Eli Carmeli

University of Haifa, H̱efa, Haifa, Israel

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Publications (111)205.17 Total impact

  • Eli Carmeli, Dror Aizenbud, Oren Rom
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    ABSTRACT: Clarifying the confusion regarding the term "muscle death" is of great importance, especially for clinicians. In response to various stimuli, skeletal muscle may undergo pathological changes, leading to muscle atrophy and consequently resulting in the loss of muscle strength and function. Depending on the stimulus, skeletal muscles can be induced to die through different mechanisms mainly via apoptosis, autophagy and necrosis. Muscle death may occur secondary to various physiological and pathological conditions such as aging, starvation, immobilization, denervation, inflammation, muscle diseases and cancer. This overview aims to elucidate the medical terminology and pathways used to describe muscle death, which are commonly confused. In addition, some of the common pathological conditions that lead to muscle death such as cachexia and sarcopenia of aging are dwelled on.
    Advances in Experimental Medicine and Biology 05/2015; DOI:10.1007/5584_2015_140 · 2.01 Impact Factor
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    Eli Carmeli
    Frontiers in Public Health 07/2014; 2:91. DOI:10.3389/fpubh.2014.00091
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    ABSTRACT: Abstract. OBJECTIVES: To summarize the current knowledge relating to diagnosing and treating Scheuermann’s disease. Scheuermann’s disease is the most common cause of structural kyphosis in adolescence. METHODS: A literature-based narrative review of English language medical literature. RESULTS AND CONCLUSIONS: Recent studies have revealed a major genetic contribution (a dominant autosomal inheritance pattern with high penetrance and variable expressivity) to the etiology of Scheuermann kyphosis with a smaller environmental component (most probably mechanical factors). The natural history of Scheuermann kyphosis remains controversial, with conflicting reports as to the severity of pain and physical disability. Since we cannot predict which kyphotic curves will progress, we are unable to determine effectiveness of brace treatment. Physical therapy is scarcely mentioned in the literature as an effective treatment for Scheuermann kyphosis. Although there is little evidence that physical therapy alone can alter the natural history of Scheuermann’s disease, it is often used as the first choice of treatment. Brace treatment appears to be more effective if an early diagnosis is made, prior to the curvature angle exceeding 50◦ in patients continuing to grow. Surgical treatment is rarely indicated for severe kyphosis (>75◦) with curve progression, refractory pain, or a neurologic deficit. Rigorous methodology clinical trials are essential to evaluate the efficacy of conservative interventions, especially different exercises and manual therapies and their combinations with braces.
    Journal of Back and Musculoskeletal Rehabilitation 06/2014; 27 (2014)(4):383–390. DOI:10.3233/BMR-140483 · 1.04 Impact Factor
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    ABSTRACT: Aims: To describe the difference in functional reach test (FRT) distance and velocity during “self-selected” and “as-fast-as-possible” reach velocities, and to describe the age-related differences associated distance and velocity in the two tests. Methods: A cross-sectional study included 73 healthy volunteers, 20–95 years of age. Reach ability while standing was measured during three trials performed at a “comfortable speed”, and three performed as fast as possible. A web camera was used to record the tests at a frequency of 15 Hz. Major findings: The forward reach was by mean longer in 1.2 cm (± 4.9 cm) (F1;70 = 4.9, p = 0.03) in the self-selected speed condition. In addition, values were significantly higher among the younger group; during the self-selected speed by 5.8 ± 2.1 cm and by 7.2 ± 2.1 cm during the as-fast-as-possible condition (F1;70 = 11.6, p < 0.001), the backward movement in the self-selected speed was smaller by 1.2 cm (± 4.9 cm) (F1;70 = 6.3, p = 0.01),The mean reach backward in both condition was significantly different between age groups (F1;70 = 15.3, p < 0.001), values were significantly higher among the older participants. In addition, a significant interaction effect was noted (F1;70 = 3.8, p = 0.05); combination of older age and as-fast-as-possible condition was associated with increased backward movement. Principal conclusion: By using simple technology and a new measure of balance assessment that measure the quality of functional reach, therapists may discover new information regarding balance performance and falls.
