Effects of capacitive and resistive electric transfer and hot pack interventions on the autonomic nervous system in young women.

The effects of thermotherapy on autonomic nervous system activity and subjective sensations of fatigue and arousal are unclear. This study compared the effects of capacitive and resistive electric transfer (Cret) interventions (deep thermotherapy) and hot packs (superficial thermotherapy) on autonomic nervous system activity in healthy young women (n = 16). Heart rate and RR interval were measured using electrocardiography, and the coefficient of variation (CV) of the RR interval was used to evaluate autonomic nervous system activity. The subjective relaxation effect was evaluated using the Roken Arousal Scale (RAS) - a fatigue arousal index. The intervention was performed on the lumbar region for 20 minutes for both Cret and hot pack. After each intervention, the CV values increased only in the Cret condition, whereas the heart rate decreased in both conditions. This suggests that parasympathetic activity was enhanced in the Cret condition. In contrast, the subjective relaxation evaluation observed a psychological relaxation effect under both conditions. Our results suggest that Cret application in the lumbar region has greater relaxation effects than hot pack application in the same region.

Effect of home-based rehabilitation of purposeful activity-based electrical stimulation therapy for chronic stroke survivors: a crossover randomized controlled trial.

BACKGROUND: In this trial we combined the effect of purposeful activity and electrical stimulation therapy (PA-EST) to promote transition of severely hemiparetic upper limb to auxiliary upper limb in chronic stroke survivors in a single-case study. OBJECTIVE: The purpose of this study was to examine the effect of PA-EST on the upper limb motor function in a crossover randomized controlled trial. METHODS: The study included eight stroke survivors (age: 63.1±10.9 years) who were receiving home-based visiting occupational therapy. The average time since stroke onset was 8.8±5.6 years. All participants had severely hemiparetic upper limb, with the Fugl-Meyer Assessment upper extremity (FMA-U) score of 21.3±8.5. Participants were randomly assigned to group A or B. Group A received PA-EST for 3 months (phase 1), followed by standard stretching and exercise for 3 months (phase 2), whereas group B had the inverse order of treatments. To avoid carry-over effect, 1-month washout period was provided between the phase 1 and 2. Two-way analysis of variance (ANOVA) with repeated measures was used for the analysis. The primary outcome was FMA-U, and the secondary outcomes were, Motor Activity Log (MAL; amount of use [AOU] and quality of movement [QOM]), and Goal attainment scale-light (GAS-light). RESULTS: Repeated measures-ANOVA revealed a significant interaction between type of intervention and time for FMA-U (F = 16.303, P = 0.005), MAL AOU (F = 7.966, P = 0.026) and QOM (F = 6.408, P = 0.039), and GAS-light (F = 6.905, P = 0.034), where PA-EST was associated with significantly improved motor function and goal achievement compared with standard stretching. CONCLUSIONS: The PA-EST may have greater effects than stretch/exercise in the recovery of hand function as reflected in FMA-U, MAL, and GAS-light. Our results suggest that PA-EST is an important and useful home-based rehabilitation program for promoting the use of the severely hemiparetic upper limb in chronic stroke survivors.

The effect of Capacitive and Resistive electric transfer on non-specific chronic low back pain.

The objective of this study was to evaluate the effect of Capacitive and Resistive electric transfer (CRet)-combined exercise therapy for participants with non-specific chronic low back pain (NSCLBP). Twenty-six received only the exercise program (E group, n = 15), or received both CRet and the same exercise program (E+CRet group, n = 11). Pain intensity, functional disability and trunk function were measured pre-, and post-intervention and there was also a 1-month follow-up period. Data analysis was performed for each index using the Mann-Whitney U test for comparisons between two groups at each time point, and the Wilcoxon signed-rank test for comparison between each time point within the group. The results of this study indicate that pain intensity was improved in both groups at post-intervention, also, the effect continued during follow-up period. In addition, functional disability was significantly improved in the E+CRet group at the post-intervention and during the follow-up period. The intervention effect on NSCLBP was higher in the E+CRet group than the E group. CRet, which is a form of deep thermotherapy, combined with exercise have a possibility of more effectiveness than exercise alone.

Transcutaneous Electrical Nerve Stimulation Improves Stair Climbing Capacity in People with Knee Osteoarthritis.

