Background: Neuromyelitis Optica (NMO) is a serious condition associated with inflammation. Early diagnosis and detection are critical for early intervention. In this systematic review, we investigate the role of the neutrophil to lymphocyte ratio (NLR) as an important biomarker for NMO.
Methods: Ten studies were selected that were sufficiently high quality and then checked for quality. The studies were organized by English language and selective inclusion criteria.
Results: NLR was significantly increased in NMO patients compared to controls. The ratio was specifically proportional to severity of disease. More severe disease had a higher ratio.
Conclusion: NLR offers a reliable and affordable method for early detection of disease severity. This can help guide appropriate treatment selection and monitor treatment response.
{"title":"The Diagnostic Value of Neutrophil to Lymphocyte Ratio as an Effective Biomarker for Neuromyelitis Optica Spectrum Disorder.","authors":"Navid Fazlinejad, Samaneh Hosseini, Shirin Yaghoobpoor, Mina Dehghani, Hanieh Bazrafshan, Shokoufeh Khanzadeh, Brandon Lucke-Wold","doi":"10.33696/rehabilitation.5.035","DOIUrl":"10.33696/rehabilitation.5.035","url":null,"abstract":"<p><strong>Background: </strong>Neuromyelitis Optica (NMO) is a serious condition associated with inflammation. Early diagnosis and detection are critical for early intervention. In this systematic review, we investigate the role of the neutrophil to lymphocyte ratio (NLR) as an important biomarker for NMO.</p><p><strong>Methods: </strong>Ten studies were selected that were sufficiently high quality and then checked for quality. The studies were organized by English language and selective inclusion criteria.</p><p><strong>Results: </strong>NLR was significantly increased in NMO patients compared to controls. The ratio was specifically proportional to severity of disease. More severe disease had a higher ratio.</p><p><strong>Conclusion: </strong>NLR offers a reliable and affordable method for early detection of disease severity. This can help guide appropriate treatment selection and monitor treatment response.</p>","PeriodicalId":73900,"journal":{"name":"Journal of physical medicine and rehabilitation (Wilmington, Del.)","volume":"5 1","pages":"16-25"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10207151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-12-31DOI: 10.33696/rehabilitation.3.022
Julian Martinez, Taylor M. Gordon, S. Strath
Functionally limiting health conditions have a high rate of prevalence worldwide and incur a significant amount of economic burden. Physical activity (PA) can prevent the onset of these conditions and alleviate economic burden by reducing symptoms, but a large portion of these individuals do not engage in health enhancing PA. Consumer wearable physical activity monitors (WPAM) are tools that have become increasingly popular within the past few years and could provide a means to improve PA levels for individuals with health conditions that cause functional limitations. This review reports on the validity of PA outcomes, feasibility and utility, and intervention/promotion effectiveness for consumer WPAM in functionally limited clinical populations. 2250 records from January 2018 to July 2021 were retrieved from PubMed, Web of Science, SPORTDiscus and CINAHL with 656 records being duplicates and 23 records passing a full-text article review. Studies included within the review looked at individuals with osteoarthritis, rheumatoid arthritis, axial spondyloarthritis, multiple sclerosis, Parkinson’s disease, ischemic stroke and peripheral arterial disease. The most popular brand of consumer WPAM was Fitbit. Validation studies for consumer WPAM were primarily focused on step counts showing overestimations for daily step counts and over- and under-estimations occurring within shorter time durations depending on step cadence. Wrist worn WPAM are the most feasible for functionally limited clinical populations with widespread utilization for associating clinically relevant outcomes with PA levels but they have limited validation to confirm their accuracy and precision in measurement. Interventions included used a mixture of a WPAM and other behavior change techniques to improve PA levels for clinical populations and show promising effectiveness. Future work is warranted on determining the validity of PA outcomes from WPAM determined to be feasible in select clinical populations and creating interventions looking at which features of a consumer WPAM intervention promote PA.
