Exercise and exerkine upregulation:Brain-derived neurotrophic factor as a potential non-pharmacological therapeutic strategy for Parkinson’s disease

Physical activity and exercise have several beneficial roles in enhancing both physiological and psychological well-being of an individual.In addition to aiding the regulation of aerobic and anaerobic metabolism,exercise can stimulate the synthesis of exerkine hormones in the circulatory system.Among several exerkines that have been investigated for their therapeutic potential,Brain-derived neurotrophic factor(BDNF)is considered the most promising candidate,especially in the management of neurodegenerative diseases.Owing to the ability of physical activity to enhance BDNF synthesis,several experimental studies conducted so far have validated this hypothesis and produced satisfactory results at the pre-clinical level.This review highlights some of the recent animal model studies that have evaluated the efficiency of exercise in enhancing BDNF synthesis and promoting neuroprotective effects.Further,this review focuses on understanding the therapeutic benefits of exercise-induced exerkine synthesis as a non-pharmacological strategy in Parkinson’s disease(PD).Regarding physical activity and exerkine induction,the neuromuscular electrical stimulation(NMES)strategy could be considered as an alternate treatment modality for patients affected with PD.

Research trends in exercise therapy for the treatment of pain in postmenopausal osteoporosis over the past decade:A bibliometric analysis

BACKGROUND Postmenopausal osteoporosis(PMOP)is the most common form of primary osteoporosis among women,and the associated pain often drives patients to seek clinical intervention.Numerous studies have highlighted the unique clinical benefits of exercise therapy(ET)in alleviating PMOP-related pain.However,bibliometric analyses examining collaboration,development trends,and research frontiers in the field of ET for PMOP pain remain scarce.AIM To explore the research trends in ET for pain treatment in PMOP patients over the past decade.METHODS All scholarly works were meticulously sourced from the Science Citation Index-Expanded within the prominent Web of Science Core Collection.Utilizing the capabilities of CiteSpace 6.2.R5,we conducted a thorough analysis of publications,authors,frequently cited scholars,contributing nations,institutions,journals of significant citation,comprehensive references,and pivotal keywords.Additionally,our examination explored keyword cooccurrences,detailed timelines,and periods of heightened citation activity.This comprehensive search,from 2014 through 2023,was completed within a single day,on October 11,2023.RESULTS In total,2914 articles were ultimately included in the analysis.There was a rapid increase in annual publication output in 2015,followed by stable growth in subsequent years.Boninger,Michael L,is the most prolific author,whereas Ware JE has the most citations.The United States’global influence is significant,surpassing all other nations.The University of California System and Harvard University are the most influential academic institutions.J Bone Joint Surg Am is the most influential journal in this field.“Spinal cord injury”is the keyword that has garnered the most attention from researchers.The developmental pattern in this field is characterized by interdisciplinary fusion,with different disciplines converging to drive progress.CONCLUSION The academic development of the field of ET for pain in PMOP has matured and stabilized.Clinical management and rehabilitation strategies,along with the mechanisms underlying the relationship between ET and bone resorption analgesia,continue to be the current and future focal points of research in this field.

Effect of Individualized Exercise Therapy on Cancer-related Fatigue and Negative Emotion in Patients with Gastrointestinal Tumor during Perioperative Period

[Objectives]To investigate the effect of exercise therapy in gastric cancer patients during perioperative period.[Methods]100 patients with gastric cancer who underwent elective operation in the Department of Gastrointestinal Surgery of Taihe Hospital Affiliated to Hubei University of Medicine were divided into observation group and control group by convenience sampling.The control group received routine nursing measures,and the experimental group received exercise therapy intervention measures on the basis of the control group.The patients were evaluated by the General Information Questionnaire,Self-Rating Anxiety Scale,Self-Rating Depression Scale and Cancer-related Fatigue Scale at the time of admission,the second week and the sixth week after operation.[Results]The time effect,intervention effect and interaction effect of anxiety score,depression score and cancer-related fatigue score were significant(all P<0.05)and the index of enhanced recovery after surgery was significant(P<0.05)in the two groups at the second and sixth week after operation.[Conclusions]Exercise therapy is beneficial to promoting the enhanced recovery after surgery in advance,reduce cancer-related fatigue,negative emotion and accelerate rehabilitation in patients with gastrointestinal tumors.

