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Music can generate a positive effect in runners' performance and motivation. However, the practical implementation of music intervention during exercise is mostly absent from the literature. Therefore, this paper designs a playback sequence system for joggers by considering music emotion and physiological signals. This playback sequence is implemented by a music selection module that combines artificial intelligence techniques with physiological data and emotional music. In order to make the system operate for a long time, this paper improves the model and selection music module to achieve lower energy consumption. The proposed model obtains fewer FLOPs and parameters by using logarithm scaled Mel-spectrogram as input features. The accuracy, computational complexity, trainable parameters, and inference time are evaluated on the Bi-modal, 4Q emotion, and Soundtrack datasets. The experimental results show that the proposed model is better than that of Sarkar et al. and achieves competitive performance on Bi-modal (84.91%), 4Q emotion (92.04%), and Soundtrack (87.24%) datasets. More specifically, the proposed model reduces the computational complexity and inference time while maintaining the classification accuracy, compared to other models. Moreover, the size of the proposed model for network training is small, which can be applied to mobiles and other devices with limited computing resources. This study designed the overall playback sequence system by considering the relationship between music emotion and physiological situation during exercise. The playback sequence system can be adopted directly during exercise to improve users' exercise efficiency.
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Música , Algoritmos , Inteligencia Artificial , Emociones , Redes Neurales de la ComputaciónRESUMEN
BACKGROUND: Stroke survivors need continuing exercise intervention to maintain functional status. This study assessed the feasibility and efficacy of an interactive telerehabilitation exergaming system to improve balance in individuals with chronic stroke, compared to conventional one-on-one rehabilitation. METHODS: In this prospective case-control pilot study, 30 Taiwanese individuals with chronic stroke were enrolled and randomly allocated to an experimental group and a control group. All participants received intervention 3 times per week for 4 weeks in the study hospital. The experiment group underwent telerehabilitation using a Kinect camera-based interactive telerehabilitation system in an independent room to simulate home environment. In contrast, the control group received conventional one-on-one physiotherapy in a dedicated rehabilitation area. The effectiveness of interactive telerehabilitation in improving balance in stroke survivors was evaluated by comparing outcomes between the two groups. The primary outcome was Berg Balance Scale (BBS) scores. Secondary outcomes were performance of the Timed Up and Go (TUG) test, Modified Falls Efficacy Scale, Motricity Index, and Functional Ambulation Category. RESULTS: Comparison of outcomes between experimental and control groups revealed no significant differences between groups at baseline and post-intervention for all outcome measures. However, BBS scores improved significantly in both groups (control group: p = 0.01, effect size = 0.49; experimental group: p = 0.01, effect size = 0.70). Completion times of TUG tests also improved significantly in the experimental group (p = 0.005, effect size = 0.70). CONCLUSION: The Kinect camera-based interactive telerehabilitation system demonstrates superior or equal efficacy compared to conventional one-on-one physiotherapy for improving balance in individuals with chronic stroke. Trial registration ClinicalTrials.gov. NCT03698357. Registered October 4, 2018, retrospectively registered.
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Equilibrio Postural/fisiología , Trastornos de la Sensación/rehabilitación , Rehabilitación de Accidente Cerebrovascular/métodos , Telerrehabilitación/métodos , Anciano , Estudios de Casos y Controles , Estudios de Factibilidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Evaluación de Resultado en la Atención de Salud , Modalidades de Fisioterapia , Proyectos Piloto , Estudios Prospectivos , Trastornos de la Sensación/etiología , Accidente Cerebrovascular/complicaciones , Accidente Cerebrovascular/fisiopatología , Juegos de VideoRESUMEN
BACKGROUND: Transcranial direct current stimulation (tDCS) and intermittent theta burst stimulation (iTBS) were both demonstrated to have therapeutic potentials to rapidly induce neuroplastic effects in various rehabilitation training regimens. Recently, we developed a novel transcranial electrostimulation device that can flexibly output an electrical current with combined tDCS and iTBS waveforms. However, limited studies have determined the therapeutic effects of this special waveform combination on clinical rehabilitation. Herein, we investigated brain stimulation effects of tDCS-iTBS on upper-limb motor function in chronic stroke patients. METHODS: Twenty-four subjects with a chronic stroke were randomly assigned to a real non-invasive brain stimulation (NIBS; who received the real tDCS + iTBS output) group or a sham NIBS (who received sham tDCS + iTBS output) group. All subjects underwent 18 treatment sessions of 1 h of a conventional rehabilitation program (3 days a week for 6 weeks), where a 20-min NIBS intervention was simultaneously applied during conventional rehabilitation. Outcome measures were assessed before and immediately after the intervention period: Fugl-Meyer Assessment-Upper Extremity (FMA-UE), Jebsen-Taylor Hand Function Test (JTT), and Finger-to-Nose Test (FNT). RESULTS: Both groups showed improvements in FMA-UE, JTT, and FNT scores after the 6-week rehabilitation program. Notably, the real NIBS group had greater improvements in the JTT (p = 0. 016) and FNT (p = 0. 037) scores than the sham NIBS group, as determined by the Mann-Whitney rank-sum test. CONCLUSIONS: Patients who underwent the combined ipsilesional tDCS-iTBS stimulation with conventional rehabilitation exhibited greater impacts than did patients who underwent sham stimulation-conventional rehabilitation in statistically significant clinical responses of the total JTT time and FNT after the stroke. Preliminary results of upper-limb functional recovery suggest that tDCS-iTBS combined with a conventional rehabilitation intervention may be a promising strategy to enhance therapeutic benefits in future clinical settings. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04369235. Registered on 30 April 2020.
