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BACKGROUND AND PURPOSE: Developing technology in the field of rehabilitation is vital to accelerate recovery and decrease the side effects of current modalities. Rehabilitation is a challenging science in which the main challenge is not just treating the patient but also to shorten the rehabilitation time and avoid harmful effects. Thus, this review demonstrates the possible design and effects of air therapy as a novel treatment branch besides hydrotherapy, electrotherapy, and manual therapy in the field of rehabilitation. METHODS: The search was conducted over clinical trials, literature reviews, and systematic reviews on the possible effects of treatments that may have similar effects to the newly developed air therapy. This search was conducted in the Web of Science, Scopus, EBSCO, and Medline databases. RESULTS: Air therapy could be used to improve the function of mechanoreceptors, improve circulation and microcirculation, decrease pain, the release of trigger points, regain the elasticity of soft tissues, treat acute and chronic inflammations, decrease muscle cramps and spasticity, strengthen muscle, and decrease muscle fatigue and Decreasing muscle fatigue and delayed muscle soreness. CONCLUSION: Air therapy is a novel treatment modality that can be used effectively in the field of rehabilitation. Air therapy could be a valuable and safe treatment in rehabilitation.
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Ar , Humanos , Modalidades de FisioterapiaRESUMO
Background: Autism spectrum disorder (ASD) is one of the most complex neurodevelopmental disorders. It affects almost all human physiological systems. Individuals with ASD often display dysregulation in their autonomic nervous system (ANS), which may elicit differing effects across age groups. Also, studying the ANS missed several important parameters related to ANS. Studying the ANS is crucial in developing adaptive behavioural strategies and maintaining communication abilities and social behaviours. Thus, this study compared the immediate effect of physical activity on the ANS in individuals with ASD in different age groups. Methods: 200 participants (106 males and 94 females) took part in a double-blinded randomised design. All participants were divided into four groups according to their age (4-7, 7-10, 10-13 and 14-18 years old). Participants performed a 60 min treadmill walk. The main outcome measurements were heart rate (HR), saturation of peripheral oxygen (SpO2), respiratory rate (RR) and end-tidal carbon dioxide (etCO2). Results: Before the study, there were non-significant differences between groups in their physical characteristics (body mass index, Childhood Autism Rating Scale, physical activity level, both parents' existence, aerobic capacity and gender) (p>0.05). At baseline measurements, there were non-significant differences between all groups for all outcome measurements (p>0.05). Immediately after physical activity, there was significant difference between group 1 and other groups (p<0.05), while all other differences were non-significant (p>0.05). At the follow-up (after 15 min of rest), group 1 maintained significant differences with the other groups for all outcome measurements (p<0.05), while there were non-significant differences between the other three groups (p>0.05). Conclusion: This study revealed that the SpO2 significantly decreased immediately after the physical activity, while HR, RR and etCO2 significantly increased immediately after physical activity in comparison to the baseline measurements. Contrary to other ANS parameters (SpO2, RR and etCO2), HR in early ages (4-7 years old) was higher after physical activity and remained elevated longer than other ages. The early ages (4-7 years old) take more time to return to the normal status of ANS parameters including SpO2, HR, RR and etCO2. Trial registration number: NCT05725733.
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Muscle fatigue is common in many populations, particularly elderlies. Aging increases the incidence of muscle fatigue and delays its recovery. There is a huge debate about the current treatments for muscle fatigue, particularly in elderlies. Recently, it has been discovered that mechanoreceptors have an important role as a sensory system in sensing muscle fatigue which could enhance the body's response to muscle fatigue. The function of mechanoreceptors could be enhanced by applying either suprathreshold or subthreshold vibration. Although suprathreshold vibration improves muscle fatigue, it can cause desensitization of cutaneous receptors, discomfort, and paresthesia, which are barriers to clinical use. Subthreshold vibration has been approved as a safe and effective method of training for mechanoreceptors; however, its use and effectiveness in muscle fatigue have never been tested or explained. Possible physiological effects of subthreshold vibration in the treatment of muscle fatigue include: (1) Enhancing the function of mechanoreceptors themselves; (2) Increasing the firing rate and function of alpha motor neurons; (3) Increasing blood flow to fatigued muscles; (4) Decreasing the rate of muscle cell death in elderlies (sarcopenia); and (5) Driving motor commands and allow better performance of muscles to decrease fatigue incidence. In conclusion, the use of subthreshold vibration could be a safe and effective treatment for muscle fatigue in elderlies. It could enhance recovery from muscle fatigue. Finally, Subthreshold Vibration is safe and effective in treating muscle fatigue in comparison to suprathreshold vibration.
