Résumé
OBJECTIVE:At present,there are a variety of treatment methods for scoliosis using specific exercise therapy,but there is a lack of comparison of efficacy between different specific exercise therapy.This article compared the effectiveness of different specific exercise therapies to treat adolescent idiopathic scoliosis through a network meta-analysis. METHODS:Domestic and foreign electronic databases of relevant studies were searched for randomized controlled trials of specific exercise therapy for adolescent idiopathic scoliosis.Search time was from January 2000 to July 2023.The literature was screened by two reviewers using RevMan 5.4 and Stata 16.0 software to extract data and assess the bias risk of of inclusion studies. RESULTS:(1)This article includes 20 randomized controlled trials with 1 377 patients.Of them,12 studies involved Schroth therapy;2 studies involved BSPTS therapy,and 6 studies involved SEAS therapy.(2)The network meta-analysis indicated that in terms of improving Cobb angle and reducing trunk rotation angle in scoliosis patients,the BSPTS therapy group and Schroth therapy group were better than the conventional control group[WMD=-4.60,95%CI(-8.37,-0.82),P<0.05;WMD=-3.37,95%CI(-4.98,-1.75),P<0.05;WMD=-3.20,95%CI(-5.50,-0.90),P<0.05;WMD=-2.13,95%CI(-3.16,-1.09),P<0.05].The Schroth therapy group performed better than the conventional control group effective in improving the International Society for Scoliosis Research-22 Questionnaire quality of life score[WMD=1.41,95%CI(0.07,2.75),P<0.05]. CONCLUSION:Given the current evidence,BSPTS therapy group and Schroth therapy group were better than the conventional control group in improving Cobb angle and reducing trunk rotation angle.In the comparison of different specific exercise therapies,BSPTS therapy can be preferred to improve Cobb angle and reduce trunk rotation angle in adolescent idiopathic scoliosis patients.In addition,Schroth therapy may be the best treatment to improve the quality of life of adolescent idiopathic scoliosis patients.Limited by the quantity and quality of the included studies,the above conclusions should be interpreted with caution and need more high-quality studies to further validation.
Résumé
Fascia,the initial response site for mechanical stimulation in manipulations,is also the target of the effect of manipulations.As the essence of manipulation is"force",how mechanical stimuli are transduced into neuroelectric and biochemical signals in the fascia and how physical and chemical signals of the fascia initiate the mechanical stimulation effect are the common key questions in the study of the principle of manipulation.The physical changes in the fascial connective tissue caused by the manipulation,such as the deformation and displacement of the fascial tissue,can act on the nerve end receptors in the fascial layer and generate neural electrical signals;they can also activate the mechanoreceptors on the fascial cell membrane and convert mechanical signals into chemical signals via mechanosensitive ion channel transduction,triggering a physicochemical coupling response in the fascial microenvironment and producing mechanical stimulation through neuro-endocrine-immune system pathways.The"mechanical force of manipulation"in the fascia is transmitted through the meridian to facilitate the body's perception and transmission of mechanical stimulation signals,indicating that the fascia is the"sensor"of coupled response to the physicochemical information of mechanical stimulation of manipulation.
Résumé
Objective To observe the influences of extremely low frequency magnetic fields irradiation in rats at different time points after traumatic brain injury (TBI).Methods According to the random number table method,450 SD rats were divided into blank control group,TBI group,electromagnetic field early irradiation group,electromagnetic field late irradiation group,and electromagnetic field early and late combined irradiation group (n=90).TBI models in rats of the later four groups were induced by connection of lateral hydraulic impact (LFP) equipment;the rats in the blank control group accepted the same operation,but did not connect to the LFP equipment.The rats in the electromagnetic field early irradiation group and electromagnetic field late irradiation group received electromagnetic field irradiation on 6 and 60 d after TBI for 15 consecutive d,respectively;and the rats in the electromagnetic field early and late combined irradiation group received twice consecutive electromagnetic field irradiation for 15 d on 6 and 60 d after TBI.Four h,15 d and 75 d after TBI,the hypoxia inducible factor-1α (HIF-1α) expression in the hippocampus of rats in each group was detected by immunohistochemical staining;TUNEL was used to detect cell apoptosis in hippocampal area of rats in each group;the contents of Evans blue (EB) and brain water in rat brain tissues were determined;the water maze experiment was used to test the learning and memory abilities of rats;HIF-1α protein expression in the hippocampal tissues of rats was detected by Western blotting.Results As compared with rats in the blank control group,rats in the TBI group,electromagnetic field early irradiation group,electromagnetic field late irradiation group,and electromagnetic field early and late combined irradiation group had significantly larger number of apoptotic cells in the hippocampus,statistically longer time boarding the escape platform,significantly higher HIF-1α protein expression at 4 h,15 d and 75 d after TBI (P＜0.05).As compared with rats in the TBI group,those in the electromagnetic field early irradiation group and electromagnetic field early and late combined irradiation group had significantly smaller number of apoptotic cells in the hippocampus,statistically shorter time boarding the escape platform,significantly lower HIF-1α protein expression,and significantly decreased EB content and brain water content 15 d after TBI (P＜0.05).As compared with rats in the TBI group,those in the electromagnetic field early irradiation group,electromagnetic field late irradiation group,and electromagnetic field early and late combined irradiation group had significantly smaller number of apoptotic cells in the hippocampus,statistically shorter time boarding the escape platform,significantly lower HIF-1α protein expression,and significantly decreased EB content and brain water content 75 d after TBI (P＜0.05).Conclusion The extremely low frequency magnetic fields irradiation is recommended in early and delayed stages of TBI;and exposure to extremely low frequency magnetic fields should be prolonged.
Résumé
Objective:To evaluate the clinical efficacy of tendon-regulating manipulation plus kinesiotherapy in treating low back pain. Methods:Sixty patients were randomized into a treatment group and a control group by using the random number table, 30 cases in each group. The treatment group was intervened by tendon-regulating manipulation plus kinesiotherapy, while the control group was by the tendon-regulating manipulation alone. The lumbar lordosis was measured by X-ray (side view), the pain was evaluated by analgesy meter, the lumbar range of motion was by using goniometer, and the function was judged by Oswestry disability index (ODI) before and after treatment, and the therapeutic efficacy was also observed. Results:After treatment, the pain level was significantly reduced, lumbar lordosis was significantly increased, the lumbar range of motion was markedly improved, and the ODI score significantly dropped (allP<0.05) in both groups; the improvement of each item in the treatment group was more significant than that in the control group (allP<0.05). The total effective rate was 90.0% in the treatment group versus 63.3% in the control group, and the difference was statistically significant (P<0.05). Conclusion:In the treatment of low back pain, tendon-regulating manipulation plus kinesiotherapy can mitigate topical pain, improve the motion of low back, enhance the quality of life, and produce a more significant therapeutic efficacy compared to tendon-regulating manipulation alone.