Efficacy of repetitive transcranial magnetic stimulation in post-stroke cognitive impairment: an overview of systematic reviews.

Objective: The reliability of clinical evidence depends on high-quality meta-analyses/ systematic reviews (MAs/SRs). However, there has been no assessment of the quality of MAs/SRs for repetitive transcranial magnetic stimulation (rTMS) in post-stroke cognitive impairment (PSCI), both nationally and internationally. This article seeks to use radar plotting to visually present the quality of MAs/SRs on rTMS for improving cognitive function in PSCI, aiming to offer an intuitive foundation for clinical research. Methods: Eight Chinese or English databases were systematically searched to collect comprehensive literature, and the retrieval time ranged from inception to 26 March 2024. Literature ranking was calculated using six dimensions: publication year, design type, AMSTAR-2 score, PRISMA score, publication bias, and homogeneity. Finally, radar plots were drafted to present a multivariate literature evaluation. The GRADE tool assessed the strength of evidence for the outcome indicators included in the MAs/SRs. Results: The 17 articles included had average scores of 12.29, 17, 9.88, 9.71, 12.88, and 12.76 for each dimension. The radar plot showed that an article published in 2023 had the highest rank and a large radar plot area, while an article published in 2021 had the lowest rank and a small radar plot area. The GRADE tool evaluation revealed that 51 pieces of evidence were of very low quality, 67 were of low quality, 12 were of moderate quality, and only one was of high quality. Conclusion: The average rank score of literature ranged from 8.50 to 17, with higher rankings indicating greater significance in literature reference. Variations in literature quality were attributed to inadequate study planning, irregular literature search and screening, insufficient description of inclusion criteria for studies, and inadequate consideration of bias risk in the included studies. Most MAs/SRs indicated that rTMS was more effective than the control group in enhancing the global cognitive function and activities of daily living in PSCI patients. However, the overall quality of the literature was generally low and needs validation from future high-quality evidence.Systematic review registration:https://www.crd.york.ac.uk/prospero/, identifier CRD42023491280.

Characterization of serum protein expression profiles in the early sarcopenia older adults with low grip strength: a cross-sectional study.

BACKGROUND: Sarcopenia refers to the progressive loss of skeletal muscle mass and muscle function, which seriously threatens the quality of life of the older adults. Therefore, early diagnosis is urgently needed. This study aimed to explore the changes of serum protein profiles in sarcopenia patients through a cross-sectional study, and to provide the reference for clinical diagnosis. METHODS: This study was a cross-sectional study carried out in the Tianjin institute of physical education teaching experiment training center from December 2019 to December 2020. Ten older adults were recruited, including 5 sarcopenia and 5 healthy older adults. After a detailed diagnostic evaluation, blood samples were collected to prepare serum for proteomic analysis using the HPLC System Easy nLC method. The differentially expressed proteins (DEPs) were screened by the limma package of R software (version 4.1.0). RESULTS: A total of 114 DEPs were identified between the patients and healthy older adults, including 48 up-regulated proteins and 66 down-regulated proteins. The functional enrichment analysis showed that the 114 DEPs were significantly enriched in 153 GO terms, which mainly involved in low-density lipoprotein particle remodeling, and negative regulation of immune response,etc. The PPI network further suggested that the cholesteryl ester transfer protein and Apolipoprotein A2 could serve as biomarkers to facilitate diagnosis of sarcopenia. CONCLUSIONS: This study provided a serum proteomic profile of sarcopenia patients, and identified two proteins with diagnostic value, which might help to improve the diagnostic accuracy of sarcopenia.

Prevalence and associated factors of possible sarcopenia and sarcopenia: findings from a Chinese community-dwelling old adults cross-sectional study.

PURPOSE: To describe the prevalence and analyse the associated factors of possible sarcopenia and sarcopenia among community-dwelling old adults in China, in order to provide effective strategies for early prevention and treatment of sarcopenia. METHODS: This cross-sectional study evaluated community-dwelling old adults aged over 60 years. The basic information, morphological indices, body composition, physical activities were collected and assessed. Possible sarcopenia and sarcopenia were diagnosed by the criteria of Asian Working Group for Sarcopenia (AWGS) in 2019. A multivariate logistic regression model with stepwise method was employed to identify factors associated with possible sarcopenia and sarcopenia. RESULTS: In total 729 old adults from Tianjin were included in this study. Eighty-one participants were diagnosed with possible sarcopenia (prevalence of 11.11%). Seventy-five participants were diagnosed with sarcopenia (prevalence of 10.29%). Age (odds ratio (OR):1.047, 95% confidence interval (CI): 1.055-1.090) and lower physical activities (low level OR:4.171, 95% CI:1.790-9.720; medium level OR:2.634, 95% CI:1.352-5.132) were significantly associated with possible sarcopenia. Age (OR:1.187, 95% CI:1.124-1.253), higher body fat percentage (OR:1.225, 95% CI:1.140-1.317), lower BMI (OR:0.424, 95% CI:0.346-0.519), lower mini-mental state examination (MMSE) scores (OR:0.865,95% CI:0.781-0.958) and low physical activities (OR:4.638, 95% CI:1.683-12.782) were significantly associated with sarcopenia. CONCLUSION: Possible sarcopenia and sarcopenia are prevalent among community-dwelling old adults in China. Ageing and lower physical activities were both associated with possible sarcopenia and sarcopenia. Old adults with sarcopenia more likely have higher body fat percentage, lower BMI and lower cognitive function compared with those without this condition.

Effects of silent myocardial ischemia on functional fitness and physical independence in 60-79-year-old adults.

