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1.
Medicine (Baltimore) ; 100(27): e25915, 2021 Jul 09.
Artigo em Inglês | MEDLINE | ID: mdl-34232164

RESUMO

ABSTRACT: Early right ventricular dysfunction in patients with non-advanced idiopathic pulmonary fibrosis (IPF) has not been fully elucidated. Thus, we aimed to assess right ventricular functions in IPF patients and controls by speckle-tracking strain echocardiography at rest and peak exercise.We screened 116 IPF patients from February to August 2019 to include 20 patients with no history of oxygen therapy, peripheral saturation levels ≥92% at rest, Gender-Age-Physiology Index score ≤5, and modified Medical Research Council score ≤3. Additionally, we enrolled 10 matched controls. Transthoracic echocardiography images were acquired at rest and during a cardiopulmonary exercise test. We analyzed 2-dimensional echocardiographic parameters and right ventricular function using the global longitudinal strain assessed by the 2-dimensional speckle-tracking technique.In the control group, we found normal values of right ventricle longitudinal strain (RVLS) at rest and at peak exercise, the latter being much more negative (-23.6 ±â€Š2.2% and -26.8 ±â€Š3.1%, respectively; P < .001). By contrast, RVLS values in the IPF group increased from -21.1 ±â€Š3.8% at rest to -17.0 ±â€Š4.5% at peak exercise (P < .001). The exercise revealed a difference between the 2 groups as the mean RVLS values moved during peak exercise in opposite directions. Patients with IPF got worse, whereas control patients presented improved right ventricular contractility.Right ventricular dysfunction was unveiled by speckle-tracking echocardiography during exercise in non-advanced IPF patients. We suggest that this reflects an inadequate right ventricular-arterial coupling decreasing the right ventricular longitudinal contraction during exercise in these patients. This parameter may be useful as an early index of suspected pulmonary hypertension.


Assuntos
Terapia por Exercício/métodos , Exercício Físico/fisiologia , Ventrículos do Coração/fisiopatologia , Hipertensão Pulmonar/fisiopatologia , Fibrose Pulmonar Idiopática/fisiopatologia , Contração Miocárdica/fisiologia , Função Ventricular Direita/fisiologia , Idoso , Estudos Transversais , Ecocardiografia , Feminino , Ventrículos do Coração/diagnóstico por imagem , Humanos , Hipertensão Pulmonar/etiologia , Hipertensão Pulmonar/terapia , Fibrose Pulmonar Idiopática/complicações , Masculino
2.
Medicine (Baltimore) ; 100(24): e26421, 2021 Jun 18.
Artigo em Inglês | MEDLINE | ID: mdl-34128906

RESUMO

INTRODUCTION: Spinal sarcopenia is a multifactorial disorder associated with the atrophy of and fatty changes to the paraspinal muscles. We previously developed the concept of spinal sarcopenia in community-dwelling older adults and investigated the association between conventional sarcopenic indices and spinal sarcopenia. However, interventional studies of spinal sarcopenia are lacking. This pilot study will aim to evaluate the effectiveness of a combined exercise and nutrition intervention for treating spinal sarcopenia. METHODS AND ANALYSIS: This open-label single-arm prospective study will include 35 community-dwelling older women who were diagnosed with spinal sarcopenia in our previous cohort study. The 12-week combined intervention will consist of back extensor strengthening exercise and nutritional supplementation. The primary outcome of this study will be isometric back extensor strength after the 12-week intervention. All functional and radiographic outcomes will be measured at 0, 12, and 24 weeks post-intervention. The data will be analyzed using the intention-to-treat principle.


Assuntos
Suplementos Nutricionais , Terapia por Exercício/métodos , Músculos Paraespinais/patologia , Treinamento de Força , Sarcopenia/terapia , Idoso , Feminino , Humanos , Vida Independente , Força Muscular , Projetos Piloto , Sarcopenia/dietoterapia
3.
Medicine (Baltimore) ; 100(25): e26357, 2021 Jun 25.
Artigo em Inglês | MEDLINE | ID: mdl-34160406

RESUMO

ABSTRACT: To investigate the effect of core stability training on nonspecific low back pain (NSLBP) in nurses.The data were collected retrospectively by reviewing the patient's medical records and pain questionnaires in our rehabilitation center. A total of 40 nurses with NSLBP were included and divided into observation group and control group. Each group were given routine health education for NSLBP. Core stability training was performed in observation group for 4 weeks. Surface electromyography (sEMG) evaluation of erector spine and multifidus muscle, pain Numeric Rating Scale (NRS) and Japanese Orthopaedic Association (JOA) scores were evaluated and analyzed before and 4 weeks after intervention.There was no significant difference of NRS score and JOA score between two groups before intervention (P > .05, respectively). The NRS and JOA scores were significantly improved in both two groups after 4 weeks of intervention (P < .05, respectively). Moreover, the improvement of NRS and JOA scores in the observation group were better than those of the control group (P < .05, respectively). No significant difference of average electromyography (AEMG) or median frequency (MF) were noted between the healthy side and the affected side in both groups before or after intervention (P > .05, respectively). After 4 weeks of intervention, the AEMG of the healthy and the affected side of the two groups showed an improved trend without significant difference (P > .05, respectively). The MF of affected side was significantly higher 4 weeks after intervention than those before treatment in the observation and control group (P < .05, respectively).Core stability training can alleviate pain, improve the fatigue resistance of the core muscles and the balance of the functions of bilateral multifidus muscles in nurses with NSLBP.