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Rehabilitación de Accidente Cerebrovascular , Accidente Cerebrovascular , Estimulación Transcraneal de Corriente Directa , Humanos , Proyectos Piloto , Recuperación de la Función , Resultado del Tratamiento , Extremidad SuperiorRESUMEN
BACKGROUND: Fibromyalgia is a chronic widespread pain condition that is associated with sleep disturbances and cognitive impairments. Neurofeedback has been demonstrated to improve pain, sleep quality, and fatigue. However, few studies have examined the effect of neurofeedback for patients with fibromyalgia. AIM: To determine the effects of neurofeedback on pain intensity, symptom severity, sleep quality, and cognitive function in patients with fibromyalgia. DESIGN: This study was a randomized controlled trial. METHOD: Eighty participants were randomized to a neurofeedback group (N = 60), receiving sensorimotor and alpha rhythm feedback for 8 weeks, or a telephone support group (N = 20). RESULTS: Results from the generalized estimating equation modelling revealed significant group-by-time interactions for Brief Pain Inventory pain severity (B = -1.35, SE = 0.46, p = .003) and pain interference (B = -1.75, SE = 0.41, p < .001), Revised Fibromyalgia Impact Questionnaire total scores (B = -16.41, SE = 3.76, p < .001), sleep onset latency (B = -25.33, SE = 9.02, p = .005), and Psychomotor Vigilance Test error (B = -1.38, SE = 0.55, p = .013) after adjustments for age, sex, duration of illness, and group differences at baseline. CONCLUSIONS: An 8-week neurofeedback training regimen of sensorimotor rhythm and alpha brain waves significantly improved pain severity and interference, fibromyalgia symptom severity, sleep latency, and sustained attention in patients with fibromyalgia.
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Dolor Crónico , Fibromialgia , Neurorretroalimentación , Fibromialgia/terapia , Humanos , Dimensión del Dolor , Calidad del Sueño , Resultado del TratamientoRESUMEN
BACKGROUND: This study aimed to evaluate the effectiveness of a customized interactive video game-based (IVGB) training on balance in older adults with mild-to-moderate Parkinson's disease (PD). METHODS: In this 12-week crossover trial, PD patients ≥65 years of age were randomly divided into Group A (a 6-week intervention phase followed by a 6-week control phase) and Group B (a 6-week control phase followed by a 6-week intervention phase). Participants received IVGB exercise training during the intervention phase and no exercise during the control phase. Functional outcomes were measured using behavioral evaluation scales and questionnaires at baseline, week 6 and week 12. RESULTS: Twenty-four PD patients were included in this study, and were evenly divided into two groups. After Bonferroni adjustment, the changes in Modified Falls Efficacy Scale (MFES) and two subscales of Multi-Directional Reach Test were significantly different between two groups in the first 6-week period. In addition, the changes in Berg Balance Scale, MFES, and two subscales of Maximum Step Length were significantly different between two groups in the second 6-week period. Compared to controls, 6-week IVGB exercise intervention significantly improved different but overlapping functional outcomes in two groups of PD patients. CONCLUSIONS: The customized IVGB exercise training improves balance, postural stability and confidence in preventing falls in older adults with mild-to-moderate PD. However, this IVGB exercise doesn't have a significant impact on quality of life. TRIAL REGISTRATION: ClinicalTrials.gov. NCT03689764 . Registered 27 September 2018, retrospectively registered.
