Effects of pulmonary rehabilitation on systemic inflammation in chronic obstructive pulmonary disease: a meta-analysis.

Chronic obstructive pulmonary disease (COPD) is marked by both lung-related and systemic symptoms, notably chronic inflammation. Despite pulmonary rehabilitation (PR) being a critical treatment for COPD, its influence on systemic inflammation remains unclear. This meta-analysis was conducted to assess PR's effect on circulating inflammatory markers in COPD patients. We systematically reviewed databases like PubMed, EMBASE, and Web of Science to select randomized controlled trials and observational studies that investigated the impact of PR on systemic inflammation. We calculated the mean differences (MD) in inflammatory markers before and after PR using a random-effects model and assessed the risk of bias with established tools. Our study included six investigations (four RCTs, two observational) with 147 COPD patients. Our findings show notable increases in IL-6 (MD 0.44, 95% CI 0.17-0.70, P = 0.001), CRP (MD 0.56, 95% CI 0.31-0.81, P<0.00001), and TNF-alpha (MD 0.41, 95% CI 0.12-0.70, P = 0.005) following PR. However, sensitivity analysis pinpointed the study by El-Kader et al. as a key influence on these results. Excluding this study led to nonsignificant changes. Thus, our meta-analysis uncovers an unanticipated rise in inflammatory markers post-PR in COPD patients, questioning the assumed anti-inflammatory benefits of PR.

The effects of high and low dose extracorporeal shockwave therapy on immune activation and immunosuppressive markers in elderly patients with osteoarthritis: a study protocol for a randomized controlled trial.

OBJECTIVE: This randomized controlled trial aims to compare the effects of high versus low dose extracorporeal shockwave therapy (ESWT) on immune system activation and regulation in elderly patients with osteoarthritis. METHODS: 120 patients aged 65 years and older with knee osteoarthritis will be randomly allocated to receive either high dose (0.25 mJ/mm2) or low dose (0.10 mJ/mm2) ESWT administered weekly for 4 weeks. Serum cytokines, stimulated immune cell subsets, and T regulatory cells will be measured at baseline, 4 weeks after intervention and at 1-month follow-up. RESULTS: High dose ESWT will increase pro-inflammatory cytokines and decrease immunosuppressive T regulatory cells compared to low dose ESWT in elderly osteoarthritis patients may be the outcome mainly. CONCLUSION: This study will provide evidence on ESWT dosing protocols and their differential immunomodulatory effects, which can guide optimal use for musculoskeletal conditions in geriatric populations.

Impaired ankle inversion proprioception during walking is associated with fear of falling in older adults.

Background: Ankle proprioception plays a critical role in lower limb movement control. However, the relationship between ankle proprioception and fear of falling (FOF) in older people is still unclear. Objective: (1) This study aims to develop a new device for measuring ankle inversion proprioceptive discrimination sensitivity during walking, i.e., the Ankle Inversion Discrimination Apparatus-Walking (AIDAW), and assess the test-retest reliability of the AIDAW in both young and older adults; (2) to evaluate the discriminant validity of the measure by comparing ankle proprioception during walking between the two groups; and (3) to explore convergent validity by determining to what extent the AIDAW proprioceptive scores correlate with Fall Efficacy Scale-International (FES-I) scores. Materials and methods: The AIDAW was purpose-built to test ankle inversion proprioceptive discrimination sensitivity during walking. The area under the receiver operating curve (AUC) was calculated as the proprioceptive discrimination score. In total, 54 adults volunteered. Test-retest reliability was evaluated in 12 young and 12 older adults, and another 15 young and 15 older adults completed the comparison study. FOF was assessed by using the FES-I. Results: The test-retest reliability intraclass correlation coefficient ICC (3,1) value for the whole group was 0.76 (95% CI: 0.52-0.89). The ICC values of the young and older groups were 0.81 (95% CI: 0.46-0.94) and 0.71 (95% CI: 0.26-0.91), respectively. The Minimal Detectable Change with 90% confidence (MDC90) values for the young and older groups were 0.03 and 0.11, respectively. There was a significant difference between the AIDAW proprioceptive sensitivity scores for the young and older groups (0.78 ± 0.04 vs. 0.72 ± 0.08, F = 5.06, p = 0.033). Spearman's correlation analysis showed that the FES-I scores were significantly and negatively correlated with the AIDAW scores (rho = -0.61, p = 0.015), with higher FOF associated with worse ankle proprioception. Conclusion: The AIDAW is a reliable and valid device for measuring ankle proprioception during walking in both young and older adults. Ankle inversion proprioceptive discrimination sensitivity during walking was found to be impaired in the elderly compared to young adults. This impairment was found to be strongly associated with FOF, suggesting that assessment and intervention for ankle proprioception in this population are needed to reduce the risk of falls.

