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Impairment in Physical Function and Mental Status in a Survivor of Severe COVID-19 at Discharge from an Acute Care a Hospital: A Case Report. 重症COVID-19幸存者出院时身体功能和精神状态的损害:1例报告
Pub Date : 2021-06-11 eCollection Date: 2021-01-01 DOI: 10.1298/ptr.E10083
Shinya Matsushima, Yusuke Kasahara, Shun Aikawa, Takeru Fuzimura, Hitoshi Yokoyama, Hironobu Katata

Background: Early mobilization and rehabilitation interventions should be provided to patients who survived severe COVID-19 to improve their physical function and activities of daily living (ADL). However, their physical and mental status at discharge has not been well described in Japan. We report the intervention provided for a survivor of severe COVID-19 and his physical and mental status at discharge from an acute care hospital.

Case report: A 62-year-old man was admitted to our emergency department with a diagnosis of COVID-19 with severe acute respiratory dysfunction. He had complicated intensive care unit-acquired weakness (ICU-AW) and delirium during mechanical ventilation therapy. Rehabilitation intervention was initiated on the seventh day post-admission and was gradually performed according to his respiratory and hemodynamic status. As a result of the rehabilitation intervention, ICU-AW and cognitive function gradually improved. On hospital day 37, he independently performed basic ADL and was discharged. However, he lost approximately 9% of his body weight at discharge. In addition, his hand grip strength and six-minute walking distance were lower and shorter than the reference values, respectively. His mental component summary of the Short Form-8™ was lower than the national standard deviation for the Japanese population.

Conclusion: Although survivors of severe COVID-19 who undergo early rehabilitation can be discharged from an acute care hospital, they may have several impairments in their physical and mental status, including muscle function, diffusion capacity, exercise tolerance, and health-related quality of life.

背景:应对COVID-19重症存活患者进行早期动员和康复干预,改善其身体功能和日常生活活动能力。然而,在日本,他们出院时的身体和精神状况并没有得到很好的描述。我们报告了一名重症COVID-19幸存者在急性护理医院出院时的身体和精神状况。病例报告:一名62岁男性因诊断为COVID-19合并严重急性呼吸功能障碍而入住急诊科。在机械通气治疗期间,患者出现重症监护病房获得性虚弱(ICU-AW)和谵妄。入院后第7天开始康复干预,根据患者呼吸和血流动力学状况逐步进行康复干预。康复干预后,ICU-AW和认知功能逐渐改善。住院第37天,患者独立完成基本ADL并出院。然而,出院时他的体重下降了大约9%。此外,他的握力和6分钟步行距离分别低于参考值和短于参考值。他对Short Form-8™的心理成分总结低于日本人口的国家标准偏差。结论:尽管接受早期康复治疗的重症COVID-19幸存者可以从急性护理医院出院,但他们的身心状态可能存在一些损伤,包括肌肉功能、扩散能力、运动耐量和与健康相关的生活质量。
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引用次数: 0
Stroke Patients Showed Improvements in Balance in Response to Visual Restriction Exercise. 脑卒中患者在视力限制训练后平衡性得到改善。
Pub Date : 2021-05-27 eCollection Date: 2021-01-01 DOI: 10.1298/ptr.E10081
Shima Jandaghi, Nahid Tahan, Alireza Akbarzadeh Baghban, Maryam Zoghi

Objective: Several strategies have been designed to improve balance after stroke. Although recent studies have suggested that the balance training in stroke should include exercises that are performed in different sensory conflict conditions, little attention has been paid to manipulation of visual input. This study aimed to compare effects of balance training on an unstable surface with balance training under visual deprivation conditions in persons with stroke.

Method: Forty-five stroke patients were randomized into three groups: the visual deprivation- stable based training (VD-SBT); unstable based training (UBT); and control (C) groups. Subjects of the VD-SBT group performed balance training on a stable surface with closed eyes. The UBT group performed balance training on an unstable surface with open eyes. Patients were assessed before and after interventions for Timed Up and Go (TUG), Four Square Step (FSS) and Five Times Sit to Stand (FTSS) tests.

Result: There was a significant difference in pre- post intervention time of TUG, FSS and FTSS tests in all three groups. In a comparison of three groups, the UBT and VD-SBT groups had a significant improvement in time of all tests but significant improvement in time of all tests was observed in the VD-SBT group in comparison with the UBT group. In the field of balance training, the manipulation of visual input was more effective than the manipulation of standing surface to reweighting the sensory information.