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Terapia por Ejercicio/métodos , Enfermedad de Parkinson/rehabilitación , Equilibrio Postural/fisiología , Juegos de Video , Accidentes por Caídas/prevención & control , Anciano , Estudios Cruzados , Terapia por Ejercicio/instrumentación , Femenino , Humanos , Masculino , Enfermedad de Parkinson/fisiopatología , Calidad de VidaRESUMEN
BACKGROUND: We designed a novel ankle foot orthosis (AFO), namely, ideal training AFO (IT-AFO), with motion feedback on the hemiparetic lower limb to improve ambulation in individuals with stroke-related hemiplegia. We, therefore sought to compare the kinematic parameters of gait between IT-AFO with and without dynamic control and conventional anterior-type AFO or no AFO. METHODS: Gait parameters were measured using the RehaWatch® system in seven individuals with hemiplegia (mean 51.14 years). The parameters were compared across four conditions: no AFO, conventional anterior AFO, IT-AFO without dynamic control, and IT-AFO with dynamic control, with three trials of a 10-m walk test for each. RESULTS: The dorsiflexion angle increased during the swing phase when the IT-AFO was worn, and it was larger with dynamic control. These data can confirm drop foot improvement; however, the difference between the parameters with- and without-AFO control conditions was not significant in the swing phase. The IT-AFO with or without dynamic control enhanced the loading response to a greater extent between the hemiparetic and unaffected lower limbs than conventional AFO or no AFO. The duration of the stance phase on the hemiparetic lower limb was also longer when using IT-AFO with and without dynamic control than that when using conventional AFO, which improved asymmetry. User comfort and satisfaction was greater with IT-AFO than with the other conditions. CONCLUSIONS: The IT-AFO with dynamic control improved gait pattern and weight shifting to the hemiparetic lower limb, reducing gait asymmetry. The difference with and without dynamic control of IT-AFO is not statistically significant, and it is limited by sample size. However, this study shows the potential of IT-AFO in applying positive motion feedback with gait training. TRIAL REGISTRATION: Taipei Medical University-Joint Institutional Review Board. N201510010 . Registered 12 February 2015. http://ohr.tmu.edu.tw/main.php .
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Retroalimentación Sensorial , Ortesis del Pié , Trastornos Neurológicos de la Marcha/rehabilitación , Rehabilitación de Accidente Cerebrovascular/instrumentación , Adulto , Anciano , Anciano de 80 o más Años , Articulación del Tobillo/fisiología , Fenómenos Biomecánicos , Retroalimentación Sensorial/fisiología , Femenino , Trastornos Neurológicos de la Marcha/etiología , Humanos , Masculino , Persona de Mediana Edad , Proyectos Piloto , Diseño de Prótesis/métodos , Accidente Cerebrovascular/complicacionesRESUMEN
Pain severity and sleep are associated with cognitive performance in patients with fibromyalgia. This study examined whether sleep mediates the relationships of pain severity with psychomotor vigilance and attention in patients with fibromyalgia by analysing 80 patients with fibromyalgia. Cognitive performance, pain severity and sleep parameters were determined using the Psychomotor Vigilance Task, Brief Pain Inventory-Short Form and sleep diaries of seven consecutive nights, respectively. The patients' demographic data were analysed for potential confounding factors. After adjustment for these confounders, a series of regression analyses was performed to examine the mediating role of sleep. The results indicated that higher pain severity was strongly associated with poorer sustained attention and lower sleep quality, the total effects of pain severity on psychomotor vigilance and attention were significant (c path: ß = 0.23, p = 0.04), and pain severity was a significant sleep quality predictor (a path: ß = -0.33, p < 0.01). When sleep quality was entered into the regression model (aâ ×â b path), the effects of pain severity on psychomotor vigilance and attention became non-significant (c' path: ß = 0.15, p = 0.20) after adjustment of age, indicating a complete mediating effect of sleep quality in the pain severity-cognitive performance relationship. In conclusion, sleep quality mediates the pain severity-cognitive performance relationship: pain affects sleep quality, which in turn impairs sustained attention. Our findings provide further insight into the processes underlying the relationship between pain and poor cognitive function. Improved sleep quality may offset the detrimental effects of pain on sustained attention.
