The Timed Up & Go test (TUG) is functional test and is a part of routine clinical examinations. The instrumented Timed Up & Go test enables its segmentation to sub-tasks: sit-to-stand, walking forward, turning, walking back, stand-to-sit, and consequently the computation of task-specific parameters and sub-tasks separately. However, there are no data on whether walking forward parameters differ from the walking back parameters. This study tested the differences between walking forward and walking back in the TUG extended to 10 m for 17 spatio-temporal gait parameters. All parameters were obtained from a GAITRite® pressure sensitive walkway (CIR Systems, Inc.). The differences were assessed for healthy controls and Parkinson's disease (PD) patients. None of investigated parameters exhibited a difference between both gait subtasks for healthy subjects group. Five parameters of interest, namely velocity, step length, stride length, stride velocity, and the proportion of the double support phase with respect to gait cycle duration, showed a statistically significant difference between gait for walking forward and walking back in PD patients. Therefore, we recommend a separate assessment for walking forward and walking back rather than averaging both gaits together.

• MeSH
• analýza chůze metody   MeSH
• časoprostorová analýza MeSH
• časové faktory MeSH
• chůze fyziologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• Parkinsonova nemoc patofyziologie   MeSH
• senioři MeSH
• studie případů a kontrol MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

BACKGROUND: The Timed Up and Go test is a well-known clinical test for assessing of mobility and fall risk. It has been shown that the IMU which use an accelerometer and gyroscope are capable of analysing the quantitative parameters of the sit-to-stand transition. RESEARCH QUESTION: Which signals obtained by the inertial sensors are suitable for continuous Timed Up & Go test sit-to-stand transition analysis? METHODS: In the study we included 29 older adult volunteers and 31 de-novo Parkinson disease (PD) patients. All subjects performed an instrumented extended TUG wearing a gyro-accelerometer. The sit-to-stand transition was detected from an angular velocity signal. The sit-to-stand signal pattern within the subject group was analyzed via an intra-class correlation between curves. Inter-subjects' variability was visualized using prediction bands. RESULTS: The angular velocity about the pitch axis exhibited the best signal match across subjects in both groups (0.50 < ICC < 0.75). When analysing acceleration, the acceleration along the antero-posterior axis showed moderate inter-subjects signal pattern match (0.50 < ICC < 0.75) in the reference group. The analysis of other signals revealed a poor signal pattern in both subject groups. SIGNIFICANCE: For optimal interpretation of the analysis of continuous curves, the signal pattern must be considered. Also, the inter-subject variability along this pattern can be informative and useful.

• MeSH
• lidé MeSH
• posturální rovnováha fyziologie   MeSH
• pozice sedu MeSH
• stoj MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

Effects of localized lower-extremity vibration on postural balance have been reported. The purpose of the current study was to investigate the effect of low-frequency vibration of calf muscles on the instrumented Timed-Up-and-Go (iTUG) test among older adults. Older adults were recruited and classified to low (n=10, age=72.9±2.8 years) and high fall risk (n=10, age=83.6±9.6) using STEADI. Vibratory system (30Hz or 40Hz), was positioned on calves along with wearable motion sensors. Participants performed the iTUG test three times, under conditions of no-vibration, 30Hz, and 40Hz vibration. Percentage differences in duration of iTUG components were calculated comparing vibration vs no-vibration conditions. Significant between-group differences were observed in iTUG (p=0.03); high fall risk participants showed reduction in the duration of turning (-10 % with 30Hz; p=0.15 and -15 % with 40Hz; p=0.03) and turning and sitting (-18 % with 30Hz; p=0.02 and -10 % with 40Hz; p=0.08). However, vibration increased turning (+18 % with 30Hz; p=0.20 and +27 % with 40Hz; p=0.12) and turning and sitting duration (+27 % with 30Hz; p=0.11 and +47 % with 40Hz; p=0.12) in low fall risk participants. Findings suggest that lower-extremity vibration affects dynamic balance; however, the level of this influence may differ between low and high fall risk older adults, which can potentially be used for assessing aging-related sensory deficits.

