Preventive effect of rehabilitation training therapy on muscle quality in patients with stroke: A retrospective study

A retrospective analysis was conducted in 45 patients with stroke. All patients received three weeks of rehabilitation training. Body composition was examined using Bio-impedance analysis methods before and after training. Barthel index was used to evaluate activities of daily living before and after the intervention. After rehabilitation training, total body water, muscle mass, protein content, inorganic salt content, and skeletal muscle content were increased while body fat content and body fat percentage were significantly decreased. Barthel Index scores showed that the ability of daily living was improved after rehabilitation. In conclusion, rehabilitation training therapy may have protective effects on sarcopenia in patients with stroke. Keywords: Stroke, sarcopenia, rehabilitation training

Cluster Randomized Controlled Trial on the Effects of 12 Months of Combined Exercise Training during Hemodialysis in Patients with Chronic Kidney Disease—Study Protocol of the Dialysis Training Therapy (DiaTT) Trial

Patients with chronic kidney disease (CKD) on hemodialysis (HD) experience treatment-related immobility and physical deconditioning, which is responsible for an increased risk of frailty and a high burden of multi-morbidity. Exercise has been shown to counteract this vicious cycle; however, its effectiveness has only been investigated in small cohorts. Therefore, the objective of the Dialysis Training Therapy (DiaTT) trial will be to assess the effects of a 12-month intradialytic exercise program on physical functioning, frailty and health economics in a large cohort of HD patients in a real-world setting. DiaTT will be a prospective, cluster-randomized (1:1), controlled, multi-center, interventional clinical trial across 28 dialysis units, aiming at the recruitment of >1100 CKD patients on HD. The intervention group will receive 12 months’ intradialytic exercise (combined aerobic and resistance training), whereas the usual care group will not receive intervention. The primary endpoint will be a change on the sit-to-stand test (STS60) result between baseline and 12 months. Secondary endpoints will include physical functioning, frailty, quality of life, 3-point MACE, hospitalizations, survival, quality of HD, health literacy and health care costs. By including almost as many patients as previously investigated in smaller trials, DiaTT will be the largest randomized, controlled trial assessing frailty, quality of life and mortality in the field of nephrology.

Efficacy of Yun-Type Optimized Pelvic Floor Training Therapy for Middle-Aged Women With Severe Overactive Bladder: A Randomized Clinical Trial

Background: This study aimed to evaluate the clinical efficacy of Yun-type optimized pelvic floor training therapy for middle-aged women with severe overactive bladder (OAB).Methods: This randomized, observer-blinded, parallel-group controlled clinical trial included 108 middle-age women with severe OAB and assigned them to the intervention group (treated with combination of Yun-type optimized pelvic floor training with solifenacin for 12 weeks) and control group (treated with solifenacin for 6 weeks and, after 2 weeks of elution, received the combination of Yun-type optimized pelvic floor training and solifenacin for 6 weeks). The outcomes associated with OAB, pelvic floor muscle (PFM) function, and sexual function were compared after 6 and 12/14 weeks of treatment.Results: The primary variables were OAB-associated outcomes, including overactive bladder symptom score (OABSS), urgent urination, urine, nocturia, urge urinary incontinence, patient's perception of bladder condition, urogenital distress inventory-6, incontinence impact questionnaire-7, voiding volume, average flow rate, and maximum flow rate. The secondary variables were indicators related to PFM function and sexual function. These indicators were significantly improved in both groups after interventions. Notably, the improvements in most of these indicators were superior in the intervention group than in the control group after 6 weeks and 12/14 weeks of treatment.Conclusions: The use of Yun-type optimized pelvic floor training adds to the benefits of solifenacin regarding severe OAB-associated outcomes, PMF function, and sexual function in middle-aged women with severe OAB. Combining Yun-type optimized pelvic floor training with traditional drug therapies may improve clinical outcomes in patients with severe OAB.Trial Registration: ChiCTR-INR-17012189.