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Atención/fisiología , Fibromialgia/psicología , Dolor/psicología , Índice de Severidad de la Enfermedad , Sueño/fisiología , Adulto , Cognición/fisiología , Estudios Transversales , Femenino , Fibromialgia/epidemiología , Fibromialgia/fisiopatología , Humanos , Masculino , Persona de Mediana Edad , Dolor/epidemiología , Dolor/fisiopatología , Estudios Prospectivos , Vigilia/fisiologíaRESUMEN
OBJECTIVES: Radiofrequency has been used to suppress spasticity affecting motion in patients with cerebral palsy and spinal cord injury. This study tested spasticity suppression and locomotion change after pulsed radiofrequency (PRF) at the dorsal root ganglion of rats with spasticity. MATERIALS AND METHODS: Twenty-four rats that survived for 28 days after thoracic spinal cord injury and showed spasticity in the right hind limb were separated randomly to a PRF group or Sham operation group. PRF consisted of 2 Hz biphasic 25 msec trains of PRF (500 kHz, 5 V intensity) applied on the right L5 dorsal root ganglion for 300 sec. Muscle tension of the right triceps surae was measured at 450 deg/sec of passive ankle dorsiflexion on the day before and 3, 7, and 14 days after PRF or sham operation. Locomotive function was evaluated by obtaining Basso, Beattie, and Bresnahan (BBB) scores. RESULTS: Muscle tension of the triceps surae decreased significantly three days after PRF, and gradually returned to baseline 14 days later. In the sham operation group, muscle tension increased significantly more than 14 days. The BBB scores declined from 10 to 8 after PRF and returned to pre-PRF levels 14 days later, while scores remained constant after sham operation. CONCLUSIONS: PRF produced significant and reversible suppression in spasticity, but this was accompanied by deterioration in locomotive function. Thus, caution should be exercised in considering the benefits and costs in suppressing spasticity in ambulatory patients, and implanted devices that apply titratable doses of PRF may be best to optimize patients' needs.
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Ganglios Espinales , Locomoción , Espasticidad Muscular , Tratamiento de Radiofrecuencia Pulsada/métodos , Traumatismos de la Médula Espinal/fisiopatología , Animales , Espasticidad Muscular/etiología , Espasticidad Muscular/fisiopatología , Ratas , Ratas Sprague-Dawley , Traumatismos de la Médula Espinal/complicacionesRESUMEN
AIM: To quantify the effects of pulsed radiofrequency (PRF) electrical stimulations of the pudendal and pelvic nerves on the bladder function of rats with detrusor overactivity. METHODS: All rats were pretreated with a continuous transvesical infusion of 0.5% acetic acid (AA) for inducing detrusor overactivity. Intravesical pressure was recorded using cysometrography (CMG) during the continuous transvesical infusion to examine the effects of PRF electrical stimulation of the pudendal and pelvic nerves individually. In addition, the activity of caspase-3, an apoptosis marker, in the pelvic nerve was examined to evaluate the impact of PRF on nerve injury. RESULTS: According to the first CMG recording, AA treatment significantly reduced bladder capacity (BC) and intercontraction interval (ICI) to 65% and 66% of the corresponding control values, respectively. Subsequently, PRF electrical stimulation of the pelvic nerve inhibited AA-induced detrusor overactivity and significantly increased BC to approximately 102-110% and ICI to 79-92%; these effects persisted for at least 4 h. Furthermore, PRF did not cause significant neural damage to the target stimulated nerves, as demonstrated by caspase-3 activity. CONCLUSION: PRF electrical stimulation of pelvic nerves exerted a long-lasting effect of suppressing AA-induced detrusor overactivity. This modality can be used as an alternative approach for improving bladder continence in patients with overactive bladder syndrome.
