scholarly journals Modest therapeutic effects of low-frequency transcutaneous electric nerve stimulation on insomnia among older adults: A 4-week multi-center, randomized controlled study

Author(s):  
Hyuk joo Lee ◽  
Jung Kyung Hong ◽  
Hayun Choi ◽  
Seockhoon Chung ◽  
In-Young Yoon

Abstract A 4-week, multi-center, randomized controlled study was conducted to evaluate the therapeutic efficacy and safety of low-frequency transcutaneous electric nerve stimulation (LF-TENS) for insomnia disorder. A total of 160 individuals aged 40 to 80 years with insomnia disorder were included and randomized to the experimental group receiving active device (n = 81) or control group receiving sham device (n = 79). Both groups used the device for four weeks, more than five days a week. The participants also completed pre- and post-intervention assessment with questionnaires, sleep diaries, wrist actigraphy, and blood tests. We found a significant improvement of subjective sleep quality, depressive/anxiety symptoms, and blood cortisol level in both experimental and control groups. Notably, among patients aged over 60 years, the experimental group showed better improvement after intervention in the change of PSQI score (2.60 ± 0.46 vs. 1.22 ± 0.46, p = 0.039; Cohen’s d = 0.99 vs 0.45) and blood cortisol level (-1.97 ± 0.53 µg/dl vs. -0.16 ± 0.53 µg/dl, p = 0.007; Cohen’s d = 0.56 vs 0.05). We found that LF-TENS was effective in improving subjective sleep quality in older adults aged over 60 years. The hypothalamic-pituitary-adrenal axis might be related to the therapeutic mechanism.

Author(s):  
Nien Xiang Tou ◽  
Shiou-Liang Wee ◽  
Wei Ting Seah ◽  
Daniella Hui Min Ng ◽  
Benedict Wei Jun Pang ◽  
...  

AbstractTranslation of community-based functional training for older adults to reduce frailty is still lacking. We evaluated the effectiveness and implementation of a community-delivered group-based functional power training (FPT) program for frail older adults within their neighborhoods. A two-arm, multicenter assessor-blind stratified randomized controlled trial was conducted at four local senior activity centers in Singapore. Sixty-one community-dwelling older adults with low handgrip strength were randomized to intervention (IG) or control (CG) group. The IG underwent the FPT program (power and balance exercises using simple equipment) delivered by a community service provider. The 12-week program comprised 2 × 60 min sessions/week. CG continued usual activities at the centers. Functional performance, muscle strength, and frailty status were assessed at baseline and 3 months. Program implementation was evaluated using RE-AIM framework. The program was halted due to Coronavirus Disease 2019-related suspension of senior center activities. Results are reported from four centers, which completed the program. IG showed significantly greater improvement in the Short Physical Performance Battery test as compared to CG (p = 0.047). No effects were found for timed up and go test performance, muscle strength, and frailty status. The community program exhibited good reach, effectiveness, adoption, and implementation. Our study demonstrated that FPT was associated with greater improvement in physical function in pre-frail/frail participants as compared to exercise activities offered at local senior activity centers. It is a feasible intervention that can be successfully implemented for frail older adults in their neighborhoods. Trial registration ClinicalTrials.gov, NCT04438876. Registered 19 June 2020–retrospectively registered.


Author(s):  
Héctor Guerrero-Tapia ◽  
Rodrigo Martín-Baeza ◽  
Rubén Cuesta-Barriuso

Background. Abdominal and lumbo-pelvic stability alterations may be the origin of lower limb injuries, such as adductor pathology in soccer players. Imbalance can be caused by both intrinsic and extrinsic factors. Methods: In this randomized controlled trial over 8 weeks, 25 female footballers were randomly allocated to an experimental group (isometric abdominal training and gluteus medius-specific training) or a control group (isometric abdominal training). Evaluations were performed at baseline, at the end of the intervention and after a 4-week follow-up period. The exercise protocol in common for both groups included three exercises: Plank, Lateral plank and Bird dog. Specific exercises for the gluteus medius were: Pelvic drop and Stabilization of the gluteus medius in knee valgus. Outcome measures were lumbar-pelvic stability and adductor strength. Results: After the intervention, there was an increase in lumbo-pelvic stability in both groups, being greater in the control group than in the experimental group (mean differences [MD]: 4.84 vs. MD: 9.58; p < 0.01) with differences in the analysis of repeated measures (p < 0.001), but not in group interaction (p = 0.26). Changes were found in adductor strength in the experimental group (MD: −2.48; p < 0.001 in the left adductor; MD: −1.48; p < 0.01 in right adductor) and control group (MD: −1.68; p < 0.001 in the left adductor; MD: −2.05; p < 0.001 in the right adductor) after the intervention, with differences in the analysis of repeated measures in left (p < 0.001) and right (p < 0.001) adductor strength. Conclusions: An abdominal and gluteal training protocol shows no advantage over a protocol of abdominal training alone for lumbo-pelvic stability and adductor strength, while improvements in both variables are maintained at four weeks follow-up.


