Outcomes of community-based and home-based pulmonary rehabilitation for pneumoconiosis patients: a retrospective study.

BACKGROUND: Pneumoconiosis patients receive community-based or home-based pulmonary rehabilitation (PR) for symptom management and enhancement of physical and mental well-being. This study aimed to review the clinical benefits of community-based rehabilitation programmes (CBRP) and home-based rehabilitation programmes (HBRP) for PR of pneumoconiosis patients. METHODS: Archival data of pneumoconiosis patients who participated in CBRP and HBRP between 2008 and 2011 was analysed. There were 155 and 26 patients in the CBRP and HBRP respectively. The outcome measures used in the pre- and post-tests were Knowledge, Health Survey Short Form-12 (SF-12), Hospital Anxiety and Depression Scale (HADS), 6-Min Walk Test (6MWT), and Chronic Respiratory Questionnaire (CRQ). Paired t-tests and the Analysis of Covariance (ANCOVA) using the patients' baseline lung functions as the covariates were performed to examine the changes in the outcomes after completing the programmes. Hierarchical multiple regression analyses were used to examine the relationships between patient's programme participation factors and different scores of the outcome measures. RESULTS: After controlling for patients' baseline lung capacities, significant improvements were revealed among patients participated in CBRP in the scores of the 6MWT, Knowledge, HADS, SF-12 PCS, and CRQ emotion and mastery. The different scores in the Knowledge and HADS were correlated with the patients' levels of programme participation. In contrast, significant improvements were only found in the scores of the Knowledge and 6MWT among patients who participated in HBRP. The gain scores of the 6MWT were correlated with the patients' levels of programme participation. CONCLUSIONS: Both CBRP and HBRP benefited patients' levels of exercise tolerance and knowledge about the disease. CBRP provided greater benefits to patients' mental and psychosocial needs. In contrast, HBRP was found to improve patients' physical function, but did not have significant impacts on patients' mental health and health-related quality of life. The attendance of patients and the participation of their relatives in treatment sessions were important factors in enhancing the positive effects of CBRP and HBRP. These positive outcomes confirm the value of pulmonary rehabilitation programmes for community-dwelling pneumoconiosis patients.

Increased neurocardiological interplay after mindfulness meditation: a brain oscillation-based approach.

Background: Brain oscillations facilitate interaction within the brain network and between the brain and heart activities, and the alpha wave, as a prominent brain oscillation, plays a major role in these coherent activities. We hypothesize that mindfully breathing can make the brain and heart activities more coherent in terms of increased connectivity between the electroencephalogram (EEG) and electrocardiogram (ECG) signals. Methods: Eleven participants (28-52 years) attended 8 weeks of Mindfulness Based Stress Reduction (MBSR) training. EEG and ECG data of two states of mindful breathing and rest, both eye-closed, were recorded before and after the training. EEGLAB was used to analyze the alpha band (8-12 Hz) power, alpha peak frequency (APF), peak power and coherence. FMRIB toolbox was used to extract the ECG data. Heart coherence (HC) and heartbeat evoked potential (HEP) were calculated for further correlation analysis. Results: After 8 weeks of MBSR training, the correlation between APF and HC increased significantly in the middle frontal region and bilateral temporal regions. The correlation between alpha coherence and heart coherence had similar changes, while alpha peak power did not reflect such changes. In contrast, spectrum analysis alone did not show difference before and after MBSR training. Conclusion: The brain works in rhythmic oscillation, and this rhythmic connection becomes more coherent with cardiac activity after 8 weeks of MBSR training. Individual APF is relatively stable and its interplay with cardiac activity may be a more sensitive index than power spectrum by monitoring the brain-heart connection. This preliminary study has important implications for the neuroscientific measurement of meditative practice.

Movement related potentials and oscillatory activities in the human internal globus pallidus during voluntary movements.

