Physical therapy combined with a laxative fruit drink for treatment of chagasic megacolon

CONTEXT: The treatment of Chagas' disease colopathy is limited to clinical management in the initial of the process, and for patients for whom surgery is not indicated or is not possible, anti-constipation diets are used, along with judicious administration of laxatives and enemas. OBJECTIVE: To evaluate over time the effects of physical-therapy interventions combined with daily ingestion of a laxative fruit drink in the treatment of chagasic megacolon. METHOD: In a quantitative, prospective, and comparative study, 12 patients of both sexes and with a mean age of 67 ± 12 years were clinically evaluated to receive 12 sessions of physical therapy twice a week, along with fruit drink, and were evaluated for intestinal constipation before and after treatment. RESULTS: A significant difference (P<0.0022) was observed in the constipation scores before and after 6 weeks of intervention in 91.7% of the patients, and in 72.7% after 12 months, with reduction of laxative medications, softer stools, and increased number of bowel movements. With respect to gender, age, and whether or not the patient had received surgical treatment, there was no significant difference (P>0.05). CONCLUSION: The proposed protocol is easy to implement, safe, non-invasive, and low-cost, with the potential to be deployed in health care by providing benefits independent of gender, age, or whether the participant has undergone surgery, improving the condition of patients with chagasic megacolon.

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Effects of Ambulation and Nondependent Transfers on Vital Signs in Patients Receiving Norepinephrine

American Journal of Critical Care ◽

10.4037/ajcc2017384 ◽

2017 ◽

Vol 26 (1) ◽

pp. 31-36 ◽

Cited By ~ 3

Author(s):

Rosario Arcaya Nievera ◽

Ann Fick ◽

Hilary K. Harris

Keyword(s):

Heart Rate ◽

Mean Arterial Pressure ◽

Physical Therapy ◽

Arterial Pressure ◽

Low Dose ◽

Vital Signs ◽

Activity Level ◽

Significant Difference ◽

Before And After ◽

Norepinephrine Dose

Purpose To assess the safety of mobilizing patients receiving low-dose norepinephrine (0.05 μg/kg per min) by examining mean arterial pressure and heart rate before and after activity with parameters set by the physician. Background Norepinephrine is a peripheral vasoconstrictor administered for acute hypotension. During activity, blood flows to the periphery to supply muscles with oxygen, which may oppose the norepinephrine vasoconstriction. The safety of mobilizing patients receiving norepinephrine is unclear. Methods Heart rate, mean arterial pressure, norepinephrine dose, and activity performed were extracted retrospectively from charts of 47 cardiothoracic surgery patients during the first patient transfer to chair or ambulation with norepinephrine infusing. Mean arterial pressure and heart rate were compared before and after physical therapy (paired t tests). Differences among norepinephrine doses and physical activity levels were evaluated (Kruskal-Wallis test). Results Forty-one of the 47 patients (87%) tolerated the activity within safe ranges of vital signs. The change in patients’ mean arterial pressure from before to after activity was not significant (P = .16), but a significant increase in heart rate occurred after activity (P < .001). A Kruskal-Wallis test showed no significant difference in the norepinephrine dose and activity level (χ2 = 6.34, P = .17). No instances of cardiopulmonary or respiratory arrest occurred during any physical therapy sessions. Conclusions Infusion of low-dose norepinephrine should not be considered an automatic reason to keep patients on bed rest.

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Patients’ Satisfaction Evaluation

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967114s00172 ◽

2014 ◽

Vol 2 (11_suppl3) ◽

pp. 2325967114S0017

Author(s):

Ebru Kaya Mutlu ◽

Arzu Razak Özdinçler

Keyword(s):

