Shaoyao Gancao Decoction for limb dysfunction after fractures around the knee: A protocol for systematic review

Review question / Objective: This study aimed to evaluate the effects of SGD on patients with limb dysfunction from the perspectives of pain, limb edema, stiffness, as well as physical dysfunction. Study designs to be included: This review only includes the intervention measures of SGD, including trials comparing SGD with standard treatment and/ or placebo. Trials of SGD combined with other therapies will be included.

Ethical Considerations in Prosthetics and Orthotics

This chapter introduces the field of advanced technology within the orthotics and prosthetics profession, a healthcare profession that combines technology and engineering science with medical and health science to produce medical devices (orthoses and prostheses) to treat medical conditions that cause physical dysfunction. The chapter sets the background to the ethical dilemmas that are encountered within the field, which technologically advanced devices cause such dilemmas and why, and then discusses the ethical dilemmas as encountered by the three stakeholders within the profession, namely the manufacturers/innovators, the prosthetic and orthotic practitioners, and the users of the devices themselves, the patients. In conclusion, the chapter looks at some solutions and recommendations to overcome or at least reduce these dilemmas.

The flavonoid procyanidin C1 has senotherapeutic activity and increases lifespan in mice

Ageing-associated functional decline of organs and increased risk for age-related chronic pathologies is driven in part by the accumulation of senescent cells, which develop the senescence-associated secretory phenotype (SASP). Here we show that procyanidin C1 (PCC1), a polyphenolic component of grape seed extract (GSE), increases the healthspan and lifespan of mice through its action on senescent cells. By screening a library of natural products, we find that GSE, and PCC1 as one of its active components, have specific effects on senescent cells. At low concentrations, PCC1 appears to inhibit SASP formation, whereas it selectively kills senescent cells at higher concentrations, possibly by promoting production of reactive oxygen species and mitochondrial dysfunction. In rodent models, PCC1 depletes senescent cells in a treatment-damaged tumour microenvironment and enhances therapeutic efficacy when co-administered with chemotherapy. Intermittent administration of PCC1 to either irradiated, senescent cell-implanted or naturally aged old mice alleviates physical dysfunction and prolongs survival. We identify PCC1 as a natural senotherapeutic agent with in vivo activity and high potential for further development as a clinical intervention to delay, alleviate or prevent age-related pathologies.

Using a Theoretical Framework in a Qualitative Metasummary About Fatigue Adaptation After Stroke

We describe how we used a theoretical framework, Adaptive Leadership Framework for Chronic Illness (ALFCI), to complete a qualitative metasummary in a scoping review of 26 articles. We abstracted and grouped qualitative findings relevant to fatigue adaptation in stroke survivors using constructs of the ALFCI as 4 main themes: 1) adaptive challenges, 2) adaptive work, 3) adaptive leadership and collaborative work, and 4) technical challenges and technical work. We found that stroke survivors encountered different aspects of challenges (e.g., physical dysfunction vs. mental distress) and utilized various adaptive work (e.g., conserving energy vs. restructuring normality) as well as what stroke survivors needed from healthcare professionals (e.g., basic knowledge about fatigue). The ALFCI provides a useful lens to synthesize qualitative findings regarding fatigue adaptation and therefore researchers can target different problems that need to be tackled for stroke survivors, care partners, or healthcare professionals, respectively.

Testosterone Therapy for Men With Age-Related Low Testosterone: Tempest in a Teacup

Serum testosterone concentrations decrease in men with age, but benefits and risks of raising testosterone levels in older men remain controversial. In the T-Trials, a total of 790 men, age 65 and older, with a serum testosterone concentration of < 275 ng/dL and symptoms of sexual dysfunction, fatigue or physical dysfunction were randomized to either testosterone gel or placebo gel for 1 year. Treatment in the testosterone arm increased serum testosterone levels to the mid-normal range for young men. Testosterone replacement was associated with a significant increase in sexual activity (p<0.001), libido and erectile function. In contrast, there was no improvement in vitality or physical function. Adverse findings included increases in non-calcified plaque formation and a higher rate of prostate events. In sum, testosterone treatment in older men was associated with modest benefits, while the risk on prostate and cardiovascular health remain unclear.

