scholarly journals The efficacy of intermittent pneumatic compression and negative pressure therapy on muscle function, soreness and serum indices of muscle damage: a randomized controlled trial

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Szczepan Wiecha ◽  
Martyna Jarocka ◽  
Paweł Wiśniowski ◽  
Maciej Cieśliński ◽  
Szymon Price ◽  
...  
Keyword(s):  
Muscle Strength ◽  
Eccentric Exercise ◽  
Negative Pressure ◽  
Muscle Function ◽  
Controlled Trial ◽  
Intermittent Pneumatic Compression ◽  
Trial Registration ◽  
Future Research ◽  
Pressure Therapy ◽  
Active Flexion

Abstract Background The study aimed to assess whether intermittent pneumatic compression (IPC) and intermittent negative pressure (INP) would attenuate the muscle damaging effects of eccentric exercise. Methods Forty-five healthy males were recruited. Immediately post, 24 and 48 h post eccentric exercise consisting of 100 drop jumps, volunteers randomly received 30-min sessions of intermittent pneumatic compression (IPC, n = 15) or intermittent negative pressure (INP, n = 15), or sham microcurrent (PT, n = 15). Creatine kinase (CK), lactate dehydrogenase (LDH), isokinetic muscle strength, soreness and active flexion of the knee joint were measured after every therapy session. Results No significant intergroup differences were observed in biochemical or functional measurements. However, there was an increase in muscle soreness (P < 0.05), CK and LDH activity (P < 0.05), and a reduction in muscle strength (P < 0.05) and range of active knee flexion (P < 0.05). Conclusions The prescription of IPC and INP did not attenuate the reduction of markers to muscle function or pain perception up to 48 h after muscle damaging exercise. Future research should focus on the potential impact of treatment frequency and duration on muscle recovery. Trial registration The study was retrospectively registered in the Australian New Zealand Clinical Trials Registry (ANZCTR); The trial registration number: ACTRN12621001294842; date of registration: 24/09/2021.

scholarly journals Use of Closed Incision Negative Pressure Therapy (ciNPT) in Breast Reconstruction Abdominal Free Flap Donor Sites

2021 ◽  
Vol 10 (21) ◽  
pp. 5176
Author(s):  
Jennifer Wang ◽  
Zyg Chapman ◽  
Emma Cole ◽  
Satomi Koide ◽  
Eldon Mah ◽  
...  
Keyword(s):  
Breast Reconstruction ◽  
Free Flap ◽  
Negative Pressure ◽  
Statistical Significance ◽  
Future Research ◽  
Wound Complications ◽  
Negative Pressure Therapy ◽  
Royal Melbourne Hospital ◽  
Pressure Therapy ◽  
The Impact

Background: Closed incision negative pressure therapy (ciNPT) may reduce the rate of wound complications and promote healing of the incisional site. We report our experience with this dressing in breast reconstruction patients with abdominal free flap donor sites. Methods: A retrospective cohort study was conducted of all patients who underwent breast reconstruction using abdominal free flaps (DIEP, MS-TRAM) at a single institution (Royal Melbourne Hospital, Victoria) between 2016 and 2021. Results: 126 female patients (mean age: 50 ± 10 years) were analysed, with 41 and 85 patients in the ciNPT (Prevena) and non-ciNPT (Comfeel) groups, respectively. There were reduced wound complications in almost all outcomes measured in the ciNPT group compared with the non-ciNPT group; however, none reached statistical significance. The ciNPT group demonstrated a lower prevalence of surgical site infections (9.8% vs. 11.8%), wound dehiscence (4.9% vs. 12.9%), wound necrosis (0% vs. 2.4%), and major complication requiring readmission (2.4% vs. 7.1%). Conclusion: The use of ciNPT for abdominal donor sites in breast reconstruction patients with risk factors for poor wound healing may reduce wound complications compared with standard adhesive dressings; however, large scale, randomised controlled trials are needed to confirm these observations. Investigation of the impact of ciNPT patients in comparison with conventional dressings, in cohorts with equivocal risk profiles, remains a focus for future research.

Blood Flow Restriction Training Applied With High-Intensity Exercise Does Not Improve Quadriceps Muscle Function After Anterior Cruciate Ligament Reconstruction: A Randomized Controlled Trial

2020 ◽  
Vol 48 (4) ◽  
pp. 825-837 ◽  
Author(s):  
Michael T. Curran ◽  
Asheesh Bedi ◽  
Christopher L. Mendias ◽  
Edward M. Wojtys ◽  
Megan V. Kujawa ◽  
...  
Keyword(s):  
Muscle Strength ◽  
High Intensity ◽  
Muscle Function ◽  
Controlled Trial ◽  
Cruciate Ligament ◽  
Quadriceps Muscle ◽  
High Intensity Exercise ◽  
Quadriceps Muscle Strength ◽  
Flow Restriction ◽  
Anterior Cruciate

