BACKGROUND Active myofascial trigger points(TrPs)often occur in the upper region of the upper trapezius(UT)muscle.These TrPs can be a significant source of neck,shoulder,and upper back pain and headaches.These TrPs an...BACKGROUND Active myofascial trigger points(TrPs)often occur in the upper region of the upper trapezius(UT)muscle.These TrPs can be a significant source of neck,shoulder,and upper back pain and headaches.These TrPs and their related pain and disability can adversely affect an individual’s everyday routine functioning,work-related productivity,and general quality of life.AIM To investigate the effects of instrument assisted soft tissue mobilization(IASTM)vs extracorporeal shock wave therapy(ESWT)on the TrPs of the UT muscle.METHODS A randomized,single-blind,comparative clinical study was conducted at the Medical Center of the Egyptian Railway Station in Cairo.Forty patients(28 females and 12 males),aged between 20-years-old and 40-years-old,with active myofascial TrPs in the UT muscle were randomly assigned to two equal groups(A and B).Group A received IASTM,while group B received ESWT.Each group was treated twice weekly for 2 weeks.Both groups received muscle energy technique for the UT muscle.Patients were evaluated twice(pre-and posttreatment)for pain intensity using the visual analogue scale and for pain pressure threshold(PPT)using a pressure algometer.RESULTS Comparing the pre-and post-treatment mean values for all variables for group A,there were significant differences in pain intensity for TrP1 and TrP2(P=0.0001)and PPT for TrP1(P=0.0002)and TrP2(P=0.0001).Also,for group B,there were significant differences between the pre-and post-treatment pain intensity for TrP1 and TrP2 and PPT for TrP1 and TrP2(P=0.0001).There were no significant differences between the two groups in the post-treatment mean values of pain intensity for TrP1(P=0.9)and TrP2(P=0.76)and PPT for TrP1(P=0.09)and for TrP2(P=0.91).CONCLUSION IASTM and ESWT are effective methods for improving pain and PPT in patients with UT muscle TrPs.There is no significant difference between either treatment method.展开更多
Tauopathies are a group of neurological disorders,including Alzheimer’s disease and frontotemporal dementia,which involve progressive neurodegeneration,cognitive deficits,and aberrant tau protein accumulation.The dev...Tauopathies are a group of neurological disorders,including Alzheimer’s disease and frontotemporal dementia,which involve progressive neurodegeneration,cognitive deficits,and aberrant tau protein accumulation.The development of tauopathies cannot currently be stopped or slowed down by treatment measures.Given the significant contribution of tau burden in primary tauopathies and the strong association between pathogenic tau accumulation and cognitive deficits,there has been a lot of interest in creating therapies that can alleviate tau pathology and render neuroprotective effects.Recently,small molecules,immunotherapies,and gene therapy have been used to reduce the pathological tau burden and prevent neurodegeneration in animal models of tauopathies.However,the major pitfall of the current therapeutic approach is the difficulty of drugs and gene-targeting modalities to cross the blood-brain barrier and their unintended side effects.In this review,the current therapeutic strategies used for tauopathies including the use of oligonucleotide-based gene therapy approaches that have shown a promising result for the treatment of tauopathies and Alzheimer’s disease in preclinical animal models,have been discussed.展开更多
Background:Assessment and quantification of skeletal muscle within the aging population is vital for diagnosis,treatment,and injury/disease prevention.The clinical availability of assessing muscle quality through diag...Background:Assessment and quantification of skeletal muscle within the aging population is vital for diagnosis,treatment,and injury/disease prevention.The clinical availability of assessing muscle quality through diagnostic ultrasound presents an opportunity to be utilized as a screening tool for function-limiting diseases.However,relationships between muscle echogenicity and clinical functional assessments require authoritative analysis.Thus,we aimed to(a) synthesize the literature to assess the relationships between skeletal muscle echogenicity and physical function in older adults(≥60 years),(b) perform pooled analyses of relationships between skeletal muscle echogenicity and physical function,and(c) perform sub-analyses to determine between-muscle relationships.Methods:CINAHL,Embase,MEDLINE,PubMed,and Web of Science databases were systematically searched to identify articles relating skeletal muscle echogenicity to physical function in older adults.Risk-of-bias assessments were conducted along with funnel plot examination.Meta-analyses with and without sub-analyses for individual muscles were performed utilizing Fisher's Z transformation for the most common measures of physical function.Fisher's Z was back-transformed to Pearson's r for interpretation.Results:Fifty-one articles(n=5095,female=~2759,male=~2301,72.5± 5.8 years,mean±SD(1 study did not provide sex descriptors))were extracted for review,with previously unpublished data obtained from the authors of 13 studies.The rectus femoris(n=34) and isometric knee extension strength(n=22) were the most accessed muscle and physical qualities,respectively.The relationship between quadriceps echogenicity and knee extensor strength was moderate(n=2924,r=-0.36(95% confidence interval:-0.38 to-0.32),p <0.001),with all other meta-analyses(grip strength,walking speed,sit-to-stand,timed up-and-go) resulting in slightly weaker correlations(r:-0.34 to-0.23,all p <0.001).Sub-analyses determined minimal differences in predictive ability between muscle groups,although combining muscles(e.g.,rectus femoris+vastus lateralis) often re sulted in stronger correlations with maximal strength.Conclusion:While correlations are modest,the affordable,portable,and noninvasive ultrasonic assessment of muscle quality is a consistent predictor of physical function in older adults.Minimal between-muscle differences suggest that echogenicity estimates of muscle quality are systemic.Therefore,practitioners may be able to scan a single muscle to estimate full-body skeletal muscle quality/composition,while researchers should consider combining multiple muscles to strengthen the model.展开更多
Parkinson’s disease(PD)is a complex neurodegenerative disorder characterized by a range of motor symptoms such as bradykinesia,resting tremor,rigidity,and postural instability,as well as non-motor symptoms,such as de...Parkinson’s disease(PD)is a complex neurodegenerative disorder characterized by a range of motor symptoms such as bradykinesia,resting tremor,rigidity,and postural instability,as well as non-motor symptoms,such as depression,anxiety,sleep disturbances,and fatigue(Bloem et al.,2021).展开更多