    05/2014; DOI:10.3109/21679169.2014.911957
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    Eli Carmeli, Bita Imam
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    ABSTRACT: The rapid growth in the number of individuals living with intellectual and developmental disabilities (IDD) along with their increased longevity present challenges to those concerned about health and well-being of this unique population. While much is known about health promotion and disease prevention in the general geriatric population, far less is known about those in older adults with IDD. Effective and efficient health promotion and disease prevention strategies need to be developed and implemented for improving the health and quality of life of older adults living with IDD. This is considered to be challenging given the continued shrinkage in the overall health care and welfare system services due to the cut in the governmental budget in some of the western countries. The ideal health promotion and disease prevention strategies for older adults with IDD should be tailored to the individuals' health risks, address primary and secondary disease prevention, and prevent avoidable impairments that cause premature institutionalization. Domains of intervention should include cognitive, mental and physical health, accommodations, workplace considerations, assistive technology, recreational activities, and nutrition.
    Frontiers in Public Health 04/2014; 2:31. DOI:10.3389/fpubh.2014.00031
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    ABSTRACT: This study examined reliability and validity of the Zuk Assessment for diagnosis of motor problems and determined standardized scores in an Israeli population aged 5 to 6 years. For standardization, 156 children recruited from 13 Kindergartens of typically developing children were evaluated with the Zuk Assessment. Intrarater and interrater reliability were examined on 2 samples of 15 and 13 children, respectively. A total of 151 children referred for motor problems were examined with the Zuk and Movement Assessment Battery for Children assessment tools for validation of the Zuk Assessment. Findings showed that the Zuk total score had a normal distribution similar to that found in the literature identifying 5.1% (-2 standard deviations) and 12% (between -1 and -2 standard deviations) of children with motor-related problems. Reliability was indicated by high intraclass correlation scores both in intrarater (intraclass correlation = .89) and interrater (intraclass correlation = .95) paradigms. The Zuk assessment identified differences in subgroups, namely, typical, suspicious, and impaired, as found in the Movement Assessment Battery for Children, confirming the Zuk validity.
    Journal of child neurology 01/2014; 29(5). DOI:10.1177/0883073813513836 · 1.67 Impact Factor
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    ABSTRACT: OBJECTIVE: Dynamic visual inputs can cause visual vertigo (VV) in patients with vestibulopathy, leading to dizziness and falls. This study investigated the influence of VV on oculomotor responses. METHODS: In this cross-sectional, single-blind study, with experimental and control groups, 8 individuals with vestibulopathy and VV, 10 with vestibulopathy and no VV, and 10 healthy controls participated. Oculomotor responses were examined with 2-dimensional video-oculography. Participants were exposed to dynamic visual inputs of vertical stripes sweeping across a screen at 20 deg/sec, while seated or in Romberg stance, with and without a fixed target. Responses were quantified by optokinetic nystagmus frequency (OKNf and gain (OKNg). RESULTS: Seated with no target, VV participants had higher OKNf than controls (37 +/- 9 vs. 24 +/- 9 peaks/sec; P < 0.05). In Romberg stance with no target, they had higher OKNf than controls (41 +/- 9 vs. 28 +/- 10 peaks/sec; P < 0.05). With a target, OKNf was higher in VV participants compared to controls (7 +/- 7 vs. 1 +/- 2 peaks/sec; P < 0.05). In Romberg with no target, OKNg was higher in the VV group (0.8 +/- 0.1) compared to controls (0.6 +/- 0.2; P = 0.024). OKNf and OKNg did not differ according to VV status. CONCLUSIONS: VV participants had increased OKNf and OKNg compared to healthy participants. Visual dependency should be considered in vestibular rehabilitation.
