Ultra-short-wave diathermy shortens the course of moderate and severe COVID-19: a randomized controlled trial

QuestionIs ultra-short-wave diathermy (USWD) safe and effective in coronavirus disease 2019 (COVID-19) ? DesignSingle-centre, evaluator-blinded, two-arm, parallel design, randomized controlled clinical trial. ParticipantsModerate and severe COVID-19 patients with acute respiratory syndrome. InterventionUSWD for 10 minutes twice daily for 12 consecutive days along with standard medical treatment (USWD group, n = 25), versus standard medical treatment alone (control group, n = 25). Outcome measuresThe primary outcomes were the duration of recovery and negative conversion rate of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on days 7, 14, 21, and 28. Secondary outcomes included clinical status (seven-category ordinal and systemic inflammatory response syndrome (SIRS) scores), computed tomography (CT), routine blood tests, and adverse events. ResultsTime to clinical recovery (USWD 36.84{+/-}9.93 vs. control 43.56{+/-}12.15, P = 0.037) was significantly shortened with a between-group difference of 6.72 days. Clinical status was improved with significant between-group differences on day 28 (SIRS, P = 0.011; seven-category scale, P = 0.003). The rate of RNA negative conversion at days 7 (P = 0.066), 14 (P = 0.239), 21 (P = 0.269), and 28 (P = 0.490) was statistically insignificant. Moreover, insignificant differences were observed in the artificial intelligence-assisted CT analysis. No treatment-associated adverse events or worsening of pulmonary fibrosis were observed. ConclusionUSWD, as adjunctive therapy, shortened the recovery course and improved clinical status of patients with COVID-19 without aggravating pulmonary fibrosis. the findings are limited due to the small sample size and early termination. RegistrationChiCTR2000029972

Development of a scoliosis rehabilitation robot and a preliminary study of its effectiveness in treating coronal deformity / 中华物理医学与康复杂志

Objective:To explore the appropriate use of a self-developed scoliosis rehabilitation robot in treating adolescent idiopathic scoliosis (AIS), and also its safety and effectiveness.Methods:The scoliosis rehabilitation robot consists of a closed-loop pneumatic control system and multi-segment torso, pelvis and upper extremity fixation devices. It provides three-dimensional synchronous correction. Eighteen AIS subjects first received 30min of robot-assisted treatment using the maximum tolerable orthotic force. The angles of their spinal processes were evaluated using ultrasound before the treatment and after 30 seconds, 5 minutes and 30 minutes of treatment, then 5min later. In a second 30sec course of treatment the transverse orthotic force was 10%, 15%, 20%, 25%, and 30% of the patient′s body weight. Any adverse effects were observed and recorded.Results:The robot ran smoothly and could apply intelligent and precise correction. No severe adverse effects were reported. The mean correction of the spinal process angles showed a significant cumulative effect with treatment time, reaching 104% at 30min. The mean process angle correction increased with the applied force. Force at 25% of the patient′s weight produced an average correction of 104% in patients with mild AIS and 65% in those whose AIS was moderate.Conclusion:The scoliosis rehabilitation robot is safe and immediately effective. Setting the transverse force at 25% of a patient′s weight gives the best corrective effect with mild AIS. Moderate AIS requires more force.

Dry Cupping, Ischemic Compression, or Their Combination for the Treatment of Trigger Points: A Pilot Randomized Trial.

Background: Chronic neck pain (NP) attributed to myofascial pain syndrome is one of the particularly common skeletal muscle disorder associated with the hyperirritable zone in the taut band of muscle. Trigger points (TPs) are the physical interpretation of the myofascial pain syndrome. In the United States, 30%-85% of pain patients have been affected by myofascial TPs. Objectives: To reveal preliminary evidence on the clinical efficacy of ischemic compression therapy, dry cupping, and their combination on improving the TPs' pressure pain threshold (PPT), neck range of motion (NROM), and neck disability index (NDI) in patients with TPs and nonspecific NP. Besides, assess the feasibility of conducting a randomized clinical trial (RCT). Design: A randomized pilot study was conducted on 24 patients with TPs and nonspecific NP. Patients were randomly assigned to three groups: the cupping group, the ischemic compression group, and the combination therapy group. PPT, NROM, and NDI were assessed before and after 4 weeks of treatment. Results: The results showed a statistically significant improvement in NDI, PPT, and NROM compared with values before the treatment (p < 0.05) in all groups. Although no significant difference was detected between ischemic compression (IC) and dry cupping, the combination approach showed significantly higher and faster improvement (p < 0.05). Conclusions: It is feasible to conduct a main RCT. Both IC and dry cupping may hold promise in treating TPs; a combination of the two therapies may provide superior improving rate.