Background: low back pain affects many individuals, with 80% classified as non-specific low back pain (NSLBP) due to mechanical rather than structural issues. The link between pelvic alignment and lumbopelvic-hip rota...Background: low back pain affects many individuals, with 80% classified as non-specific low back pain (NSLBP) due to mechanical rather than structural issues. The link between pelvic alignment and lumbopelvic-hip rotation movement for NSLBP is controversial. Methods: twenty males with NSLBP and 20 healthy males participated. Data collected included static pelvic asymmetry and active lumbopelvic-hip rotation with motion capture system for kinematic analysis. Results: Unpaired T test was used to compare the difference of kinematic parameters between two groups. NSLBP group showed significantly larger angles between the ASIS-PSIS line and the z-axis (p Conclusion: Evaluations focusing on bone structure alone may be inadequate. A more comprehensive approach including functional assessments like muscle strength and range of motion could be beneficial. Integrating lumbopelvic-hip movement patterns and pelvic symmetry into clinical assessments should be considered, as they may be influenced by physical activity.展开更多
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...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.展开更多
Attention constitutes a fundamental psychological feature guiding our mental effort toward specific objects, concurrent with processes such as memory, reasoning, and imagination. Visual attention, crucial for selectin...Attention constitutes a fundamental psychological feature guiding our mental effort toward specific objects, concurrent with processes such as memory, reasoning, and imagination. Visual attention, crucial for selecting surrounding information, often decreases in older adults and patients with cerebrovascular disorders. Effective methods to enhance attention are scarce. Here, we investigated whether color information influences visual attention and brain activity during task performance, utilizing EEG. We examined 13 healthy young adults (seven women and six men;mean age: 21.2 ± 0.58 years) using 19-electrode electroencephalograms to assess the impact of color information on visual attention. The Clinical Assessment for Attention cancellation test was conducted under the black, red, and blue color conditions. Wilcoxon’s signed-rank test was used to assess differences in task performance (task time and error) between conditions. Spearman’s rank correlation was utilized to examine the correlation in power levels between task performance and color conditions. Significant variations in total task errors were observed among color conditions. The black condition exhibited the highest error frequency (0.7 ± 0.9 times), followed by the red condition (0.5 ± 0.8 times), with the lowest error frequency occurring in the blue (0.2 ± 0.4 times) condition (black vs. red: P = 0.03;black vs. blue: P = 0.00;red vs. blue: P = 0.032). No time difference was observed. The black condition showed negative delta and high-gamma correlations in the central electrodes. The red condition revealed positive alpha and low-gamma correlations in the frontal and occipital areas. Although no correlations were observed in the blue condition, it enhanced attentional performance. Positive alpha and low-gamma waves might be crucial for spotting attentional errors in key areas. Our findings provide insights into the effects of color information on visual attention and potential neural correlates associated with attentional processes. In conclusion, our study implies a connection between color information and attentional task performance, with blue font associated with the most accurate performance.展开更多
Objective: This study aimed to evaluate the immediate psychological effects of coordination exercises on women in Japan. Methods: The subjects were 17 adult women (height, 160.1 ± 5.1 cm;weight, 54.3 ± 10.5 ...Objective: This study aimed to evaluate the immediate psychological effects of coordination exercises on women in Japan. Methods: The subjects were 17 adult women (height, 160.1 ± 5.1 cm;weight, 54.3 ± 10.5 kg;age, 57.8 ± 8.3 years) living in the community and attending a fitness club. The subjects performed a coordination exercise called Life Kinetik®. The subjects responded to the Two-Dimensional Mood Scale–Short Term before and after performing 30 minutes of Life Kinetik®. The results were tabulated and four psychological states were calculated (i.e., vitality, stability, pleasure, and arousal). The pre- and post-implementation results were statistically analyzed using a corresponding t-test. Results: Significant differences were found in activation and arousal levels, but not in stability and comfort levels. Conclusion: The coordination exercise, Life Kinetik®, was found to be an exercise program with potential psychological benefits, as it could change women’s psychological condition to active and excited states.展开更多
Impaired motor and functional activity following stroke often has negative impacts on the patient, the family and society. The available rehabilitation programs for stroke patients are reviewed. Conventional rehabilit...Impaired motor and functional activity following stroke often has negative impacts on the patient, the family and society. The available rehabilitation programs for stroke patients are reviewed. Conventional rehabilitation strategies(Bobath, Brunnstrom, proprioception neuromuscular facilitation, motor relearning and function-based principles) are the mainstream tactics in clinical practices. Numerous advanced strategies for sensory-motor functional enhancement, including electrical stimulation, electromyographic biofeedback, constraint-induced movement therapy, robotics-aided systems, virtual reality, intermittent compression, partial body weight supported treadmill training and thermal stimulation, are being developed and incorporated into conventional rehabilitation programs. The concept of combining valuable rehabilitative procedures into "a training package", based on the patient's functional status during different recovery phases after stroke is proposed. Integrated sensorimotor rehabilitation programs with appropriate temporal arrangements might provide great functional benefits for stroke patients.展开更多
Background:Structured vigorous physical activity(VPA)can improve cognitive control in children,but studies relating daily physical activity(PA)to cognitive control have yielded conflicting findings.While objectively m...Background:Structured vigorous physical activity(VPA)can improve cognitive control in children,but studies relating daily physical activity(PA)to cognitive control have yielded conflicting findings.While objectively measured daily PA summarizes all occurrences of PA within a registered period,a minimum duration of continuous PA is required for registration of a PA bout.Because brief bouts of high-intensity PA can account for a large proportion of children’s daily activity-related energy expenditure,this study assessed whether daily and bouted VPA were selectively related to cognitive control in preadolescents relative to other PA intensities.Methods:A total of 75 children between the ages of 8 and 10 years(49%girls)wore an ActiGraph wGT 3 X+on the hip for 7 days.The acceleration signal from the vertical axis was summarized over 1 s,5 s,and 15 s epochs.Daily and boutecd modercate PA,moderate-to-vigorous PA,and VPA were measured.PA bouts were expressed as the frequency and time spent in 2 different continuous PA bouts,one lasting≥10 s and the other lasting≥30 s at a given intensity.Inhibitory control was assessed using behavioral responses