    Journal of Vestibular Research 01/2014; 24(4):305-11. DOI:10.3233/VES-140519 · 1.46 Impact Factor
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    ABSTRACT: The aim of this study was to evaluate the effect of an intensive physical therapy protocol in patients who contract 'Intensive Care Unit Acquired Weakness' (ICUAW), in terms of muscle strength, breathing and functional indices. This was a prospective, single blinded study, in a general hospital intensive care unit. Patients who required mechanical ventilation longer than 48 hours and who were expected to remain mechanically ventilated for at least another 48 hours were randomly divided into two intervention groups: Group I (n=9) - the Routine care group, received physical therapy according to our daily custom protocol. Group II (n=9) - the Intensive treatment group, were treated by the same protocol twice a day. The main outcome measures included the Medical Research Council physical strength examination (MRC); Maximal inspiratory pressure (MIP); Hand grip dynamometer and Sitting balance test. Significant strength improvement from first (T1) to second (T2) measurements was demonstrated for variables MIP and MRC in favor of the intensive treatment group (p<0.05). The intensive treatment group also required shorter intensive care length of stay (LOS) than the routine care group (p=0.043). It is possible that an intensive therapy protocol may facilitate the initial recovery process in patients who suffer from intensive care unit acquired weakness.
    The Clinical Respiratory Journal 12/2013; 9(1). DOI:10.1111/crj.12091 · 2.20 Impact Factor
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    ABSTRACT: The authors undertook a study to determine whether hand grip strength is associated with body sway rate among older adults with intellectual disability. They employed cross-sectional data from a nonrandomized controlled trial. Subjects were 16 older adults (8 females and 8 males; mean age 51.3 year) with mild-to-moderate intellectual disability residing in a supported living facility in Israel. Voluntary hand grip strength was measured isometrically using Jamar® hydraulic dynamometer, and body sway was assessed by Posture Scale Analyzer. Multivariate adjusted logistic regression model was used. Findings showed that hand grip strength in both arm flexed and extended was associated with body sway (−.608 to −.879), particularly among males. In females, the association was found only in eyes open condition, whereas in males it was found with both eyes closed and open. The authors concluded that hand grip strength was found to be negatively correlated with body sway rate and that low grip strength was associated with greater body sway. Low grip strength may be a rehabilitative impairment worthy of further investigation as a modifiable factor linked to sway rate among older adults with intellectual and developmental disability.
    Journal of Policy and Practice in Intellectual Disabilities 12/2013; 10(4). DOI:10.1111/jppi.12055 · 0.97 Impact Factor
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    ABSTRACT: The vestibulo-ocular response (VOR) may not be fully developed in children with an intellectual and developmental disability (IDD). This study aimed to identify the presence of VOR deficit in children and young adults with unspecified mild-to-moderate intellectual and developmental disability and its effect on balance control. Twenty-one children and young adults with IDD ranging in age from 8 to 22 years (mean 17.5±3.9 years) were included in the study. The VOR was evaluated with the Head Impulse Test and the Static and Dynamic Visual Acuity Test (S&D-VAT). Postural stability was measured in an upright standing position by the Clinical Test for Sensory Interaction in Balance (CTSIB), single leg stance (SLS) during eyes open and eyes closed, and Romberg stance under eyes open and eyes closed conditions using a force platform. Reduced vestibulo-ocular responses were found in 13 of 21 (62%) participants who were able to complete testing. In the fifth condition of the CTSIB (standing on foam with eyes closed), those without VOR deficit were able to maintain balance longer than those with VOR deficit (29s [median 30] vs. 12s [median 7.3], respectively; p=0.03). The study demonstrates potential effects of VOR deficit in children and young adults with IDD and some significant differences in balance control between those with and without a VOR deficit. VOR function in children and young adults with IDD should be routinely tested to enable early detection of deficits.
