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1.
Transl Pediatr ; 11(5): 663-675, 2022 May.
Article in English | MEDLINE | ID: mdl-35685075

ABSTRACT

Background: Peer-mediated intervention (PMI) is an intervention that teaches normally developing peers to help children with autism spectrum disorder (ASD) actively participate in social interactions. Previous studies have shown that PMI applied to school settings is effective for children with ASD, but more multiple-baseline single-subject design. Many questions are still not clear due to the large clinical variability in children with ASD. This study investigated the effectiveness of PMI on social skills of children with ASD at varying symptom levels and analyzed the specific changes. Methods: This study used a randomized, single-blind, parallel-controlled design to analyze the effect of PMI in a hospital setting. Fifty-five children aged 4-12 years were diagnosed with ASD by clinicians using the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and stratified randomly allocated to either the experimental group or the control group using the envelope method. The experimental group utilized PMI, whereas the control group utilized behavioral therapy based on applied behavior analysis (ABA) [early intensive behavioral intervention (EIBI)]. This study primarily utilized the Social Responsiveness Scale (SRS) to evaluate the social performance of autistic children prior to and after the intervention. Results: Fifty-five participants were recruited and analyzed, the experimental group (n=29; mild to moderate n=18, severe n=11) and the control group (n=26; mild to moderate n=15, severe n=11). After the intervention, the experimental group's SRS score fell significantly more than the control group's (t=-3.918, P=0.000), d=-1.043; the mild to moderate subgroup experienced the same situation (H=17.811, P=0.009), d=-1.642. At the same time, the decline in social communication scores was significantly greater in the experimental group compared to the control group (t=-3.869, P=0.000), and the 95% confidence interval was -10.067 to -3.193. The social motivation of the mild-to-moderate subgroup of the experimental group (H=16.894, P=0.011), -3.000 (25th percentile, 75th percentile: -3.000, 0.000), and the behavioral patterns of autism (H=18.150, P=0.006), -3.000 (25th percentile, 75th percentile: -5.000, 0.000), the decreased value was significantly larger. Conclusions: PMI therapy can increase social motivation in children with mild to moderate ASD, minimize undesirable behavior patterns, effectively improve overall social skills and enhance effective social communication with others. Trial Registration: Chinese Clinical Trial Registry ChiCTR2100049185.

2.
BMC Geriatr ; 21(1): 731, 2021 12 24.
Article in English | MEDLINE | ID: mdl-34952569

ABSTRACT

BACKGROUND: Coronary heart disease (CHD), sarcopenia and depression are common disorders that markedly impair quality of life and impose a huge financial burden on society. They are also frequently comorbid, exacerbating condition and worsening prognosis. This study aimed to investigate the additive effects of CHD and sarcopenia on the risk of new onset depressive symptoms in older adults. METHODS: The prospective cohort study comprised 897 Chinese community-dwelling participants who were aged 60 years and older (386 men; mean age 66.9 ± 5.9 years) without depressive symptoms at baseline, recruited from Chadian of Tianjin, China. Sarcopenia was defined according to the Asian Working Group for Sarcopenia (AWGS) criteria. CHD was identified via medical records or new diagnosed by at least two physicians. Depressive symptoms were assessed using the Geriatric Depression Scale (GDS) ≥11. Longitudinal data on new onset depressive symptoms were collected up to 12 months after baseline. RESULTS: We found that 103 (11.5%) of the 897 participants without depressive symptoms at baseline had developed depressive symptoms. Participants were classified into mutually exclusive groups based on sarcopenia status and CHD: normal, CHD alone, sarcopenia alone, and co-occurring groups. A logistic regression showed that the CHD alone [odd ratios (OR) = 1.78, 95% confidence interval (CI) = 1.05-3.02], sarcopenia alone (OR = 2.79, 95% CI = 1.26-6.22), and co-occurring (OR = 7.19, 95% CI = 2.75-18.81) had higher risk of depressive symptoms than the normal group after adjusting for the covariates. CONCLUSIONS: CHD and sarcopenia synergistically increase the risk of new onset depressive symptoms in older adults. Thus, older adults may require early detection, and appropriate interventions should be implemented.


