results of this systematic review identify the consistent and prevalent indicators of concussion and their associations , derived from the strongest evidence in the published literature .
|
BACKGROUND Currently , there is no evidence -based definition for concussion that is being uniformly applied in clinical and research setting s. OBJECTIVE To conduct a systematic review of the highest- quality literature about concussion and to assemble evidence about the prevalence and associations of key indicators of concussion .
The goal was to establish an evidence -based foundation from which to derive , in future work , a definition , diagnostic criteria , and prognostic indicators for concussion .
| 48,891 | 14,754,723 |
Grade 1 or “Ding” Concussions in High School Athletes
|
Background Recent concussion management guidelines have suggested that athletes with mild ( grade 1 ) concussions may be returned to play if asymptomatic for 15 minutes . The purpose of this study was to assess the utility of a current concussion management guideline in classifying and managing mild concussion . Hypothesis High school athletes diagnosed with a grade 1 concussion will demonstrate measurable decline in neuropsychological functioning that persists during the 1st week of recovery . Study Design Prospect i ve study design ed to evaluate neuropsychological functioning both prior to and following concussion . Methods Forty-three high school athletes completed neuropsychological test performance and symptom ratings prior to the season and at two times during the 1st week following mild concussion . Results Thirty-six hours after injury , mildly concussed high school athletes demonstrated a decline in memory ( P < 0.003 ) and a dramatic increase in self-reported symptoms ( P < 0.00001 ) compared to baseline performance . Conclusions Athletes with grade 1 concussion demonstrated memory deficits and symptoms that persisted beyond the context in which they were injured . These data suggest that current grade 1 return-to-play recommendations that allow for immediate return to play may be too liberal . Clinical Relevance A reconsideration of current concussion grading systems appears to be warranted
| 2,014 |
The results of this systematic review identify the consistent and prevalent indicators of concussion and their associations , derived from the strongest evidence in the published literature .
|
BACKGROUND Currently , there is no evidence -based definition for concussion that is being uniformly applied in clinical and research setting s. OBJECTIVE To conduct a systematic review of the highest- quality literature about concussion and to assemble evidence about the prevalence and associations of key indicators of concussion .
The goal was to establish an evidence -based foundation from which to derive , in future work , a definition , diagnostic criteria , and prognostic indicators for concussion .
|
2,014 | 25,006,974 |
The results of this systematic review identify the consistent and prevalent indicators of concussion and their associations , derived from the strongest evidence in the published literature .
|
BACKGROUND Currently , there is no evidence -based definition for concussion that is being uniformly applied in clinical and research setting s. OBJECTIVE To conduct a systematic review of the highest- quality literature about concussion and to assemble evidence about the prevalence and associations of key indicators of concussion .
The goal was to establish an evidence -based foundation from which to derive , in future work , a definition , diagnostic criteria , and prognostic indicators for concussion .
