Is functional electrical stimulation effective in improving walking in adults with lower limb impairment due to an upper motor neuron lesion? An umbrella review.

PURPOSE: To conduct an umbrella review of systematic reviews on functional electrical stimulation (FES) to improve walking in adults with an upper motor neuron lesion. METHODS: Five electronic databases were searched, focusing on the effect of FES on walking. The methodological quality of reviews was evaluated using AMSTAR2 and certainty of evidence was established through the GRADE approach. RESULTS: The methodological quality of the 24 eligible reviews (stroke, n = 16; spinal cord injury (SCI), n = 5; multiple sclerosis (MS); n = 2; mixed population, n = 1) ranged from critically low to high. Stroke reviews concluded that FES improved walking speed through an orthotic (immediate) effect and had a therapeutic benefit (i.e., over time) compared to usual care (low certainty evidence). There was low-to-moderate certainty evidence that FES was no better or worse than an Ankle Foot Orthosis regarding walking speed post 6 months. MS reviews concluded that FES had an orthotic but no therapeutic effect on walking. SCI reviews concluded that FES with or without treadmill training improved speed but combined with an orthosis was no better than orthosis alone. FES may improve quality of life and reduce falls in MS and stroke populations. CONCLUSION: FES has orthotic and therapeutic benefits. Certainty of evidence was low-to-moderate, mostly due to high risk of bias, low sample sizes, and wide variation in outcome measures. Future trials must be of higher quality, use agreed outcome measures, including measures other than walking speed, and examine the effects of FES for adults with cerebral palsy, traumatic and acquired brain injury, and Parkinson's disease.

Fatigue interventions in long term, physical health conditions: A scoping review of systematic reviews.

OBJECTIVE: Fatigue is prominent across many long term physical health conditions. This scoping review aimed to map the fatigue intervention literature, to ascertain if certain interventions may be effective across conditions, and if novel interventions tested in specific long term conditions may be promising for other conditions. METHODS: Scoping review methodological frameworks were used. Electronic bibliographic databases were searched (inception to November 2016) for systematic reviews of fatigue interventions in long term conditions. Inclusion criteria were: long term physical health condition; review focus on fatigue management; objective and systematic review process; primary review outcome is fatigue. Articles focussing on surgical interventions or treatments thought to trigger fatigue were excluded. A narrative synthesis was performed. RESULTS: Of 115 full texts screened, 52 reviews were included. Interventions were categorised as pharmacological and non-pharmacological (exercise, psychological/behavioural and complementary medicine). Pharmacological interventions did not consistently demonstrate benefit, except for anti-TNFs and methylphenidate which may be effective at reducing fatigue. Non-pharmacological interventions such as graded exercise and fatigue-specific psychological interventions may be effective, but heterogeneous intervention components limit conclusions. 'Complementary medicine' interventions (e.g. Chinese herbal medicines) showed promise, but the possibility of publication bias must be considered. CONCLUSIONS: Further research is necessary to inform clinical practice. The reported effectiveness of some interventions across inflammatory health conditions, such as anti-TNFs, aerobic exercise, and psychologically based approaches such as CBT, highlights a potential transdiagnostic avenue for fatigue management. More novel strategies that may be worth exploring include expressive writing and mindfulness, although the mechanisms for these in relation to fatigue are unclear. More work is needed to identify transdiagnostic mechanisms of fatigue and to design interventions based on these.

Hemato-Immunological Responses and Disease Resistance in Siberian Sturgeon Acipenser baerii Fed on a Supplemented Diet of Lactobacillus plantarum.

