The use of mindfulness-based interventions in stroke rehabilitation: A scoping review.

PURPOSE/OBJECTIVE: There is emerging evidence for the use of mindfulness-based interventions (MBIs) to improve health outcomes in the context of stroke rehabilitation. This scoping review identified recently available evidence and possible research gaps regarding how MBIs affect psychological and physical rehabilitation outcomes in individuals poststroke. RESEARCH METHOD/DESIGN: Electronic searches were performed using the four major databases, CINAHL, MEDLINE, PsycINFO, and Web of Science. Sixteen studies out of a total of 404 relevant studies met the selection criteria for inclusion in this review. RESULTS: Our findings indicate diverse results on the benefits of MBIs in individuals poststroke across a range of rehabilitative outcomes. For instance, significant improvements in mental fatigue, cognition, and quality of life were observed for most of the studies while the outcomes for mood and physical functioning were mixed. CONCLUSIONS/IMPLICATIONS: The available evidence lends qualified support to the view that mindfulness has the potential to be a therapeutic intervention that offers health benefits to individuals poststroke. Yet, the diversity of results highlights the need for a more rigorous examination in further research. We also identified several knowledge gaps in mindfulness research in the stroke population, such as the limited amount of evidence for mindfulness-based cognitive therapy (MBCT), inadequate evaluations of physical outcomes, and the lack of methodologically robust trials. Further investigations are warranted to strengthen the evidence for the feasibility and effectiveness of MBIs. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Effectiveness of Deep Water Running on Improving Cardiorespiratory Fitness, Physical Function and Quality of Life: A Systematic Review.

Deep Water Running (DWR) is a form of aquatic aerobic exercise simulating the running patterns adopted on dry land. Little is known on the effectiveness of DWR despite gaining popularity. The objective of this study is to systematically review the effects of DWR on cardiorespiratory fitness, physical function, and quality of life in healthy and clinical populations. A systematic search was completed using six databases, including SPORTDiscus, MEDLINE, CINAHL, AMED, Embase, and The Cochrane Library, up to February 2022. Eleven studies evaluating the effectiveness of DWR on cardiorespiratory fitness (CRF), physical function, or quality of life (QoL), compared with no interventions (or standard treatment) or land-based trainings were identified. Data relevant to the review questions were extracted by two independent reviewers when means and standard deviations were reported, and standardized mean differences were calculated. A quality assessment was conducted using selected items from the Downs and Black checklist. A total of 11 clinical trials (7 randomized controlled trials) with a total of 287 participants were included. Meta-analyses were not completed due to the high level of clinical and statistical heterogeneity between studies. Compared with land-based training, DWR showed similar effects on CRF with limited studies reporting outcomes of physical function and QoL compared with the no-exercise control group. DWR appears to be comparable to land-based training for improving CRF. The aquatic environment may provide some advantages for off-loaded exercise at high intensity in populations that are weak, injured or in pain, but more studies are required.

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

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

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

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

Bilateral Transcutaneous Electrical Nerve Stimulation Improves Lower-Limb Motor Function in Subjects With Chronic Stroke: A Randomized Controlled Trial.

BACKGROUND: Transcutaneous electrical nerve stimulation (TENS) has been used to augment the efficacy of task-oriented training (TOT) after stroke. Bilateral intervention approaches have also been shown to be effective in augmenting motor function after stroke. The purpose of this study was to compare the efficacy of bilateral TENS combined with TOT versus unilateral TENS combined with TOT in improving lower-limb motor function in subjects with chronic stroke. METHODS AND RESULTS: Eighty subjects were randomly assigned to bilateral TENS+TOT or to unilateral TENS+TOT and underwent 20 sessions of training over a 10-week period. The outcome measures included the maximal strength of the lower-limb muscles and the results of the Lower Extremity Motor Coordination Test, Berg Balance Scale, Step Test, and Timed Up and Go test. Each participant was assessed at baseline, after 10 and 20 sessions of training and 3 months after the cessation of training. The subjects in the bilateral TENS+TOT group showed greater improvement in paretic ankle dorsiflexion strength (ß=1.32; P=0.032) and in the completion time for the Timed Up and Go test (ß=-1.54; P=0.004) than those in the unilateral TENS+TOT group. However, there were no significant between-group differences for other outcome measures. CONCLUSIONS: The application of bilateral TENS over the common peroneal nerve combined with TOT was superior to the application of unilateral TENS combined with TOT in improving paretic ankle dorsiflexion strength after 10 sessions of training and in improving the completion time for the Timed Up and Go test after 20 sessions of training. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT02152813.