Cardiac rehabilitation and exercise therapy in the elderly： Should we invest in the aged？

Coronary heart disease （CHD） is the leading cause of death worldwide and becomes increasingly prevalent among patients aged 65 years and older.Elderly patients are at a higher risk for complications and accelerated physical deconditioning after a cardiovascular event,especially compared to their younger counterparts.The last few decades were privy to multiple studies that demonstrated the beneficial effects of cardiac rehabilitation （CR） and exercise therapy on mortality,exercise capacity,psychological risk factors,inflammation,and obesity among patients with CHD.Unfortunately,a significant portion of the available data in this field pertains to younger patients.A viable explanation is that older patients are grossly underrepresented in these programs for multiple reasons starting with the patient and extending to the physician.In this article,we will review the benefits of CR programs among the elderly,as well as some of the barriers that hinder their participation.

Addition of hip exercises to treatment of patellofemoral pain syndrome:A meta-analysis

AIM:To determine if the addition of hip-strengthening exercises decreases pain and improves function in patients with patellofemoral pain syndrome.METHODS:The authors completed a systematic reviewsearching eight databases(i.e.,Pub Med,Cochrane,CINHAL,MEDLINE,Sports Discus,EMBASE,APTA Hooked on Evidence,and PEDro).Two independent reviewers screened and excluded studies if they did not meet the following inclusion criteria:subjects had a primary diagnosis of patellofemoral pain syndrome(PFPS),intervention group included hip-strengthening exercises,control group included a traditional physical therapy intervention,study included outcome measures of pain and/or function,study used a randomized controlled trial design,PEDro score was ≥ 7,and study was published in a peer-reviewed journal.Primary outcome measures were subjective scales of pain and function.These measures were converted to standardized mean difference [effect size(ES)],and a random-effects model was used to calculate the overall ES.RESULTS:Two hundred eighty-three studies were screened for inclusion in our meta-analysis.Nine studies were deemed suitable for data extraction and analysis.A total of 426 subjects were used in the nine studies.Overall,there was a significant positive effect of hip-strengthening exercises on measures of pain and function in subjects with PFPS(ES = 0.94,P = 0.00004).None of the individual studies had a negative ES,with study ES ranging from 0.35 to 2.59.Because of the high degree of between-study variance(I2 = 76%;Q = 34.0,P < 0.001),subgroup meta-analyses and meta-regressions were performed.None of the potential moderator variables that were investigated(e.g.,outcome type,hip region targeted,duration of treatment) could explain a significant amount of the between-study variance in ES(P ≥ 0.23).CONCLUSION:Overall,the addition of hip-strengthening exercises to traditional physical therapy produced greater improvements in measures of pain and function.

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.

Tubular conduits,cell-based therapy and exercise to improve peripheral nerve regeneration

Peripheral nerve injuries （PNI） are a major clinical prob- lem. In general, PNI results from motor vehicle accidents, lacerations with sharp objects, penetrating trauma （gunshot wounds） and stretching or crushing trauma and fractures. It is estimated that PNI occur in 2.8% of trauma patients and this number reaches 5% if plexus and root lesions are in- cluded. However, due to lack of recent epidemiological stud- ies, these data probably underestimate the actual number of nerve injuries

Integration of Chinese herbal medicines and exercise for insomnia:a systematic review and meta-analysis

Background:As a disease,insomnia is often ignored by the general public.Insomnia,which not directly fatal,may be equivalent to chronic suicide if it is not paid attention to.However,there are many theories on how to treat insomnia,and researchers have been searching for a cure.Chinese herbal medicine(CHM)and exercise therapy(ET)are relatively effective,and have been used since ancient times to treat insomnia.This study aimed to examine the effect of CHM combined with ET(CHM-ET)on patients with insomnia.Methods:We searched eight electronic databases including PubMed,Web of Science,EMBASE,the Cochrane Library,the China National Knowledge Infrastructure(CNKI),the China Biology Medicine disc(CBMdisc),the China Science and Technology Journal Database(VIP),the Wanfang Database to find randomized controlled trials(RCTs)evaluating CHM-ET in the treatment of insomnia patients up to September 13,2022.Two researchers read and screened the publications to extract data.We used the pittsburgh sleep quality index(PSQI)as the evaluation indicators for each study,and the other was the total effective rate(TER).The Cochrane risk-of-bias assessment tool was used to assess the risk of bias of the included literature.The level of evidence for this result was assessed by GARDE method.The meta-analysis was performed using STATA 14 software and RevMan 5.3.The research method was registered with PROSPERO(CRD42022350926).Results:We included fourteen randomized controlled trials,which including a total of 1,126 participants.Compared with the control group,the experimental group showed significantly improvements in sleep effect as reflected by the reduced PSQI score[mean difference(MD)=-2.47,95%confidence interval(CI)(-3.15,-1.78),I^(2)=92%]with low quality of evidence,and increased TER[risk ratio(RR)=1.23,95%CI(1.14,1.33),I^(2)=40%]with moderate quality of evidence.Compared with hypnotic drugs,CHM-ET significantly reduced the PSQI score[mean difference(MD)=-3.18,95%CI(-5.48,-0.89),I^(2)=73%]with low quality of evidence.The PSQI of CHM-ET significantly decreased compared with single CHM[mean difference(MD)=-3.04,95%CI(-5.84,-0.25),I^(2)=98%]with low quality of evidence,and ET[mean difference(MD)=-2.44,95%CI(-2.87,-2.02),I^(2)=0%]with moderate quality of evidence.No serious adverse reactions were observed.Conclusion:This review suggested that CHM-ET may be an effective treatment for insomnia.However,given the limited quality of the studies and methodologies included in the trials,further rigorous randomized controlled trials are needed for more accurate results.

