Effects of home-based neurostimulation on outcomes after stroke: a systematic review and meta-analysis.

BACKGROUND: Home-based rehabilitation is a cost-effective means of making services available for patients. The aim of this study is to determine the evidence in the literature on the effects of home-based neurostimulation in patients with stroke. METHOD: We searched PubMED, Embase, Web of Science, Scopus, and CENTRAL for randomized controlled trials on the subject matter using keywords such as stroke, electrical stimulation and transcranial direct current stimulation. Information on participants' characteristics and mean scores on the outcomes of interest were extracted. Risks of bias and methodological quality of the included studies were assessed using Cochrane Risks of bias tool and PEDro scale respectively. The data was analyzed using both narrative and quantitative syntheses. In the quantitative synthesis, meta-analysis was carried out using random effect model analysis. RESULT: The results showed that, home-based neurostimulation is superior to the control at improving upper limb muscle strength (SMD = 0.72, 95% CI = 0.08 to 1.32, p = 0.03), functional mobility (SMD = -0.39, 95% CI = -0.65 to 0.14, p = 0.003) and walking endurance (SMD = 0.33, 95% CI = 0.08 to 0.59, p = 0.01) post intervention; and upper limb motor function (SMD = 0.9, 95% CI = 0.10 to 1.70, p = 0.03), functional mobility (SMD = -0.30, 95% CI = -0.56 to -0.05, p = 0.02) and walking endurance (SMD = 0.33, 95% CI = 0.08 to 0.59, p = 0.01) at follow-up. CONCLUSIONS: Home-based neurostimulation can be used to improve upper and lower limb function after stroke.

Effect of exoskeleton devices on work-related musculoskeletal disorders (WMSDs) among healthcare workers: a scoping review.

Work-related musculoskeletal disorders (WMSDs) have been a concern among healthcare workers, impacting their well-being and patient safety. Exoskeleton technologies have gained a growing interest as an ergonomic intervention for WMSDs. This scoping review explores exoskeleton effects on WMSDs among healthcare workers. A comprehensive search identified 9 eligible studies published in English between 2013 and 2023. Exoskeletons showed promising effects on objective measures, selectively reducing muscle activation in a task-dependent manner. They also improved force exertion and body posture parameters in specific scenarios. Subjectively, exoskeletons reduced discomfort, pain, fatigue, and received positive perceptions with acceptable usability. However, the impact on perceived exertion varied with tasks. While exoskeletons have shown potential in enhancing healthcare workers' well-being and performance, more work is required to refine their effectiveness and maximise benefits in different healthcare settings. The study revealed the need for standardised methodologies, consideration of participant characteristics, and optimisation of exoskeleton design.

This scoping review investigated the effects of exoskeleton technologies on WMSDs among healthcare workers. The review identified 9 studies published between 2013 and 2023. Overall, exoskeletons showed promise in reducing muscle activation, improving force exertion, posture, and subjective measures. Standardised methodologies and design optimisation are needed to maximise benefits.

Reliability, Concurrent Validity, and Minimal Detectable Change of Timed Up and Go Obstacle Test in People With Stroke.

OBJECTIVE: The aims of this study were to investigate the psychometric property of the timed Up and Go Obstacle (TUGO) test in people with stroke. DESIGN: Cross-sectional design. SETTING: University based neurorehabilitation laboratory. PARTICIPANTS: Twenty-eight people with stroke and 30 healthy older adults. INTERVENTION: Not Applicable. OUTCOME MEASURES: The TUGO (obstacle heights: 0, 5, 17 cm) test completion times, Fugl-Meyer Assessment (FMA) score, ankle dorsiflexor and plantarflexor muscle strength, Berg Balance Scale (BBS) score, Narrow Corridor Walking Test (NCWT) completion time, timed Up and Go (TUG) test completion time, and Community Integrated Measure. RESULTS: Excellent inter-rater (intraclass correlation coefficient [ICC]=0.999-1.000) and test-retest reliabilities (ICC=0.917-0.975) were found for TUGO test completion times for all obstacle heights. The TUGO test completion times for all obstacle heights were significantly correlated with NCWT and TUG test completion times (r=0.817-0.912). Only TUGO test completion times for 0 and 5 cm obstacle heights showed significant correlations with BBS scores (r=-0.518 to -0.534), while the TUGO test completion time for the 17 cm obstacle height correlated significantly with FMA scores. The minimal detectable change and optimal cut-off values for TUGO test completion times for the 0, 5, and 17 cm obstacle heights were 2.54, 3.60, and 3.07 s, and 14.69, 14.76, and 16.10 s, respectively. CONCLUSION: The TUGO test is a reliable, valid, and easy-to-administer clinical measure to discriminate between people with stroke and healthy older adults.