Effects of Ving Tsun Chinese Martial Art Training on Upper Extremity Muscle Strength and Eye-Hand Coordination in Community-Dwelling Middle-Aged and Older Adults: A Pilot Study.

Objectives. To evaluate the effects of Ving Tsun (VT) martial art training on the upper extremity muscle strength and eye-hand coordination of middle-aged and older adults. Methods. This study used a nonequivalent pretest-posttest control group design. Forty-two community-dwelling healthy adults participated in the study; 24 (mean age ± SD = 68.5 ± 6.7 years) underwent VT training for 4 weeks (a supervised VT session twice a week, plus daily home practice), and 18 (mean age ± SD = 72.0 ± 6.7 years) received no VT training and acted as controls. Shoulder and elbow isometric muscle strength and eye-hand coordination were evaluated using the Lafayette Manual Muscle Test System and a computerized finger-pointing test, respectively. Results. Elbow extensor peak force increased by 13.9% (P = 0.007) in the VT group and the time to reach peak force decreased (9.9%) differentially in the VT group compared to the control group (P = 0.033). For the eye-hand coordination assessment outcomes, reaction time increased by 2.9% in the VT group and decreased by 5.3% in the control group (P = 0.002). Conclusions. Four weeks of VT training could improve elbow extensor isometric peak force and the time to reach peak force but not eye-hand coordination in community-dwelling middle-aged and older adults.

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

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

Core Muscle Activity during TRX Suspension Exercises with and without Kinesiology Taping in Adults with Chronic Low Back Pain: Implications for Rehabilitation.

This study aimed to examine the effects of kinesiology taping (KT) and different TRX suspension workouts on the amplitude of electromyographic (EMG) activity in the core muscles among people with chronic low back pain (LBP). Each participant (total n = 21) was exposed to two KT conditions: no taping and taping, while performing four TRX suspension exercises: (1) hamstring curl, (2) hip abduction in plank, (3) chest press, and (4) 45-degree row. Right transversus abdominis/internal oblique (TrAIO), rectus abdominis (RA), external oblique (EO), and superficial lumbar multifidus (LMF) activity was recorded with surface EMG and expressed as a percentage of the EMG amplitude recorded during a maximal voluntary isometric contraction of the respective muscles. Hip abduction in plank increased TrAIO, RA, and LMF EMG amplitude compared with other TRX positions (P < 0.008). Only the hamstring curl was effective in inducing a high EMG amplitude of LMF (P < 0.001). No significant difference in EMG magnitude was found between the taping and no taping conditions overall (P > 0.05). Hip abduction in plank most effectively activated abdominal muscles, whereas the hamstring curl most effectively activated the paraspinal muscles. Applying KT conferred no immediate benefits in improving the core muscle activation during TRX training in adults with chronic LBP.

The effects of a 6-month Tai Chi Qigong training program on temporomandibular, cervical, and shoulder joint mobility and sleep problems in nasopharyngeal cancer survivors.