This study aimed to examine the effect of transcutaneous electrical nerve stimulation (TENS) on stair climbing capacity in individuals with pre-radiographic to mild knee osteoarthritis (OA). This is a secondary analysis of data from a single, participant-blinded, randomized controlled trial with a pre-post design. Participants with pre-radiographic to mild knee OA (mean age, 59.1 years; 72.9% women) were randomly assigned into two groups, a TENS (n = 30) and a sham-TENS groups (n = 29). TENS or sham-TENS treatments were applied to all participants by using the prototype TENS device with pre-specified parameters. The primary outcome measures included valid and reliable functional measures for stair climbing (stair-climb test [SCT]), visual analog scale for knee pain during the SCT, and quadriceps muscle strength. TENS improved SCT time by 0.41 s (95% confidence interval [CI]: 0.07, 0.75). The time reduction in the transition phase explains the TENS therapeutic effect. Post-hoc correlation analyses revealed a non-significant but positive relationship between the pain relief effect and improved 11-step SCT time in the TENS group but not in the sham-TENS group. These results indicate that the TENS intervention may be an option for reducing the burden of early-stage knee OA.

Effects of deep thermotherapy on chest wall mobility of healthy elderly women.

Chest wall mobility decreases with age in community-dwelling women aged 65 years or older. Thermotherapy is used to improve soft-tissue extensibility. However, its effects on chest wall mobility are unclear. This study aimed to examine the effect of thermotherapy on chest wall mobility in healthy elderly women. Twenty-eight elderly women participated in this study. Chest wall mobility at three levels (axillary, xiphoid, and tenth rib), respiratory function (forced vital capacity and forced expiratory volume), and tissue temperature (skin temperature (ST)) and deep temperature (DT) with 10 mm and 20 mm depth from the skin (10 mm DT and 20 mm DT)) were measured before and after 15 minutes of thermotherapy. The subjects randomly received one of the three interventions (capacitive and resistive electric transfer (CRet), hot pack (HP), and sham CRet (sham)). Chest wall mobility at all levels significantly increased after CRet intervention. Hot pack significantly increased tenth rib excursion; it also significantly increased ST, 10 mm DT, and 20 mm DT, whereas CRet significantly increased 10 mm DT and 20 mm DT. There were significant differences between CRet, HP, and sham in ST, 10 mm DT, and 20 mm DT. Furthermore, 20 mm DT had increased more in CRet than in HP. CRet improved chest wall mobility at all levels and HP improved at the tenth rib level. This implies that CRet can be one of the approaches to improve chest wall mobility.

Risk factors of low back pain and the relationship with sagittal vertebral alignment in Tanzania.

BACKGROUND: LBP is a common and serious problem affecting vast populations of the world. However, only few studies on LBP in sub-Saharan Africa have been conducted. Studies report that LBP and pelvic angle are interrelated, and African residents have a high pelvic tilt. The strategy to prevent LBP should focus on activities that promote holistic health. For that purpose, it is important to grasp the state of LBP and how it affects people's lifestyle in Tanzania to clarify the direction of implementation of physiotherapy treatment and reduce the incidences of LBP among adults. This study aimed to investigate the prevalence and presentation of low back pain (LBP) and the relationship between anthropometric measurements and LBP among people in Moshi city, Kilimanjaro region Tanzania. METHODS: Following signing consent forms, participants were given questionnaires regarding LBP and then grouped accordingly into either asymptomatic or symptomatic cohorts. Anthropometric measurements of participants' height, weight, curvature of the spine, and pelvic angle were obtained. RESULTS: A Mann-Whitney U test analysis showed a significant difference in pelvic angle, body mass index (BMI), and thoracic kyphosis angle between the asymptomatic group and the symptomatic group. No significant differences in lumbar lordosis angle or abdominal muscle strength were found between the two groups. CONCLUSIONS: A person with symptomatic LBP in Tanzania has a large anteversion of the pelvic tilt and a thoracic kyphotic posture. This study shows a relationship between sagittal spinal alignment and LBP in Tanzania, which could allow for prospective identification of subjects prone to developing LBP in the future.

Acute effects of capacitive and resistive electric transfer (CRet) on the Achilles tendon.

