Comparison of Different Physical Therapies Combined with Acupuncture for Poststroke Cognitive Impairment: a Network Meta-Analysis

Objective. Physical therapy combined with acupuncture is the current research hotspot in the treatment of poststroke cognitive impairment, but which combination treatment is the best is still controversial. Based on the network meta-analysis method, we evaluated the efficacy of various physical therapies combined with acupuncture for the treatment of poststroke cognitive impairment. Methods. We retrieved diverse randomized controlled trials of various physical therapies combined with acupuncture for the treatment of cognitive dysfunction after stroke. We selected studies, extracted data, and evaluated the risk of literature bias for the included randomized controlled trials. We used STATA 14.0 for the current network meta-analysis. Results. Fifteen randomized controlled trials involving 1288 patients were included, which involved 7 treatment plans that included 3 control treatment plans and 4 acupuncture treatment plans combined with physical therapy. The best treatment plan for improving the Mini-Mental State Examination score of poststroke cognitive impairment is acupuncture combined with hyperbaric oxygen therapy. The best treatment option for improving the Montreal Cognitive Assessment score of poststroke cognitive impairment is acupuncture combined with hyperbaric oxygen therapy. The best option for improving the Barthel index score of poststroke cognitive impairment is acupuncture combined with transcranial magnetic stimulation. In terms of improving the overall clinical effectiveness of poststroke cognitive impairment, the best treatment option is acupuncture combined with transcranial magnetic stimulation. Conclusion. The analysis of all the results shows that acupuncture combined with hyperbaric oxygen therapy can significantly improve poststroke cognitive impairment compared with other combined treatments. However, due to the overall quality and quantity of the included studies, more randomized controlled trials focusing on clinical research on acupuncture combined with physical therapy for poststroke cognitive impairment are required to support the current evidence. This trial is registered with CRD42020200092.

A Systematic Review on Skin Whitening Product

Skin whitening is a term used for lightening the complexion of the skin through artificial means like creams, lotions, soaps and injections. Unfortunately, the appeal of these skin bleaching products is based on the obsession of people across the world with skin color. Melanins are produced by specialized cells, termed melanocytes, which are located primarily in the skin, hair bulbs, and eyes. The melanins can be of two basic types: eumelanin’s, which are brown or black, and phaeomelanin’s, which are red or yellow, in mammals typically there are mixtures of both types Increased production and accumulation of melanins characterize number of skin diseases, which include hyperpigmentation such as melanoma, post-inflammatory melanoderma, solar lentigo, etc. Several modalities of treatment for these problems are available including chemical agents or physical therapies. The aim of this review article is to show that some of the skin whitening creams, often sold illegally without a prescription may contain dangerous ingredients that could put people health at risk

bonpa indigenous cure system of sowa rigpa or ‘science of healing’ practices

The Tibetan medicinal system is among the oldest known healing traditions practiced in the world. History is witness to the fact that there is a vast treasure trove of indigenous knowledge and practices. It offers a holistic treatment system that is aimed at regulating and maintaining an astute balance of the functional principles defining human existence through mind and body. Indigenous medicine is an integral part of the Tibetan culture and has grown and developed across several centuries and geographical spaces. The origins of Tibetan system that pertain to the Bon religious tenets are apparently very old as aspects of the Tibetan medicine have been traced to ancient cultures over 2,500 years old. Traditionally the Tibetan curative system has been known as Sowa-Rigpa Medicine meaning the ‘Science of Healing’. “It is a centuries old system of treatment that is based on a complex approach to diagnosis, incorporating techniques like taking the pulse and conducting an analysis of bodily fluids besides making an examination of the behavior and dietary intake. The medicines are composed of natural materials (e.g., herbs, minerals, plants, leaves etc) and physical therapies (e.g. Tibetan acupuncture, moxabustion, etc) to treat illness.

Physical Therapy for the Horizontal Semicircular Cupulolithiasis: A Prospective Interventional Case Series from an Otoneurology Center in South Rajasthan, India

Objective This article aims to study the effect of physical therapy in patients of horizontal semicircular cupulolithiasis with results audited in the short term. Design Nonrandomized prospective interventional study. Study Sample Four patients with horizontal semicircular cupulolithiasis. Results All four patients in whom diagnostic supine roll test (carried at least thrice to look for the sustainability as well as the polarity of the nystagmus) elicited apogeotropic horizontal positional nystagmus lasting more than 1 minute were subjected to therapeutic head-shaking maneuver (HSM). The results were audited immediately after the physical therapy, and at 1 hour. Follow-up by telephonic interviews for 4 weeks was done in all patients. Three out of four patients responded to HSM alone. One patient who did not respond to HSM was successfully treated with four other sequent physical therapies. Conclusion The response of physical therapy for horizontal semicircular cupulolithiasis occasionally indicates the side of the cupula to which otoconial debris is adherent (Cup-U or Cup-C). Occasionally, Cup-C variant of horizontal semicircular cupulolithiasis can be transformed by physical therapy to long posterior arm horizontal semicircular canalolithiasis—a disorder with better established treatment options.