Research progress in spasmodic torticollis rehabilitation treatment

Spasmodic torticollis(ST)is a focal dystonia that affects adults,causing limited muscle control and impacting daily activities and quality of life.The etiology and curative methods for ST remain unclear.Botulinum toxin is widely used as a firstline treatment,but long-term usage can result in reduced tolerance and adverse effects.Rehabilitation therapy,with its minimal side effects and low potential for harm,holds significant clinical value.This article explores the effectiveness of adjunctive therapies,including exercise therapy,transcranial magnetic stimulation,shockwave therapy,neuromuscular electrical stimulation,vibration therapy,electromyographic biofeedback,and acupuncture,in the treatment of ST.The aim is to provide clinicians with additional treatment options and to discuss the efficacy of rehabilitation therapy for ST.

The Effect of Electro-Acupuncture on Motor Function Recovery in Patients with Acute Cerebral Infarction:A Randomly Controlled Trial

The aim of this study is to investigate the effect of electro-acupuncture treatment in acute phase of cerebral infarction on the motor functions. In this randomly controlled trial, 86 patients were allocated to two groups, the experimental group given clinical and electro-acupuncture treatments for a period of 4 weeks, and the control group given clinical treatment plus active and/or passive functional exercise. The result showed that the level of impairment and disability in both groups were improvement according to the Chinese Stroke Scale, Brunnstrom-Fugl-Meyer score, and Barthel Index throughout the study and 3 months after. The motor functions and the activities of daily living (ADL) were improved significantly in the electro-acupuncture group as compared with the control group (P

Study of virtual reality for mild cognitive impairment:A bibliometric analysis using CiteSpace

Objectives Non-invasive and low-cost virtual reality(VR)technology is important for early evaluation and intervention in mild cognitive impairment(MCI).This study aimed to demonstrate the current status of overseas and domestic research as well as the focus and frontier of VR technology among individuals with MCI through a bibliometric analysis.Methods Studies from the core collection of Web of Science™between 1995 and 2020 were used;furthermore,CiteSpace 5.7 R3 was utilized to analyse information on authors/cited authors,keywords,burst words,and cited references.Results In total,230 publications were identified.Most studies were published in the USA(45 publications)and Italy(41 publications),where Guiseppe Riva ranks first(14 publications),and Tarnanas I is the author with the highest centrality(0.44).The hot topics in VR applications in the MCI population are‘physical activity,’‘people,’‘single-blind,’‘disease,’‘walking,’‘technology,’‘working memory,’and‘risk’in recent years.The keyword‘mild cognitive impairment’has attracted extensive attention since 2012,showing the strongest citation outbreak(8.28).The clustering results of the literature show the research types and emerging trends,including‘exergame,’‘serious games,’‘spatial navigation,’‘activities of daily living,’‘exercise,’‘enriched environment’and‘wayfinding.‘Conclusions Cognitive assessment and nonpharmacological intervention research on patients with MCI have become the focus of dementia prevention in recent years.Virtual technology,combined with traditional methods such as exercise therapy,provides new ideas for innovative cognitive evaluation and cognitive intervention.