| 48,892 | 17,371,884 |
Predicting Intracranial Traumatic Findings on Computed Tomography in Patients with Minor Head Injury: The CHIP Prediction Rule
|
Context Available prediction rules to guide selective use of computed tomography in patients with minor head injuries were developed for use in patients with a history of loss of consciousness . Contribution This prospect i ve study included 3181 adults with minor head injury with or without loss of consciousness . A prediction rule based on risk factors ( such as age ; Glasgow Coma Scale score ; skull fracture ; and posttraumatic vomiting , amnesia , or seizure ) successfully identified patients who had intracranial computed tomography findings ( sensitivity , approximately 95 % ) or neurosurgical intervention ( sensitivity , 100 % ) . Caution External validation in different population s is needed before widespread application of the rule . The Editors Minor head injury is one of the most common injuries seen in western emergency departments , with an estimated incidence of 100 to 300 per 100000 people ( 1 ) . Patients with minor head injury include those with blunt injury to the head who have a normal or minimally altered level of consciousness on presentation in the emergency department , that is , a Glasgow Coma Scale ( GCS ) score of 13 to 15 , and a maximum loss of consciousness of 15 minutes , posttraumatic amnesia for 60 minutes , or both ( 2 ) . Intracranial complications after minor head injury are infrequent but commonly require in-hospital observation and occasionally require neurosurgical intervention ( 3 , 4 ) . The imaging procedure of choice for reliable , rapid diagnosis of intracranial complications is computed tomography ( CT ) ( 5 , 6 ) . Because most patients with minor head injury do not show traumatic abnormalities on CT , it seems inefficient to scan all patients with minor head injury to exclude intracranial complications . Of the published prediction rules for the selective use of CT in patients with minor head injury , the New Orleans Criteria ( NOC ) and the Canadian CT Head Rule ( CCHR ) have been externally vali date d ( 79 ) . Research ers in internal and external validation studies have shown that both rules identify 100 % of patients requiring neurosurgical intervention and most patients with traumatic intracranial findings on CT ( 3 , 1012 ) . The external validation studies , however , yielded lower specificities than the development studies ( 10 , 12 ) . The originally reported specificities were probably too optimistic because of their partial derivation from data sets that were also used for the model development ( 13 ) . Also , in both studies research ers included only a subset of patients with minor head injury . Most notably , research ers developed the NOC and the CCHR for patients with minor head injury who have a history of loss of consciousness or amnesia , which many of these patients presenting to emergency departments do not have . Generalizability of the NOC and the CCHR is therefore limited . We aim ed to develop a widely applicable and easy-to-implement prediction rule for the selective use of CT in all patients with minor head injury with or without a history of loss of consciousness . To avoid optimism for the model 's performance , we used penalty factors and internal validation by using bootstrapping procedures to attain more realistic predictions of the model 's performance in an external patient population ( 13 ) . Methods Patients We prospect ively collected data on consecutive patients in 4 university hospitals in the Netherl and s that were participating in the CT in Head Injury Patients ( CHIP ) study ( Figure 1 ) ( 14 ) . Inclusion criteria included initial presentation within 24 hours of blunt injury to the head , a minimum age of 16 years , and a Glasgow Coma Scale ( GCS ) score of 13 to 14 or a GCS score of 15 , with at least 1 of the following risk factors : history of loss of consciousness , short-term memory deficit , amnesia for the traumatic event , posttraumatic seizure , vomiting , severe headache , clinical evidence of intoxication with alcohol or drugs , use of anticoagulants or history of coagulopathy , external evidence of injury above the clavicles , and neurologic deficit . Exclusion criteria were transfer from another hospital , contraindications for CT , or concurrent injuries precluding a head CT at presentation . Figure 1 . Study flow diagram . The number of patients presenting with head injury is an estimate based on the proportion of patients included out of the total number of trauma patients seen by a neurologist or neurologist-in-training in the emergency department of the participating center that included most patients . CT = computed tomography . A neurologist or a neurologist-in-training under telephone supervision of a neurologist examined patients , after which a head CT was performed as soon as possible , in accordance with the current Dutch guidelines ( 15 ) . We performed head CT according to a routine trauma protocol , with a maximum slice thickness of 5 mm infratentorially and 8 mm supratentorially , without intravenous contrast administration . A neuroradiologist or a trauma radiologist ( 9 in total , not blinded to the patients ' history and clinical findings ) interpreted scans in brain and bone window setting s. The institutional review board waived patient informed consent after review of our study protocol because current Dutch