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      Resting Metabolic Rate Analysis in Chronic Hemiparesis Patients

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          Abstract

          The objective of the present study was to compare resting metabolic rate (RMR) of chronic hemiparetic patients to sedentary health individuals. The sample was composed of 16 individuals, that were divided into two groups. The first group had eight hemiparetic patients and the second group was formed by eight sedentary individuals. To access and analyze the gases information a VO2000 analyzer was used. The following variables were measured: VO 2, VCO 2, VE, QR, grams of fat (GrFAT), grams of carbohydrate. RMR was calculated based on Weir’s equation. There was a significant shift on ventilation variables: VE (P<0.0003), VO 2 (P<0.0004) and VCO 2 (P<0.0001) on hemiparetic individuals group when compared to control group. When the energetic substrate used behavior is observed, it shows that fat consumption (represented by GrFAT) is higher on the hemiparetic group when compared to controls (P<0.0001) significant differences were observed for RMR between groups (P<0.0001). RMR showed a correlation to VO 2 on the hemiparetic group (r=0.9277, P=0.0022). To sum up, it was observed through the results that individuals with hemiparesis as a sequel of stroke showed a RMR larger than normal individuals.

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          Comparison of predictive equations for resting metabolic rate in healthy nonobese and obese adults: a systematic review.

          David Frankenfield, Lori Roth-Yousey, Charlene Compher (2005)
          An assessment of energy needs is a necessary component in the development and evaluation of a nutrition care plan. The metabolic rate can be measured or estimated by equations, but estimation is by far the more common method. However, predictive equations might generate errors large enough to impact outcome. Therefore, a systematic review of the literature was undertaken to document the accuracy of predictive equations preliminary to deciding on the imperative to measure metabolic rate. As part of a larger project to determine the role of indirect calorimetry in clinical practice, an evidence team identified published articles that examined the validity of various predictive equations for resting metabolic rate (RMR) in nonobese and obese people and also in individuals of various ethnic and age groups. Articles were accepted based on defined criteria and abstracted using evidence analysis tools developed by the American Dietetic Association. Because these equations are applied by dietetics practitioners to individuals, a key inclusion criterion was research reports of individual data. The evidence was systematically evaluated, and a conclusion statement and grade were developed. Four prediction equations were identified as the most commonly used in clinical practice (Harris-Benedict, Mifflin-St Jeor, Owen, and World Health Organization/Food and Agriculture Organization/United Nations University [WHO/FAO/UNU]). Of these equations, the Mifflin-St Jeor equation was the most reliable, predicting RMR within 10% of measured in more nonobese and obese individuals than any other equation, and it also had the narrowest error range. No validation work concentrating on individual errors was found for the WHO/FAO/UNU equation. Older adults and US-residing ethnic minorities were underrepresented both in the development of predictive equations and in validation studies. The Mifflin-St Jeor equation is more likely than the other equations tested to estimate RMR to within 10% of that measured, but noteworthy errors and limitations exist when it is applied to individuals and possibly when it is generalized to certain age and ethnic groups. RMR estimation errors would be eliminated by valid measurement of RMR with indirect calorimetry, using an evidence-based protocol to minimize measurement error. The Expert Panel advises clinical judgment regarding when to accept estimated RMR using predictive equations in any given individual. Indirect calorimetry may be an important tool when, in the judgment of the clinician, the predictive methods fail an individual in a clinically relevant way. For members of groups that are greatly underrepresented by existing validation studies of predictive equations, a high level of suspicion regarding the accuracy of the equations is warranted.
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            Disorders of the respiratory muscles.

            Pasini Laghi, M. Tobin (2003)
            The act of breathing depends on coordinated activity of the respiratory muscles to generate subatmospheric pressure. This action is compromised by disease states affecting anatomical sites ranging from the cerebral cortex to the alveolar sac. Weakness of the respiratory muscles can dominate the clinical manifestations in the later stages of several primary neurologic and neuromuscular disorders in a manner unique to each disease state. Structural abnormalities of the thoracic cage, such as scoliosis or flail chest, interfere with the action of the respiratory muscles-again in a manner unique to each disease state. The hyperinflation that accompanies diseases of the airways interferes with the ability of the respiratory muscles to generate subatmospheric pressure and it increases the load on the respiratory muscles. Impaired respiratory muscle function is the most severe consequence of several newly described syndromes affecting critically ill patients. Research on the respiratory muscles embraces techniques of molecular biology, integrative physiology, and controlled clinical trials. A detailed understanding of disease states affecting the respiratory muscles is necessary for every physician who practices pulmonary medicine or critical care medicine.
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              Mitochondrial metabolism of reactive oxygen species.