Conclusion: We recommended balance rehabilitation programs after stroke performed under conditions to stimulate the use of underused sensory input.

目的:已经设计了几种策略来改善中风后的平衡。虽然最近的研究表明,中风中的平衡训练应该包括在不同的感觉冲突条件下进行的练习,但很少关注视觉输入的操纵。本研究旨在比较脑卒中患者在视觉剥夺条件下在不稳定表面进行平衡训练与平衡训练的效果。方法:45例脑卒中患者随机分为三组:视觉剥夺-稳定训练组(VD-SBT);不稳定基础训练(UBT);和控制(C)组。VD-SBT组受试者闭着眼睛在稳定的表面上进行平衡训练。UBT组睁着眼睛在不稳定的表面上进行平衡训练。在干预前后对患者进行定时起身(TUG)、四次方步(FSS)和五次坐立(FTSS)测试。结果:三组干预前后TUG、FSS、FTSS测试时间差异均有统计学意义。在三组比较中,UBT组和VD-SBT组在所有测试的时间上都有显著改善,但与UBT组相比,VD-SBT组在所有测试的时间上都有显著改善。在平衡训练领域,操纵视觉输入比操纵站立面更有效地重新加权感觉信息。结论:我们推荐在刺激未充分使用的感觉输入的条件下进行中风后平衡康复计划。
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引用次数: 2
Walking Attainment in Very Low Birth Weight Infants in Japan. 日本极低出生体重婴儿的行走能力。
Pub Date : 2021-05-10 eCollection Date: 2021-01-01 DOI: 10.1298/ptr.E10087
Yuu Uchio, Naoko Shima, Kaho Nakamura, Osamu Nitta, Tetsuo Ikai

Objective: To clarify the corrected age of walking attainment in very low birth weight infants by birth weight and gestational age, and determine perinatal factors affecting the delay in walking attainment.

Method: This was a longitudinal study. We investigated walking attainment and perinatal factors in 145 very low birth weight infants without neurological abnormalities (mean birth weight 1019.3 ± 299.7 g, gestational age 29.0 ± 2.9 weeks). The study infants were stratified by birth weight (group A: <1,000 g, group B: 1,000 g≤, <1,500 g) and gestational age (group I: <28 weeks, group II: 28 weeks≤, <37 weeks) and were compared using unpaired t-tests. Furthermore, we examined the perinatal factors that affect the delay in walking attainment using multiple regression analysis.

Results: Of the walking attainment, infants in Group A were older than those in Group B (50th percentile, 15.8 vs. 14.7 months). Infants in Group I were older than those in Group II (50th percentile, 16.0 vs. 14.8 months). Using multiple regression analysis with walking attainment age as the dependent variable, the duration of mechanical ventilation was found to be significantly related.

Conclusion: Very low birth weight infants with light weight and short gestational age have delayed walking attainment, and longer duration of mechanical ventilation increases the risk of delay.

目的:通过出生体重和胎龄来明确极低出生体重儿行走能力达到的正确年龄,并确定影响行走能力达到延迟的围生期因素。方法:本研究为纵向研究。研究145例无神经系统异常的极低出生体重儿(平均出生体重1019.3±299.7 g,胎龄29.0±2.9周)的行走能力及围产儿因素。研究婴儿按出生体重分层(A组:结果:在行走能力方面,A组婴儿比B组婴儿大(第50百分位,15.8个月对14.7个月)。I组婴儿比II组大(第50百分位,16.0比14.8个月)。以行走年龄为因变量进行多元回归分析,发现机械通气时间与行走年龄有显著相关。结论:极低出生体重儿体重轻、胎龄短存在行走发育迟缓,延长机械通气时间增加行走发育迟缓的风险。
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引用次数: 0
Anatomical Increased/Decreased Changes in the Brain Area Following Individuals with Chronic Traumatic Complete Thoracic Spinal Cord Injury. 慢性创伤性完全性胸脊髓损伤后脑区解剖变化的增加/减少。
Pub Date : 2021-04-01 eCollection Date: 2021-01-01 DOI: 10.1298/ptr.E10076
Takashi Murayama, Kousuke Takahama, Kazumasa Jinbo, Tomoyoshi Kobari

Objectives: This study aimed to investigate anatomical changes in the brain following chronic complete traumatic thoracic spinal cord injury (ThSCI) using voxel-based morphometry (VBM). That is, it attempted to examine dynamic physical change following thoracic injury and the presence or absence of regions with decreased and increased changes in whole brain volume associated with change in the manner of how activities of daily living are performed.