guidelines and European Federation of Neurological Societies ' guidelines recommend routine head CT for patients meeting our inclusion criteria ( 15 , 16 ) . Definitions We considered a patient to have a history of loss of consciousness when a witness or the patient reported it . We defined short-term memory deficit as persistent antero grade amnesia . We deemed amnesia present for the traumatic event if the patient could not recall the entire traumatic event . We defined posttraumatic seizure as a seizure witnessed or suspected after the injury and vomiting as an episode of emesis after the traumatic event . We classified headache as being either diffuse or localized . We evaluated the presence and severity of intoxication clinical ly by evidence of slurred speech , alcoholic fetor , or nystagmus ; we did not perform routine blood toxicology tests . Anticoagulant treatment included only coumarin derivatives . We scored the use of platelet aggregation inhibitors ( for example , aspirin and clopidrogel ) , but we did not consider it to be a risk factor . We assessed noniatrogenic coagulopathy , which we considered a risk factor , by patient history , but we did not perform routine blood coagulation tests . We defined external evidence of injury as clinical ly significant discontinuity of the skin or extensive bruising . We classified injury suspect of a fracture as clinical signs of fracture , whereas we classified other injuries , such as contusions , lacerations , or abrasions , as contusion . We defined focal neurologic deficit as any abnormality on routine clinical neurologic examination that indicated a focal cerebral lesion . Data Collection We collected data on patient and trauma characteristics , symptoms , and risk factors ; physical and neurologic examination ; CT findings ; and neurosurgical intervention . Examining physicians entered data on patient history and examination into a data base ( OpenSDE , Erasmus MCUniversity Medical Center Rotterdam , Rotterdam , the Netherl and s ) before the patient underwent CT . If this interfered with their clinical workflow , they entered the data after the CT ( 17 ) . The reading radiologist added the CT findings . We collected data on neurosurgical intervention , additional CT scans performed , and the clinical outcomes of patients by search ing the hospital 's patient information system . Outcome Measures Our primary outcome measure for this analysis was any intracranial traumatic finding on CT , which included all neurocranial traumatic findings except for isolated linear skull fractures . A secondary outcome measure was neurosurgical intervention contingent to initial CT . We defined neurosurgical intervention as any neurosurgical procedure ( craniotomy , intracranial pressure monitoring , elevation of skull fracture , or ventricular drainage ) within 30 days of the traumatic event . Risk Factors We selected all of the risk factors from the NOC and the CCHR ( 7 , 9 ) : age , headache , vomiting , intoxication , persistent antero grade amnesia , retro grade amnesia more than 30 minutes , injury above the clavicles ( including clinical signs of skull or basal skull fracture ) , GCS score less than 15 at 2 hours postinjury , and dangerous trauma mechanism ( pedestrian vs. vehicle , fall from height , and ejected from motor vehicle ) . We tested other risk factors from clinical guidelines for the use of CT in minor head injury ( 15 , 16 , 1821 ) for additional effects . We combined the variables cyclist versus vehicle and pedestrian versus vehicle into 1 variable ( pedestrian or cyclist vs. vehicle ) for statistical analysis because they are similar trauma mechanisms . Statistical Analysis We based sample size on an estimated 25 variables for multivariable logistic regression analysis . For reliable analysis , we required at least 10 events of the primary outcome measure per variable , that is , 250 events for 25 variables ( 22 ) . Given an incidence of traumatic findings on CT of 8 % to 10 % , we needed to include 3125 patients . We assumed that missing data were missing at r and om , and we imputed them on the basis of the available data means to avoid bias ( 2327 ) . The proportion of imputed data was 3.8 % , which included items documented as unknown and items that were not documented . Of all cases , 1956 ( 62 % ) were complete . Loss of consciousness and posttraumatic amnesia had the highest proportion of missing or unknown data ( 18 % and 10 % , respectively ) . We imputed both as present on the basis of the available variable means and as consistent with clinical practice . We used the entire data set , after missing value imputation , for all analyses . We evaluated the study sample for demographic characteristics , mechanism of injury , traumatic findings , neurosurgical intervention , GCS scores , and the presence of risk factors . We tested associations of each risk factor with the primary
| 2,014 |
The results of this systematic review identify the consistent and prevalent indicators of concussion and their associations , derived from the strongest evidence in the published literature .
|
BACKGROUND Currently , there is no evidence -based definition for concussion that is being uniformly applied in clinical and research setting s. OBJECTIVE To conduct a systematic review of the highest- quality literature about concussion and to assemble evidence about the prevalence and associations of key indicators of concussion .