Subject(s)
Coronary Disease , Sarcopenia , Aged , Coronary Disease/diagnosis , Coronary Disease/epidemiology , Depression/diagnosis , Depression/epidemiology , Humans , Male , Middle Aged , Prospective Studies , Quality of Life , Sarcopenia/diagnosis , Sarcopenia/epidemiology
3.
Front Pharmacol ; 12: 643619, 2021.
Article in English | MEDLINE | ID: mdl-33995053

ABSTRACT

COVID-19 is a highly infectious respiratory virus, which can proliferate by invading the ACE2 receptor of host cells. Clinical studies have found that the virus can cause dyspnea, pneumonia and other cardiopulmonary system damage. In severe cases, it can lead to respiratory failure and even death. Although there are currently no effective drugs or vaccines for the prevention and treatment of COVID-19, the patient's prognosis recovery can be effectively improved by ameliorating the dysfunction of the respiratory system, cardiovascular systems, and immune function. Intermittent hypoxic preconditioning (IHP) as a new non-drug treatment has been applied in the clinical and rehabilitative practice for treating chronic obstructive pulmonary disease (COPD), diabetes, coronary heart disease, heart failure, hypertension, and other diseases. Many clinical studies have confirmed that IHP can improve the cardiopulmonary function of patients and increase the cardiorespiratory fitness and the tolerance of tissues and organs to ischemia. This article introduces the physiological and biochemical functions of IHP and proposes the potential application plan of IHP for the rehabilitation of patients with COVID-19, so as to provide a better prognosis for patients and speed up the recovery of the disease. The aim of this narrative review is to propose possible causes and pathophysiology of COVID-19 based on the mechanisms of the oxidative stress, inflammation, and immune response, and to provide a new, safe and efficacious strategy for the better rehabilitation from COVID-19.

4.
J Affect Disord ; 286: 71-77, 2021 05 01.
Article in English | MEDLINE | ID: mdl-33714172

ABSTRACT

BACKGROUND: Mild cognitive impairment (MCI) represents an intermediate state between normal cognitive aging and dementia. We aimed to investigate the association and mediation pathways of sarcopenia, including its individual components (muscle mass, muscle strength, and physical performance), and depressive symptoms with MCI in the older adults. METHODS: This study consisting of 1394 community-dwelling Chinese older adults aged 60 years and older in Tianjin and Shanghai, China. Sarcopenia was defined according to the Asian Working Group for Sarcopenia (AWGS) criteria. Depressive symptoms were evaluated by the 30-item Geriatric Depression Scale (GDS). Cognitive function was assessed by Mini-Mental State Examination (MMSE), the Chinese version of the Dementia Rating Scale (CDRS) was used to apply the diagnostic of non-dementia, and instrument activities of daily living (IADL) were used to evaluate daily living activities. Logistic regression and mediation analyses fully adjusted for all potential confounding factors were conducted. RESULTS: Sarcopenia, handgrip strength, gait speed, and depressive symptoms were associated with MCI. Furthermore, depressive symptoms significantly mediated the association of sarcopenia, handgrip strength, and gait speed with cognitive function. The relationship of depressive symptoms and cognition were also mediated by sarcopenia, handgrip strength, and gait speed. LIMITATIONS: This is a cross-sectional study. CONCLUSIONS: Our findings suggest that sarcopenia may contribute substantially to the development of MCI in the older adults via depressive symptoms, although the reverse may also be true. These findings may help guide clinicians to better diagnose and manage MCI in the context of concomitant sarcopenia and depressive symptoms.