Assuntos
Terapia por Exercício/métodos , Dor Lombar/terapia , Força Muscular/fisiologia , Enfermeiras e Enfermeiros , Músculos Paraespinais/fisiopatologia , Adulto , Estudos de Casos e Controles , Eletromiografia , Feminino , Seguimentos , Humanos , Dor Lombar/diagnóstico , Dor Lombar/fisiopatologia , Masculino , Medição da Dor , Estudos Retrospectivos , Resultado do Tratamento , Adulto Jovem
4.
Medicine (Baltimore) ; 100(25): e26356, 2021 Jun 25.
Artigo em Inglês | MEDLINE | ID: mdl-34160405

RESUMO

ABSTRACT: In dystonic and spastic movement disorders, abnormalities of motor control and somatosensory processing as well as cortical modulations associated with clinical improvement after botulinum toxin A (BoNT-A) treatment have been reported, but electrophysiological evidence remains controversial. In the present observational study, we aimed to uncover central correlates of post-stroke spasticity (PSS) and BoNT-A-related changes in the sensorimotor cortex by investigating the cortical components of somatosensory evoked potentials (SEPs). Thirty-one chronic stroke patients with PSS of the upper limb were treated with BoNT-A application into the affected muscles and physiotherapy. Clinical and electrophysiological evaluations were performed just before BoNT-A application (W0), then 4 weeks (W4) and 11 weeks (W11) later. PSS was evaluated with the modified Ashworth scale (MAS). Median nerve SEPs were examined in both upper limbs with subsequent statistical analysis of the peak-to-peak amplitudes of precentral P22/N30 and postcentral N20/P23 components. At baseline (W0), postcentral SEPs were significantly lower over the affected cortex. At follow up, cortical SEPs did not show any significant changes attributable to BoNT-A and/or physiotherapy, despite clear clinical improvement. Our results imply that conventional SEPs are of limited value in evaluating cortical changes after BoNT-A treatment and further studies are needed to elucidate its central actions.


Assuntos
Toxinas Botulínicas Tipo A/administração & dosagem , Espasticidade Muscular/tratamento farmacológico , Fármacos Neuromusculares/administração & dosagem , Reabilitação do Acidente Vascular Cerebral/métodos , Acidente Vascular Cerebral/complicações , Adulto , Idoso , Potenciais Somatossensoriais Evocados/efeitos dos fármacos , Terapia por Exercício/métodos , Feminino , Seguimentos , Humanos , Masculino , Nervo Mediano/efeitos dos fármacos , Nervo Mediano/fisiopatologia , Pessoa de Meia-Idade , Espasticidade Muscular/diagnóstico , Espasticidade Muscular/etiologia , Espasticidade Muscular/fisiopatologia , Córtex Somatossensorial/efeitos dos fármacos , Córtex Somatossensorial/fisiopatologia , Acidente Vascular Cerebral/fisiopatologia , Resultado do Tratamento , Extremidade Superior/inervação , Adulto Jovem
5.
Medicine (Baltimore) ; 100(25): e26500, 2021 Jun 25.
Artigo em Inglês | MEDLINE | ID: mdl-34160466

RESUMO

ABSTRACT: This study aimed to perform cluster analysis in patients with chronic pain to extract groups with similar circadian rhythms and compare neuropathic pain and psychological factors among these groups to identify differences in pain-related outcomes. A total of 63 community-dwellers with pain lasting at least 3 months and Numerical Rating Scale scores of ≥2 were recruited from 3 medical institutions. Their pain circadian rhythms were evaluated over 7 days by measuring pain intensity at 6-time points per day using a 10-cm visual analog scale. Cluster analysis was performed using 6 variables with standardized visual analog scale values at 6-time points for individual participants to extract groups with similar pain circadian rhythms. The results of the Neuropathic Pain Symptom Inventory and psychological evaluations in each group were compared using the Kruskal-Wallis test. The results revealed 3 clusters with different circadian rhythms of pain. The total and evoked pain subscale Neuropathic Pain Symptom Inventory scores differed among the 3 clusters. The results suggest that a thorough understanding of circadian pain rhythms in chronic pain patients may facilitate the performance of activities of daily living and physical exercise from the perspective of pain management.


