Effect of tap dance on plantar pressure, postural stability and lower body function in older patients at risk of diabetic foot: a randomized controlled trial

IntroductionTo examine the effects of tap dance (TD) on dynamic plantar pressure, static postural stability, ankle range of motion (ROM), and lower extremity functional strength in patients at risk of diabetic foot (DF).Research design and methodsA randomised, single-blinded, two-arm prospective study of 40 patients at risk of DF was conducted. The intervention group (n=20) received 16 weeks of TD training (60 min/session×3 sessions/week). The control group attended four educational workshops (1 hour/session×1 session/month). Plantar pressure, represented by the primary outcomes of peak pressure (PP) and pressure-time integral (PTI) over 10 areas on each foot, was measured using the Footscan platform system. Secondary outcomes comprised static postural stability, ankle ROM and lower extremity functional strength.ResultsReductions in intervention group PP (right foot: mean differences=4.50~27.1, decrease%=25.6~72.0; left foot: mean differences=−5.90~6.33, decrease%=−22.6~53.2) and PTI at 10 areas of each foot (right foot: mean differences=1.00~12.5, decrease%=10.4~63.6; left foot: mean differences=0.590~25.3, decrease%=21.9~72.6) were observed. Substantial PP and PTI differences were noted at the second through fourth metatarsals, medial heel and lateral heel in the right foot. Substantial PP and PTI differences were detected at metatarsals 1 and 2 and metatarsal 2 in the left foot, respectively. Moderate training effects were found in plantar flexion ROM of both feet, lower extremity functional strength, and length of center-of-pressure trajectory with eyes closed and open (r=0.321–0.376, p<0.05).ConclusionsA 16-week TD training program can significantly improve ankle ROM, lower extremity functional strength, and static postural stability. To attain greater improvements in plantar pressure, a longer training period is necessary.Trial registration numberChiCTR1800014714.

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The importance of NT proBNP in hypertensive patients management for preventing heart failure

Romanian Medical Journal ◽

10.37897/rmj.2021.1.13 ◽

2021 ◽

Vol 68 (1) ◽

pp. 71-76

Author(s):

Irina Cuciureanu ◽

◽

Anamaria-Georgiana Avram ◽

Maria Suzana Guberna ◽

Cătălina Liliana Andrei ◽

...

Keyword(s):

Heart Failure ◽

At Risk ◽

Diastolic Dysfunction ◽

Medical Management ◽

Systolic Dysfunction ◽

Intervention Group ◽

Control Group ◽

Cardiovascular Pathology ◽

Hypertensive Patients ◽

Patients At Risk

Purpose. NT proBNP is routinely used in the diagnosis and prognosis of HF. The study aimed to determine whether the value of NT proBNP can be used in hypertensive patients to detect patients at risk of developing HF and whether in these patients medical management guided by NT proBNP can prevent the development of HF. Material and methods. We included 275 hypertensive patients who presented to the Bagdasar-Arseni Emergency Hospital for cardiological consultation for a period of 3 years. Patients diagnosed with heart failure or left ventricular systolic dysfunction and patients with symptoms of heart failure at enrollment were excluded. We divided the patients into 2 groups, a control group and an intervention group. Patients in the intervention group were managed according to the NT proBNP value, and patients in the control group received standard treatment. Results. The objectives pursued at 3 years were: diagnosis of heart failure, systolic or diastolic dysfunction of the left ventricle and hospitalization for cardiovascular pathology. After 3 years, in the control group there were 34 patients (25.4%) who developed HF, compared to 24 patients (17.0%) in the intervention group. In the control group, 51 patients (38.1%) were diagnosed with LV systolic dysfunction compared to 37 patients (26.2%) in the intervention group. Regarding diastolic LV dysfunction, in the control group there were 83 patients (61.9%), and in the intervention group there were 73 patients (51.8%). Also, the rate of hospitalizations for cardiovascular pathology was higher in the control group 47 patients (35.1%) compared to 27 patients (19.1%) in the intervention group. Discussions. Hypertensive patients in the intervention group, who were managed according to the NT proBNP value, had a lower incidence rate of heart failure, LV systolic or diastolic dysfunction, or hospitalizations for cardiovascular events than in the control group. Conclusions. The value of NT proBNP may be useful for detecting hypertensive patients at risk of developing HF, and NT proBNP-guided medical management may prevent or delay the onset of HF.