Subject(s)
Cognitive Dysfunction , Sarcopenia , Activities of Daily Living , Aged , China/epidemiology , Cognitive Dysfunction/epidemiology , Cross-Sectional Studies , Depression/epidemiology , Geriatric Assessment , Hand Strength , Humans , Independent Living , Middle Aged , Sarcopenia/epidemiology
5.
Trials ; 20(1): 306, 2019 May 29.
Article in English | MEDLINE | ID: mdl-31142359

ABSTRACT

BACKGROUND: Total knee arthroplasty (TKA) is an optimal option for patients with middle-to-end-stage knee osteoarthritis. However, the management of postoperative acute pain remains inefficient. Transcutaneous electrical acupoint stimulation (TEAS) is a nonpharmacological method to manage postoperative acute pain. Different frequencies of TEAS have been tested using varying parameters, but the optimal analgesic frequency remains controversial. The aim of this study was to explore the optimal analgesic frequency of TEAS for treating acute pain after the primary unilateral TKA. METHODS/DESIGN: This is a double-blind, randomized controlled trial. A total of 156 patients are randomly assigned to: G1, 5 Hz TEAS; G2, 100 Hz TEAS; G3, mixed TEAS (alternative use of daily 5 Hz and 100 Hz TEAS) and G4, placebo TEAS. In the G1, G2 and G3 groups, TEAS is conducted at acupoints SP9 and GB34 of the leg that was operated on (at a wave of continuous, balanced and asymmetrical biphasic square, with a pulse width of 200 µs, and a strong but comfortable current) for 30 min prior to a 30-min rehabilitation session per day for 2 weeks. In G4 group, TEAS is delivered at a strong but comfortable current for 30 s, then the current is gradually decreased to none over the next 15 s. The primary outcomes are measured before surgery, at baseline (POD 3, before TEAS intervention), week 1 and 2 after TEAS intervention with the Numeric Pain Rating Scale and The American Knee Society Score. The secondary outcomes include: (1) Active range of motion of the knee that was operated on; (2) Surface electromyography of both quadriceps; (3) Modified 30-s sit to stand test; (4) Additional usage of analgesia; and (5) SF-36. The additional outcomes include: (1) Patients' satisfaction rate; (2) Patient's expectation rate; and (3) Incidence of analgesia-related side effects. To test the blinding of participants and assessors, they are asked to guess whether the subjects received active or placebo TEAS within 5 min after the latest intervention. The safety and financial cost of TEAS are assessed. DISCUSSION: Mixed TEAS has more favorable effect on acute pain control than the placebo or 5 Hz or 100 Hz TEAS. TRIAL REGISTRATION: ChiCTR1800016347 . Date of registration was 26 May 2018. Retrospectively registered.


Subject(s)
Acute Pain/therapy , Arthroplasty, Replacement, Knee , Pain, Postoperative/therapy , Randomized Controlled Trials as Topic , Transcutaneous Electric Nerve Stimulation/methods , Acupuncture Points , Double-Blind Method , Electromyography , Humans , Outcome Assessment, Health Care , Range of Motion, Articular
6.
Zhongguo Zhen Jiu ; 38(3): 234-8, 2018 Mar 12.
Article in Chinese | MEDLINE | ID: mdl-29701038

