Effects of Physical Exercise and Music Therapy on Cognitive Aspects in Tunisian Patients with Mild Alzheimer’s Type Dementia

Aim: The objective of this research is to highlight the effectiveness of physical exercise and music therapy in older patients with Alzheimer’s disease (AD). Methods: Patients with a mild level of AD were included in this study, divided into the therapy group (TG;N = 30, aged 68 ± 3.2 years) and the control group (CG;N=30, aged 65 ± 2.6 years). The therapy group was enrolled in an exercise-training program (walking, resistance and balance exercises) combined with musical therapy for 10 weeks (three sessions of 60 minutes per week). The Control group was instructed to follow their daily rhythm of life (e.g., rest, reading) under the same conditions. The intervention program was enrolled under the supervision of;one psychologist;a neurologist;two music therapists, and two physiotherapists, all belonging to the same hospital unit. After 10 weeks of participation in the combined program, cognitive parameters were improved in the therapy group measured with the Behavior Pathology in Alzheimer Disease (BEHAVE-AD), (p < 0.05) for activity disturbance, diurnal rhythm disturbances, anxieties and phobias, affective disturbance. The percentage range of improvements is 1.07% to 2.96%. Results: Our results demonstrate that physical exercise combined with music therapy improves cognitive function in patients with Alzheimer’s disease. Conclusions: Physical exercise and music therapy are beneficial combined treatments for improving life quality in older patients. This approach may be useful to help patients with a mild level of Alzheimer’s disease improve their behavioral and psychological parameters.

物理治疗(Physical Therapy)专业在美国的发展——美国高校体育系新专业介绍

物理治疗专业培养专业的康复和治疗人员 ,对人的残障、损伤和疾病予以预防、治疗和康复 ,特别是对体育运动中出现的损伤与康复有着重要的作用。该专业在美国已有 80多年的发展历史 ,体育教育出现此专业只有近几十年的历程。随着大众体育运动的普及和人们对健康与安全的日益关心 ,物理治疗专业必将受到全社会的重视和欢迎。

Does physical therapy and rehabilitation improve outcomes for diabetic foot ulcers?

One of the most common and serious complications of diabetes mellitus is ulceration of the foot. Among persons with diabetes, 12%-25% will present to a healthcare institution for a foot disorder during their lifespan. Despite currently available medical and surgical treatments, these are still the most common diabetes-related cause of hospitalization and of lower extremity amputations. Thus, many adjunctive and complementary treatments have been developed in an attempt to improve outcomes. We herein review the available literature on the effectiveness of several treatments, including superficial and deep heaters, electro-therapy procedures, prophylactic methods, exercise and shoe modifications, on diabetic foot wounds. Overall, although physical therapy modalities seem to be useful in the treatment of diabetic foot wounds, further randomized clinical studies are required.

Practical Guidance for Non-Specialist Physical Therapists Managing People with Hemophilia and Musculoskeletal Complications

People with hemophilia (PWH) have impaired blood coagulation and hemostasis. Bleeding into joints and muscles is the main manifestation of the disorder, causing severe joint damage and muscle complications. Lifelong, regular physical therapy is therefore important for PWH, in order to support recovery from bleeds and reduce recurrences. Ideally, these individuals should be in the care of a hemophilia treatment center (HTC), where a physical therapist (PT) should be a regular part of the comprehensive team. However, not all PWH have convenient access to an HTC, and they may be referred to local non-specialist PTs, who may have only limited experience with the condition, for day-to-day physical therapy treatment. This article, written by four experienced hemophilia PTs, introduces key aspects of the pathology of the hemophilic joint in adult PWH with musculoskeletal complications or established joint disease (or those with inhibitors) that are relevant to PTs. The characteristic differences between the joints of PWH and those of people with similar pathologies are clarified. Practical advice on how the physical therapy consultation can be adjusted for PWH is given, and the importance of communicating with the HTC emphasized. The aim of this narrative review is to raise awareness of hemophilia and joint disease for non-specialist PTs, and serve as helpful background information for PTs who encounter PWH with musculoskeletal complications or established joint disease in their clinics.

