The effects of pre-transplantation center-based cardiac rehabilitation on the postoperative quality of life and adherence to exercise in patients undergoing heart transplantation.

BACKGROUND: Heart transplantation (HTx) is the final treatment option for patients with chronic heart failure. Several studies have reported that exercise therapy, which is a component of cardiac rehabilitation, improves exercise capacity and the quality of life (QOL) in patients with heart failure. METHODS: Three patients, referred to an inpatient cardiac rehabilitation before HTx, participated in center-based cardiac rehabilitation (CBCR) during the hospitalization period. The CBCR, including aerobic exercises and resistance training, was conducted 3-4 days/week under cardiac rehabilitation team. Clinical outcomes included QOL using short form (SF)-36 questionnaire and the level of physical activity using international physical activity questionnaire (IPAQ) were evaluated before and after following the CBCR. RESULTS: These patients showed an improved QOL in physical components with mean 32% and in mental components with mean 43%. The adherence to exercise confirmed by level of physical activity also increased as much as mean 1275 MET-minutes at 3 months after transplantation. CONCLUSIONS: The findings in case report show the safety and effectiveness of CBCR in patients waiting for HTx during hopitalization. This is the first case report showing the effect of CBCR in admission period in Korean patients undergoing HTx.

Can exercise-based cardiac rehabilitation increase physical activity in patients who have undergone total thoracoscopic ablation?

Evidence of the effect of exercise therapy in patients who have undergone total thoracoscopic ablation is lacking. This study aimed to evaluate the effects of eight weeks exercise-based cardiac rehabilitation on cardiopulmonary fitness and adherence to exercise in patients who underwent total thoracoscopic ablation and followed a regimen of exercise therapy. Twenty-four patients were involved in the study and were divided into two groups. The exercise group underwent exercise therapy, which included aerobic and resistance exercises, twice a week as part of an eight weeks hospital-based outpatient cardiac rehabilitation program. Cardiopulmonary exercise test was used to evaluate exercise capacity and the International Physical Activity Questionnaire was utilized to identify the amount of physical activity and confirm adherence to exercise at six months postoperatively. There were significant differences between the groups in moderate activity level (p = 0.004) and extent of total physical activity (p = 0.0001). Complications such as recurrent atrial fibrillation did not occur during the exercise training. Exercise-based cardiac rehabilitation was beneficial in maintaining the activity level at six months postoperatively. Early exercise intervention at four weeks post-surgical ablation is a safe and effective therapy that can increase physical activity. Further studies are needed to verify the effect of exercise intervention in a larger sample size of patients who have undergone total thoracoscopic ablation.

A hybrid fiber-optic photoluminescence measurement system and its application in InGaN/GaN light emitting diode epi-wafer morphology studies.

We report a fiber optic photoluminescence (PL) measurement system using a novel hybrid probe composed of a series of single mode fiber (SMF) and double-clad fiber (DCF) terminated with a coreless silica fiber (CSF) segment and glass micro-lens formed on its cleaved-facet. The fiber probe provided a good guidance and focusing capability for the excitation photon with a focal length of 125 µm and a beam diameter of 13.6 µm. Utilizing a special DCF-to-DCF coupling scheme, the photoluminescence signals were efficiently collected and delivered to a photodetector with a low loss. Utilizing the proposed system, PL morphology was investigated over a 200 × 200 µm(2) area for two types of InGaN/GaN blue light emitting diode (LED) epi-wafers grown on 1) an un-patterned sapphire substrate (UPSS), and 2) a patterned sapphire substrate (PSS). The uniformity in the relative PL intensity and the spectral uniformity in terms of the peak PL wavelength were experimentally compared and analyzed.

Effects of Combined Exercise Program on Spinal Curvature and Balance Ability in Adolescents with Kyphosis.

