A Loop System along Skin with Transmitted Pilomotor Line for Vibrating Regulation of whole Body Function

In Chinese traditional medicine (CTM), meridians are described as a set of linear and longitudinal pathways along body skin. Acupuncture at acupoints provoke signals that transmit along the pathway and arrive to focal organs, which can treat more than one hundred of diseases. The pathway has been proved by modern anatomical and physiological researches. Linear structure and activity: There exist a loop system along body skin, consisted of a complex of sympathetic-arrector pili muscles (AP muscles) and concentrated mast cells in the rats. Along certain skin pathway, abundant sympathetic endings distribute within the AP muscles, which are appeared as sympathetic-substance lines (SSL) by macro-autoradiography. Under the line, mast cells are densely distributed. After shaving rat’s hairs, the new hairs firstly grow along some lines and loops, called hair-loop-lines (HLL). Acupuncture or injection of α receptor agonist at an acupoint produce a pilomotor line and simulate strong acupuncture effect, accompanying with neurogenic inflammation along the line in the rats. These three lines are coincident each other. The pilomotor line can be blocked by local injecting of α receptor antagonist, by crosscutting off skin or by applying procaine along the line, or by peritoneal injecting of cromoglicate. All these suggest that the pilomotor line along the SSL is the pathway for transmitting acupuncture signals independently and then producing acupuncture effect. Mechanism of linear transmission: The local piloerection stimulates the nerve nets of sympathetic endings and low threshold mechanical sensitive C-fibers around the hair follicles, whose excitation transmit to adjacent hair follicles by cross innervation and provoke new piloerection and neurosecretion respectively by axon reflex. Excited peripherical endings of C-fibers release neuropeptides (SP and CGRP) that stimulate mast cell degranulation. The released histamine stimulates C-fibers to produce gentle itch and further release of neuropeptides from C-fibers. Moreover, histamine stimulates AP muscle contraction. Thus, a positive feedback loop along hair follicles—C-fibers—mast cells is initiated and the pilomotor is enhanced and transmitted, accompanying histamine-mediated inflammation and sensation. The diffusion of released NA and histamine to adjacent skin also play important role in the transmission. Both axon reflex and diffusing action are united to cooperation for chain transmission of acupuncture signals. Mechanism of acupuncture effect: The acupuncture effect does not unidirectionally increase or decrease, but oscillate periodically, with about 28 min per circle. It is assumed that acupuncture leads the whole-body function change undulately and every organ in the body finds their own balance point through vibration. Therefore, acupuncture is auto-regulation, bi-regulation and vibrating regulation. The vibration is assumed by periodically excited and inhibited afferent signals from pilomotor line that lead periodical oscillation of whole CNS and the following oscillation of whole-body function.As a sum, under the guidance of CTM, a novel and unknown linear system hidden along skin have been discovered, which play an important role in the horizontal and integrative regulation on whole-body function, as expected in the integrative physiology. Importantly, there is a new type of mechanical transmission of signal.

Occupational Therapists’ Perceptions of Robotics Use for Patients With Chronic Stroke

Importance: The effectiveness of robotic therapy in stroke rehabilitation has been established by many studies, and occupational therapists should consider using robotics in their clinical practice. However, little is known about occupational therapy practitioners’ experience using robotics. Objective: To explore occupational therapists’ perceptions of the mechanisms and outcomes of occupational therapy using robotics with chronic stroke patients. Design: Qualitative study with semistructured focus group interviews. Data were analyzed using thematic analysis. Setting: Hospitals and institutions in Japan in which occupational therapists used robotics in their clinical practice. Participants: Twenty-seven occupational therapists with experience in using robotics with chronic stroke patients as a self-training method that involved repetitive movements of a paralyzed upper extremity. Participants were interviewed in nine focus groups. Results: Five themes—(1) body function, (2) values, (3) performance skills, (4) occupational performance, and (5) participation—and 12 subthemes were identified on the basis of the Occupational Therapy Practice Framework: Domain and Process (3rd ed.). Participants indicated that robotics improved patients’ body function and promoted a desire for independence, which resulted in improved occupational performance and participation in their desired occupations. Conclusions and Relevance: Occupational therapists regarded robotics as an adjunct to other therapy, which improved patients’ body function and promoted their desire for independence. What This Article Adds: Findings from this research provide insights into using robotics to enhance occupational therapy practice.

Using ICF to Describe Problems With Functioning in Everyday Life for Children Who Completed Treatment for Brain Tumor: An Analysis Based on Professionals' Documentation

