Effects of qigong Training on Muscle Strengths, Flexibility, Cardiopulmonary Fitness, and Antioxidant/Oxidant Responses in Sedentary Middle-Aged and Elderly Type 2 Diabetes Mellitus Women: A Quasi-Experimental Design, Placebo-Controlled Study.

Background: Qigong exercise training has been suggested to elicit beneficial effects on physical functioning, reduction of oxidative stress, and improved antioxidant capacity in women. However, regular exercise training may support the development of antioxidant defense mechanisms and beneficially modulate oxidant/antioxidant responses. Objective: To evaluate the effects of an 8-week qigong exercise training on exercise performance and oxidative stress responses in sedentary middle-aged and elderly women suffering from type 2 diabetic mellitus (T2DM). Method/design: Quasi-experimental design, placebo-controlled study. Setting: The Department of Physical Therapy, Faculty of Allied Health Science, Burapha University, Thailand. Participants: Thirty-six sedentary middle-aged and elderly women with T2DM. Intervention: Participants were allocated to qigong exercise (n = 20) or to the control group (CG, n = 20). Primary outcome measures: Muscle strengths, flexibility, VO2 max predicted, and walking intensity derived from the 6-minute walk test. Secondary outcome measures: Fasting plasma glucose, antioxidant/oxidant stress parameters, and body composition. Results: Leg strength and trunk flexibility were improved after qigong training and changes were significantly different compared with the CG (all p < 0.05). VO2 max predicted, 6-min walking distance, and walking intensity were all increased (p < 0.05), and oxidative stress markers were diminished after qigong training (p < 0.05). The antioxidant/oxidant balance was improved after qigong training (p < 0.05). Conclusion: The presented findings indicate that 8 weeks of qigong training significantly improved leg strength and trunk flexibility in middle-aged and elderly women with T2DM, partly associated with a more favorable antioxidant/oxidant balance. These effects may beneficially impact on health in this specific population. Clinical Trial Number: TCTR20221003001.

Biocomposite Scaffolds Based on Chitosan Extraction from Shrimp Shell Waste for Cartilage Tissue Engineering Application.

Chitosan-based scaffolding possesses unique properties that make it highly suitable for tissue engineering applications. Chitosan is derived from deacetylating chitin, which is particularly abundant in the shells of crustaceans. This study aimed to extract chitosan from shrimp shell waste (Macrobrachium rosenbergii) and produce biocomposite scaffolds using the extracted chitosan for cartilage tissue engineering applications. Chitinous material from shrimp shell waste was deproteinized and deacetylated. The extracted chitosan was characterized and compared to commercial chitosan through various physicochemical analyses. The findings revealed that the extracted chitosan shares similar trends in the Fourier transform infrared spectroscopy spectrum, energy dispersive X-ray mapping, and X-ray diffraction pattern to commercial chitosan. Despite differences in the degree of deacetylation, these results underscore its comparable quality. The extracted chitosan was mixed with agarose, collagen, and gelatin to produce the blending biocomposite AG-CH-COL-GEL scaffold by freeze-drying method. Results showed AG-CH-COL-GEL scaffolds have a 3D interconnected porous structure with pore size 88-278 µm, high water uptake capacity (>90%), and degradation percentages in 21 days between 5.08% and 30.29%. Mechanical compression testing revealed that the elastic modulus of AG-CH-COL-GEL scaffolds ranged from 44.91 to 201.77 KPa. Moreover, AG-CH-COL-GEL scaffolds have shown significant potential in effectively inducing human chondrocyte proliferation and enhancing aggrecan gene expression. In conclusion, AG-CH-COL-GEL scaffolds emerge as promising candidates for cartilage tissue engineering with their optimal physical properties and excellent biocompatibility. This study highlights the potential of using waste-derived chitosan and opens new avenues for sustainable and effective tissue engineering solutions.

Analysis of the concurrent validity and reliability of five common clinical goniometric devices.

Measurement errors play an important role in the development of goniometric equipment, devices used to measure range of motion. Reasonable validity and reliability are critical for both the device and examiner before and after to testing in human subjects. The objective is to evaluate the concurrent validity and reliability of five different clinical goniometric devices for the purpose of establishing an acceptable measurement error margin for a novel device. We explored the validity and inter- and intrarater reliability scores of five goniometric devices namely (i) the universal goniometer (UG), a two-armed hand-held goniometer, (ii) the inclinometer (IC), featuring a single base, fluid level, and gravity-weighted inclinometer, (iii) the digital inclinometer (DI), functioning as both a DI and dynamometer, (iv) the smartphone application (SA), employing gyroscope-based technology within a smartphone platform application and (v) the modified inclinometer (MI), a gravity pendulum-based inclinometer equipped with a specialized fixing apparatus. Measurements were obtained at 12 standard angles and 8 human shoulder flexion angles ranging from 0° to 180°. Over two testing sessions, 120 standardized angle measurements and 160 shoulder angle measurements from 20 shoulders were repetitively taken by three examiners for each device. The intraclass correlation coefficient (ICC), standard error of measurement (SEM), and minimal detectable change (MDC) were calculated to assess reliability and validity. Concurrent validity was also evaluated through the execution of the 95% limit of agreement (95% LOA) and Bland-Altman plots, with comparisons made to the UG. The concurrent validity for all device pairs was excellent in both study phases (ICC > 0.99, 95% LOA - 4.11° to 4.04° for standard angles, and - 10.98° to 11.36° for human joint angles). Inter- and intrarater reliability scores for standard angles were excellent across all devices (ICC > 0.98, SEM 0.59°-1.75°, MDC 1°-4°), with DI showing superior reliability. For human joint angles, device reliability ranged from moderate to excellent (ICC 0.697-0.975, SEM 1.93°-4.64°, MDC 5°-11° for inter-rater reliability; ICC 0.660-0.996, SEM 0.77°-4.06°, MDC 2°-9° for intra-rater reliability), with SA demonstrating superior reliability. Wider angle measurement however resulted in reduced device reliability. In conclusion, our study demonstrates that it is essential to assess measurement errors independently for standard and human joint angles. The DI is the preferred reference for standard angle testing, while the SA is recommended for human joint angle testing. Separate evaluations across the complete 0°-180° range offer valuable insights.