功能受限的健康状况在世界范围内的流行率很高，并造成大量的经济负担。体育活动(PA)可以预防这些疾病的发生，并通过减轻症状减轻经济负担，但这些个体中的很大一部分没有从事促进健康的PA。消费者可穿戴式身体活动监测仪(WPAM)是在过去几年中变得越来越流行的工具，可以为有健康状况导致功能限制的个人提供一种改善PA水平的方法。这篇综述报告了PA结果的有效性、可行性和实用性，以及在功能有限的临床人群中消费WPAM的干预/推广效果。从PubMed、Web of Science、SPORTDiscus和CINAHL检索2018年1月至2021年7月的2250条记录，其中656条记录为重复记录，23条记录通过全文文章审查。该综述的研究对象包括骨关节炎、类风湿关节炎、轴向脊椎关节炎、多发性硬化症、帕金森病、缺血性中风和外周动脉疾病患者。消费者WPAM最受欢迎的品牌是Fitbit。消费者WPAM的验证研究主要集中在步数上，显示了对每日步数的高估，以及根据步频在较短时间内发生的高估和低估。腕式WPAM对于功能受限的临床人群是最可行的，广泛应用于将临床相关结果与PA水平相关联，但其测量的准确性和精密度验证有限。干预措施包括混合使用WPAM和其他行为改变技术来改善临床人群的PA水平，并显示出有希望的效果。未来的工作有必要确定WPAM在选定临床人群中可行的PA结果的有效性，并创建干预措施，研究消费者WPAM干预措施的哪些特征会促进PA。
{"title":"The Use of Consumer Wearable Physical Activity Monitors in Clinical Populations with Functional Limitations","authors":"Julian Martinez, Taylor M. Gordon, S. Strath","doi":"10.33696/rehabilitation.3.022","DOIUrl":"https://doi.org/10.33696/rehabilitation.3.022","url":null,"abstract":"Functionally limiting health conditions have a high rate of prevalence worldwide and incur a significant amount of economic burden. Physical activity (PA) can prevent the onset of these conditions and alleviate economic burden by reducing symptoms, but a large portion of these individuals do not engage in health enhancing PA. Consumer wearable physical activity monitors (WPAM) are tools that have become increasingly popular within the past few years and could provide a means to improve PA levels for individuals with health conditions that cause functional limitations. This review reports on the validity of PA outcomes, feasibility and utility, and intervention/promotion effectiveness for consumer WPAM in functionally limited clinical populations. 2250 records from January 2018 to July 2021 were retrieved from PubMed, Web of Science, SPORTDiscus and CINAHL with 656 records being duplicates and 23 records passing a full-text article review. Studies included within the review looked at individuals with osteoarthritis, rheumatoid arthritis, axial spondyloarthritis, multiple sclerosis, Parkinson’s disease, ischemic stroke and peripheral arterial disease. The most popular brand of consumer WPAM was Fitbit. Validation studies for consumer WPAM were primarily focused on step counts showing overestimations for daily step counts and over- and under-estimations occurring within shorter time durations depending on step cadence. Wrist worn WPAM are the most feasible for functionally limited clinical populations with widespread utilization for associating clinically relevant outcomes with PA levels but they have limited validation to confirm their accuracy and precision in measurement. Interventions included used a mixture of a WPAM and other behavior change techniques to improve PA levels for clinical populations and show promising effectiveness. Future work is warranted on determining the validity of PA outcomes from WPAM determined to be feasible in select clinical populations and creating interventions looking at which features of a consumer WPAM intervention promote PA.","PeriodicalId":73900,"journal":{"name":"Journal of physical medicine and rehabilitation (Wilmington, Del.)","volume":"17 1","pages":"73 - 90"},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90244576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-04-29DOI: 10.33696/REHABILITATION.2.011
T. Dillingham, J. Kenia, A. Popescu, C. Plastaras, S. Becker, F. Shofer
Background context: Exercise therapy for low back pain has long been prescribed as one of the initial remedies for back pain. Traditional therapy is completed under a therapist’s supervision and consists of lumbar stabilization, aerobic exercise and stretching exercises. Recent studies have explored treating back pain with aerobic exercise such as walking which can be done anywhere and without supervision which is lower cost and easily administered. Purpose: To assess a therapeutic dosage of aerobic exercise that is associated with pain reduction in persons experiencing low back pain. Study design: Case series. Participant description: Sixteen patients entered the study and twelve patients completed the study (mean ± SD: age 51 ± 11 years; weight 89.2 ± 16 kg). Subjects were included if they were ages 18–65, had chronic back pain lasting for more than 3 months and a score of greater than 30% on the Oswestry Low Back Disability Questionnaire. Methods: Subjects underwent a six-week exercise program using the elliptical trainer three times each week. Exercise duration was steadily increased each week for the length of the study. The total cumulative amount of work that coincided with significant reductions in chronic low back pain was then identified. Results: At 4 weeks, pain scores were significantly reduced from baseline (3.2 vs 4.7, p<0.0001). This significant pain reduction corresponded to an average of 30.8 Kcal/kg of body mass in cumulative work performed. Pain was significantly reduced by 21% and 32% on the Oswestry Questionnaire and the PROMIS 29 respectively. Conclusions: These pilot findings suggest that approximately 30.8 kcal/Kg of accumulated physiological work is a therapeutic “dosage” of exercise needed for significant reduction in chronic back pain. Clinicians can begin to use this benchmark for their oversight of rehabilitation programs to determine if an exercise program has been sufficiently intense and long enough in duration for managing their patients with chronic low back pain.
