Predictors for Failed Removal of Nasogastric Tube in Patients With Brain Insult.

OBJECTIVE: To construct a prognostic model for unsuccessful removal of nasogastric tube (NGT) was the aim of our study. METHODS: This study examined patients with swallowing disorders receiving NGT feeding due to stroke or traumatic brain injury in a regional hospital. Clinical data was collected, such as age, sex, body mass index (BMI), level of activities of daily living (ADLs) dependence. Additionally, gather information regarding the enhancement in Functional Oral Intake Scale (FOIS) levels and the increase in food types according to the International Dysphagia Diet Standardization Initiative (IDDSI) after one month of swallowing training. A stepwise logistic regression analysis model was employed to predict NGT removal failure using these parameters. RESULTS: Out of 203 patients, 53 patients (26.1%) had experienced a failed removal of NGT after six months of follow-up. The strongest predictors for failed removal were age over 60 years, underweight BMI, total dependence in ADLs, and ischemic stroke. The admission prediction model categorized patients into high, moderate, and low-risk groups for removal failure. The failure rate of NGT removal was high not only in the high-risk group but also in the moderate-risk groups when there was no improvement in FOIS levels and IDDSI food types. CONCLUSION: Our predictive model categorizes patients with brain insults into risk groups for swallowing disorders, enabling advanced interventions such as percutaneous endoscopic gastrostomy for high-risk patients struggling with NGT removal, while follow-up assessments using FOIS and IDDSI aid in guiding rehabilitation decisions for those at moderate risk.

Lower Back Pain Heralding Cauda Equina Syndrome in a Patient With Achondroplasia.

Achondroplasia is the most common cause of congenital dwarfism and is associated with multiple complications due to impaired skeletal development. Herein, we report a 21-year-old woman with achondroplasia experiencing lower back pain which progressed to lower limb weakness and urinary retention. Magnetic resonance imaging revealed decreased interpedicular distance and severe stenosis of the lumbosacral spinal canal. Cauda equina syndrome was diagnosed and she underwent laminectomy. After decompression, pain, muscle strength and bladder function improved significantly. This case highlights the importance of early recognition of spinal compression in patients with achondroplasia.

Ergogenic Effects of Green Tea Combined with Isolated Soy Protein on Increasing Muscle Mass and Exercise Performance in Resistance-Trained Mice.

It is well known that supplementation with high protein after exercise can effectively promote muscle synthesis and repair, while green tea is rich in catechins that have antioxidant effects. We aimed to explore the effects of green tea combined with isolated soy protein on increase muscle mass in resistance-trained mice. A total of 32 male ICR mice (8-weeks old) were divided into four groups (n = 8/group), sedentary control group (SC), isolated soy protein with green tea group (ISPG), resistance training group (RT), isolated soy protein and green tea combine with resistance training group (ISPG + RT). All mice received control or ISPG by oral gavage for four consecutive weeks. Forelimb grip and exhaustive swimming time were used for exercise performance evaluation. In biochemical profile, we analyzed lactate, ammonia, blood urea nitrogen (BUN), and glucose and muscle damage index creatine kinase (CK) after exercise as biochemical parameters of exercise fatigue. The grip strength, muscular endurance, and exhaustive swimming time of the ISPG + RT group were significantly increased than other groups (p < 0.05), and also significantly decreased in serum lactate and ammonia levels (p < 0.05, respectively). The ISP + RT group was not only increased in quadriceps weight, (p < 0.05) but also decreased EFP (p < 0.05). We recommend using a 4-week supplementation with ISPG, combined with RT, to increase muscle mass, exercise performance, glycogen storage, and reduce fatigue biochemical parameters after exercise. The benefits of long-term supplementation or application to human supplementation can be further explored in the future.

Gender differences of the improvement in balance control based on the real-time visual feedback system with smart wearable devices.