Psychosocial and Physical Predictors of Stress in University Students during the COVID-19 Pandemic: An Observational Study.

Currently, university students are at a high risk of stress due to university adjustment, educational interruption, and alterations in daily life because of the COVID-19 pandemic. This study examined the relationship of psychosocial and physical factors with stress in university students during the pandemic. Demographic, psychosocial, physical, and self-perceived stress level information were obtained from 409 Thailand university students. A multiple regression analysis was performed, with stress level as the dependent variable and gender, age, study period, study program, social support, self-esteem, health literacy, health behavior score, sedentary behavior, and physical activity (PA) as independent variables. Most participants had moderate stress levels (68.9%), high self-esteem (83.9%) and social support (66.5%), fair health literacy (41.1%) and health behavior (32%), sedentary lifestyle (85.3%), and PA-levels lower than 600 min per week (57.46%). The regression analysis showed that 45.7% of the variability in stress level was predicted by self-esteem, study period, social support, travel domain of PA, and health behavior. COVID-19 and the attendant restrictions resulted in moderate levels of stress in Thailand university students. High self-esteem, long duration of study, great social support, and having healthy behavior may contribute to the prevention of stress in this population.

Analysis of neck and back muscle activity during the application of various pillow designs in patients with forward head posture.

BACKGROUND: There are currently no reports of biomechanical changes in patients with forward head posture (FHP) that result in altered muscle activation throughout various functions with muscle activation response during diverse sleep postures. OBJECTIVE: This study investigated neck and back muscle activity in individuals with and without FHP during a maintained side-sleeping position by incorporating various pillow designs. METHODS: Thirty-four participants (i.e., 17 in each group) were enrolled. The muscle activity was investigated via surface electromyography during the use of three trial pillows: orthopedic pillow, hollow pillow, and Thai neck support pillow. RESULTS: With the application of all three trial pillow, the FHP group demonstrated significantly greater middle-lower trapezius muscle activity than the normal head posture group (p< 0.05). Sternocleidomastoid and upper trapezius (UT) muscle activity were similar between the two groups (p> 0.05). Only UT muscle activity was affected by variations in pillow design. In the normal group, no difference was observed in the muscle activity between all three pillows (p> 0.05). CONCLUSIONS: Feasibly, the ability to appropriately modify a pillow configuration without creating undesired muscle activation was limited to those exhibiting FHP. Therefore, specially designed pillows or mattresses should be investigated in terms of their relevance to muscle fatigue and potential musculoskeletal pain in FHP patients.

The Effects of Electrical Stimulation Program on Navicular Height, Balance, and Fear of Falling in Community-Dwelling Elderly.

INTRODUCTION: Intrinsic foot muscle weakness is a crucial cause of balance deficit in the elderly, which leads to a limited range of motion from the fear of falling and subsequently decreases the quality of life. Muscle strengthening via transcutaneous electrical stimulation (TENS) is an effective intervention; however, its effects on elderly people have rarely been reported. This study was conducted to investigate the effects of TENS on navicular height, balance, and fear of falling. METHOD: In this study, forty-eight participants aged 65-75 years were included and were randomly divided into two groups: the TENS and control groups. Before and after 4 weeks of training, navicular height, balance, and fear of falling were measured. RESULT: After 4 weeks of training, navicular height significantly increased in both groups (p < 0.05); however, the increase was higher in the TENS group (p = 0.035). The TENS group had a better improvement in balance in all four directions-front, back, left, and right (p < 0.05). However, postural balance improvements in the control group were observed in three directions only-front, back, and left (p < 0.05)-without any significant difference between the two groups. Furthermore, the TENS group decreased the scale of fear of falling after 4 weeks of training (p = 0.039). CONCLUSION: In summary, the results of this study can be used as part of the muscle strengthening via ES for decreasing the risk of falls or fear of falling in the elderly.

Gait Improvement in Chronic Stroke Survivors by Using an Innovative Gait Training Machine: A Randomized Controlled Trial.

Chronic stroke leads to the impairment of lower limb function and gait performance. After in-hospital rehabilitation, most individuals lack continuous gait training because of the limited number of physical therapists. This study aimed to evaluate the effects of a newly invented gait training machine (I-Walk) on lower limb function and gait performance in chronic stroke individuals. Thirty community-dwelling chronic stroke individuals were allocated to the I-Walk machine group (n = 15) or the overground gait training (control) group (n = 15). Both groups received 30 min of upper limb and hand movement and sit-to-stand training. After that, the I-Walk group received 30 min of I-Walk training, while the control followed a 30-minute overground training program. All the individuals were trained 3 days/week for 8 weeks. The primary outcome of the motor recovery of lower limb impairment was measured using the Fugl-Meyer Assessment (FMA). The secondary outcomes for gait performance were the 6-minute walk test (6 MWT), the 10-meter walk test (10 MWT), and the Timed Up and Go (TUG). The two-way mixed-model ANOVA with the Bonferroni test was used to compare means within and between groups. The post-intervention motor and sensory subscales of the FMA significantly increased compared to the baseline in both groups. Moreover, the 6 MWT and 10 MWT values also improved in both groups. In addition, the mean difference of TUG in the I-Walk was higher than the control. The efficiency of I-Walk training was comparable to overground training and might be applied for chronic stroke gait training in the community.