OBJECTIVE: To study internal globus pallidus (GPi) activities and the interactions among the bilateral GPi and motor cortical areas during voluntary movements. METHODS: Five patients with cervical dystonia who underwent bilateral GPi deep brain stimulation (DBS) were studied. Local field potentials from the GPi DBS electrodes and EEG were recorded while the patients performed externally triggered and self-initiated right wrist movements. RESULTS: Movement related potentials were recorded at the GPi bilaterally before the onset of self-initiated but not externally triggered movements. In all movements studied, frequency analysis revealed a ≈ 10-24 Hz beta event related desynchronisation at bilateral GPi and with EEG recorded over the mid-frontal (Cz-Fz) and the bilateral sensorimotor cortical regions (C3/C4-Cz). A ≈ 64-68 Hz, gamma event related synchronisation was found with EEG recorded over the mid-frontal (Cz-Fz), the sensorimotor cortices (C3-Cz) and the GPi contralateral to movements. Both beta event related desynchronisation and gamma event related synchronisation occurred before the onset of self-initiated movements and at the onset of externally triggered movements. There was a resting ≈ 5-18 Hz coherence between the bilateral GPi, which attenuated for ≈ 1 s during movements. Gamma coherences were observed between EEG recorded over the mid-frontal (Cz-Fz), contralateral sensorimotor cortices (C3-Cz) and the GPi from 0 to 0.5 s after movement onset for externally triggered movements and from 0.5 s before to 0.5 s after movement onset for self-initiated movements. CONCLUSIONS: The beta and gamma frequency bands in the GPi are modulated by the preparation of self-initiated movements and the execution of self-initiated and externally triggered movements. The 5-18 Hz coherence at the bilateral GPi may be related to dystonia and its attenuation may facilitate voluntary movements.

Source separation on single channel EEG: A pilot study on effect of transcranial alternating current stimulation on scalp meridian.

Brain electrical stimulation has shown the capability to modulate neural activities in a variety of ways. Compared with transcranial direct current stimulation(tDCS), transcranial alternating current stimulation (tACS) may affect brain activities differently through a frequency-based mechanism. This pilot study applied tACS to the scalp following the meridian (Jingluo) of traditional Chinese medicine to explore its potential neural modulation effect. A wearable electroencephalogram (EEG) device was used to measure the frontal activity in a female participant before and after tACS longitudinally. A combined method of singular spectrum analysis (SSA)-independent components analysis (ICA) was applied to separate potential artifacts from ocular and other irrelevant sources. The results demonstrated that SSA-ICA could effectively separate signals from different sources especially the ocular artifact. EEG spectrum analysis showed that short-term tACS could increase the power of delta waves. This study has good implications for the use of tACS and SSA-ICA method for the study of brain activities. Future research is needed to refine more optimum parameters of tACS and SSA-ICA to make the evidence more solid.Clinical Relevance- tACS may influence the brain wave oscillations through the frequency-based mechanism. SSA-ICA method helps to broaden the use of wearable EEG devices for various clinical applications.

Somatosensory evoked potentials recorded from the human pedunculopontine nucleus region.

The pedunculopontine nucleus region (PPNR) is an integral component of the midbrain locomotor region and has widespread connections with the cortex, thalamus, brain stem, cerebellum, spinal cord, and especially, the basal ganglia. No previous study examined the somatosensory connection of the PPNR in human. We recorded somatosensory evoked potentials (SEP) from median nerve stimulation through deep brain stimulation (DBS) electrodes implanted in the PPNR in 8 patients (6 with Parkinson's disease, 2 with progressive supranuclear palsy). Monopolar recordings from the PPNR contacts showed triphasic or biphasic potentials. The latency of the largest negative peak was between 16.8 and 18.7 milliseconds. Bipolar derivation revealed phase reversal with median nerve stimulation contralateral to the DBS electrode in 6 patients. There was no difference in SEP amplitude and latency between on and off medication states. We also studied the high frequency oscillations (HFOs) by filtering the signal between 500 and 2,500 Hz. The HFOs could be identified only from contralateral stimulation and had intraburst frequencies of 1061 ± 121 Hz, onset latencies of 13.8 ± 1.2 milliseconds, and burst durations of 7.3 ± 1.1 milliseconds. Among the 10 recordings with HFOs, only 1 had possible phase reversal in the bipolar derivation. Our results suggest that there are direct somatosensory inputs to the PPNR. The slow components and HFOs of the SEP have different origins.

Specific patterns of weak (1 microTesla) transcerebral complex magnetic fields differentially affect depression, fatigue, and confusion in normal volunteers.