to a modified flanker task(mean reaction time(RTmean)and accuracy).Attentional resource allocation and co gnitive processing speed were measured using the amplitude and latency of the P3 component of event-related brain potentials,respectively.Associations between PA,behavioral indices of inhibitory control,P3 amplitude,and latency were assessed using hierarchical regression models.Results:Daily VPA was not related to RTmean or accuracy on either congruent or incongruent trials.In contrast,more time spent in VPA bouts lasting≥30 s predicted shorter P3 latency across epochs and flanker congruencies(allβ≤-0.24,all p≤0.04).The associations between shorter P3 latency and the time spent in moderate-to-vigorous PA bouts lasting≥30 s were less consistent and largely limited to congruent trials(congruent:β(-0.3 1,-0.34)).No significant associations were observed upon correction for false discovery rate.Conclusion:The pattern of uncorrected associations aligns with the dose-response literature and suggests that brief VPA bouts may yield the greatest benefits to cognitive processing speed in preadolescents.Future studies using measures of brain structure and function are needed to understand the mechanisms linking bouted VPA to neurocognitive function during childhood.展开更多
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....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.展开更多
Studies have demonstrated that some cutaneous biophysical properties vary with the part of the body. The results to date of skin conditions in human skin of multiple parts of the body have not yet been well establishe...Studies have demonstrated that some cutaneous biophysical properties vary with the part of the body. The results to date of skin conditions in human skin of multiple parts of the body have not yet been well established. In this study, we assessed the differences in the skin’s sebum, moisture, pores, wrinkles, pigmentation, and elasticity of each body part in Korean men in their 20s. A total of 34 healthy men were enrolled. A Skin Diagnosis Meter was used to measure the skin’s surface sebum, moisture, pores, wrinkles, pigmentation, and elasticity of each body part. The sebum content was significantly higher on the face than at other sites. Moisture was significantly high on the feet. Pores were significantly high on the face. Wrinkles were significantly high on the face. Pigmentation was high on the face and neck, but not significantly. Elasticity was significantly high on the hands. In the correlation analysis results, sebum and pore were positively correlated, but sebum and moisture and wrinkle and elasticity were negatively correlated. For nearly the first time, this study resulted in systematic reference values for standardized biophysical measuring methods and body parts reflecting the skin physiology of healthy South Korean men. The results show that skin’s surface sebum, moisture, pores, wrinkles, pigmentation, and elasticity vary with the part of the body.展开更多
The aim of the study was to investigate the effect of a hydrotherapy program on FVC, FEV, PEF, RR and SaO<sub>2</sub> on children with Down syndrome over six months and to compare it with a conventional re...The aim of the study was to investigate the effect of a hydrotherapy program on FVC, FEV, PEF, RR and SaO<sub>2</sub> on children with Down syndrome over six months and to compare it with a conventional respiratory physiotherapy program. Eighteen children, with Down Syndrome, aged 6 - 11 years (9.53 ± 0.454), divided into two groups of nine, the intervention group (IG), that participated in the hydrotherapy program and the control group (CG) participated in the classical physiotherapy program. We calculated mean values of FVC, FEV, PEF, RR and SaO2 before and after six months intervention for both groups. There was a statistically significant improvement in all factors for both groups. However, were statistically more significant for the intervention group (IG). Based on a specific protocol of intervention in the water and at the same time with a group of children who participated in a similar program of classical respiratory physiotherapy, it was found to be statistically more important than the second group in improving respiratory function. We recommend the use of hydrotherapy as a complementary therapy that should be part of the weekly program of these children in addition to the existing treatments they attend.展开更多
BACKGROUND The prevalence of chronic obstructive pulmonary disease(COPD)is increasing worldwide,and at the same time it is associated with increased mortality and reduced quality of life.Efforts to build sustainable r...BACKGROUND The prevalence of chronic obstructive pulmonary disease(COPD)is increasing worldwide,and at the same time it is associated with increased mortality and reduced quality of life.Efforts to build sustainable rehabilitation approaches to COPD treatment and prevention are crucial.The system of long-term pulmonary rehabilitation care is insufficient.The main reasons for the absence of these outpatient programs are the lack of experience,the lack of interest of insurance companies in secondary prevention programs,and the lack of healthcare facilities in large geographical areas.The possibility of at-home pulmonary rehabilitation models(telemonitoring and telecoaching)could solve this problem.CASE SUMMARY A 71-year-old man with severe COPD,Global Initiative for Obstructive Lung Diseases stage 3 underwent an 8-wk remotely monitored inspiratory muscle training with a device based on the test of incremental respiratory endurance method.Spirometry,body plethysmography,test of incremental respiratory endurance examination,6-min walking test,body mass index,airflow obstruction,dyspnea,exercise capacity index,and subjective perception of dyspnea were performed as part of the initial and final examination.The patient performed training at home,and the physiotherapist monitored the patient remotely through a web application that allowed the physiotherapist to evaluate all training parameters in real-time and respond to any problems.After 8 wk of home training,there was a significant increase in all monitored values:maximal inspiratory pressure,a novel parameter sustained maximal inspiratory pressure,forced expiratory volume in 1 s,total lung capacity,forced vital capacity,peak expiratory flow,and inspiratory capacity.There was also an improvement in the perception of dyspnea according to the COPD Assessment Test and a modified Medical Research Council Breathlessness Scale,an increase in exercise tolerance according to the 6-min walking test,and a decrease in the exercise capacity index as a predictor of prognosis.CONCLUSION Respiratory telerehabilitation was greatly beneficial in a cooperative patient with COPD and may represent an alternative therapeutic approach to the increasing incidence of all lung diseases.展开更多