The Effects of Pain Neuroscience Education with Conventional Physical Therapy on Chronic Plantar Fasciitis: A Case Study

Background and Purpose: Plantar Fasciitis (PF) is a condition that affects the foot and causes complaints such as pain and stiffness. The most common symptom of this condition is pain. There are many treatment options to deal with this condition, such as conservative therapy, medications, and surgical interventions in rare cases. This case study aims to investigate the potential impact of pain neuroscience education (PNE), combined with a conventional Physical Therapy (PT) program on a 37-year-old-patient with chronic plantar fasciitis. Case description: A 37-year-old male health care professional presented to an outpatient physical therapy clinic with a diagnosis of chronic PF for around two years. The participant had tried several treatment options with no improvement of his symptoms. After undergoing a physical therapy evaluation, he was given a plan of care for twelve sessions by a skilled physical therapist for a six-week period, with each session consisting of 30 minutes of conventional PT, followed by 5 to 15 minutes of PNE. Results: After completing the prescribed plan of care, the patient reported a reduction in subjective symptoms via the Visual Analog Scale (VAS). He also reported improvement with symptoms and functional independence via the Foot Function Index (FFI). The patient reported no change in the quality of sleep via Pittsburg Sleep Quality Index (PSQI). Lastly, he demonstrated no objective improvement in foot pressure with the Navicular Drop Test. Discussion: This case report indicates that PNE, combined with conventional PT for PF can have a positive impact on subjective pain and foot function. PNE should involve many topics about the physiology of pain and the nervous system and should be administered by a certified therapeutic pain specialist. Further studies are recommended to investigate the impact of this intervention in combination with traditional PT for PF in larger populations.

Improving cancer therapy by combining cell biological, physical, and molecular targeting strategies

Successful cancer therapy depends on selective killing of tumor cells while sparing normal cells. Selectivity can be achieved through treatment strategies that target tumor cells. A recent report from the Li laboratory （1） describes an elegant strategy to selectively kill tumor cells by combining several targeting strategies based on cell biological, physical, and molecular （genetic） properties of tumor and normal cells that enhances tumor cell killing in vitro and in an in vivo tumor xenograft model. The idea of using a multiplex targeting approach is reminiscent of strategies in which several antibiotics are used to treat bacterial infections while minimizing the chance that rare antibiotic-resistant mutants will arise within a population.

Effective of exercise therapy on functional balance, physical performance and quality of life among patients undergoing hemodialysis: randomized controlled trial

Background:Patients undergoing hemodialysis suffer from deteriorating physical health,impaired physical function,and have a low quality of life,that explained by insufficient metabolic clearance.To overcome these obstacles,cost-effective strategies must be developed,including exercise as a complement to hemodialysis therapy.Objective:To determine the effectiveness of exercise therapy on functional balance,physical performance,and quality of life among patients undergoing hemodialysis:a randomized controlled trial.Methods:This randomized controlled trial study was carried out on 68 patients with chronic kidney disease undergoing hemodialysis for at least six months and had a medically stable condition who were randomly divided into training(n=32)exercise therapy and(n=31)control,groups.The training group participated in 8-week(3 sessions per week)resistance exercise therapy in three sets of 10 repetitions of knee extension,hip flexion,and hip abduction with the use of an elastic band under the supervision of a training physiotherapist and researcher during the first hour of the three routine hemodialysis treatment session per week.But the control group did not experience any intervention.To analyze the data,two-way analysis of variance and Bonferroni statistical tests were used at the significant level of(P=0.05).Results:6 Minute-Walk Test(6MWT)(0.013),and in the Physical Activity Scale for the Elderly(PASE)(0.014),and Short Survey Form 36(SF-36)questionnaires and health-related quality of life(HRQOL)(0.001)had significant improvements in the training group in comparison to the control group from pre to post-test,also physical performance(0.001)was improving as compared with control group(0.89)at(P=0.05).Conclusion:Resistance exercise therapy interventions for eight weeks effectively improve the physical function and performance,activity levels,and health-related quality of life of patients with chronic kidney disease and undergoing regular hemodialysis compared with a control group.