INTRODUCTION: Nasopharyngeal cancer (NPC) survivors often sustain head-neck-shoulder impairments from conventional treatments, which could disturb sleep. This novel study aimed to examine the efficacy of Tai Chi (TC) Qigong in optimizing temporomandibular joint (TMJ), cervical, and shoulder joint mobility and reducing sleep problems in NPC survivors. METHODS: Fifty-two NPC survivors participated in the study. The experimental group (n = 25) received 6 months of TC Qigong training (1.5 h/session; 4 sessions/wk including self-practice) while the control group (n = 27) received no training. Cervical side flexion and rotation, shoulder flexion and horizontal flexion range of motion (ROM), mouth opening capacity (interincisor distance), and sleep problems (Medical Outcomes Study Sleep Scale) were assessed at baseline, mid-intervention (3 months), immediately after TC Qigong training, and at 6-month follow-up. RESULTS: Intention-to-treat analysis revealed improvement in cervical side flexion ROM only (P < .008) and unchanged shoulder and TMJ mobility (P > .008) after the TC Qigong training. Deterioration was observed in shoulder flexion ROM and mouth opening capacity in the no-training controls over time (P < .008). Sleep problems also decreased in the TC Qigong group (P < .008), and this effect was most profound during the follow-up period. In addition, improvement in cervical side flexion ROM was associated with a reduction in sleep problems in the experimental group after TC Qigong training (P < .05). CONCLUSIONS: The 6-month TC Qigong intervention improved neck mobility, maintained TMJ and shoulder joint mobility, and reduced sleep problems for NPC survivors. TC Qigong could be an effective nonpharmacological intervention for managing progressive trismus, chronic neck and shoulder hypomobility, and reducing sleep problems among NPC survivors.

A home-based program of transcutaneous electrical nerve stimulation and task-related trunk training improves trunk control in patients with stroke: a randomized controlled clinical trial.

BACKGROUND: Impaired trunk motor control is common after stroke. Combining transcutaneous electrical nerve stimulation (TENS) with task-related trunk training (TRTT) has been shown to enhance the recovery of lower limb motor function. OBJECTIVE: This study investigated whether combining TENS with TRTT would enhance trunk control after stroke. Methods. Thirty-seven subjects with stroke were recruited into a randomized controlled clinical trial. Subjects were randomly assigned to any one of the three 6-week home-based training groups: (1) TENS + TRTT, (2) placebo TENS + TRTT, or (3) control without active training. The outcome measures included isometric peak trunk flexion torque and extension torque; forward seated and lateral seated reaching distance to the affected and unaffected side; and Trunk Impairment Scale (TIS) scores. All outcome measures were assessed at baseline, after 3 and 6 weeks of training, and 4 weeks after training ended at follow-up. RESULTS: Both the TENS + TRTT and the placebo-TENS + TRTT groups had significantly greater improvements in isometric peak trunk flexion torque and extension torque, lateral seated reaching distance to affected and unaffected side, and TIS score than the control group after 3 weeks of training. The TENS + TRTT group had significantly greater and earlier improvement in its mean TIS score than the other 2 groups. CONCLUSIONS: Home-based TRTT is effective for improving trunk muscle strength, sitting functional reach and trunk motor control after stroke in subjects without somatosensory deficits. The addition of TENS to the trunk augments the effectiveness of the exercise in terms of TIS scores within the first 3 weeks of training.

Musculoskeletal strength, balance performance, and self-efficacy in elderly ving tsun chinese martial art practitioners: implications for fall prevention.

Objectives. To (1) compare the bone strength, lower limb muscular strength, functional balance performance, and balance self-efficacy between Ving Tsun (VT) martial art practitioners and nonpractitioners and (2) identify the associations between lower limb muscular strength, functional balance performance, and balance self-efficacy among the VT-trained participants. Methods. Thirty-five VT practitioners (mean age ± SD = 62.7 ± 13.3 years) and 49 nonpractitioners (mean age ± SD = 65.9 ± 10.5 years) participated in the study. The bone strength of the distal radius, lower limb muscular strength, functional balance performance, and balance self-efficacy were assessed using an ultrasound bone sonometer, the five times sit-to-stand test (FTSTS), the Berg balance scale (BBS), and the Chinese version of the activities-specific balance confidence scale, respectively. A multivariate analysis of covariance was performed to compare all the outcome variables between the two groups. Results. Elderly VT practitioners had higher radial bone strength on the dominant side (P < 0.05), greater lower limb muscular strength (P = 0.001), better functional balance performance (P = 0.003), and greater balance confidence (P < 0.001) than the nonpractitioners. Additionally, only the FTSTS time revealed a significant association with the BBS score (r = -0.575, P = 0.013). Conclusions. VT may be a suitable health-maintenance exercise for the elderly. Our findings may inspire the development of VT fall-prevention exercises for the community-dwelling healthy elderly.