Acute ankle sprain in athletes:Clinical aspects and algorithmic approach

Acute ankle sprain is the most common lower limb injury in athletes and accounts for 16%-40%of all sports-related injuries.It is especially common in basketball,American football,and soccer.The majority of sprains affect the lateral ligaments,particularly the anterior talofibular ligament.Despite its high prevalence,a high proportion of patients experience persistent residual symptoms and injury recurrence.A detailed history and proper physical examination are diagnostic cornerstones.Imaging is not indicated for the majority of ankle sprain cases and should be requested according to the Ottawa ankle rules.Several interventions have been recommended in the management of acute ankle sprains including rest,ice,compression,and elevation,analgesic and anti-inflammatory medications,bracing and immobilization,early weight-bearing and walking aids,foot orthoses,manual therapy,exercise therapy,electrophysical modalities and surgery(only in selected refractory cases).Among these interventions,exercise and bracing have been recommended with a higher level of evidence and should be incorporated in the rehabilitation process.An exercise program should be comprehensive and progressive including the range of motion,stretching,strengthening,neuromuscular,proprioceptive,and sport-specific exercises.Decision-making regarding return to the sport in athletes may be challenging and a sports physician should determine this based on the self-reported variables,manual tests for stability,and functional performance testing.There are some common myths and mistakes in the management of ankle sprains,which all clinicians should be aware of and avoid.These include excessive imaging,unwarranted non-weightbearing,unjustified immobilization,delay in functional movements,and inadequate rehabilitation.The application of an evidence-based algorithmic approach considering the individual characteristics is helpful and should be recommended.

Progression of intervention-focused research for Gulf War illness

The Persian Gulf War of 1990 to 1991 involved the deployment of nearly 700,000 American troops to the Middle East.Deployment-related exposures to toxic substances such as pesticides,nerve agents,pyridostigmine bromide(PB),smoke from burning oil wells,and petrochemicals may have contributed to medical illness in as many as 250,000 of those American troops.The cluster of chronic symptoms,now referred to as Gulf War Illness(GWI),has been studied by many researchers over the past two decades.Although over$500 million has been spent on GWI research,to date,no cures or condition-specific treatments have been discovered,and the exact pathophysiology remains elusive.Using the 2007 National Institute of Health(NIH)Roadmap for Medical Research model as a reference framework,we reviewed studies of interventions involving GWI patients to assess the progress of treatment-related GWI research.All GWI clinical trial studies reviewed involved investigations of existing interventions that have shown efficacy in other diseases with analogous symptoms.After reviewing the published and ongoing registered clinical trials for cognitivebehavioral therapy,exercise therapy,acupuncture,coenzyme Q10(CoQ10),mifepristone,and carnosine in GWI patients,we identified only four treatments(cognitive-behavioral therapy,exercise therapy,CoQ10,and mifepristone)that have progressed beyond a phase II trial.We conclude that progress in the scientific study of therapies for GWI has not followed the NIH Roadmap for Medical Research model.Establishment of a standard case definition,prioritized GWI research funding for the characterization of the pathophysiology of the condition,and rapid replication and adaptation of early phase,single site clinical trials could substantially advance research progress and treatment discovery for this condition.

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.

TCM Treatment for 50 Cases of Acute Protrusion of the Lumbar Intervertebral Disc

From January 1998 to August 2000, the author has treated 50 cases of acute protrusion of the lumbar intervertebral disc by Chinese herbs, massotherapy, and functional exercise with satisfactory therapeutic results reported in the following.

Appropriateness of a Physiotherapic Treatment Protocol for the Axillary Web Syndrome, Applied in a Territorial Rehabilitation Service: Description of a Clinical Case

The “Axillary web syndrome” (AWS) is an early complication following breast cancer surgery with axillary lymph nodes dissection. Case Report: The patient is a 69-year-old woman, retired ex-employee, with outcome surgery right axillary lymphadenectomy with shoulder pain and functional limitation with diagnosis AWS it where it was recommended the physiotherapy. The patient had improvement in terms of shoulder function and pain and quality of life. Conclusions: The description of the clinical case afflicted with AWS and the treatment protocol applied, highlighted the good performance of the results, notably as concerns patient’s quality of life. This result could represent a starting point for creating clinical trials aimed at building appropriate rehabilitation route in territorial rehabilitation services.

Effects of an active lifestyle on the physical frailty of liver transplant candidates