Physical Therapy ◽

Physical Therapy Modalities ◽

Osteoarthritis Of The Knee ◽

Global Rating ◽

Duration Of Treatment ◽

Patients Satisfaction ◽

Significant Difference ◽

Before And After ◽

Passive Mobilization ◽

Satisfaction Evaluation

Objectives: Although many studies were focused on the assessment of patients' satisfaction, few studies have specifically addressed this issue for knee osteoartritis. Global rating of change (GRC) scales are very commonly used in clinical research, particularly in the musculoskeletal area. The purpose of this study was to evaluate the patients’ satisfaction of the Mulligan’s Mobilization with Movement (MWM) techniques, Passive Mobilization (PM) techniques and physical therapy modalities (PTM) (superficial heat or cold, Transcutaneous Electrical Nerve Stimulation (TENS) and therapeutic ultrasound) in subjects with osteoarthritis of the knee. Methods: Thirty subjects with bilateral osteoarthritis of the knee were randomly assigned to the MWM group (n=21) or the PM group (n=21) or PTM group (n=22). The duration of treatment was a maximum of 5 weeks (12 sessions) in all groups. The subjects’ satisfaction were assessed before and after treatment by the GRC scales. One-way analysis of variance was used to compare the groups. When significance was observed, pairwise post hoc tests were performed using Tukey’s test. Results: Mean age and body mass index (BMI) of our study group were 54±7 years and 31±5 kg/m²,respectively in the MWM group, 56±6 years and 31±4 kg/m²,respectively in the PM group and 57±6 years and 32±5 kg/m²,respectively in the PTM group There were no significant differences between the groups with respect to age, BMI and GRC before treatment (p>0.05). Patients satisfaction of the three groups after treatment were significantly different (F=6.732 p=0.002). Pairwise comparisons of the treatment groups revealed a significant difference in the patients’ satisfaction between MWM and PTM (p=0.007), and between PM and PTM (p=0.007); there was no significant difference between MWM and PM (p>0.05). Conclusion: Manual therapy seemed to be superior to physical therapy modalities for the patients’ satisfaction. Therefore, we suggest that physiotherapist either can apply MWM or PM techniques based on their clinical experience in the management of osteoarthritis of the knee.

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Comparison of three physical therapy interventions with an emphasis on the gait of individuals with Parkinson’s disease

Fisioterapia em Movimento ◽

10.1590/1980-5918.030.004.ao04 ◽

2017 ◽

Vol 30 (4) ◽

pp. 691-701

Author(s):

Maria Eduarda Brandão Bueno ◽

Ana Carolina dos Reis Andrello ◽

Marcelle Brandão Terra ◽

Hevely Beatriz Celestino dos Santos ◽

Júlia Marson Marquioli ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Physical Therapy ◽

Rating Scale ◽

Post Intervention ◽

Timed Up And Go ◽

Intervention Protocol ◽

Before And After ◽

Yahr Scale ◽

Therapy Interventions

Abstract Introduction: Gait impairments are one of the earliest signs reported by patients with Parkinson’s disease (PD) and cause an increased number of falls and decreased quality of life among these patients. Objective: To compare the effectiveness of three physical therapy interventions using Rhythmic Cues (RC), Swiss Ball (SB) and Dual Task (DT), with an emphasis on gait treatment (step and stride length, duration and velocity), in individuals with PD. Methods: Quasi-randomized clinical trial addressing a sample composed of 45 individuals assigned to three groups. The individuals were assessed before and after the intervention protocol using the following: Modified Hoehn and Yahr Scale (HY), Unified Parkinson’s Disease Rating Scale (UPDRS), Footprint analysis, Video Gait analysis, and Timed Up and Go Test (TUG). The groups were homogeneous concerning age, HY and UPDRS. Statistical analysis was performed using SPSS, version 20.0. Results: Statistically significant differences were found in all the variables analyzed in the RC and SB groups when compared in the pre- and post-intervention. With the exception of the TUG variable, the DT group presented statistically significant differences in all the remaining variables. Conclusion: The three interventions were effective for the outcomes under study, but the SB group presented the greatest magnitude of change (effect size), while the RC group presented the greatest improvement in the temporal gait variables (duration and velocity) and TUG.

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Effects of rice-based and wheat-based diets on bowel movements in young Korean women with functional constipation

European Journal of Clinical Nutrition ◽

10.1038/s41430-020-0636-1 ◽

2020 ◽

Vol 74 (11) ◽

pp. 1565-1575

Author(s):

Su-Jin Jung ◽

Mi-Ra Oh ◽

Soo-Hyun Park ◽

Soo-Wan Chae

Keyword(s):