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BACKGROUND: Cupping therapy has been used to treat musculoskeletal impairments for about 4000 years. Recently, world athletes have provoked an interest in it, however, the evidence to support its use in managing musculoskeletal and sports conditions remains unknown. OBJECTIVE: To evaluate the evidence level of the effect of cupping therapy in managing common musculoskeletal and sports conditions. METHODS: 2214 studies were identified through a computerized search, of which 22 met the inclusion criteria. The search involved randomized and case series studies published between 1990 and 2019. The search involved five databases (Scopus, MEDLINE (PubMed), Web of Science, Academic Search Complete PLUS (EBSCO), and CrossRef) and contained studies written in the English language. Three analyses were included: the quality assessment using the PEDro scale, physical characteristic analysis, and evidence-based analysis. RESULTS: The results showed that most studies used dry cupping, except five which used wet cupping. Most studies compared cupping therapy to non-intervention, the remaining studies compared cupping to standard medical care, heat, routine physiotherapy, electrical stimulation, active range of motion and stretching, passive stretching, or acetaminophen. Treatment duration ranged from 1 day to 12 weeks. The evidence of cupping on increasing soft tissue flexibility is moderate, decreasing low back pain or cervical pain is low to moderate, and treating other musculoskeletal conditions is very low to low. The incidence of adverse events is very low. CONCLUSION: This study provides the first attempt to analyze the evidence level of cupping therapy in musculoskeletal and sports rehabilitation. However, cupping therapy has low to moderate evidence in musculoskeletal and sports rehabilitation and might be used as a useful intervention because it decreases the pain level and improves blood flow to the affected area with low adverse effects.
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Ventosaterapia , Dor Lombar , Esportes , Humanos , Acetaminofen , Ventosaterapia/efeitos adversos , Modalidades de FisioterapiaRESUMO
BACKGROUND: Frozen shoulder (FS) is a familiar disorder. Diabetics with FS have more severe symptoms and a worse prognosis. Thus, this study investigated the influence of enhancing dynamic scapular recognition on shoulder disability and pain in diabetics with FS. CASE SUMMARY: A Forty-five years-old male person with diabetes mellitus and a unilateral FS (stage II) for at least 3 mo with shoulder pain and limitation in both passive and active ranges of motion (ROMs) of the glenohumeral joint of ≥ 25% in 2 directions participated in this study. This person received dynamic scapular recognition exercise was applied to a diabetic person with a unilateral FS (stage II). The main outcome measures were upward rotation of the scapula, shoulder pain and disability index, and shoulder range of motion of flexion, abduction, and external rotation. The dynamic scapular exercise was performed for 15 min/session and 3 sessions/wk lasted for 4 wk. After 4 wk of intervention, there were improvements between pre-treatment and post-treatment in shoulder pain, shoulder pain and disability index, shoulder ROM, and upward rotation of the scapula. CONCLUSION: This case report suggested that enhancing dynamic scapular recognition may improve shoulder pain and disability; upward rotation of the scapula; and shoulder ROM of shoulder abduction, flexion, and external rotation after 4 wk.