The goal was to establish an evidence -based foundation from which to derive , in future work , a definition , diagnostic criteria , and prognostic indicators for concussion .
|
2,014 | 25,006,974 |
The results of this systematic review identify the consistent and prevalent indicators of concussion and their associations , derived from the strongest evidence in the published literature .
|
BACKGROUND Currently , there is no evidence -based definition for concussion that is being uniformly applied in clinical and research setting s. OBJECTIVE To conduct a systematic review of the highest- quality literature about concussion and to assemble evidence about the prevalence and associations of key indicators of concussion .
The goal was to establish an evidence -based foundation from which to derive , in future work , a definition , diagnostic criteria , and prognostic indicators for concussion .
| 48,893 | 22,071,014 |
Elevated levels of serum glial fibrillary acidic protein breakdown products in mild and moderate traumatic brain injury are associated with intracranial lesions and neurosurgical intervention.
|
STUDY OBJECTIVE This study examines whether serum levels of glial fibrillary acidic protein breakdown products ( GFAP-BDP ) are elevated in patients with mild and moderate traumatic brain injury compared with controls and whether they are associated with traumatic intracranial lesions on computed tomography ( CT ) scan ( positive CT result ) and with having a neurosurgical intervention . METHODS This prospect i ve cohort study enrolled adult patients presenting to 3 Level I trauma centers after blunt head trauma with loss of consciousness , amnesia , or disorientation and a Glasgow Coma Scale ( GCS ) score of 9 to 15 . Control groups included normal uninjured controls and trauma controls presenting to the emergency department with orthopedic injuries or a motor vehicle crash without traumatic brain injury . Blood sample s were obtained in all patients within 4 hours of injury and measured by enzyme-linked immunosorbent assay for GFAP-BDP ( nanograms/milliliter ) . RESULTS Of the 307 patients enrolled , 108 were patients with traumatic brain injury ( 97 with GCS score 13 to 15 and 11 with GCS score 9 to 12 ) and 199 were controls ( 176 normal controls and 16 motor vehicle crash controls and 7 orthopedic controls ) . Receiver operating characteristic curves demonstrated that early GFAP-BDP levels were able to distinguish patients with traumatic brain injury from uninjured controls with an area under the curve of 0.90 ( 95 % confidence interval [ CI ] 0.86 to 0.94 ) and differentiated traumatic brain injury with a GCS score of 15 with an area under the curve of 0.88 ( 95 % CI 0.82 to 0.93 ) . Thirty-two patients with traumatic brain injury ( 30 % ) had lesions on CT . The area under these curves for discriminating patients with CT lesions versus those without CT lesions was 0.79 ( 95 % CI 0.69 to 0.89 ) . Moreover , the receiver operating characteristic curve for distinguishing neurosurgical intervention from no neurosurgical intervention yielded an area under the curve of 0.87 ( 95 % CI 0.77 to 0.96 ) . CONCLUSION GFAP-BDP is detectable in serum within an hour of injury and is associated with measures of injury severity , including the GCS score , CT lesions , and neurosurgical intervention . Further study is required to vali date these findings before clinical application
| 2,014 |
The results of this systematic review identify the consistent and prevalent indicators of concussion and their associations , derived from the strongest evidence in the published literature .
|
BACKGROUND Currently , there is no evidence -based definition for concussion that is being uniformly applied in clinical and research setting s. OBJECTIVE To conduct a systematic review of the highest- quality literature about concussion and to assemble evidence about the prevalence and associations of key indicators of concussion .
The goal was to establish an evidence -based foundation from which to derive , in future work , a definition , diagnostic criteria , and prognostic indicators for concussion .
|
2,014 | 25,006,974 |
The results of this systematic review identify the consistent and prevalent indicators of concussion and their associations , derived from the strongest evidence in the published literature .
|
BACKGROUND Currently , there is no evidence -based definition for concussion that is being uniformly applied in clinical and research setting s. OBJECTIVE To conduct a systematic review of the highest- quality literature about concussion and to assemble evidence about the prevalence and associations of key indicators of concussion .
