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1.
Chin Med J (Engl) ; 132(15): 1815-1822, 2019 Aug 05.
Artigo em Inglês | MEDLINE | ID: mdl-31306225

RESUMO

BACKGROUND: Emerging evidences have indicated that the composition of gut microbiota was significantly influenced by central nervous system diseases. The digestion and metabolism disturbances of patients with amyotrophic lateral sclerosis (ALS) might be strongly associated with ALS; however, this has rarely been evaluated in these populations. This study was to evaluate bacterial and archaeal composition of gut flora and the corresponding metabolism performance of these micro-organisms in fecal samples of patients with ALS. METHODS: A comparative study was performed on the intestinal microbiota from eight patients with ALS and eight healthy individuals at Huadong Hospital during November 2017 to April 2018; meanwhile, the metabolite concentrations of human endotoxin, short-chain fatty acids (SCFA), NO2-N/NO3-N, and γ-aminobutyric acid were also evaluated by spectrophotometry methods. The correlations between intestinal microbiota and metabolite concentration were compared between the two groups using one-way analysis of variance; the relative abundance of beneficial and harmful micro-organisms in fecal samples was also analyzed. RESULTS: In general, the richness and evenness of bacterial and archaeal communities of healthy individuals were healthier than that of patients with ALS. The phylum Firmicutes/Bacteroidetes ratio, genus Methanobrevibacter showed an enhancive tendency in patients with ALS, whereas the relative abundance of beneficial micro-organisms (genera Faecalibacterium and Bacteroides) presented a significant decrease tendency in patients with ALS. In addition, the average concentrations of human endotoxin, SCFA, NO2-N/NO3-N, and γ-aminobutyric acid in patients with ALS and healthy individuals were 64.2 vs. 65.3 EU/mL, 57.5 vs. 55.3 µg/mL, 5.7 vs. 5.3 ng/mL, and 6.1 vs. 5.4 µmol/L, respectively, indicating that the digestion and metabolism functions of gastrointestinal tract of patients might decline with this disease. CONCLUSIONS: The relative abundance of beneficial and harmful micro-organisms respectively showed decrease and increase tendency in patients with ALS.

2.
Clin Rehabil ; 33(9): 1479-1491, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31081365

RESUMO

OBJECTIVE: The aim of this study was to validate a novel pictorial-based Longshi Scale for evaluating a patient's disability by healthcare professionals and non-professionals. DESIGN: Prospective study. SETTING: Rehabilitation departments from a grade A, class 3 public hospital, a grade B, class 2 public hospital, and a private hospital and seven community rehabilitation centers. SUBJECTS: A total of 618 patients and 251 patients with functional disabilities were recruited in a two-phase study, respectively. MAIN MEASURES: Outcome measure: pictorial scale of activities of daily living (ADLs, Longshi Scale). Reference measure: Barthel Index. The Spearman correlation coefficient was used to analyze the validity of Longshi Scale against Barthel Index. RESULTS: In phase 1 study, from March 2016 to August 2016, the results demonstrated that the Longshi Scale was both reliable and valid (intraclass correlation coefficient based on two-way random effect (ICC2,1) = 0.877-0.974 for intra-rater reliability; ICC2,1 = 0.928-0.979; κ = 0.679-1.000 for inter-rater reliability; intraclass correlation coefficient based on one-way random effect (ICC1,1) = 0.921-0.984 for test-retest reliability and Spearman correlation coefficient = 0.836-0.899). In the second phase, in March 2018, results further demonstrated that the Longshi Scale had good inter-rater and intra-rater reliability among healthcare professionals and non-professionals including therapists, interns, and personal care aids (ICC1,1 = 0.822-0.882 on Day 1; ICC1,1 = 0.842-0.899 on Day 7 for inter-rater reliability). In addition, the Longshi Scale decreased assessment time significantly, compared with the Barthel Index assessment (P < 0.01). CONCLUSION: The Longshi Scale could potentially provide an efficient way for healthcare professionals and non-professionals who may have minimal training to assess the ADLs of functionally disabled patients.