Assuntos
Dor Crônica/diagnóstico , Ritmo Circadiano/fisiologia , Neuralgia/diagnóstico , Atividades Cotidianas , Idoso , Idoso de 80 Anos ou mais , Dor Crônica/fisiopatologia , Dor Crônica/psicologia , Dor Crônica/terapia , Cronoterapia/métodos , Terapia por Exercício/métodos , Feminino , Humanos , Vida Independente , Masculino , Pessoa de Meia-Idade , Neuralgia/fisiopatologia , Neuralgia/psicologia , Neuralgia/terapia , Manejo da Dor/métodos , Medição da Dor/estatística & dados numéricos , Psicometria , Estatísticas não Paramétricas , Inquéritos e Questionários/estatística & dados numéricos
6.
Medicine (Baltimore) ; 100(22): e26064, 2021 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-34087850

RESUMO

OBJECTIVE: The aim of this study was to evaluate the efficacy and safety of acupuncture in the treatment of urinary retention after hysterectomy in women. METHODS: This research searched for 6 database documents, and the deadline is July 23, 2020. This study included a randomized controlled trial of women with urinary retention after hysterectomy. These randomized controlled trials compare acupuncture with bladder function training or other nonacupuncture treatments, and measure urodynamics, effectiveness (BR), and urinary tract infection rates (UIR). Four independent reviewers participated in data extraction and evaluation. Assess the risk of bias in each article, and conduct a meta-analysis according to the type of acupuncture. The result is expressed as a mean difference (MD) or relative risk (RR) with a 95% confidence interval (CI). RESULTS: The meta-analysis contains 12 studies. Most studies indicate low risk or unknown risk, but the GRADE scores of the combined results show low or moderate levels. After the combined analysis, we found that acupuncture versus bladder function exercise and other nonacupuncture therapies can significantly improve the values of post voided residual urine (PVR) (MD = -25.29; 95% CI [-30.45 to -20.73]), maximal cystometric capacity (MD = 39.54; 95% CI [10.30-68.78]), bladder capacity for first voiding desire (MD = -61.98; 95% CI [-90.69 to -33.26]) and maximal flow rate (MFR) (MD = 7.58; 95% CI [5.19-9.97]). And compared with the control group, acupuncture still has advantages in BR (RR = 1.36; 95% CI [1.18-1.56]) and UIR (RR = 0.22; 95% CI [0.08-0.82]). These heterogeneities have been resolved through subgroup analysis, and their main sources are related to different intervention times, the time to start the intervention, and different PVR requirements. CONCLUSIONS: There is insufficient evidence that acupuncture can increase the patient's MFR, BR, and UIR. However, acupuncture can effectively improve the PVR, maximal cystometric capacity, and bladder capacity for first voiding desire values of patients with urinary retention after hysterectomy. Although limited due to the quality and methodological limitations of the included studies, acupuncture can still be used as an effective and safe treatment for women with urinary retention after hysterectomy. REGISTRATION: The research has been registered and approved on the PROSPERO website. The registration number is CRD42019119238.


Assuntos
Terapia por Acupuntura/métodos , Histerectomia/efeitos adversos , Retenção Urinária/etiologia , Retenção Urinária/terapia , Terapia por Exercício/métodos , Feminino , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto , Infecções Urinárias/epidemiologia
7.
Medicine (Baltimore) ; 100(22): e26184, 2021 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-34087883

RESUMO

ABSTRACT: The aim of this study was to assess the physical activity level of health care professionals, as well as the differences by sex, age, academic background, and among different health care professions.This is an cross-sectional study.Health care settings in the Valencian Community, Spain.A total of 647 health care professionals.Physical activity was assessed with the European Health Interview Survey-Physical Activity Questionnaire (EHIS-PAQ) that includes the assessment of work-related physical activity, transport-related physical activity, health-enhancing physical activity, muscle-strengthening physical activity, and total physical activity.93.51% of all health care professionals were physically active at work. Transport-related physical activity and health-enhancing physical activity were significantly lower in women (21.62% vs 41.86%, P < .001; and 50.19% vs 68.99%, P < .001, respectively). In addition, compliance with health-enhancing and muscle-strengthening physical activity guidelines were lower in older professionals (42.7% vs 61.84%, P < .001; and 47.57% vs 61.84%, P < .001, respectively). Those with higher education were more compliant with health-enhancing and muscle-strengthening physical activity guidelines (58.55% vs 45.69%, P = .002; and 60.24% vs 48.28%, P = .003, respectively). Moreover, 67.98% of physiotherapists performed health-enhancing physical activity and 67.54% muscle-strengthening physical activity regularly, and significant differences in all outcomes were observed compared to the rest of health care professionals (P < .05). Technicians showed lower work-related and total physical activity than nurses and nursing assistants (74.55% vs 90.37%, P = .002; and 83.64% vs 95.72%, P < .001, respectively). Additionally, nursing assistants showed higher work-related physical activity compared to nurses (97.18% vs 90.37%, P = .008).Most health care professionals showed an appropriate level of physical activity. Men performed more transport-related and health-enhancing physical activity than women. Younger professionals and those with higher education were more compliant with health-enhancing and muscle-strengthening physical activity guidelines. Physiotherapists were more physically active when compared to the rest of health care professionals.