A feeding trial was conducted to investigate the effects of different levels of dietary Lactobacillus plantarum on hemato-immunological parameters and resistance against Streptococcus iniae infection in juvenile Siberian sturgeon Acipenser baerii. Fish (14.6 ± 2.3 g) were fed three experimental diets prepared by supplementing a basal diet with L. plantarum at different concentrations [1 × 107, 1 × 108 and 1 × 109 colony-forming units (cfu) g-1] and a control (non-supplemented basal) diet for 8 weeks. Innate immune responses (immunoglobulin (Ig), alternative complement activity (ACH50) and lysozyme activity) were significantly higher in fish fed the 1 × 108 and 1 × 109 cfu g-1 L. plantarum diet compared to the other groups (P < 0.05). Furthermore, fish fed on various levels of L. plantarum significantly showed higher red blood cell (RBC), hemoglobin (Hb), white blood cell (WBC) and monocyte compared to those of the control group (P < 0.05). At the end of the feeding experiment, some fish were challenged with S. iniae to quantify the level of disease resistance. The mortality after S. iniae challenge was decreased in fish fed a probiotic. These results indicated that dietary supplementation of L. plantarum improved immune response and disease resistance of Siberian sturgeon juvenile.

The effect of reflexology on pain perception aspects in nurses with chronic low back pain in Isfahan.

BACKGROUND: The most important part in experiencing and recognizing the threshold of pain is the perception of pain. Reflexology is a kind of complementary therapy which is rooted in the beliefs of the community. This study was aimed to determine the effect of reflexology on pain perception aspects in patients with chronic low back pain. MATERIALS AND METHODS: This single-blind clinical trial study was performed on 50 nurses with chronic low back pain, who were selected by convenient sampling and then randomly divided into the case and the control groups. Reflexology was conducted for 2 weeks in both groups as three 40-min sessions per week. Perception aspects of pain were measured using the McGill pain perceptual dimension scale score. Data analysis was performed using SPSS. RESULTS: The overall mean scores of perceptual aspects of pain after the intervention in the case and the control groups were 20 ± 5.97 and 29.60 ± 7.38, respectively, and independent t-test showed a statistically significant difference between the two groups (P < 0.001). Comparing the results in the cognitive aspects of pain separately showed a significant difference between the two groups in the aspects of sensory, pain assessment, and diversity before and after the intervention (P < 0.001), but the difference in the emotional aspect was not significant. CONCLUSIONS: Reflexology, which can be done by nurses, has the ability to reduce the intensity score and cognitive aspects of pain. Therefore, it is proposed to be included in patients' surveillance.

Dietary Administration of Lactobacillus plantarum Enhanced Growth Performance and Innate Immune Response of Siberian Sturgeon, Acipenser baerii.

We investigated the effects of Lactobacillus plantarum used as a dietary supplement on the growth performance and innate immune response in juvenile Siberian sturgeon Acipenser baerii. Juvenile fish (14.6 ± 2.3 g) were fed three experimental diets prepared by supplementing a basal diet with L. plantarum at different concentrations [1 × 10(7), 1 × 10(8) and 1 × 10(9) colony-forming units (cfu) g(-1)] and a control (non-supplemented basal) diet for 8 weeks. Growth performance indices were increased in fish fed the 1 × 10(8) cfu g(-1) L. plantarum diet compared to the other groups. There was an increased innate immune response in fish fed the experimental diets. The highest levels of lysozyme activity, total immunoglobulin (IgM) and complement component 3 (C3) were observed in fish fed the diet containing L. plantarum at a concentration of 1 × 10(8) cfu g(-1), but there was no significant difference in the level of complement component 4 (C4) in fish fed the experimental diets or the control diet. The present study underlying some positive effects (growth performance and immune indices) of dietary administration of L. plantarum at a concentration of 1 × 10(8) cfu g(-1) in the Siberian sturgeon.

Dietary peppermint (Mentha piperita) extracts promote growth performance and increase the main humoral immune parameters (both at mucosal and systemic level) of Caspian brown trout (Salmo trutta caspius Kessler, 1877).