BACKGROUND Liver transplantation is the most important therapeutic intervention for end-stage liver disease(ELD).The prioritization of these patients is based on the model for end-stage liver disease(MELD),which can successfully predict short-term mortality.However,despite its great validity and value,it cannot fully incorporate several comorbidities of liver disease,such as sarcopenia and physical frailty,variables that can sufficiently influence the survival of such patients.Subsequently,there is growing interest in the importance of physical frailty in regard to mortality in liver transplant candidates and recipients,as well as its role in improving their survival rates.AIM To evaluate the effects of an active lifestyle on physical frailty on liver transplant candidates.METHODS An observational study was performed within the facilities of the Department of Transplant Surgery of Aristotle University of Thessaloniki.Twenty liver transplant candidate patients from the waiting list of the department were included in the study.Patients that were bedridden,had recent cardiovascular incidents,or had required inpatient treatment for more than 5 d in the last 6 mo were excluded from the study.The following variables were evaluated:Activity level via the International Physical Activity Questionnaire(IPAQ);functional capacity via the 6-min walking test(6MWT)and cardiopulmonary exercise testing;and physical frailty via the Liver Frailty Index(LFI).RESULTS According to their responses in the IPAQ,patients were divided into the following two groups based on their activity level:Active group(A,10 patients);and sedentary group(S,10 patients).Comparing mean values of the recorded variables showed the following results:MELD(A:12.05±5.63 vs S:13.99±3.60;P>0.05);peak oxygen uptake(A:29.78±6.07 mL/kg/min vs S:18.11±3.39 mL/kg/min;P<0.001);anaerobic threshold(A:16.71±2.17 mL/kg/min vs S:13.96±1.45 mL/kg/min;P<0.01);6MWT(A:458.2±57.5 m vs S:324.7±55.8 m;P<0.001);and LFI(A:3.75±0.31 vs S:4.42±0.32;P<0.001).CONCLUSION An active lifestyle can be associated with better musculoskeletal and functional capacity,while simultaneously preventing the evolution of physical frailty in liver transplant candidates.This effect appears to be independent of the liver disease severity.

Feasibility of Recruiting and Assessing Health-Related Quality of Life and Physical Function in Older Chinese Adults with Cerebral Infarction

Objective:While it is known that exercise therapy can improve physical and emotional function in cerebral infarction(CD)patients,few studies have examined how well this would be accepted by older adults in China.Methods:In this study,the feasibility of recruiting and asessing healh-related quality of life and physical function in older Chinese adults with cerebral infarction was asessed.Specific aims of the studly were to evalhuate the feasibility of recnuiting older adults,with and without CI,from three different locations/settings in China;Compare the quality of life and physical function measures between CI and control subjects;Propose future larger randomized controlled studies of aerobic and resistance exercise training in both human and animal models after CI.Results:Overall,66/275(24.0%)surveys that were sent to older Chinese adults were retumed and evaluated.Of those surveys returned,18(27%)met the study inclusion and exclusion critenia.Consequently,the results of this feasibility study indicate there is a recruitment yield(number of subject contacted/number of subjects who qualified for study)of 6.5%.These number varied at the different sites/settings.but the highest recruitment yield was seen in hospitalized patients.Despite small sample sizes,there were statistically sigmificant differences in health-related quality of life and physical function between CI patients and control subjects.Conclusion:This feasibility study demonstated that it is possible to successfully recruit CI patients for an exercise intervention study as well as to perform important assessments of health-related quality of life and physical fumction.Further randomized controlled trials,in humans and animal models,will be needed determine if aerobic and/or resistance exercise training can improve health and physical function in older CI patients.Additional studies will be needed to determine the specific mechanisms responsible for the benefits see with aerobic and resistance training.

Exercise-induced hypoalgesia in chronic neck pain: A narrative review

Chronic neck pain(CNP)is a worldwide health problem with several risk factors.One of the most widely used treatments for managing this condition is therapeutic exercise,which could generate a response called exerciseinduced hypoalgesia(EIH).There is no consensus on the best exercise modality to induce hypoalgesia.Therefore,this review aims to analyze and synthesize the state-of-the-art about the hypoalgesic effect of exercise in subjects with CNP.We included articles on EIH and CNP in patients older than 18 years,with pain for more than three months,where the EIH response was measured.Articles that studied CNP associated with comorbidities or measured the response to treatments other than exercise were excluded.The studies reviewed reported variable results.Exercise in healthy subjects has been shown to reduce indicators of pain sensitivity;however,in people with chronic pain,the response is variable.Some investigations reported adverse effects with increased pain intensity and decreased pain sensitivity,others found no clinical response,and some even reported EIH with decreased pain and increased sensitivity.EIH is an identifiable,stimulable,and helpful therapeutic response in people with pain.More research is still needed on subjects with CNP to clarify the protocols and therapeutic variables that facilitate the EIH phenomenon.In addition,it is necessary to deepen the knowledge of the intrinsic and extrinsic factors that influence EIH in people with CNP.

A Summary of Clinical Treatment for 58 Cases of Hemiplegia with Electro-Acupuncture and Massage

Hemiplegia refers to one-side paralysis of limbs,accompanied with deviation of the eyes and mouth,stifftongue and dysphasia,a syndrome seen in variousconditions after cerebrovascular accident.The author hastreated 58 such cases with electro-acupuncture,massage,and motortherapy,and obtained very good therapeuticeffect as reported in the following.