Normal young adults were exposed for 20 min once per week for a total of 3 sessions to 1 of 7 configurations of weak (1 microTesla) magnetic fields or to a sham field. The fields were spatially rotated and applied through the brain at the level of the temporoparietal lobes. The Profile of Mood States was taken before and after each session. Before, during, and after the treatments, heart rate, plethysmographic activity, and skin conductance were measured by computer. The results indicated that the burst-firing pattern previously demonstrated to be effective for clinical depression, improved mood and vigour compared to the sham-field or other treatments. Subjects who were exposed to a burst-firing pattern, a complex-sequenced pattern, and a pattern whose electrical equivalents stimulate long-term potential in hippocampus slices also exhibited less psychometric fatigue after the sessions compared to subjects who received the sham field or random-sequenced fields. These results replicate previous studies and indicate that rationally designed complex patterns of magnetic fields may simulate pharmacological treatments.

A reliability and validity study on upper limb range of motion measurement using mobile sensor compared with goniometers / Estudio de confiabilidad y validez sobre la medición del rango de movimiento de las extremidades superiores utilizando un sensor móvil en comparación con goniómetro

Introduction: The use of tele-rehabilitation devices to aid physiotherapy has gained popularity in recent years. In particular, measuring limb range of motion with a wearable mobile sensor can facilitate rehabilitation therapies by providing more efficient progress monitoring and reducing clinicians’ workload. This study aimed to examine the test-retest reliability and validity of using a wearable mobile sensor to measure upper limb range of motion (ROM).Materials and methods: Participants were recruited by convenient sampling. They were instructed to perform four kinds of upper limb movements including shoulder flexion, abduction, external rotation and elbow flexion, from which the ROM was measured by Mobile sensors REBEE (XCLR8 Technologies) and a standard goniometer (Model 12-1000) in each movement. Each kind of movements and the two ROM measurements were performed twice for the evaluation of test-retest reliability using Intraclass Correlation Coefficients (ICC). Pearson's correlations were computed between the ROM measured by the mobile sensors and the goniometer in each movement to assess construct validities of the mobile sensors. The agreement (95% mean difference) between the two sets of measurement was illustrated by Bland-Altman plots.Results: Thirty-four asymptomatic young Asian adults (15 males) participated in this study (Mage ± SD, 24.2 ± 3.82 years). The ICC for the ROM measured by the sensors were between 0.94 and 0.99, p <0.01 and for the goniometer measurements were between 0.95 and 0.98, p <0.01 in the four movements, indicating excellent reliability in both measurement methods. The Pearson's correlation between the sensor’s and goniometric ROM measurements in four kinds of movements ranged from r =0.96 to 0.99, p <0.01, indicating a very strong construct validity for using the mobile sensors to measure upper limb ROM. The mean difference between the two measurements ranged from 0.13 degrees to 7.6 degrees...(AU)

Introducción: El uso de dispositivos de tele-rehabilitación para ayudar a la fisioterapia ha ganado popularidad en los últimos años. En particular, medir el rango de movimiento de las extremidades con un sensor móvil portátil puede facilitar las terapias de rehabilitación al proporcionar una supervisión del progreso más eficiente y reducir la carga de trabajo de los médicos. Este estudio tuvo como objetivo examinar la confiabilidad y la validez test-retest del uso de un sensor móvil portátil para medir el rango de movimiento de las extremidades superiores (ROM).Materiales y métodos: Los participantes fueron reclutados mediante muestreo conveniente. Se les indicó que realizaran cuatro tipos de movimientos de las extremidades superiores, incluida la flexión del hombro, la abducción, la rotación externa y la flexión del codo, a partir de los cuales se midió el ROM con los sensores móviles REBEE (XCLR8 Technologies) y un goniómetro estándar (Modelo 12-1000) en cada movimiento. . Cada tipo de movimientos y las dos mediciones de ROM se realizaron dos veces para la evaluación de la confiabilidad test-retest utilizando coeficientes de correlación intraclase (ICC). Se calcularon las correlaciones de Pearson entre el ROM medido por los sensores móviles y el goniómetro en cada movimiento para evaluar la validez de constructo de los sensores móviles. La concordancia (diferencia media del 95%) entre los dos conjuntos de medidas se ilustró mediante gráficos de Bland-Altman.Resultados: Treinta y cuatro adultos jóvenes asiáticos asintomáticos (15 hombres) participaron en este estudio (Mage ± SD, 24,2 ± 3,82 años). El ICC para el ROM medido por los sensores estuvo entre 0.94 y 0.99, p <0.01 y para las mediciones del goniómetro estuvo entre 0.95 y 0.98, p <0.01 en los cuatro movimientos, lo que indica una excelente confiabilidad en ambos métodos de medición...(AU)