The Effect of Lower-Limb Exercise on Pain Management of the Patients Undergoing Posterior Lumbar Fusion Surgery: A Retrospective Case-Control Study

Purpose. The purpose of this study is to investigate the clinical effect of lower-limb exercise, when combined with celecoxib, on pain management of patients undergoing posterior lumbar fusion surgeries. Methods. The patients undergoing posterior lumbar fusion surgeries between 01/2018 and 06/2021 were retrospectively identified, with their data collected. After surgery, some patients took celecoxib for analgesia (celecoxib group, 200 mg/day) while the others took celecoxib together with lower-limb exercise (combined group, celecoxib-200 mg/day). On postoperative days (POD) 1, 3, 7, and 14, data were collected and analyzed regarding the following items: patient satisfaction, lower-limb muscle force, lumbar JOA score (29 points), Oswestry Disability Index (ODI), and visual analog scale (VAS) score. Results. A total of 225 participants were included in this study. Specifically, 120 cases were admitted into in the celecoxib group and 105 were included in the combined group. Comparisons of baseline data did not indicate any difference between the combined group and the celecoxib group. Data analysis showed that patient satisfaction in the combined group was significantly higher than the celecoxib group on POD 3, 7, and 14, respectively (all p < 0.001 ). Moreover, the combined group had less VAS score compared with the celecoxib group on POD 3, 7, and 14, respectively (all p < 0.01 ). In addition, lower-limb muscle force in the combined group was significantly stronger than that in the celecoxib group on POD 3 and POD 7, respectively (both p < 0.01 ). Furthermore, the combined group achieved less ODI score than the celecoxib group on POD 3, 7, and 14, respectively (all p < 0.05 ). Comparisons of the lumbar JOA score did not suggest any statistical difference during the whole follow-up period. Conclusions. In conclusion, postoperative lower-limb rehabilitation exercise can help to release pain after lumbar fusion surgeries. Additionally, postoperative lower-limb exercise can facilitate the recovery of lower-limb muscle force, as well as improving patient satisfaction.

Effects of free range-of-motion upper limb exercise based on mirror therapy on shoulder function in patients after breast cancer surgery: study protocol for a randomized controlled trial

Background Shoulder function complications are common after treatment for breast cancer. Quite a few survivors still report a limited shoulder range of motion, even though the free range-of-motion upper limb exercise is helpful to restore shoulder function. Mirror therapy (MT) is a classical and effective rehabilitation technique to recover motor and sensory function for the limbs; in addition, studies have reported that MT has an influence on patients with shoulder functional dysfunction including increasing shoulder range of motion, improving shoulder function scores, and decreasing pain scores. Here, we describe a protocol of a randomized controlled trial to explore if free range-of-motion upper limb exercise based on MT has efficacy on shoulder function in survivors after surgery of breast cancer. Methods/design This is a prospective, single-blind, two-arm randomized controlled trial. An estimated 70 participants will be randomly allocated to (1) the MT group or (2) the control group. The participants in the control group receive free range-of-motion upper limb exercise, and participants in the MT group will engage in free range-of-motion upper limb exercise based on MT. The intervention will start on the first day after surgery and be completed at 8 weeks after surgery. The primary outcome in this protocol is shoulder range of motion (ROM), while the Constant-Murley Score (CMS); Disability of the Arm, Shoulder, and Hand Questionnaire (DASH); Tampa Scale of Kinesiophobia (13-item TSK); visual analog scale (VAS); grip strength; arm circumference; and lymphedema are the secondary outcomes. Assessment will be conducted before allocation (baseline) and at 2 weeks, 4 weeks, and 8 weeks after surgery. Discussion Based on the results that MT has an influence on shoulder function immediately after intervention in patients without nerve injury, this randomized controlled trial is to observe the efficacy of MT on shoulder function after a long-term intervention in breast cancer survivors. We look forward to the innovation of this study for both breast cancer rehabilitation and MT. Trial registration Chinese Clinical Trial Registry (ChiCTR) ChiCTR2000033080. Registered on 19 May 2020

Kinesiophobia and Outcomes of Lower Extremity Exercise Regime in Subjects with Knee Osteoarthritis: A Case Series