The goal was to establish an evidence -based foundation from which to derive , in future work , a definition , diagnostic criteria , and prognostic indicators for concussion .
| 48,894 | 21,610,342 |
Diagnosing mild traumatic brain injury: where are we now?
|
BACKGROUND The brain acoustic monitor ( BAM ) , an indicator of cerebral autoregulation , has previously shown high sensitivity but low specificity for computed tomographic ( CT ) abnormality in patients following the clinical diagnosis of traumatic brain injury . We assessed the utility of the BAM in diagnosing mild TBI ( mTBI ) in patients with and without normal findings of CT scan , a population for which there are a few objective markers of disease . METHODS We prospect ively studied 369 patients with mechanism of injury consistent with TBI . The diagnosis was evaluated by five methods : ( a ) study enrollment ( i.e. , mechanism of injury ) , ( b ) signs of head trauma , ( c ) expert physician assessment , ( d ) presence of initial symptoms ( loss of consciousness [ LOC ] ; amnesia ) , and ( e ) BAM . All patients had a head CT scan . We compared the BAM screen results with the diagnosis of mTBI and BAM data from 50 normal volunteers and 49 trauma control patients not thought to have TBI . RESULTS None of the diagnostic methods correlated well with the others . Correlation between the methods ranged from 21 % to 71 % . BAM discriminated between patients with mTBI versus without TBI ( p<0.01 ) and patients with mTBI versus normal subjects ( p<0.001 ) . There were 14 patients with new abnormal findings of CT scans . A history of LOC and physical signs of head injury were associated with a new abnormality on head CT ( p<0.05 and p<0.01 , respectively ) , whereas an abnormal BAM signal was suggestive ( p=0.08 ) . The sensitivity of BAM abnormality for head CT abnormality was 100 % , with a specificity of 30.14 % . CONCLUSION There is no gold st and ard for the diagnosis of mTBI . BAM screening is a useful diagnostic adjunct in patients with mTBI and may facilitate decision making . An abnormal BAM reading adds significance to LOC as a predictor of a new abnormality on head CT . In our study , opting not to CT scan patients with a normal BAM signal would have missed no new CT findings and no patients who required medical intervention for TBI , at a cost savings of $ 202,950
| 2,014 |
The results of this systematic review identify the consistent and prevalent indicators of concussion and their associations , derived from the strongest evidence in the published literature .
|
BACKGROUND Currently , there is no evidence -based definition for concussion that is being uniformly applied in clinical and research setting s. OBJECTIVE To conduct a systematic review of the highest- quality literature about concussion and to assemble evidence about the prevalence and associations of key indicators of concussion .
The goal was to establish an evidence -based foundation from which to derive , in future work , a definition , diagnostic criteria , and prognostic indicators for concussion .
|
2,014 | 25,006,974 |
The results of this systematic review identify the consistent and prevalent indicators of concussion and their associations , derived from the strongest evidence in the published literature .
|
BACKGROUND Currently , there is no evidence -based definition for concussion that is being uniformly applied in clinical and research setting s. OBJECTIVE To conduct a systematic review of the highest- quality literature about concussion and to assemble evidence about the prevalence and associations of key indicators of concussion .