Combination of acupuncture and medical training therapy on tension type headache: Results of a randomised controlled pilot study

Objectives The aim of this study was to compare the effects of acupuncture and medical training therapy alone and in combination with those of usual care on the pain sensation of patients with frequent episodic and chronic tension-type headache. Design This was a prospective single-centre randomised controlled trial with four balanced treatment arms. The allocation was carried out by pre-generated randomisation lists in the ratio 1:1:1:1 with different permutation block sizes. Setting The study was undertaken in the outpatient clinic of Rehabilitation Medicine of the Hannover Medical School. Participants and interventions: Ninety-six adult patients with tension-type headache were included and randomised into usual care (n = 24), acupuncture (n = 24), medical training (n = 24), and combination of acupuncture and medical training (n = 24). One patient was excluded from analysis because of withdrawing her/his consent, leaving 95 patients for intention to treat analysis. Each therapy arm consisted of 6 weeks of treatment with 12 interventions. Follow-up was at 3 and 6 months. Main outcome measures Pain intensity (average, maximum and minimum), frequency of headache, responder rate (50% frequency reduction), duration of headache and use of headache medication. Clinical results: The combination of acupuncture and medical training therapy significantly reduced mean pain intensity compared to usual care (mean = −38%, standard deviation = 25%, p = 0.012). Comparable reductions were observed for maximal pain intensity (−25%, standard deviation = 20%, 0.014) and for minimal pain intensity (−35%, standard deviation = 31%, 0.03). In contrast, neither acupuncture nor medical training therapy differed significantly from usual care. No between-group differences were found in headache frequency, mean duration of headache episodes, and pain medication intake. At 3 months, the majority of all patients showed a reduction of at least 50% in headache frequency. At 6 months, significantly higher responder rates were found in all intervention groups compared to usual care. Conclusions In contrast to monotherapy, only the combination of acupuncture and medical training therapy was significantly superior in reduction of pain intensity compared to usual care. Trial registration: Registered on 11 February 2019. German Clinical Trials Register, DRKS00016723.

BCI Training Effects on Chronic Stroke Correlate with Functional Reorganization in Motor-Related Regions: A Concurrent EEG and fMRI Study

Brain–computer interface (BCI)-guided robot-assisted training strategy has been increasingly applied to stroke rehabilitation, while few studies have investigated the neuroplasticity change and functional reorganization after intervention from multimodality neuroimaging perspective. The present study aims to investigate the hemodynamic and electrophysical changes induced by BCI training using functional magnetic resonance imaging (fMRI) and electroencephalography (EEG) respectively, as well as the relationship between the neurological changes and motor function improvement. Fourteen chronic stroke subjects received 20 sessions of BCI-guided robot hand training. Simultaneous EEG and fMRI data were acquired before and immediately after the intervention. Seed-based functional connectivity for resting-state fMRI data and effective connectivity analysis for EEG were processed to reveal the neuroplasticity changes and interaction between different brain regions. Moreover, the relationship among motor function improvement, hemodynamic changes, and electrophysical changes derived from the two neuroimaging modalities was also investigated. This work suggested that (a) significant motor function improvement could be obtained after BCI training therapy, (b) training effect significantly correlated with functional connectivity change between ipsilesional M1 (iM1) and contralesional Brodmann area 6 (including premotor area (cPMA) and supplementary motor area (SMA)) derived from fMRI, (c) training effect significantly correlated with information flow change from cPMA to iM1 and strongly correlated with information flow change from SMA to iM1 derived from EEG, and (d) consistency of fMRI and EEG results illustrated by the correlation between functional connectivity change and information flow change. Our study showed changes in the brain after the BCI training therapy from chronic stroke survivors and provided a better understanding of neural mechanisms, especially the interaction among motor-related brain regions during stroke recovery. Besides, our finding demonstrated the feasibility and consistency of combining multiple neuroimaging modalities to investigate the neuroplasticity change.