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Tratamiento de Radiofrecuencia Pulsada , Vejiga Urinaria Hiperactiva/terapia , Ácido Acético , Animales , Modelos Animales de Enfermedad , Femenino , Ratas , Ratas Sprague-Dawley , Resultado del Tratamiento , Vejiga Urinaria Hiperactiva/inducido químicamente , Vejiga Urinaria Hiperactiva/fisiopatologíaRESUMEN
Abnormal upper limb function seriously impacts a patient's daily life. After receiving emergency treatment patient should receive function-rebuilding and recovery training. The objective of this study is to integrate IR-camera, an infrared emitter, with a conventional passive hand skateboard training device for conventional upper limb training and the training process is comprehensively recorded and analyzed. Patients participating in the occupational therapy have a binding band attached to hand skateboard on the table to guide the patient in moving the hand skateboard along the designated path to train the patient's upper limbs. Six people with normal upper limb function participated in the stability test. The device repeatability and test results were verified acceptable. Eight patients with abnormal upper limb function (their upper limb function was damaged due to stroke, MMSE > =27) were trained for 4 weeks. The patient scores in finishing rate and finishing time showed significant improvement. The paired T test results (satisfy p < 0.05 or p < 0.01) between wk-1 and wk-2 are significant. The paired T test results (satisfy p < 0.01) between wk-1 and wk-4 are extremely significant. The new IR-Camera system focuses continuously on the "Figure of eight" curve. The system is light weight and convenient for stroke in home use. The study applies IR-camera technology to the conventional hand skateboard for upper limb training. The experiments show that the hardware of the proposed device no longer delays in response and can result in obvious clinical advances. The proposed device is verified worthy of promotion.
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Rayos Infrarrojos , Terapia Ocupacional/métodos , Teléfono Inteligente , Rehabilitación de Accidente Cerebrovascular/instrumentación , Rehabilitación de Accidente Cerebrovascular/métodos , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Dispositivo de Identificación por Radiofrecuencia , Recuperación de la FunciónRESUMEN
The role of 5-HT1A receptors in regulating voiding functions remains unclear, particularly regarding the urine flow rate (UFR) during voiding. This study examined the effects of 5-HT1A receptors on regulating urethral functions in female rats and investigated underlying modulatory mechanisms. Intravesical pressure (IVP), external urethral sphincter-electromyography (EUS-EMG), and UFR were simultaneously recorded during continuous transvesical infusion to examine the effects of a 5-HT1A receptor agonist (8-OH-DPAT) and antagonist (WAY-100635) on bladder and urethral functions. In addition, this study evaluated the independent roles of urethral striated and smooth muscles in the UFR in rats after a neuromuscular blockade (NMB) treatment and bilateral hypogastric nerve transection. Our results revealed that 8-OH-DPAT significantly increased the maximal UFR but reduced the mean UFR. This discrepancy may be because 8-OH-DPAT markedly increased the maximal UFR during the initial segment of the flow duration and subsequently induced an approximately zero level of long oscillatory waves during the remaining flow duration. Thus the mean UFR was reduced because of the prolonged approximately zero level of the UFR. However, paralyzing the EUS with an NMB agent, 8-OH-DPAT, significantly increased the maximal and mean UFRs because the prolonged zero level of the oscillatory UFR did not continue. These results support the hypothesis that the increased UFR in female rats during voiding is due to the induction of urethral smooth muscle relaxation by 8-OH-DPAT. This paper provides a detailed understanding of the role of 5-HT1A receptors in controlling the UFR in female rats.
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Receptor de Serotonina 5-HT1A/efectos de los fármacos , Agonistas del Receptor de Serotonina 5-HT1/uso terapéutico , Urodinámica/efectos de los fármacos , 8-Hidroxi-2-(di-n-propilamino)tetralin/farmacología , Animales , Desnervación , Electromiografía , Femenino , Plexo Hipogástrico/fisiología , Bloqueantes Neuromusculares/farmacología , Piperazinas/farmacología , Piridinas/farmacología , Ratas , Ratas Sprague-Dawley , Antagonistas del Receptor de Serotonina 5-HT1/farmacología , Antagonistas de la Serotonina/farmacología , Uretra/fisiopatología , Micción/efectos de los fármacosRESUMEN
BACKGROUND/PURPOSE: Few studies have investigated the feasibility of using pudendal neuromodulation to regulate bladder function in spinal cord-injured (SCI) animals. The present study aimed to determine the effects of electrical activation of the pudendal sensory branch on improving voiding functions in rats 6 weeks after a spinal cord injury and to explore the underlying neuromodulatory mechanisms. METHODS: Two urodynamic measurements were used to assess the effects of electrical stimulation (ES) on bladder and urethral functions: simultaneous recordings of the intravesical pressure (IVP) during continuous isotonic transvesical infusion (i.e., isotonic IVP) and external urethral sphincter (EUS) electromyography (EUS-EMG), and simultaneous recordings of transvesical pressure under isovolumetric conditions (i.e., isovolumetric IVP) and urethral perfusion pressure (UPP). RESULTS: Six weeks after the SCI, the rats showed voiding dysfunction, as indicated by abnormal cystometric measurements (e.g., increased volume threshold, increased contraction amplitude, and increased residual volume, and decreased voided volume). The voiding efficiency (VE) decreased to 13% after the SCI, but increased to 22-34% after applying pudendal afferent stimulation. In addition, pudendal stimulation significantly increased the EUS burst period and increased the difference between the UPP and the high-frequency oscillation (HFO) baselines, and changed the time offset between bladder and EUS activities. These findings suggest that pudendal afferent stimulation improved the VE by prolonging the micturition interval, decreased the urethral resistance, and recovered detrusor-sphincter dyssynergia during the voiding phase. CONCLUSION: This study demonstrates the feasibility of using pudendal neuromodulation in chronic SCI rats. These results could aid in developing an advanced neural prosthesis to restore bladder function in clinical settings.
