Neuroregenerative potential of intravenous G-CSF and autologous peripheral blood stem cells in children with cerebral palsy: a randomized, double-blind, cross-over study.

OBJECTIVE: We performed a randomized, double-blind, cross-over study to assess the neuroregenerative potential of intravenous granulocyte colony-stimulating factor (G-CSF) followed by infusion of mobilized peripheral blood mononuclear cells (mPBMCs) in children with cerebral palsy (CP). METHODS: Children with non-severe CP were enrolled in this study. G-CSF was administered for 5 days, then mPBMCs were collected by apheresis and cryopreserved. One month later (M1), recipients were randomized to receive either mPBMCs or a placebo infusion, and these treatment groups were switched at 7 months (M7) and observed for another 6 months (M13). We assessed the efficacy of treatment by evaluating neurodevelopmental tests, as well as by brain magnetic resonance imaging-diffusion tensor imaging (MRI-DTI) and 18F-fluorodeoxyglucose (FDG) brain positron emission tomography-computed tomography (PET-CT) scanning to evaluate the anatomical and functional changes in the brain. RESULTS: Fifty-seven patients aged 4.3 ± 1.9 (range 2-10) years and weighing 16.6 ± 4.9 (range 11.6-56.0) kg were enrolled in this study. The administration of G-CSF as well as the collection and reinfusion of mPBMCs were safe and tolerable. The yield of mPBMCs was comparable to that reported in studies of pediatric donors without CP and patients with nonhematologic diseases. 42.6% of the patients responded to the treatment with higher neurodevelopmental scores than would normally be expected. In addition, larger changes in neurodevelopment test scores were observed in the 1 month after G-CSF administration (M0-M1) than during the 6 months after reinfusion with mPBMCs or placebo (M1-M7 or M7-M13). Patients who received G-CSF followed by mPBMC infusion at 7 months (T7 group) demonstrated significantly more neurodevelopmental improvement than patients who received G-CSF followed by mPBMC infusion at 1 month (T1 group). In contrast to the results of neurodevelopment tests, the results of MRI-DTI at the end of this study showed greater improvement in the T1 group. Although we observed metabolic changes to the cerebellum, thalamus and cerebral cortex in the 18F-FDG brain PET-CT scans, there were no significant differences in such changes between the mPBMC and placebo group or between the T1 and T7 group. CONCLUSIONS: Neurodevelopmental improvement was seen in response to intravenous G-CSF followed by mPBMC reinfusion, particularly to the G-CSF alone even without mPBMC reinfusion. Further studies using a larger number of mPBMCs for the infusion which could be collected by repeated cycles of apheresis or using repeated cycles of G-CSF alone, are needed to clarify the effect of mPBMC reinfusion or G-CSF alone (Trial registration: ClinicalTrials.gov, NCT02983708. Registered 5 December, 2016, retrospectively registered).

The effects of shoe heel height and gait velocity on position sense of the knee joint and balance.

[Purpose] The aim of this study was to examine the effects of increased heel height and gait velocity on balance control and knee joint position sense. [Subjects and Methods] Forty healthy adults were randomly allocated to 4 groups: low-heel, low-speed group (3 cm, 2 km/h), low-heel, high-speed group (3 cm, 4 km/h), high-heel, low-speed group (9 cm, 2 km/h), high-heel, and high-speed group (9 cm, 4 km/h), with 10 subjects per group. Static and dynamic balance was evaluated using the I-Balance system and knee joint position sense using a goniometer. Measurements were compared using a pre- and posttest design. [Results] Increasing heel height and gait velocity decreased knee joint position sense and significantly increased the amplitude of body sway under conditions of static and dynamic balance, with highest sway amplitude induced by the high-heel, high-speed condition. [Conclusion] Increased walking speed in high heels produced significant negative effects on knee joint sense and balance control.

Effects of breathing exercises on lung capacity and muscle activities of elderly smokers.

[Purpose] Elderly smokers have a reduced chest diameter due to weakening of the respiratory muscles, and this results in decreased ventilation, leading to a vicious circle. Therefore, the present study investigated the effects of an intervention program to enhance the pulmonary function and muscle activity of elderly smokers. [Subjects and Methods] Participants were randomly assigned to one of two experimental groups or a control (CG) group. The experimental groups performed exercises three times per week for six weeks, whereas the CG performed no exercises. One of the experimental groups performed a Feedback Breathing Exercise (FBE) for 15 minutes, and the other repeated three sets of Balloon-Blowing Exercises (BBE) with sufficient rest of more than one minute between sets. [Results] In the experimental groups, FVC, FEV1/FVC, PEF and muscle activity of the rectus abdominis significantly improved after four weeks, but no significant differences were observed in FEV1 or VC after six weeks. [Conclusion] The results show that FBE and BBE improved the pulmonary functions of elderly smokers, demonstrating the potential benefits of the development of various training methods using balloons, and group programs, including recreational factors, for increasing respiratory muscles strength.