Methods: Twelve individuals with chronic traumatic complete ThSCI (age; 21-63 years, American Spinal Injury Association Impairment Scale; grade C-D) participated in this study. VBM was used to investigate the regions with increased volume and decreased volume in the brain in comparison with healthy control individuals.

Results: Decreases in volume were noted in areas associated with motor and somatosensory functions, including the right paracentral lobule (PCL)-the primary motor sensory area for lower limbs, left dorsal premotor cortex, and left superior parietal lobule (SPL). Furthermore, increased gray matter volume was noted in the primary sensorimotor area for fingers and arms, as well as in higher sensory areas.

Conclusions: Following SCI both regions with increased volume and regions with decreased volume were present in the brain in accordance with changes in physical function. Using longitudinal observation, anatomical changes in the brain may be used to determine the rehabilitation effect by comparing present cases with cases with cervical SCI or cases with incomplete palsy.

目的:本研究旨在利用基于体素的形态测量法(VBM)研究慢性完全性外伤性胸椎脊髓损伤(ThSCI)后大脑的解剖变化。也就是说,它试图检查胸部损伤后的动态物理变化,以及与日常生活活动方式变化相关的全脑容量变化减少或增加区域的存在或缺失。方法:慢性外伤性完全性ThSCI患者12例(年龄;21-63岁,美国脊髓损伤协会损伤量表;C-D级)参加本研究。与健康对照个体相比,VBM用于研究脑容量增加和减少的区域。结果:与运动和体感觉功能相关的区域体积减少,包括右侧中央旁小叶(PCL)-下肢的主要运动感觉区域,左侧背侧运动前皮层和左侧顶叶上小叶(SPL)。此外,在手指和手臂的初级感觉运动区以及高级感觉区,灰质体积增加。结论:脊髓损伤后,脑容量增加区域和脑容量减少区域根据身体功能的变化同时存在。通过纵向观察,将本病例与颈椎脊髓损伤或不完全性瘫痪病例进行比较,可以利用脑的解剖变化来判断康复效果。
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引用次数: 2
Association between Social Frailty and Sleep Quality among Community-dwelling Older Adults: A Cross-sectional Study. 社区居住老年人社会脆弱与睡眠质量的关系:一项横断面研究。
Pub Date : 2021-04-01 eCollection Date: 2021-01-01 DOI: 10.1298/ptr.E10085
Taiji Noguchi, Ippei Nojima, Tomoe Inoue-Hirakawa, Hideshi Sugiura

Objective: We examined the association between social frailty and subjective sleep quality among community-dwelling adults.

Methods: This cross-sectional study recruited Japanese adults over the age of 60 years from health check-ups held in a public townhall in a suburban area between 2018 and 2019. Social frailty was evaluated using five criteria (living alone, not visiting friends sometimes, going out less frequently than the last year, not feeling helpful to friends or family, and not talking to someone every day) and categorized into three groups: non-frailty, pre-frailty, and frailty. Sleep quality was assessed according to the Pittsburgh Sleep Quality Index (PSQI) by giving participants a self-reported questionnaire. We performed multivariable linear regression analysis, denoting social frailty as an independent variable, and the global PSQI score as a dependent variable.

Results: Data from 300 older adults were analyzed, 51.0% of whom were female. The participants' mean age was 73.0 years (standard deviation = 5.8). Multivariable analysis revealed the notable association between social frailty and a high global PSQI score (compared with non-frailty, frailty: β = 0.94, 95% CI = 0.08 to 1.80, p = 0.033). Of the five determiners of social frailty, not talking with someone every day was especially associated with a high global PSQI score (β = 1.57, 95% CI = 0.49 to 2.66, p = 0.005).

Conclusion: The present study suggests that social frailty is associated with poor sleep quality among community-dwelling older adults. Our findings indicate the importance of social frailty on sleep quality among older adults.