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Terapia por Estimulación Eléctrica , Nervio Pudendo/fisiología , Traumatismos de la Médula Espinal/complicaciones , Uretra/patología , Trastornos Urinarios/terapia , Animales , Modelos Animales de Enfermedad , Electromiografía , Femenino , Ratas , Ratas Sprague-Dawley , Micción , UrodinámicaRESUMEN
[Purpose] Upper extremity rehabilitation after an injury is very important. This study proposes radio frequency identification (RFID) technology to improve and enhance the effectiveness of the upper extremity rehabilitation. [Subjects and Methods] People use their upper extremities to conduct daily activities. When recovering from injuries, many patients neglect the importance of rehabilitation, which results in degraded function. This study recorded the training process using the traditional rehabilitation hand gliding cart with a RFID reader, RFID tags in the panel, and a servo host computer. [Results] Clinical evidence, time taken to achieve a full score, counts of missing the specified spots, and Brunnstrom stage of aided recovery, the proximal part of the upper extremity show that the RFID-based upper extremity training significantly and reduce negative impacts of the disability in daily life and activities. [Conclusion] This study combined a hand-gliding cart with an RFID reader, and when patients moved the cart, the movement could be observed via the activated RFID tags. The training data was collected and quantified for a better understanding of the recovery status of the patients. Each of the participating patients made progress as expected.
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[Purpose] The introduction of emerging technologies such as the wireless Blobo bluetooth ball with multimedia features can enhance wrist physical therapy training, making it more fun and enhancing its effects. [Methods] Wrist injuries caused by fatigue at work, improper exercise, and other conditions are very common. Therefore, the reconstruction of wrist joint function is an important issue. The efficacy of a newly developed integrated wrist joint rehabilitation game using a Blobo bluetooth ball with C# software installed was tested in wrist rehabilitation (Flexion, Extension, Ulnar Deviation, Radial Deviation). [Results] Eight subjects with normal wrist function participated in a test of the system's stability and repeatability. After performing the Blobo bluetooth ball wrist physical therapy training, eight patients with wrist dysfunction experienced approximately 10° improvements in range of motion (ROM) of flexion extension, and ulnar deviation and about 6° ROM improvement in radial deviation. The subjects showed progress in important indicators of wrist function. [Conclusion] This study used the Blobo bluetooth ball in wrist physical therapy training and the preliminary results were encouraging. In the future, more diverse wrist or limb rehabilitation games should be developed to meet the needs of physical therapy training.