Effects of Nintendo Wii Fit Plus training on ankle strength with functional ankle instability.

[Purpose] The objective of this study was to examine the effects of a training program using the Nintendo Wii Fit Plus on the ankle muscle strengths of subjects with functional ankle instability. [Subjects and Methods] This study was conducted using subjects in their 20s who had functional ankle instability. They were randomized to a strengthening training group and a balance training group with 10 subjects in each, and they performed an exercise using Nintendo Wii Fit Plus for 20 minutes. In addition, every participant completed preparation and finishing exercises for 5 minutes, respectively. [Results] The muscle strengths after conducting plantar flexion and dorsiflexion significantly increased at the angular velocities of 60° and 120° in the strengthening training group. Furthermore, the muscle strengths after conducting plantar flexion, dorsiflexion, eversion, and inversion significantly increased at the angular velocities of 60° and 120° in the balance training group. [Conclusion] The balance training group using Nintendo Wii Fit Plus showed better results than the strengthening training group. Consequently, it is recommended to add the balance training program of the Nintendo Wii Fit Plus to conventional exercise programs to improve ankle muscle strength in functional ankle instability at a low cost.

Association between osteoporotic fractures and quality of life based on the Korean Community Health Survey of 2010.

[Purpose] To assess the relationship between fractures and quality of life (QOL) of osteoporosis patients as well as the treatment methods and locations of fractures following osteoporosis diagnosis. [Subjects and Methods] Participants were selected from a cohort consisting of 229,229 subjects who participated in the Korean Community Health Survey. Those who were not diagnosed with osteoporosis by a doctor were excluded from the study (326) and the final analysis included 17,387 previously diagnosed participants with osteoporosis. Multiple linear regression analysis was conducted. [Results] The QOL was significantly lower for subjects receiving treatment for osteoporosis compared to those who had not previously received treatment. Subjects who experienced a fracture similarly had a lower QOL compared to those who did not have a fracture. In addition, the QOL of subjects who experienced a fracture in the pelvis, spine, or wrists was significantly lower compared to those without fractures in these areas. [Conclusion] Better knowledge of osteoporosis leads to early recognition of symptoms and timely treatment. This results in better treatment outcomes and improved QOL for patients. Therefore, the need for physical therapy that is based on research evidence of osteoporosis treatment methods should be presented.

The relationship between fracture and quality of life in Korean adults receiving treatment for osteoporosis based on the 2010 Korean Community Health Survey.

[Purpose] The purpose of this study was to investigate the relationship between fracture and quality of life in Korean adults receiving treatment for osteoporosis based on the 2010 Korean Community Health Survey (KCHS). [Subjects and Methods] This study utilized the raw data of the 2010 KCHS. In the survey, osteoporosis was assessed in 228,903 subjects, excluding 326 for whom there was insufficient data. There were 17,387 subjects with osteoporosis confirmed by a doctor's diagnosis and 9,419 of them were being treated for osteoporosis at the time of the survey. [Results] Among the patients being treated, those with fractures had a significantly lower QOL than patients who did not experience fractures. The lower QOL scores were caused by hip, vertebral and wrist fractures, and in all cases, QOL was significantly lower. Greater numbers of fractures significantly lowered QOL scores compared to participants without fractures. [Conclusion] Fractures in patients receiving treatment for osteoporosis have a direct impact on QOL. Among the different types of fractures, hip fractures resulted in the lowest scores. Therefore, to avoid additional fractures caused by inappropriate management of osteoporosis, we suggest that there is a need to improve fall related self-efficacy and prevention programs.

The relationship between stroke patients' socio-economic conditions and their quality of life: the 2010 Korean community health survey.