ABSTRACT

OBJECTIVE: On the basic therapy, to assess the clinical effects of dynamic scalp acupuncture, scalp acupuncture combined with proprioceptive neuromuscular facilitation (PNF) therapy and simple PNF therapy for upper limb motor impairment in ischemic post-stroke spastic hemiplegia. METHODS: A total of 90 cases were randomly assigned into a PNF group, a dynamic scalp acupuncture group and a scalp acupuncture group, 30 cases in each group. Basic therapy and PNF therapy were applied in the three groups. PNF therapy was used during scalp acupuncture in the dynamic scalp acupuncture group. PNF therapy was applied after scalp acupuncture in the scalp acupuncture group. The points were the upper 1/5 and middle 2/5 of Dingnieqianxiexian (MS 6) and Dingniehouxiexian (MS 7) at the lesion side, the hemiparalysis contralateral side. The treatment was given for 6 months, once a day and 1 month as a course. The modified Ashworth scale (MAS), the Fugl-Meyer motor assessment (FMA) and Barthel index (BI) were observed before treatment and 2 weeks, 1 month, 3 months, and 6 months after treatment. RESULTS: The MAS 1 month, 3 months and 6 months after treatment were improved compared with those before treatment in the three groups ( all P<0.05), and the MAS results in the dynamic scalp acupuncture group were better than those in the PNF and scalp acupuncture group (all P<0.05). The FMA and BI scores 1 month, 3 months and 6 months after treatment were higher than those before treatment (all P<0.05). The FMA Scores in the 3 time points and after treatment in the dynamic scalp acupuncture group were higher than those in the other two groups (all P<0.05). CONCLUSION: PNF therapy during scalp acupuncture can relieve the spasmodic condition of patients with upper limb motor impairment in ischemic post-stroke spasmodic hemiplegia, and improve the limb function and life activity, which is better than PNF therapy after scalp acupuncture and simple PNF therapy.


Subject(s)
Acupuncture Therapy , Brain Ischemia/complications , Hemiplegia/therapy , Stroke/complications , Brain Ischemia/rehabilitation , Combined Modality Therapy , Hemiplegia/rehabilitation , Humans , Scalp , Stroke Rehabilitation , Treatment Outcome
7.
J Healthc Eng ; 2017: 7056469, 2017.
Article in English | MEDLINE | ID: mdl-29065637

ABSTRACT

PURPOSE: With the aim of investigating the spatiotemporal features of early gait pattern and knee kinematics after total knee arthroplasty and analyzing the association between outcomes of gait analyses and knee kinematic parameters, the relationship between walking and dynamic knee deformity at the early period after total knee arthroplasty was assessed in this study. METHODS: Eighteen patients including 14 women and 4 men who underwent total knee arthroplasty were analyzed using three-dimensional gait analysis system to observe gait parameters and values of maximum knee flexion angle (MKFA) during swing phase and knee flexion angle (KFA) and knee valgus angle (KVA) at midstance phase. RESULTS: 3D gait analysis showed that operated side exhibited significantly less total support time and single support time as well as significantly longer swing phase compared with the other side. During walking, the operated side had significantly smaller MKFA and greater KFA and KVA than the nonoperated side. There was moderate to significant correlation between gait pattern and the dynamic knee kinematics. CONCLUSION: The gait abnormality of patients after TKA was associated with inadequate flexion of knees at swing phase and insufficient extension at stance phase as well as increased range of valgus.


Subject(s)
Arthroplasty, Replacement, Knee , Gait , Knee/physiology , Walking , Aged , Biomechanical Phenomena , Data Interpretation, Statistical , Female , Humans , Imaging, Three-Dimensional , Knee/physiopathology , Knee Joint/physiology , Knee Joint/physiopathology , Male , Middle Aged , Osteoarthritis, Knee/surgery , Range of Motion, Articular
8.
Int J Mol Sci ; 17(12)2016 Dec 06.
Article in English | MEDLINE | ID: mdl-27929425

ABSTRACT

To investigate whether the coexistence of hypertension and ovariectomy will increase cardiac Fas receptor and mitochondrial-dependent apoptotic pathways, histopathological analysis, the TUNEL assay and Western blotting were performed on the excised hearts from three groups of female spontaneously hypertensive rats (SHR), which were divided into a sham-operated group (SHR-Sham), bilaterally ovariectomized group (SHR-OVX) and normotensive Wistar Kyoto rats (WKY). Compared with the WKY group, the SHR-Sham group exhibited decreased protein levels of ERα, ERß, p-Akt/Akt, Bcl-2, Bcl-xL and p-Bad and decreased further in the SHR-OVX group, as well as protein levels of t-Bid, Bak, Bad, Bax, cytochrome c, activated caspase-9 and activated caspase-3 (mitochondria-dependent apoptosis) increased in the SHR-Sham group and increased further in the SHR-OVX group. Compared with the WKY group, protein levels of Fas ligand, TNF-α, Fas death receptors, TNFR1, FADD and activated caspase-8 (Fas receptor-dependent apoptosis) increased in the SHR-Sham group, but did not increase in the SHR-OVX group, except Fas ligand and TNF-α. The coexistence of hypertension and ovariectomy attenuated the estrogen receptor survival pathway and appeared to additively increase the cardiac mitochondria-dependent, but not the Fas receptor-dependent apoptosis pathway, which might provide one possible mechanism for the development of cardiac abnormalities in hypertensive postmenopausal women.