    Research in developmental disabilities 04/2013; 34(6):1951-1957. DOI:10.1016/j.ridd.2013.03.007 · 4.41 Impact Factor
  • Oz Zur, Eli Carmeli
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    ABSTRACT: Dizziness is one of the most troublesome symptoms of vestibular disorders, although its description remains somewhat imprecise, encompassing vertigo, lightheadedness, disequilibrium and giddiness. Symptoms include sensitivity to motion stimuli and discomfort with open spaces, such as empty streets and bridges. It is accompanied by varying degrees of anxiety and phobic behaviors. Several tools have been developed in an attempt to quantify the degree of disability, self-perceived health status and quality of life in patients with dizziness. This review focuses on the University of California, Los Angeles Dizziness Questionnaire (UCLA-DQ), which is used to assess the effect of dizziness on quality of life. This paper also includes a summary of the advantages and disadvantages of the UCLA-DQ and compares it to other instruments used to assess dizziness. In spite of a few disadvantages, we believe that this multidimensional questionnaire is an appropriate tool for evaluating patients with vestibular impairment. It should be used during the acute phase of symptoms, as well as during and after rehabilitative therapy, to assess patient improvement.
    Journal of Vestibular Research 01/2013; 23(6):279-83. DOI:10.3233/VES-130480 · 1.46 Impact Factor
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    Research in Developmental Disabilities 03/2012; 33(2):781. DOI:10.1016/j.ridd.2011.12.003 · 3.40 Impact Factor
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    ABSTRACT: Adults with Down syndrome (DS) are often physically inactive, which may accelerate the onset of disease and aging symptoms. Eight older persons with DS (aged 54-61), and 10 younger persons with DS (aged 26-35) living in a residential care center were examined. Eighteen age- and gender-matched individuals without DS served as control groups. Sensory-motor tasks and Posture Scale Analyzer (PSA) were used to examine coordination and standing stability. The isokinetic muscle strength test was used for muscle strength investigation. The functional performance, coordination, and leg muscle strength of the older adults with DS were more impaired than both the younger DS and the control groups. The older DS group showed lower sway rate and more symmetrical weight-bearing distribution during quiet standing than both the younger DS and the control groups. Our observations may have significant implications for understanding movement dysfunction in older adults with DS.
    Research in developmental disabilities 03/2012; 33(1):165-71. DOI:10.1016/j.ridd.2011.09.008 · 4.41 Impact Factor
  • Health 01/2012; 04(09):769-774. DOI:10.4236/health.2012.429119 · 0.51 Impact Factor
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    ABSTRACT: This study assessed the potential therapeutic benefi t of using HandTutor™ in combination with traditional rehabilitation in a post-stroke sub-acute population. The study compares an experimental group receiving traditional therapy combined with HandTutorTM treatment, against a control group receiving only traditional therapy. An assessor-blinded, randomized controlled pilot trial, was conducted in the Reuth rehabilitation unit in Israel. Thirty-one stroke patients in the sub-acute phase, were randomly assigned to one of the two groups (experimental or control) in sets of three. The experimental group (n = 16) underwent a hand rehabilitation programme using the HandTutorTM combined with traditional therapy. The control group (n = 15) received only traditional therapy. The treatment schedules for both groups were of similar duration and frequency. Improvements were evaluated using three indicators: 1) The Brunnström-Fugl-Meyer (FM) test, 2) the Box and Blocks (B&B) test and 3) improvement parameters as determined by the HandTutorTM software. Following 15 consecutive treatment sessions, a signifi cant improvement was observed within the experimental group (95% confi dence intervals) compared with the control group: B&B p = 0.015; FM p = 0.041, HandTutor™ performance accuracy on x axis and performance accuracy on y axis p < 0.0003. The results from this pilot study support further investigation of the use of the HandTutorTM in combination with traditional occupational therapy and physiotherapy during post stroke hand function rehabilitation.