The association between satisfaction with life and anxiety symptoms among Chinese elderly: a moderated mediation analysis.

BACKGROUND: Previous studies have suggested that certain personal psychological variables (e.g., life satisfaction and cognitive function) and physical variables (e.g., body mass index [BMI]) are significantly associated with individuals' anxiety symptoms. However, relevant research on elderly is lagging and no studies have yet investigated the combined impact of these variables on anxiety. Thus, we conducted the present study to investigate the potential moderator role of BMI and the potential mediator role of cognitive function underlying the relationship between life satisfaction and anxiety symptoms in Chinese elderly based in Hong Kong. METHODS: Sixty-seven elderly aged 65 years old and above were recruited from the local elderly community centres in this pilot study. Each participant underwent a systematic evaluation using the Satisfaction with Life Scale (SWLS), Hong Kong Version of the Montreal Cognitive Assessment (HK-MoCA), and the Hamilton Anxiety Rating Scale (HAM-A) and were measured for their body weight and height. Regression analysis using the bootstrapping method was employed to test the hypothesized moderated mediation model. RESULTS: Our findings demonstrated the overall model accounted for 23.05% of the variance in scores of HAM-A (F (8, 57) = 2.134, p = 0.047) in Chinese elderly. There was a significant association between life satisfaction and anxiety symptoms (p = 0.031), indicating that individuals with higher life satisfaction were associated with less anxiety symptoms. Moreover, this relationship was positively moderated by BMI (b = 0.066, 95% CI [0.004, 0.128]), especially in Chinese elderly with BMI at a lower level (b = -0.571, 95% CI [-0.919, -0.224]) and an average level (b = -0.242, 95% CI [-0.460, -0.023]). No significant mediator role was detected for cognitive function (b = -0.006, 95% CI [-0.047, 0.044]) in our model. CONCLUSIONS: Our findings suggest that increased life satisfaction can reduce anxiety symptoms among Chinese elderly as their BMI decreases (when BMI ranged between "mean - 1SD" and "mean" of the population). The significant interaction between psychological and physical factors underlying anxiety symptoms found in this study, presents a promising opportunity for translation into multi-level psychological and physical interventions for the management of anxiety in ageing patients during clinical practice.

Prevalence, associated factors and predictors of post stroke pneumonia in a Nigerian population: A retrospective study.

OBJECTIVES: Stroke can trigger an immune response that can raise the risk of infection, alter tracheal epithelium, reduce pulmonary clearance and impair secretions drainage capacity. Infection, altered tracheal epithelium, reduced pulmonary clearance, impaired secretions drainage capacity and aspiration can cause pneumonia after stroke. The aim of this study is to find out the prevalence of post stroke pneumonia in a Nigerian population and factors that are associated with it. MATERIALS AND METHOD: Study data was extracted from the case files of patients with stroke who were managed between 1st January, 2011 and 1st February, 2021 in the study setting. RESULTS: The result showed that, there was a record of only 591 patients with stroke (mean age, 62.78 ± 14.86 years) who were managed in the two hospitals during the period of the study. Out of this number, only 102 (17.3 %) had pneumonia. Presence of the pneumonia was only significantly (p < 0.05) associated with sex, type of stroke, lower limb muscle power, and outcome (died or alive). However, only those with ischaemic stroke are less likely to have pneumonia (Odds ratio=  0.467; CI: 0.275 to 0.791, p=  0.005), and patients who survived the stroke and are alive are less likely to develop pneumonia (Odds ratio=  0.150; CI: 0.092 to 0.245, p < 0.001). CONCLUSIONS: Pneumonia occurs to a large extent after stroke. Therefore, it is important measures are taken to prevent it or complications arising from it especially in those with a hemorrhagic stroke.