Aim: To estimate the effectiveness of lower limb exercise regime in subjects with knee osteoarthritis in terms of Kinesiophobia. Methodology: This was a case series, conducted in the Physiotherapy Department Health Centre University of the Punjab Lahore after ethical approval from June 2018 to February 2019 on 44 patients with knee Osteoarthritis. Non-probability purposive sampling technique was used to enroll the participants according to predefined inclusion and exclusion criteria. Lower limb exercise regime was applied for eight weeks, thrice a week. TAMPA scale for Kinesiophobia (TSK), KOOS and 6 min walk test (6MWT) were used to measure the outcomes. Paired sample T test was applied to find the difference before and after LLEP. Statistical significance was set at P= 0.05 Results: Mean age of the participants was 52±6.54 years ranging from 41-65 years. The mean difference in pre and post treatment KOOS Score was 15.13±12.38 (P=.000), 14.34±7.97 (P=.000) for TAMPA Score and 196.00±94.01 (P=.000) for 6 Mint walk distance. Conclusion: Lower limb exercise program is found effective in the management of knee osteoarthritis. Subjects undergoing in 8 weeks lower limb exercise program showed improvement in KOOS Score, reduction in TAMPA Score, and improvement in 6 mint walk distance. Keywords: Knee Osteoarthritis, Kinesiophobia, TAMPA, knee osteoarthritis outcome score (KOOS), Lower limb exercise regime,

Effects of Free Range-of-Motion Upper Limb Exercise Based on Mirror Therapy on Shoulder Function in Patients After Breast Cancer Surgery: Study Protocol for a Randomized Controlled Trial

Background Shoulder function complications are common after surgery for breast cancer. Quite a few survivors still reported a limited shoulder range of motion, even though the free range-of-motion upper limb exercise is helpful to restore shoulder function post-operatively. Mirror therapy(MT) is a classical and effective rehabilitation technique to recover motor and sensory function for limbs, in addition, studies have reported that MT has the influence on patients with shoulder functional dysfunction including increasing shoulder range of motion, improving shoulder function scores, and decreasing pain scores. Here we describe a protocol of a randomized controlled trial to explore if the free range-of-motion upper limb exercise based on mirror therapy has efficacy on shoulder function in breast cancer survivors after surgery.Methods/design This is a prospective, single-blind, two-arm randomized controlled trial. An estimated 70 participants will be randomly allocated to 1) MT group or 2) control group. The participants in the control group receive free range-of-motion upper limb exercise, and participants in the MT group will engages in free range-of-motion upper limb exercise based on mirror therapy. The intervention will start from the first day after surgery and will be completde at 8 weeks after surgery. Primary outcomes in this protocol is shoulder range of motion(ROM), while the Constant-Murley Score(CMS), Disability of arm, shoulder, and hand Questionnaire (DASH), Tampa Scale of Kinesiophobia (13-item TSK), Visual Analogue Scale(VAS), grip strength, arm circumference, and lypmphedema are secondary outcomes. Assessment will be conducted before allocation(baseline) and at 2 weeks, 4 weeks, and 8 weeks after surgery.Discussion Based on results that mirror therapy has influence on shoulder function immediately after intervention in patients without nerve injury, this randomized controlled trial is the first study to observe the efficacy of mirror therapy on shoulder function after a long time intervention in breast cancer survivors. We look forward the innovation of this study for both breast cancer rehabilitation and mirror therapy. Trial registration Chinese Clinical Trial Registry (ChiCTR): ChiCTR 2000033080. Registered on 19 May 2020, http://www.chictr.org.cn/searchproj.aspx.

EFFECT OF LOWER LIMB EXERCISE ON POSTURE STABILITY AND BRAIN ACTIVITY DURING WHOLE BODY VIBRATION FOR THE ELDERLY

This study aimed to investigate the effect of lower limb exercise on electroencephalogram (EEG) activity and posture stability during whole body vibration (WBV) for healthy elderly people. Subjects were composed of 20 elderly people who were over 60 years old and had no disease. They were subjected to WBV of 30[Formula: see text]Hz and strength intensity of 20 (total 5 sets, 20[Formula: see text]s/set, rest time: 20[Formula: see text]s, except for the final set). The subjects were grouped into two groups. One group of 11 subjects was WBVSt (WBV of upright stance) and the other group of nine subjects was WBVSq (WBV of squat posture). In the WBVSt group, the subjects were requested to maintain a standing position, whereas those in the WBVSq group were asked to perform 60∘-knee flexion squat at 2[Formula: see text]s intervals during WBV stimulation. In this study, the electromyography (EMG) was measured on the right and left erector spinae, rectus femoris, vastus lateralis, vastus medialis, tibialis anterior to evaluate lower limb muscle activity and postural stability during timed up and go (TUG) test before and after WBV. The EEG was measured on frontal (F3, F4, F7, F8), central (Cz, C3, C4), temporal (T3, T4, T5, T6), parietal (P3, P4), and occipital (O1, O2) lobes to evaluate brain activity during the check of mini-mental state examination for dementia screening (MMSE-DS) before and after WBV. The results of this study showed improved postural stability and muscle activation for the healthy elderly during lower limb and WVB exercises. The WBVSq group showed higher changes in TUG-test ([Formula: see text]) and iEMG analysis by EMG ([Formula: see text]) compared with the WBVSt group. However, there was no significant change in MMSE-DS ([Formula: see text]). Because of the increase in relative SMR power by EEG, the central (C4), frontal (F7) and parietal (P3, P4) lobes were activated in WBVSt group ([Formula: see text]); however, all regions, except the parietal lobe, were activated in WBVSq group ([Formula: see text]). Lower limb exercise with WBV stimulation improved postural stability, lower limb muscle, and brain activation for the elderly. These results may be helpful to the protocol of exercise using WBV for the healthy elderly.