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Objective: The purpose of this study was to measure the effect of adding vertical downward correction to dynamic scapular recognition exercise on scapular dyskinesis and shoulder pain and disability in people with adhesive capsulitis. Methods: Sixty-seven participants with adhesive capsulitis were randomized into 2 groups. The taping intervention group performed a dynamic scapular recognition exercise using a wireless biofeedback system and a continual vertical downward correction using rigid taping with 50% to 75% tension. The comparison group performed a similar dynamic scapular recognition exercise but with sham taping. The primary outcome measures were scapular dyskinesis, scapular upward rotation, and Shoulder Pain and Disability Index, and the secondary outcome measures were shoulder flexion, abduction, and external rotation. Results: After 2 weeks, there were significant differences between the taping intervention group and the comparison group in scapular dyskinesis, scapular upward rotation, shoulder flexion, abduction, and Shoulder Pain and Disability Index (P < .05), and nonsignificant differences in shoulder external rotation (P > .05). After 2 and 6 months, there were significant differences between groups in all dependent outcome measures (P < .05). Conclusion: This study demonstrated that from adding taping with a vertical downward correction to dynamic scapular recognition exercises, significant short-term and long-term improvements in scapular dyskinesis and shoulder pain and disability in people with adhesive capsulitis were observed. These improvements persisted for 6 months after intervention.
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Objective: The purpose of this study was to examine the effect of 8 weeks of biofeedback on reaction time and central somatosensory conduction time in patients with forward head posture and cervical radiculopathy. Methods: We performed a double-blinded randomized controlled trial. Seventy patients with forward head posture and cervical radiculopathy were randomly distributed into study and control groups. The study group received biofeedback forward head posture corrective exercise for 8 weeks, while the control group did not receive any treatment. The main outcome measures were reaction time and central somatosensory conduction time. The secondary outcome measures were the craniovertebral angles, nerve conduction time at N13 and N20, referred arm pain, and neck disability index. Results: After 4 weeks, there were nonsignificant differences between both groups in reaction time and central somatosensory conduction time (P > .05); while there were significant differences between both groups in N13, N20, craniovertebral angle, referred arm pain, and neck disability index scores (P < .05). After 8 weeks, there were significant differences between both groups in all outcome measures (P < .05). Conclusion: In this study, participants receiving biofeedback forward head posture corrective exercise improved both reaction time and central somatosensory conduction time after 8 weeks when compared to a control, nontreatment group.
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COVID-19 is a world disaster. In response to COVID-19 quarantine, stress, anxiety, and depression may easily develop which negatively affect immunity and decrease the patient's response against the COVID-19 virus. This study investigated the effect of an integrated intervention combining cognitive-behavioural stress management (CBSM) and progressive muscle relaxation (PMRs) on immune biomarkers and disease severity and progression in patients with COVID-19 and the period to which these changes last. Thirty patients with mild or moderate COVID-19 were randomly distributed into intervention and control groups. The intervention group performed an integrated intervention combining CBSM and PMRs. There were three outcome measures including blood immune markers, salivary immunoglobulin A, and Wisconsin scale (WIS). Two-week post-intervention, there were significant differences between groups in the WIS total score, Leucocytes, Lymphocytes, Interleukin-6, and Immunoglobulin-A. While there were non-significant differences between both groups in Interleukin-10 and TNF-α. The significant differences between groups in the WIS total score, Leucocytes, Lymphocytes, Interleukin-6, and Immunoglobulin-A significantly continued 1 week as a follow-up. This study concluded that performing an integrated intervention combining CBSM and PMRs for 2 weeks significantly increases immune biomarkers mainly Leucocytes, Lymphocytes, Interleukin-10, and Interleukin-6 along with S-IgA. Also, this protocol significantly decreases disease severity and associated stress, anxiety, and depression; and enhances the quality of life in patients with COVID-19. The study was retrospectively registered with NCT04998708.