This study aimed to investigate the acute effects of capacitive and resistive electric transfer (CRet) on Achilles tendon elongation during muscle contraction, as well as the circulation in the peritendinous region. Sixteen healthy men participated in this study. All 16 participants underwent 2 interventions: (1) CRet trial and (2) CRet without power (sham trial). Tendon elongation was measured four times. Using near-infrared spectroscopy, the blood circulation (volume of total-hemoglobin (Hb), oxygenated hemoglobin (oxy-Hb), and deoxygenated hemoglobin (deoxy-Hb)) was measured for 5 min before the intervention and for 30 min after the intervention. The differences between the measurements obtained before and after intervention were compared between the two interventions. The changes in tendon elongation and deoxy-Hb were not significantly different between the interventions. Total- and oxy-Hb were significantly increased in the CRet trial compared with the sham trial. In addition, the increases in total-Hb and oxy-Hb lasted for 30 min after the CRet intervention (CRet vs. sham: oxy-Hb: F = 8.063, p = 0.001, total-Hb: F = 4.564, p = 0.011). In conclusion, CRet significantly improved blood circulation in the peritendinous region.

Immediate Effects of Transcutaneous Electrical Nerve Stimulation on Pain and Physical Performance in Individuals With Preradiographic Knee Osteoarthritis: A Randomized Controlled Trial.

OBJECTIVE: To investigate the effect of transcutaneous electrical nerve stimulation (TENS) on knee pain and comprehensive physical function in preradiographic knee osteoarthritis. DESIGN: A single, participant-blinded, randomized controlled trial (RCT) with pre-post design. SETTING: University research laboratory. PARTICIPANTS: Patients with knee pain belonging to Kellgren-Lawrence grade 0 or 1 (N=50; aged 50-69y) were randomly assigned to the TENS (n=25) and sham-TENS groups (n=25). INTERVENTIONS: All participants wore the TENS device under the patella of the symptomatic knee. After measurement, the TENS devices in the TENS group were turned on, and those in the sham-TENS group were not connected. MAIN OUTCOME MEASURES: The primary outcome measures included the stair climb test, timed Up and Go (TUG) test, 6-minute walk test (6MWT), and knee pain evaluated using the visual analog scale (VAS) for stair climb test, TUG test, and 6MWT. Secondary outcomes included knee extensor strengths and the 2-step test and stand-up test from the locomotive syndrome risk test. RESULTS: Multiple regression analysis revealed that TENS intervention significantly improved the walk distance and VAS score of the 6MWT, after adjusting for premeasurement data (distance; P=.015, VAS; P=.030). CONCLUSIONS: Use of TENS improved the VAS score for pain and the distance walked in the 6MWT for individuals with Kellgren-Lawrence grade 0 or 1 of the knee. Thus, TENS may be effective for long-distance walking in patients with preradiographic knee osteoarthritis.

Effect of Capacitive and Resistive electric transfer on changes in muscle flexibility and lumbopelvic alignment after fatiguing exercise.

[Purpose] This study aimed to clarify the effects of Capacitive and Resistive electric transfer (CRet) on changes in muscle flexibility and lumbopelvic alignment after fatiguing exercise. [Subjects and Methods] Twenty-two healthy males were assigned into either the CRet (n=11) or control (n=11) group. Fatiguing exercise and CRet intervention were applied at the quadriceps muscle of the participants' dominant legs. The Ely test, pelvic tilt, lumbar lordosis, and superficial temperature were measured before and after exercise and for 30 minutes after intervention. Statistical analysis was performed using one-way analysis of variance, with Tukey's post-hoc multiple comparison test to clarify within-group changes and Student's t-test to clarify between-group differences. [Results] The Ely test and pelvic tilt were significantly different in both groups after exercise, but there was no difference in the CRet group after intervention. Superficial temperature significantly increased in the CRet group for 30 minutes after intervention, in contrast to after the exercise and intervention in the control group. There was no significant between-group difference at any timepoint, except in superficial temperature. [Conclusion] CRet could effectively improve muscle flexibility and lumbopelvic alignment after fatiguing exercise.

Comparison of the effects of kilohertz- and low-frequency electric stimulations: A systematic review with meta-analysis.