Thoracic hyperkyphosis is associated with postural abnormality, physical function, and quality of life. This study aimed to examine the effects of a combined exercise program on the spinal curvature and balance ability in adolescents with kyphosis. Fifty-one adolescents (mean age 21.95 ± 3.90 year, 23 male and 28 female) diagnosed with kyphosis were randomly divided into two groups: an experimental group (n = 25) and a control group (n = 26). All participants in the study group underwent a combined exercise program for 60 min, three times per week, for 12 weeks. Cobb's angle and forward head angle showed significant differences between the two groups (p < 0.001). The anterior and posterior weight distributions of static and dynamic plantar foot pressures showed a significant difference between the two groups (p < 0.001), and significant differences were observed only in the study group (p < 0.001). However, the left and right static plantar foot pressures did not differ significantly. In conclusion, these results demonstrate that a combined exercise program is an effective intervention for the improvement of alignment in the spinal curve and balance in adolescents with postural kyphosis.

Effects of Augmented Reality Game-Based Cognitive-Motor Training on Restricted and Repetitive Behaviors and Executive Function in Patients with Autism Spectrum Disorder.

Restricted and repetitive behaviors (RRBs) and executive dysfunction are widely acknowledged as core features and hallmarks in patients with autism spectrum disorder (ASD). This study aimed to investigate the effects of augmented reality (AR) using motivational games with cognitive-motor exercises on RRBs, executive function (EF), attention, and reaction time in patients with ASD. Twenty-four patients (range from 6 to 18 years) diagnosed with ASD were recruited from local social welfare centers and randomly allocated to the AR game-based cognitive-motor training group (study group) or the conventional cognitive training group (control group). Both groups completed 30 min training sessions, twice a week for four weeks. Outcome measures were conducted before and after the intervention. As a result, improvements were observed in all the subscales of the RRBs in the study group except for self-injurious and ritualistic behavior. Significant improvements were observed in EF and reaction time in the study group, which was significantly higher compared to the control group. With the present findings, we can suggest that cognitive-motor training using AR game-based content generates positive effects on improving executive function reaction time and accuracy of responses and has a limited effect on RRBs in patients with ASD. This can be proposed as a complementary intervention associated with individualized daily management.

Effects of Augmented Reality-Based Dual-Task Program on Physical Ability by Cognitive Stage with Developmental Disabilities.

People diagnosed with developmental disabilities are less likely to participate in physical activities even if they are provided opportunities. This study aimed to examine the effects of dual-task exercise-based augmented reality (AR) on muscle strength, muscle endurance, balance ability, and flexibility among people with developmental disabilities. Twenty-seven patients with developmental disabilities were included in the study. The intervention was based on an AR-based rehabilitation program and lasted for 8 weeks. The results showed a statistically significant improvement in muscle strength, muscle endurance, balance ability, and flexibility after the intervention (p < 0.05). The AR-based dual-task program increased interest and motivation in the high-cognitive-stage groups, while less interest and motivation were observed in the low-cognitive-stage groups. Our results suggest that an AR-based dual-task program can be an effective method to improve physical ability in patients with high cognitive levels.

Effect of Combined Exercise Program on Lower Extremity Alignment and Knee Pain in Patients with Genu Varum.

This study aimed to assess the effect of a combined exercise program on lower-extremity alignment and knee pain in patients with genu varum. Forty-seven middle-aged women with knee pain and genu varum were randomly divided into the exercise (EG, n = 24) and control (CG, n = 23) groups. The exercise group underwent a combined exercise program lasting 60 min in one session, three times a week for 12 weeks. Knee-to-knee length (KTKL), hip-knee-ankle angle (HKAA), hip inclination angle (HIA), and medial proximal tibial angle (MPTA) were assessed to evaluate lower-extremity alignment. To evaluate knee pain, the short form-McGill Pain Questionnaire (SF-MPQ) were used. There was a significant difference between the groups, and a decrease of 16% in KTKL (from 6.48 ± 1.26 cm to 5.47 ± 1.21 cm) was shown in EG. Other variables, including HKAA, HIA, and MPTA on the right side, showed significant differences between pre- and post-intervention in EG (p < 0.01, p < 0.01, and p < 0.01, respectively). SF-MPQ score improved with 45% from 18.75 ± 1.64 to 10.33 ± 2.47 after exercise intervention in EG. These results suggest that the combined exercise program, including strength and neuromuscular exercises, is an effective intervention for improving lower-extremity alignment and knee pain in middle-aged women with genu varum.