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OBJECTIVE: To assess the efficacy and benefits of pelvic rehabilitation programs in terms of functional outcomes and quality of life for patients with fecal incontinence and defecation disorders after rectal cancer surgery. DESIGN: Prospective, observational study. SETTING: University hospital physiotherapy clinics. PARTICIPANTS: Patients (N=32) who experienced fecal incontinence after sphincter-saving surgery with the intersphincteric resection (ISR) technique and could follow and cooperate with the treatment schedule were included in the present study. INTERVENTIONS: Pelvic rehabilitation programs included electrical stimulation (ES) and biofeedback (BF). MAIN OUTCOME MEASURES: Functional results, Wexner score, and anorectal manometry were used to assess the clinical outcomes of rehabilitation treatment. RESULTS: Maximum squeeze pressure improved after rehabilitation training (P=.014). There were no statistical differences in resting pressure, resting muscle electromyography, and maximum squeeze electromyography (P=.061, P=.76, and P=.99, respectively). The mean stool frequency was 18.8 per 24 hours before the pelvic intervention program and 7.8 per 24 hours after ES and BF training (P<.001). Of the 32 patients, 27 required antidiarrheal medications before treatment, and after completion of the training, only 9 patients still needed antidiarrheal medications (P<.001). Significant improvements were observed in the Wexner score (17.74 vs 12.93; P<.001). CONCLUSIONS: Our data show that ES and BF are effective in the treatment of fecal incontinence, leading to improvement of quality of life for patients with low rectal cancer after ISR.
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Biorretroalimentación Psicológica/métodos , Terapia por Estimulación Eléctrica/métodos , Incontinencia Fecal/etiología , Incontinencia Fecal/rehabilitación , Neoplasias del Recto/cirugía , Adulto , Anciano , Electromiografía , Femenino , Hospitales Universitarios , Humanos , Masculino , Manometría , Persona de Mediana Edad , Modalidades de Fisioterapia , Estudios Prospectivos , Calidad de VidaRESUMEN
Recent advances in microelectronics and wireless transmission technology have led to the development of various implantable sensors for real-time monitoring of bladder conditions. Although various sensing approaches for monitoring bladder conditions were reported, most such sensors have remained at the laboratory stage due to the existence of vital drawbacks. In the present study, we explored a new concept for monitoring the bladder capacity on the basis of potentiometric principles. A prototype of a potentiometer module was designed and fabricated and integrated with a commercial wireless transmission module and power unit. A series of in vitro pig bladder experiments was conducted to determine the best design parameters for implementing the prototype potentiometric device and to prove its feasibility. We successfully implemented the potentiometric module in a pig bladder model in vitro, and the error of the accuracy of bladder volume detection was <±3%. Although the proposed potentiometric device was built using a commercial wireless module, the design principles and animal experience gathered from this research can serve as a basis for developing new implantable bladder sensors in the future.
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Potenciometría/instrumentación , Vejiga Urinaria/fisiología , Tecnología Inalámbrica/instrumentación , Animales , Diseño de Equipo , Monitoreo Ambulatorio/instrumentación , Tamaño de los Órganos/fisiología , Prótesis e Implantes , Porcinos , Vejiga Urinaria/cirugíaRESUMEN
[Purpose] Stroke and other cerebrovascular diseases are major causes of adult mobility problems. Because stroke immobilizes the affected body part, balance training uses the healthy body part to complete the target movement. The muscle utilization rate on the stroke affected side is often reduced which further hinders affected side functional recovery in rehabilitation. [Subjects and Methods] This study tested a newly-developed interactive device with two force plates to measuring right and left side centers of pressure, to establish its efficacy in the improvement of the static standing ability of patients with hemiplegia. An interactive virtual reality game with different side reaction ratios was used to improve patient balance. The feasibility of the proposed approach was experimentally demonstrated. [Results] Although the non-affected-side is usually used to support the body weight in the standing position, under certain circumstances the patients could switch to using the affected side. A dramatic improvement in static standing balance control was achieved in the eyes open condition. [Conclusion] The proposed dual force plate technique used in this study separately measured the affected and non-affected-side centers of pressure. Based on this approach, different side ratio integration was achieved using an interactive game that helped stroke patients improve balance on the affected side. Only the patient who had suffered stroke relatively recently benefited significantly. The proposed technique is of little benefit for patients whose mobility has stagnated to a certain level.
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This study extensively examined the role of a 5-HT(1A) receptor in controlling voiding function in anesthetized male rats. A simultaneous recording of the intravesical pressure (IVP), external urethral sphincter (EUS)-electromyography (EMG), and urine flow rate (UFR) during continuous cystometry was used. 8-Hydroxy-2-(di-n-propylamino)-tetralin (8-OH-DPAT), a 5-HT(1A) receptor agonist, significantly improved the voiding efficiency, as detected by increases in the evoked contraction amplitude, EUS burst period, and silent period, and decreases in the volume threshold, pressure threshold, and residual volume. Interestingly, the UFR during voiding was reduced by 8-OH-DPAT, as evidenced by decreases in the maximal UFR and mean UFRs of the voiding period, spike duration, and interspike interval. Conversely, treating rats with WAY-100635, a 5-HT(1A) antagonist, produced effects opposite to those produced by 8-OH-DPAT. These findings suggest that 8-OH-DPAT improved the voiding efficiency by enhancing the detrusor contractile ability and prolonging EUS burst period, which would compensate for the lower UFR, resulting from urethral smooth muscle contractions and longer EUS silent periods during voiding. The present study contributes to our understanding of the role of 5-HT(1A) receptors in controlling the urine flow rate in male rats.