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Effect of Mechanical Chest Percussion on Intracranial Pressure: A Pilot Study

American Journal of Critical Care ◽

10.4037/ajcc2009523 ◽

2009 ◽

Vol 18 (4) ◽

pp. 330-335 ◽

Cited By ~ 9

Author(s):

DaiWai M. Olson ◽

Suzanne M. Thoyre ◽

Stacey N. Bennett ◽

Joanna B. Stoner ◽

Carmelo Graffagnino

Keyword(s):

At Risk ◽

Brain Injury ◽

Intracranial Pressure ◽

Intracranial Hypertension ◽

Intervention Group ◽

Control Group ◽

Secondary Brain Injury ◽

Physical Stimulation ◽

Patients At Risk ◽

Injured Patients

Background Treatment of brain injury is often focused on minimizing intracranial pressure, which, when elevated, can lead to secondary brain injury. Chest percussion is a common practice used to treat and prevent pneumonia. Conflicting and limited anecdotal evidence indicates that physical stimulation increases intracranial pressure and should be avoided in patients at risk of intracranial hypertension.Objectives To explore the safety of performing chest percussion for patients at high risk for intracranial hypertension.Methods A total of 28 patients with at least 1 documented episode of intracranial hypertension who were having intracranial pressure monitored were studied in a prospective randomized control trial. Patients were randomly assigned to either the control group (no chest percussion) or the intervention group (10 minutes of chest percussion at noon). Intracranial pressure was recorded once a minute before, during, and after the intervention.Results Mean intracranial pressures for the control group before, during, and after the study period (14.4, 15.0, and 15.9 mm Hg, respectively) did not differ significantly from pressures in the intervention group (13.6, 13.7, and 14.2 mm Hg, respectively).Conclusions Mechanical chest percussion may be a safe intervention for nurses to use on neurologically injured patients who are at risk for intracranial hypertension.

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Efficacy of Aloe vera/ Plantago Major Gel in Diabetic Foot Ulcer: A Randomized Double-Blind Clinical Trial

Current Drug Discovery Technologies ◽

10.2174/1570163815666180115093007 ◽

2019 ◽

Vol 16 (2) ◽

pp. 223-231 ◽

Cited By ~ 2

Author(s):

Younes Najafian ◽

Zahra M. Khorasani ◽

Mona N. Najafi ◽

Shokouh S. Hamedi ◽

Marjan Mahjour ◽

...

Keyword(s):

Clinical Trial ◽

Diabetic Foot ◽

Intervention Group ◽

Aloe Vera ◽

Foot Ulcer ◽

Diabetic Foot Ulcer ◽

Control Group ◽

Plantago Major ◽

Double Blind ◽

Significant Difference

Background:Diabetic foot ulcer (DFU) is one of the most common complications of diabetic patients. Mostly, non-healing DFU leads to infection, gangrene, amputation and even death. High costs and poor healing of the wounds need a new treatment such as alternative medicine. So, the aim of this study was to evaluate the efficacy of Aloe vera/ Plantago major gel (Plantavera gel) in healing of DFUMethods:Forty patients with DFU enrolled in a double-blind randomized clinical trial. The patients who were randomly assigned into the intervention group (n = 20), received topical Plantavera gel in addition to the routine cares, whereas the patients in the control group (n = 20), received topical Placebo gel in addition to the routine cares. Intervention was done twice a day for 4 weeks in the both groups. Photography and an evaluation of DFU healing were conducted by a checklist and then were scored at baseline and at the end of each week. The collected data was analyzed by SPSS software.Results:At the end of the study, there was a significant difference between the two groups in terms of total ulcer score (P<0.001) and Plantavera gel significantly reduced the ulcer surface comparing with the control group (P=0.039). However, there was not a significant difference between the two groups (P=0.263) in terms of the ulcer depth. During this study, no side effect was observed for Plantavera gel in the intervention group.Conclusion:Topical Plantavera gel seems to be an effective, cheap and safe treatment. Of course, further studies are required to confirm the properties of the wound healing of this gel.