Fatty Acid Content ◽

Brown Rice ◽

Functional Constipation ◽

Bowel Function ◽

Colon Transit Time ◽

Dietary Fiber Intake ◽

Significant Difference ◽

Before And After ◽

Bowel Movements ◽

Colon Transit

Abstract Background Although several studies have reported the effects that dietary fiber intake from different types of grains and fiber components have on bowel movements, insufficient attention has been paid to comparing and evaluating the effects of rice-based and wheat-based diets. This study compared and evaluated the effects of ingesting rice-based (brown rice-based diet: BRD; white rice-based diet: WRD) and wheat-based diet (WD) on the bowel movements of young women with functional constipation. Method Based on an open, randomized, controlled, and parallel design, 39 subjects were assigned to BRD, WRD, and WD groups (13 in each group). Each participant had received three types of experimental diets over the course of 4 weeks and we recommended that the subjects eat only the test diet provided during the study. Primary outcomes (total colon transit time TCTT) and secondary outcomes (bowel movements, short-chain fatty acid content, and fecal enzyme activity) were compared before and after the 4-week intervention period. Results After the 4-week study, the rice-based diet (BRD and WRD) groups and the WD group had a statistically significant difference in TCTT (p = 0.028). The TCTT of the BRD group was significantly reduced (p = 0.028) compared with the WRD group (−16.5 ± 8.1 vs +6.8 ± 2.1), and the TCTT of the WD group was also significantly reduced (p = 0.022) compared with that of the WRD group (−17.1 ± 11.9 vs +6.8 ± 2.1). Conclusion Among women with functional constipation, the BRD and WD both improved bowel function by reducing TCTT and increasing the number of bowel movements compared with the WRD group.

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Balance and Mobility Following Stroke: Effects of Physical Therapy Interventions With and Without Biofeedback/Forceplate Training

Physical Therapy ◽

10.1093/ptj/81.4.995 ◽

2001 ◽

Vol 81 (4) ◽

pp. 995-1005 ◽

Cited By ~ 191

Author(s):

Ruth Ann Geiger ◽

Jeffery B Allen ◽

Joanne O'Keefe ◽

Ramona R Hicks

Keyword(s):

Physical Therapy ◽

Berg Balance Scale ◽

Treatment Session ◽

Control Group ◽

Perceptual Skills ◽

Balance Scale ◽

Visual Biofeedback ◽

Before And After ◽

Therapy Interventions ◽

Experimental Group

Abstract Background and Purpose. Visual biofeedback/forceplate systems are often used for treatment of balance disorders. In this study, the researchers investigated whether the addition of visual biofeedback/forceplate training could enhance the effects of other physical therapy interventions on balance and mobility following stroke. Subjects. The study included a sample of convenience of 13 outpatients with hemiplegia who ranged in age from 30 to 77 years (X̄=60.4, SD=15.4) and were 15 to 538 days poststroke. Methods. Subjects were assigned randomly to either an experimental group or a control group when the study began, and their cognitive and visual-perceptual skills were tested by a psychologist. Subjects were also assessed using the Berg Balance Scale and the Timed “Up & Go” Test before and after 4 weeks of physical therapy. Both groups received physical therapy interventions designed to improve balance and mobility 2 to 3 times per week. The experimental group trained on the NeuroCom Balance Master for 15 minutes of each 50-minute treatment session. The control group received other physical therapy for 50 minutes. Results. Following intervention, both groups scored higher on the Berg Balance Scale and required less time to perform the Timed “Up & Go” Test. These improvements corresponded to increased independence of balance and mobility in the study population. However, a comparison of mean changes revealed no differences between groups. Discussion and Conclusion. Although both groups demonstrated improvement following 4 weeks of physical therapy interventions, no additional effects were found in the group that received visual biofeedback/forceplate training combined with other physical therapy.

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Use of an inertial measurement unit sensor in pedicle screw placement improves trajectory accuracy

PLoS ONE ◽

10.1371/journal.pone.0242512 ◽

2020 ◽

Vol 15 (11) ◽

pp. e0242512

Author(s):

Satoshi Baba ◽

Kenichi Kawaguchi ◽

Kazuhito Itamoto ◽

Takeshi Watanabe ◽

Mitsumasa Hayashida ◽

...

Keyword(s):