    Physiotherapy Research International 12/2011; 16(4):191-200. DOI:10.1002/pri.485
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    ABSTRACT: The decline in cognitive ability and physical performance in older adults with intellectual disabilities (ID) is accompanied by less participation in social activities and a sedentary lifestyle; however the pathogenesis is not clear yet. It was recently suggested that chronic disease, adverse drug reactions, and aging create a cascade of events that can be best characterized as an asymptomatic inflammatory process. This cascade of events is mediated by cytokine interleukins 1 and 6 (IL-1α, and IL-6), nitric oxide (NO) and total oxidative stress (OS). Our hypothesis was that chronic inflammation in the bloodstream of persons with ID contributes to their "premature aging". To test this hypothesis, we measured and compared the levels of inflammatory molecules in persons with and without ID. Fifteen adults with, and 15 adults without ID (control group) participated in this study. The levels of NO metabolites (NOx), IL-1α, and IL-6 were obtained from participants' serum. OS markers were drawn from participants' capillary. Western blot, RT-PCR and specific chemical analysis were used as measurement tools. The levels of inflammatory molecules and OS were significantly higher in persons with ID compared to the control group. Asymptomatic inflammation in the bloodstream of the older adults with ID might explain the "premature aging" of these individuals. Monitoring the levels of inflammatory molecules could serve as biomarkers of "premature aging" which may allow early diagnosis and intervention, and improve the quality of care for persons with ID.
    Research in developmental disabilities 11/2011; 33(2):369-75. DOI:10.1016/j.ridd.2011.10.002 · 4.41 Impact Factor
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    ABSTRACT: To describe long-term activity limitation, participation restriction, and patients' overall perception of recovery among stroke patients 4 years poststroke, and to evaluate the association between the factors. In addition, the study investigated those factors present at the time of stroke onset, which could predict the level of activity limitation and participation restriction at 4 years poststroke. Prospective, 4-year follow-up study. Subjects' homes, via telephone. All first ever stroke patients (N=139) admitted to the Sheba Medical Center in Israel between February and March 2004 were followed and reassessed for activity and participation restrictions. Not applicable. Barthel index (BI) (activity limitation, BI<95) and Frenchay Activities Index (FAI) (participation restriction, FAI<30). Perception of recovery was assessed by 2 simple questions. At 4 years poststroke, 9 patients (6.4%) were lost to follow-up, 71 (54.1%) patients had survived; 42.3% with activity limitation, 28.2% were classified as restricted in participation, and 78.1% felt they had not completely recovered. Age at stroke onset and disability in the acute phase were the most significant predictors of activity limitation at 4 years poststroke. None of the demographic characteristics or baseline clinical features predicted participation restriction. A positive association (ρ=0.6) was noted between activity limitation and participation restriction 4 years poststroke. This is the first study to describe long-term outcomes poststroke in Israel. Activity limitation and participation restriction remain highly prevalent up to 4 years after stroke. The potential influence of additional factors (psychosocial, cognitive, and environmental) as predictors of participation restriction should be topics for future investigation.
    Archives of physical medicine and rehabilitation 11/2011; 92(11):1802-8. DOI:10.1016/j.apmr.2011.06.014 · 2.44 Impact Factor
  • Eli Carmeli, Bita Imam, Joav Merrick
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    ABSTRACT: The aim was to determine the association between loss of muscle mass, loss of muscle strength, and physical ability in individuals with ID. Upper and lower extremity strength, muscle mass and muscle quality (MQ) were calculated. Physical ability was measured according to the Katz activities of daily living (ADL), stair climb test, and sit-to-stand test. We found a strong correlation between quadriceps strength and physical ability in ADL (r=0.92 for males, and r=0.88 for females), and a low-moderate correlation between hand grip strength and physical ability in ADL (r=0.40 for males, and r=0.46 for females). MQ showed a strong relationship between pre-sarcopenia and sarcopenia. Quadriceps strength is a promising measure of age-related muscle changes and it is strongly associated with physical and functional decline.