目的:探讨社区居民的社会脆弱与主观睡眠质量之间的关系。方法:这项横断面研究招募了2018年至2019年期间在郊区一个公共市政厅进行健康检查的60岁以上的日本成年人。社会脆弱是用五个标准来评估的(独自生活,有时不拜访朋友,比去年更少外出,对朋友或家人没有帮助,每天不与某人交谈),并分为三组:非脆弱,脆弱前和脆弱。根据匹兹堡睡眠质量指数(PSQI),通过给参与者一份自我报告的问卷来评估睡眠质量。我们进行了多变量线性回归分析,将社会脆弱性作为自变量,将整体PSQI评分作为因变量。结果:分析了300名老年人的数据,其中51.0%为女性。参与者的平均年龄为73.0岁(标准差= 5.8)。多变量分析显示,社会脆弱与高整体PSQI评分之间存在显著关联(与非脆弱相比,脆弱:β = 0.94, 95% CI = 0.08至1.80,p = 0.033)。在社会脆弱的五个决定因素中,不每天与某人交谈与高整体PSQI评分特别相关(β = 1.57, 95% CI = 0.49至2.66,p = 0.005)。结论:目前的研究表明,在社区居住的老年人中,社会脆弱性与睡眠质量差有关。我们的研究结果表明,社会脆弱性对老年人睡眠质量的重要性。
{"title":"Association between Social Frailty and Sleep Quality among Community-dwelling Older Adults: A Cross-sectional Study.","authors":"Taiji Noguchi,&nbsp;Ippei Nojima,&nbsp;Tomoe Inoue-Hirakawa,&nbsp;Hideshi Sugiura","doi":"10.1298/ptr.E10085","DOIUrl":"https://doi.org/10.1298/ptr.E10085","url":null,"abstract":"<p><strong>Objective: </strong>We examined the association between social frailty and subjective sleep quality among community-dwelling adults.</p><p><strong>Methods: </strong>This cross-sectional study recruited Japanese adults over the age of 60 years from health check-ups held in a public townhall in a suburban area between 2018 and 2019. Social frailty was evaluated using five criteria (living alone, not visiting friends sometimes, going out less frequently than the last year, not feeling helpful to friends or family, and not talking to someone every day) and categorized into three groups: non-frailty, pre-frailty, and frailty. Sleep quality was assessed according to the Pittsburgh Sleep Quality Index (PSQI) by giving participants a self-reported questionnaire. We performed multivariable linear regression analysis, denoting social frailty as an independent variable, and the global PSQI score as a dependent variable.</p><p><strong>Results: </strong>Data from 300 older adults were analyzed, 51.0% of whom were female. The participants' mean age was 73.0 years (standard deviation = 5.8). Multivariable analysis revealed the notable association between social frailty and a high global PSQI score (compared with non-frailty, frailty: β = 0.94, 95% CI = 0.08 to 1.80, p = 0.033). Of the five determiners of social frailty, not talking with someone every day was especially associated with a high global PSQI score (β = 1.57, 95% CI = 0.49 to 2.66, p = 0.005).</p><p><strong>Conclusion: </strong>The present study suggests that social frailty is associated with poor sleep quality among community-dwelling older adults. Our findings indicate the importance of social frailty on sleep quality among older adults.</p>","PeriodicalId":74445,"journal":{"name":"Physical therapy research","volume":"24 2","pages":"153-162"},"PeriodicalIF":0.0,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8419475/pdf/ptr-24-02-0153.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39424114","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}
引用次数: 3
Respiratory Impairment, Limited Activity, and Pulmonary Rehabilitation in Patients with Interstitial Lung Disease. 间质性肺病患者的呼吸障碍、活动受限和肺部康复。
Pub Date : 2021-04-01 eCollection Date: 2021-01-01 DOI: 10.1298/ptr.R0012
Ryo Kozu, Kazuya Shingai, Masatoshi Hanada, Masato Oikawa, Hiroki Nagura, Hiroshi Ito, Chika Kitagawa, Takako Tanaka

Interstitial lung disease (ILD) is a diverse group of chronic lung conditions characterized by dyspnea, exercise-induced hypoxemia (EIH), and exercise intolerance. Since activity limitations and impaired health-related quality of life (HRQoL) in ILD are similar to those in other chronic respiratory diseases, including chronic obstructive pulmonary disease (COPD), pulmonary rehabilitation is also indicated for patients with ILD. This rehabilitation program mainly comprises exercise training and self-management education. Exercise training is the most important component of pulmonary rehabilitation. It significantly improves dyspnea and enhances exercise capacity and HRQoL in patients with ILD. The standard exercise prescription used for COPD is also effective for ILD. However, considering that disease progression and exercise-limiting factors are different in patients with COPD is necessary. Severe EIH, the adverse effects of corticosteroid administration, and comorbidities often lead to difficulty in employing a sufficient exercise intensity. Some modifications in the exercise prescription for individual patients or strategies to minimize EIH and dyspnea are required to optimize training intensity. Since EIH is common and severe in patients with ILD, supplemental oxygen should be provided. In advanced and more severe patients, who have difficulty in performing exercises, energy conservation techniques and the use of energy-saving devices to improve and maintain the patients' activities of daily living may be effective..