The present study was designed to evaluate the effects of hippotherapy on standing balance in patients with incomplete cervical spinal cord injuries. Ten patients (8 men and 2 women) who were diagnosed with cervical l...The present study was designed to evaluate the effects of hippotherapy on standing balance in patients with incomplete cervical spinal cord injuries. Ten patients (8 men and 2 women) who were diagnosed with cervical levels of injury between 3 and 6, and D according to the ASIA Impairment Scale. All patients were tested by the physiotherapists prior to and after hippotherapy treatment. Standing balance was measured using the Interactive Balance System (IBS). The weight distribution index was significantly increased in application of hippotherapy compared with control groups in patients with a neurologic level of cervical 3 and 4, and with Brown-Sequard syndrome, respectively. However, most of the patients exhibited no significant changes in the standing balance index, such as F1, F2-4, F5-6, F7-8, and SI scores, after hippotherapy. These results suggest that hippotherapy did not have a significant effect on the standing balance of patients with incomplete cervical spinal cord injuries.展开更多
We examined the changes in numerous skin conditions before and after the ap-plication of interferential current therapy to various regions of healthy male bodies. In this study, we assessed the differences in the skin...We examined the changes in numerous skin conditions before and after the ap-plication of interferential current therapy to various regions of healthy male bodies. In this study, we assessed the differences in the skin’s sebum, moisture levels, pores, wrinkles, pigmentation, and elasticity on the shoulders, lower back, and the knees of Korean males in their 20s. A total of 30 healthy males were in-cluded in the study. We used a skin diagnosis meter as a device for measuring the state of the skin. A statistical difference was found when comparing the pre- and post-measurement values in regards to the moisture levels, wrinkles, and pig-mentation. In the correlation analysis results, the sebum and pigmentation, moisture levels and wrinkles, moisture levels and pigmentation, and moisture levels and elasticity were all positively correlated, respectively. The results of this study partially suggest that a change in skin condition is associated with ex-ternal stimulation. The study also found that the effects of the application of in-terferential current therapy on the various skin conditions may differ depending on the region of the body that the application is conducted as well.展开更多
<span style="font-family:Verdana;"><strong>Objective:</strong></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span sty...<span style="font-family:Verdana;"><strong>Objective:</strong></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> To investigate whether a physical therapist trained through the Mechanical Diagnosis and Therapy (MDT) diploma program could guess psychological Patient Reported Outcome Measure (PROM) scores of individuals with low back pain (LBP) by taking patient history and completing a physical evaluation.</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Methods: </span></b></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">Ten participants with LBP completed PROMs immediately before history taking and again after a physical evaluation. PROMs included the Pain Catastrophizing Scale (PCS), Tampa Scale for Kinesiophobia (TSK), Hospital Anxiety and Depression Scale, and Pain Coping Strategy Questionnaire. A physical therapist who completed the MDT diploma program took the patients’ history and completed their physical evaluation. The therapist completed the same PROMs immediately after both history taking and physical evaluation. Correlations between patient and therapist scores were calculated using Spearman’s </span><i><span style="font-family:Verdana;">ρ</span></i><span style="font-family:Verdana;">. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> Statistically significant positive correlations were detected in </span></span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">the PCS (</span><i><span style="font-family:Verdana;">ρ</span></i><span style="font-family:Verdana;"> = 0.65) and TSK (</span><i><span style="font-family:Verdana;">ρ</span></i><span style="font-family:Verdana;"> = 0.78) before history taking, and in the PCS (</span><i><span style="font-family:Verdana;">ρ</span></i><span style="font-family:Verdana;"> = 0.81) and TSK (</span><i><span style="font-family:Verdana;">ρ</span></i><span style="font-family:Verdana;"> = 0.74) after physical evaluation.</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Discussion: </span></b></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">The results are based on one MDT therapist and generalizability of the findings is limited. However, the current preliminary findings justify the need for further studies to explore effective post-graduate training to promote a patient centered approach.</span></span></span>展开更多
Background:Recognizing sport-related concussion(SRC)is challenging and relies heavily on subjective symptom reports.An objective,biological marker could improve recognition and understanding of SRC.There is emerging e...Background:Recognizing sport-related concussion(SRC)is challenging and relies heavily on subjective symptom reports.An objective,biological marker could improve recognition and understanding of SRC.There is emerging evidence that salivary micro-ribonucleic acids(miRNAs)may serve as biomarkers of concussion;however,it remains unclear whether concussion-related miRNAs are impacted by exercise.We sought to determine whether40 miRNAs previously implicated in concussion pathophysiology were affected by participation in a variety of contact and non-contact sports.Our goal was to refine a miRNA-based tool capable of identifying athletes with SRC without the confounding effects of exercise.Methods:This case-control study harmonized data from concussed and non-concussed athletes recruited across 10 sites.Levels of salivary miRNAs within 455 samples from 314 individuals were measured with RNA sequencing.Within-subjects testing was used to identify and exclude miRNAs that changed with either(a)a single episode of exercise(166 samples from 83 individuals)or(b)season-long participation in contact sports(212 samples from 106 individuals).The miRNAs that were not impacted by exercise were interrogated for SRC diagnostic utility using logistic regression(172 samples from 75 concussed and 97 non-concussed individuals).Results:Two miRNAs(miR-532-5p and miR-182-5p)decreased(adjusted p<0.05)after a single episode of exercise,and 1 miRNA(miR-4510)increased only after contact sports participation.Twenty-three miRNAs changed at the end of a contact sports season.Two of these miRNAs(miR-26b-3p and miR-29c-3p)were associated(R>0.50;adjusted p<0.05)with the number of head impacts sustained in a single football practice.Among the 15 miRNAs not confounded by exercise or season-long contact sports participation,11 demonstrated a significant difference(adjusted p<0.05)between concussed and non-concussed participants,and 6 displayed moderate ability(area under curve>0.70)to identify concussion.A single ratio(miR-27a-5p/miR-30a-3p)displayed the highest accuracy(AUC=0.810,sensitivity=82.4%,specificity=73.3%)for differentiating concussed and non-concussed participants.Accuracy did not differ between participants with SRC and non-SRC(z=0.5,p=0.60).Conclusion:Salivary miRNA levels may accurately identify SRC when not confounded by exercise.Refinement of this approach in a large cohort of athletes could eventually lead to a non-invasive,sideline adjunct for SRC assessment.展开更多