Assuntos
Doenças Cardiovasculares/prevenção & controle , Exercício Físico/fisiologia , Pessoal de Saúde/estatística & dados numéricos , Fisioterapeutas/estatística & dados numéricos , Prevenção Primária/métodos , Adulto , Comportamento Cooperativo , Estudos Transversais , Terapia por Exercício/métodos , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Força Muscular/fisiologia , Espanha/epidemiologia , Inquéritos e Questionários
8.
J Laryngol Otol ; 135(7): 574-578, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34130763

RESUMO

OBJECTIVE: To investigate the effect of laryngeal elevation training without highly loaded head lifting on swallowing function in patients with dysphagia. METHODS: Fifty-seven patients with dysphagia (36 men; mean age, 78.5 ± 11.4 years) were included. All participants performed the swallowing forehead exercise and the chin push-pull manoeuvre for two months. Videoendoscopy to assess swallowing function, the peak expiratory flow test and the hand grip strength test were performed at the initial visit (time 1) and two months after the start of the intervention (time 2). We used the Hyodo score, a scoring method for videoendoscopic assessment, for evaluation of swallowing function. RESULTS: The linear mixed model showed a significant main effect of time (the Hyodo score at time 1 was greater than the score at time 2). The effects of the co-variates were not significant. CONCLUSION: The present study demonstrated the significant effect of laryngeal elevation training without head lifting on the Hyodo score.


Assuntos
Transtornos de Deglutição/reabilitação , Terapia por Exercício/métodos , Fonoterapia/métodos , Idoso , Idoso de 80 Anos ou mais , Deglutição , Transtornos de Deglutição/fisiopatologia , Feminino , Humanos , Laringoscopia , Modelos Lineares , Masculino , Resultado do Tratamento
9.
J Clin Neurosci ; 89: 211-215, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34119269

RESUMO

Robot-assisted gait training using a voluntary-driven wearable cyborg, Hybrid Assistive Limb (HAL), has been shown to improve the mobility of patients with neurological disorders; however, its effect on the quality of life (QOL) of patients is not clear. The aim of this study was to assess the effects of HAL-assisted gait training on QOL and mobility in patients with neuromuscular diseases (NMDs). Ten patients with NMDs (seven men and three women, mean age: 57 ± 11 years), with impairment in mobility but could walk alone with aids underwent two courses of gait training with HAL over 6 months, and the single course consisted of nine sessions of training for 4 weeks. We compared the findings of the 2 min walk test, 10 m walk test, the Short Form-36 (SF-36) questionnaire, and the Hospital Anxiety and Depression Scale at baseline, after the 1st training, before the 2nd training, and after the 2nd training using the Friedman test. A significant improvement was observed in the 2 min walking distance from baseline (93 ± 50 m) to after the 2nd training (115 ± 48 m, P = 0.034), as well as in the domains of vitality (P = 0.019) and mental component summary score (P = 0.019) of SF-36. The improvement in 10 m walking speed was significantly correlated with that in the physical functioning (R = 0.831, P = 0.003) and role physical (R = 0.697, P = 0.025) domains in the SF-36. Our findings suggest that HAL-assisted gait training is effective in improving QOL associated with mental health as well as gait ability in selected patients with NMDs.


Assuntos
Terapia por Exercício/métodos , Exoesqueleto Energizado , Marcha/fisiologia , Doenças Neuromusculares/terapia , Robótica/métodos , Caminhada/fisiologia , Adulto , Idoso , Terapia por Exercício/instrumentação , Terapia por Exercício/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Neuromusculares/psicologia , Qualidade de Vida/psicologia , Robótica/instrumentação , Caminhada/psicologia
10.
Clin Interv Aging ; 16: 1161-1171, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34188459

RESUMO

Purpose: Information and communication technology (ICT)-based training devices for older adults' care related to dementia are being developed to enhance older adults' cognitive functions. Older adults who require bicycle training devices can improve muscle strength and balance of lower limbs by continuously contracting and relaxing lower-limb muscles and improving cognitive function to prevent dementia. This study was conducted to investigate the effects of an ICT-based multicomponent program on body composition and cognitive function in older adults. Patients and Methods: In a randomized controlled intervention test on 20 people over the age of 60 (exercise group: n = 10; control: n = 10), the multicomponent program was applied to the exercise group twice per week, once per day for 12 weeks, at 30 min per session, whereas the control group was advised to maintain their usual daily activities. Results: Comparing body composition changes and cognitive function changes before and after intervention exhibited statistically significant differences in skeletal muscle mass (P=0.01) and modified Alzheimer's disease assessment scale-cognitive score (P=0.01) between the two groups. Conclusion: It can be difficult to be engaged in a simple repetitive exercise program. Therefore, to meet older adults' interests and expectations, a customized ICT-based multicomponent program, which can improve body composition and cognitive function in older adults and is believed to help prevent dementia, is recommended. Trial Registration: UMIN000042129 (https://www.umin.ac.jp/english/).