间质性肺病(ILD)是一组以呼吸困难、运动性低氧血症(EIH)和运动不耐受为特征的慢性肺部疾病。由于ILD患者的活动受限和健康相关生活质量受损(HRQoL)与其他慢性呼吸系统疾病(包括慢性阻塞性肺疾病(COPD))相似,因此肺康复也适用于ILD患者。这项康复计划主要包括运动训练和自我管理教育。运动训练是肺部康复的重要组成部分。它能显著改善ILD患者的呼吸困难,提高运动能力和HRQoL。用于COPD的标准运动处方对ILD也有效。然而,考虑到COPD患者的疾病进展和运动限制因素不同是必要的。严重的EIH,皮质类固醇给药的不良反应和合并症往往导致难以采用足够的运动强度。为了优化训练强度,需要对个别患者的运动处方或策略进行一些修改,以尽量减少EIH和呼吸困难。由于EIH在ILD患者中常见且严重,因此应提供补充氧气。对于运动困难的晚期和重症患者,节能技术和使用节能装置改善和维持患者的日常生活活动可能是有效的。
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引用次数: 4
Self-rated Changes of Health Status during Stay-at-home Orders among Older Adults Using the Long-term Care Insurance System of Japan: A Cross-sectional Study. 日本长期护理保险制度下老年人居家令期间健康状况自评变化的横断面研究
Pub Date : 2021-04-01 eCollection Date: 2021-01-01 DOI: 10.1298/ptr.E10089
Takazumi Ono, Mieko Kashima, Yasuyoshi Asakawa

Objectives: To reveal self-rated changes of health status during stay-at-home orders among older adults and to verify whether decrease in frequency of going outdoors during these orders was related to self-rated changes in health status.

Method: A self-completed questionnaire for older adults was provided in 2 dayservice facilities and a nursing station. We operationally defined health status with 4 domains (motor function, oral and swallowing function, depression, and social networks) and designed the questionnaire to determine self-rated changes in health status using factor analysis. After factor analysis, regression analyses were conducted. Dependent variable was each factor score (self-rated changes of health status), and independent variable was decrease in frequency of going outdoors.

Results: Approximately 80% of participants answered that their health status had "worsened" in motor function (75.0%-87.2%). Moreover, more than 70% of participants answered "worsened" in "Feeling energy" and "Getting together and speaking with friends" (72.3% and 75.7%, respectively). Regression analyses demonstrated that, after adjusting for covariates, the decrease in frequency of going outdoors was related to self-rated changes of motor function and friend network.

Conclusion: During stay-at-home orders, older adults felt deterioration in their motor function, in feeling energy, and in their friend network, especially people who had decreased their frequency of going outdoors felt more deterioration in their motor function and in their friend network.

目的:揭示老年人在居家令期间健康状况的自评变化,并验证在居家令期间外出频率的减少是否与健康状况自评变化有关。方法:在2个日间服务机构和1个护理站对老年人进行问卷调查。我们从4个领域(运动功能、口腔和吞咽功能、抑郁和社会网络)定义了操作性的健康状况,并设计了问卷,利用因子分析来确定健康状况的自评变化。因子分析后进行回归分析。因变量为各因子得分(健康状况自评变化),自变量为户外活动次数减少。结果:约80%的参与者回答他们的健康状况在运动功能方面“恶化”(75.0%-87.2%)。此外,超过七成的受访者在“感受能量”和“与朋友聚会和交谈”两项回答“恶化”(分别为72.3%和75.7%)。回归分析表明,调整协变量后,外出频率的下降与运动功能和朋友网络的自评变化有关。结论:在居家命令期间,老年人的运动功能、感觉能量和朋友网络都出现了恶化,尤其是那些减少户外活动频率的人,他们的运动功能和朋友网络的恶化更严重。
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引用次数: 3
Monophasic Pulsed Current Stimulation of Duty Cycle 10% Promotes Differentiation of Human Dermal Fibroblasts into Myofibroblasts. 占空比为 10%的单相脉冲电流刺激可促进人真皮成纤维细胞分化为肌成纤维细胞
Pub Date : 2021-03-18 eCollection Date: 2021-01-01 DOI: 10.1298/ptr.E10064
Mikiko Uemura, Masaharu Sugimoto, Yoshiyuki Yoshikawa, Terutaka Hiramatsu, Taketo Inoue