One of the predominant effects of PD is alteration of motor skills, which leads to compromised posture and physical balance. Aquatic physical therapy, performed in a heated pool, can serve as one of intervention alter...One of the predominant effects of PD is alteration of motor skills, which leads to compromised posture and physical balance. Aquatic physical therapy, performed in a heated pool, can serve as one of intervention alternatives for PD carriers. Aim: To analyze the effects of the Halliwick Concept hydrotherapy in acquisition of motor skills in Parkinson’s disease (PD) patients. Methods: A clinical, qualitative method was used to evaluate 7 volunteers (59.85 ± 7.92 years of age, both male and female), who were in II and III stages of PD according to the Hoehn & Yar Scale. The participants were evaluated in the start and end of the interventions phase, and then the evaluation was conducted interventions in a heated pool (32?C - 34?C) twice a week, each session lasting approximately 30 minutes, totaling 10 sessions. The Halliwick Principles’ 3-phase 10-point methods were used for acquisition of aquatic motor skills. Results: They indicate an improvement in their ability to float in prone and supine positions (P = 0.04*) and longitudinal rotation in the bipedal position. Conclusion: The activation of motor control improved the motor skills of the participants.展开更多
文摘BACKGROUND Active myofascial trigger points(TrPs)often occur in the upper region of the upper trapezius(UT)muscle.These TrPs can be a significant source of neck,shoulder,and upper back pain and headaches.These TrPs and their related pain and disability can adversely affect an individual’s everyday routine functioning,work-related productivity,and general quality of life.AIM To investigate the effects of instrument assisted soft tissue mobilization(IASTM)vs extracorporeal shock wave therapy(ESWT)on the TrPs of the UT muscle.METHODS A randomized,single-blind,comparative clinical study was conducted at the Medical Center of the Egyptian Railway Station in Cairo.Forty patients(28 females and 12 males),aged between 20-years-old and 40-years-old,with active myofascial TrPs in the UT muscle were randomly assigned to two equal groups(A and B).Group A received IASTM,while group B received ESWT.Each group was treated twice weekly for 2 weeks.Both groups received muscle energy technique for the UT muscle.Patients were evaluated twice(pre-and posttreatment)for pain intensity using the visual analogue scale and for pain pressure threshold(PPT)using a pressure algometer.RESULTS Comparing the pre-and post-treatment mean values for all variables for group A,there were significant differences in pain intensity for TrP1 and TrP2(P=0.0001)and PPT for TrP1(P=0.0002)and TrP2(P=0.0001).Also,for group B,there were significant differences between the pre-and post-treatment pain intensity for TrP1 and TrP2 and PPT for TrP1 and TrP2(P=0.0001).There were no significant differences between the two groups in the post-treatment mean values of pain intensity for TrP1(P=0.9)and TrP2(P=0.76)and PPT for TrP1(P=0.09)and for TrP2(P=0.91).CONCLUSION IASTM and ESWT are effective methods for improving pain and PPT in patients with UT muscle TrPs.There is no significant difference between either treatment method.
基金supported by National Institute of Health grant number R03AG075597(to MMK and TP)Department of Defense Award Number HT9425-23-1-0043(to MMK).
文摘Tauopathies are a group of neurological disorders,including Alzheimer’s disease and frontotemporal dementia,which involve progressive neurodegeneration,cognitive deficits,and aberrant tau protein accumulation.The development of tauopathies cannot currently be stopped or slowed down by treatment measures.Given the significant contribution of tau burden in primary tauopathies and the strong association between pathogenic tau accumulation and cognitive deficits,there has been a lot of interest in creating therapies that can alleviate tau pathology and render neuroprotective effects.Recently,small molecules,immunotherapies,and gene therapy have been used to reduce the pathological tau burden and prevent neurodegeneration in animal models of tauopathies.However,the major pitfall of the current therapeutic approach is the difficulty of drugs and gene-targeting modalities to cross the blood-brain barrier and their unintended side effects.In this review,the current therapeutic strategies used for tauopathies including the use of oligonucleotide-based gene therapy approaches that have shown a promising result for the treatment of tauopathies and Alzheimer’s disease in preclinical animal models,have been discussed.
文摘Background:Assessment and quantification of skeletal muscle within the aging population is vital for diagnosis,treatment,and injury/disease prevention.The clinical availability of assessing muscle quality through diagnostic ultrasound presents an opportunity to be utilized as a screening tool for function-limiting diseases.However,relationships between muscle echogenicity and clinical functional assessments require authoritative analysis.Thus,we aimed to(a) synthesize the literature to assess the relationships between skeletal muscle echogenicity and physical function in older adults(≥60 years),(b) perform pooled analyses of relationships between skeletal muscle echogenicity and physical function,and(c) perform sub-analyses to determine between-muscle relationships.Methods:CINAHL,Embase,MEDLINE,PubMed,and Web of Science databases were systematically searched to identify articles relating skeletal muscle echogenicity to physical function in older adults.Risk-of-bias assessments were conducted along with funnel plot examination.Meta-analyses with and without sub-analyses for individual muscles were performed utilizing Fisher's Z transformation for the most common measures of physical function.Fisher's Z was back-transformed to Pearson's r for interpretation.Results:Fifty-one articles(n=5095,female=~2759,male=~2301,72.5± 5.8 years,mean±SD(1 study did not provide sex descriptors))were extracted for review,with previously unpublished data obtained from the authors of 13 studies.The rectus femoris(n=34) and isometric knee extension strength(n=22) were the most accessed muscle and physical qualities,respectively.The relationship between quadriceps echogenicity and knee extensor strength was moderate(n=2924,r=-0.36(95% confidence interval:-0.38 to-0.32),p <0.001),with all other meta-analyses(grip strength,walking speed,sit-to-stand,timed up-and-go) resulting in slightly weaker correlations(r:-0.34 to-0.23,all p <0.001).Sub-analyses determined minimal differences in predictive ability between muscle groups,although combining muscles(e.g.,rectus femoris+vastus lateralis) often re sulted in stronger correlations with maximal strength.Conclusion:While correlations are modest,the affordable,portable,and noninvasive ultrasonic assessment of muscle quality is a consistent predictor of physical function in older adults.Minimal between-muscle differences suggest that echogenicity estimates of muscle quality are systemic.Therefore,practitioners may be able to scan a single muscle to estimate full-body skeletal muscle quality/composition,while researchers should consider combining multiple muscles to strengthen the model.