Assuntos
Cognição/fisiologia , Demência/prevenção & controle , Informática Médica/métodos , Força Muscular/fisiologia , Terapia de Exposição à Realidade Virtual/métodos , Idoso , Idoso de 80 Anos ou mais , Exercício Físico/fisiologia , Terapia por Exercício/métodos , Feminino , Humanos , Masculino , Projetos de Pesquisa
11.
J Sports Med Phys Fitness ; 61(6): 857-866, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34110122

RESUMO

INTRODUCTION: Exercise can have a positive effect on body functioning and immunity. This study systematically evaluated the effect of exercise intervention on patients diagnosed with primary insomnia. Based on the meta-analysis, we developed exercise recommendations to help improving sleep quality in these patients. EVIDENCE ACQUISITION: Using a combination of manual and electronic retrieval strategies, we examined the CNKI, VIP, Wanfang, Web of Science, SpringerLink, EBSCO, PubMed, Cochrane Library, and Embase databases; and identified randomized controlled trials that addressed the effects of exercise intervention on primary insomnia and were published before October 2019. Risk of bias was assessed based on the Cochrane Handbook 5.1.0, and meta-analysis was conducted using STATA 13.0 (StataCorp LLC; College Station, TX, USA). EVIDENCE SYNTHESIS: Data were included for 1269 patients who received exercise interventions and 1203 patients who received drug therapy or no intervention (controls) in 23 trials of high quality. Meta-analysis showed that exercise intervention had a significant effect on the treatment of primary insomnia (SMD: -1.64, 95% CI: -2.08 to -1.19, P<0.001). Subgroup analysis showed significant effect sizes for older patients (>60 years) (SMD: -1.69, 95% CI: -2.40 to -0.97, P<0.001), aerobic exercise (SMD: -2.21, 95% CI: -2.89 to -1.53, P<0.001), interventions lasting 8-12 weeks (SMD: -2.58, 95% CI: -3.61 to -1.54, P<0.001), interventions lasting ≤60 min (SMD: -2.29, 95% CI: -3.66 to -0.92, P=0.001), Asian patients (SMD: -1.86, 95% CI: -2.42 to -1.31, P<0.001), and interventions ≤4 times/week (SMD: -1.70, 95% CI: -2.29 to -1.11, P<0.001). Both bias and sensitivity analyses suggested that our meta-analysis gave robust results. CONCLUSIONS: Our results indicate that exercise intervention has a significant positive influence on primary insomnia, especially for older patients. We recommend that an exercise regimen of 60 min 4-5 times a week for 8-12 weeks can improve sleep quality and treat the symptoms of primary insomnia. Future studies should focus on verifying and extending our results by increasing sample size and improving the quality of studies included.


Assuntos
Terapia por Exercício/métodos , Exercício Físico , Distúrbios do Início e da Manutenção do Sono/terapia , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto
12.
Clin Interv Aging ; 16: 973-983, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34079243

RESUMO

Purpose: This study evaluates the feasibility of delivering a virtual (online) falls prevention intervention for older adults with mild cognitive impairment (MCI). Methods: Community-dwelling older adults with MCI (mean age = 76.2 years, 72% women) were randomized to either a Tai Ji Quan (n = 15) or stretching group (n = 15) and participated in 60-minute virtual exercise sessions, via Zoom, twice weekly for 24 weeks. The primary outcome was the incidence of falls. Secondary outcomes were the number of fallers and changes from baseline in the 4-Stage Balance Test, 30-second chair stands, and Timed Up and Go Test under both single- and dual-task conditions. Results: The intervention was implemented with good fidelity, an overall attendance rate of 79%, and 13% attrition. Compared with stretching, Tai Ji Quan did not reduce falls (incidence rate ratio = 0.58; 95% confidence interval [CI], 0.32 to 1.03) or the number of fallers (relative risk ratio = 0.75; 95% CI, 0.46 to 1.22) at week 24. The Tai Ji Quan group, however, performed consistently better than the stretching group in balance (between-group difference in change from baseline, 0.68 points; 95% CI, 0.12 to 1.24), 30-second chair stands (1.87 stands; 95% CI, 1.15 to 2.58), and Timed Up and Go under single-task (-1.15 seconds; 95% CI, -1.85 to -0.44) and dual-task (-2.35; 95% CI, -3.06 to -1.64) conditions. No serious intervention-related adverse events were observed. Conclusion: Findings from this study suggest the feasibility, with respect to intervention fidelity, compliance, and potential efficacy, of implementing an at-home, virtual, interactive Tai Ji Quan program, delivered in real-time, as a potential balance training and falls prevention intervention for older adults with MCI. The study provides preliminary data to inform future trials.