Objective: We examined the effect of silent myocardial ischemia (SMI) on functional fitness levels and physical independence in 60-79-year-old individuals. Methods: We conducted a cross-sectional study with 716 older adults and used an electrocardiograph and an ambulatory electrocardiogram to diagnose those with SMI. Physical independence was assessed using the Composite Physical Function scale, whereas physical fitness was assessed using the Senior Fitness Test battery. Results: The 60-79-year-old females and males with SMI were more likely to have lower scores for lower and upper body strength, agility/dynamic balance, and aerobic endurance (p < 0.05) than those without SMI. The scores for lower and upper body flexibility in all age groups for both genders were not significant (p > 0.05). Binary logistic regression analysis revealed that old adults with SMI had a higher risk of losing physical independence later in life than those without SMI (p < 0.05). Conclusion: This study showed that individuals with SMI have lower fitness levels and increased risk of losing physical independence than those without SMI.

Unilateral intramuscular needling can improve ankle dorsiflexor strength and muscle activation in both legs.

BACKGROUND/OBJECTIVE: The aim of this study was to determine whether unilateral manual needling at nonacupoints could result in bilateral strength gain similar to that found in electroacupuncture at specific acupoints. METHODS: Fifty healthy male volunteers with an age range of 19-27 years were recruited and randomly allocated into five groups: (1) manual acupuncture and (2) electroacupuncture at two acupoints (ST-36 and ST-39); (3) manual acupuncture and (4) electroacupuncture at two nonacupoints on the tibialis anterior muscle; and (5) control group. The intervention groups received needling in each session on the right leg for 15 minutes in Week 1, 20 minutes in Week 2, and 30 minutes in Weeks 3-8, three sessions per week. The maximal isometric ankle dorsiflexion strength and muscle activation (as determined by twitch interpolation) of both legs were assessed pre, post, 2 weeks post, and 3 weeks post the experimental period. RESULTS: Mixed models (linear) with repeated-measures analysis identified significant strength gains (p < 0.01) after the intervention period in both limbs, while no significant differences were detected between the intervention groups and between the two legs, and no change was found in the control group. A significant improvement in muscle activation (p < 0.01) was also observed in both legs in the intervention groups. CONCLUSION: It was concluded that both unilateral manual and electric needling caused significant bilateral strength gain, and this effect was not specific to the selected acupoints or electric stimulation. The strength gain was sustained for at least 3 weeks after the 8-week intervention.

Bilateral effects of 6 weeks' unilateral acupuncture and electroacupuncture on ankle dorsiflexors muscle strength: a pilot study.

OBJECTIVES: To determine the effect of unilateral manual acupuncture at selected acupoints on ankle dorsiflexion strength of both limbs, and compare the effect with that of electroacupuncture at the same acupoints and sham points. DESIGN: Randomized controlled trial. SETTING: Rehabilitation laboratory of a university. PARTICIPANTS: Young men (N=43) were randomly allocated into 4 groups: control; manual acupuncture and electroacupuncture on 2 acupoints (ST-36 and ST-39); and electroacupuncture on 2 nonacupoints. These points were located on the tibialis anterior muscle. INTERVENTIONS: The participants in the experimental groups received 15 to 30 minutes of acupuncture or electroacupuncture on the right leg in each session, 3 sessions per week for 6 weeks. MAIN OUTCOME MEASURES: The maximal strength in isometric ankle dorsiflexion of both legs was assessed before and after the experimental period. RESULTS: Repeated-measures analysis of variance identified significant and similar strength gains (range, 35%-64% in the right leg and 32%-49% in the left leg; P<.01) in all acupuncture groups, but not in the control group (-2% to 2%, P>.05). CONCLUSIONS: Unilateral manual acupuncture and electroacupuncture at the acupoints can improve muscle strength in both limbs, and electroacupuncture at the nonacupoints as used in this study can also induce similar strength gains.

Bilateral effect of unilateral electroacupuncture on muscle strength.

OBJECTIVES: This study aimed to examine the bilateral effect of 4 weeks of unilateral electroacupuncture on leg muscle strength. DESIGN: The effect of unilateral electroacupuncture at two selected acupoints, Zusanli (ST-36) and Xiajuxu (ST-39), which are located on the anterior tibialis muscle, on dorsiflexion strength was evaluated by statistical analyses of the interactions between the muscle strength pre and post 4 weeks of intervention, between the two legs, and between an experimental and a control group. SETTINGS/LOCATION: The trial was carried out in the exercise rehabilitation laboratory at Tianjin University of Sport. SUBJECTS: Thirty (30) healthy men with an average age of 20.9 +/- 2.98 (SD) years were randomly allocated into an electroacupuncture group (EG) and a control group (CG). They were physically active, but without specific strength training or previous experience of acupuncture. INTERVENTIONS: Participants in the EG were given 3 sessions of electroacupuncture per week. In each session, the electroacupuncture was applied to the right leg at the acupoints with 8 duty cycles of 1 minute on and 1 minute off, pulse width of 1 millisecond, frequency of 40 Hz, and intensity of 30-40 V. Participants in the CG group kept their normal daily activities without additional intervention. OUTCOME MEASURES: The maximum strength in dorsiflexion of each leg was examined by having participants lift weights in the range of motion of approximately 20 degrees at the ankle joint. RESULTS: Repeated-measures analysis of variance with Bonferroni adjustment detected significant increase in strength of both legs (right 21.3%, left 15.2%) in the EG (p<0.05) and the increase was significantly higher than that of the CG (p<0.05). The CG showed no significant change (right 3.0%, left 4.8%), post-treatment. CONCLUSIONS: Unilateral electroacupuncture at the selected acupoints improved muscle strength of both limbs. These findings may have implications in physical therapy and rehabilitation settings.