PURPOSE: The body maintains stability by integrating inputs from the central nervous system of vision, hearing, proprioception, and multiple senses. With the development of smart wearable devices, smart wearable devices can provide real-time center of pressure position-assisted balance control, which is beneficial to maintain physical balance. METHODS: Forty healthy college students (20 male, 20 female) participated in this study, and the posture balance actions of left-leg stance non-visual feedback, left-leg stance visual feedback, right-leg stance non-visual feedback, and right-leg stance visual feedback were performed. Visual feedback provided smart insoles matching Podoon APP on a tablet computer with the COP position displayed by a dot as real-time visual feedback. RESULTS: The experimental results show that the displacement, velocity, radius, and area of the COP decreased significantly in the left-leg stance visual feedback/ right-leg stance visual feedback, the test compared the parameters in the left-leg stance non-visual feedback/right-leg stance nonvisual feedback (P < 0.05). Providing visual feedback through intelligent insoles can reduce the movement of the center of mass and maintain physical stability for healthy young people of different genders. In the one leg visual/non-visual in standing, the COP maximum anteroposterior displacement, COP anteroposterior velocity, COP radius, and COP area in women are significantly smaller than in men (P < 0.05). Women have better real-time balance control ability than men with smart insoles. CONCLUSIONS: The simple intelligent wearable assisted devices can immediately increase the control ability in static stance of men and women, and women have better real-time balance control ability than men.

Application of Real-Time Visual Feedback System in Balance Training of the Center of Pressure with Smart Wearable Devices.

Balance control with an upright posture is affected by many factors. This study was undertaken to investigate the effects of real-time visual feedback training, provided by smart wearable devices for COP changes for healthy females, on static stance. Thirty healthy female college students were randomly divided into three groups (visual feedback balance training group, non-visual feedback balance training group, and control group). Enhanced visual feedback on the screen appeared in different directions, in the form of fluctuations; the visual feedback balance training group received real-time visual feedback from the Podoon APP for training, while the non-visual feedback balance training group only performed an open-eye balance, without receiving real-time visual feedback. The control group did not do any balance training. The balance training lasted 4 weeks, three times a week for 30 min each time with 1-2 day intervals. After four weeks of balance training, the results showed that the stability of human posture control improved for the one leg static stance for the visual feedback balance training group with smart wearable devices. The parameters of COP max displacement, COP velocity, COP radius, and COP area in the visual feedback balance training group were significantly decreased in the one leg stance (p < 0.05). The results showed that the COP real-time visual feedback training provided by smart wearable devices can better reduce postural sway and improve body balance ability than general training, when standing quietly.

Effect of Ambulance Stretcher Bed Height Adjustment on CPR Quality and Rescuer Fatigue in a Laboratory Environment.

Background: The quality of cardiopulmonary resuscitation (CPR) is closely related to the survival rate of a patient, and it is crucial to maintain the quality of CPR during the ambulance journey to the receiving hospital. The purpose of this study was to investigate the effects of different stretcher bed heights on operator CPR quality. Methods: In this randomized crossover trial, 16 male emergency medical technicians-paramedics (EMT-Ps) performed continuous chest compressions on a hemimorphic mannequin for 5 minutes, alternating between the current height of the stretcher bed on the ambulance (38 ± 1 cm) (S-38) and the height of the participant's midpoint of the patella (S-knee), where the stretcher bed surface is. Results: According to the analysis of the quality of CPR exercises with two different stretcher bed heights at 5 minutes of continuous chest compression, the mean chest compression depth (CCD) of the S-38 position (53.81 ± 1.91 cm) was significantly lower than that of the S-knee (55.12 ± 2.03 cm; p < 0.001). The mean chest compression rate (CCR) of the S-38 position (111.44 ± 3.44 beats/min) was significantly higher than that of the S-knee (109.63 ± 4.46 beats/min; p = 0.027). The mean of total chest compressions (TCC) of the S-38 position (557.44 ± 16.81 times) was significantly higher than that of the S-knee (548.24 ± 19.40 times; p = 0.029). The rating of perceived exertion (RPE) of the S-38 position was significantly higher than that of the S-knee (12.75 ± 1.91 %; p = 0.015). Only the chest compression rebound rate (CCRR) (S-38: 97.56 ± 4.63 % vs. S-knee: 98.31 ± 1.89 %, p = 0.401) and the chest compression fraction (CCF) (S-38: 98.44 ± 0.81 % vs. S-knee: 98.44 ± 0.96 %, p = 1.000) did not reach a significant difference. Conclusion: When a resuscitator is performing chest compressions in a standing position in an ambulance, the excessive downward leaning of the resuscitator's upper body affects CPR quality and increases fatigue. This study has verified that setting the stretcher bed of the ambulance at the knee height of the EMTs provides better CPR quality and lower fatigue.

Effect of Acupuncture on Timeliness of Male Shoulder Joint Endurance.