Bilateral Transcutaneous Electrical Nerve Stimulation Improves Upper Limb Motor Recovery in Stroke: A Randomized Controlled Trial.

BACKGROUND: Recent evidence has shown bilateral transcutaneous electrical nerve stimulation (Bi-TENS) combined with task-oriented training (TOT) to be superior to unilateral transcutaneous electrical nerve stimulation (Uni-TENS)+TOT in improving lower limb motor functioning following stroke. However, no research explored the effect of Bi-TENS+TOT in improving upper limb motor recovery. This study aimed to compare Bi-TENS+TOT with Uni-TENS+TOT, Placebo transcutaneous electrical nerve stimulation (Placebo-TENS)+TOT, and no treatment (Control) groups in upper limb motor recovery. METHODS: This is a 4-group parallel design. One hundred and twenty subjects were given either Bi-TENS+TOT, Uni-TENS+TOT, Placebo-TENS+TOT, or Control without treatment in this randomized controlled trial. Twenty 60-minute sessions were administered 3× per week for 7 weeks. The outcome measure was the Fugl-Meyer Assessment of Upper Extremity, which was assessed at baseline, after 10 sessions (mid-intervention) and 20 sessions (post-intervention) of intervention, and at 1- and 3-month follow-up. RESULTS: Patients in the Bi-TENS+TOT group showed greater improvement in the Fugl-Meyer Assessment of Upper Extremity scores than Uni-TENS+TOT (mean difference, 2.13; P=0.004), Placebo-TENS+TOT (mean difference, 2.63; P<0.001), and Control groups (mean difference, 3.11; P<0.001) at post-intervention. Both Bi-TENS+TOT (mean difference, 3.39; P<0.001) and Uni-TENS+TOT (mean difference, 1.26; P=0.018) showed significant within-group improvement in the Fugl-Meyer Assessment of Upper Extremity scores. Patients in the Bi-TENS+TOT group showed earlier within-group improvement in the Fugl-Meyer Assessment of Upper Extremity scores at mid-intervention than Uni-TENS+TOT. These improvements were maintained at the 3-month follow-up assessment. CONCLUSIONS: Bi-TENS combined with TOT is an effective therapy for improving upper limb motor recovery following stroke. REGISTRATION: URL: https://www. CLINICALTRIALS: gov; Unique identifier: NCT03112473.

Translation and initial validation of Chinese (Cantonese) version of Modified Fatigue Impact Scale (MFIS-C) in people with stroke.

PURPOSE: To translate and culturally adapt the Modified Fatigue Impact Scale (MFIS) to Chinese version, and to psychometrically test it in stroke population. METHODS: This study consisted of 2 phases. In phase one, we translated and culturally adopted the original English version of MFIS into Chinese (Cantonese) (MFIS-C). In phase two, the MFIS was psychometrically tested using a cohort of community-dwelling people with stroke (n = 101) and healthy control (n = 50). Among the stroke participants, 52 of them were reassessed after a 1-week interval. RESULTS: The MFIS-C demonstrated satisfactory content validity and good to excellent internal consistency. The overall MFIS-C and its subscales have good test-retest reliability. The MDC95 were 14.86, 7.49, and 9.70 for the overall MFIS-C physical, cognitive and psychosocial subscales, respectively. The overall MFIS-C and its 2 subscales have significant weak to moderate negative correlations with the Community Integration Measure and the 12-item Short Form Health Survey Version 2. Our findings revealed that the people with chronic stroke living in Hong Kong were reported to have high level of fatigue. CONCLUSION: The MFIS-C is a reliable and valid measure for assessing the level of fatigue in people with stroke.

The effect of aquatic High Intensity Interval Training on cardiometabolic and physical health markers in women: A systematic review and meta-analysis.

