Early and Delayed Postoperative Rehabilitation after Arthroscopic Rotator Cuff Repair: A Comparative Study of Clinical Outcomes

BACKGROUND@#The duration of immobilization after arthroscopic rotator cuff repair and the optimal time to commence rehabilitation are still the subject of ongoing debates. This study was undertaken to evaluate the functional outcome and rotator cuff healing status after arthroscopic rotator cuff repair by comparing early and delayed rehabilitation.@*METHODS@#Totally, 76 patients with small, medium, and large sized rotator cuff tears underwent arthroscopic repair using the suture-bridge technique. In early rehabilitation group, 38 patients commenced passive range of motion at postoperative day 2 whereas 38 patients assigned to the delayed rehabilitation group commenced passive range of motion at postoperative week 3. At the end of the study period, clinical and functional evaluations (Constant score, the University of California, Los Angeles [UCLA] shoulder score) were carried out, subsequent to measuring the range of motion, visual analogue scale for pain, and isokinetic dynamometer test. Rotator cuff healing was confirmed by magnetic resonance imaging at least 6 months after surgery.@*RESULTS@#No significant difference was obtained in range of motion and visual analogue scale between both groups. Functional outcomes showed similar improvements in the Constant score (early: 67.0–88.0; delayed: 66.9–91.0; p<0.001) and the UCLA shoulder score (early: 20.3–32.3; delayed: 20.4–32.4; p<0.001). Furthermore, rotator cuff healing showed no significant differences between the groups (range, 6–15 months; average, 10.4 months).@*CONCLUSIONS@#Delayed passive rehabilitation does not bring about superior outcomes. Therefore, early rehabilitation would be useful to help patients resume their daily lives.

Radix Polygalae Extract Attenuates PTSD-like Symptoms in a Mouse Model of Single Prolonged Stress and Conditioned Fear Possibly by Reversing BAG1

Radix Polygalae (RP) has been used to relieve psychological stress in traditional oriental medicine. Recently, cell protective, antiamnestic and antidepressant-like effects were disclosed but the possible application of RP to post-traumatic stress disorder, in which exaggerated fear memory persists, has not yet been explored. For this purpose, the effects of RP on fear behavior was examined in a mouse model of single prolonged stress and conditioned fear (SPS-CF), previously shown to mimic key symptoms of post-traumatic stress disorder. Male mice received daily oral dose of RP extract or vehicle during the SPS-CF procedure. Then fear-related memory (cohort 1, n=25), non-fear-related memory (cohort 2, n=38) and concentration-dependent effects of RP on fear memory (cohort 3, n=41) were measured in 3 separate cohort of animals. Also working memory and anxiety-like behaviors were measured in cohort 1. RP-treated SPS-CF mice exhibited attenuated contextual but not cued freezing and no impairments in the working memory and spatial reference memory performances relative to vehicle-treated SPS-CF controls. RP-treated SPS-CF and naive mice also demonstrated no difference in anxiety-like behavior levels relative to vehicle-treated SPS-CF and naive controls, respectively. In the hippocampus of SPS-CF mice, expression of BAG1, which regulates the activity of GR, was decreased, whereas RP increased expression of BAG1 in naïve and SPS-CF mice. These results suggest that RP exerts some symptomatic relief in a mouse with exaggerated fear response. RP and its molecular components may thus constitute valuable research targets in the development of novel therapeutics for stress-related psychological disorders.

The Effectiveness of Community-based Muscle and Joint Self Management Program for Older Adults

PURPOSE: The aim of this study was to determine the effectiveness of a community-based muscle and joint self-management program with muscle stretching and muscle strengthening exercises for community-dwelling older adults. METHODS: The study was a pre-and-post design in a single group, which examined the effects after the intervention of muscle and joint self-management program for 6 weeks, on the 42 subjects of the elderly who registered in a Community Senior Center in J city. Data analyses were conducted with paired t-test by using a SAS (version 9.2 for Windows) program. RESULTS: The effectiveness of muscle and joint self-management program on shoulder flexibility and right knee extension (flexibility) were significantly improved (t=2.72, p=.010; t=−2.26, p=.029). Joint symptoms (pain, stiffness), physical functioning, depression, fatigue, and left knee extension were not significantly improved after the muscle and joint self-management program. CONCLUSION: The results showed the possibility of this 6-week exercise program in improving shoulder and knee flexibility for community-dwelling older adults.