              Paola Venditti, John L Stefano, S Meo (2013)
              For a long time mitochondria have mainly been considered for their role in the aerobic energy production in eukaryotic cells, being the sites of the oxidative phosphorylation, which couples the electron transfer from respiratory substrates to oxygen with the ATP synthesis. Subsequently, it was showed that electron transfer along mitochondrial respiratory chain also leads to the formation of radicals and other reactive oxygen species, commonly indicated as ROS. The finding that such species are able to damage cellular components, suggested mitochondrial involvement in degenerative processes underlying several diseases and aging. More recently, a new role for mitochondria, as a system able to supply protection against cellular oxidative damage, is emerging. Experimental evidence indicates that the systems, evolved to protect mitochondria against endogenously produced ROS, can also scavenge ROS produced by other cellular sources. It is possible that this action, particularly relevant in physio-pathological conditions leading to increased cellular ROS production, is more effective in tissues provided with abundant mitochondrial population. Moreover, the mitochondrial dysfunction, resulting from ROS-induced inactivation of important mitochondrial components, can be attenuated by the cell purification from old ROS-overproducing mitochondria, which are characterized by high susceptibility to oxidative damage. Such an elimination is likely due to two sequential processes, named mitoptosis and mitophagy, which are usually believed to be induced by enhanced mitochondrial ROS generation. However, they could also be elicited by great amounts of ROS produced by other cellular sources and diffusing into mitochondria, leading to the elimination of the old dysfunctional mitochondrial subpopulation. Copyright © 2013 Elsevier B.V. and Mitochondria Research Society. All rights reserved.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Neurol Int
                Journal ID (iso-abbrev): Neurol Int
                Journal ID (publisher-id): NI
                Title: Neurology International
                Publisher: PAGEPress Publications, Pavia, Italy
                ISSN (Print): 2035-8385
                ISSN (Electronic): 2035-8377
                Publication date (Electronic): 14 November 2014
                Publication date Collection: 23 October 2014
                Volume: 6
                Issue: 4
                Electronic Location Identifier: 5442
                Affiliations
                [1 ]Rio de Janeiro Federal Institute of Education, Science and Technology , Brazil
                [2 ]Physiotherapy Department, Plínio Leite University Center , Rio de Janeiro, Brazil
                [3 ]Rehabilitation Science Program, Analysis of Human Movement Laboratory, Augusto Motta University Center (UNISUAM) , Rio de Janeiro, Brazil
                [4 ]Physical Therapy Department, Federal University of Rio de Janeiro (UFRJ) , Brazil
                [5 ]Plínio Leite University Center , Rio de Janeiro, Brazil
                [6 ]Research in Neurology Department, D’Or Institute for Research and Education , Rio de Janeiro, Brazil
                [7 ]Neurology Department, Federal Fluminense University - UFF , Niterói, Rio de Janeiro, Brazil
                Author notes
                Instituto Federal de Educação, Ciência e Tecnologia do Rio de Janeiro, Campus Realengo, Rua Professor Carlos Wenceslau (antiga Rua Oliveira Braga), 343 Realengo, Rio de Janeiro 21715-000, Brazil. +55.21.346.34497. mauricio.junior@ 123456ifrj.edu.br

                Contributions: the authors contributed equally.

                Conflict of interests: the authors declare no potential conflict of interests.

                Article
                DOI: 10.4081/ni.2014.5442
                PMC ID: 4274406
                PubMed ID: 25568736
                SO-VID: 1fe07971-d68d-49da-84a6-427865658159
                Copyright © ©Copyright M. de Sant’Anna Jr et al.
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 16 April 2014
                Date revision received : 13 August 2014
                Date accepted : 02 September 2014
                Page count
                Figures: 2, Tables: 1, Equations: 0, References: 26, Pages: 4
                Categories
                Subject: Article

                ScienceOpen disciplines: Neurology
                Keywords: energy metabolism,calorimetry,stroke,respiratory muscles,rehabilitation
                Data availability:
                ScienceOpen disciplines: Neurology
                Keywords: energy metabolism, calorimetry, stroke, respiratory muscles, rehabilitation

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