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Treinamento Autógeno , COVID-19 , Cognição , Estresse Psicológico , Humanos , Biomarcadores , COVID-19/psicologia , Interleucina-10 , Interleucina-6 , Qualidade de Vida , Estresse Psicológico/terapia , Imunoglobulina ARESUMO
BACKGROUND: The World Health Organization in March 2020 has announced that COVID-19 is a world pandemic because the number of infected cases increases rapidly. however, there are several available vaccines, their protection is limited to a certain period. Thus, the role of modalities that improve immune functions should be performed to counter COVID-19 viral load and decrease mortality rates. OBJECTIVE: To investigate the effect of aerobic exercise on immune biomarkers, disease severity, and progression in patients with COVID-19. DESIGN: A randomized controlled study. PARTICIPANTS: Thirty patients with COVID-19 participated in this study. Participants' age ranged from 24 to 45 years old. Participants had a mild or moderate COVID-19. Participants were assigned randomly into two groups, exercise and control groups. There were two main dependent variables including blood immune markers and severity of respiratory symptoms. INTERVENTIONS: All participants performed 2 weeks of moderate-intensity aerobic exercise for 40 min/session, 3 sessions/week. The measurements were performed at baseline, and after 2-weeks. RESULTS: At baseline measurements, there were non-significant differences between both groups in the Wisconsin scale total score, Leucocytes, Lymphocytes, Interleukin-6, Interleukin-10, Immunoglobulin-A, and TNF-α (P > .05). After the intervention, the Wisconsin scale (patient-oriented illness-specific quality-of-life) total score significantly decreased in the intervention group (P < .05); while, Leucocytes, Lymphocytes, and Immunoglobulin-A significantly increased in the intervention group (P < .05). CONCLUSION: The current study indicated that 2 weeks of moderate-intensity aerobic exercise decreased the severity and progression of COVID-19 associated disorders and quality of life. Also, a 2-weeks of aerobic exercise positively affected immune function by increasing the amounts of Leucocytes, Lymphocytes, Immunoglobulin A.
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COVID-19 , Exercício Físico , Adulto , Biomarcadores , Exercício Físico/imunologia , Humanos , Pessoa de Meia-Idade , Qualidade de Vida , SARS-CoV-2 , Adulto JovemRESUMO
Most recently, the whole world is struggling against the virulent pandemic COVID-19. Due to the unbounded global spread of the disease, having biosensors with high performance such as high sensitivity and accuracy is of utmost importance. In this paper, the effects of various parameters on the behaviors of micro-biosensors are investigated in order to enhance their performance. These parameters are related to the geometry and material, and they are assumed to be gradually changing in the longitudinal direction of the biosensor according to a power law. Therefore, they are called functionally graded geometrical and material parameters. Another aspect is when considering microcantilever-based biosensors, the main behavior parameter is the deflection at the free end. In the analyses, the influences of the surface stress and van der Waals intermolecular forces are taken into account. Also, the total energy of the beam, which is the combination of the van der Waals energy and the elastic strain energy, is accomplished. In addition, the equivalent force causing the deflection is also evaluated using Castigliano method for two cases. These cases account for a concentrated force at the free end and a distributed load along the biosensor, respectively. Since the governing equations account for the size dependency and the considered parameters are functions of the position, the solution is too complex to be achieved analytically, and therefore, numerical methods are applied. For uniform biosensors made of homogeneous materials, or in other words when all parameters are not varying with the position, the obtained results are compared with those in the literature, and good agreement is obtained. On the other hand, the performance, which include sensitivity and limit of detection, of functionally graded biosensors can be enhanced by proper choices of the considered parameters and the corresponding exponent of the gradation function.
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BACKGROUND: COVID-19 is a world disaster. The relationship between COVID-19 and Diabetes Mellitus (DM) is double-faced because DM is considered one of the COVID-19 key risk factors causing an increase in COVID-19 related conditions and death rates; at the same time, high stress in patients with COVID-19 can lead to the occurrence of DM. This relationship adversely affects immune functions. Relaxation techniques have been demonstrated to positively affect immune functions, glycemic control, and stress levels. METHODS: A search in Scopus, Web of Science, Medline databases, and EBSCO has been made. The search included clinical trials and systematic and literature reviews on the effects of relaxation techniques on immune functions, glycemic control, and stress levels. RESULTS: This review found that relaxation techniques produce short-term effects on decreasing stress levels through autonomic regulation, controlling glycemic control through decreasing hyperglycemia, and increasing immune functions through increasing immune cells and immunoglobins A. CONCLUSION: This review summarizes the important role of performing regular relaxation techniques in COVID-19 patients with DM. Relaxation techniques benefit diabetic patients with COVID-19 through decreasing stress levels, better controlling of glycemic control, and increasing immune functions.
