Understanding Yin-Yang Philosophic Concept Behind Tai Chi Practice.

Yin-yang theorizes that everything in the world is interoppositionally unified with 2 dynamic opposites (yin and yang), interrooted, interchangeable, and interconvertible. Tai chi (TC) movements and postures are essentially yin-yang concept-based. However, there is still a lack of understanding of yin-yang concepts and applications among people practicing TC. So, in this concept review, we aimed to provide basic understanding of the yin-yang concept and characteristics behind TC practice. Terms derived from the yin-yang concept in TC practice may include blood/qi (energy), stability/mobility, closing/opening moves, expiration/inspiration, solid/empty stance, and defensive/offensive hand movements and postures. These yin-yang attributes are interrestricted and dependent on maintaining a dynamic mind-body harmony. With the yin-yang application, TC can be considered a self-controlled balance perturbation exercise to challenge the stability-mobility (yin-yang) to a new level of harmony. As a health promotion holistic intervention, TC can facilitate the flow in blood/qi pathways or meridians to improve medical conditions. As an integrative mind-body exercise, TC can activate different body parts and brain regions to participate in and coordinate the combined physical and mental activities.

A home-based exercise program for children with congenital heart disease following interventional cardiac catheterization: study protocol for a randomized controlled trial.

BACKGROUND: Cardiac catheterization has opened an innovative treatment field for cardiac disease; this treatment is becoming the most popular approach for pediatric congenital heart disease (CHD) and has led to a significant growth in the number of children with cardiac catheterization. Unfortunately, based on evidence, it has been demonstrated that the majority of children with CHD are at an increased risk of "non-cardiac" problems. Effective exercise therapy could improve their functional status significantly. As studies identifying the efficacy of exercise therapy are rare in this field, the aims of this study are to (1) identify the efficacy of a home-based exercise program to improve the motor function of children with CHD with cardiac catheterization, (2) reduce parental anxiety and parenting burden, and (3) improve the quality of life for parents whose children are diagnosed with CHD with cardiac catheterization through the program. METHODS/DESIGN: A total of 300 children who will perform a cardiac catheterization will be randomly assigned to two groups: a home-based intervention group and a control group. The home-based intervention group will carry out a home-based exercise program, and the control group will receive only home-based exercise education. Assessments will be undertaken before catheterization and at 1, 3, and 6 months after catheterization. Motor ability quotients will be assessed as the primary outcomes. The modified Ross score, cardiac function, speed of sound at the tibia, functional independence of the children, anxiety, quality of life, and caregiver burden of their parents or the main caregivers will be the secondary outcome measurements. DISCUSSION: The proposed prospective randomized controlled trial will evaluate the efficiency of a home-based exercise program for children with CHD with cardiac catheterization. We anticipate that the home-based exercise program may represent a valuable and efficient intervention for children with CHD and their families. TRIAL REGISTRATION: http://www.chictr.org.cn/ on: ChiCTR-IOR-16007762 . Registered on 13 January 2016.

Differences in the Limits of Stability Between Older Rolling Walker Users and Older Single-Tip-Cane Users - A Preliminary Study.

PURPOSE: To identify the differences in the limits of stability (LOS) between older rolling walker and single-tip-cane users. DESIGN: This was a matched paired t-test design with repeated measure. METHODS: Eighteen older subjects were matched based on age, gender, and functional level. The subjects were assessed using the multidirectional reach test initially and 5-month later in four directions: forward, backward, leftward, and rightward. FINDINGS: Initially, there were no differences between cane users and rolling walker users in the LOS in all directions. However, 5-month later, the cane users who held their canes in their right hand had significantly better stability in forward and rightward reach than the walker users (p < .05). Further, the walker users demonstrated significantly decreased functional reach in forward reach (p < .05). CONCLUSION: Cane users might have better stability than walker users in the forward direction and in the direction toward the side holding the cane. This study may provide guide for clinicians including nurses for selecting appropriate rehabilitative interventions for older adults using walkers and canes.

Surface Projection of Interosseous Foramen of the Leg: Cadaver Study.

Purpose. This study was conducted to identify the surface projection of the interosseous foramen and associated structures of the proximal leg using the average clinician's thumb width as a quick measurement to assist in differential diagnosis and treatment. Methods. Twelve cadavers (5 males and 7 females, age range = 51-91 years, and mean age = 76.9) were dissected for analysis. Location and size of interosseous foramen, location of anterior tibial artery, location of deep fibular nerve, and corresponding arterial branches were measured and converted into thumb widths. Results. Mean thumb width measured among the cadavers was 17.94 ± 3.9 mm. The interosseous foramen measured was approximately 1 thumb width vertically (18.47 ± 3.0 mm) and 1/2 thumb width horizontally (7.32 ± 2.1 mm) and was located approximately 1 thumb width distally to the tibial tuberosity (20.81 ± 6.8 mm) and 2 thumb widths (37.47 ± 4.7 mm) lateral to the tibial ridge. The anterior tibial artery and deep fibular nerve converged approximately 4 thumb widths (74.31 ± 14.8 mm) inferior to the tibial tuberosity and 2 thumb widths (33.46 ± 4.9 mm) lateral to the tibial ridge. Conclusion. Clinicians may identify anatomical structures of the proximal leg with palpation using the thumb width for measurement.