Acupuncture as a traditional and commonly used treatment has been used to improve the performance of athletes. In the improvement of female shoulder joint explosive force and muscle endurance also has an immediate effect. However, whether the effect of acupuncture therapy can be maintained after improving athletic performance still worth further discussion. The purpose of this study was to explore the timeless of the physical neurophysiological response induced by acupuncture at specific acupoints in improving endurance performance. Seventeen healthy male participants completed six groups of shoulder joint isokinetic exercises. The isokinetic exercise completed in the first group was taken as the baseline. After acupuncture for 15 min, the following 5 isokinetic experiments were completed. Acupuncture acupoints included Binao (LI14), Jianliao (SJ14), Naohui (SJ13), Zhongfu (LU1), Xiabai (LU4), Tianfu (LU3) and Xiaoluo (SJ12). The results show that acupuncture can improve physical performance for 10-20 min. After acupuncture, the maximum torque, average power, average work and total work values significantly increased (p < 0.05). Stimulation of acupoints can effectively improve the performance of periarticular muscle endurance around the shoulder, but this improvement is limited by time.

Effect of Acupuncture on the Timeliness of Explosive Forces Generated by the Male Shoulder Joint.

Athletes aim to improve muscle strength to optimize sports performance and gain a competitive edge. Although modern sports medicine includes rehabilitation treatment methods for improving the explosive force of athletes, including acupuncture, a common alternative therapy, research on the effectiveness of acupuncture in improving the timeliness of explosive forces is limited. There is uncertainty regarding how long the effects of acupuncture treatment persist after treatment. Therefore, the purpose of this study was to explore the effect of acupuncture on the timeliness of explosive forces generated by the male shoulder joint. Eighteen healthy men underwent tests of shoulder adduction/abduction (Add/Abd) and flexion/extension (Flex/Ext) through an isokinetic measurement system. Acupuncture was used to stimulate LU1 (Zhongfu), LU3 (Tianfu), LU4 (Xiabai), LI14 (Binao), SJ13 (Naohui), SJ14 (Jianliao), and SJ12 (Xiaoluo), and the isokinetic parameters were recorded before and after acupuncture. After acupuncture, isokinetic muscle force parameters including the maximum (Max) torque, the average power, the average peak power, the average work, and the total work increased significantly (P < 0.05), whereas the average max torque Abd/Flex did not. Additionally, the preintervention values of the shoulder joints for Add/Abd and Flex/Ext were significantly greater than those at post 1 and post 2 (P < 0.05). The isokinetic results suggest that acupuncture can increase the explosive force of the male shoulder joint Add/Abd and Flex/Ext. Muscle cannot be fully activated when calcium saturation is below the maximal level. In this case, the postactivation potentiation (PAP) may enhance voluntary muscle force production. The effect of acupuncture is time-dependent, that is, the effects of acupuncture gradually weaken and disappear by approximately 10 minutes after acupuncture. Therefore, we suggest that acupuncture is used as an alternative therapy in sports competitions to increase the explosive forces of the shoulder joint, thereby improving sports performance.

Influences of Different Drop Height Training on Lower Extremity Kinematics and Stiffness during Repetitive Drop Jump.

Drop jump (DJ) is often used as a plyometric exercise to improve jumping performance. Training from improper drop heights and for improper durations lead to unfavorable biomechanical changes in the lower extremities when landing, which result in reduced training effects and even lower extremity injuries. Purpose. To study the effects of repeated DJ training at drop heights of 30 cm, 40 cm, and 50 cm (drop jump height (DJH) 30, DJH40, and DJH50) on lower extremity kinematics and kinetics. The 1st, 50th, 100th, 150th, and 200th DJs (DJ1, DJs50, DJs100, DJs150, and DJs200) were recorded by using a BTS motion capture system and force platform. The MATLAB software was used to compare the kinematic and stiffness data of DJ1, DJs50, DJs100, DJs150, and DJs200 with one-way ANOVA repeated measure. If there were significant differences, the LSD method was used for post hoc comparisons. Methods. Twenty healthy male Division III athlete volunteers were selected as subjects, and 200 drop jumps (DJs200) were performed from DJH30, DJH40, and DJH50. Results. The jumping height (JH), contact time (CT), and GRF increased with drop height, and the stiffness of the legs and ankle at DJH30 was higher than that at DJH40 and DJH50 (p < 0.05). Conclusion. Within DJs200, training at DJH50 yield the high impact easily leads to lower extremity injury; training at DJH30 can increase the stiffnesses of the legs and ankle joints, thus effectively utilizing the SSC benefits to store and release elastic energy, reducing the risk of lower extremity musculoskeletal injury. Therefore, coaches can choose different drop heights and training quantities for each person to better prevent lower extremity injury.