2021 ◽  
Vol 26 (1) ◽  
Author(s):  
Shamekh Mohamed El-Shamy ◽  
Ehab Mohamed Abd El Kafy

Abstract Background TheraTogs promotes proprioceptive sense of a child with cerebral palsy and improves abnormal muscle tone, posture alignment, balance, and gait. Therefore, the aim of this study was to investigate the efficacy of TheraTogs orthotic undergarment on gait pattern in children with dyskinetic cerebral palsy. Thirty children with dyskinetic cerebral palsy were selected for this randomized controlled study. They were randomly assigned to (1) an experimental group that received TheraTogs orthotic undergarment (12 h/day, 3 days/week) plus traditional physical therapy for 3 successive months and (2) a control group that received only traditional physical therapy program for the same time period. Gait parameters were measured at baseline and after 3 months of intervention using Pro-Reflex motion analysis. Results Children in both groups showed significant improvements in the gait parameters (P < 0.05), with significantly greater improvements in the experimental group than in the control group. Conclusions The use of TheraTogs may have a positive effect to improve gait pattern in children with dyskinetic cerebral palsy. Trial registration This trial was registered in the ClinicalTrial.gov PRS (NCT03037697).


2019 ◽  
Author(s):  
Chao Hsing Yeh ◽  
Cuicui Li ◽  
Ronald Glick ◽  
Elizabeth A. Schlenk ◽  
Kathryn Albers ◽  
...  

Abstract Background: Chronic low back pain (cLBP) is a major health problem and the most common pain condition among those 60 years of age or older in the US. Despite the development of pharmacological and nonpharmacological interventions, cLBP outcomes have not improved and disability rates continue to rise. This study aims to test auricular point acupressure (APA) as a non-invasive, nonpharmacological self-management strategy to manage cLBP and to address current shortcomings of cLBP treatment. Methods: For this prospective randomized controlled study, participants will be randomly assigned into three groups: (1) APA (active points related to cLBP), (2) Comparison Group -1 (non-active points, unrelated to cLBP), (3) Comparison Group-2 (enhanced educational control, an educational booklet on cLBP will be given and the treatment used by participants for their cLBP will be recorded). The ecological momentary assessment smartphone app will be used to collect real-time cLBP outcomes and adherence to APA practice. Treatment and nonspecific psychological placebo effects will be measured via questionnaires for all participants. This proposed trial will evaluate the APA sustained effects for cLBP at 12-month follow-up. Monthly phone follow-up will be used to collect study outcomes. Blood will be collected during study visits at baseline, post-APA treatment, and follow-up study visits at 1-, 3-, 6-, 9- and 12-months post-completion of treatment for a total of 7 assessments. Appointments will start between 9 and 11 am to control for circadian variation in cytokine levels. Discussion: This study is expected to provide vital information on the efficacy, sustainability, and underlying mechanism of APA on cLBP necessary for APA to gain acceptance from both healthcare providers and patients, which would provide a strong impetus for including APA as part of cLBP management in clinical and home settings. Trial registration: NCT03589703, Registered on May 22, 2018 Keywords: Chronic low back pain, auricular point acupressure, older adults, cytokines


2020 ◽  
Author(s):  
Kyungmi Chung ◽  
Seoyoung Kim ◽  
Eun Lee ◽  
Jin Young Park