Orange a-plane InGaN/GaN light-emitting diodes grown on r-plane sapphire substrates.

We report on orange a-plane light-emitting diodes (LEDs) with InGaN single quantum well (SQW) grown on r-plane sapphire substrates by metal organic chemical vapor deposition (MOCVD). The peak wavelength and the full-width at half maximum (FWHM) at a drive current of 20mA were 612.2 nm and 72 nm, respectively. The device demonstrated a blue shift in emission wavelength from 614.6 nm at 10 mA to 607.5 nm at 100 mA, representing a net shift of 7.1 nm over a 90 mA range, which is the longest wavelength compared with reported values in nonpolar LEDs. The polarization ratio values obtained from the orange LED varied between 0.36 and 0.44 from 10 to 100mA and a weak dependence of the polarization ratio on the injection current was observed.

Enhanced electroluminescence of a-plane InGaN light emitting diodes grown on oxide-patterned r-plane sapphire substrates.

We report on the new fabrication method of a-plane InGaN light emitting diodes (LEDs) using the epitaxy on patterned insulator on sapphire substrate (EPISS). Cathodoluminescence spectrum of the fully coalesced a-plane GaN template showed that band edge emission intensity of the wing region was four times higher than that of the window region. Threading dislocations and basal stacking faults densities in wing region were ~1×107 cm⁻² and ~5☓104 cm⁻¹, respectively. Blue-emitting (443.4 nm) a-plane InGaN LED employing EPISS showed the optical power of 3.1 mW and the EL FWHM of 25.2 nm at the injection current of 20 mA.

Effects of exercise on cervical muscle strength and cross-sectional area in patients with thoracic hyperkyphosis and chronic cervical pain.

There is a lack of studies comparing the effects of different exercise types in patients with thoracic hyperkyphosis. Twenty-four subjects were divided into three groups: corrective exercise, resistance exercise, and physical therapy. The groups performed their respective interventions, two times per week for three months. Clinical outcomes, including the value of Cobb's angle, cervical muscle strength and endurance, and the cross-sectional area of the cervical deep muscles were measured pre- and post-intervention. There was a significant difference in the changes in the thoracic Cobb's angle between the groups (P < 0.001). The corrective exercise group revealed a significantly superior increase in muscle strength and endurance between pre- and post-intervention (P < 0.012). There was a significant difference in the cross-sectional area of the cervical deep muscles included longus capitis and multifidus between the groups (P < 0.036 and 0.007, respectively). The corrective exercise group showed the most significant increase in cross-sectional area between pre- and post-intervention (P < 0.012). A corrective exercise program is a more effective intervention than traditional resistance exercise and physical therapy for improving the thoracic Cobb's angle, cervical muscle strength and endurance, and the cross-sectional area of the deep muscles in patients with thoracic hyperkyphosis.Trial registration: KCT0005292.

Effects of Rehabilitation Exercise on Cardiovascular Risk Factors and Muscle Cross-Sectional Area in Overweight Patients with Low Back Pain.

Limited studies exist on the effects of exercise therapy on obese and normal-weight patients. Herein, we investigated the effect of a 12-week rehabilitation exercise program on cardiovascular risk factors, Oswestry Disability Index (ODI), and change in the cross-sectional area (CSA) of lumbar muscles in patients with obesity and normal-weight low back pain (LBP). LBP patients were allocated to the overweight LBP group (OLG; n = 15) and normal-weight LBP group (NLG; n = 15). They performed a rehabilitation exercise program three times per week for 12 weeks. Cardiovascular risk factors, ODI score, and lumbar muscle CSA were assessed pre- and post-intervention. Body composition, body weight (p < 0.001), and body mass index (p < 0.001) significantly improved after the exercise intervention in OLG. Body fat percentage significantly decreased in both groups, but OLG (p < 0.001) showed slightly greater improvement than NLG (p = 0.034). Total cholesterol (p = 0.013) and low-density lipoprotein (p = 0.002) significantly improved in OLG. ODI score improved significantly in both groups (p = 0.000). Lumbar muscle CSA showed a significant difference in the context of the time result (p = 0.008). OLG showed a significant improvement post-intervention (p = 0.003). The rehabilitation exercise program was more beneficial on cardiovascular risk factors and change in lumbar muscle CSA in OLG, suggesting an intensive exercise intervention needed for overweight patients with LBP.