The goal was to establish an evidence -based foundation from which to derive , in future work , a definition , diagnostic criteria , and prognostic indicators for concussion .
| 48,895 | 21,150,147 |
Tracking Neurocognitive Performance following Concussion in High School Athletes
|
Abstract Objective : To extend previous research design s and examine cognitive performance up to 30 days postconcussion . Method : A prospect i ve cohort design was used to examine 2000 athletes from 8 mid-Michigan area high schools to compare baseline neurocognitive performance with postconcussion neurocognitive performance . All concussed athletes were readministered the Immediate Post Assessment and Cognitive Test ( ImPACT ) at 2 , 7 , 14 , 21 , and 30 days postconcussion . Results : A total of 72 high school athletes ( aged 15.8 ± 1.34 years ) sustained a concussion . A significant with in-subjects effect for reaction time ( F = 10.01 ; P = 0.000 ) , verbal memory ( F = 3.05 ; P = 0.012 ) , motor processing speed ( F = 18.51 ; P = 0.000 ) , and total symptoms following an injury ( F = 16.45 ; P = 0.000 ) was found . Concussed athletes demonstrated a significant decrease in reaction time up to 14 days postconcussion ( P = 0.001 ) compared with baseline reaction time . Reaction time returned to baseline levels at 21 days postinjury ( P = 0.25 ) . At 7 days postinjury , impairments in verbal memory ( P = 0.003 ) and motor processing speed ( P = 0.000 ) were documented and returned to baseline levels by 14 days postinjury . Concussed athletes self-reported significantly more symptoms at 2 days postconcussion ( P = 0.000 ) and exhibited a resolution of symptoms by 7 days postinjury ( P = 0.06 ) . Conclusion : High school athletes could take up to 21 days to return to baseline levels for reaction time . These data support current recommendations for the conservative management of concussion in the high school athlete
| 2,014 |
The results of this systematic review identify the consistent and prevalent indicators of concussion and their associations , derived from the strongest evidence in the published literature .
|
BACKGROUND Currently , there is no evidence -based definition for concussion that is being uniformly applied in clinical and research setting s. OBJECTIVE To conduct a systematic review of the highest- quality literature about concussion and to assemble evidence about the prevalence and associations of key indicators of concussion .
The goal was to establish an evidence -based foundation from which to derive , in future work , a definition , diagnostic criteria , and prognostic indicators for concussion .
|
2,014 | 25,006,974 |
The results of this systematic review identify the consistent and prevalent indicators of concussion and their associations , derived from the strongest evidence in the published literature .
|
BACKGROUND Currently , there is no evidence -based definition for concussion that is being uniformly applied in clinical and research setting s. OBJECTIVE To conduct a systematic review of the highest- quality literature about concussion and to assemble evidence about the prevalence and associations of key indicators of concussion .
The goal was to establish an evidence -based foundation from which to derive , in future work , a definition , diagnostic criteria , and prognostic indicators for concussion .
| 48,896 | 20,680,882 |
Agreement between Parents and Children on Ratings of Post-Concussive Symptoms Following Mild Traumatic Brain Injury
|
The level of parent-child agreement on post-concussive symptoms ( PCS ) was examined in children following mild traumatic brain injuries ( TBI ) . As part of a larger longitudinal study , 186 children with mild TBI and 99 with orthopedic injuries ( OI ) , from 8 to 15 years of age , were recruited prospect ively . Parents and children completed the PCS Interview ( PCS-I ) and the Health and Behavior Inventory ( HBI ) at 2 weeks , 1 month , 3 months , and 12 months postinjury . Item-level correlations between child and parent ratings on both measures of PCS were significant but modest in both groups . Parent-child correlations for composite scales on the HBI and the total score on the PCS-I were significant in both groups , but somewhat higher in the OI group than in the mild TBI group . Mean symptom ratings tended to be significantly higher for children as compared to parents , especially for somatic symptoms . Parents and children display modest agreement when reporting PCS ; their ratings correlate significantly , but children report higher mean levels of symptoms than parents
| 2,014 |
The results of this systematic review identify the consistent and prevalent indicators of concussion and their associations , derived from the strongest evidence in the published literature .
|
BACKGROUND Currently , there is no evidence -based definition for concussion that is being uniformly applied in clinical and research setting s. OBJECTIVE To conduct a systematic review of the highest- quality literature about concussion and to assemble evidence about the prevalence and associations of key indicators of concussion .