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Impact of Somatosensory Training on Neural and Functional Recovery of Lower Extremity in Patients with Chronic Stroke: A Single Blind Controlled Randomized Trial

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18020583 ◽

2021 ◽

Vol 18 (2) ◽

pp. 583

Author(s):

Reem M. Alwhaibi ◽

Noha F. Mahmoud ◽

Mye A. Basheer ◽

Hoda M. Zakaria ◽

Mahmoud Y. Elzanaty ◽

...

Keyword(s):

Physical Therapy ◽

Lower Extremity ◽

Functional Recovery ◽

Intervention Group ◽

Chronic Stroke ◽

Post Treatment ◽

Control Group ◽

Stroke Patients ◽

Significant Difference ◽

Group Post

Recovery of lower extremity (LE) function in chronic stroke patients is considered a barrier to community reintegration. An adequate training program is required to improve neural and functional performance of the affected LE in chronic stroke patients. The current study aimed to evaluate the effect of somatosensory rehabilitation on neural and functional recovery of LE in stroke patients. Thirty male and female patients were recruited and randomized to equal groups: control group (GI) and intervention group (GII). All patients were matched for age, duration of stroke, and degree of motor impairment of the affected LE. Both groups received standard program of physical therapy in addition to somatosensory rehabilitation for GII. The duration of treatment for both groups was eight consecutive weeks. Outcome measures used were Functional Independent Measure (FIM) and Quantitative Electroencephalography (QEEG), obtained pre- and post-treatment. A significant improvement was found in the FIM scores of the intervention group (GII), as compared to the control group (GI) (p < 0.001). Additionally, QEEG scores improved within the intervention group post-treatment. QEEG scores did not improve within the control group post-treatment, except for “Cz-AR”, compared to pretreatment, with no significant difference between groups. Adding somatosensory training to standard physical therapy program results in better improvement of neuromuscular control of LE function in chronic stroke patients.

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Implementation and effectiveness of a multi-domain program for older adults at risk of cognitive impairment at neighborhood senior centres

Scientific Reports ◽

10.1038/s41598-021-83408-5 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Pei Ern Mary Ng ◽

Sean Olivia Nicholas ◽

Shiou Liang Wee ◽

Teng Yan Yau ◽

Alvin Chan ◽

...

Keyword(s):

Quality Of Life ◽

Older Adults ◽

At Risk ◽

Cognitive Impairment ◽

Mobile Application ◽

Intervention Group ◽

Blood Parameters ◽

Attrition Rate ◽

Control Group

AbstractTo address the paucity of research investigating the implementation of multi-domain dementia prevention interventions, we implemented and evaluated a 24-week, bi-weekly multi-domain program for older adults at risk of cognitive impairment at neighborhood senior centres (SCs). It comprised dual-task exercises, cognitive training, and mobile application-based nutritional guidance. An RCT design informed by the Reach, Effectiveness, Adoption, Implementation, Maintenance framework was adopted. Outcome measures include cognition, quality of life, blood parameters, and physical performance. Implementation was evaluated through questionnaires administered to participants, implementers, SC managers, attendance lists, and observations. The program reached almost 50% of eligible participants, had an attrition rate of 22%, and was adopted by 8.7% of the SCs approached. It was implemented as intended; only the nutritional component was re-designed due to participants’ unfamiliarity with the mobile application. While there were no between-group differences in cognition, quality of life, and blood parameters, quality of life reduced in the control group and physical function improved in the intervention group after 24 weeks. The program was well-received by participants and SCs. Our findings show that a multi-domain program for at-risk older adults has benefits and can be implemented through neighborhood SCs. Areas of improvement are discussed.Trial registration: ClinicalTrials.gov NCT04440969 retrospectively registered on 22 June 2020.