Balance Performance in Irradiated Survivors of Nasopharyngeal Cancer with and without Tai Chi Qigong Training.

This cross-sectional exploratory study aimed to compare the one-leg-stance time and the six-minute walk distance among TC Qigong-trained NPC survivors, untrained NPC survivors, and healthy individuals. Twenty-five survivors of NPC with TC Qigong experience, 27 survivors of NPC without TC Qigong experience, and 68 healthy individuals formed the NPC-TC Qigong group, NPC-control group, and healthy-control group, respectively. The one-leg-stance (OLS) timed test was conducted to assess the single-leg standing balance performance of the participants in four conditions: (1) standing on a stable surface with eyes open, (2) standing on a compliant surface with eyes open, (3) standing on a stable surface with eyes closed, and (4) standing on a compliant surface with eyes closed. The six-minute walk test (6MWT) was used to determine the functional balance performance of the participants. Results showed that the NPC-control group had a shorter OLS time in all of the visual and supporting surface conditions than the healthy control group (P < 0.05). The OLS time of the TC Qigong-NPC group was comparable to that of the healthy control group in the somatosensory-challenging condition (condition 3) (P = 0.168) only. Additionally, there was no significant difference in the 6MWT distance among the three groups (P > 0.05). TC Qigong may be a rehabilitation exercise that improves somatosensory function and OLS balance performance among survivors of NPC.

Effects of qigong training on health-related quality of life, functioning, and cancer-related symptoms in survivors of nasopharyngeal cancer: a pilot study.

This study aimed to investigate the effects of Qigong intervention on quality of life (QOL), health-related functioning, and cancer-related symptoms in survivors of nasopharyngeal cancer (NPC). Twenty-five survivors of NPC were included in the experimental group (mean age ± SD: 55.4 ± 7.5 years) and 27 in the control group (mean age ± SD: 58.7 ± 9.5 years). The experimental group underwent a weekly 1.5-hour Qigong training program and an identical home program (three times/week) for six months. The control group received no training. Global health status/QOL, functioning, and cancer-related symptoms were assessed by the European Organization for Research and Treatment of Cancer QLQ-C30 and QLQ-H&N35 questionnaires before training began, after three months of Qigong training, at the end of the six-month Qigong intervention (i.e., posttest), and six months posttest. Intention-to-treat analysis revealed no statistically (P > 0.05) or clinically significant improvement in global health status/QOL, functioning, or symptoms in either group. The experimental group had 45.8% fewer sense-related (smell and taste) problems (P < 0.05) but 98.6% more speech-related problems (P < 0.05) than the control group after the Qigong intervention. Qigong training resulted in no apparent improvement in health-related QOL, functionality, or cancer-related symptoms in cancer-free survivors of NPC, except for a possible reduction in smell- and taste-related problems.

Effects of a 6-month Tai Chi Qigong program on arterial hemodynamics and functional aerobic capacity in survivors of nasopharyngeal cancer.

PURPOSE: Survivors of nasopharyngeal cancer (NPC) often sustain cardiovascular complications after conventional cancer treatments. Tai Chi (TC) Qigong training may be a viable way to improve peripheral circulatory status and aerobic capacity in this population. The objective of this study was to evaluate the effects of a 6-month TC Qigong training program on blood flow velocities and resistance, palmar skin temperature, and functional aerobic capacity in survivors of NPC. METHODS: Twenty-five and 27 survivors of NPC volunteered to join the intervention group (mean age, 55.4 ± 7.5 years) and control group (mean age, 58.7 ± 9.5 years), respectively. The intervention group underwent a TC Qigong training program-the modified 18 Forms TC Internal Qigong-for 6 months, while the control group received no training. Peripheral arterial blood flow velocities and resistance, palmar skin temperature, and functional aerobic capacity were measured by a Doppler ultrasound machine, an infrared thermometer, and six-minute walk test, respectively. All outcomes were assessed at baseline, mid-intervention (3-month), post-intervention (6-month), and follow-up (12-month) periods. RESULTS: The TC Qigong group had higher diastolic blood flow velocity (p = 0.010), lower arterial blood flow resistance (p = 0.009), and higher palmar skin temperature (p = 0.004) than the control group after TC Qigong training. However, only the diastolic blood flow velocity was higher in the TC Qigong group than in the control group during the no-training follow-up period (p = 0.032). Additionally, an improvement in functional aerobic capacity was found in the intervention group after TC Qigong training (p < 0.008) but not in the control group over time (p > 0.008). CONCLUSIONS: TC Qigong training may improve peripheral circulatory status and functional aerobic capacity among people treated for NPC. However, this is only a pilot study and future definitive trials are needed to confirm the results. IMPLICATIONS FOR CANCER SURVIVORS: TC Qigong may have enormous potential as a rehabilitation intervention for survivors of NPC to improve arterial hemodynamics and functional aerobic capacity.