Patient’s Perception of Autonomy Support and Shared Decision Making in Physical Therapy

Background: Shared Decision Making (SDM) is primarily intended to enhance patient autonomy. To date, the relationship between patients’ perceived levels of involvement and autonomy support has never been investigated in the field of physical therapy. Based on the recently reported extremely low level of observed SDM in physical therapy, similarly poor patient perceptions are expected. Objective: The main objectives of this study were to examine patients’ perceptions of SDM and autonomy support in physical therapy and to explore the relationship between both. Design: Patient survey after real consultations in physical therapy. Methods: Patients completed the Dyadic Observing Patient Involvement (Dyadic OPTION) instrument and the Health Care Climate Questionnaire (HCCQ) to examine patients’ perceived levels of SDM and autonomy support, respectively. Multilevel analyses were applied to determine the relationship between both perceptions. Results: Two hundred and twenty-nine patients, who were recruited by 13 physical therapists, agreed to participate. The median Dyadic OPTION score was 72.9 out of a total possible score of 100. The median HCCQ score was 94.3 out of a total possible score of 100. Patients’ experienced level of SDM (b = 0.14;p < 0.001) and patients’ age (b = 0.12;p = 0.001) contributed to patients’ perceived autonomy support. None of the physical therapist characteristics were related to patients’ perceived autonomy support. Limitations: Only 13 out of 125 therapists who were personally contacted agreed to participate. Conclusion: Using patients’ perceptions, we found that a relationship between SDM and autonomy support existed. In contrast to observational studies, our study also demonstrated that the participating physical therapists individually tailored patient support by adapting their implementation of SDM to each patient.

Improving Balance through Virtual Reality and Physical Therapy Integration

Background and Purpose: Virtual reality (VR) is an innovative technology that shows promise in the assistance of physical therapy (PT). This case report explores the use of virtual reality with a patient suffering from unilateral vestibular hypofunction (UVH). Case Description: The patient is a 50-year-old male who was referred to physical therapy following a motor vehicle accident. The patient was diagnosed with having an acute left UVH, accompanied by reports of dizziness, imbalance and gait disturbances which impaired him from his work in construction. Intervention: The patient was seen two to three times a week for 40-minute sessions along with an individualized home exercise program. Interventions included vestibular rehabilitation exercises, balance training, gait training, and VR. The goals of VR were to provide task-specific simulations to improve postural balance, decrease anxiety through exposure therapy, and improve smooth eye pursuits to improve static balance. Outcomes: Outcomes used included subjective questionnaires such as the Activities-Specific Balance Confidence survey and the Dizziness Handicap Inventory (DHI) as well as functional tests like the Sensory Organization Test, Motor Control Test, and the Functional Gait Assessment (FGA). Outcome measures were performed at initial evaluation, at the 10th visit, and again at discharge. Notable improvements were seen on DHI and FGA scores. Conclusion: Dizziness, confidence, balance, and gait improved following vestibular rehabilitation combined with VR. Outcomes of this case suggest that virtual reality in conjunction with vestibular rehabilitation therapy is effective in improving deficits of unilateral vestibular hypofunction. Additionally, the use of VR in this case report suggests this can be an effective tool for intervention to facilitate patient-specific goals.

Age and Gender-Related Differences in Physical Functions of the Elderly Following One-Year Regular Exercise Therapy

Reports on physical functions during maintenance period of the elderly with cardiac and other serious diseases are limited. This study aims to clarify age and gender-related differences in their physical functions. Participants included 167 elderly individuals (males, 78;mean age, 76.5 years;SD = 6.0 years;females, 89;mean age, 75.5 years;SD = 4.5 years) who participated in a 1-year regular exercise therapy twice a week. The following eight physical function tests were selected: grip strength, 10-m obstacle walking time, one-legged balance with eyes open, sit-ups, sitting trunk flexion, 6-min walk, stepping by sitting position, and a timed up & go (TUG). Two-way analysis of variance was used to examine mean differences by gender and age: young elderly group (aged 65 - 74 years) and old elderly group (aged ≥ 75 years). In the grip strength, sit-ups, 6-min walk, 10-m obstacle walking time, stepping by sitting position, and sitting trunk flexion tests, males were superior in the former four tests, and females were superior in the latter two tests. The young elderly group was superior in all tests except for sit-ups compared with the old elderly group. The balance during one-legged with eyes open test was superior in males compared with females in the young elderly group, but decreased in males in the old elderly group. In conclusion, physical functions of the elderly during maintenance period are different between genders. Muscle strength, muscle endurance, whole-body endurance, and walking ability are superior in males, whereas flexibility and agility are superior in females. The old elderly group was inferior in all the elements of physical function except muscle endurance.