BACKGROUND: We performed a meta-analysis of randomized controlled trials (RCTs) assessing the effect of Aquatic High Intensity Interval Training (AHIIT) on cardiometabolic and physical health markers in women. METHODS: Systematic search used 7 databases (MEDLINE, PubMed, SPORTDiscus, Cochrane, Embase, CINAL complete, PsycINFO). The Physiotherapy Evidence Database (PEDro) score was used to evaluate the methodological quality of the studies. Clinical trials compared AHIIT with a control group that receive no exercise training. We integrated randomized controlled trials published in English, and participants were women aged ≥18 years. The outcome of interest was the change in cardiometabolic and physical health markers. RESULTS: Among 242 articles screened, 18 articles (13 trials) were included in this meta-analysis comparing AHIIT (n = 261) with a control group (n = 215). The median PEDro score was 5.5 out of 10 (range, 4-8). AHIIT significantly improved peak oxygen uptake (Hedges' g 0.610; 95% CI 0.277-0.943; P < 0.001), reduced resting heart rate (Hedges' g -0.495; 95% CI -0.866 to -0.124; P < 0.05), as well as chair to stand test. (Hedges' g 0.548; 95% CI 0.019 to 1.077; P < 0.05). CONCLUSION: AHIIT has a moderate effect in improving cardiometabolic and physical health markers in women.

Non-pharmacological interventions for fatigue in older adults: a systematic review and meta-analysis.

BACKGROUND: Non-pharmacological interventions are widely used to treat fatigue in clients with specific diseases but the findings may not be applicable to older adults experiencing fatigue, which also relates to the physiological changes of ageing. Non-pharmacological interventions for fatigue alleviation in older adults have not been reviewed and meta-analysed. OBJECTIVE: To evaluate the immediate and long-term effects of non-pharmacological interventions on fatigue in community-dwelling older adults. METHODS: Randomised controlled trials published from 2008 to May 2018 were searched in CINAHL, Cochrane Library, Embase, Medline, PsycINFO, PubMed and Web of Science databases. The reference lists of the publications, forward citation and clinical trial registries were also reviewed. Relevant data were extracted and meta-analysis was conducted using Cochrane Review Manager 5.3. RESULTS: Eight studies, with a total of 1093 participants, were identified. Non-pharmacological interventions included mindfulness meditation, a behavioural lifestyle programme, muscle relaxation, pet insect-assisted therapy, yoga, Tai Chi and cognitive behavioural therapy. Non-pharmacological interventions elicited significant immediate positive effects on fatigue (SMD: -0.40, 95% CI -0.62 to -0.18), although there was no lasting effect. Both physical and cognitive/mental interventions effectively alleviated fatigue. CONCLUSION: Non-pharmacological interventions appear to be effective in alleviating fatigue at immediate post-intervention in community-dwelling older adults. More studies with robust designs and adequate sample sizes are needed in the future.

Neuro-physiological correlates of sluggish cognitive tempo (SCT) symptoms in school-aged children.

This study was the first to examine the relationship between neurophysiological abnormalities and symptoms of sluggish cognitive tempo (SCT) in children. Thirty children aged 6-12 years were recruited. Their heart rate variability (HRV) was measured under resting and warning signal conditions. At rest, the children's SCT symptoms were found to be positively associated with their HRV (indicated by the standard deviation of the Poincaré plot along the line of identity in normalized units, SD2 nu). SCT symptoms were also positively associated with a change in SD2 nu between the resting and warning signal conditions. When controlling for symptoms of attention deficit hyperactivity disorder, the children's SCT symptoms were significantly predicted by their resting SD2 nu and by changes in SD2 nu and the percentage of successive RR intervals that differ by more than 50 ms (pNN50) between the resting and warning signal conditions. These findings suggest that the readiness and regulation of the autonomic nervous system may contribute to symptoms of SCT. Specifically, disturbances in the internal neurophysiological system may explain the difficulties experienced by children when exposed to environmental stimulation. These initial data support the hypothesis that SCT results from deficiencies in arousal.

Decreasing Fear of Falling in Chronic Stroke Survivors Through Cognitive Behavior Therapy and Task-Oriented Training.