Background: Children treated for brain tumors often experience persistent problems affecting their activity performance and participation in everyday life, especially in school. Linking these problems to the International Classification of Functioning, Disability and Health (ICF) classification system can be described as affecting body function, activity performance, and/or participation. Services involved in the everyday life of the child have different focus and goals when meeting the child in context, which advantage the use of ICF to overcome this impediment to follow-up and provide comprehensive support for children who have completed treatment for a brain tumor.Aim: The aim of the study was to use the ICF classification system to describe how professionals in healthcare, habilitation, and school document problems with everyday life functioning at body, activity, and participation levels for children who completed treatment for a brain tumor.Materials and Methods: A retrospective review of records from healthcare, habilitation, and school concerning nine children completed treatment for brain tumor was implemented. Identified problems in everyday life were linked to ICF codes. Descriptive statistics of ICF-linked code frequency supplemented by network visualization diagrams viewing the co-occurrence between codes within the body, activity participation, and environmental components were performed.Results: Most documented problems were found in healthcare records, whereas the documentation in habilitation and school was sparse. The frequently occurring codes, independent of record source, were linked to the body function component, and ICF-linked problems in habilitation and school were salient in the activity and participation component. To gain a holistic picture of relations between ICF codes and problems, network visualization diagrams were used to illustrate clusters of problems.Conclusion: Code prevalence likely reflects where healthcare professionals and educators focus their attention when meeting the needs of children treated for a brain tumor in context. To maximize the comprehensive view of functioning and participation of children in everyday life, the full range of difficulties regarding body impairments, activity limitations, and participation restrictions must be identified and linked to each other in patterns of co-occurrence, which the ICF facilitate. However, ICF provides no guidance on how to identify networks of problems within the body, activity, and participation. Identifying such networks is important for building comprehensive interventions for children.

The ICF model as a practical tool to facilitate holistic communication with individuals during their rehabilitation: A qualitative study

During rehabilitation, professionals and patients experience difficulties addressing complex issues. In a hermeneutical approach we examine how the ICF model can capture the complexity of the rehabilitation process using secondary deductive content analysis of transcripts from a previous interview study in line with COREQ. When focusing on interactions, the ICF model captures the complexity of individuals’ issues in a convincing way. Three themes were identified: ‘The influence body function, activity, participation and environment have on an individual’s ability to handle daily tasks of personal importance’, ‘The influence the environment in combination with body function, activity, and personal factors have on an individual’s ability to maintain their social roles’, and ‘The influence personal factors and body functions have on an individual’s confidence in participating in activities they like’. The findings show that the ICF model could provide a useful tool to facilitate communication regarding individuals’ complex issues that are often neglected.

Musculoskeletal Adaptation of Young and Older Adults in Response to Environmental, Physical, and Cognitive Conditions

Accidental falls present a large functional and financial burden among people aged 65 years and older. Falls, injuries associated with falls, and the fear of falling decrease quality of life, physical function, and independence for older adults. To prevent falls, improve stability, and protect joints from damage or injury, the typical response to "challenging" conditions include cautious gait, increase muscle co-contraction, and decreased range of motion. These compensatory strategies are more pronounced in the older adult population with apprehensive "cautious" gait at slower speeds, decreased knee flexion, and increased muscle activation around the knee and ankle. The underlying mechanisms and driving forces behind accidental falls are not well investigated. Additionally, the effects of aging on the ability of the musculoskeletal system to adapt to changing and challenging conditions is poorly understood. There exists a gap in knowledge regarding the relationship between accidental fall risk factors, knee joint stability, adaptation mechanisms, and whole-body function. Establishing these relationships between stability and musculoskeletal adaptation may have far reaching implications on improving whole-body function through targeted joint- and muscle-level interventions. The purpose of this study was to compare neuromechanics (whole-body function) of young and older adults walking across various external challenging conditions, quantifying adaptation strategies for both cohorts. This was accomplished through two objectives. In the first objective, joint kinematics, ground reaction force loading and impulse, and lower-limb muscle activation strategies for ten young and ten older adults walking on normal, slick, and uneven surfaces were compared to assess how musculoskeletal adaptation strategies change with age. For the second objective, a pipeline to create subject-specific lower-limb finite element models was developed to investigate joint-level behavior across cohorts. Proof-of-concept for the model development and analysis process was demonstrated for an older and a young adult to implement a novel metric for functional stability and dynamic laxity of the knee joint during the stance phase of gait. Kinematic, force, and muscle activation analysis showed that an uneven surface reduced sagittal joint kinematics during the first 25% of stance, indicating a surface-specific compensatory strategy. Additionally, older adults tended to prepare for and step onto the uneven surfaces in a more conservative manner with joints more flexed or bent. This anticipatory or cautious musculoskeletal adaptation of older adults was also seen in reduced magnitude of initial vertical loading during the loading response of stance (0-25% stance). Results of this research study provide insight into the differences that exist in joint stiffening and other musculoskeletal adaption strategies for young and older adults during external challenging conditions. Specifically, understanding the relationships between joint-level stability and whole-body musculoskeletal function has the potential to inform targeted muscle training programs and joint-level interventions to improve whole-body musculoskeletal function and reduce risk of injuries.

Positive Body Image of Female Students: A Predictive Study of the Integrative Body Image Model

This paper focuses on testing hypothesized psychosocial predictors factors (general unconditional acceptance, body acceptance by others, body function appreciation) for positive body image among 812 female students aged between 18 and 35 years. Path analysis procedures contained in the Mplus Version 7 program were used to evaluate the positive body image model. The positive body image model indicated that greater perceived body acceptance by others was linked to greater body function appreciation which in turn was linked to higher positive body image. Perceived body image acceptance by others was directly related to higher positive body image. General unconditional acceptance did not lead to female students greater body function appreciation. The findings revealed some important positive body image predicting factors, and these results can be used to improve positive body image interventions.