Objective: Many clinical trials have shown the therapeutic effects of electrical stimulation (ES) in various conditions. Our previous studies showed that ES (200 μA and 2 Hz) promotes migration and proliferation of human dermal fibroblasts (HDFs). However, the effective duty cycle and the effect of ES on myofibroblast differentiation are unclear. This study aimed to investigate the relationship between duty cycle and myofibroblast differentiation.

Methods: HDFs were subjected to ES (200 μA and 2 Hz) for 24 h with the duty cycle adapted at 0% (control), 10%, 50%, or 90%. α-smooth muscle actin (SMA) and transforming growth factor (TGF)-β1 mRNA and α-SMA protein expressions were assessed. Collagen gel contraction was observed for 48 h after ES initiation and the gel area was measured. Cell viability and pH of culture medium were analyzed for cytotoxicity of the ES.

Results: Cell viabilities were decreased in the 50% and the 90% groups but ES did not influence on pH of culture media. ES with a duty cycle of 10% significantly promoted the mRNA expression of α-SMA and TGF-β1. α-SMA protein expression in the 10% group was also significantly higher than that of the control group. Collagen gel subjected to ES with a duty cycle of 10% was contracted.

Conclusion: Duty cycle can influence on myofibroblast differentiation and ES with a duty cycle 10% is the effective for wound healing.

目的:许多临床试验表明,电刺激(ES)对各种疾病都有治疗作用。我们之前的研究表明,电刺激(200 μA 和 2 Hz)可促进人真皮成纤维细胞(HDFs)的迁移和增殖。然而,ES的有效占空比和对肌成纤维细胞分化的影响尚不清楚。本研究旨在探讨占空比与肌成纤维细胞分化之间的关系。方法:将 HDFs 放在 ES(200 μA 和 2 Hz)中 24 小时,占空比调整为 0%(对照组)、10%、50% 或 90%。在 ES 启动后的 48 小时内观察胶原凝胶收缩并测量凝胶面积。对细胞活力和培养基 pH 值进行分析,以确定 ES 的细胞毒性:结果:50% 和 90% 组的细胞活力下降,但 ES 对培养基的 pH 值没有影响。占空比为 10%的 ES 能明显促进 α-SMA 和 TGF-β1 的 mRNA 表达,10% 组的α-SMA 蛋白表达也明显高于对照组。在占空比为 10%的 ES 条件下,胶原凝胶发生收缩:占空比可影响肌成纤维细胞的分化,占空比为 10%的 ES 对伤口愈合有效。
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引用次数: 0
The Progress of the Gait Impairment and Brain Activation in a Patient with Post-stroke Hemidystonia. 脑卒中后半肌张力障碍患者步态障碍与脑激活的研究进展。
Pub Date : 2021-02-24 eCollection Date: 2021-01-01 DOI: 10.1298/ptr.E10032
Satoshi Yamamoto, Daisuke Ishii, Kyoko Kanae, Yusuke Endo, Kenichi Yoshikawa, Kazunori Koseki, Ryo Nakazawa, Hanako Takano, Masahiko Monma, Arito Yozu, Akira Matsushita, Yutaka Kohno

Objective: We explore the effects of body weight-supported (BWS) treadmill training, including the change of cortical activation, on a patient with post-stroke hemidystonia.

Patient: The patient was a 71-year-old man with left thalamus hemorrhage. His motor symptoms indicated slight impairment. There was no overactive muscle contraction in the supine, sitting, or standing positions. During his gait, the right initial contact was the forefoot, and his right knee showed an extension thrust pattern. These symptoms suggested that he had post-stroke hemidystonia.

Methods: The patient performed BWS treadmill training 14 times over 3 weeks. The effects of the BWS training were assessed by a step-length analysis, electromyography and functional magnetic resonance imaging (fMRI).