Protective effect of miR-33-5p on the M1/M2 polarization of microglia and the underlying mechanism.

This study was aimed to investigate the influence of miR-33-5p on the M1/M2 polarization of microglia and the underlying mechanism. Transcriptome sequencing was performed using microglia from miR-33-5p mimic and control groups. In total, 507 differentially expressed genes, including 314 upregulated genes and 193 downregulated genes, were identified. The subnetwork of module A, which was extracted from the protein-protein interaction networks, mainly contained the downregulated genes. Cdk1,Ccnb,and Cdc20, the members of module-A networks with the highest degrees, possess the potential of being biomarkers of ischemic stroke due to their function in the cell cycle. NFY, a transcription factor, was predicted to have the regulatory relation with nine downregulated genes. Overall, our findings will provide a valuable foundation for genetic mechanisms and treatment studies of ischemic stroke.

Kinesio taping in treatment of chronic non-specific low back pain: a systematic review and meta-analysis.

OBJECTIVE: To compare the efficacy of kinesio taping on chronic non-specific low back pain with that of other general physical therapies. METHODS: Relevant studies published up to 31 July 2018 were searched in electronic databases (PubMed, Web of Science, Science Direct, Physiotherapy Evidence Database (PEDro), Cochrane Library, Wanfang Data, Vip Data and China National Knowledge Infrastructure). The quality of included studies was assessed using a risk of bias assessment tool, as recommended by the Cochrane Collaboration. Data from visual analogue scales and Oswestry Disability Index were extracted as selected outcome indicators. Tests of heterogeneity were performed. Weight-ed mean difference (WMD) data with its 95% confidence intervals (95% CI) were used as a measure of effect sizes, in order to pool the results from each included study using either a fixed or random effects model (where appropriate and possible). RESULTS: Eight studies fulfilled the inclusion and exclusion criteria. The quality of included studies was moderate. Patients with chronic non-specific low back pain in the kinesio taping group achieved better pain relief (WMD = -1.22; 95% CI -1.49 to -0.96, I2 = 91%, p < 0.00001) and activities of daily living (WMD = -7.11; 95% CI -8.70 to -5.51, I2 = 77%, p < 0.0001) than those in the control group. CONCLUSION: Kinesio taping may be a new, simple and convenient choice for intervention in low back pain. In the future, we can measure the efficacy about kinesio taping via clinical application in order to prove the possibility of treatment for low back pain.

Effect of Kinesio Taping on the Walking Ability of Patients with Foot Drop after Stroke.

OBJECTIVE: The purpose of this study was to investigate the effect of kinesio taping on the walking ability in patients with foot drop after stroke. METHODS: Sixty patients were randomly divided into the experimental group (with kinesio taping) and the control group (without kinesio taping). The 10-Meter Walking Test (10MWT), Timed Up and Go Test (TUGT), stride length, stance phase, swing phase, and foot rotation of the involved side were measured with the German ZEBRIS gait running platform analysis system and were used to evaluate and compare the immediate effects of kinesio taping. All the measurements were made in duplicate for each patient. RESULTS: The demographic variables of patients in both groups were comparable before the treatment (p>0.05). After kinesio taping treatment, significant improvement was found in the 10MWT and the TUGT for patients in the experimental group (p<0.05). There were significant differences in the 10MWT and TUGT between the experimental and control groups after treatment (p<0.05). In terms of gait, we found significant improvement in stride length (p<0.001), stance phase (p<0.001), swing phase (p<0.001), and foot rotation (p<0.001) of the involved side in experimental group after treatment compared with those before treatment. Further, the functional outcomes and gait ability were significantly improved in the experimental group after treatment (p<0.05), compared to the control group. CONCLUSION: Kinesio taping can immediately improve the walking function of patients with foot drop after stroke.