The effect of action observation combined with occupational therapy on the upper limb function and ability in the activities of daily living of stroke survivors / 中华物理医学与康复杂志

Objective To observe the effect of action observation combined with occupational therapy on the upper limb function and ability in the activities of daily living after a stroke. Methods Forty-two stroke survivors were randomly divided into a treatment group and a control group, each of 21. Both groups were given conventional rehabilita-tion training and conventional occupational therapy. The treatment group additionally performed action observation. The Fugl-Meyer assessment ( FMA-UE ) , a Hong Kong version of the functional test for the hemiplegic upper extremity ( FTHUE-HK) and the Modified Barthel index ( MBI) were used for assessment before and after 8 weeks of treatment. Results Before the treatment there were no significant differences between the two groups. Afterward, significant im-provement was observed in all of the measurements in both groups. Compared with the control group, the treatment group showed more significant improvement in its average FMA-UE, FTHUE-HK and MBI scores. Conclusion Action observation can improve the effects of rehabilitation and occupational therapy after stroke.

The effect of action observation combined with occupational therapy on the upper limb function and ability in the activities of daily living of stroke survivors / 中华物理医学与康复杂志

Objective@#To observe the effect of action observation combined with occupational therapy on the upper limb function and ability in the activities of daily living after a stroke.@*Methods@#Forty-two stroke survivors were randomly divided into a treatment group and a control group, each of 21. Both groups were given conventional rehabilitation training and conventional occupational therapy. The treatment group additionally performed action observation. The Fugl-Meyer assessment (FMA-UE), a Hong Kong version of the functional test for the hemiplegic upper extremity (FTHUE-HK) and the Modified Barthel index (MBI) were used for assessment before and after 8 weeks of treatment.@*Results@#Before the treatment there were no significant differences between the two groups. Afterward, significant improvement was observed in all of the measurements in both groups. Compared with the control group, the treatment group showed more significant improvement in its average FMA-UE, FTHUE-HK and MBI scores.@*Conclusion@#Action observation can improve the effects of rehabilitation and occupational therapy after stroke.

Pattern-specific physiotherapy for chronic neck pain based on functional impairment / 中华物理医学与康复杂志

Objective To explore the effect of pattern-specific physical therapy based on functional impair-ment on chronic neck pain ( CNP ) . Methods Ninety-three CNP patients treated in the outpatient department of our hospital between March 2016 and November 2017 were randomly divided into a study group ( n=46) and a control group ( n=47) . The control group received routine physical treatment, while the study group was treated with pattern-specific physical therapy involving local pain management, traction, soft tissue relaxation, mobilization, strength training, posture control training and active exercise as well as health education. Each was based on a physical exami-nation and pattern classification by doctors and therapists. The subjects in both groups were required to complete 3 to 6 ninety-minute sessions of outpatient treatment and 6 thirty-minute sessions of self-training at home over 2 weeks. Pain intensity and cervical dysfunction were rated using a visual analogue scale ( VAS) and a neck disability index ( NDI) before and after the two-week intervention and one month later. Before the intervention and during the follow-up, postural analyses for the head and neck in a standing position were performed. The cranial vertebral angle ( CVA) , protracted shoulder angle ( PSA) and sagittal head elevation were measured. Results Eighty-seven par-ticipants completed the treatments and follow-up. After the 2-week intervention, the average VAS rating at the end of cervical anteflection in the study group was significantly lower than that in the control group ( P≤0.05) . Significantly greater improvement in the NDI scores was observed in the study group than the control group ( P≤0.05) . During the follow-up, it was found that the average CVA score had improved more significantly in the study group than with the control group ( P≤0.01) , but there were no significant differences in the other measurements between the two groups.Conclusion This pattern-specific physical therapy process is more effective for relieving the end pain during cervical anteflection quickly. It can improve functioning and ability in daily activities to some degree, as well as correct head and neck posture in the long term. It may be helpful in regulating physical therapy for neck pain and for developing a standardized treatment protocol for CNP .

Effects of different biofeedback training techniques on the static balance of hemiplegic patients / 中华物理医学与康复杂志