The effects of different types of aquatic exercise training interventions on a high-fructose diet-fed mice.

Gradual weight gain in modern people and a lowering onset age of metabolic disease are highly correlated with the intake of sugary drinks and sweets. Long-term excessive fructose consumption can lead to hyperglycemia, hyperlipidemia and accumulation of visceral fat. Abdominal obesity is more severe in females than in males. In this study, we used a high-fructose-diet-induced model of obesity in female mice. We investigated the effects of aquatic exercise training on body weight and body composition. After 1 week of acclimatization, female ICR mice were randomly divided into two groups: a normal group (n=8) fed standard diet (control), and a high-fructose diet (HFD) group (n=24) fed a HFD. After 4 weeks of induction followed by 4 weeks of aquatic exercise training, the 24 obese mice were divided into 3 groups (n=8 per group): HFD with sedentary control (HFD), HFD with aquatic strength exercise training (HFD+SE), and HFD with aquatic aerobic exercise training (HFD+AE). We conducted serum biochemical profile analysis, weighed the white adipose tissue, and performed organ histopathology. After 4 weeks of induction and 4 weeks of aquatic exercise training, there was no significant difference in body weight among the HFD, HFD+SE and HFD+AE groups. Serum triglyceride (TG), AST, ALT, and uric acid level were significantly lower in the HFD+SE and HFD+AE groups than in the HFD group. The weight of the perirenal fat pad was significantly lower in the HFD+AE group than in the HFD group. Hepatic TG and total cholesterol (TC) were significantly lower in the HFD+AE group than in the other groups. Long-term intake of a high-fructose diet can lead to obesity and increase the risk of metabolic disease. Based on our findings, we speculate that aquatic exercise training can effectively promote health and fitness. However, aquatic aerobic exercise training appears to have greater benefits than aquatic strength exercise training.

Effects of Acupuncture on Explosive Force Production by the Healthy Female Shoulder Joint.

BACKGROUND: Acupuncture is often used to treat chronic conditions, such as pain. In recent years, given the importance of the explosive forces generated by shoulder muscles for the completion of motor tasks, studies in which nerves were stimulated through acupuncture to increase the explosive forces were conducted. This study explored the effect of acupuncture on explosive force production by the muscles of the female shoulder joint. METHODS: Eighteen healthy women underwent shoulder adduction (Add), abduction (Abd), flexion (Flex), and extension (Ext) tests with an isokinetic measurement system. Acupuncture was used to stimulate the Zhongfu (LU1), Tianfu (LI3), Xiabai (LU4), Binao (LI14), Naohui (SJ13), Jianliao (SJ14), and Xiaoluo (SJ12) points, and electromyography (EMG) signals were recorded before and after acupuncture. RESULTS: After acupuncture, there was a significant difference in the average maximum work, the average maximum power, the average maximum speed, the total work in Add/Abd and Flex/Ext, the EMG signals, and the stiffness of the muscles in Abd and Ext (P < 0.05). There were no significant differences in the average maximum torque in Abd or Flex. CONCLUSION: Based on the results, there may be a significant correlation between the manipulation of different acupoints by acupuncture and the average maximum torque and stiffness. Acupuncture may stimulate nerves to activate muscles and induce a postactivation potentiation effect that improves explosive force production. Therefore, acupuncture as an auxiliary tool may increase the explosive forces generated by acupoint-related muscles by stimulating nerves.

Effect of Coriolus versicolor Mycelia Extract on Exercise Performance and Physical Fatigue in Mice.

In this study, Coriolus versicolor mycelia (CVM) was evaluated the ergogenic and anti-fatigue activities. Male ICR mice were divided into four groups (n = 8/group) to receive vehicle or CVM by oral gavage for 4 weeks at 0, 615, 1230 or 3075 mg/kg/day, which were respectively designated the vehicle, CVM-1X, CVM-2X and CVM-5X groups. Forelimb grip strength, endurance swimming time, and levels of physical fatigue-associated parameters serum lactate, ammonia, glucose and creatine kinase (CK) after physical challenge were performed to evaluate exercise performance and anti-fatigue activity. Results revealed that the forelimb grip strength of mice in group CVM-1X, CVM-2X and CVM-5X were significantly increased by 1.20-, 1.18- and 1.23-fold, respectively, compared to the vehicle group. After the 15 minute swimming exercise, the levels of serum lactate of CVM-1X, CVM-2X and CVM-5X groups were significantly lower than the vehicle control group by 29%, 23% and 31%, respectively. The levels of ammonia in CVM-1X, CVM-2X and CVM-5X groups were significantly lowered by 22%, 25% and 41%, respectively, compared to the vehicle control group. In addition, the levels of serum CK in CVM-2X and CVM-5X groups were significantly lowered by 13% and 11%, respectively, compared to the vehicle control group. Accordingly, the supplementation with CVM has beneficial effects on performance improvement and anti-fatigue activity, and thus has great potential as a source for natural health products.