Assuntos
Acidentes por Quedas/prevenção & controle , Disfunção Cognitiva/reabilitação , Equilíbrio Postural/fisiologia , Qualidade de Vida , Tai Ji/métodos , Idoso , Idoso de 80 Anos ou mais , Terapia por Exercício/métodos , Estudos de Viabilidade , Feminino , Humanos , Vida Independente , Masculino , Estudos de Tempo e Movimento
13.
Medicine (Baltimore) ; 100(23): e25511, 2021 Jun 11.
Artigo em Inglês | MEDLINE | ID: mdl-34114980

RESUMO

BACKGROUND: Female pelvic floor dysfunction is one of the common chronic diseases affecting women's physical and mental health. Pregnancy and delivery are one of the main causes. Pelvic floor rehabilitation is a common method for the treatment of postpartum pelvic floor dysfunction, but it has some defects. Acupoint injection has advantages in the treatment of postpartum pelvic floor dysfunction, but there is a lack of standard clinical research to verify it. Therefore, the purpose of this randomized controlled trial is to evaluate the efficacy and safety of acupoint injection combined with pelvic floor rehabilitation in the treatment of postpartum pelvic floor disorders. METHODS: This is a prospective randomized controlled trial to study the efficacy and safety of acupoints injection combined with pelvic floor rehabilitation. And it is approved by the Ethics Committee of Clinical Research of our hospital. Patients were randomly divided into observation group (acupoint injection combined with pelvic floor rehabilitation group) or control group (pelvic floor rehabilitation group alone). The patients were followed up for 8 weeks after 12 weeks of treatment. The observation indexes included: pelvic organ prolapse degree, pelvic floor muscle strength, urinary incontinence score, adverse reactions, among others. Data were analyzed using the statistical software package SPSS version 18.0. CONCLUSIONS: This study will evaluate the efficacy and safety of acupoint injection combined with pelvic floor rehabilitation in the treatment of postpartum pelvic floor dysfunction, and provide reliable reference for the clinical application of this project. TRIAL REGISTRATION: OSF Registration number: DOI 10.17605/OSF.IO/VC65Z.


Assuntos
Terapia por Acupuntura/métodos , Terapia por Exercício/métodos , Distúrbios do Assoalho Pélvico , Transtornos Puerperais , Pontos de Acupuntura , Feminino , Humanos , Injeções , Distúrbios do Assoalho Pélvico/etiologia , Distúrbios do Assoalho Pélvico/reabilitação , Distúrbios do Assoalho Pélvico/terapia , Transtornos Puerperais/reabilitação , Transtornos Puerperais/terapia , Resultado do Tratamento
14.
J Manipulative Physiol Ther ; 44(4): 295-306, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-34090550

RESUMO

OBJECTIVE: The purpose of this study was to compare the effects of a 6-week program of pelvic floor muscle training (PFMT) plus connective tissue massage (CTM) to PFMT alone in women with overactive bladder (OAB) symptoms on those symptoms, pelvic floor muscle strength, and quality of life. METHODS: Thirty-four participants were randomly divided into PFMT+CTM (n = 17) and PFMT (n = 17) groups. PFMT was applied every day and CTM was applied 3 days a week for 6 weeks. Before treatment, at week 3, and after treatment (week 6), we assessed pelvic floor muscle strength (with a perineometer), bladder symptoms (with a urine diary), OAB symptom severity (with the 8-item Overactive Bladder Questionnaire [OAB-V8]), urgency (with the Patient Perception of Intensity of Urgency Scale [PPIUS]), and quality of life (with King's Health Questionnaire [KHQ]). The Mann-Whitney U test, χ2 test, Friedman test, and Dunn multiple comparison test were used for analysis. RESULTS: In both groups, pelvic floor muscle strength increased, whereas OAB symptoms and PPIUS and KHQ scores decreased after treatment (P < .05). Although the OAB-V8, PPIUS, and KHQ scores decreased at week 3, frequency, OAB-V8, and PPIUS scores, in addition to some parameters of the KHQ, decreased after treatment in the PFMT+CTM group compared to the PFMT group (P < .05). CONCLUSION: Compared to PFMT alone, PFMT+CTM achieved superior outcomes in reducing OAB symptoms in the early and late periods.


Assuntos
Tecido Conjuntivo , Terapia por Exercício/métodos , Massagem/métodos , Diafragma da Pelve , Bexiga Urinária Hiperativa/terapia , Adulto , Feminino , Humanos , Pessoa de Meia-Idade , Qualidade de Vida/psicologia , Inquéritos e Questionários , Resultado do Tratamento
15.
Medicine (Baltimore) ; 100(18): e25505, 2021 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-33950925

RESUMO

BACKGROUND: The argument on the efficacy of medical nutritional therapy and comprehensive nutritional care remains to be resolved. Therefore, we conducted this protocol of systematic review and meta-analysis to evaluate the efficacy between medical nutritional therapy and comprehensive nutritional care for patients with gestational diabetes mellitus (GDM). METHODS: We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols reporting guidelines and the recommendations of the Cochrane Collaboration to conduct this study. Reviewers will search the PubMed, Cochrane Library, Web of Science, and EMBASE online databases using the key phrases "gestational diabetes mellitus," "comprehensive nutrition care," and "medical nutritional therapy" for all cohort studies published up to May 20, 2021. There is no restriction in the dates of publication or language in the search for the current review. The studies on cohort study focusing on comparing medical nutritional therapy and comprehensive nutrition care for GDM patients will be included in our meta-analysis. The outcomes include blood glucose levels, complications, weight change, and incidence of cesarean section. Where disagreement in the collection of data occurrs, this will be resolved through discussion. RESULTS: We hypothesized that these 2 methods would provide similar therapeutic benefits. OSF REGISTRATION NUMBER: 10.17605/OSF.IO/SC8HJ.