Perceived Stress and Coping Strategies in Entry-Level Doctor of Physical Therapy Students Enrolled in a Hybrid-Learning Curriculum during the Pandemic

Physical therapy students can experience elevated levels of stress due to the pressure to be successful, changes in the environment, personal concerns, the lack of spare time, increased work, or financial burdens. The purpose of this study was to examine the perceived stress and coping strategies of Doctor of Physical Therapy (DPT) students enrolled in a hybrid-learning curriculum during the COVID-19 pademic. A total of 73 students enrolled in the DPT hybrid-learning curriculum responded to a survey which consisted of socio-demographics, the 10-item Perceived Stress Scale (PSS), and the 28-item Brief COPE. A general question regarding stress relating to COVID-19 was presented as a sliding percentage. Data analysis included a Spearman correlation, a Kruskal-Wallis test, and a linear regression to evaluate coping mechanisms against PSS scores. The mean (± SD) score on the PSS was 22.65 (± 10.21) and the Brief COPE was 59.18 (± 10.61). A non-significant negative correlation was found between the PSS and Brief COPE (r = -0.024). A third of the variation in the perceived stress score could be accounted for by students utilizing coping mechanisms regardless of other factors (R2 = 0.35). No significant differences were found when comparing PSS and Brief Cope to age, hours worked per week and term. Perceived stress was higher in females compared to males, but the results were not significant. Stress related to COVID-19 mean percentage reported by DPT students was 49.03%. During a global pandemic, DPT students enrolled in a hybrid-learning curriculum reported elevated levels of stress but reported higher adaptive versus maladaptive coping strategies. It can be beneficial that universities evaluate the stress and coping methods of students to potentially avoid the negative impacts of stress.

The Application Status of Horticultural Therapy in the Study of College Students’Physical and Mental Health

Horticultural therapy,as a new medical method,has a good effect on human physical,mental health and society.This study focused on the significance of horticultural therapy in college students,the research of experimental content and the problems encountered in the specific implementation,fully understood the application status of horticultural therapy on college students’physical and mental health,and proposed that agricultural colleges and universities could take advantage of their own advantages to actively carry out relevant research,in order to provide technical support for the comprehensive development of horticultural therapy in college students.

Research Progress of LipiFlow Therapy for Meibomian Gland Dysfunction

Meibomian gland dysfunction(MGD)is a common ocular surface disease,and the pathogenesis of MGD is closely related to the alteration of meibomian gland morphology and(or)function.At present,the treatment strategy for MGD consists of physical therapy,artificial lubricants,topical and systemic antibiotics and antiinflammatory agents,topical steroids andΩ-3 dietary supplementation.Recently,the thermal pulsation system(LipiFlow)has been used clinically,which allows heat to be applied to the palpebral surfaces of the upper and lower eyelids directly over the meibomian glands,while simultaneously applying pulsatile pressure to the outer eyelid surfaces.Due to its specific design,the cornea and eyeball can successfully avoid the potential damage from overheating and improper expression,which will greatly improve the safety during the clinical application and patients'compliance.Studies have showed that the effectiveness of LipiFlow when treating MGD is at least as well as twice-daily lid warming and massage for 3 months,which displays a broad application prospect.At present,the application of LipiFlow in China has not been fully developed,and only some hospitals have experimental applications.This paper summarizes the research progress of LipiFlow treatment in MGD.