Background and Purpose- Research has shown that balance training is effective for reducing the fear of falling in individuals with a history of stroke. In this study, we evaluated (1) whether cognitive behavior therapy could augment the beneficial effects of task-oriented balance training (TOBT) in reducing the fear of falling in chronic stroke survivors and (2) whether it could, in turn, reduce fear-avoidance behavior and improve related health outcomes. Methods- Eighty-nine cognitively intact subjects with mildly impaired balance ability were randomized into the following 2 groups that underwent 90-minutes interventions 2 days per week for 8 weeks: (1) cognitive behavior therapy + TOBT or (2) general health education + TOBT (control). The primary outcome was the fear of falling, and the secondary outcomes were fear-avoidance behavior, balance, fall risk, independent daily living, community integration, and health-related quality of life. The outcomes were assessed at baseline, after 4 and 8 weeks of intervention, and 3 and 12 months after completing the intervention. Results- Eighty-two subjects completed the intervention and follow-up assessments. From postintervention to 12 months after completing the intervention, the cognitive behavior therapy + TOBT participants reported greater reduction in the fear of falling and fear-avoidance behavior and greater improvements in balance and independent daily living than the general health education + TOBT participants. Conclusions- Cognitive behavior therapy should be considered as an adjuvant therapy to standard physiotherapy for cognitively intact individuals with a history of stroke. Clinical Trial Registration- URL: https://clinicaltrials.gov. Unique identifier: NCT02937532.

Cutoff Score of the Lower-Extremity Motor Subscale of Fugl-Meyer Assessment in Chronic Stroke Survivors: A Cross-Sectional Study.

OBJECTIVE: To derive an optimal cutoff score for the lower-extremity motor subscale of the Fugl-Meyer Assessment (FMA) to differentiate stroke survivors with high mobility function from those with low mobility function using a data-driven approach. DESIGN: Cross-sectional study. SETTING: University-based clinical research laboratory. PARTICIPANTS: Chronic stroke survivors (N=80) recruited from local self-help groups. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Lower-extremity motor subscale of Fugl-Meyer Assessment (FMA-LE), Berg Balance Scale, 5 times sit-to-stand test, comfortable walking speed, 6-minute walk test, and timed Up and Go test. RESULTS: K-mean clustering analysis classified 42 stroke survivors in the high mobility function group. The receiver operating characteristic curve showed that FMA-LE can differentiate stroke survivors based on their mobility level (area under the curve, 0.85). An FMA-LE score of 21 of 34 was the best cutoff score (sensitivity, 0.87; specificity: 0.81). CONCLUSIONS: An FMA-LE score of 21 or higher could indicate a high level of mobility function in chronic stroke survivors.

Cognitive behavioural therapy for fear of falling and balance among older people: a systematic review and meta-analysis.

BACKGROUND: fear of falling is prevalent among older people and associated with various health outcomes. A growing number of studies have examined the effects of interventions designed to reduce the fear of falling and improve balance among older people, yet our current understanding is restricted to physiological interventions. Psychological interventions such as cognitive behavioural therapy (CBT) have not been reviewed and meta-analysed. OBJECTIVE: to perform a systematic review and meta-analysis evaluating the effects of CBT on reducing fear of falling and enhancing balance in community-dwelling older people. METHOD: randomised controlled trials (RCTs) addressing fear of falling and balance were identified through searches of six electronic databases, concurrent registered clinical trials, forward citation and reference lists of three previous systematic reviews. RESULTS: a total of six trials involving 1,626 participants were identified. Four studies used group-based interventions and two adopted individual intervention. Intervention period ranged from 4 to 20 weeks, and the number and duration of face-to-face contact varied. Core components of the CBT intervention included cognitive restructuring, personal goal setting and promotion of physical activities. The risk of bias was low across the included studies. Our analysis suggests that CBT interventions have significant immediate and retention effects up to 12 months on reducing fear of falling, and 6 months post-intervention effect on enhancing balance. CONCLUSIONS: CBT appears to be effective in reducing fear of falling and improving balance among older people. Future researches to investigate the use of CBT on reducing fear of falling and improving balance are warranted.

The sitting and rising test for assessing people with chronic stroke.