基金supported by the Deutsche Forschungsgemeinschaft(DFG,German Research Foundation),No.424778381-TRR 295(to MM)。
文摘Parkinson’s disease(PD)is a complex neurodegenerative disorder characterized by a range of motor symptoms such as bradykinesia,resting tremor,rigidity,and postural instability,as well as non-motor symptoms,such as depression,anxiety,sleep disturbances,and fatigue(Bloem et al.,2021).
文摘Background: low back pain affects many individuals, with 80% classified as non-specific low back pain (NSLBP) due to mechanical rather than structural issues. The link between pelvic alignment and lumbopelvic-hip rotation movement for NSLBP is controversial. Methods: twenty males with NSLBP and 20 healthy males participated. Data collected included static pelvic asymmetry and active lumbopelvic-hip rotation with motion capture system for kinematic analysis. Results: Unpaired T test was used to compare the difference of kinematic parameters between two groups. NSLBP group showed significantly larger angles between the ASIS-PSIS line and the z-axis (p Conclusion: Evaluations focusing on bone structure alone may be inadequate. A more comprehensive approach including functional assessments like muscle strength and range of motion could be beneficial. Integrating lumbopelvic-hip movement patterns and pelvic symmetry into clinical assessments should be considered, as they may be influenced by physical activity.
文摘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.
文摘Attention constitutes a fundamental psychological feature guiding our mental effort toward specific objects, concurrent with processes such as memory, reasoning, and imagination. Visual attention, crucial for selecting surrounding information, often decreases in older adults and patients with cerebrovascular disorders. Effective methods to enhance attention are scarce. Here, we investigated whether color information influences visual attention and brain activity during task performance, utilizing EEG. We examined 13 healthy young adults (seven women and six men;mean age: 21.2 ± 0.58 years) using 19-electrode electroencephalograms to assess the impact of color information on visual attention. The Clinical Assessment for Attention cancellation test was conducted under the black, red, and blue color conditions. Wilcoxon’s signed-rank test was used to assess differences in task performance (task time and error) between conditions. Spearman’s rank correlation was utilized to examine the correlation in power levels between task performance and color conditions. Significant variations in total task errors were observed among color conditions. The black condition exhibited the highest error frequency (0.7 ± 0.9 times), followed by the red condition (0.5 ± 0.8 times), with the lowest error frequency occurring in the blue (0.2 ± 0.4 times) condition (black vs. red: P = 0.03;black vs. blue: P = 0.00;red vs. blue: P = 0.032). No time difference was observed. The black condition showed negative delta and high-gamma correlations in the central electrodes. The red condition revealed positive alpha and low-gamma correlations in the frontal and occipital areas. Although no correlations were observed in the blue condition, it enhanced attentional performance. Positive alpha and low-gamma waves might be crucial for spotting attentional errors in key areas. Our findings provide insights into the effects of color information on visual attention and potential neural correlates associated with attentional processes. In conclusion, our study implies a connection between color information and attentional task performance, with blue font associated with the most accurate performance.
文摘Objective: This study aimed to evaluate the immediate psychological effects of coordination exercises on women in Japan. Methods: The subjects were 17 adult women (height, 160.1 ± 5.1 cm;weight, 54.3 ± 10.5 kg;age, 57.8 ± 8.3 years) living in the community and attending a fitness club. The subjects performed a coordination exercise called Life Kinetik®. The subjects responded to the Two-Dimensional Mood Scale–Short Term before and after performing 30 minutes of Life Kinetik®. The results were tabulated and four psychological states were calculated (i.e., vitality, stability, pleasure, and arousal). The pre- and post-implementation results were statistically analyzed using a corresponding t-test. Results: Significant differences were found in activation and arousal levels, but not in stability and comfort levels. Conclusion: The coordination exercise, Life Kinetik®, was found to be an exercise program with potential psychological benefits, as it could change women’s psychological condition to active and excited states.
基金Supported by The National Science Council of Taiwan,No.NSC100-2410-H-006-025-MY3
文摘Impaired motor and functional activity following stroke often has negative impacts on the patient, the family and society. The available rehabilitation programs for stroke patients are reviewed. Conventional rehabilitation strategies(Bobath, Brunnstrom, proprioception neuromuscular facilitation, motor relearning and function-based principles) are the mainstream tactics in clinical practices. Numerous advanced strategies for sensory-motor functional enhancement, including electrical stimulation, electromyographic biofeedback, constraint-induced movement therapy, robotics-aided systems, virtual reality, intermittent compression, partial body weight supported treadmill training and thermal stimulation, are being developed and incorporated into conventional rehabilitation programs. The concept of combining valuable rehabilitative procedures into "a training package", based on the patient's functional status during different recovery phases after stroke is proposed. Integrated sensorimotor rehabilitation programs with appropriate temporal arrangements might provide great functional benefits for stroke patients.
基金funded in part by National Institute of Child Health and Human Development (NICHD RO1 HD069381) (to CHH and AFK)National Institute of Food and Agriculture, U.S. Department of Agriculture (2011-67001-30101)University of Illinois at Urbana-Champaign and Abbott Nutrition through the Center for Nutrition, Learning, and Memory (ANGC1204) (to CHH and NAK)
文摘Background:Structured vigorous physical activity(VPA)can improve cognitive control in children,but studies relating daily physical activity(PA)to cognitive control have yielded conflicting findings.While objectively measured daily PA summarizes all occurrences of PA within a registered period,a minimum duration of continuous PA is required for registration of a PA bout.Because brief bouts of high-intensity PA can account for a large proportion of children’s daily activity-related energy expenditure,this study assessed whether daily and bouted VPA were selectively related to cognitive control in preadolescents relative to other PA intensities.Methods:A total of 75 children between the ages of 8 and 10 years(49%girls)wore an ActiGraph wGT 3 X+on the hip for 7 days.The acceleration signal from the vertical axis was summarized over 1 s,5 s,and 15 s epochs.Daily and boutecd modercate PA,moderate-to-vigorous PA,and VPA were measured.PA bouts were expressed as the frequency and time spent in 2 different continuous PA bouts,one lasting≥10 s and the other lasting≥30 s at a given intensity.Inhibitory control was assessed using behavioral responses to a modified flanker task(mean reaction time(RTmean)and accuracy).Attentional resource allocation and co gnitive processing speed were measured using the amplitude and latency of the P3 component of event-related brain potentials,respectively.Associations between PA,behavioral indices of inhibitory control,P3 amplitude,and latency were assessed using hierarchical regression models.Results:Daily VPA was not related to RTmean or accuracy on either congruent or incongruent trials.In contrast,more time spent in VPA bouts lasting≥30 s predicted shorter P3 latency across epochs and flanker congruencies(allβ≤-0.24,all p≤0.04).The associations between shorter P3 latency and the time spent in moderate-to-vigorous PA bouts lasting≥30 s were less consistent and largely limited to congruent trials(congruent:β(-0.3 1,-0.34)).No significant associations were observed upon correction for false discovery rate.Conclusion:The pattern of uncorrected associations aligns with the dose-response literature and suggests that brief VPA bouts may yield the greatest benefits to cognitive processing speed in preadolescents.Future studies using measures of brain structure and function are needed to understand the mechanisms linking bouted VPA to neurocognitive function during childhood.