3.
Arch Phys Med Rehabil ; 100(11): 2167-2178, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31004565

RESUMO

OBJECTIVE: This study systematically reviews previous work on the effects of whole body vibration exercise (WBVE) on pain associated with chronic musculoskeletal disorders. DATA SOURCES: Seven electronic databases (PubMed, Embase, CINAHL, Web of Science, Cochrane, Physiotherapy Evidence Database [PEDro], and the China National Knowledge Infrastructure) were searched for articles published between January 1980 and September 2018. STUDY SELECTION: Randomized controlled trials involving adults with chronic low back pain (CLBP), osteoarthritis (OA), or fibromyalgia were included. Participants in the WBVE intervention group were compared with those in the nontreatment and non-WBVE control groups. DATA EXTRACTION: Data were independently extracted using a standardized form. Methodological quality was assessed using PEDro. DATA SYNTHESIS: Suitable data from 16 studies were pooled for meta-analysis. A random effects model was used to calculate between-groups mean differences at 95% confidence interval (CI). The data were analyzed depending on the duration of the follow-up, common disorders, and different control interventions. RESULTS: Alleviation of pain was observed at medium term (standardized mean difference [SMD], -0.67; 95% CI, -1.14 to -0.21; I2, 80%) and long term (SMD, -0.31; 95% CI, -0.59 to -0.02; I2, 0%). Pain was alleviated in osteoarthritis (OA) (SMD, -0.37; 95% CI, -0.64 to -0.10; P<.05; I2, 22%) and CLBP (SMD, -0.44; 95% CI, -0.75 to -0.13; P<.05; I2, 12%). Long-term WBVE could relieve chronic musculoskeletal pain conditions of OA (SMD, -0.46; 95% CI, -0.80 to -0.13; P<.05; I2, 0%). WBVE improved chronic musculoskeletal pain compared with the treatment "X" control (SMD, -0.37; 95% CI, -0.61 to -0.12; P<.05; I2, 26%), traditional treatment control (SMD, -1.02; 95% CI, -2.44 to 0.4; P>.05; I2, 94%) and no treatment control (SMD, -1; 95% CI, -1.76 to -0.24; P<.05; I2, 75%). CONCLUSIONS: Evidence suggests positive effects of WBVE on chronic musculoskeletal pain, and long durations of WBVE could be especially beneficial. However, WBVE does not significantly relieve chronic musculoskeletal pain compared with the traditional treatment. Further work is required to identify which parameters of WBVE are ideal for patients with chronic musculoskeletal pain.

4.
Medicine (Baltimore) ; 97(42): e12802, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30334972

RESUMO

This study aimed to evaluate the efficiency of the International Classification of Functioning, Disability, and Health (ICF) in stroke rehabilitation assessment in China and to identify correlations between the ICF and several commonly used clinical assessment instruments for stroke.In total, 52 hospitals and 5 premier rehabilitation and neurology research centers participated in this cross-sectional multicenter clinical study. A total of 2822 stroke patients admitted to a neurology or rehabilitation department of a participating medical center between July 2012 and June 2014 were included. The ICF checklist contains 4 parts with 128 two-level items: body functions, body structures, activities and participation, and environmental factors. We analyzed the results of ICF assessments and determined whether correlations existed between the various items of the ICF and several commonly used clinical assessment instruments.In all but 3 instances, the scores for the ICF-b-body function, ICF-s-body structure-degree of impairment, ICF-s-body structure-impairment location, ICF-d-activity performance, ICF-d-ability performance, ICF-e-facilitator, and ICF-e-barrier correlated significantly (P < .05) with the scores for the commonly used clinical assessment instruments.The ICF checklist is a new rehabilitation assessment instrument that is compatible with commonly used clinical assessment scales for stroke and can be used in combination with these scales.


Assuntos
Avaliação da Deficiência , Classificação Internacional de Funcionalidade, Incapacidade e Saúde , Avaliação de Resultados (Cuidados de Saúde)/métodos , Reabilitação do Acidente Vascular Cerebral/estatística & dados numéricos , Acidente Vascular Cerebral/fisiopatologia , Atividades Cotidianas , Idoso , Lista de Checagem , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento
5.
Knee Surg Sports Traumatol Arthrosc ; 24(4): 1081-5, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-26017745

RESUMO

PURPOSE: Lateral ankle sprain is the most common injury. A previous study demonstrated that patients with mechanical ankle instability suffered deficits in postural control, indicating that structural damage of the lateral ankle ligaments may produce a balance deficit. The purpose of this study was to confirm that lateral ligaments reconstruction could improve postural control in patients with mechanical ankle instability. METHODS: A total of 15 patients were included in the study. Each patient had a history of an ankle sprain with persistent symptoms of ankle instability and a positive anterior drawer test and had been treated nonoperatively for at least 3 months. All patients were diagnosed with lateral ankle ligaments tear by ultrasonography and magnetic resonance imaging. They underwent arthroscopic debridement and open lateral ankle ligaments reconstruction with a modified Broström procedure. One day before and 6 months after the operation, all of the participants underwent single-limb postural sway tests. The anterior drawer test and the American Orthopedic Foot and Ankle Society scale score were used to evaluate the clinical results in these patients. RESULTS: At 6 months after the operation, with the patients' eyes closed, there was significantly decreased postural sway in the anteroposterior direction, the circumferential area, and the total path length on the operated ankles compared with those measurements before the operation. With eyes open, however, no difference was found in postural sway before and after the operation. CONCLUSIONS: Postural control was improved by reconstructing the lateral ligaments. LEVEL OF EVIDENCE: IV.