• MeSH
• biomechanika MeSH
• hodnocení rizik metody   MeSH
• kosterní svaly fyziologie   MeSH
• lidé MeSH
• pilotní projekty MeSH
• pohyb fyziologie   MeSH
• posturální rovnováha fyziologie   MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• techniky fyzikální terapie * MeSH
• úrazy pádem prevence a kontrola   statistika a číselné údaje   MeSH
• vibrace terapeutické užití   MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

OBJECTIVES: The GO-BACK study was designed to evaluate the efficacy and safety of golimumab (GLM) treatment withdrawal in adults with non-radiographic axial spondyloarthritis (nr-axSpA) who demonstrate inactive disease during a 10-month open-label (OL) GLM run-in. METHODS: Eligible participants received OL GLM in period 1. In period 2, participants who achieved inactive disease were randomized 1:1:1 to receive double-blind (DB) treatment with monthly placebo (PBO, treatment withdrawal) or continued GLM treatment given monthly (GLM QMT) or every 2 months (GLM Q2MT). Participants who did not have a disease flare continued DB treatment for ∼12 months. Participants with a disease flare discontinued DB treatment and resumed monthly OL GLM. Primary endpoint compared the proportion of participants without a disease flare in the continued GLM treatment groups (QMT or Q2MT) vs PBO in a multiplicity-controlled, step-down fashion. Safety follow-up continued for ∼3 months after last treatment. RESULTS: A total of 188 patients, out of the 323 enrolled, were eligible for participation in period 2. Both GLM QMT and GLM Q2MT were superior to treatment withdrawal (PBO) in preventing disease flare (P < 0.001), with a treatment-difference vs PBO of 50.4% and 34.4% for the GLM QMT and GLM Q2MT groups, respectively. The time-to-first flare was significantly longer (log-rank P < 0.0001) with GLM treatment compared with PBO. Of 53 participants (in Q2MT or PBO) who had a confirmed disease flare, 51 (96.2%) attained a clinical response within 3 months of restarting OL GLM. Adverse events were consistent with the known GLM safety profile. CONCLUSION: Among participants with active nr-axSpA who attained inactive disease after 10 months of GLM treatment, continued GLM treatment is well tolerated and provides superior protection against disease flares compared with GLM withdrawal. (EudraCT: 2015-004020-65, registered on 30 March 2022; NCT: 03253796, registered on 18 August 2017.).

• MeSH
• dospělí MeSH
• dvojitá slepá metoda MeSH
• lidé MeSH
• non-radiografická axiální spondyloartritida * MeSH
• opakovaná terapie MeSH
• syndrom vzplanutí nemoci MeSH
• výsledek terapie MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• randomizované kontrolované studie MeSH

There is a growing number of patients returning to dialysis after a failed kidney transplant, and there is increasing evidence of higher mortality among this population. Whether removal of the failed renal allograft affects survival while receiving long-term dialysis is not well understood. We identified all adults who received a kidney transplant and returned to long-term dialysis after renal allograft failure between January 1994 and December 2004 from the US Renal Data System. Among 10,951 transplant recipients who returned to long-term dialysis, 3451 (31.5%) received an allograft nephrectomy during follow-up. Overall, 34.6% of these patients died during follow-up. Receiving an allograft nephrectomy associated with a 32% lower adjusted relative risk for all-cause death (adjusted hazard ratio 0.68; 95% confidence interval 0.63 to 0.74) after adjustment for sociodemographic characteristics, comorbidity burden, donor characteristics, interim clinical conditions associated with receiving allograft nephrectomy, and propensity to receive an allograft nephrectomy. In conclusion, within a large, nationally representative sample of high-risk patients returning to long-term dialysis after failed kidney transplant, receipt of allograft nephrectomy independently associated with improved survival.

• MeSH
• chronické selhání ledvin chirurgie   MeSH
• homologní transplantace MeSH
• ledviny chirurgie   MeSH
• lidé MeSH
• míra přežití MeSH
• nefrektomie MeSH
• příčina smrti MeSH
• rejekce štěpu mortalita   MeSH
• retrospektivní studie MeSH
• transplantace ledvin MeSH
• Check Tag
• lidé MeSH
• Geografické názvy
• Spojené státy americké MeSH

Práce je zaměřena na vnitřní rizikové faktory pádů u geriatrických pacientů, hodnocení přítomnosti těchto faktorů, jejich vztah k četnosti pádů a následků po pádu. Hlavním cílem práce je zjistit přítomné vnitřní rizikové faktory pádu, ověřit test Timed get up and go a vliv svalové síly na vznik pádu. Metodikou ke zjištění přítomnosti rizikových faktorů pádu byl použit řízený rozhovor a fyzikální vyšetření. Výzkumný soubor tvořilo 70 hospitalizovaných seniorů s Mini Mental State Examination nad 25 bodů. Článek poukazuje na vhodné faktory screeningu pádu a přehledně zobrazuje senzitivitu a specificitu jednotlivých vybraných faktorů pádu. Závěrem je doporučeno zavést „Timed get up and go“ test a měření svalové síly do screeningu rizika pádu a ověřit dané metody na širším vzorku respondentů a na jiných pracovištích. Klíčová slova: geriatrie – pád – vnitřní faktory – „Timed get up go test“