Pedicle Screw ◽

Inertial Measurement Unit ◽

Low Cost ◽

Measurement Unit ◽

Rotational Angle ◽

Inertial Measurement ◽

Computed Tomography Images ◽

Freehand Technique ◽

Significant Difference ◽

Before And After

Ascertaining the accuracy of the pedicle screw (PS) trajectories is important as PS malpositioning can cause critical complications. We aimed to determine the angle range over which estimation is unreliable; build a low-cost PS placement support system that uses an inertial measurement unit (IMU) to enable the monitoring of surgical tools and PS trajectories, and determine the situations where IMU support would be most beneficial. In PS insertion experiments, we used cadaver samples that included lumbar porcine spines. Computed tomography images obtained before and after PS insertion were viewed. Offsets between the planned and implanted PS trajectories in the freehand and IMU-assisted groups were analyzed. The PS cortical bone breaches were classified according to the Gertzbein and Robbins criteria (GRC). Added head-down tilted sample experiments were repeated wherein we expected a decreased rostro-caudal rotational accuracy of the PS according to the angle estimation ability results. Evaluation of the PS trajectory accuracy revealed no significant advantage of IMU-assisted rostro-caudal rotational accuracy versus freehand accuracy. According to the GRC, IMU assistance significantly increased the rate of clinically acceptable PS positions (RoCA) than the freehand technique. In the head-down tilted sample experiments, IMU assist provided increased accuracies with both rostro-caudal and medial rotational techniques when compared with the freehand technique. In the freehand group, RoCA was significantly decreased in samples with rostral tilting relative to that in the samples without. However, In the IMU-assisted group, no significant difference in RoCA between the samples with and without head-down tilting was observed. Even when the planned PS medial and/or rostro-caudal rotational angle was relatively large and difficult to reproduce manually, IMU-support helped maintain the PS trajectory accuracy and positioning safety. IMU assist in PS placement was more beneficial, especially for larger rostro-caudal and/or medial rotational pedicle angles.

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71. Diagnostic Stewardship of Clostridioides difficile Testing

Open Forum Infectious Diseases ◽

10.1093/ofid/ofab466.273 ◽

2021 ◽

Vol 8 (Supplement_1) ◽

pp. S153-S153

Author(s):

Zahra Qamar ◽

Lisa A Spacek ◽

Dagan Coppock ◽

Kaya Patel ◽

Nathan L’Etoile ◽

...

Keyword(s):

Retrospective Analysis ◽

Chain Reaction ◽

Clostridioides Difficile ◽

Highly Sensitive ◽

Significant Difference ◽

Before And After ◽

Bowel Movements ◽

Sensitive Polymerase Chain Reaction ◽

Polymerase Chain ◽

Clinically Significant

Abstract Background C. difficile (CD) testing is frequently ordered inappropriately. Highly sensitive polymerase chain reaction (PCR) tests can detect CD colonization leading to misdiagnosis. Providers often overlook other causes of diarrhea, notably laxatives. To improve diagnostic stewardship, our hospital introduced an electronic medical record (EMR)-based order set (OS). Methods In a 926-bed, teaching hospital, we conducted a 3-step intervention to improve CD diagnostic stewardship. (1) A retrospective analysis of CD orders before and after OS implementation was done to assess its impact on inappropriate orders. The OS included two questions: (a) Did patient have ≥ 3 loose bowel movements in past 24 hours? and (b) No laxatives in past 24 hours? An appropriate order was defined if “yes” to both questions. It was still appropriate if “no” to either question but ≥ 2 unexplained following features: fever > 100.4 F, abdominal pain, megacolon, ileus or leukocytosis > 11,000 cells/mm3 in prior day. (2) After implementation of OS, house staff compliance with OS was surveyed via email. (3) Rationale for inappropriate orders was discussed with providers. Results Of 238 patients in retrospective analysis, 44% were ≥ 65 years and 37% had other potential causes of diarrhea. Common clinical features were leukocytosis (40%) and fever (31%). There was no significant difference in inappropriate testing: pre-OS 27/99 (27%) vs post-OS 44/139 (32%) (p=0.47). Of 43 house officers who participated in the survey, 75% indicated they over rode the OS. When asked to provide rationale of inappropriate CD testing, providers acknowledged inappropriate ordering but did not want to miss a CD diagnosis and frequently overlooked other causes of diarrhea. Conclusion Appropriate CD testing relies on providers’ appreciation of a clinical picture consistent with CD infection, confirmation of clinically significant diarrhea, and consideration of other causes of diarrhea. Providers order inappropriate tests, not due to lack of knowledge, but likely fear of missing diagnosis and overlooking other causes of diarrhea. Disclosures All Authors: No reported disclosures

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Occurrence of metabolic risk in schoolchildren using a noninvasive indicator: waist and height ratio

Journal of Human Growth and Development ◽

10.7322/jhgd.152160 ◽

2018 ◽

Vol 28 (3) ◽

pp. 252-257

Author(s):

Arieli Fernandes Dias ◽

Caroline Brand ◽

Vanilson Batista Lemes ◽

Adroaldo Cezar Araujo Gaya ◽

Anelise Reis Gaya

Keyword(s):