Effectiveness of a Group Exercise Class vs. Home Exercise Program as a Follow-up to Physical Therapy for Older Adults with High Fall Risk

This quasi-experimental study compared the results of a traditional model of physical therapy(PT)care to a PT wellness model known as GroupHab.The traditional model included discharge from PT with a home exercise program(HEP)to be self-administered with or without the addition of a community-based exercise program.The wellness model included participation in a PT-designed and supervised group exercise program(GroupHab class)in an outpatient clinical setting following discharge from PT.Independent t-tests were used to compare the number of falls,exercise frequency,and exercise duration between the two groups.A repeated measures,analysis of variance(RM-ANOVA)compared changes in balance confidence scores both within and between groups,and a multivariate analysis of variance(MANOVA)analyzed group differences across multiple quality of life ratings using the SF-20.All data were analyzed at the 0.05 alpha level using SPSS 24 statistical software.Our results showed a significantly greater reduction in recurrent falls among the GroupHab wellness group compared to the HEP group(t=2.811,p=0.009).The resulting odds ratio for subsequent falls was 2.2 among HEP participants and 0.2 among GroupHab participants.Exercise adherence was also greater for those who participated in the GroupHab class.They documented greater exercise frequency(t=-3.253,p=0.002)and more exercise minutes(t=-7.188,p<0.001)than those who participated in the HEP.When comparing changes in the participants’balance confidence,we found an average increase of 5%among GroupHab participants compared to a 6%decrease among HEP participants(F=16.877,p<0.001,power=0.981).Although our multivariate analysis of the SF-20 scores revealed no significant difference overall(F=0.768,p=0.73),the univariate analyses showed significantly greater improvements among GroupHab participants in selected areas of physical function.These results suggest that at-risk older adults who are discharged into a functionally-based group exercise class are less likely to experience recurrent falls and are more likely to have more confidence in their balance than those who are discharged with a standard HEP and/or use of community-based exercise classes.

Comparison of Physical Therapy Follow-Up of Patients with Operated and Non-Operated Lumbar Spinal Stenosis According to the Nottingham Health Profile-Pain Scale

Background: Lumbar spinal stenosis (LSS) continues to be a major problem in societies, causing job loss and lowering quality of life. There are two types of treatment methods, physical therapy and surgery. If patients with LSS avoid treatment, they are likely to experience neurological deterioration in later years. Objective: The study aimed to evaluate the effect of physical therapy applied after decompression surgery or the effect of only applied physical therapy in patients with lumbar spinal stenosis. Materials and Methods: The results of the physical therapy follow-up of patients who had surgery and did not have surgery due to lumbar spinal stenosis between July 2014 and December 2019 were compared with each other. All patients received physical therapy for 6 months. Included were 42 patients who underwent decompression surgery due to LSS; 56 patients were not operated. Clinical outcomes were measured using the Nottingham Health Profile-Pain (NHP-Pain) scale at the initial, first, third and sixth months. The results were compared statistically. Results: The age of the operated patients was 54.69 ± 8.42 (39 - 71), while the non-operated patients were 59.16 ± 14.04 (34 - 83). There was no significant difference in the statistical comparison (p = 0.053). While the body mass index (BMI) of the operated patients was 29.43 ± 4.99 (21 - 40), the BMI of the non-operated patients was 28.84 ± 4.62 (22 - 42). There was no significant difference in the statistical comparison (p = 0.552). The scores of a 6-month physical therapy follow-up of patients were evaluated according to the NHP-pain scale. The values of patients who underwent surgery, initial - 1st month (p < 0.001), 1st month - 3rd month (p = 0.028), 3rd month - 6th month (p = 0.389) follow-up of the intervals were compared statistically. The values of non-operated patients, initial - 1st month (p = 0.008), 1st month -3rd month (p = 0.013), 3rd month - 6th month (p = 0.025) were compared statistically. Patients with and without surgery had significantly different initial pain scores (p < 0.001). Conclusions: The NHP-Pain scores of the patients undergoing physical therapy with the operation were shown to provide more significant improvement than the group receiving only the physical therapy. Patients with LSS should be treated with an operation to obtain the maximum benefit of physical therapy.