Conversation Training Therapy: Let's Talk It Through

This article introduces a novel approach to voice therapy called conversation training therapy (CTT). CTT is the first voice therapy approach to remove the therapeutic hierarchy common in most treatment programs. Rather, CTT uses patient-driven conversation as the sole stimuli in therapy to increase perceptual awareness of voice production in conversational speech. The genesis as to why CTT was developed, as well as the conceptual, theoretical, and component parts of CTT, will be explained. In addition, this article will offer examples of the language of therapy, as it applies to CTT and how to trouble-shoot if problems arise. Medical documentation relevant to CTT will also be outlined. Last, results from a recent efficacy study on CTT will be reported.

Penerapan Latihan Keterampilan Sosial: Bermain Peran Pada Pasien Skizofrenia dengan Masalah Keperawatan Isolasi Sosial Di Ruang Puri Mitra RSJ Menur Surabaya

ABSTRACTPatients have difficulty in spontaneously relating to others who are manifested by isolating themselves, not being mindful and unable to share experiences. If social isolation patients are not resolved quickly, they can endanger the safety of themselves and others. The purpose of this research is to apply social skills training therapy: role play with social isolation nursing problem in Puri Mitra Meniran Mental Room of Menur Surabaya. The study design uses a case study, the subject of one patient's study with a catatonic diagnosis of schizophrenia, with social isolation nursing issues. Methods of collection by observation, interview, physical examination, and application of social skills training therapy: role play. Application of social skills training therapy: this role play is performed for approximately 60 minutes every day. The application is given in SP 1 step 6 on the 9th day indicating the patient is willing to communicate with others. Once this implementation is applied there is an increase in interacting with others. So the more often done for patients with social isolation then very helpful and facilitate the patient in interacting with others. Keywords: Social Isolation, Social Skills; Role Playing AbstrakPasien mengalami kesulitan dalam berhubungan secara spontan dengan orang lain yang dimanifestasikan dengan mengisolasi diri, tidak ada perhatian dan tidak sanggup berbagi pengalaman. Bila pasien isolasi sosial tidak cepat teratasi maka akan dapat membahayakan keselamatan diri sendiri maupun orang lain. Tujuan penelitian ini untuk menerapkan terapi latihan keterampilan sosial: bermain peran dengan masalah keperawatan isolasi sosial di Ruang Puri Mitra Rumah Sakit Jiwa Menur Surabaya. Desain penelitian menggunakan studi kasus, subjek penelitian satu orang pasien dengan diagnosa medis skizofrenia katatonik, dengan masalah keperawatan isolasi sosial. Metode pengumpulan dengan cara observasi, wawancara, pemeriksaan fisik, dan penerapan terapi latihan keterampilan sosial: bermain peran. Penerapan terapi latihan keterampilan sosial: bermain peran ini dilakukan selama kurang lebih 60 menit setiap hari. Penerapan tersebut diberikan dalam SP 1 langkah ke 6 di hari ke 9 menunjukkan pasien mau berkomunikasi dengan orang lain. Setelah diberikan penerapan ini terjadi peningkatan berinteraksi dengan orang lain. Sehingga semakin sering dilakukan untuk pasien dengan isolasi sosial maka sangat membantu dan mempermudah pasien dalam berinteraksi dengan orang lain. Keywords: Isolasi Sosial, Keterampilan Sosial; Bermain Peran

Principles of rehabilitation of patients with ischemic heart disease after surgical revascularization of myocardium

The article reflects the modern principles of medical rehabilitation of patients with coronary heart disease who underwent coronary artery bypass surgery. The method of active training therapy with swimming is described, and the dynamics of the functional state of patients at various time points after surgery is also shown. Following the above approaches to compiling personalized programs of rehabilitation measures, taking into account the severity of the intervention, the presence of complications and clinical status, can reduce the factors of atherosclerosis progression, restore the psychological state, increase the physical activity and quality of life of the patient.