BACKGROUND As an evidence-based psychotherapy for treating insomnia, cognitive behavioral therapy for insomnia (CBT-I), which helps people with sleep problems to change their unhelpful sleep-related beliefs and habits, has been well-established in older adults. Recently, the utilization of mobile CBT-I apps has been getting attention from mental health professionals and researchers; however, whether mobile CBT-I apps are usable among older users has yet to be determined. OBJECTIVE The aims of this study were to explore the relationships between subjective sleep quality and subjective memory complaints and depressive symptoms; to explore the relationship between perceived difficulty in mobile app use and usability of the mobile phone–based self-help CBT-I app, named MIND MORE, in urban community-dwelling Korean older adults; to compare changes in subjective sleep quality from pre-intervention to post-intervention, during which they used the mobile app over a 1-week intervention period; and evaluate adherence to the app. METHODS During the 2-hour training program delivered on 1 day titled “Overcoming insomnia without medication: How to use the ‘MIND MORE’ mobile app for systematic self-management of insomnia” (pre-intervention), 41 attendants were asked to gain hands-on experience with the app facilitated by therapists and volunteer workers. They were then asked to complete questionnaires on sociodemographic characteristics, subjective evaluation of mental health status (ie, depression, memory loss and impairment, and sleep problems), and app usability. For the 1-week home-based self-help CBT-I using the app (post-intervention), 9 of the 41 program attendants, who had already signed up for the pre-intervention, were guided to complete the given questionnaires on subjective evaluation of sleep quality after the 1-week intervention, specifically 8 days after the training program ended. RESULTS Due to missing data, 40 of 41 attendants were included in the data analysis. The main findings of this study were as follows. First, poor subjective sleep quality was associated with higher ratings of depressive symptoms (40/40; ρ=.60, <i>P</i>&lt;.001) and memory complaints (40/40; ρ=.46, <i>P</i>=.003) at baseline. Second, significant improvements in subjective sleep quality from pre-intervention to post-intervention were observed in the older adults who used the MIND MORE app only for the 1-week intervention period (9/9; <i>t</i><sub>8</sub>=3.74, <i>P</i>=.006). Third, apart from the program attendants who did not have a smartphone (2/40) or withdrew from their MIND MORE membership (3/40), those who attended the 1-day sleep education program adhered to the app from at least 2 weeks (13/35, 37%) to 8 weeks (2/35, 6%) without any further contact. CONCLUSIONS This study provides empirical evidence that the newly developed MIND MORE app not only is usable among older users but also could improve subjective sleep quality after a 1-week self-help intervention period.


2020 ◽  
Author(s):  
Héctor Guerrero-Tapia ◽  
Rodrigo Martín-Baeza ◽  
Rubén Cuesta-Barriuso

Abstract Background: Abdominal and lumbo-pelvic stability alterations may origin lower limb injuries, such as for example adductor pathology in soccer players. Imbalance can be caused by both intrinsic and extrinsic factors. Methods: This randomized controlled trial conducted over an 8-week period included 25 female footballers randomly allocated to an experimental group (isometric abdominal training and gluteus medius-specific training) or a control group (isometric abdominal training). The exercise protocol in common for both groups included three exercises: Plank, Lateral plank and Bird dog. Specific exercises for the gluteus medius were: Pelvic drop and Stabilization of the gluteus medius in knee valgus. Outcome measures were lumbo-pelvic stability and adductor strength.Results. Lumbo-pelvic stability after surgery was higher in the control group (MD: 4.84 vs MD: 9.58; p < .01) with differences in the analysis of repeated measures (p<.001), but not in group interaction (p =.26). Changes were found in adductor strength in the experimental group (MD: -2.48; p<.001 in the left adductor; MD: -1.48; p<.01 in right adductor) and control group (MD: -1.68; p<.001 in the left adductor; MD: -2.05; p<.001 in the right adductor) after the intervention, with differences in the analysis of repeated measures in left (p<.001) and right (p<.001) adductor strength.Conclusions. An abdominal and gluteal training protocol shows no advantage over a protocol of abdominal training alone for lumbo-pelvic stability and adductor strength and flexibility, while improvements are maintained at four weeks follow-up. Trial Registration Number: NCT03617887.


2018 ◽  
Vol 73 ◽  
pp. 136-144 ◽  
Author(s):  
Emerson Sebastião ◽  
Edward McAuley ◽  
Ryosuke Shigematsu ◽  
Brynn C. Adamson ◽  
Rachel E. Bollaert ◽  
...  

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