背景:长期以来，运动疗法一直被认为是治疗腰痛的初始疗法之一。传统的治疗是在治疗师的监督下完成的，包括腰椎稳定、有氧运动和伸展运动。最近的研究探索了用有氧运动来治疗背痛，比如步行，这种运动可以在任何地方进行，不需要监督，成本更低，管理起来也更容易。目的:评估有氧运动治疗剂量与腰痛患者疼痛减轻的关系。研究设计:病例系列。参与者描述:16例患者进入研究，12例患者完成研究(平均±SD:年龄51±11岁;重量(89.2±16kg)。受试者年龄在18-65岁之间，慢性背痛持续3个月以上，Oswestry腰背残疾问卷得分超过30%。方法:受试者接受为期六周的运动计划，每周使用椭圆机训练三次。在研究期间，每周的运动时间稳步增加。然后确定了与慢性腰痛显著减少相一致的总累积工作量。结果:4周时，疼痛评分较基线显著降低(3.2 vs 4.7, p<0.0001)。这种显著的疼痛减轻与平均每公斤体重30.8千卡的累积工作相对应。在Oswestry问卷和PROMIS 29中，疼痛分别显著减少了21%和32%。结论:这些初步研究结果表明，大约30.8 kcal/Kg的累积生理工作是显著减少慢性背痛所需的治疗性运动“剂量”。临床医生可以开始使用这一基准来监督康复计划，以确定锻炼计划是否足够强烈，持续时间是否足够长，以管理慢性腰痛患者。
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{"title":"Energy Expenditure and Nutrition in Neurogenic Obesity following Spinal Cord Injury.","authors":"Gary J Farkas, David R Gater","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":73900,"journal":{"name":"Journal of physical medicine and rehabilitation (Wilmington, Del.)","volume":"2 1","pages":"11-13"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7100891/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37783459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Timothy Dillingham, Jessica Kenia, Adrian Popescu, Christopher Plastaras, Scott Becker, Frances Shofer
Background context: Exercise therapy for low back pain has long been prescribed as one of the initial remedies for back pain. Traditional therapy is completed under a therapist's supervision and consists of lumbar stabilization, aerobic exercise and stretching exercises. Recent studies have explored treating back pain with aerobic exercise such as walking which can be done anywhere and without supervision which is lower cost and easily administered.
Purpose: To assess a therapeutic dosage of aerobic exercise that is associated with pain reduction in persons experiencing low back pain.
Study design: Case series.
Participant description: Sixteen patients entered the study and twelve patients completed the study (mean ± SD: age 51 ± 11 years; weight 89.2 ± 16 kg). Subjects were included if they were ages 18-65, had chronic back pain lasting for more than 3 months and a score of greater than 30% on the Oswestry Low Back Disability Questionnaire.
Methods: Subjects underwent a six-week exercise program using the elliptical trainer three times each week. Exercise duration was steadily increased each week for the length of the study. The total cumulative amount of work that coincided with significant reductions in chronic low back pain was then identified.
Results: At 4 weeks, pain scores were significantly reduced from baseline (3.2 vs 4.7, p<0.0001). This significant pain reduction corresponded to an average of 30.8 Kcal/kg of body mass in cumulative work performed. Pain was significantly reduced by 21% and 32% on the Oswestry Questionnaire and the PROMIS 29 respectively.
Conclusions: These pilot findings suggest that approximately 30.8 kcal/Kg of accumulated physiological work is a therapeutic "dosage" of exercise needed for significant reduction in chronic back pain. Clinicians can begin to use this benchmark for their oversight of rehabilitation programs to determine if an exercise program has been sufficiently intense and long enough in duration for managing their patients with chronic low back pain.