Assuntos
Traumatismos do Tornozelo/fisiopatologia , Articulação do Tornozelo/fisiopatologia , Instabilidade Articular/fisiopatologia , Ligamentos Laterais do Tornozelo/fisiopatologia , Equilíbrio Postural/fisiologia , Adulto , Traumatismos do Tornozelo/diagnóstico , Traumatismos do Tornozelo/cirurgia , Articulação do Tornozelo/cirurgia , Artroscopia , Desbridamento , Teste de Esforço , Feminino , Humanos , Instabilidade Articular/cirurgia , Ligamentos Laterais do Tornozelo/lesões , Ligamentos Laterais do Tornozelo/cirurgia , Imagem por Ressonância Magnética , Masculino , Procedimentos Ortopédicos , Procedimentos Cirúrgicos Reconstrutivos , Ultrassonografia , Adulto Jovem
6.
J Int Med Res ; 41(2): 418-26, 2013 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-23569036

RESUMO

OBJECTIVE: Randomized, controlled, blinded trial to evaluate the effectiveness of strategic targeted exercise for preventing falls in elderly people. METHODS: Elderly people were randomly allocated to either a control group that received conventional exercise, or a training group that received conventional exercise plus proprioception and cognitive exercises. Subjects were asked to exercise three times a week (40 min per session) for 8 weeks. In the pre- and post-training sessions, all participants were assessed using a static postural control test with eyes open and closed, the Berg Balance Scale (BBS) and the joint position sense test of the lower limbs. RESULTS: After 8 weeks, there were statistically significant improvements in the training group (n = 50) compared with the control group (n = 50) for mediolateral sway distance with eyes open and eyes closed, anteroposterior sway distance with eyes open but not with eyes closed, BBS scores and joint position sense test for the left but not the right knee. CONCLUSION: This study demonstrated that strategic targeted exercise could produce more beneficial effects on balance and proprioception function than conventional exercise alone, in elderly people.


Assuntos
Acidentes por Quedas/prevenção & controle , Exercício , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Demografia , Feminino , Humanos , Articulações/fisiopatologia , Masculino , Pessoa de Meia-Idade , Equilíbrio Postural/fisiologia
10.
Artigo em Inglês | MEDLINE | ID: mdl-23346195

RESUMO

Background. Tai Chi is a traditional Chinese medicine exercise used for improving neuromuscular function. This study aimed to investigate the effects of Tai Chi versus proprioception exercise program on neuromuscular function of the ankle in elderly people. Methods. Sixty elderly subjects were randomly allocated into three groups of 20 subjects per group. For 16 consecutive weeks, subjects participated in Tai Chi, proprioception exercise, or no structured exercise. Primary outcome measures included joint position sense and muscle strength of ankle. Subjects completed a satisfaction questionnaire upon study completion in Tai Chi and proprioception groups. Results. (1) Both Tai Chi group and proprioception exercise group were significantly better than control group in joint position sense of ankle, and there were no significant differences in joint position sense of ankle between TC group and PE group. (2) There were no significant differences in muscle strength of ankle among groups. (3) Subjects expressed more satisfaction with Tai Chi than with proprioception exercise program. Conclusions. None of the outcome measures on neuromuscular function at the ankle showed significant change posttraining in the two structured exercise groups. However, the subjects expressed more interest in and satisfaction with Tai Chi than proprioception exercise.

11.
PLoS One ; 7(12): e52082, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-23284879

RESUMO

OBJECTIVE: To review the effects of core stability exercise or general exercise for patients with chronic low back pain (LBP). SUMMARY OF BACKGROUND DATA: Exercise therapy appears to be effective at decreasing pain and improving function for patients with chronic LBP in practice guidelines. Core stability exercise is becoming increasingly popular for LBP. However, it is currently unknown whether core stability exercise produces more beneficial effects than general exercise in patients with chronic LBP. METHODS: Published articles from 1970 to October 2011 were identified using electronic searches. For this meta-analysis, two reviewers independently selected relevant randomized controlled trials (RCTs) investigating core stability exercise versus general exercise for the treatment of patients with chronic LBP. Data were extracted independently by the same two individuals who selected the studies. RESULTS: From the 28 potentially relevant trials, a total of 5 trials involving 414 participants were included in the current analysis. The pooling revealed that core stability exercise was better than general exercise for reducing pain [mean difference (-1.29); 95% confidence interval (-2.47, -0.11); P = 0.003] and disability [mean difference (-7.14); 95% confidence interval (-11.64, -2.65); P = 0.002] at the time of the short-term follow-up. However, no significant differences were observed between core stability exercise and general exercise in reducing pain at 6 months [mean difference (-0.50); 95% confidence interval (-1.36, 0.36); P = 0.26] and 12 months [mean difference (-0.32); 95% confidence interval (-0.87, 0.23); P = 0.25]. CONCLUSIONS: Compared to general exercise, core stability exercise is more effective in decreasing pain and may improve physical function in patients with chronic LBP in the short term. However, no significant long-term differences in pain severity were observed between patients who engaged in core stability exercise versus those who engaged in general exercise. SYSTEMATIC REVIEW REGISTRATION: http://www.crd.york.ac.uk/PROSPERO PROSPERO registration number: CRD42011001717.


Assuntos
Terapia por Exercício , Dor Lombar/reabilitação , Dor Lombar/terapia , Humanos , Viés de Publicação , Resultado do Tratamento
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