文摘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.
文摘Studies have demonstrated that some cutaneous biophysical properties vary with the part of the body. The results to date of skin conditions in human skin of multiple parts of the body have not yet been well established. In this study, we assessed the differences in the skin’s sebum, moisture, pores, wrinkles, pigmentation, and elasticity of each body part in Korean men in their 20s. A total of 34 healthy men were enrolled. A Skin Diagnosis Meter was used to measure the skin’s surface sebum, moisture, pores, wrinkles, pigmentation, and elasticity of each body part. The sebum content was significantly higher on the face than at other sites. Moisture was significantly high on the feet. Pores were significantly high on the face. Wrinkles were significantly high on the face. Pigmentation was high on the face and neck, but not significantly. Elasticity was significantly high on the hands. In the correlation analysis results, sebum and pore were positively correlated, but sebum and moisture and wrinkle and elasticity were negatively correlated. For nearly the first time, this study resulted in systematic reference values for standardized biophysical measuring methods and body parts reflecting the skin physiology of healthy South Korean men. The results show that skin’s surface sebum, moisture, pores, wrinkles, pigmentation, and elasticity vary with the part of the body.
文摘The aim of the study was to investigate the effect of a hydrotherapy program on FVC, FEV, PEF, RR and SaO<sub>2</sub> on children with Down syndrome over six months and to compare it with a conventional respiratory physiotherapy program. Eighteen children, with Down Syndrome, aged 6 - 11 years (9.53 ± 0.454), divided into two groups of nine, the intervention group (IG), that participated in the hydrotherapy program and the control group (CG) participated in the classical physiotherapy program. We calculated mean values of FVC, FEV, PEF, RR and SaO2 before and after six months intervention for both groups. There was a statistically significant improvement in all factors for both groups. However, were statistically more significant for the intervention group (IG). Based on a specific protocol of intervention in the water and at the same time with a group of children who participated in a similar program of classical respiratory physiotherapy, it was found to be statistically more important than the second group in improving respiratory function. We recommend the use of hydrotherapy as a complementary therapy that should be part of the weekly program of these children in addition to the existing treatments they attend.
基金Ministry of Health of the Czech Republic(University Hospital Brno,65269705),No.NU21J-09-00004.
文摘BACKGROUND The prevalence of chronic obstructive pulmonary disease(COPD)is increasing worldwide,and at the same time it is associated with increased mortality and reduced quality of life.Efforts to build sustainable rehabilitation approaches to COPD treatment and prevention are crucial.The system of long-term pulmonary rehabilitation care is insufficient.The main reasons for the absence of these outpatient programs are the lack of experience,the lack of interest of insurance companies in secondary prevention programs,and the lack of healthcare facilities in large geographical areas.The possibility of at-home pulmonary rehabilitation models(telemonitoring and telecoaching)could solve this problem.CASE SUMMARY A 71-year-old man with severe COPD,Global Initiative for Obstructive Lung Diseases stage 3 underwent an 8-wk remotely monitored inspiratory muscle training with a device based on the test of incremental respiratory endurance method.Spirometry,body plethysmography,test of incremental respiratory endurance examination,6-min walking test,body mass index,airflow obstruction,dyspnea,exercise capacity index,and subjective perception of dyspnea were performed as part of the initial and final examination.The patient performed training at home,and the physiotherapist monitored the patient remotely through a web application that allowed the physiotherapist to evaluate all training parameters in real-time and respond to any problems.After 8 wk of home training,there was a significant increase in all monitored values:maximal inspiratory pressure,a novel parameter sustained maximal inspiratory pressure,forced expiratory volume in 1 s,total lung capacity,forced vital capacity,peak expiratory flow,and inspiratory capacity.There was also an improvement in the perception of dyspnea according to the COPD Assessment Test and a modified Medical Research Council Breathlessness Scale,an increase in exercise tolerance according to the 6-min walking test,and a decrease in the exercise capacity index as a predictor of prognosis.CONCLUSION Respiratory telerehabilitation was greatly beneficial in a cooperative patient with COPD and may represent an alternative therapeutic approach to the increasing incidence of all lung diseases.
文摘The present study was designed to evaluate the effects of hippotherapy on standing balance in patients with incomplete cervical spinal cord injuries. Ten patients (8 men and 2 women) who were diagnosed with cervical levels of injury between 3 and 6, and D according to the ASIA Impairment Scale. All patients were tested by the physiotherapists prior to and after hippotherapy treatment. Standing balance was measured using the Interactive Balance System (IBS). The weight distribution index was significantly increased in application of hippotherapy compared with control groups in patients with a neurologic level of cervical 3 and 4, and with Brown-Sequard syndrome, respectively. However, most of the patients exhibited no significant changes in the standing balance index, such as F1, F2-4, F5-6, F7-8, and SI scores, after hippotherapy. These results suggest that hippotherapy did not have a significant effect on the standing balance of patients with incomplete cervical spinal cord injuries.