OBJECTIVE: This study aimed to determine whether kilohertz-frequency alternating current (KFAC) is superior to low-frequency pulsed current (PC) in increasing muscle-evoked torque and lessening discomfort. DATA SOURCES: The electronic databases PubMed, PEDro, CINAHL, and CENTRAL were searched for related articles, published before August 2017. Furthermore, citation search was performed on the original record using Web of Science. REVIEW METHODS: Randomized controlled trials, quasi-experimental studies, and within-subject repeated studies evaluating and comparing KFAC and PC treatments were included. The pooled standardized mean differences (SMDs) of KFAC and PC treatments, with 95% confidence intervals (CIs), were calculated using the random effects model. RESULTS: In total, 1148 potentially relevant articles were selected, of which 14 articles with within-subject repeated designs (271 participants, mean age: 26.4 years) met the inclusion criteria. KFAC did not significantly increase muscle-evoked torque, compared to PC (pooled SMD: -0.25; 95% CI: -0.53, 0.06; P = 0.120). KFAC had comparable discomfort compared to that experienced using PC (pooled SMD: -0.06; 95% CI: -0.50, 0.38; P = 0.800). These estimates of the effects had a high risk of bias, as assessed using the Downs and Black scale, and were highly heterogeneous studies. CONCLUSIONS: This meta-analysis does not establish that KFAC is superior to PC in increasing muscle-evoked torque and lessening discomfort level. However, no strong conclusion could be drawn because of a high risk of bias and a large amount of heterogeneity. High quality studies comparing the efficacy between PC and KFAC treatments with consideration of potential confounders is warranted to facilitate the development of effective treatment.

Effect of Capacitive and Resistive electric transfer on haemoglobin saturation and tissue temperature.

PURPOSE: This study aims to evaluate the effects of Capacitive and Resistive electric transfer (CRet) and hotpack (HP) on haemoglobin saturation and tissue temperature. MATERIALS AND METHODS: The participants were 13 healthy males (mean age 24.5 ± 3.0). They underwent three interventions on different days: (1) CRet (CRet group), (2) HP (HP group) and (3) CRet without power (sham group). The intervention and measurement were applied at the lower paraspinal muscle. Indiba® active ProRecovery HCR902 was used in the CRet group, and the moist heat method was used in the HP group. Oxygenated, deoxygenated and total haemoglobin (oxy-Hb, deoxy-Hb, total-Hb) counts were measured before and after the 15-min interventions, together with the temperature at the skin surface, and at depths of 10 mm and 20 mm (ST, 10mmDT and 20mmDT, respectively). The haemoglobin saturation and tissue temperature were measured until 30 min after the intervention and were collected at 5-min intervals. Statistical analysis was performed for each index by using the Mann-Whitney U test for comparisons between all groups at each time point. RESULTS: Total-Hb and oxy-Hb were significantly higher in the CRet group than in the HP group continuously for 30 min after the intervention. The 10mmDT and 20mmDT were significantly higher in the CRet group than in the HP group from 10- to 30 min after intervention. CONCLUSIONS: The effect on haemoglobin saturation was higher in the CRet group than in the HP group. In addition, the CRet intervention warmed deep tissue more effectively than HP intervention.

Mail-Based Intervention for Sarcopenia Prevention Increased Anabolic Hormone and Skeletal Muscle Mass in Community-Dwelling Japanese Older Adults: The INE (Intervention by Nutrition and Exercise) Study.

OBJECTIVE: The aim of the Intervention by Nutrition and Exercise (INE) study was to investigate the effects of a mail-based intervention for sarcopenia prevention on muscle mass and anabolic hormones in community-dwelling older adults. DESIGN: A cluster-randomized controlled trial. SETTING AND PARTICIPANTS: This trial recruited community-dwelling adults aged 65 years and older in Japan. The 227 participants were cluster randomized into a walking and nutrition (W/N) group (n = 79), a walking (W) group (n = 71), and a control (C) group (n = 77). We analyzed the physical and biochemical measurements in this substudy. INTERVENTION: Six months of mail-based intervention (a pedometer-based walking program and nutritional supplementation). MEASUREMENTS: The skeletal muscle mass index (SMI) using the bioelectrical impedance data acquisition system, biochemical measurements, such as those of insulinlike growth factor (IGF-1), dehydroepiandrosterone sulfate (DHEA-S), and 25-hydroxy vitamin D (25[OH]D), as well as frailty, were assessed by the Cardiovascular Health Study criteria. RESULTS: Participants in the W/N and W groups had significantly greater improvements in SMI, IGF-1, and 25(OH)D (P < .05) than those in the C group. Participants in the W/N group had significantly greater improvements in DHEA-S (P < .05) than in the other groups. These effects were more pronounced in frail, older adults. CONCLUSION: These results suggest that the mail-based walking intervention of the remote monitoring type for sarcopenia prevention can increase anabolic hormone levels and SMI in community-dwelling older adults, particularly in those who are frail.