A Cadaveric Investigation of the Dorsal Scapular Nerve.

Compression of the dorsal scapular nerve (DSN) is associated with pain in the upper extremity and back. Even though entrapment of the DSN within the middle scalene muscle is typically the primary cause of pain, it is still easily missed during diagnosis. The purpose of this study was to document the DSN's anatomy and measure the oblique course it takes with regard to the middle scalene muscle. From 20 embalmed adult cadavers, 23 DSNs were documented regarding the nerve's spinal root origin, anatomical route, and muscular innervations. A transverse plane through the laryngeal prominence was established to measure the distance of the DSN from this plane as it enters, crosses, and exits the middle scalene muscle. Approximately 70% of the DSNs originated from C5, with 74% piercing the middle scalene muscle. About 48% of the DSNs supplied the levator scapulae muscle only and 52% innervated both the levator scapulae and rhomboid muscles. The average distances from a transverse plane at the laryngeal prominence where the DSN entered, crossed, and exited the middle scalene muscle were 1.50 cm, 1.79 cm, and 2.08 cm, respectively. Our goal is to help improve clinicians' ability to locate the site of DSN entrapment so that appropriate management can be implemented.

Assessment of canes used by older adults in senior living communities.

The purpose of this cross-sectional study is to provide basic but essential information about how older cane users obtain their canes and how they use these canes for their daily mobility, since there is still lack of information on these areas. Ninety-three older (≥65 years old) subjects who use canes for daily activities were recruited from four assisted living facilities and five retirement centers for this cross-sectional study. The assessment involved interviewing cane users with a questionnaire, examining their canes, and investigating how these canes were used by their owners during ambulation. The commonly used canes are (from most to least): adjustable single-tip, un-adjustable (wooden), small quad, and large quad. Five major problems from data analysis were identified: lack of medical consultation for device selection/use, incorrect cane height/maintenance, placement of cane in improper hand, inability to maintain the proper reciprocal gait pattern, and improper posture during ambulation. Only forward-leaning posture during ambulation might be associated with increased falls among the older cane users. Knowledge of these problems could assist health professionals to implement appropriate interventions in clinical settings and to provide community service to address all problems related to cane use.

Assessment of rolling walkers used by older adults in senior-living communities.

AIM: Rolling walkers (RW) are among the most common ambulatory devices used in senior-living communities. However, many observational studies have associated RW use with an increased risk of falling. Studies on how older RW users obtain and use their RW are lacking. Therefore, this study's purpose was to provide information about RW use that can aid clinical professionals in understanding how to educate RW users. METHODS: Data was gathered from 158 RW users (>or=65 years old) who had used their RW for an approximate mean of 24 months. Assessment utilized questionnaires, inspections and demonstrations. RESULTS: Almost 80% of all participants obtained an RW without consultation with a medical professional (61% through their own means; 19% through medical professionals without receiving instruction or demonstration). The most common misuse was incorrect RW height (55%). Maintenance problems were observed in approximately 17% of the RW. All users admitted that their walkers had not been rechecked by medical professionals since they had obtained them. Forward-leaning posture was apparent in participants during static standing (40%) and during ambulation (50%). Forward-leaning posture during ambulation seemed to be more problematic in causing falls. CONCLUSION: Lack to consult a medical professional when obtaining an RW, incorrect RW height, poor RW maintenance and forward-leaning posture were problems commonly identified. This knowledge could assist medical professionals in implementing strategies to address these problems.

Comparison of gait characteristics between older rolling walker users and older potential walker users.

The purpose of this study was to investigate whether there are differences in gait parameters between true walker users and potential walker users during ambulation. Subjects consisted of 18 rolling walker (RW) users (true user group, TUG) and 15 RW non-users (potential user group, PUG). The older adults in the PUG had a history of at least one fall in the last 12 months or a non-surgery hospitalization in the last 3 months. All subjects traversed the GAITRitewalkway using a RW appropriately adjusted for the subject's height until three successful trials were obtained. The PUG performed three additional trials walking on the GAITRite walkway without RW assistance. Walking with a RW, the PUG users demonstrated decreased cadence, speed, swing time, step and stride length, and increased double support and stance time compared to walking without a RW. When comparing the TUG and PUG, both walking with a RW, the TUG subjects demonstrated decreased cadence, speed, swing time, step length and stride length, and increased double support and stance time. These results revealed that using a RW for ambulation might result in the user developing a gait pattern with a slower speed, smaller steps, increased stance time, and decreased swing time. The results seemed to indicate that this altered gait pattern may become more apparent the longer an individual uses a RW for ambulation assistance.