背景:长期以来，运动疗法一直被认为是治疗腰痛的初始疗法之一。传统的治疗是在治疗师的监督下完成的，包括腰椎稳定、有氧运动和伸展运动。最近的研究探索了用有氧运动来治疗背痛，比如步行，这种运动可以在任何地方进行，不需要监督，成本更低，管理起来也更容易。目的:评估有氧运动治疗剂量与腰痛患者疼痛减轻的关系。研究设计:病例系列。参与者描述:16例患者进入研究，12例患者完成研究(平均±SD:年龄51±11岁;重量(89.2±16kg)。受试者年龄在18-65岁之间，慢性背痛持续3个月以上，Oswestry腰背残疾问卷得分超过30%。方法:受试者接受为期六周的运动计划，每周使用椭圆机训练三次。在研究期间，每周的运动时间稳步增加。然后确定了与慢性腰痛显著减少相一致的总累积工作量。结果:在第4周，疼痛评分从基线显著降低(3.2 vs 4.7)。结论:这些试点研究结果表明，大约30.8千卡/公斤的累积生理工作是显著减少慢性背痛所需的治疗性运动“剂量”。临床医生可以开始使用这一基准来监督康复计划，以确定锻炼计划是否足够强烈，持续时间是否足够长，以管理慢性腰痛患者。
{"title":"Pain Outcomes with an Elliptical Regimen (POWER) Study: Identifying the Proper Dosage of Exercise for Therapeutic Effect in Persons with Chronic Back Pain.","authors":"Timothy Dillingham, Jessica Kenia, Adrian Popescu, Christopher Plastaras, Scott Becker, Frances Shofer","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background context: </strong>Exercise therapy for low back pain has long been prescribed as one of the initial remedies for back pain. Traditional therapy is completed under a therapist's supervision and consists of lumbar stabilization, aerobic exercise and stretching exercises. Recent studies have explored treating back pain with aerobic exercise such as walking which can be done anywhere and without supervision which is lower cost and easily administered.</p><p><strong>Purpose: </strong>To assess a therapeutic dosage of aerobic exercise that is associated with pain reduction in persons experiencing low back pain.</p><p><strong>Study design: </strong>Case series.</p><p><strong>Participant description: </strong>Sixteen patients entered the study and twelve patients completed the study (mean ± SD: age 51 ± 11 years; weight 89.2 ± 16 kg). Subjects were included if they were ages 18-65, had chronic back pain lasting for more than 3 months and a score of greater than 30% on the Oswestry Low Back Disability Questionnaire.</p><p><strong>Methods: </strong>Subjects underwent a six-week exercise program using the elliptical trainer three times each week. Exercise duration was steadily increased each week for the length of the study. The total cumulative amount of work that coincided with significant reductions in chronic low back pain was then identified.</p><p><strong>Results: </strong>At 4 weeks, pain scores were significantly reduced from baseline (3.2 vs 4.7, p<0.0001). This significant pain reduction corresponded to an average of 30.8 Kcal/kg of body mass in cumulative work performed. Pain was significantly reduced by 21% and 32% on the Oswestry Questionnaire and the PROMIS 29 respectively.</p><p><strong>Conclusions: </strong>These pilot findings suggest that approximately 30.8 kcal/Kg of accumulated physiological work is a therapeutic \"dosage\" of exercise needed for significant reduction in chronic back pain. Clinicians can begin to use this benchmark for their oversight of rehabilitation programs to determine if an exercise program has been sufficiently intense and long enough in duration for managing their patients with chronic low back pain.</p>","PeriodicalId":73900,"journal":{"name":"Journal of physical medicine and rehabilitation (Wilmington, Del.)","volume":"2 2","pages":"23-28"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7377601/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38189083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-12-16DOI: 10.33696/REHABILITATION.2.008
G. Farkas, D. Gater
Worldwide, obesity is a public health concern and a metabolic ailment characterized by excessive adipose tissue accumulation resulting from an imbalance of energy expenditure and energy intake [1]. This disorder is a known risk factor for cardiovascular disease, type 2 diabetes mellitus, dyslipidemia, hypertension, and metabolic syndrome, and in recent years, it has been described as a systemic inflammatory disease with chronic consequences [2].
{"title":"Energy Expenditure and Nutrition in Neurogenic Obesity following Spinal Cord Injury","authors":"G. Farkas, D. Gater","doi":"10.33696/REHABILITATION.2.008","DOIUrl":"https://doi.org/10.33696/REHABILITATION.2.008","url":null,"abstract":"Worldwide, obesity is a public health concern and a metabolic ailment characterized by excessive adipose tissue accumulation resulting from an imbalance of energy expenditure and energy intake [1]. This disorder is a known risk factor for cardiovascular disease, type 2 diabetes mellitus, dyslipidemia, hypertension, and metabolic syndrome, and in recent years, it has been described as a systemic inflammatory disease with chronic consequences [2].","PeriodicalId":73900,"journal":{"name":"Journal of physical medicine and rehabilitation (Wilmington, Del.)","volume":"36 1","pages":"11 - 13"},"PeriodicalIF":0.0,"publicationDate":"2019-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82069853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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