Effects of qigong exercise on upper limb lymphedema and blood flow in survivors of breast cancer: a pilot study.

HYPOTHESIS: Qigong exercise is a popular method for relieving the side effects of conventional cancer treatments in survivors of breast cancer, yet its effects are not empirically assessed. This study aimed to investigate the effects of qigong exercise on upper limb lymphedema, arterial resistance, and blood flow velocity in survivors with breast cancer and mastectomy. STUDY DESIGN: This study was conducted as a prospective clinical trial. METHODS: Eleven survivors of breast cancer with qigong experience (mean age = 58.3 ± 10.1 years) were assigned to the experimental group and 12 survivors of breast cancer without qigong experience (mean age = 53.8 ± 4.2 years) were assigned to the control group. They all had breast cancer-related lymphedema. All procedures were completed within one session. After baseline measurements were taken, the experimental group performed 18 Forms Tai Chi Internal Qigong for approximately 6 minutes while the control group rested for similar duration in a sitting position. Both groups were then reassessed. All participants were measured on their affected upper limb circumference (by using tape measures), peripheral arterial resistance, and blood flow velocities (using a Doppler ultrasound machine). RESULTS: The between-group differences were not significant for all outcome measures at baseline (P > .05). The circumferences of the affected upper arm, elbow, forearm and wrist decreased after qigong exercise (P < .05). However, no significant difference was found in the circumference measures between the 2 groups posttest (P > .0125). In terms of vascular outcomes, the resistance index decreased and the maximum systolic arterial blood flow velocity (SV) and minimum diastolic arterial blood flow velocity (DV) increased significantly after qigong exercise (P < .05). The between-group difference was close to significant for SV (P = .018) and was significant for DV (P < .001) posttest. CONCLUSION: Qigong exercise could reduce conventional cancer therapy side effects such as upper limb lymphedema and poor circulatory status in survivors of breast cancer. However, such effects may be temporary, and further studies must be conducted to explore longer term effects.

Differential postural control and sensory organization in young tennis players and taekwondo practitioners.

This study compared the sensory organization and standing balance of adolescent tennis players, taekwondo (TKD) practitioners, and healthy control participants. Sixty participants including 12 tennis players, 21 TKD practitioners, and 27 healthy control participants were tested. All of the participants underwent the Sensory Organization Test (SOT) and the Unilateral Stance Test (UST) on a Smart Equitest system. Results revealed that tennis players had higher SOT visual ratios than the control participants (p = .005), and TKD practitioners swayed more slowly in the UST than the control participants (p = .039). No differences (p > .05) were found in the composite score, somatosensory ratio, or vestibular ratio between the groups. Tennis players swayed less when they relied more on visual input to maintain balance, whereas TKD practitioners were more stable when standing on one leg. Parents may consider these sports as recreational activities for their children to develop specific balance abilities.

Shoulder Mobility, Muscular Strength, and Quality of Life in Breast Cancer Survivors with and without Tai Chi Qigong Training.