Developments in Biological Mechanisms and Treatments for Negative Symptoms and Cognitive Dysfunction of Schizophrenia

The causal mechanisms and treatment for the negative symptoms and cognitive dysfunction in schizophrenia are the main issues attracting the attention of psychiatrists over the last decade. The first part of this review summarizes the pathogenesis of schizophrenia, especially the negative symptoms and cognitive dysfunction from the perspectives of genetics and epigenetics. The second part describes the novel medications and several advanced physical therapies (e.g., transcranial magnetic stimulation and transcranial direct current stimulation) for the negative symptoms and cognitive dysfunction that will optimize the therapeutic strategy for patients with schizophrenia in future.

Playing your pain away: designing a virtual reality physical therapy for children with upper limb motor impairment

Children with upper limb motor impairment often undergo repetitive therapeutic physiotherapy sessions to minimize functional disabilities of the affected area. Even though therapeutic processes can improve functional outcomes and minimize persistent disabilities, patients often neglect to participate fully in physical therapies due to the associated procedural pain. Over recent decades, there has been a growing interest in designing non-pharmacological interventions which aim to minimize pain during physical therapies and improve functional outcomes. Via two interrelated studies, we explored the use of virtual reality (VR) as a tool to provide therapeutic physiotherapy for child patients in an out-patient hospital department. We found that VR is an effective solution for children with upper limb motor impairment undergoing painful therapeutic process within a hospital environment. VR can improve functional disabilities, alleviate perceived pain, reduce the perceived difficulty of rehabilitation exercises, increase exercise duration and produce positive emotions towards the therapy.Trial registration number and date of registration Protocol ID NCT03998995. Release Date: June 25, 2019.

P16: PHYSICAL THERAPIES FOR DVT PROPHYLAXIS IN SURGICAL PATIENTS: A SYSTEMATIC REVIEW AND EVIDENCE QUALITY APPRAISAL

Introduction Venous thromboembolism represents a significant clinical and socioeconomic burden. Surgical patients are an inherently high-risk cohort for VTE although traditional prophylactic pharmacological therapies are contraindicated in select cohorts. Novel physical therapies such as calf exercises and electrostimulation have been proposed for such patients. The aim of this systematic review is to appraise the clinical utility of novel physical therapies used for DVT prophylaxis in surgical and trauma patients. Method A systematic review of MEDLINE, EMBASE and CINAHL using a PRISMA-compliant methodology up to July 2019 was conducted. Abstract screening and data extraction were performed in duplicate. Risk of bias and quality assessments were performed for each study using the GRADE framework. Result A total of 272 articles were identified, of which 10 met inclusion criteria. Five studies evaluated the use of calf electrostimulation, the remaining studies evaluated active toe movement, bespoke compression bandages, blood flow restriction exercises, calf massage and a portable compression device. Four randomized controlled trials demonstrated a significant reduction in radiological DVT incidence with electrostimulation, post-operative massage and pneumatic compression versus controls. All included studies had a moderate to high risk of bias. Conclusion The role of physical therapies as prophylactic measures in VTE remain equivocal. No study demonstrated a significant reduction in clinically evident DVT. The physical therapies can be beneficial in patients who also received pharmacological therapy, whilst physical therapies alone may be of no benefit. Heterogenous study design and poor methodological quality limit comparison of study findings at present. Take-home message Physical therapies as prophylactic measures in venous thromboembolism may offer benefit when combined with pharmacotherapy. When used alone, physical therapies may offer no benefit.

Lipoedema – a growing problem in Spain

Lipoedema is a chronic disease frequent in women, that causes an abnormal fat deposition in their lower limbs, with a remarkable disproportion between the upper and lower part of the body, easy bruising and pain. Despite the lack of pathognomonic tests for lipoedema, more and more patients in social networks are claiming they suffer from it, giving the disease more visibility but allowing a lot of fake information about lipoedema. Information for self-care and realistic expectations are important. Depending on the severity, the treatment includes: physical therapies, compression garments, exercise, diet, psychological support and surgical treatment.

Rehabilitation of the canine patient following spinal cord injury: a practical guide

This article forms part of a series exploring the rehabilitation of the canine shoulder, elbow, back, hip and stifle following injury or disease. Discussed here are different rehabilitation techniques used to address neurological deficits, pain and weakness following spinal injury, including physical therapies, electrotherapies and acupuncture.