Effect of Different Exercise Types on the Cross-Sectional Area and Lumbar Lordosis Angle in Patients with Flat Back Syndrome.

Flat back syndrome (FBS) is a sagittal imbalance wherein the normal spinal curvature is reduced. This study aimed to compare the effects of different exercise programs on the cross-sectional area (CSA) of the lumbar muscles, lumbar lordosis angle (LLA), lumbar disability, and flexibility in patients with FBS. Thirty-six females with flexible FBS were randomly allocated to the corrective exercise group (CEG, n = 12), resistance exercise group (REG, n = 12), and physical therapy group (PTG, n = 12). CEG and REG patients participated in a 12-week exercise intervention for 60 min three times per week. The CSA, LLA, Oswestry disability index (ODI), and sit-and-reach test were measured before and after intervention. CSA showed a significant difference between groups (p < 0.01), with CEG and REG demonstrating a significant increase (p < 0.05 and p < 0.05, respectively). LLA showed a significant difference between groups (p < 0.001); CEG showed a higher increase than did REG (p < 0.01) and PTG (p < 0.001). ODI also showed a significant difference between groups (p < 0.001), being lower in CEG than in REG (p < 0.001) and PTG (p < 0.001). Lumbar flexibility significantly improved in all groups, albeit with a significant difference (p < 0.001). Although corrective and resistance exercise programs effectively improve these parameters, corrective exercise is superior to other interventions for patients with FBS.

Optimal aerobic exercise intensity and its influence on the effectiveness of exercise therapy in patients with pulmonary arterial hypertension: a systematic review.

BACKGROUND: Exercise intensity in exercise training programs is an important determinant of program efficacy, such as improvement in exercise capacity and quality of life (QOL). It is not well known whether differently applied exercise intensities are efficacious when used in exercise-based cardiac rehabilitation programs for patients with pulmonary arterial hypertension (PAH). METHODS: Three databases (PubMed, EMBASE, and CINAHL) were searched with the following inclusion criteria: comparative study of exercise interventions for patients with pulmonary arterial hypertension. Three clinical specialists (a physician, nurse, and exercise physiologist) selected the included articles using the process of systematic review. Included articles were grouped according to aerobic exercise intensity: low, moderate-to-vigorous, and vigorous. The level of evidence for each study was rated using Sackett's levels of evidence. RESULTS: Of 1,452 studies reviewed, 8 were included according to the inclusion criteria (3 randomized controlled trials (RCTs), 3 prospective studies, and 2 case series). Exercise capacity for a six-minute walk distance (mean: 57.7 m) and QOL improved in the above moderate intensity group, while the low intensity group did not show improvement after intervention. For termination criteria, data obtained from the reviewed articles were not sufficient to suggest any exercise intensity recommendations for patients with pulmonary arterial hypertension. DISCUSSION: The findings in this study suggest that at least moderate aerobic exercise intensity is needed to significantly improve six-minute walk distance and QOL in individuals diagnosed with World Health Organization Group 1 of pulmonary arterial hypertension. There is a need for prospective RCTs comparing different exercise intensities in this patient population.

Effects of Different Types of Contraction Exercises on Shoulder Function and Muscle Strength in Patients with Adhesive Capsulitis.