The study is focused on intrinsic risk factors for geriatric patients, evaluation of presence of these factors, their connection to the frequency of falls and consequences. The main aim of study was to find out the number of intrinsic risk factors present in falls and to verify the “Timed get up and go” test and influence of muscle strength on fall risk. Controlled interviews and physical assessment were used to detect the presence of risk factors. The research sample consisted of 70 hospitalized seniors with Mini-Mental State Examination scores of over 25 points. The article points to the appropriate screening for risk factors and outlines the sensitivity and specificity of these factors. In conclusion, there is a recommendation to implement a “Timed get up and go” test and measurement of muscle strength to screen for fall risk and to validate the methods on a wider number of respondents, and other wards. Keywords: geriatrics – fall – intrinsic factors – Timed get up go test

• Klíčová slova
• „Timed get up go test“,
• MeSH
• anamnéza MeSH
• časové faktory MeSH
• chůze (způsob) MeSH
• diagnostické sebehodnocení MeSH
• hodnocení rizik metody   statistika a číselné údaje   MeSH
• hospitalizace MeSH
• hospitalizovaní pacienti * psychologie   statistika a číselné údaje   MeSH
• křehký senior * MeSH
• lidé MeSH
• plnění a analýza úkolů MeSH
• postura těla MeSH
• posturální rovnováha MeSH
• prospektivní studie MeSH
• rozhovory jako téma MeSH
• sebezhodnocení (psychologie) MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• senzitivita a specificita MeSH
• statistika jako téma MeSH
• svalová síla - dynamometr MeSH
• svalová síla MeSH
• úrazy pádem * prevence a kontrola   statistika a číselné údaje   MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH

Inerciálne senzory prešli v poslednom období rýchlym vývojom umožňujúcim ich bezproblémové využitie v klinickej praxi. Vďaka svojej prenositeľnosti a malým rozmerom je možné s nimi pracovať nie len v kontrolovaných laboratórnych podmienkach, ale i v domácom prostredí. Cieľom tohto textu bolo preto zhrnúť aktuálne dostupné možnosti týkajúce sa využitia inerciálnych senzorov v klinickej praxi, a to nie len z pohľadu pohybových činností, ktoré je možné skúmať, ale i z pohľadu najčastejšie využívaných metodologických prístupov. Podrobne sme sa venovali hodnoteniu posturálnej stability, inštrumentálnej verzii chodeckých klinických testov, Timed Up and Go a Sit-to-Stand testu, ale taktiež hodnoteniu pohybovej aktivity.

Inertial sensors with their rapid development in the recent years have become useful tools in clinical practice. They can be used in a controlled laboratory environment as well as home environment because of their portability and small size. The aim of this manuscript was to summarise topical possibilities for the use of inertial sensors in clinical practice, including information about suitable activities that can be studied and methodological approaches for their quantification. The assessment of postural stability, instrumented versions of clinical walking tests, Timed Up and Go or Sit-to-Stand tests as well as physical activity monitoring are discussed in detail.

• Klíčová slova
• Timed Up and Go, Sit-to-Stand, inerciální senzory,
• MeSH
• akcelerometrie metody   MeSH
• analýza chůze MeSH
• chůze fyziologie   MeSH
• lidé MeSH
• lokomoce fyziologie   MeSH
• nositelná elektronika * MeSH
• pohybová aktivita fyziologie   MeSH
• postura těla fyziologie   MeSH
• posturální rovnováha fyziologie   MeSH
• svalová síla fyziologie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• přehledy MeSH

• Klíčová slova
• angličtina,
• MeSH
• interpersonální vztahy MeSH
• komunikace MeSH
• řeč MeSH
• Publikační typ
• příručky MeSH

• Konspekt
• Sociální interakce. Sociální komunikace
• NLK Obory
• lingvistika, lékařská terminologie