The goal was to establish an evidence -based foundation from which to derive , in future work , a definition , diagnostic criteria , and prognostic indicators for concussion .
|
2,014 | 25,006,974 |
The results of this systematic review identify the consistent and prevalent indicators of concussion and their associations , derived from the strongest evidence in the published literature .
|
BACKGROUND Currently , there is no evidence -based definition for concussion that is being uniformly applied in clinical and research setting s. OBJECTIVE To conduct a systematic review of the highest- quality literature about concussion and to assemble evidence about the prevalence and associations of key indicators of concussion .
The goal was to establish an evidence -based foundation from which to derive , in future work , a definition , diagnostic criteria , and prognostic indicators for concussion .
| 48,897 | 8,379,832 |
Mild pediatric traumatic brain injury: a cohort study.
|
Using a prospect i ve , cohort design , we investigated whether children with mild traumatic brain injury ( TBI ) differed from individually matched controls on measures of intellectual , neuropsychological , academic , and " real world " functioning . Subjects included children between the ages of 6 and 15 years who sustained mild , moderate , and severe closed head injuries and were consecutively identified on presentation to the emergency departments of two regional , university medical centers . One hundred twenty-nine children were eligible for enrollment . Seventeen refused enrollment . Fifty-nine of the 112 enrolled children were classified as mildly injured . Six of these children dropped out , leaving 53 mildly injured cases for analysis . Individually matched controls from the classroom of the injured cases were identified based on age , gender , and premorbid academic achievement and behavior . Assessment measures included st and ardized intellectual , neuropsychological , and academic measures . Also , parent and teacher question naires , measuring social , educational , domestic , and community living skills were used . Among 51 outcome variables only five were significantly associated with injury at initial or 1-year testing after adjusting for multiple comparisons . However , these five associations were either very weak or implausible . Results from this study suggest that mild TBI produces virtually no clinical ly significant long-term deficits in intellectual , neuropsychological , academic , or " real world " functioning
| 2,014 |
The results of this systematic review identify the consistent and prevalent indicators of concussion and their associations , derived from the strongest evidence in the published literature .
|
BACKGROUND Currently , there is no evidence -based definition for concussion that is being uniformly applied in clinical and research setting s. OBJECTIVE To conduct a systematic review of the highest- quality literature about concussion and to assemble evidence about the prevalence and associations of key indicators of concussion .
The goal was to establish an evidence -based foundation from which to derive , in future work , a definition , diagnostic criteria , and prognostic indicators for concussion .
|
2,014 | 25,006,974 |
The results of this systematic review identify the consistent and prevalent indicators of concussion and their associations , derived from the strongest evidence in the published literature .
|
BACKGROUND Currently , there is no evidence -based definition for concussion that is being uniformly applied in clinical and research setting s. OBJECTIVE To conduct a systematic review of the highest- quality literature about concussion and to assemble evidence about the prevalence and associations of key indicators of concussion .
The goal was to establish an evidence -based foundation from which to derive , in future work , a definition , diagnostic criteria , and prognostic indicators for concussion .
| 48,898 | 10,081,599 |
Epidemiology and predictors of post-concussive syndrome after minor head injury in an emergency population.