Effect of a Kinect-based exercise game on improving executive cognitive performance in community-dwelling elderly: case control study.

BACKGROUND: Decrease of dual-task (DT) ability is known to be one of the risk factors for falls. We developed a new game concept, Dual-Task Tai Chi (DTTC), using Microsoft's motion-capture device Kinect, and demonstrated that the DTTC test can quantitatively evaluate various functions that are known risk factors for falling in elderly adults. Moreover, DT training has been attracting attention as a way to improve balance and DT ability. However, only a few studies have reported that it improves cognitive performance. OBJECTIVE: The purpose of this study was to demonstrate whether or not a 12-week program of DTTC training would effectively improve cognitive functions. METHODS: This study examined cognitive functions in community-dwelling older adults before and after 12 weeks of DTTC training (training group [TG]) or standardized training (control group [CG]). Primary end points were based on the difference in cognitive functions between the TG and the CG. Cognitive functions were evaluated using the trail-making test (part A and part B) and verbal fluency test. RESULTS: A total of 41 elderly individuals (TG: n=26, CG: n=15) participated in this study and their cognitive functions were assessed before and after DTTC training. Significant differences were observed between the two groups with significant group × time interactions for the executive cognitive function measure, the delta-trail-making test (part B-part A; F1,36=4.94, P=.03; TG: pre mean 48.8 [SD 43.9], post mean 42.2 [SD 29.0]; CG: pre mean 49.5 [SD 51.8], post mean 64.9 [SD 54.7]). CONCLUSIONS: The results suggest that DTTC training is effective for improving executive cognitive functions. TRIAL REGISTRATION: Japan Medical Association Clinical Trial Registration Number: JMA-IIA00092; https://dbcentre3.jmacct.med.or.jp/jmactr/App/JMACTRS06/JMACTRS06.aspx?seqno=2682 (Archived by WebCite at http://www.webcitation.org/6NRtOkZFh).

Effects of the thermal environment on articular chondrocyte metabolism: a fundamental study to facilitate establishment of an effective thermotherapy for osteoarthritis.

AIM: To facilitate establishment of an effective thermotherapy for osteoarthritis (OA), we investigated the effects of the thermal environment on articular chondrocyte metabolism in vitro. METHODS: Chondrocytes were isolated from porcine knee joints, and cultured at 32°C, 37°C and 41°C. Cell proliferation and viability were assessed at Days 2, 4 and 8. In addition, TdT-mediated dUTP nick end labeling (TUNEL) assay was performed at Day 3 to determine the proportion of apoptotic chondrocytes. Analysis of genes specific for factors related to the cartilage extracellular matrix (ECM), cartilage destruction, and cartilage protection was performed at Day 2. Furthermore, evaluation of heat stress tolerance, and heat shock protein 70 (HSP70) mRNA expression and protein synthesis was performed at Day 2 and 3, respectively. RESULTS: Cell proliferation was more at 37°C than at 32°C and 41°C. Cell viability and the number of TUNEL-positive cells were not affected until Day 8 and 3, respectively. The expression of the ECM-related genes was up-regulated at higher temperature. The expression of MMP13, a type II collagen destructive enzyme, and that of TIMP1 and TIMP2, which are MMP inhibitors, were up-regulated at higher temperatures. Finally, the chondrocytes cultured at 41°C may acquire heat stress tolerance, in part, due to the up-regulation of HSP70, and may inhibit apoptosis induced by various stresses, which is observed in OA. CONCLUSIONS: The thermal environment affects articular chondrocyte metabolism, and a heat stimulus of approximately 41°C could enhance chondrocyte anabolism and induce heat stress tolerance.