[Purpose] To investigate the inter-rater and test-retest reliability of the sitting-rising test (SRT), the correlations of sitting-rising test scores with measures of strength, balance, community integration and quality of life, as well as the cut-off score which best discriminates people with chronic stroke from healthy older adults were investigated. [Subjects and Methods] Subjects with chronic stroke (n=30) and healthy older adults (n=30) were recruited. The study had a cross-sectional design, and was carried out in a university rehabilitation laboratory. Sitting-rising test performance was scored on two occasions. Other measurements included ankle dorsiflexor and plantarflexor strength, the Fugl-Meyer assessment, the Berg Balance Scale, the timed up and go test, the five times sit-to-stand test, the limits of stability test, and measures of quality of health and community integration. [Results] Sitting-rising test scores demonstrated good to excellent inter-rater and test-retest reliabilities (ICC=0.679 to 0.967). Sitting-rising test scores correlated significantly with ankle strength, but not with other test results. The sitting-rising test showed good sensitivity and specificity. A cut-off score of 7.8 best distinguished healthy older adults from stroke subjects. [Conclusions] The sitting-rising test is a reliable and sensitive test for assessing the quality of sitting and rising movements. Further studies with a larger sample are required to investigate the test's validity.

Comparison between smartphone pedometer applications and traditional pedometers for improving physical activity and body mass index in community-dwelling older adults.

[Purpose] The effectiveness of a smartphone pedometer application was compared with that of a traditional pedometer for improving the physical activity and weight status of community-dwelling older adults. [Subjects and Methods] This study had a nonequivalent pretest-posttest control group design. Ninety-seven older adults (mean age ± SD, 60.1 ± 5.5 years) joined the smartphone pedometer group and underwent a 2-week walking intervention based on a smartphone pedometer application. Fifty-four older adults (mean age ± SD, 65.3 ± 8.7 years) joined the traditional pedometer group and underwent a 2-week walking intervention based on a traditional pedometer. The participants' physical activity was evaluated using the International Physical Activity Questionnaire-Short Form, and their weight status was quantified by calculating the body mass index. The daily pedometer count was also documented. [Results] No significant time, group, or time-by-group interaction effects were found for any of the outcome variables. However, trends of improvement in physical activity and body mass index were seen only in the smartphone pedometer group. [Conclusion] A smartphone pedometer application might be more favorable than a traditional pedometer in improving physical activity and body mass index in community-dwelling older adults. However, further experimental studies are necessary to confirm the results.

Effects of Ving Tsun Chinese martial art training on musculoskeletal health, balance performance, and self-efficacy in community-dwelling older adults.

[Purpose] The aim of this study was to investigate the effects of Ving Tsun (VT) Chinese martial art training on radial bone strength, upper- and lower-limb muscular strength, shoulder joint mobility, balance performance, and self-efficacy in elderly participants. [Subjects and Methods] Twelve seniors voluntarily joined the VT training group, and twenty-seven seniors voluntarily joined the control group. The VT group received VT training for three months, while the control group received no training. The bone strength of the distal radius was assessed using an ultrasound bone sonometer. Muscular strength in the limbs was evaluated using a Jamar handgrip dynamometer and the five times sit-to-stand test. Shoulder joint mobility was examined using a goniometer. Balance performance and self-efficacy were evaluated using the Berg Balance Scale and the Chinese version of the Activities-specific Balance Confidence Scale, respectively. [Results] The results revealed a nonsignificant group-by-time interaction effect, group effect, and time effect for all outcome variables. However, general trends of maintenance or improvement in all outcome parameters were observed to a greater extent in the VT group than in the control group. [Conclusion] VT training might be a potential fall-prevention exercise that can be used to maintain general physique, balance, and confidence in the elderly population. A further randomized controlled trial is needed to confirm this postulation.

Effect of arm position and foot placement on the five times sit-to-stand test completion times of female adults older than 50 years of age.