|
OBJECTIVE To determine if clinical variables or neurobehavioural test ( NBT ) scores obtained in the ED within 24 hours of minor head injury ( MHI ) predict the development of postconcussive syndrome ( PCS ) . METHODS Prospect i ve , observational study of 71 MHI patients and 60 orthopaedic controls . MHI defined as loss of consciousness < 10 minutes or amnesia , GCS 15 , no skull fracture or new neurologic focality on PE , and no brain injury on CT ( if done ) . All patients received a seven part NBT battery in the ED . Telephone follow-up was done at 1 , 3 and 6 months to determine if patients met the DSM IV definition of PCS . ANALYSIS Stepwise , multivariate , logistic regression . RESULTS Predictors of PCS at 1 month were female gender ( OR = 7.8 ; 95 % CI = 41.6 , 1.98 ) , presence of both retro grade and antero grade amnesia ( OR = 0.055 ; CI = 0.002 , 0.47 ) , Digit Span Forward Scores ( OR = 0.748 ; CI = 0.52 , 1.03 ) and Hopkins Verbal Learning A scores ( OR = 0.786 ; CI = 0.65 , 0.91 ) ; at 3 months , presence of both retro grade and antero grade amnesia ( OR = 0.13 ; CI = 0.0 , 0.93 ) , Digit Span Forward Scores ( OR = 0.744 ; CI = 0.58 , 0.94 ) . No variables fit the model at 6 months . 92 % of males scoring > 25 on Hopkins Verbal Learning A did not have PCS at 1 month , and 89 % of females scoring < 9 on Digit Span Forward did have PCS at 1 month . CONCLUSIONS Gender and two NBTs can help predict PCS after MHI
| 2,014 |
The results of this systematic review identify the consistent and prevalent indicators of concussion and their associations , derived from the strongest evidence in the published literature .
|
BACKGROUND Currently , there is no evidence -based definition for concussion that is being uniformly applied in clinical and research setting s. OBJECTIVE To conduct a systematic review of the highest- quality literature about concussion and to assemble evidence about the prevalence and associations of key indicators of concussion .
The goal was to establish an evidence -based foundation from which to derive , in future work , a definition , diagnostic criteria , and prognostic indicators for concussion .
|
2,014 | 25,006,974 |
The results of this systematic review identify the consistent and prevalent indicators of concussion and their associations , derived from the strongest evidence in the published literature .
|
BACKGROUND Currently , there is no evidence -based definition for concussion that is being uniformly applied in clinical and research setting s. OBJECTIVE To conduct a systematic review of the highest- quality literature about concussion and to assemble evidence about the prevalence and associations of key indicators of concussion .
The goal was to establish an evidence -based foundation from which to derive , in future work , a definition , diagnostic criteria , and prognostic indicators for concussion .
| 48,899 | 11,950,406 |
Immediate Neurocognitive Effects of Concussion
|
OBJECTIVE To prospect ively measure the immediate neurocognitive effects and early course of recovery from concussion and to examine the effects of loss of consciousness ( LOC ) and posttraumatic amnesia ( PTA ) on the severity of neurocognitive impairment immediately after concussion . METHODS A sports-related concussion research model was used to allow prospect i ve immediate evaluation of concussion . A total of 2385 high school and college football players were studied . Ninety-one players ( 3.8 % ) sustained concussions during the study . A brief neurocognitive and neurological screening measure , the St and ardized Assessment of Concussion , was used to assess cognitive functioning before the football season , immediately after injury , and 15 minutes , 48 hours , and 90 days after injury . RESULTS St and ardized Assessment of Concussion scores immediately after concussion were significantly lower than the preseason baseline score and the noninjured population baseline mean , even for injured subjects without LOC or PTA . Subjects with LOC were most severely impaired immediately after injury , whereas those without LOC or PTA were least impaired . Significant impairment was also detected 15 minutes after injury , but all three groups returned to baseline levels of cognitive functioning within 48 hours . CONCLUSION These findings are the first to demonstrate not only that a gradient of increasing concussion severity is represented by PTA and LOC but also that measurable neurocognitive abnormalities are evident immediately after injury without PTA or LOC
| 2,014 |
The results of this systematic review identify the consistent and prevalent indicators of concussion and their associations , derived from the strongest evidence in the published literature .
|
BACKGROUND Currently , there is no evidence -based definition for concussion that is being uniformly applied in clinical and research setting s. OBJECTIVE To conduct a systematic review of the highest- quality literature about concussion and to assemble evidence about the prevalence and associations of key indicators of concussion .
The goal was to establish an evidence -based foundation from which to derive , in future work , a definition , diagnostic criteria , and prognostic indicators for concussion .
|
Subsets and Splits
No community queries yet
The top public SQL queries from the community will appear here once available.