Comparative effectiveness of high-intensity laser therapy and ultrasound therapy for hemiplegic shoulder pain in stroke patients: a randomized controlled trial".

BACKGROUND: Hemiplegic shoulder pain (HSP) is a prevalent clinical manifestation following stroke, often causing considerable discomfort and disability. Various therapeutic approaches have been developed to address HSP. OBJECTIVES: This study aimed to compare the effectiveness of HILT versus US therapy in alleviating HSP in stroke patients. METHODS: A double-blind randomized controlled trial enrolled stroke patients with HSP within one year post-onset. Participants were randomly assigned to HILT (with sham US) or US therapy (with sham HILT). Both groups received 10-minute sessions of their assigned therapy modality along with daily shoulder range of motion (ROM) exercises 5 times per week over two consecutive weeks. Pain reduction was the primary outcome, with shoulder ROM as secondary outcomes. RESULTS: Thirty patients (11 women, 19 men; mean age: 60.80 ± 11.51 years) were included. After the two-week intervention, significant improvements were observed in pain reduction at rest and during motion in the HILT group, and in pain reduction during motion and shoulder internal rotation in the US group compared to pre-treatment values within each group. However, there was no significant difference between the HILT and US therapy groups in any evaluated parameter. CONCLUSIONS: Comparable efficacy was found between HILT and US therapy in reducing pain and improving shoulder ROM for HSP in stroke patients. Both modalities, when combined with shoulder ROM exercises, offer viable options for managing HSP in this population. Further research with larger sample sizes is needed to validate these findings and explore long-term outcomes.

Efficacy and safety of a simple home-based resistance exercise program for older adults with low muscle mass: a prospective longitudinal clinical trial.

Low muscle mass is a common condition among older adults that adversely affects strength, physical performance and quality of life. This study aimed to investigate the efficacy and safety of a simple home-based resistance exercise program for older adults with low muscle mass, which was defined as appendicular skeletal mass (ASM) measured by bioimpedance analysis lower than 5.7 kg/m2 in females, and lower than 7.0 kg/m2 in males. This home-based resistance exercise program targets 10 muscles with a frequency of 3-5 days/week for 24 weeks. ASM, grip strength, gait speed and functional reach were measured at baseline, 3 and 6 months. The same four outcomes were then remeasured at 9 months to assess long-term effects. A total of 112 participants (average age: 70 years) were recruited. The mean difference between baseline and 6 months was statistically significant for all outcomes, including ASM [0.12 kg/m2: 95% confidence interval (CI), 0.05-0.18; P = 0.001], gait speed (0.19 meter/s: 95% CI, 0.14-0.25; P < 0.001), grip strength (2.06 kg: 95% CI, 1.32-2.80; P < 0.001), and functional reach distance (4.18 cm: 95% CI, 3.18-5.18; P < 0.001). Change over time for all main outcomes from baseline to 9 months also showed statistically significant improvement. The most commonly reported adverse events were muscle pain, joint pain and fatigue. The majority of participants (90-93%) had good exercise compliance, even at the end of the study. In conclusion, this 24-week simple home-based resistance exercise program significantly improved all main outcomes with low adverse events, and most participants continued the program after the end of the intervention.

Factors related to interrupted inpatient stroke rehabilitation due to acute care transfer or death.

OBJECTIVES: To identify factors that are independently related to interrupted stroke rehabilitation due to acute care transfer or death. METHODS: Medical records of stroke inpatients admitted from 2012 to 2017 were reviewed. Stroke inpatients with interrupted stroke rehabilitation due to acute care transfer or death were enrolled into the case group. Those without interruption admitted in the same month were randomly selected into the control group (case to control ratio of 1 : 5). Ten clinical factors were studied. RESULTS: Among stroke inpatients, 3.2% were transferred to acute care facilities and 0.2% died. The most common causes of acute care transfer were respiratory tract infection, intracranial hemorrhage, recurrent ischemic stroke, ischemic heart disease, and seizure. Three factors were found to be significantly associated with interrupted stroke rehabilitation, i.e. presence of feeding tube, presence of anemia and age. Our results also revealed significant association between presence of feeding tube and respiratory tract infection (p = 0.005). CONCLUSION: Feeding tube, anemia and old age were identified as independent predictors of interrupted stroke rehabilitation due to acute care transfer or death. Interventions to reduce severe complications should be implemented in order to prevent interruption of rehabilitation process and to reduce the patient transfer rate.