Objectives. To compare the shoulder mobility, muscular strength, and quality of life (QOL) among breast cancer survivors with and without Tai Chi (TC) Qigong training to those of healthy individuals and to explore the associations between shoulder impairments and QOL in breast cancer survivors with regular TC Qigong training. Methods. Eleven breast cancer survivors with regular TC Qigong training, 12 sedentary breast cancer survivors, and 16 healthy participants completed the study. Shoulder mobility and rotator muscle strength were assessed by goniometry and isokinetic dynamometer, respectively. QOL was assessed using the Functional Assessment of Cancer Therapy-Breast (FACT-B) questionnaire. Results. Goniometric measurements of the active range of motion in the flexion, abduction, and hand-behind-the-back directions were similar among the three groups. The TC Qigong-trained breast cancer survivors had significantly higher isokinetic peak torques of the shoulder rotator muscles (at 180°/s) than untrained survivors, and their isokinetic shoulder muscular strength reached the level of healthy individuals. Greater shoulder muscular strength was significantly associated with better functional wellbeing in breast cancer survivors with TC Qigong training. However, no significant between-group difference was found in FACT-B total scores. Conclusions. TC Qigong training might improve shoulder muscular strength and functional wellbeing in breast cancer survivors.

Transcutaneous electrical stimulation on acupoints combined with task-related training to improve motor function and walking performance in an individual 7 years poststroke: a case study.

BACKGROUND AND PURPOSE: Impaired walking function and spasticity are common sequelae of stroke. Prior studies have shown that a rehabilitation program combining transcutaneous electrical stimulation (TES) with task-related training (TRT) improves motor function in individuals with stroke. However, it is unclear if this approach is beneficial for individuals with long-standing stroke. CASE DESCRIPTION: The subject of this case study was a 61-year-old man who was 7 years poststroke. He exhibited limitations of walking function, impaired strength of the ankle muscles, and severe plantarflexor spasticity. INTERVENTIONS: For 4 weeks, the patient performed a 5-day/wk home program consisting of 60 minutes of TES (below motor threshold) to the acupoints in the affected lower leg, followed by 60 minutes of TRT. He documented his daily home program activities in a log, and 3 times a week he received a call from the therapist to verify his adherence. The patient also had 8 clinic visits, which focused on instruction to ensure adherence to the (TES + TRT) protocol and progression of the program. OUTCOMES: After the 4-week program, plantarflexor spasticity decreased and ankle dorsi- and plantarflexor strength improved. More important, there were notable improvements in gait velocity, walking endurance, and functional mobility. These gains were maintained at 4 weeks posttreatment. DISCUSSION: This accessible home program was safe and effective for decreasing impairment and improving function in an individual with long-term, chronic stroke. The gains were maintained 4 weeks posttreatment. Details are provided for developing a home program integrating somatosensory TES and TRT.

Does the use of TENS increase the effectiveness of exercise for improving walking after stroke? A randomized controlled clinical trial.

OBJECTIVE: To investigate whether surface electrical stimulation can increase the effectiveness of task-related exercises for improving the walking capacity of patients with chronic stroke. DESIGN: Randomized, placebo-controlled clinical trial. SETTING: Home-based programme. SUBJECTS: One hundred and nine hemiparetic stroke survivors were assigned randomly to: (1) transcutaneous electrical nerve stimulation (TENS), (2) TENS + exercise, (3) placebo stimulation + exercise, or (4) control group. INTERVENTIONS: The TENS group received 60 minutes of electrical stimulation. Both the TENS + exercise group and placebo stimulation + exercise group did 60 minutes of exercises, followed respectively by 60 minutes of electrical and placebo stimulation. Treatment was given five days a week for four weeks. The control group had no active treatment. OUTCOME MEASURES: Comfortable gait speed was measured using a GAITRite II walkway system. Walking endurance and functional mobility were measured by the distance covered during a 6-minute walk test (6MWT) and by timed up and go test scores before treatment, after two weeks and after four weeks of treatment, and at follow-up four weeks after treatment ended. RESULTS: When compared with the other three groups, only the combined TENS + exercise group showed significantly greater absolute and percentage increases in gait velocity (by 37.1-57.5%, all P<0.01) and reduction in timed up and go scores (by -14.9 to -23.3%, P<0.01) from week 2 onwards. When compared with the control and TENS groups, only the combined TENS + exercise group covered significantly more distance in the 6MWT (by 22.2-34.7%, P<0.01) from week 2 onwards. CONCLUSION: TENS can improve the effectiveness of task-related exercise for increasing walking capacity in hemiparetic stroke survivors.