Asunto(s)
Receptor de Serotonina 5-HT1A/metabolismo , Serotonina/metabolismo , Uretra/metabolismo , Vejiga Urinaria/metabolismo , Micción , Urodinámica , Animales , Electromiografía , Masculino , Presión , Ratas Sprague-Dawley , Receptor de Serotonina 5-HT1A/efectos de los fármacos , Agonistas del Receptor de Serotonina 5-HT1/farmacología , Antagonistas del Receptor de Serotonina 5-HT1/farmacología , Factores Sexuales , Transducción de Señal , Factores de Tiempo , Uretra/efectos de los fármacos , Vejiga Urinaria/efectos de los fármacos , Micción/efectos de los fármacos , Urodinámica/efectos de los fármacosRESUMEN
In this study, we examined the possibility that 5-HT1A receptors may underlie sexually dimorphic mechanisms affecting the regulation of urethral functions in anesthetized rats. Simultaneous recordings of intravesical pressure under isovolumetric conditions, external urethral sphincter-electromyography, and urethral perfusion pressure were used to examine the effects of a 5-HT1A receptor agonist [8-hydroxy-2-(di-n-propylamino)tetralin (8-OH-DPAT)] and antagonist (WAY-100635) on bladder and urethral functions. This research also evaluated the effects of 8-OH-DPAT and α-bungarotoxin (a neuromuscular blockade agent) on urethral continence using leak point pressure testing, and the distribution of 5-HT1A receptors in the lower urinary tract was assessed by immunohistochemistry. The serotonergic mechanism that controls the urinary bladder and external urethral sphincter-electromyography activity showed no significant sexual differences, but urethral activity in urethral perfusion pressure and leak point pressure values exhibited some sexual differences. 8-OH-DPAT enhanced urethral pressure during continence in rats of both sexes, but the drug elevated the pressure during voiding in male rats and reduced it in female rats. The distribution of 5-HT1A receptors in the spinal cord also showed some sexual differences. The present study contributes to our understanding of the role of 5-HT1A receptors in physiological and immunohistochemical properties of urethral smooth muscle in rats of different sexes. These findings may be a basis for the future development of pharmacotherapies for stress urinary incontinence in men.
Asunto(s)
Receptor de Serotonina 5-HT1A/metabolismo , Caracteres Sexuales , Uretra/fisiología , 8-Hidroxi-2-(di-n-propilamino)tetralin/farmacología , Animales , Femenino , Masculino , Piperazinas/farmacología , Piridinas/farmacología , Ratas , Ratas Sprague-Dawley , Agonistas del Receptor de Serotonina 5-HT1/farmacología , Antagonistas del Receptor de Serotonina 5-HT1/farmacologíaRESUMEN
Flavonoids are natural compounds derived from plants and some of them have been shown to inhibit osteoclast formation, implicating their potential use for the treatment of osteoporosis. Conventionally, the screening of antiosteoclastic agents is a tedious process that requires visual counting of the number of osteoclasts produced. The purpose of this study was to establish an easier and faster method for screening the antiosteoclastogenic flavonoids by using an enzyme assay. Tartrate-resistant acid phosphatase (TRAP) is a marker enzyme of the osteoclast. Results obtained demonstrated that cellular TRAP activity tended to correlate with the number of osteoclasts formed. However, the secreted TRAP activity was actually responsible for the resorption activities of the functional osteoclasts. Consequently, the effectiveness of antiosteoclastogenic agents was screened for by assessing their inhibition on receptor activator of NF-κB ligand (RANKL)-induced TRAP secretion. The half-inhibitory concentrations of flavonoids on TRAP secretion were employed as indices to compare the effectiveness of various flavonoids. The effective flavonoids also exhibited similar inhibitory potencies in the pit-formation analysis. This protocol provides a rapid analysis to screen for effective antiosteoclastogenic agents.