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COVID-19 , Diabetes Mellitus , Diabetes Mellitus/terapia , Controle Glicêmico , Humanos , Imunidade , Terapia de Relaxamento , SARS-CoV-2RESUMO
Sarcopenia is a common condition in older adults, which causes the frequent occurrence of muscle fatigue. Muscle fatigue commonly develops among seniors. Muscle fatigue is a type of physical fatigue that occurs due to either motor or sensory dysfunctions. Current interventions developed to decrease the occurrence of muscle fatigue, which include either increasing rest periods or subdividing large tasks into small ones. The effectiveness of these interventions is highly contradicted. Recently, researchers discovered that mechanoreceptors are the main receptors of muscle fatigue, however, no clinical study investigated the effect of performing proprioceptive training to enhance the mechanoreceptors and decrease the occurrence of muscle fatigue. Performing proprioceptive training could improve muscle fatigue by improving its sensory part. The function of mechanoreceptors might consequently enhance fatigue and decrease the progression rate of sarcopenia. Thus, this review was conducted to suggest a novel approach of treatment to enhance fatigue and decrease Sarcopenia in seniors. This might be accomplished through increasing the firing rate of α- motor neurons, increasing the amount of Ca2+ ions in the neuromuscular junction, slowing the progression rate of Sarcopenia, and correcting movement deviations, which commonly occur with muscle fatigue in seniors. In conclusion, proprioceptive training could play an effective role in decreasing the progression rate of sarcopenia and enhancing the fatigability among seniors.
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Fadiga/etiologia , Fadiga/terapia , Fadiga Muscular , Exercícios de Alongamento Muscular , Sarcopenia/complicações , Progressão da Doença , HumanosRESUMO
OBJECTIVE: This study hypothesized that the prolonged use of taping during athletic activities produces more significant increases in proprioception, balance, and vertical jump among volleyball players with CAI. DESIGN: A randomized controlled study. PARTICIPANTS: One-hundred participants with chronic ankle instability (CAI) participated in this study. Participants were distributed into 3-groups: taping group, bandaging group, and control group. PRIMARY OUTCOME MEASURES: Proprioception (ankle range of motion absolute error), balance(Y-balance test), and vertical jump (vertical jump tester). INTERVENTIONS: Three interventions were performed: ankle rigid taping, ankle bandaging, and placebo taping. The measurements were performed at baseline, immediately, 2-weeks and 2-months after support. RESULTS: Immediately after supports, there were non-significant differences between all groups for proprioception, balance (P < .05). There was a significant difference between banding and control groups, and taping and control groups for the vertical jump (P < .05). After 2-weeks and 2-months, there were significant differences between bandaging and control groups, and taping and control groups for proprioception, balance, and vertical jump (P < .05). There were non-significant differences between taping and bandaging groups (P < .05) during all assessments. CONCLUSION: This study indicated that ankle taping and bandaging immediately improve vertical jump only; while they improve proprioception, balance, and vertical jump after 2-weeks and 2-months.