    Archives of gerontology and geriatrics 07/2011; 55(1):181-5. DOI:10.1016/j.archger.2011.06.032 · 1.53 Impact Factor
  • E. Carmeli, A. Bachar, R. Beiker
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    ABSTRACT: Rett syndrome (RTT) is characterized by microcephaly, cognitive impairment, abnormal muscle tone, epilepsy, and ataxia, yet misdiagnoses are not uncommon. Oxidative stress (OS) and matrix metalloproteinases (MMPs) has been implicated in a variety of neurological diseases and inflammatory conditions. The aims of the study were to investigate the serum values of global oxidative stress (OS) and levels of MMP-2 (gelatinase), MMP-9 and 13 (collagenase) in RTT girls, since we hypothesized that OS and MMPs play a role in the on-going pathological processes of RS leading to the progression and deterioration of their neurological functions. Total level of MMP-2, 9 and 13 were measured in serum of six RTT girls (average age of 14.2 ± 1.6) by ELISA, and global OS was measured by CR 3000 instrument, FORM system. The RTT girls had significant (p = 0.001) increased serum levels of MMP-2 (mean values) and MMP-9 (mean values), yet MMP-13 mean values were comparable to age-and-gender matched non RTT girls. OS values were significantly higher in RTT girls comparing control groups. The increased OS values and MMP-2 and 9 levels in RTT girls suggest their involvement in the chronic pathogenesis resulting in continuing neurological damage. Our findings can provide another aspect indicating certain MMPs and OS as possible biochemical markers and their potential application in future therapeutic strategies. KeywordsRett syndrome–matrix metalloproteinase–oxidative stress
    Neurochemical Journal 06/2011; 5(2):141-145. DOI:10.1134/S1819712411020024 · 0.19 Impact Factor
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    ABSTRACT: To examine the feasibility, safety and effectiveness of an early aerobic rehabilitation program for patients after minor ischemic stroke. Design: Randomized control trial. Twenty-eight patients, 1-3 weeks post minor ischemic stroke (modified Rankin scale; mRS ≤ 2), were randomly assigned to intervention or control groups. Measures were taken at weeks 1 and 6. All participants were instructed in home practice to achieve strength and flexibility, and were asked to continue their normal community routine. Intervention group participants performed a supervised exercise training program twice a week for 6 weeks. Exercise capacity was evaluated by the 6-minute walk distance test (6MWD), and the modified Bruce treadmill test. Eight subjects out of 14 participated in all 12 training sessions, one at less than 50% of the sessions, while five reached the highest stage of the program. No adverse events were noted during the intervention period. In the intention to treat analysis a significant improvement over time was seen for the functional parameters only. No interaction (group*time) was found. According to the per protocol analysis a significant interaction effect was found; only the intervention group participants showed a significant clinical change in the 6MWD test (412 ± 178 meters to 472 ± 196 meters, vs the control group 459 ± 116 meters to 484 ± 122 meters, p< 0.01). An early supervised aerobic training after minor ischemic stroke is feasible and well tolerated and, in a per-protocol analysis, was associated with improved walking endurance. Further studies with a larger sample size are needed to assess the effect of such a program on functional abilities, prevention of risk factors, and recurrent stroke.
    Neurorehabilitation 01/2011; 28(2):85-90. DOI:10.3233/NRE-2011-0636 · 1.74 Impact Factor

Publication Stats

1k Citations
205.17 Total Impact Points


  • 2005–2014
    • University of Haifa
      • • Faculty of Social Welfare and Health Sciences
      • • School of Physiotherapy
      H̱efa, Haifa, Israel
  • 2000–2012
    • Tel Aviv University
      • • Department of Physical Therapy
      • • Sackler Faculty of Medicine
      Tell Afif, Tel Aviv, Israel
  • 2009
    • University of Florida
      • Department of Applied Physiology and Kinesiology
      Gainesville, FL, United States
  • 2004
    • National Institute of Child Health and Human Development
      Maryland, United States
  • 1993–1996
    • Technion - Israel Institute of Technology
      • Ruth and Bruce Rappaport Faculty of Medicine
      Haifa, Haifa District, Israel