We sought to evaluate the effectiveness of a multi-component, case manager-led exacerbation prevention/management model for reducing emergency department visits. Secondary outcomes included hospitalisation, mortality, health-related quality of life, chronic obstructive pulmonary disease (COPD) severity, COPD self-efficacy, anxiety and depression.Two-centre randomised controlled trial recruiting patients with ≥2 prognostically important COPD-associated comorbidities. We compared our multi-component intervention including individualised care/action plans and telephone consults (12-weekly then 9-monthly) with usual care (both groups). We used zero-inflated Poisson models to examine emergency department visits and hospitalisation; Cox proportional hazard model for mortality.We randomised 470 participants (236 intervention, 234 control). There were no differences in number of emergency department visits or hospital admissions between groups. We detected difference in emergency department visit risk, for those that visited the emergency department, favouring the intervention (RR 0.74, 95% CI 0.63-0.86). Similarly, risk of hospital admission was lower in the intervention group for those requiring hospital admission (RR 0.69, 95% CI 0.54-0.88). Fewer intervention patients died (21 36) (HR 0.56, 95% CI 0.32-0.95). No differences were detected in other secondary outcomes.Our multi-component, case manager-led exacerbation prevention/management model resulted in no difference in emergency department visits, hospital admissions and other secondary outcomes. Estimated risk of death (intervention) was nearly half that of the control.

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SUMMARY The purpose of this study was to determine whether, and to what extent, performance on a measure of motor function (Gross Motor Function Measure, GMFM) was related to the physiological fitness of children with cerebral palsy (CP). Two elements of physiological function were measured: aerobic power and anaerobic power of the arms and legs. 15 boys and eight girls aged between seven and 13.9 years with spastic CP participated in the study. There was a good relationship between the standing and walking, running and jumping sub‐sections and the total score of the GMFM on one hand, and anaerobic capacity of the legs on the other. However, the relationships for the arms were limited, indicating that the GMFM is not a suitable tool for providing information about aerobic fitness in children with CP, or about anaerobic power of the arms. RÉSUMÉ Performance musculaire et fonction motrice globale chez les enfants avec I.M.C. spastique Le but de cette étude était de déterminer si, et dans quelle mesure, les performances des fonctions motrices globales (Mesure de la fonction motrice globale = GMFM) étaient reliées à létat physiologique des enfants I.M.C. Deux éléments de fonction physiologique furent mesurés: la puissance en aérobie et la puissance en anaérobie des bras et jes jambes. 5 garçons et hurt filles, ǎgés de sept à 13.9 ans participèrent à létude. II y une bonne relation entre les sous‐sections de tenue, de marche, de course et de saut et le score total GMFM d'une part, et la capacité des jambes en anaérobie d'autre part. En revanche, les relations pour le bras furent médiocres, indiquant que la GMFM n'est pas un outil utilisable pour fournir des informations sur l'adaptabilité aérobique des enfants I.M.C., ou sur la puissance des bras en anaérobie. ZUSAMMENFASSUNG Muskelleistung und grobmotorische Funktion bei Kindern mit spastischer Cerebralparese Es war das Ziel dieser Studie festzustellen, ob und bis zu welchem Grad ein Zusammenhang zwischen Leisung irn Bereich einer motorischen Funktion (Gross Motor Function Measure, GMFM) und physiologischer Fitness von Kindern mit Cerebralparese (CP) bestand. Es wurden zwei Elemente der physiologischen Funktion gemessen: aerobe Kraft und anaerobe Kraft der Arme und Beine. 15 Jungen und acht Mádchen im Alter von sieben bis 13‐9 Jahren mit spastischer CP nahmen an der Studie teil. Es fand sich eine klare Beziehung zwischen den Untergruppe Stehen und Gehen, Rennen und Springen und dem Gesamtscore des GMFM einerseits und der anaeroben Leistung der Beine andererseits. Die Relationen für die Arme waren jedoch begrenzt, was bedeutet, daß das GMFM nicht geeignet ist, Informationen über anaerobe Fitness bei Kindern mit CP oder über aǹaerobe Kraft der Arme zu liefern. RESUMEN Realización muscular y función motora grosera en nin̂os con parálisis cerebral espastica El propóstito de este estudio fue el determinar si, y en qué extensión, la realizacion en la medición de la función motora (Medición de la Función Motora Grosera, MFMG) estaba en relación ...

The present study was designed to investigate the effects of different types of physical fatigue-past demand for exertion-on the performance of a visual detection task performed with and without masking. 31 male subjects were first administered a VO2 max test and familiarized with the detection task. They were divided into two groups to control potential effects of masking. They were subjected to three experimental treatment involving the utilization of different sources of energy: (a) a short anaerobic alactic acid effort recruiting phosphocreatine, (b) a supramaximal effort (anaerobic lactic acid) recruiting glycogen without oxygen, and (c) a progressive (partially anaerobic) effort recruiting glycogen and oxygen. All three were performed on a treadmill. Blood samples were collected for the anaerobic lactacid and the partially anaerobic exercises. Once fatigued, all subjects undertook the detection task. A 2 X 3 X 2 X 8 analysis of variance, with repeated measures on the last three factors, was applied to the data (mask/no mask X type of exercise X pre-post performance measures X location of the letter to be detected). No significant difference was found for either the main effects or interactions, except for the location of the letter and the mask/no mask condition. It appears therefore that a physically fit population (mean VO2 max = 62.39 ml X kg(-1) X min(-1)) shows no detectable decrement in a perceptual task performed after fatiguing exercises recruiting various types of energy sources.