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Evaluating the effectiveness of interventions to reducing screen time in children: meta-analysis of randomized controlled trials

Journal of Public Mental Health ◽

10.1108/jpmh-03-2021-0039 ◽

2021 ◽

Vol ahead-of-print (ahead-of-print) ◽

Author(s):

Duygu Akçay ◽

Nuray Barış

Keyword(s):

Effect Size ◽

Subgroup Analysis ◽

Screen Time ◽

Meta Analysis ◽

Intervention Group ◽

Evidence Base ◽

Control Group ◽

Content Type ◽

Mean Differences ◽

The Impact

Purpose The purpose of this paper is to evaluate the impact of interventions focused on reducing screen time in children. Design/methodology/approach Studies that aim to investigate the effects of interventions aimed at reducing the time spent in front of the screen (i.e. screen time). A Random-effects model was used to calculate the pooled standard mean differences. The outcome was to evaluate the screen time in children in the 0–18 age range. A subgroup analysis was performed to reveal the extent to which the overall effect size varied by subgroups (participant age, duration of intervention and follow). Findings For the outcome, the meta-analysis included 21 studies, and the standard difference in mean change in screen time in the intervention group compared with the control group was −0.16 (95% confidence interval [CI], −0.21 to −0.12) (p < 0.001). The effect size was found to be higher in long-term (=7 months) interventions and follow-ups (p < 0.05). Originality/value Subgroup analysis showed that a significant effect of screen time reduction was observed in studies in which the duration of intervention and follow-up was =7 months. As the evidence base grows, future researchers can contribute to these findings by conducting a more comprehensive analysis of effect modifiers and optimizing interventions to reduce screen time.

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Implementation of a QTc-interval monitoring protocol by pharmacists to decrease cardiac risk in at-risk patients in an acute care inpatient psychiatric facility

Mental Health Clinician ◽

10.9740/mhc.2019.03.082 ◽

2019 ◽

Vol 9 (2) ◽

pp. 82-87 ◽

Cited By ~ 1

Author(s):

Nicole M. Daniel ◽

Kim Walsh ◽

Henry Leach ◽

Lauren Stummer

Keyword(s):

At Risk ◽

Acute Care ◽

Medical Center ◽

Intervention Group ◽

Psychiatric Hospitals ◽

Control Group ◽

Qtc Interval ◽

Psychiatric Facility ◽

End Point ◽

Monitoring Protocol

Abstract Introduction Many medications commonly prescribed in psychiatric hospitals can cause QTc-interval prolongation, increasing a patient's risk for torsades de pointes and sudden cardiac death. There is little guidance in the literature to determine when an electrocardiogram (ECG) and QTc-interval monitoring should be performed. The primary end point was improvement of the appropriateness of ECGs and QTc-interval monitoring of at-risk psychiatric inpatients at Barnabas Health Behavioral Health Center (BHBH) and Monmouth Medical Center (MMC) following implementation of a standardized monitoring protocol. The secondary end point was the number of pharmacist-specific interventions at site BHBH only. Methods Patients who met the inclusion criteria were assessed using a standardized QTc-prolongation assessment algorithm for ECG appropriateness. A retrospective analysis of a control group (no protocol) from January 1, 2016, to July 17, 2017, was compared with a prospective analysis of the intervention group (with protocol) from December 11, 2017, to March 11, 2018. Results At BHBH, appropriate ECG utilization increased 25.5% after implementation of a standardized protocol (P = .0172) and appropriate omission of ECG utilization improved by 26% (P < .00001). At MMC, appropriate ECGs decreased by 5%, and appropriate ECG omissions increased by 28%, neither of which were statistically significant (P = 1.0 and P = .3142, respectively). There was an increase in overall pharmacist monitoring. Discussion The study demonstrated that pharmacist involvement in ECG and QTc-interval monitoring utilizing a uniform protocol may improve the appropriateness of ECG and QTc-interval monitoring in patients in an acute care inpatient psychiatric hospital.

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