Silver Sneakers in Central PA: Assessment of a Community based Exercise Program in a Mixed Rural/Urban Catchment Area

Older cancer survivors present with unique challenges that may impact quality of life and increase physical dysfunction if not properly managed. Regular physical activity (PA) can help mitigate these effects. Silver Sneakers (SS), a free exercise program available to Medicare beneficiaries, has more than 16,000 US locations. To understand capacity of SS to serve older adults in our mixed rural/urban catchment area of Central Pennsylvania, we 1) identified all registered SS program locations in our 28-county catchment area and; 2) conducted phone questionnaires with SS program staff. Approximately 18 gyms closed during the pandemic, leaving a sample of 121 participating gyms. We talked to 80 gyms (66% response rate) to understand member and programming characteristics, training of staff and program marketing. Geographic locations of SS were mixed – 39% in rural and 61% in urban counties; the majority (43%) were located in private gyms or YMCAs. The majority of gyms reported membership was equally mixed by gender and described ages of members as 65-80 years (94%). Program staff said that many members exercised several times per week with friends/family. Program staff also reported that social opportunities (35%) were a primary reason participants remained active in SS. Most (89%) of the facilities were still able to offer SS during the pandemic, with the majority (60%) adapting format to Zoom and other video platforms to conduct classes. Overall, SS programs offer a sustainable option to facilitate access to exercise programs and reduce barriers to PA among older adults in our catchment area.

THE THERAPEUTIC EFFECT OF SPORTS ON RELIEVING CHRONIC FATIGUE

ABSTRACT Introduction Chronic fatigue syndrome (CFS) is a group of long-term fatigue; the rest is difficult to achieve. At the same time, it is accompanied by corresponding physical dysfunction and psychological and mental symptoms. It is very meaningful to find exercise countermeasures to cope with chronic fatigue syndrome actively. Object This article analyzes the current students’ CFS to realize the cognition of the disease. At the same time, it analyzes the effect of sports on the treatment of chronic fatigue to help students formulate related sports programs. Method The article conducts a related questionnaire survey and analysis of students and analyzes CFS and exercise status symptoms. Results Generally, students with CFS did not actively participate in sports and had poor physical fitness, especially muscle endurance and cardiopulmonary function. However, students who actively participate in sports training basically do not have CFS. Conclusion CFS students should strengthen physical exercise and improve the CFS situation through exercise. Level of evidence II; Therapeutic studies - investigation of treatment results.

Virtual Reality as a Promising Tool Supporting Oncological Treatment in Breast Cancer

Breast cancer (BC) treatment is associated with many physical and psychological symptoms. Psychological distress or physical dysfunction are one of the most common side effects of oncological treatment. Functional dysfunction and pain-related evasion of movement may increase disability in BC. Virtual reality (VR) can offer BC women a safe environment within which to carry out various rehabilitation interventions to patient support during medical procedures. The aim of this systematic review was to conduct an overview of the clinical studies that used VR therapy in BC. The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines method: the initial search identified a total of 144 records, and 11 articles met the review criteria and were selected for the analysis. The results showed that VR seems to be a promising tool supporting oncological treatment in BC patients. VR can have a positive effect on mental and physical functions, such as relieving anxiety during oncotherapy, diminution pain syndrome, and increasing the range of motion and performance in daily activities.

Developing a Self-Report Tool to Measure Functional Limitation in Children Aged 7-12 Years with Physical Dysfunction

Objective: To develop a self-report questionnaire to measure functional limitation in children aged 7- 12 years with physical dysfunction. Study design: Methodological research design Method: The study was conducted in phases: drafting of the questionnaire, content validation, pilot testing, revision of the questionnaire, field testing and test-retest reliability. A total of 66 items were generated through a review of the literature and interviews of twenty five children, their parents and health-care professionals. Qualitative and quantitative content validation through expert review and item reduction resulted in a 59-item questionnaire which was pilot tested on a sample of 10 children with physical dysfunction. With further inputs the questionnaire was revised. Thus, the final questionnaire with 60 items in two versions (a child and a caregiver’s version) in both Hindi and English was developed. Results: Qualitative review and Content validity was established for the Children’s Functional Limitation Scale. The questionnaire demonstrated high internal consistency (Cronbach’s alpha=0.91), moderate agreement between parents and children (weighted kappa= 0.718) and good test-retest reliability (weighted kappa=0.88). Conclusion: “Children’s Functional Limitation Scale” is a valid and reliable tool for documenting difficulties perceived by children with physical dysfunction. Also, the study demonstrates ability of children to reliably report their limitations. Keywords: Functional limitation, Activities of Daily living, Self-Report, Questionnaire, Children with physical dysfunctions