[Purpose] The relationship between stroke patients' socio-economic conditions and quality of life (QOL) using the 2010 Korean Community Health Survey (KCHS) statistics was examined. [Subjects and Methods] A total of 4,604 stroke patients were analyzed. Socio-economic conditions were sex, age, educational level, monthly household income, occupation, residential area, and living with family. [Results] The results show a statistically significant lower QOL for men than for women, for those aged 75 years or over compared to individuals between 19 years and 64 years, and for elementary (or lower) or middle school graduates compared to higher education graduates. QOL was also significant lower among patients whose household income was KRW4 million (US$3,746.72) or less a month. Finally, QOL was significantly lower for patients without an occupation compared to those with an occupation, for patients in rural areas compared to urban areas, and for patients who did not live with family compared to those who lived with family. [Conclusion] We showed the importance of the relationships between socio-economic conditions and QOL of stroke patient.

The relationship between stroke and quality of life in Korean adults: based on the 2010 Korean community health survey.

[Purpose] The purpose of this study was to investigate the status of stroke in the Republic of Korea and its relationship with QOL based on standardized data. [Subjects and Methods] This study utilized raw data from the 2010 KCHS. In total, 229,229 individuals participated in the 2010 survey. The final analysis identified 4,604 individuals who had been diagnosed by a doctor with stroke. To identify the correlation between the aftereffect-related characteristics of stroke patients and QOL, a multiple linear regression analysis was performed. [Results] Participants experiencing aftereffects had a statistically significantly lower QOL than participants who had not experienced aftereffects. Regarding the types of aftereffects, participants experiencing palsy in the arms and legs, facial palsy, communication disabilities, swallowing or eating disabilities, and visual disabilities had a statistically significantly lower QOL than participants without aftereffects. The QOL of participants with one, two, three, four, or five aftereffects was statistically significantly less than that of participants without aftereffects [Conclusion] Stroke directly influences QOL and the number of types of aftereffects experienced by patients. Therefore, it is highly important that physical therapists seek to end the occurrence of one or more types of aftereffects in stroke patients.

Effectiveness of sling exercise for chronic low back pain: a systematic review.

[Purpose] This study investigated effects of sling exercise for patients with chronic low back pain. [Methods] We reviewed all relevant papers indexed in PubMed, SCOPUS, and the Cochrane Registered Trials. Eligible trials were randomized controlled trials that compared sling exercise with any type of treatment. We extracted data on muscle thickness, muscle activation, pain, and disability, and assessed the methodological quality of the data. Seven studies met our inclusion criteria. [Results] When sling exercise had an impact on activation of the trunk muscles, increasing the trunk muscle thickness, and the reduction in pain and disability had been assessed shortly after the final exercise session, it was more effective than general exercise at activating trunk muscles, but not more effective at increasing trunk muscle thickness and improving pain and disability than general exercise. [Conclusion] As sling therapy studies are based on a small number of trials, we cannot draw conclusions about the therapeutic effects of sling exercise. When segmental stabilizing exercise and individually designed programs are added to sling exercise, it increases the effectiveness of sling exercise at improving low back pain. This should be the focus of future studies.

Which Treatment is More Effective for Functional Ankle Instability: Strengthening or Combined Muscle Strengthening and Proprioceptive Exercises?

[Purpose] The purpose of this study was to implement combined muscle strengthening and proprioceptive exercises to examine the effects of combined exercises on functional ankle instability. [Subjects and Methods] Experiments were conducted with 30 adult males and females. The study subjects were randomly assigned to either a control group (Group A), a muscle strengthening exercise group (Group B), or a combined muscle strengthening and proprioceptive exercise group (Group C) consisting of 10 subjects each. In Group A, measurements were only conducted before and after the experiment without any intervention, whereas the exercise programs for Group B and Group C were implemented three days per week for four weeks. [Results] Muscle strength showed significant increases in Groups B and C compared with the control group during plantar flexion, dorsiflexion, inversion, and eversion. The Cumberland ankle instability tool showed significant increases in Group B and Group C compared with Group A and significant increases in Group C compared with Group B. [Conclusion] Applying combined muscle strengthening and proprioceptive exercises to those who have functional ankle instability is more effective than applying only muscle strengthening exercises.

Furo-1,2-naphthoquinones from Crataegus pinnatifida with ICAM-1 expression inhibition activity.

Two new furo-1,2-naphthoquinones, crataequinones A (1) and B (2), were isolated from the fruits of Crataegus pinnatifida. The structures of two new compounds were determined as 11,12-dimethoxy-3,4-furo-1,2-naphthoquinone (1) and 11,12-dimethoxy-5-hydroxy-3,4-furo-1,2-naphthoquinone (2) by spectroscopic analysis. The two compounds 1 and 2 showed significant inhibitory activity with IC50 values of 33 and 90 microM, respectively, against the expression of intercellular adhesion molecule-1 (ICAM-1).