Background: A major goal of rehabilitation after anterior cruciate ligament reconstruction (ACLR) is restoring quadriceps muscle strength. Unfortunately, current rehabilitation paradigms fall short of this goal, such that substantial quadriceps muscle strength deficits can limit return to play and increase the risk of recurrent injuries. Blood flow restriction training (BFRT) involves the obstruction of venous return to working muscles during exercise and may lead to better recovery of quadriceps muscle strength after ACLR. Purpose: To examine the efficacy of BFRT with high-intensity exercise on the recovery of quadriceps muscle function in patients undergoing ACLR. Study Design: Randomized controlled trial; Level of evidence, 2. Methods: A total of 34 patients (19 female, 15 male; mean age, 16.5 ± 2.7 years; mean height, 169.0 ± 19.7 cm; mean weight, 73.2 ± 17.7 kg) scheduled to undergo ACLR were randomly assigned to 1 of 4 groups: concentric (n = 8), eccentric (n = 8), concentric with BFRT (n = 9), and eccentric with BFRT (n = 9). The exercise component of the intervention consisted of patients performing a single-leg isokinetic leg press, at an intensity of 70% of the patients’ 1-repetition maximum during either the concentric or eccentric action, for 4 sets of 10 repetitions 2 times per week for 8 weeks beginning at 10 weeks postoperatively. Patients randomized to the BFRT groups performed the leg-press exercise with a cuff applied to the thigh, set to a limb occlusion pressure of 80%. Isometric and isokinetic (60 deg/s) quadriceps peak torque, quadriceps muscle activation, and rectus femoris muscle volume were assessed before ACLR, after BFRT, and at the time that patients returned to activity and were converted to the change in values from baseline for analysis. Also, 1-way analyses of covariance were used to compare the change in values for each dependent variable between groups after BFRT and at return to activity ( P ≤ .05). Results: No significant differences were found between groups for any outcome measures at either time point ( P > .05). Conclusion: An 8-week BFRT plus high-intensity exercise intervention did not significantly improve quadriceps muscle strength, activation, or volume. On the basis of our findings, the use of BFRT in conjunction with high-intensity resistance exercise in patients undergoing ACLR to improve quadriceps muscle function may not be warranted. Registration: NCT03141801 ( ClinicalTrials.gov identifier)

scholarly journals Closed-Incision Negative-Pressure Therapy in Obese Patients Undergoing Cesarean Delivery: A Randomized Controlled Trial

2017 ◽  
Vol 07 (03) ◽  
pp. e151-e157 ◽  
Author(s):  
Ravindu Gunatilake ◽  
Geeta Swamy ◽  
Leo Brancazio ◽  
Michael Smrtka ◽  
Jennifer Thompson ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Cesarean Delivery ◽  
Negative Pressure ◽  
Controlled Trial ◽  
Obese Women ◽  
Opioid Use ◽  
Negative Pressure Therapy ◽  
Serious Adverse Events ◽  
Pressure Therapy ◽  
Randomized Controlled

Background Postcesarean wound morbidity is a costly complication of cesarean delivery for which preventative strategies remain understudied. Objective We compared surgical site occurrences (SSOs) in cesarean patients receiving closed-incision negative-pressure therapy (ciNPT) or standard-of-care (SOC) dressing. Study Design A single-center randomized controlled trial compared ciNPT (5–7 days) to SOC dressing (1–2 days) in obese women (body mass index [BMI] ≥ 35), undergoing cesarean delivery between 2012 and 2014. Participants were randomized 1:1 and monitored 42 ± 10 days postoperatively. The primary outcome SSOs included unanticipated local inflammation, wound infection, seroma, hematoma, dehiscence, and need for surgical or antibiotic intervention. Results Of the 92 randomized patients, 82 completed the study. ciNPT and SOC groups had similar baseline characteristics. Mean BMI was 46.5 ± 6.5 and no treatment-related serious adverse events. Compared with SOC, the ciNPT group had fewer SSOs (7/43 [16.3%] vs. 2/39 [5.1%], respectively; p = 0.16); significantly fewer participants with less incisional pain both at rest (39/46 [84.8%] vs. 20/46 [43.5%]; p < 0.001) and with incisional pressure (42/46 [91.3%] vs. 25/46 [54.3%]; p < 0.001); and a 30% decrease in total opioid use (79.1 vs. 55.9 mg morphine equivalents, p = 0.036). Conclusion A trend in SSO reduction and a statistically significant reduction in postoperative pain and narcotic use was observed in women using ciNPT.

scholarly journals No beneficial effects of vitamin D supplementation on muscle function or quality of life in primary hyperparathyroidism: results from a randomized controlled trial