The effects of dietary administration of peppermint (Mentha piperita L.) on Caspian brown trout fish (Salmo trutta caspius) were studied. Fish were divided into 4 groups before being fed diets supplemented with 0% (control), 1%, 2% and 3% of peppermint extracts for 8 weeks. Dose-dependent increases in growth, immune (both in skin mucus and blood serum) and hematological parameters (number of white cells, hematocrit and hemoglobin content), as well as in amylase activity and in the number of lactic acid bacteria on intestine were recorded in fish fed supplemented diets compared to control fish. However, the dietary peppermint supplements have different effects on the number of blood leucocytes depending on the leukocyte cell type. While no significant differences were observed in the number of blood monocytes and eosinophils, the number of lymphocytes was decreased, respectively, on fish fed peppermint enriched diets, respect to the values found in control fish. Furthermore, dietary peppermint supplements have no significant effect on blood biochemical parameters, enzymatic activities of liver determined in serum and total viable aerobic bacterial count on intestine of Caspian brown trout. Present results support that dietary administration of peppermint promotes growth performance and increases the main humoral immune parameters (both at mucosal and systemic level) and the number of the endogenous lactic acid bacteria of Caspian brown trout. This study underlying several positive effects of dietary administration of peppermint to farmed fish.

Protective role of calcium ion against stress-induced osmotic fragility of red blood cells in patients with type 2 diabetes mellitus.

Type 2 diabetes mellitus can increase osmotic fragility of red blood cells. Osmotic fragility test is an index of the function of cytoskeletal proteins and of the calcium pump activity in RBC membrane. The aim of this study is to determine the effect of physiological calcium supplement on red blood cell osmotic fragility of patients with type 2 diabetes mellitus. Osmotic fragility of red cells was determined for 30 healthy subjects and 30 patients in a NaCl gradient medium. 5 mg/dl of calcium was added to media and the osmotic fragility were evaluated for RBCs of patients and healthy subjects. Comparison of patients and control group showed higher sensitivity of red cells of patients to osmotic fragility upon exposure to higher sodium chloride concentrations. Comparison of initial, fifty percent and total hemolysis showed significant difference on initial and fifty percent hemolysis between two groups (P < 0.001). In healthy subjects, Fifty percent hemolysis index showed a smaller change after addition of calcium, from 4.1 ± 0.22 to 3.9 ± 0.2 (P < 0.05). Fifty percent hemolysis index for patients significantly decreased from 4.45 ± 0.17 to 4 ± 0.17 after addition of calcium (P < 0.001). Osmotic fragility increases in patients with diabetes. The role of calcium in cell membrane integrity was more prominent in the patients with diabetes than the healthy subjects, emphasizing the role of calcium on the membrane stability. We showed for the first time that controlling calcium ion concentration in patients with diabetes could exert a protective and beneficial role against membrane-affecting conditions.

The effects of reflexology on chronic low back pain intensity in nurses employed in hospitals affiliated with Isfahan University of Medical Sciences.

BACKGROUND: Humans have been involved with the phenomena of pain and pain relief from the ancient times. Back pain is the most common pain. In fact, eight out of ten people experience it in their lifetime. However, individuals with specific jobs, including nurses, are faced with this problem more. Nursing is in the top ten careers suffering from the most severe musculoskeletal injuries. There are non-pharmacologic and pharmacologic treatments to relieve back pain. One of the non-medical treatments of pain is called reflexology which is a branch of complementary and alternative therapies. This research has been conducted to investigate the effect of reflexology on chronic low back pain intensity. MATERIALS AND METHODS: This study was a double-blind clinical trial. The study population consisted of 50 female and male nurses suffering from chronic low back pain working in hospitals affiliated with Isfahan University of Medical Sciences. The participants were divided into two groups of reflexology and non-specific massage. A questionnaire was completed through interviews and a 40 minute sessions of interventions were performed three times a week for two weeks. Pain intensity was measured by Numerical Analogue Scale for pain before and after the intervention. Descriptive and inferential statistics, including independent t-test and chi-square test, were used to analyze the data. FINDINGS: The results showed a significantly higher reduction in pain intensity scores in the reflexology group after the intervention as compared with the non-specific massage group. However, the non-specific massage was also significantly effective in reducing pain. CONCLUSIONS: Reflexology can be effective in reducing the severity of chronic back pain, i.e. it is able to reduce pain from moderate to mild. Thus, this technique is recommended to be performed by nurses as a complementary therapy in patient care.