AIM: To offer an up-to-date review of all available treatment strategies for patients with synchronous colorectal liver metastases (CLM). METHODS: A comprehensive literature search was performed to identify articles related to the management of patients with synchronous CLM. A search of the electronic databases PubMed, MEDLINE, and Google Scholar was conducted in September 2014. The following search terms were used: synchronous colorectal liver metastases, surgery, stage IV colorectal cancer, liver-first approach, and up-front hepatectomy. These terms were employed in various combinations to maximize the search. Only articles written in English were included. Particular attention was devoted to studies and review articles that were published within the last six years (2009-2014). Additional searches of the cited references from primary articles were performed to further improve the review. The full texts of all relevant articles were accessed by two independent reviewers. RESULTS: Poor long-term outcomes of patients with synchronous CLM managed by a traditional treatment strategy have led to questions about the timing and sequence of possible therapeutic interventions. Thus, alternative paradigms called reverse strategies have been proposed. Presently, there are four treatment strategies available: (1) primary first approach (or traditional approach) comprises resection of the primary colorectal tumor followed by chemotherapy; subsequent liver resection is performed 3-6 mo after colorectal resection (provided that CLM are still resectable); (2) simultaneous resection of the primary colorectal tumor and CLM during a single operation presents intriguing options for a highly select group of patients, which can be associated with significant postoperative morbidity; (3) liver-first (or chemotherapy-first) approach comprises preoperative chemotherapy (3-6 cycles) followed by liver resection, adjuvant chemotherapy, and resection of the primary colorectal tumor (it is best suited for patients with asymptomatic primary tumors and initially unresectable or marginally resectable CLM); and (4) up-front hepatectomy (or "true" liver-first approach) includes liver resection followed by adjuvant chemotherapy, colorectal resection, and adjuvant chemotherapy (strategy can be offered to patients with asymptomatic primary tumors and initially resectable CLM). CONCLUSION: None of the aforementioned strategies appears inferior. It is necessary to establish individual treatment plans in multidisciplinary team meetings through careful appraisal of all strategies.

• MeSH
• adjuvantní chemoterapie MeSH
• časové faktory MeSH
• hepatektomie * škodlivé účinky   mortalita   MeSH
• karcinom mortalita   sekundární   terapie   MeSH
• kolektomie * škodlivé účinky   mortalita   MeSH
• kolorektální nádory mortalita   patologie   terapie   MeSH
• lidé MeSH
• nádory jater mortalita   sekundární   terapie   MeSH
• neoadjuvantní terapie MeSH
• protinádorové látky aplikace a dávkování   škodlivé účinky   MeSH
• rizikové faktory MeSH
• rozvrh dávkování léků MeSH
• staging nádorů MeSH
• výběr pacientů MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

Amputací dochází mj. k funkčním omezením při vykonávání pohybů každodenního života, které jsou závislé na dostatečné posturální kontrole. Hodnocení posturální kontroly ve specifických podmínkách pomocí funkčních testů představuje jednu z rychlých, finančně a časově nenáročných možností pro lékaře a fyzioterapeuty. V naší studii jsme se zaměřili na testy nejvíc reflektující běžné denní aktivity a omezení, se kterými se amputovaní střetávají. 5 transtibiálně amputovaných a 5 zdravých jedinců absolvovalo soubor testů: Timed Up and Go Test, Functional Reach Test, Four Square Step Test a Lateral Reach Test. Rozdíly mezi skupinami byly hodnoceny pomocí věcné významnosti (Cohenovo d). Kromě posledního z uvedených testů je možné považovat vliv amputace na výsledky měření za velký. Na druhou stranu stanovení jednoznačných závěrů a doporučení komplikuje fakt, že charakteristika testovaných souborů do současné doby publikovaných prací je odlišná z hlediska věku, typu amputace i stanovených norem.

Amputation results in functional limitation of everyday life movements which depend on sufficiently adequate postural control. The evaluation of postural control in specific conditions by means of functional tests represents a rapid, financially and time undemanding possibilities for physicians and physiotherapists. In their study the authors specifically addressed the tests best reflecting common daily activities and limitations, which the subjects encounter after amputation. Five subjects after transtibial amputations and five healthy subjects took part in a series of tests: Timed Up and Go Test, Functional Reach Test, Four Square Step Test a Lateral Reach Test. The differences between the two groups were evaluated by means of matter-of-fact significance according to Cohen. Except of the last test mentioned the influence of amputation should be considered as significant. On the other hand any establishment of unambiguous conclusions and recommendations is complicated by the characteristics of the tested groups which differ from those published so far in relation to age, amputation type and established standards..

• Klíčová slova
• posturální stabilita, transtibiálně amputovaní, funkční testy, dynamické podmínky,
• MeSH
• amputace MeSH
• amputovaní * rehabilitace   statistika a číselné údaje   MeSH
• časové faktory MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• pilotní projekty MeSH
• plnění a analýza úkolů * MeSH
• postura těla MeSH
• posturální rovnováha * fyziologie   MeSH
• reprodukovatelnost výsledků MeSH
• senioři MeSH
• statistika jako téma MeSH
• studie případů a kontrol MeSH
• tibie chirurgie   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• práce podpořená grantem MeSH