文摘We examined the changes in numerous skin conditions before and after the ap-plication of interferential current therapy to various regions of healthy male bodies. In this study, we assessed the differences in the skin’s sebum, moisture levels, pores, wrinkles, pigmentation, and elasticity on the shoulders, lower back, and the knees of Korean males in their 20s. A total of 30 healthy males were in-cluded in the study. We used a skin diagnosis meter as a device for measuring the state of the skin. A statistical difference was found when comparing the pre- and post-measurement values in regards to the moisture levels, wrinkles, and pig-mentation. In the correlation analysis results, the sebum and pigmentation, moisture levels and wrinkles, moisture levels and pigmentation, and moisture levels and elasticity were all positively correlated, respectively. The results of this study partially suggest that a change in skin condition is associated with ex-ternal stimulation. The study also found that the effects of the application of in-terferential current therapy on the various skin conditions may differ depending on the region of the body that the application is conducted as well.
文摘<span style="font-family:Verdana;"><strong>Objective:</strong></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> To investigate whether a physical therapist trained through the Mechanical Diagnosis and Therapy (MDT) diploma program could guess psychological Patient Reported Outcome Measure (PROM) scores of individuals with low back pain (LBP) by taking patient history and completing a physical evaluation.</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Methods: </span></b></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">Ten participants with LBP completed PROMs immediately before history taking and again after a physical evaluation. PROMs included the Pain Catastrophizing Scale (PCS), Tampa Scale for Kinesiophobia (TSK), Hospital Anxiety and Depression Scale, and Pain Coping Strategy Questionnaire. A physical therapist who completed the MDT diploma program took the patients’ history and completed their physical evaluation. The therapist completed the same PROMs immediately after both history taking and physical evaluation. Correlations between patient and therapist scores were calculated using Spearman’s </span><i><span style="font-family:Verdana;">ρ</span></i><span style="font-family:Verdana;">. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> Statistically significant positive correlations were detected in </span></span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">the PCS (</span><i><span style="font-family:Verdana;">ρ</span></i><span style="font-family:Verdana;"> = 0.65) and TSK (</span><i><span style="font-family:Verdana;">ρ</span></i><span style="font-family:Verdana;"> = 0.78) before history taking, and in the PCS (</span><i><span style="font-family:Verdana;">ρ</span></i><span style="font-family:Verdana;"> = 0.81) and TSK (</span><i><span style="font-family:Verdana;">ρ</span></i><span style="font-family:Verdana;"> = 0.74) after physical evaluation.</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Discussion: </span></b></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">The results are based on one MDT therapist and generalizability of the findings is limited. However, the current preliminary findings justify the need for further studies to explore effective post-graduate training to promote a patient centered approach.</span></span></span>
基金supported by a sponsored research agreement between Quadrant Biosciences and the Penn State College of Medicine to ACLsupported by the National Center for Advancing Translational Sciences(Grant KL2 TR002015,Grant UL1 TR002014)。
文摘Background:Recognizing sport-related concussion(SRC)is challenging and relies heavily on subjective symptom reports.An objective,biological marker could improve recognition and understanding of SRC.There is emerging evidence that salivary micro-ribonucleic acids(miRNAs)may serve as biomarkers of concussion;however,it remains unclear whether concussion-related miRNAs are impacted by exercise.We sought to determine whether40 miRNAs previously implicated in concussion pathophysiology were affected by participation in a variety of contact and non-contact sports.Our goal was to refine a miRNA-based tool capable of identifying athletes with SRC without the confounding effects of exercise.Methods:This case-control study harmonized data from concussed and non-concussed athletes recruited across 10 sites.Levels of salivary miRNAs within 455 samples from 314 individuals were measured with RNA sequencing.Within-subjects testing was used to identify and exclude miRNAs that changed with either(a)a single episode of exercise(166 samples from 83 individuals)or(b)season-long participation in contact sports(212 samples from 106 individuals).The miRNAs that were not impacted by exercise were interrogated for SRC diagnostic utility using logistic regression(172 samples from 75 concussed and 97 non-concussed individuals).Results:Two miRNAs(miR-532-5p and miR-182-5p)decreased(adjusted p<0.05)after a single episode of exercise,and 1 miRNA(miR-4510)increased only after contact sports participation.Twenty-three miRNAs changed at the end of a contact sports season.Two of these miRNAs(miR-26b-3p and miR-29c-3p)were associated(R>0.50;adjusted p<0.05)with the number of head impacts sustained in a single football practice.Among the 15 miRNAs not confounded by exercise or season-long contact sports participation,11 demonstrated a significant difference(adjusted p<0.05)between concussed and non-concussed participants,and 6 displayed moderate ability(area under curve>0.70)to identify concussion.A single ratio(miR-27a-5p/miR-30a-3p)displayed the highest accuracy(AUC=0.810,sensitivity=82.4%,specificity=73.3%)for differentiating concussed and non-concussed participants.Accuracy did not differ between participants with SRC and non-SRC(z=0.5,p=0.60).Conclusion:Salivary miRNA levels may accurately identify SRC when not confounded by exercise.Refinement of this approach in a large cohort of athletes could eventually lead to a non-invasive,sideline adjunct for SRC assessment.
文摘One of the predominant effects of PD is alteration of motor skills, which leads to compromised posture and physical balance. Aquatic physical therapy, performed in a heated pool, can serve as one of intervention alternatives for PD carriers. Aim: To analyze the effects of the Halliwick Concept hydrotherapy in acquisition of motor skills in Parkinson’s disease (PD) patients. Methods: A clinical, qualitative method was used to evaluate 7 volunteers (59.85 ± 7.92 years of age, both male and female), who were in II and III stages of PD according to the Hoehn & Yar Scale. The participants were evaluated in the start and end of the interventions phase, and then the evaluation was conducted interventions in a heated pool (32?C - 34?C) twice a week, each session lasting approximately 30 minutes, totaling 10 sessions. The Halliwick Principles’ 3-phase 10-point methods were used for acquisition of aquatic motor skills. Results: They indicate an improvement in their ability to float in prone and supine positions (P = 0.04*) and longitudinal rotation in the bipedal position. Conclusion: The activation of motor control improved the motor skills of the participants.