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Articulação do Tornozelo/fisiopatologia , Fita Atlética , Instabilidade Articular/terapia , Voleibol/lesões , Adulto , Traumatismos do Tornozelo/fisiopatologia , Traumatismos do Tornozelo/terapia , Bandagens , Feminino , Humanos , Instabilidade Articular/fisiopatologia , Masculino , Equilíbrio Postural , Propriocepção , Amplitude de Movimento Articular , Adulto JovemRESUMO
BACKGROUND AND AIMS: COVID-19 is a public world crisis, however, it is a self-limited infection. In COVID-19, the strength of immune and respiratory systems is a critical element. Thus, this review was conducted to demonstrate the short and long term effects of increasing the aerobic capacity on increasing the function and strength of immune and respiratory systems, particularly those essential for overcoming COVID-19 infections and associated disorders. METHODS: This review was carried out by searching in Web of Science, Scopus, EBSCO, Medline databases. The search was conducted over clinical trials and literature and systematic reviews on the effects of increasing the aerobic capacity on the function and strength of specific immune and respiratory elements essential for overcoming COVID-19 infections. RESULTS: This review found that increasing the aerobic capacity could produce short-term safe improvements in the function of immune and respiratory systems, particularly those specific for COVID-19 infections. This could be mainly produced through three mechanisms. Firstly, it could improve immunity by increasing the level and function of immune cells and immunoglobulins, regulating CRP levels, and decreasing anxiety and depression. Secondly, it could improve respiratory system functions by acting as an antibiotic, antioxidant, and antimycotic, restoring normal lung tissue elasticity and strength. Lastly, it could act as a protective barrier to decrease COVID-19 risk factors, which helps to decrease the incidence and progression of COVID-19. CONCLUSION: This review summarizes that increasing the aerobic capacity is recommended because it has potential of improving immune and respiratory functions which would help counter COVID-19.
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Infecções por Coronavirus/imunologia , Infecções por Coronavirus/prevenção & controle , Exercício Físico , Imunidade Celular/imunologia , Controle de Infecções/métodos , Oxigênio/metabolismo , Pandemias/prevenção & controle , Pneumonia Viral/imunologia , Pneumonia Viral/prevenção & controle , Sistema Respiratório/imunologia , Betacoronavirus/imunologia , Betacoronavirus/patogenicidade , COVID-19 , Infecções por Coronavirus/tratamento farmacológico , Infecções por Coronavirus/transmissão , Infecções por Coronavirus/virologia , Humanos , Pneumonia Viral/transmissão , Pneumonia Viral/virologia , SARS-CoV-2 , Tratamento Farmacológico da COVID-19RESUMO
INTRODUCTION: Accidental fall is a serious problem in older adults. The incidence of accidental fall increases by any dysfunction in the proprioceptive system. The function of the proprioceptive system usually is much affected in people with Diabetes Mellitus (DM), particularly in older ages. However, proprioceptive exercise significantly improves the balance control in older adults, no systematic review demonstrated its effectiveness in improving the balance control in older adults with DM. Thus, this systematic review was conducted to examine the effectiveness of adding proprioceptive exercise to any balance training in older adults with DM. METHODS: A systematic search was performed in five major databases. The inclusion criteria of this search included older adults with DM, peripheral neuropathy, randomized control trial, and proprioceptive dysfunction. The exclusion criterion of this search included any study where participants had a history of a disease that might affect the balance control such as ataxia, stroke, and Parkinsonism. The outcome of interest was the importance of including proprioceptive exercise in increasing the effectiveness of balance training in older adults with DM. RESULTS: Nine RCTs met the inclusion criteria for this systematic review. Seven studies of these nine studies included randomization details. Only two studies included the blindness, and only one of them included double blindness. The description of the withdrawal of participants was shown in eight studies. All the included studies used a control group and accomplished the homogeny between subjects in the both groups. CONCLUSION: This systematic review showed that proprioceptive exercise is a vital component that should be included in any balance training to gain short-term improvement in the balance control in older adults with DM.