Assuntos
Diabetes Gestacional/terapia , Dieta Saudável , Terapia por Exercício/métodos , Educação em Saúde/métodos , Glicemia/análise , Cesárea/estatística & dados numéricos , Terapia Combinada/métodos , Aconselhamento/métodos , Diabetes Gestacional/sangue , Diabetes Gestacional/diagnóstico , Estudos de Viabilidade , Feminino , Humanos , Metanálise como Assunto , Período Pós-Prandial , Gravidez , Revisões Sistemáticas como Assunto , Resultado do Tratamento
16.
Thorax ; 76(7): 664-671, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-33931570

RESUMO

PURPOSE: Functional electrical stimulation-assisted cycle ergometry (FESCE) enables in-bed leg exercise independently of patients' volition. We hypothesised that early use of FESCE-based progressive mobility programme improves physical function in survivors of critical care after 6 months. METHODS: We enrolled mechanically ventilated adults estimated to need >7 days of intensive care unit (ICU) stay into an assessor-blinded single centre randomised controlled trial to receive either FESCE-based protocolised or standard rehabilitation that continued up to day 28 or ICU discharge. RESULTS: We randomised in 1:1 ratio 150 patients (age 61±15 years, Acute Physiology and Chronic Health Evaluation II 21±7) at a median of 21 (IQR 19-43) hours after admission to ICU. Mean rehabilitation duration of rehabilitation delivered to intervention versus control group was 82 (IQR 66-97) versus 53 (IQR 50-57) min per treatment day, p<0.001. At 6 months 42 (56%) and 46 (61%) patients in interventional and control groups, respectively, were alive and available to follow-up (81.5% of prespecified sample size). Their Physical Component Summary of SF-36 (primary outcome) was not different at 6 months (50 (IQR 21-69) vs 49 (IQR 26-77); p=0.26). At ICU discharge, there were no differences in the ICU length of stay, functional performance, rectus femoris cross-sectional diameter or muscle power despite the daily nitrogen balance was being 0.6 (95% CI 0.2 to 1.0; p=0.004) gN/m2 less negative in the intervention group. CONCLUSION: Early delivery of FESCE-based protocolised rehabilitation to ICU patients does not improve physical functioning at 6 months in survivors. TRIAL REGISTRATION NUMBER: NCT02864745.


Assuntos
Estado Terminal/reabilitação , Ergometria/métodos , Terapia por Exercício/métodos , Unidades de Terapia Intensiva , Força Muscular/fisiologia , Debilidade Muscular/reabilitação , Qualidade de Vida , Respiração Artificial/métodos , Estimulação Elétrica , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Debilidade Muscular/fisiopatologia , Estudos Prospectivos , Fatores de Tempo
17.
Respir Med ; 183: 106438, 2021 07.
Artigo em Inglês | MEDLINE | ID: covidwho-1219627

RESUMO

BACKGROUND: The impact of the COVID-19 pandemic on functional exercise capacity seemed quickly clinically evident. The objective of this study was to assess the functional exercise capacity of patients with severe COVID-19 and to evaluate the effect of a telerehabilitation program in the specific context of the COVID-19 pandemic. METHOD: Patients hospitalized for severe or critical COVID-19 were recruited. The functional exercise capacity (1-min sit-to-stand test (STST)) was prospectively quantified at discharge. A telerehabilitation program was then proposed. A control group was composed with the patients refusing the program. RESULTS: At discharge, none of the 48 recruited patients had a STST higher than the 50th percentile and 77% of them were below the 2.5th percentile. SpO2 was 92.6 ± 3.0% after STST and 15 patients had oxygen desaturation. After 3-months of follow-up, the number of repetitions during STST significantly increased either in telerehabilitation (n = 14) (p < 0.001) or in control groups (n = 13) (p = 0.002) but only one patient had a result higher than the 50th percentile (in Telerehabilitation group) and 37% of them were still under the 2.5th percentile for this result. The improvement was significantly and clinically greater after the telerehabilitation program (p = 0.005). No adverse events were reported by the patients during the program. CONCLUSIONS: Patients hospitalized for COVID-19 have a low functional exercise capacity at discharge and the recovery after three months is poor. The feasibility and the effect of a simple telerehabilitation program were verified, this program being able to substantially improve the functional recovery after three months.