The five times-sit-to stand test (FTSTS) is a clinical test which is commonly used to assessed the functional muscle strength of the lower limbs of older adults. The aim of this study was to examine the effect of different arm positions and foot placements on the FTSTS completion times of older female adults. [Subjects and Methods] Twenty-nine healthy female subjects, aged 63.1±5.3 years participated in this cross-sectional study. The times required to complete the FTSTS with 3 different arm positions (hands on thighs, arms crossed over chest, and an augmented arm position with the arms extended forward) and 2 foot placements (neutral and posterior) were recorded. The interaction effect and main effect of arm positions and foot placements were examined using a 3 (arm position) × 2 (foot placement) two-way repeated measures analysis of variance (ANOVA). [Results] There was no interaction effect among the 3 arm positions in the 2 foot placements. A significant main effect was identified for foot placement, but not arm position. Posterior foot placement led to a shorter FTSTS time compared to that of normal foot placement. [Conclusion] With the same arm position, FTSTS completion times with posterior foot placement tended to be shorter. Therefore, the standard foot placement should be used for FTSTS administration.

Changes in heart-rate variability of survivors of nasopharyngeal cancer during Tai Chi Qigong practice.

[Purpose] To explore the changes in heart-rate variability (HRV) of survivors of nasopharyngeal cancer (NPC) before, during, and after a Tai Chi (TC) Qigong exercise. [Subjects and Methods] Eleven survivors of NPC participated voluntarily in the study. The heart rate of each participant was measured continuously for 1 minute before the TC Qigong intervention, during the 5-minute TC Qigong intervention, and for 1 minute after the intervention, using a Polar heart-rate monitor. Spectral HRV was expressed in terms of normalised low frequency (LF) power, normalised high frequency (HF) power, and the low frequency/high frequency (LF/HF) power ratio. [Results] Both the LF-power and the HF-power components had significant time effects. However, the time effect of the LF/HF power ratio was not significant. Post hoc contrast analysis revealed a significant decrease in LF power and a concomitant increase in HF power during the 4th minute and 5th minute of the TC Qigong exercise. [Conclusion] Five minutes of TC Qigong exercise was found to improve HRV by increasing HF power and decreasing LF power, but these effects were transient. TC Qigong might be an appropriate exercise for improving the ANS function and psychological and cardiac health of survivors of NPC.

Relationships of post-stroke fatigue with mobility, recovery, performance, and participation-related outcomes: a systematic review and meta-analysis.

Background: Effective post-stroke mobility, recovery, performance, and participation are key goals for stroke survivors. However, these outcomes may be hindered by post-stroke fatigue (PSF), which can affect numerous aspects of post-stroke mobility, recovery, performance, functioning, community participation, and return to work. This review aimed to assess the scientific evidence on the relationship between PSF and mobility function, functional recovery, functional performance, and participation-related outcomes among stroke survivors. Method: A comprehensive search of Cochrane Central, PubMed, Embase, and Web of Science (WoS) databases was conducted from inception to December 2023. Observational, cross-sectional, and longitudinal studies were included. The methodological quality of the included studies was assessed using the National Institute of Health's quality assessment tool, while the risk of bias was assessed using the Quality in Prognostic Studies tool. A total of 28 studies (n = 2,495 participants, 1,626 men, mean age ranging from 52.5 ± 9.5 to 71.1 ± 9.9 years) were included. The data analysis was conducted using narrative and quantitative synthesis. Fixed and random effects meta-analyses were conducted to explore the relationships between PSF and relevant outcomes. Results: Chronic PSF was found to have significant negative correlations with mobility (meta r = -0.106, p < 0.001), balance performance (meta r = -0.172; 95%; p = 0.004), and quality of life (meta r = -0.647; p < 0.001). It also showed significant positive correlations with stroke impairment (meta r = 0.144, p < 0.001) and disability (meta r = 0.480, p < 0.001). Additionally, exertion/acute PSF had significantly negative correlations with walking economy (meta r = -0.627, p < 0.001) and walking endurance (meta r = -0.421, p = 0.022). The certainty of evidence was deemed moderate for these relationships. Conclusion: Our findings indicate that higher levels of PSF are associated with poorer mobility, balance, and participation, as well as greater disability and stroke impairment. Future studies, especially prospective longitudinal and randomized controlled trials, are warranted to substantiate our findings. Systematic review registration: PROSPERO, identifier: CRD42023492045.