Metabolic Disorders ◽

Low Cost ◽

Childhood And Adolescence ◽

Metabolic Risk ◽

Height Ratio ◽

Chi Square ◽

Non Invasive ◽

Significant Difference ◽

Waist To Height Ratio ◽

The City

Introduction: Metabolic disorders in childhood and adolescence have been increasing considerably. Thus, the importance of performing an early diagnosis is emphasized. Objective: To analyse the occurrence of metabolic risk using a non-invasive marker in schoolchildren. Methods: This is a descriptive study with a quantitative approach, with random sample of 174 schoolchildren (70 boys and 104 girls) from 10 state high schools in the city of Passo Fundo, Rio Grande do Sul, Brazil. The height (cm) was verified according to the procedures of the Brazilian Sport Project and the waist circumference (cm) was measured with a flexible and inelastic tape measure. From this the waist-to-height ratio was calculated, which takes into account the proportion of abdominal fat by the individual’s height, considering the cut-off point of Ashwell & Hsieh. For data analysis we used descriptive and chi-square statistics. Results: The metabolic risk of schoolchildren was 13.8%, when stratified by sex, the occurrences were 11.4% for males and 15.4% for females, but there was no significant difference between the sexes (X2= 0.54; p= 0.45). Conclusion: The use of non-invasive markers for the diagnosis of metabolic risk indicated a high occurrence of it in schoolchildren, with the girls presenting a higher risk. The use of this method is important because it allows the evaluation of a greater number of schoolchildren and the early identification of health risk. In addition to being a low-cost, easy-to-apply method.

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Measuring oxygen saturation and pulse rate in dairy cows before and after machine milking using a low-cost pulse oximeter

Journal of Agricultural Engineering ◽

10.4081/jae.2021.1155 ◽

2021 ◽

Vol 52 (1) ◽

Author(s):

Aldo Calcante ◽

Francesco M. Tangorra

Keyword(s):

Oxygen Saturation ◽

Dairy Cows ◽

Pulse Rate ◽

Pulse Oximeter ◽

Low Cost ◽

Machine Milking ◽

Lactation Stage ◽

Significant Difference ◽

Before And After ◽

Milking Machine

The present study was aimed to measure the haemoglobin oxygen saturation and the pulse rate at teat level on dairy cows after and before milking, using a low cost pulse oximeter developed especially. The pulse oximeter has been tested during a three days of field test involving 18 Holstein Friesian cows raised in a commercial farm located in Northern Italy. The results highlighted that there is a significant difference both in haemoglobin oxygen saturation (SpO2) and pulse rate before and after milking considering the entire sample of animals. By dividing the sample according to the milking time (fast < 8 min and slow > 8 min), a significant difference between fast and slow cows has been observed for SpO2, whilst no difference has been noted considering the lactation stage (< 70 DIM and 71-140 DIM). About the pulse rate, on the contrary, milking time and lactation stage were not significantly different. This confirms that machine milking can create stress to the teat evoking circulatory impairment of its tissue and that pulse oximetry could be useful for detecting machine milking-induced alterations of teats. In perspective, the pulse oximeter could be used as a part of a monitoring system of the milking machine, enabling to change its operating parameters in order to minimize the mechanical stress on the teats.

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Effects of In-Hospital Physical Therapy on Activities of Daily Living in Patients with Hepatocellular Carcinoma

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17239098 ◽

2020 ◽

Vol 17 (23) ◽

pp. 9098

Author(s):

Hayato Narao ◽

Keisuke Hirota ◽

Shunji Koya ◽

Manabu Tomita ◽

Yuta Manako ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Physical Therapy ◽

Activities Of Daily Living ◽

Cancer Treatment ◽

Daily Living ◽

Functional Independence Measure ◽

Functional Independence ◽

Knee Extension ◽

Significant Difference ◽

Before And After

Activities of daily living (ADL) are frequently impaired in patients with hepatocellular carcinoma (HCC). In this retrospective study, we aimed to investigate the effects of physical therapy on ADLs in patients with HCC during hospitalization for cancer treatment. Nineteen patients with HCC were enrolled. During hospitalization, patients performed a combination of resistance training, stretching, and aerobic exercise (20–60 min/day). ADLs were assessed using the functional independence measure (FIM). Changes in FIM were evaluated by before–after analysis. No significant difference was seen in Child–Pugh class before and after physical therapy. The bilateral knee extension strength and chair stand test were significantly increased after physical therapy compared with before physical therapy (p = 0.001 and p = 0.008, respectively). The total FIM score was significantly increased after physical therapy compared with that before physical therapy (p = 0.0156). Among the 18 indexes of FIM, the stairs index was significantly improved after physical therapy compared with that before physical therapy (5.9 vs. 6.4 points, p = 0.0241). We demonstrated that physical therapy improved muscle strength without worsening liver function. Furthermore, physical therapy improved FIM, especially in the stairs index, in patients with HCC. Thus, physical therapy may be beneficial in patients with HCC during cancer treatment.

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