Correlation of Exercise Capacity with Functional Disability in Patients with Osteoarthritis of Knee

Introduction: Osteoarthritis of knee is a progressive joint disease which produces pain, inflammation and destruction of joint which in turn leads to range of motion limitation and walking disabilities. Affection in physical functioning is determined not only by just activities involving lower limb capacity but also by the activities which require use of upper extremities. Hence in this study, 6MWD and no. of rings moved in 6 minutes were taken as an outcome measures for determining the exercise capacity. KOOS is a self-administered questionnaire which was used in its cross culturally adapted format for determining the functional disability in patients. Objectives: 1. To study correlation of exercise capacity with functional disability in patients with osteoarthritis of knee. 2. To study correlation of upper limb exercise capacity with lower limb exercise capacity in patients with osteoarthritis of knee. Methods: Cross sectional, observational study including 30 patients of either gender having unilateral osteoarthritis of knee conducted in a tertiary care hospital. Results: No. of rings moved in 6 minutes and global KOOS score showed no statistically significant correlation. 6MWD and global KOOS score showed no statistically significant correlation. 6 minute walk distance and 6 minute peg board ring test showed no statistically significant correlation. Conclusion: The study suggests that there is no correlation of exercise capacity with functional disability in patients with osteoarthritis of knee. Also, there is no correlation found between upper limb exercise capacity and lower limb exercise capacity in patients with osteoarthritis of knee. KEY WORDS: Knee osteoarthritis, Knee pain, squat depth, functional disability, cardiorespiratory endurance, Knee Injury and Osteoarthritis Outcome Score, Quality of life.

Evaluation of the intervention of home-based pulmonary rehabilitation in patients with chronic obstructive pulmonary disease

Objective Chronic obstructive pulmonary disease (COPD) can be prevented and treated, although presenting with persistent airflow restriction; the airflow restriction caused by COPD is mostly progressive. In recent years, more attention has been paid to the home-based pulmonary rehabilitation (PR) and its influence on COPD. Exercise training is the basic constituent of PR. However, it is not clear which exercise trainings are the ideal ways to deliver home-based PR. Methods In this review, we focus on the effect of home-based exercise training on patients with COPD. We searched literature, which was necessarily required to be randomized controlled trails (RCTs) from the establishment of the four respective databases (Medline, PubMed, Web of Science, and China National Knowledge Infrastructure) from January 2008 to January 2018. We used the Cochrane collaborative “risk of bias” tool to assess the quality of evidence. A total of 21 trials (1694 participants) were included. Through the analysis of the literature, we find that a simple, low-cost, and low-intensity family-based lung-rehabilitation plan to adapt to the real life may lead to the improvement of the ability to exercise, the reduction of the difficulty in breathing, and the improvement of carrying out daily activities. Results In the exercise training of home-based PR, lower limb exercise (LLE) training demonstrated a more perceptible effect in improving the quality of life of patients with COPD. At the same time, the combination of LLE training, breathing training, and upper limb exercise training is more obvious than the simple LLE training. In addition, home-based low-intensity aerobic training may sometimes be no less than the outpatient or center intervention to improve dyspnea, health status, and exercise tolerance. In conclusion, the simple and easy home-based PR exercise program is useful. Long-term home-based PR may require an enhanced need for maintenance. Conclusions A simple, low-cost, and low-intensity high blood pressure response (HBPR) plan to adapt to the real life may lead to an augmentation in the ability to exercise, a reduction of the difficulty in breathing, and an improvement in carrying out day-to-day activities. HBPR strategies can benefit patients (elderly patients with COPD at home) in the long term.