Although several studies have reported the effect of exercise therapy for adhesive capsulitis (AC), studies on the comparison of different exercise types on shoulder muscle strength and function in patients with AC are lacking. This study aimed to investigate the effect of different exercise types on shoulder muscle strength and function in patients with AC. Thirty female patients with AC were categorized into an eccentric contraction exercise group (ECG, n = 15; age, 51.53 ± 4.73 years) and a concentric contraction exercise group (CCG, n = 15; age, 52.40 ± 4.03 years). The participants in each group performed a different exercise program three times per week for 60 min per session for 12 weeks. The range of motion (ROM) of the shoulder joint, visual analog scale, shoulder muscle strength, and Constant-Murley score (CMS) were measured before the intervention and after 12 weeks of the exercise intervention. Shoulder ROM in flexion (increase of 31%) and external rotation (ER) (increase of 54%) showed a significant improvement in the ECG (p < 0.05). Muscle strength in ER was significantly different between the two groups (p < 0.05). Pain severity showed improvement in the ECG (decrease of 61%) after the intervention (p < 0.01). The CMS in the ECG (increase of 48%) showed a greater improvement than that in the CCG after the intervention (p < 0.01). This study showed that eccentric contraction exercise had a more beneficial effect than concentric contraction exercise for improving shoulder muscle strength and function in females with AC.

Effect of Equine-Assisted Activities on Cardiac Autonomic Function in Children with Cerebral Palsy: A Pilot Randomized-Controlled Trial.

Objective: Children with cerebral palsy (CP) have an impaired cardiac autonomic function. Attenuated heart rate recovery (HRR), which is a valuable prognostic parameter for autonomic nervous system, is known to be associated with an increased risk of cardiovascular events and all-cause mortality. However, only few studies have observed the effects of exercise on the cardiac autonomic function in children with CP. The purpose of this pilot study was to examine the effects of equine-assisted activity (EAA) program on cardiac autonomic function in children with CP. Design: A single-blinded, parallel, two-arm pilot trial with 1:1 randomization to the EAA or control group. Setting: A tertiary university hospital and a local arena. Subjects: Twenty-six children with CP (Gross Motor Function Classification System Levels I-II). Intervention: Each lesson of the EAA program for the EAA group was conducted for 40 min twice a week, and the whole program duration was 16 weeks (a total of 32 sessions). Outcome measures: A graded exercise test was performed to measure the resting heart rate (RHR), HRR, and peak oxygen uptake (VO2peak) on both groups before and after the 16-week period. Results: The autonomic nervous function measured by the response of HRR improved at 1 min (p < 0.009), 3 min (p < 0.001), and 5 min (p < 0.004) only in the EAA group. RHR significantly improved in the EAA group (p < 0.013), whereas the VO2peak did not significantly differ between the two groups. Conclusion: The HRR and RHR of the children with CP improved after completing the 16-week EAA program. The results demonstrated that the program had a positive effect on the improvement of cardiac autonomic function in these patients. Clinical Trial Registration Number: NCT03870893.

Enhanced light extraction of nonpolar a-plane (11-20) GaN light emitting diodes on sapphire substrates by photo-enhanced chemical wet etching.

The extraction efficiency of nonpolar a-plane (11-20) GaN LEDs on sapphire substrates has been enhanced by selectively etching the mesa sidewall faces and the n-type GaN surfaces with photoenhanced chemical wet etching. Submicron-sized trigonal prisms having prismatic planes of {1-100} were clearly displayed on the n-type GaN surfaces as well as the sidewall face after 5 min etching at 60 degrees C. The radiation patterns have shown that more light is extracted in all directions and the output powers of surface textured a-plane GaN LEDs have increased by 25% compared with control samples. PEC wet etching produced unique feature of etching morphology on the mesa sidewall faces and the n-type GaN surface.

Zero-internal fields in nonpolar InGaN/GaN multi-quantum wells grown by the multi-buffer layer technique.

The potential of nonpolar a-plane InGaN/GaN multi-quantum wells (MQWs), which are free from a strong piezoelectric field, was demonstrated. An a-GaN template grown on an r-plane sapphire substrate by the multi-buffer layer technique showed high structural quality with an omega full width at half maximum value along the c-axis of 418 arcsec obtained from high-resolution x-ray diffraction analysis. From barrier analysis by deep level transient spectroscopy, it appeared that a-plane InGaN/GaN MQWs can solve the efficiency droop problem as they have a lower electron capture barrier than the c-plane sample. The peak shift of the temperature-dependent photoluminescence signal for the nonpolar InGaN/GaN MQWs was well fitted by Varshni's empirical equation with zero-internal fields. A high photoluminescence efficiency of 0.27 from this sample also showed that nonpolar MQWs can be the key factor to solve the efficiency limitation in conventional c-plane GaN based light emitting diodes.