Results: The patient's nonparetic step length was extended significantly in the Inter-BWS (p<0.001) and Post-BWS (p=0.025) periods compared to the Pre-BWS session. The excessive muscle activity of the right gastrocnemius medialis in the swing phase was decreased at the Inter-BWS, Post-BWS, and follow-up compared to the Pre-BWS session. The peak timing difference of the bilateral tibialis anterior muscle became significant (p<0.05) on the first day of the intervention. The fMRI revealed that the cortical areas activated by the motor task converged through the intervention (p<0.05, family-wise error corrected).

Conclusion: These results suggest that there was improvement of the patient's symptoms of post-stroke hemidystonia due to changes in the brain activity during voluntary movement after BWS intervention. Body weight-supported treadmill training may thus be an effective treatment for patients with poststroke hemidystonia.

目的:探讨体重支撑(BWS)跑步机训练对脑卒中后半肌张力障碍患者的影响,包括皮质激活的变化。患者:71岁男性,左丘脑出血。他的运动症状显示有轻微损伤。仰卧位、坐位或站立位均无过度活跃的肌肉收缩。在他的步态中,右初始接触是前足,右膝盖呈伸展推力模式。这些症状表明他有中风后半肌张力障碍。方法:患者在3周内进行了14次BWS跑步机训练。通过步长分析、肌电图和功能磁共振成像(fMRI)来评估BWS训练的效果。结果:interbws中患者的非麻痹步长明显延长(p)。结论:BWS干预后,由于患者在自主运动时脑活动的改变,患者脑卒中后半系统障碍症状有所改善。因此,体重支持的跑步机训练可能是卒中后半肌张力障碍患者的有效治疗方法。
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引用次数: 0
Effect of Home-based Exercise Therapy for Peripheral Arterial Disease Patients Underwent Endovascular Treatment: A Clinical Controlled Design. 接受血管内治疗的外周动脉疾病患者接受家庭运动疗法的效果:临床对照设计
Pub Date : 2021-02-24 eCollection Date: 2021-01-01 DOI: 10.1298/ptr.E10056
Shota Otsuka, Tomoyuki Morisawa, Yu Hojo, Atsuhisa Ishida, Akira Tamaki

Objective: This study aimed to clarify the effect of home-based exercise therapy on physical activity in peripheral arterial disease (PAD) patients after EVT.

Methods: Study design was controlled clinical design. The subjects were 30 patients (76.6% men) who underwent EVT in the Sakakibara Heart Institute of Okayama. Patients with EVT meeting the inclusion criteria were divided into two groups, intervention group (Home-based exercise) and control group. Patients' basic characteristics, the number of steps walked and QOL questionnaire (WIQ, SEPA, Vascu QOL) were assessed before surgery and, at the 3 month after discharge. A two-way analysis of variance (ANOVA) was performed to compare number of steps walked and QOL questionnaire.

Results: Interaction effect were observed in the number of steps walked (F (1,28) =13.89, p<0.01). A multiple comparison test confirmed a significant increase between results of before surgery and at three months after surgery in the intervention group (p<0.01). An interaction between the presence and absence of intervention was found for the WIQ pain score (F(1,28) = 5.86, p=0.01), speed score (F(1,28) = 3.80, p=0.04) and SEPA (F(1,28) = 4.99, p=0.03). In a multiple comparison study, there was a significant increase in WIQ pain and speed scores in both groups before and 3 months after discharge from the hospital.

Conclusion: Home-based exercise therapy using physical activity indices has the potential to improve number of steps and quality of life in patients with PAD after EVT.

研究目的本研究旨在阐明家庭运动疗法对 EVT 后外周动脉疾病(PAD)患者体力活动的影响:研究设计为临床对照设计。研究对象为在冈山榊原心脏研究所接受 EVT 的 30 名患者(76.6% 为男性)。符合纳入标准的 EVT 患者被分为两组,即干预组(家庭锻炼)和对照组。在手术前和出院后 3 个月对患者的基本特征、行走步数和 QOL 问卷(WIQ、SEPA、Vascu QOL)进行评估。对步行步数和 QOL 问卷进行了双向方差分析(ANOVA):结果:步行步数存在交互效应(F(1,28)=13.89,p):采用体力活动指数的家庭运动疗法有可能改善 EVT 后 PAD 患者的行走步数和生活质量。
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Physical therapy research
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