Subject(s)
Apoptosis/physiology , Hypertension/complications , Myocardium/pathology , Ovariectomy/adverse effects , Animals , Blood Pressure/physiology , Caspase 3/metabolism , Caspase 9/metabolism , Female , Myocardium/metabolism , Rats , Rats, Inbred SHR , Rats, Wistar , Tumor Necrosis Factor-alpha/metabolism , fas Receptor/metabolism
9.
Zhongguo Gu Shang ; 29(9): 866-869, 2016 Sep 25.
Article in Chinese | MEDLINE | ID: mdl-29282961

ABSTRACT

With the aging of the population, the incidence of knee osteoarthritis (KOA) is increasing year by year. Exercise is one of the none medicine therapies in KOA rehabilitation. When making proper KOA exercise prescription, it's necessary to consider about the mechanisms involved in the interaction between exercise and articular cartilage, and obey the principle of choosing right programs, moderate frequency and intensity avoiding the injury of articular cartilage. The standard of KOA sport prescription is still controversial, so the mechanisms involved in the effect of aerobic exercise on protecting and damaging the articular cartilage need further research.


Subject(s)
Cartilage, Articular , Exercise Therapy , Exercise , Osteoarthritis, Knee/rehabilitation , Humans
10.
Zhongguo Zhen Jiu ; 34(11): 1067-72, 2014 Nov.
Article in Chinese | MEDLINE | ID: mdl-25675562

ABSTRACT

OBJECTIVE: To optimize the therapeutic programs for periarthritis of shoulder treated with acupuncture, moxibustion and kinetohterapy with orthogonal design method adopted. METHODS: The orthogonal design table of L8 (2(7)) hierarchical principle was used to randomly divide 192 patients of periarthritis of shoulder into 8 groups, 24 cases in each one. Separately, 4 factors and each different 2 levels were adopted in treatment, named acupuncture timing (factor A: A, acute stage, A2 adhesion stage), acupoint combination (factor B: B, local acupoints, B2 local acupoints and distal acupoints along meridians), filiform needling and warm needling therapy (factor C: C1 acupuncture with filiform needle, CZ acupuncture with filiform needle and warm needling therapy) and positive functional exercise (factor D: D1 without positive functional exercise, D2 with positive functional exercise). The treatment was given once a day, 10 treatments made one session and 2 sessions were required totally. The time points of observation were the point after 1 session of treatment and after 2 sessions of treatment. The short-form McGill pain questionnaire (MPQ) and shoulder joint motor disturbance score were adopted for evaluation. RESULTS: In the orthogonal design analysis, taking the hierarchical factors into consideration, the age was considered as the main factor in the evaluation of shoulder pain and shoulder motor disturbance (P<0.01), and the shoulder function grade apparently impacted pain evaluation and the efficacy on shoulder motor disturbance (P<0.01). The best combination of 4 factors and 2 levels were A1B1CzD2 and A2BC2D2. SAS statistical analysis showed that at acute stage and adhesion stage, CZ Dz , meaning acupuncture with fifiform needling and warm needling therapy combined with positive functional exercise, is the main factor of the improvements of shoulder motor function (P<0.05). CONCLUSION: For periarthritis of shoulder at acute stage, the combined therapy of acupuncture at local acupoints, warm needling and positive functional exercise is adopted. At chronic stage, the combined therapy of acupuncture at local acupoints and distal acupoints, acupuncture with filiform needle and warm needling and positive functional exercise is the best program. Additionally, in clinical treatment, the patients' age, sex, shoulder joint function and duration of treatment should be considered comprehensively for the impacts on the efficacy.