Preoperative Rotator Muscle Strength Ratio Predicts Shoulder Function in Patients After Rotator Cuff Repair.

BACKGROUND: Shoulder function after rotator cuff repair is associated with patient satisfaction after surgery. Several studies have demonstrated that the muscle strength ratio (external rotators/internal rotators) is an important factor to evaluate shoulder function, but little is known about the relationship between the preoperative muscle strength ratio and postoperative shoulder function. PURPOSE: To evaluate the effect of the preoperative muscle strength ratio of the shoulder rotators on function after rotator cuff repair. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: The study participants were patients with small- to medium-sized rotator cuff tears diagnosed by magnetic resonance imaging; 77 patients were included in the analysis. Preoperative muscle strength was assessed through use of isokinetic equipment. Patients were classified into 2 groups (normal and abnormal) according to a normal strength ratio range of 55% to 75%, with "abnormal" meaning a deviation of more than 15% from the normal range. The American Shoulder and Elbow Surgeons (ASES) score and the Constant score were used to evaluate shoulder function preoperatively and postoperatively at 6 months, 1 year, and 2 years. RESULTS: There were 30 patients in the normal group and 47 in the abnormal group, with a preoperative muscle strength ratio of 63.5% ± 5.5% and 42.6% ± 6.1%, respectively. The ASES score was 88.6 ± 9.1 in the normal group and 77.5 ± 13.6 in the abnormal group at 2 years postoperatively, and the Constant score was 82.7 ± 8.4 in the normal group and 69.5 ± 13.4 in the abnormal group at 2 years postoperatively. A significant difference was found in postoperative shoulder function between the normal and abnormal groups. CONCLUSION: This study demonstrated that the preoperative muscle strength ratio was associated with postoperative shoulder function. The preoperative muscle strength ratio should be considered an important predictor of shoulder function after rotator cuff repair.

Is Scapular Stabilization Exercise Effective for Managing Nonspecific Chronic Neck Pain?: A Systematic Review.

Scapular stabilization is thought to have an important role in improving pain and dysfunction around the neck and shoulders, but evidence of this is lacking. We aim to systematically review the effect of a scapular stabilization exercise (SSE) on pain and dysfunction in patients with nonspecific chronic neck pain (NP). We searched the PubMed, EMBASE, CINAHL, and Cochrane Library databases using the terms (NP [MeSH] OR NP OR cervical pain OR neck ache OR cervicalgia) AND (scapular exercise OR periscapular exercise OR SSEs). We included suitable studies that met the study's inclusion criteria. Among the 227 studies identified by our search strategy, a total of four (three randomized controlled studies and one prospective study) met the inclusion criteria. The SSE was intense. It included three sets of 10 repetitions. In most of the studies, the exercises were conducted 3 times per week. Most studies reported that the SSE improved pain and dysfunction in patients with nonspecific chronic NP; however, the reviewed articles did not use the same variables for measurement. Additionally, the sample size was small. Although several studies show that SSE might improve NP and dysfunction, the effects of SSE on pain and dysfunction in the neck region remain unclear because the number of studies was small. Further high-quality studies are necessary to identify the detailed effects of SSE in patients with NP.

Mask-free hybrid long-period fiber grating fabrication by self-assembled periodic polymerization in silica hollow optical fiber.

We report a type of hybrid optical fiber created by filling the central hole of a silica hollow optical fiber (HOF) with an organic polymer to serve as the core. After suitable curing of the polymer filling of the HOF, a self-assembled one-dimensional polymer-air periodic structure was created without the need for an amplitude mask. This acts as a long-period fiber grating device with an axial refractive index modulation. Details of the fabrication method for the hybrid fiber grating and its transmission spectra analysis are reported.