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Acidentes por Quedas/prevenção & controle , Complicações do Diabetes/complicações , Terapia por Exercício/métodos , Propriocepção , Transtornos de Sensação/terapia , Idoso , Humanos , Pessoa de Meia-Idade , Equilíbrio Postural , Ensaios Clínicos Controlados Aleatórios como Assunto , Transtornos de Sensação/etiologiaRESUMO
BACKGROUND: Examine the ability of a dynamic scapular recognition exercise to improve scapular upward rotation and decrease shoulder pain and disability in patients with adhesive capsulitis of the shoulder. METHODS: A test-retest randomized controlled study design was used. A total of sixty-six patients with unilateral adhesive capsulitis were equally divided into two groups. The study group received a dynamic scapular recognition exercise using a wireless biofeedback system, while the control group received placebo treatment in the form of active range-of-motion (ROM) exercises of the sound upper limb. A digital inclinometer was used to measure the scapular upward rotation and ROM of the shoulder joint, and the Shoulder Pain and Disability Index (SPADI) was used to measure the shoulder pain and disability. RESULTS: Study results showed that after two weeks, there were statistically significant differences between the study and control groups in scapular upward rotation and shoulder flexion and abduction (P < .05) and nonsignificant differences in shoulder external rotation and SPADI (P > .05). After two and six months, there were statistically significant differences between study and control groups in scapular upward rotation; shoulder flexion, abduction and external rotation; and SPADI scores (P < .05). CONCLUSION: This study showed that a dynamic scapular recognition exercise significantly improves scapular upward rotation and the ROM of shoulder flexion and abduction after two weeks. At two and six months, this exercise improves scapular upward rotation; ROM of shoulder flexion, abduction, and external rotation; and SPADI scores. These improvements persisted for six months after the performance of this exercise.
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Bursite/fisiopatologia , Bursite/terapia , Terapia por Exercício/métodos , Escápula/fisiopatologia , Dor de Ombro/fisiopatologia , Dor de Ombro/terapia , Avaliação da Deficiência , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Medição da Dor , Amplitude de Movimento Articular/fisiologiaRESUMO
Muscle fatigue is a serious problem in patients with motor neuron diseases (MNDs). It commonly disturbs both daily life activity and rehabilitation tolerance. A particular concern should be taken when MNDs occur in older ages. Older patients with MNDs usually have a worse clinical presentation and a lower survival rate. This could increase the occurrence of muscle fatigue. Muscle fatigue occurs due to a dysfunction in either motor or sensory systems. Current exercise interventions performed to decrease the occurrence of muscle fatigue focused only on treating motor causes of muscle fatigue. It has been demonstrated that these interventions have a high debate in their effectiveness on decreasing the occurrence of muscle fatigue. Also, these exercise interventions ignored training the affected sensory part of muscle fatigue, however, the important role of the sensory system in driving the motor system. Thus, this review aimed to develop a novel exercise intervention by using proprioceptive training as an intervention to decrease the occurrence of muscle fatigue in patients with MNDs particularly, older ones. The physiological effects of proprioceptive training to decrease the occurrence of muscle fatigue could include two effects. The first effect includes the ability of the proprioceptive training to increase the sensitivity of muscle spindles as an attempt to normalize the firing rate of α-motoneurons, which their abnormalities have major roles in the occurrence of muscle fatigue. The second effect includes its ability to correct the abnormal movement-compensations, which develop due to the biomechanical constraints imposed on patients with MNDs.
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An alkaline-forced degradation hydrolytic product of vinpocetine was prepared and characterized by 1H-NMR, FTIR spectroscopy, and MS. Subsequently, a simple, selective, and validated reversed-phase HPLC method was developed for the simultaneous estimation of vinpocetine and folic acid in the presence of a vinpocetine alkaline degradation product. Chromatographic separation was achieved using an isocratic mobile phase consisting of acetonitrile-0.02 M KH2PO4 [containing 0.2% (v/v) triethylamine and adjusted to pH 6 with orthophosphoric acid; (80 + 20, v/v)] at a flow rate of 0.9 mL/min at ambient temperature on a Eurospher II C18 (250 × 4.6 mm, 5 µm) column, with UV detection at 280 nm for folic acid and 230 nm for vinpocetine and its alkaline hydrolytic product. Linearity, accuracy, and precision were found to be acceptable over a concentration range of 12.5-200 µg/mL for vinpocetine and 1-16 µg/mL for folic acid. The proposed method was successfully applied for the determination of both drugs and a vinpocetine hydrolysis product in a laboratory-prepared mixture and in a capsule containing both drugs.