2015 ◽  
Vol 172 (5) ◽  
pp. 609-617 ◽  
Author(s):  
Lars Rolighed ◽  
Lars Rejnmark ◽  
Tanja Sikjaer ◽  
Lene Heickendorff ◽  
Peter Vestergaard ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Vitamin D ◽  
Muscle Strength ◽  
Muscle Function ◽  
Postural Stability ◽  
Controlled Trial ◽  
Well Being ◽  
Vitamin D Supplementation ◽  
Beneficial Effects

ContextImpairments of muscle function and strength in patients with primary hyperparathyroidism (PHPT) are rarely addressed, although decreased muscle function may contribute to increased fracture risk.ObjectiveWe aimed to assess the changes in muscle strength, muscle function, postural stability, quality of life (QoL), and well-being during treatment with vitamin D or placebo before and after parathyroidectomy (PTX) in PHPT patients.DesignA randomized placebo-controlled trial.PatientsWe included 46 PHPT patients, mean age 58 (range 29–77) years and 35 (76%) were women.InterventionsDaily treatment with 70 μg (2800 IU) cholecalciferol or placebo for 52 weeks. Treatment was administered 26 weeks before PTX and continued for 26 weeks after PTX.Main outcome measuresChanges in QoL and measures of muscle strength and function.ResultsPreoperatively, 25-hydroxyvitamin D (25OHD) increased significantly (50–94 nmol/l) compared with placebo (57–52 nmol/l). We did not measure any beneficial effects of supplementation with vitamin D compared with placebo regarding well-being, QoL, postural stability, muscle strength, or function. In all patients, we measured marked improvements in QoL, well-being (P<0.01), muscle strength in the knee flexion and extension (P<0.001), and muscle function tests (P<0.01) after surgical cure. Postural stability improved during standing with eyes closed (P<0.05), but decreased with eyes open (P<0.05).ConclusionsPatients with PHPT and 25OHD levels around 50 nmol/l did not benefit from vitamin D supplementation concerning muscle strength, muscle function, postural stability, well-being, or QoL. Independent of preoperative 25OHD levels, PTX improved these parameters.

scholarly journals Home-based (virtual) rehabilitation improves motor and cognitive function for stroke patients: a randomized controlled trial of the Elements (EDNA-22) system

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Peter H. Wilson ◽  
Jeffrey M. Rogers ◽  
Karin Vogel ◽  
Bert Steenbergen ◽  
Thomas B. McGuckian ◽  
...  
Keyword(s):  
Active Control ◽  
Data Storage ◽  
Performance Monitoring ◽  
Brain Injuries ◽  
Controlled Trial ◽  
Training Group ◽  
Trial Registration ◽  
Future Research ◽  
Virtual Rehabilitation ◽  
Home Based

Abstract Background Home-based rehabilitation of arm function is a significant gap in service provision for adult stroke. The EDNA-22 tablet is a portable virtual rehabilitation-based system that provides a viable option for home-based rehabilitation using a suite of tailored movement tasks, and performance monitoring via cloud computing data storage. The study reported here aimed to compare use of the EDNA system with an active control (Graded Repetitive Arm Supplementary Program—GRASP training) group using a parallel RCT design. Methods Of 19 originally randomized, 17 acute-care patients with upper-extremity dysfunction following unilateral stroke completed training in either the treatment (n = 10) or active control groups (n = 7), each receiving 8-weeks of in-home training involving 30-min sessions scheduled 3–4 times weekly. Performance was assessed across motor, cognitive and functional behaviour in the home. Primary motor measures, collected by a blinded assessor, were the Box and Blocks Task (BBT) and 9-Hole Pegboard Test (9HPT), and for cognition the Montreal Cognitive Assessment (MoCA). Functional behaviour was assessed using the Stroke Impact Scale (SIS) and Neurobehavioural Functioning Inventory (NFI). Results One participant from each group withdrew for personal reasons. No adverse events were reported. Results showed a significant and large improvement in performance on the BBT for the more-affected hand in the EDNA training group, only (g = 0.90). There was a mild-to-moderate effect of training on the 9HPT for EDNA (g = 0.55) and control (g = 0.42) groups, again for the more affected hand. In relation to cognition, performance on the MoCA improved for the EDNA group (g = 0.70). Finally, the EDNA group showed moderate (but non-significant) improvement in functional behaviour on the SIS (g = 0.57) and NFI (g = 0.49). Conclusion A short course of home-based training using the EDNA-22 system can yield significant gains in motor and cognitive performance, over and above an active control training that also targets upper-limb function. Intriguingly, these changes in performance were corroborated only tentatively in the reports of caregivers. We suggest that future research consider how the implementation of home-based rehabilitation technology can be optimized. We contend that self-administered digitally-enhanced training needs to become part of the health literacy of all stakeholders who are impacted by stroke and other acquired brain injuries. Trial registration Australian New Zealand Clinical Trials Registry (ANZCTR) Number: ACTRN12619001557123. Registered 12 November 2019, http://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=378298&isReview=true

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