Effect of burdock extract on physical performance and physiological fatigue in mice.

Burdock (BD) is a common vegetable with many pharmacological properties. However, few studies have examined the effect of BD on exercise performance and physical fatigue. We aimed to evaluate the potential beneficial effects of BD on fatigue and ergogenic functions following physical challenge in mice. METHODS: Male ICR mice were divided into four groups to receive either vehicle, or BD at 348.5, 697 or 1,742.5 mg/kg/day, by daily oral gavage for 4 weeks. Exercise performance and fatigue were evaluated from forelimb grip strength, exhaustive swimming time, and post-exercise levels of physical fatigue-related biomarkers serum lactate, ammonia, glucose, and creatine kinase (CK). RESULTS: BD supplementation elevated endurance and grip strength in a dose-dependent manner. It also significantly decreased lactate, ammonia, and CK levels after physical challenge. In addition, BD supplementation had few subchronic toxic effects. CONCLUSIONS: Supplementation with BD has a wide spectrum of bioactive effects, including health promotion, performance improvement, and fatigue reduction.

Hypolipidemic effects and safety of Lactobacillus reuteri 263 in a hamster model of hyperlipidemia.

We aimed to verify the beneficial effects of probiotic strain Lactobacillus reuteri 263 (Lr263) on hypolipidemic action in hamsters with hyperlipidemia induced by a 0.2% cholesterol and 10% lard diet (i.e., high-cholesterol diet (HCD)). Male Golden Syrian hamsters were randomly divided into two groups: normal (n = 8), standard diet (control), and experimental (n = 32), a HCD. After a two-week induction followed by a six-week supplementation with Lr263, the 32 hyperlipidemic hamsters were divided into four groups (n = 8 per group) to receive vehicle or Lr263 by oral gavage at 2.1, 4.2, or 10.5 × 10(9) cells/kg/day for 6 weeks, designated the HCD, 1X, 2X and 5X groups, respectively. The efficacy and safety of Lr263 supplementation were evaluated by lipid profiles of serum, liver and feces and by clinical biochemistry and histopathology. HCD significantly increased serum levels of total cholesterol (TC), triacylglycerol (TG) cholesterol, high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C), LDL-C/HDL-C ratio, hepatic and fetal TC and TG levels, and degree of fatty liver as compared with controls. Lr263 supplementation dose dependently increased serum HDL-C level and decreased serum TC, TG, LDL-C levels, LDL-C/HDL-C ratio, hepatic TC and TG levels, and fecal TG level. In addition, Lr263 supplementation had few subchronic toxic effects. Lr263 could be a potential agent with a hypolipidemic pharmacological effect.

Metastasis in vertebra mimicking acute compression fractures in a patient with osteoporosis: MRI findings.

Elderly patients who have osteoporosis and a cancer history with backache and vertebral fractures are diagnostic challenges. We present a case of an 87-year-old man who complained of severe low-back pain with radiation to the lower limbs and weakness of the lower limbs. The patient had had a fall on a bus 1 month before admission. The patient also had a history of colon cancer and had received a colostomy 9 years before. In this admission, lumbar spine radiographs showed compressive fractures of vertebral bodies at L1 and L3. Magnetic resonance imaging (MRI) showed hyperemic change of the L3 marrow with osteonecrosis (fluid sign). The ventral thecal sac was slightly compressed due to retropulsion of L3. The L1 marrow was normal. Bone densitometry of the calcaneous revealed osteoporosis. The patient was then treated by vertebroplasty and bilateral foraminotomy of L3 after a diagnosis of acute compressive fracture. On histology, there was a metastatic adenocarcinoma arranged in glands and nests in the bone and paraspinal soft tissue. On retrospective viewing, an axial gadolinium-enhanced MRI revealed paraspinal extension of soft tissue at L3, which is highly suggestive of metastasis in a vertebra.