Subject(s)
Acupuncture Therapy , Exercise Therapy , Moxibustion , Periarthritis/therapy , Shoulder Pain/therapy , Acupuncture Points , Adult , Aged , Combined Modality Therapy , Female , Humans , Male , Middle Aged
11.
Zhongguo Gu Shang ; 24(3): 266-8, 2011 Mar.
Article in Chinese | MEDLINE | ID: mdl-21485585

ABSTRACT

Osteoarthritis (OA) is a kind of degenerative disease characterized by hyperosteogeny at the joint margins and articular cartilage degeneration. Mechanical stress can regulate the multiple functions of cells. The integrin as one of the mechanoreceptors on the surface of cells, mainly mediated adhesion between cells and extracellular matrix, which plays an important role in the mechanical signal transmission to regulate the physiological functions of cell. Therefore, it is very important to select proper mechanical stimulation (such as naprapathy) in the early and middle stage of osteoarthritis, which regulate the expression of integrins to affect the function of chondrocytes, repair the damaged chondrocyte and delay the articular cartilage degeneration.


Subject(s)
Chondrocytes/metabolism , Gene Expression Regulation , Integrins/metabolism , Mechanical Phenomena , Protein Subunits/metabolism , Animals , Biomechanical Phenomena , Chondrocytes/cytology , Chondrocytes/pathology , Humans
12.
Zhongguo Zhen Jiu ; 27(12): 914-6, 2007 Dec.
Article in Chinese | MEDLINE | ID: mdl-18271237

ABSTRACT

Acupuncture anesthesia (AA) appeared in 1950s. It originates with Chinese TCM researchers and is one of important achievements of modern medicine. AA was developed vigorously and applied widely between 1960s-1970s. Due to the objective and subjective reasons, clinical application and research of AA in recent 20 years have developed very little. The paper reviews the formation and development processes of AA, analyzes the advantages and mechanisms of AA and its problems, then provides the feasible advice for the development of AA.


Subject(s)
Acupuncture Analgesia , Humans
13.
Zhong Xi Yi Jie He Xue Bao ; 2(6): 432-4, 2004 Nov.
Article in Chinese | MEDLINE | ID: mdl-15539021

ABSTRACT

OBJECTIVE: To study the etiological factors of knee osteoarthritis and to provide the anatomical basis of corrective therapy for knee joint deformity by comparing the biomechanical differences of the knee joints between the osteoarthritis patients and the normal people. METHODS: The sexes, ages, heights, weights, painful characters and accompanied symptoms were recorded, and the femoral angle, tibial angle, femorotibial angle, joint space angle, and the height and width of condylus medialis and lateralis were measured for 29 selected knee osteoarthritis patients. And the biomechanical data of the patients were compared with those of the 19 normal people. RESULTS: The femoral angle of the osteoarthritis patients was smaller and the joint space angle was greater statistically than that of the normal people, and the ratios of height and width of condylus medialis and condylus lateralis of the osteoarthritis patients were greater than those of the normal people. CONCLUSION: In the patients, the gravity line of the lower limb inclines to the condylus medialis, so the condylus medialis is more vulnerable. And the configuration of the condylus of the patients, which is narrower and longer, is different from that of the normal people. It may be one of the etiological factors of knee osteoarthritis.


Subject(s)
Osteoarthritis, Knee/pathology , Radiography , Adult , Aged , Aged, 80 and over , Biomechanical Phenomena , Female , Femur Head/diagnostic imaging , Femur Head/pathology , Humans , Knee Joint/diagnostic imaging , Knee Joint/pathology , Knee Joint/physiopathology , Male , Middle Aged , Osteoarthritis, Knee/physiopathology , Tibia/diagnostic imaging , Tibia/pathology
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