Document Detail


Brace modification improves aerobic performance in Charcot-Marie-Tooth disease: a single-subject design.
MedLine Citation:
PMID:  11475477     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Ankle-foot orthoses (AFOs) can lower energy expenditure in patients with hemiplegia by 10%-13%. Review of the lower motor injury literature reveals insufficient physiologic evidence supporting the use or modification of AFOs in patients with lower motor neuron injury and, specifically, progressive conditions such as Charcot-Marie-Tooth disease. We sought to test the hypothesis that optimal AFOs would improve submaximal aerobic performance and submaximal perceived exertion, while producing no change in maximal aerobic capacity. DESIGN: In an individual with Charcot-Marie-Tooth disease, a single-subject design study was used. An A-B-A design was used, with "A" corresponding to use of the patient's old AFOs and "B" corresponding to the newly prescribed AFOs. The subject underwent treadmill exercise tolerance testing using a modified Balke protocol. Indirect calorimetry was used to measure oxygen consumption per unit time (VO2), and the Borg scale was used to measure perceived exertion. RESULTS: At the same submaximal exercise intensities, VO2, rate-pressure product, and perceived exertion were all reduced when using the modified AFOs. Additionally, these conditions allowed the subject to conduct the treadmill exercise test 20% longer. Maximal VO2 remained constant under all conditions. CONCLUSION: Optimizing the AFO prescription in a patient with Charcot-Marie-Tooth disease can enhance physiologic performance and perceived exertion at submaximal activity levels. Larger controlled trials are necessary to further demonstrate such benefits in patients with progressive neuropathy and other causes of lower motor neuron injury.
Authors:
J Bean; A Walsh; W Frontera
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  American journal of physical medicine & rehabilitation / Association of Academic Physiatrists     Volume:  80     ISSN:  0894-9115     ISO Abbreviation:  Am J Phys Med Rehabil     Publication Date:  2001 Aug 
Date Detail:
Created Date:  2001-07-27     Completed Date:  2001-08-09     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8803677     Medline TA:  Am J Phys Med Rehabil     Country:  United States    
Other Details:
Languages:  eng     Pagination:  578-82     Citation Subset:  AIM; IM    
Affiliation:
Department of Physical Medicine and Rehabilitation, Harvard Medical School, and Spaulding Rehabilitation Hospital, Boston, Massachusetts, USA.
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MeSH Terms
Descriptor/Qualifier:
Ankle*
Braces*
Charcot-Marie-Tooth Disease / physiopathology,  rehabilitation*
Exercise Therapy
Gait
Hemodynamics
Humans
Male
Middle Aged
Oxygen Consumption

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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