Efficacy of an Exercise Game Based on Kinect in Improving Physical Performances of Fall Risk Factors in Community-Dwelling Older Adults.

OBJECTIVE: The purpose of this study was to demonstrate whether a 12-week program of training with dual-task Tai Chi (DTTC), which is a new concept game we developed using Kinect (Microsoft, Redmond, WA), would be effective in improving physical functions of fall risk factors. MATERIALS AND METHODS: This study examined balance, muscle strength, locomotive ability, and dual-task ability in community-dwelling older adults (75.4±6.3 years) before and after 12 weeks of DTTC training (training group [TG]; n=32) or standardized training (control group [CG]; n=41). Primary end points were based on the difference in physical functions between the TG and the CG. RESULTS: Significant differences were observed between the two groups with significant group×time interaction for the following physical function measures: timed up-and-go (TUG) (P<0.01), one-leg standing (OLS) (P<0.05), and 5 chair stand (5-CS) (P<0.05). There were no significant differences among the other measures: 10-m walking time under standard conditions, manual-task conditions, and cognitive-task conditions, 10-m maximal walking time, and Functional Reach test scores. Thus, the scores of TUG, OLS, and 5-CS in the TG improved significantly with DTTC training compared with the CG. CONCLUSIONS: The results suggest that the DTTC training is effective in improving balance ability and mobility, which are risk factors for falls.

Concept Software Based on Kinect for Assessing Dual-Task Ability of Elderly People.

OBJECTIVE: Assessment of fall risk of elderly people is a critical issue. Dual-task (DT) ability is a criterion for risk assessment. We developed new concept software based on Microsoft (Redmond, WA) Kinect™ for assessing DT ability. The software is named "Dual-Task Tai Chi" (DTTC) and includes Tai Chi and number place (Sudoku) components. The purpose of this study is to validate the DTTC test for assessment of DT ability. SUBJECTS AND METHODS: Forty-five community-dwelling elderly (mean age, 74.1±6.6 years) individuals participated in this study. They performed DTTC, locomotive, cognitive, and DT tests. DT ability was evaluated with a 10-m walk under a cognitive-task condition and a 10-m walk under a manual-task condition. The correlation between the time taken to complete the DTTC test and each function test was determined using Pearson correlation coefficients. Stepwise multiple regression analysis was conducted to assess the relationship between the DTTC test results and results of the other tests. RESULTS: The time taken to complete the DTTC test was correlated with DT ability, locomotive functioning, and cognitive functioning. Results of stepwise multiple regression analysis confirmed that DT, balance, and cognitive ability are statistically significant. No statistically significant association was found for the other variables. CONCLUSIONS: The DTTC test quantitatively evaluates a compound function including DT, balance, and cognitive abilities.

Histone modifiers, YY1 and p300, regulate the expression of cartilage-specific gene, chondromodulin-I, in mesenchymal stem cells.

Elucidating the regulatory mechanism for tissue-specific gene expression is key to understanding the differentiation process. The chondromodulin-I gene (ChM-I) is a cartilage-specific gene, the expression of which is regulated by the transcription factor, Sp3. The binding of Sp3 to the core-promoter region is regulated by the methylation status of the Sp3-binding motif as we reported previously. In this study, we have investigated the molecular mechanisms of the down-regulation of ChM-I expression in mesenchymal stem cells (MSCs) and normal mesenchymal tissues other than cartilage. The core-promoter region of cells in bone and peripheral nerve tissues was hypermethylated, whereas the methylation status in cells of other tissues including MSCs did not differ from that in cells of cartilage, suggesting the presence of inhibitory mechanisms other than DNA methylation. We found that a transcriptional repressor, YY1, negatively regulated the expression of ChM-I by recruiting histone deacetylase and thus inducing the deacetylation of associated histones. As for a positive regulator, we found that a transcriptional co-activator, p300, bound to the core-promoter region with Sp3, inducing the acetylation of histone. Inhibition of YY1 in combination with forced expression of p300 and Sp3 restored the expression of ChM-I in cells with a hypomethylated promoter region, but not in cells with hypermethylation. These results suggested that the expression of tissue-specific genes is regulated in two steps; reversible down-regulation by transcriptional repressor complex and tight down-regulation via DNA methylation.