Objective To compare the static standing balance of stroke patients after different biofeedback protocols.Methods Thirty-two stroke patients were randomly divided into a knowledge of performance (KP) group,a knowledge of results (KR) group and a control group.All 3 groups received 4 weeks of conventional rehabilitation training plus another 30min of static standing balance training per day.The KP group received audio-visual feedback in real time during the training.The KR group received section result feedback.The control group received no feedback during the extra balance training.Before and after the training,the performance of the 3 groups was evaluated using Berg's Balance Scale (BBS) and a portable biofeedback device.Results Average BBS performance improved significantly more in the KP group (3.08± 1.08) than in KR group (1.30±0.67) and control group (1.20± 0.79) (P＜0.05).No significant difference was detected between the KR and control groups (P＞0.05).The average improvements of the KP group in terms of Standing with Eyes Closed and Tandem Standing (0.92±0.79 and 0.83± 0.39) were significantly highcr than those in the KR (0.30± 0.48 and 0.20± 0.42) and control groups (0.01 ± 0.01 and 0.40±0.52) (P＜0.05).Average trunk angular displacements in all four directions [Anterior (2.83±0.93;6.15± 1.85),Posterior (2.56±0.88;5.97±1.74);Left (2.86±1.16;6.49±2.42),Right (2.68±1.43;5.98±2.05)] in the KP group was significantly higher than in the others (P＜0.05).No significant differences were detected between the KR and control groups in BBS results or in posture.Conclusions Static standing training should incorporate real time biofeedback.It is then more effective than conventional standing training or training with section results feedback.It is worth spreading in clinical applications.

Valpar technology can improve the treatment of early vascular cognitive impairment / 中华物理医学与康复杂志

Objective To observe the therapeutic effect of the Valpar system combined with computer-aided technology in treating early vascular cognitive impairment (VCI).Methods Forty patients in the early stage of VCI were randomly divided into a treatment group and a control group,each of 20.Regular and computer-aided cognition training were applied in both groups,while training using the Valpar system was additionally used in the treatment group.Patients in both groups were assessed using the Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) and the modified Barthel Index (MBI) before,and after 4 and 8 weeks of treatment.Results Before the treatment,there were no significant differences between the 2 groups in LOTCA and MBI scores (P＞0.05).After 4 and 8 weeks of treatment,the average total LOTCA score in the observation group was significantly better than before the treatment,as were the average scores on the various dimensions,and the average MBI score (P＜0.05).After 4 weeks of treatment the control group showed significant improvement in the patients' orientation (3.50±0.89),visual perception (13.50± 1.43),spatial perception (2.40±0.50),visuomotor construction (24.00± 1.17) and attention (2.30±0.87).However,after both 4 and 8 weeks of treatment,all the measurements of the observation group were significantly better than those of the control group at the same time point (P＜0.05).Conclusion The Valpar system can significantly improve the recovery of cognitive function and ability in the activities of daily living of patients in the early stage of VCI.It is worth applying in clinical practice.

Effects of proprioception training on the motor function and ability in the activities of daily living of hemiplegic stroke patients / 中华物理医学与康复杂志

Objective To study the effects of proprioception training on the motor function and ability in the activities of daily living (ADL) of hemiplegic stroke patients. Methods Forty hemiplegic stroke patients were divided into study group and a control group ( n =20 in each).The two groups received conventional rehabilitation treatment and pharmacotherapy,but the study group received additional proprioception training.The Technobody proprioceptive system assessment,the Fugl-Meyer lower limb assessment (FMA),the Berg balance scale (BBS) and the modified Barthel index (MBI) were used to evaluate their proprioceptive ability,lower limb motor function,balance and ADL ability,before and after 4 weeks of treatment. Results After 4 weeks,proprioception,lower limb motor function,balance and ADL ability had all improved significantly in the experimental group.Lower limb motor function,balance and ADL ability had also improved significantly in the control group,but they showed no significant change in their average proprioceptive ability.The improvement in the experimental group was superior to that of the control group in terms of proprioceptive ability,balance and ADL ability. Conclusions Proprioception training can improve the motor function (including the proprioception and balance) and ADL ability of hemiplegic stroke patients.

Hyperbaric oxygen for diabetic peripheral neuropathy: A systematic review / 中华物理医学与康复杂志

Objective To explore whether there is enough clinical evidence to confirm that hyperbaric oxygen (HBO) does more good than other treatments in treating patients with diabetic peripheral neuropathy. Methods Published clinical trials on hyperbaric oxygen treatment for diabetic peripheral neuropathy were collected through electronic searches of PubMed, the Cochrane Central Register of Controlled Trials, EMbase, Science Citation Index Expanded, the China Biological Medicine Database (CBM-disc), the Chinese National Knowledge Infrastructure (CNKI) and the VIP Database for Chinese Technical Periodicals (from the date of establishment of the databases to July 2010). The bibliographies of the retrieved articles were also checked. Results A total of 7 trials involving 446 patients with diabetic peripheral neuropathy were included. All studies reported positive results regarding the effects,but the quality of the studies was generally poor. The main problem was that most trials were reported as randomized and controlled, but with no description of the methods of randomization, concealment and blinding. Conclusions HBO in the treatment of diabetic peripheral neuropathy is promising based on present evidence. However at present,definite conclusions cannot be drawn about whether hyperbaric oxygen treatment is superior to the alternatives for patients with diabetic peripheral neuropathy. Higher quality randomized and controlled trials are required.