The Physical and Clinical Aspects of Radiation Therapy in Skin Cancer and Subcutaneous Tissue Neoplasm

Cancers, malignant melanoma and sarcomas of the skin represent the most common group of malignancies in humans. The main treatment method of almost all skin cancers and subcutaneous tissue tumours is surgery, which consists of complete removal of a neoplastic lesion, with an adequate margin of healthy tissue. Radiotherapy plays an adjuvant role in this process, meaning complementing of the surgical procedure. This study compared four methods of irradiation treatment of cancer located in the skin or in subcutaneous tissues: contact brachytherapy, conventional orthovoltage therapy, electron beam conformal teleradiotherapy and IMRT dynamically shaped photonic beams conformal teleradiotherapy. In order to compare the methods and techniques of surface radiotherapy, following specific objectives were formulated. At the beginning in order to compare the scopes of the absorbed doses at different tissue depths, an analysis of parameters describing particular beams or radiation source has been performed—the curves for the absorbed-dose depth drop-offs. Doses distribution in tissue-like phantoms stimulating homogeneous cuboidal tissue block has been determined. A quality comparison of dose distribution in 2D and 3D treatment planning system for contact brachytherapy application has been made. The dose distribution for electron beam in the system has been determined. Conformal plannings for electron beam treatment, contact brachytherapy applicator treatment and 4 photon beams treatment optimized in IMRT technology have been performed. Dose distribution has been performed for the irradiated female patient within the well chest—the target included the recurrence area in the post-operative scar. The radiation therapy with X-rays has actually been completely eliminated from skin cancer and subcutaneous tissue radiotherapy by the electrons generated in linear accelerators, contact brachytherapy HDR and by high-energy photons used in conformal techniques, ex. IMRT. It is because the residual dose beyond the target is the highest for single X-ray beam. Although in brachytherapy HDR a rapid dose drop-off is observed, 5 cm from its normalization level for the target the residual radiation remains at the level of several percent. So, both X-rays beam radiation and brachytherapy in skin cancer treatment is connected with the administration of the dose with a high gradient in the health tissues. The dose distribution for photon conformal techniques IMRT or for electron radiation looks different. There with the dose normalization at the level of 90% or 85% we deal with the dose layer, the division does not exceed 15% of heterogeneity.

Physical rehabilitation for lung transplant candidates and recipients: An evidence-informed clinical approach

Physical rehabilitation of lung transplant candidates and recipients plays an important in optimizing physical function prior to transplant and facilitating recovery of function post-transplant. As medical and surgical interventions in lung transplantation have evolved over time, there has been a demographic shift of individuals undergoing lung transplantation including older individuals, those with multiple co-morbidites, and candidates with respiratory failure requiring bridging to transplantation. These changes have an impact on the rehabilitation needs of lung transplant candidates and recipients. This review provides a practical approach to rehabilitation based on research and clinical practice at our transplant centre. It focuses on functional assessment and exercise prescription during an uncomplicated and complicated clinical course in the pre-transplant, early and late post-transplant periods. The target audience includes clinicians involved in pre- and posttransplant patient care and rehabilitation researchers.

The effects of plyometric jump training on physical fitness attributes in basketball players:A meta-analysis`

Background:There is a growing body of experimental evidence examining the effects of plyometric jump training(PJT)on physical fitness attributes in basketball players;however,this evidence has not yet been comprehensively and systematically aggregated.Therefore,our objective was to meta-analyze the effects of PJT on physical fitness attributes in basketball players,in comparison to a control condition.Methods:A systematic literature search was conducted in the databases PubMed,Web of Science,and Scopus,up to July 2020.Peer-reviewed controlled trials with baseline and follow-up measurements investigating the effects of PJT on physical fitness attributes(muscle power,i.e.,jumping performance,linear sprint speed,change-of-direction speed,balance,and muscle strength)in basketball players,with no restrictions on their playing level,sex,or age.Hedge’s g effect sizes(ES)were calculated for physical fitness variables.Using a random-effects model,potential sources of heterogeneity were selected,including subgroup analyses(age,sex,body mass,and height)and single training factor analysis(program duration,training frequency,and total number of training sessions).Computation of metaregression was also performed.Results:Thirty-two studies were included,involving 818 total basketball players.Significant(p<0.05)small-to-large effects of PJT were evident on vertical jump power(ES=0.45),countermovement jump height with(ES=1.24)and without arm swing(ES=0.88),squat jump height(ES=0.80),drop jump height(ES=0.53),horizontal jump distance(ES=0.65),linear sprint time across distances≤10 m(ES=1.67)and>10 m(ES=0.92),change-of-direction performance time across distances≤40 m(ES=1.15)and>40 m(ES=1.02),dynamic(ES=1.16)and static balance(ES=1.48),and maximal strength(ES=0.57).The meta-regression revealed that training duration,training frequency,and total number of sessions completed did not predict the effects of PJT on physical fitness attributes.Subgroup analysis indicated greater improvements in older compared to younger players in horizontal jump distance(>17.15 years,ES=2.11;≤17.15 years,ES=0.10;p<0.001),linear sprint time>10 m(>16.3 years,ES=1.83;≤16.3 years,ES=0.36;p=0.010),and change-of-direction performance time≤40 m(>16.3 years,ES=1.65;≤16.3 years,ES=0.75;p=0.005).Greater increases in horizontal jump distance were apparent with>2 compared with≤2 weekly PJT sessions(ES=2.12 and ES=0.39,respectively;p<0.001).Conclusion:Data from 32 studies(28 of which demonstrate moderate-to-high methodological quality)indicate PJT improves muscle power,linear sprint speed,change-of-direction speed,balance,and muscle strength in basketball players independent of sex,age,or PJT program variables.However,the beneficial effects of PJT as measured by horizontal jump distance,linear sprint time>10 m,and change-of-direction performance time≤40 m,appear to be more evident among older basketball players.