Assuntos
COVID-19/reabilitação , Terapia por Exercício/métodos , Tolerância ao Exercício/fisiologia , Pandemias , Recuperação de Função Fisiológica , Telerreabilitação/métodos , Idoso , Bélgica/epidemiologia , COVID-19/epidemiologia , COVID-19/fisiopatologia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , SARS-CoV-2
18.
Chron Respir Dis ; 18: 14799731211015691, 2021.
Artigo em Inglês | MEDLINE | ID: covidwho-1219161

RESUMO

Individuals with lasting symptoms of COVID-19 should be offered a comprehensive recovery programme. 30 individuals (mean[SD] age 58[16]) that completed a 6 week, twice supervised rehabilitation programme demonstrated statistically significant improvements in exercise capacity, respiratory symptoms, fatigue and cognition. Participants improved by 112 m on the Incremental Shuttle Walking Test and 544 seconds on the Endurance Shuttle Walking Test. There were no serious adverse events recorded, and there were no dropouts related to symptom worsening. COVID-19 rehabilitation appears feasible and significantly improves clinical outcomes.


Assuntos
COVID-19/reabilitação , Dispneia/reabilitação , Terapia por Exercício/métodos , Tolerância ao Exercício/fisiologia , Fadiga/reabilitação , Caminhada/fisiologia , COVID-19/complicações , COVID-19/epidemiologia , Dispneia/etiologia , Dispneia/fisiopatologia , Fadiga/etiologia , Fadiga/fisiopatologia , Seguimentos , Humanos , Pandemias , Qualidade de Vida , SARS-CoV-2 , Inquéritos e Questionários
19.
NeuroRehabilitation ; 48(4): 513-522, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33967063

RESUMO

BACKGROUND: In hemiparetic patients, the skeletal muscle is mainly affected with a combination of abnormalities (denervation, remodeling, spasticity, and eventually muscular atrophy). OBJECTIVE: This study examined the role of eccentric exercise in strengthening muscles of the lower extremity and ultimately improving autonomy in patients with post-stroke hemiparesis during gait. METHODS: Thirty-seven patients hemiparetic adults were recruited, randomized into a control group (n = 19) and an intervention group receiving eccentric muscle strengthening (n = 18). The protocol consisted of three sets of five repetitions of eccentric contraction of the paretic limb after determining the maximum repetition (1 MRI). Evaluation of the 1RM, 10 meters and 6WMT was performed before and after the exercise for each group. Manova test was used to compare the differences between the control and intervention groups. RESULTS: The paretic limb showed significant increase in one-repetition maximum (1RM) between before and after rehabilitation (p≤0.00003). The two groups of Patients increased their walking speed (p≤0.0005), but we observed a significant difference between groups only for the 6MWT and not on the 10 meters Test. CONCLUSIONS: Eccentric training can be useful in strengthening the muscles of the lower limbs, and promoting gait performance. Eccentric training could complement other methods of managing patients with post-stroke hemiparesis.


Assuntos
Terapia por Exercício/métodos , Paresia/reabilitação , Reabilitação do Acidente Vascular Cerebral/métodos , Acidente Vascular Cerebral/complicações , Velocidade de Caminhada , Adulto , Idoso , Humanos , Masculino , Pessoa de Meia-Idade , Músculo Esquelético/fisiopatologia , Paresia/etiologia , Acidente Vascular Cerebral/patologia
20.
NeuroRehabilitation ; 48(4): 563-570, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33967065

RESUMO

BACKGROUND: Aquatic exercises are among the treatments available to improve the quality of life after stroke. OBJECTIVES: To investigate changes in the quality of life after 8-week of aquatic exercises in post-stroke individuals. METHODS: A case series study was designed, including four male participants. Exclusive aquatic exercise was performed for 8-week, 50 minutes per session, 2×/week. Their quality of life was evaluated before and after the intervention using the Stroke Impact Scale (SIS). RESULTS: Participant 1 improved in the mobility domain, achieving a Clinically Important Difference (CID). Participant 2 improved in the strength and mobility domain, achieving CID; his stroke recovery was 6%, and it reached 50% post-intervention. Participant 3 improved in the mobility domain, achieving a CID and a Minimal Detectable Change (MDC); his stroke recovery increased from 45 to 60% post-intervention. Participant 4 improved the strength, mobility, and activities of daily living domains, achieving a CID and a MDC, but his stroke recovery remained unchanged at 80%. CONCLUSIONS: All participants achieved a CID in the mobility domain; thus, the aquatic exercise intervention was considered meaningful. Moreover, the SIS is able to evaluate aspects of the recovery process regarding health-related quality of life after stroke, as demonstrated by the results of the overall recovery after aquatic exercises.


Assuntos
Terapia por Exercício/métodos , Qualidade de Vida , Reabilitação do Acidente Vascular Cerebral/métodos , Atividades Cotidianas , Humanos , Masculino , Pessoa de Meia-Idade , Água
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