Effects of exercise on physical limitations and fatigue in rheumatic diseases

Physical activity covers not just sports but also simple everyday movements such as housework,walking and playing.Regular exercise has a great importance in maintaining good health,indeed inactivity is a risk factor for different chronic diseases.Physical exercise can play a crucial role in the treatment of rheumatic diseases,optimizing both physical and mental health,enhancing energy,decreasing fatigue and improving sleep.An exercise program for patients with rheumatic diseases aims to preserve or restore a range of motion of the affected joints,to increase muscle strength and endurance,and to improve mood and decrease health risks associated with a sedentary lifestyle.In this editorial I describe the benefits of the exercise on physical limitations and fatigue in rheumatic diseases that seem to have a short and long-term effectiveness.A literature review was conducted on Pub Med,Scopus and Google Scholar using appropriate keywords based on the present editorial.

Efficacy of therapeutic ultrasound vs sham ultrasound on pain and physical function in people with knee osteoarthritis: A meta-analysis of randomized controlled trials

AIM: To determine the efficacy of therapeutic ultrasound vs sham for improving pain and physical function immediately post-intervention in people with knee osteoarthritis(OA). METHODS: We hand searched meta-analyses on the topic published in 2010 and updated the search in three electronic databases(MEDLINE, EMBASE, CINAHL) January 1, 2009 to September 5, 2013 to identify relevant studies. The inclusion criteria were human randomized controlled trials published in the English language in which active therapeutic ultrasound was compared tosham ultrasound, data for people with knee OA were reported separately, participants were blinded to treatment allocation and outcomes assessed before and after treatment included pain, self-reported physical function and performance-based physical function. Two reviewers independently screened titles and abstracts retrieved in the search to identify trials suitable for full text review. Data extraction and risk of bias assessment of the identified trials were completed independently by two reviewers. Pooled analyses were conducted using inverse-variance random effects models.RESULTS: We screened 1013 titles and abstracts. Meta-analysis of pain outcomes from 5 small trials(281 participants/OA knees) showed that, compared to sham ultrasound, therapeutic ultrasound improves pain [standardized mean difference(SMD)(95%CI) =-0.39(-0.70--0.08); P = 0.01] but not physical function [self-reported in 3 trials(130 participants/OA knees): SMD(95%CI) =-0.21(-0.55-0.14), P = 0.24; walking performance in 4 trials(130 participants/OA knees): SMD(95%CI) =-0.11(-0.59-0.37), P = 0.65). For the walking performance outcome, the dispersion of the estimated effects exceeded that expected due to sampling error(χ2 = 8.37, P = 0.04, I 2 = 64%). Subgroup analyses of three trials that administered high dose ultrasound improved the consistency(I2 = 28%) but the treatment effect remained insignificant.CONCLUSION: Meta-analyzed double-blind placebocontrolled randomized trials provide low-strength evidence that therapeutic ultrasound decreases knee OA pain and very low-strength evidence that it does not improve physical function.