Evaluation of the effectiveness of transcranial electrostimulation in treatment of neuropsychiatric disorders

Objectives: Evaluation of the effectiveness the method of transcranial electrostimulation in treatment of neuropsychiatric disorders with the use of a patches by the company “Aganyan”. Materials and methods: The study was a double-blind, randomized, placebo-controlled study, participated 106 patients with neuropsychiatric disorders. All participants in were divided into tables according to gender, age and diagnosis. Each subject was given the “Aganyan” patches and a special brochure, in which the method of application was indicated in detail. The wearable patch includes a flexible substrate, a binder an adhesive layer, with an electrode foil attached to it. Patients applied one patch behind each ear. The patches were applied for eight hours every third day for three months. To assess the effectiveness of therapy in patients the following tests were used: The Montreal Cognitive Assessment Scale; MMSE Scale: Concise Mental Status Scale; diaries of observation of the patient’s condition to identify side effects; special brochures in which the subjects independently indicated the effects of the “Aganyan” patches. Tests were performed before and after the use of the “Aganyan” patches. Results: When using the patches of the “Aganyan” company, none of the participants in the study had any side effects; According to the results of the Montreal test according to the criterion of memory and the MMSE test, the effectiveness of the patch was noted in patients with all clinical diagnoses. The greatest positive dynamics was revealed according to the results of the Montreal test according to the criterion of memory in patients with migraine (30%), insomnia (31%), vascular dementia (32%), and according to the results of the MMSE test in patients with diagnoses: cerebrovascular disease: consequences of a cerebral infarction brain (31%), vascular dementia (56%). Conclusion: The patches of “Aganyan” company have proven its effectiveness through electrical stimulation with low-intensity current in patients in different age groups with different clinical diagnoses.

Comparative efficacy of inspiratory, expiratory and combined respiratory muscle training on the pulmonary functions and chest expansion in acute stroke survivors

Background: Respiratory muscle strength can be reduced in patients diagnosed with stroke, which reasonably justifies the use of respiratory muscle training in this population. This study determines the comparative efficacy of inspiratory, expiratory, and combined respiratory muscle training on the pulmonary functions and chest expansion in acute stroke survivors. Method: Forty-five acute stroke survivors (15 in each group) completed all protocols of the study. Participants were randomly assigned to any one of three groups. In addition to the conventional exercise therapy, participants received any one of the three respiratory muscle training protocols (inspiratory muscle training, expiratory muscle training or combined respiratory muscle training). Chest expansion was assessed using tape measure and pulmonary function parameters were assessed using a spirometer. Results: Paired t-test analysis showed significant improvements in the chest expansion and the pulmonary function parameters following training in each group. One-way ANOVA showed significant improvements in the pulmonary function parameters across the three groups but not in the chest expansion with p - value = 0.405. Least significant difference (LSD), post-hoc analysis shows that the significant difference for FEV1, FVC and FEV1/FVC lies between inspiratory muscle training group and expiratory muscle training group. Conclusion: When the three training methods were compared, it was found that expiratory muscle training was the most beneficial in improving the pulmonary functions and chest expansion in acute stroke survivors.

FITT-CORRECT: Updated dynamic and evidence-based principle of exercise prescription

Objective: The FITT (Frequency, Intensity, Time, and Type) principle is an effective foundation in EP. However, the CORRECT components; C–Combination of interventions, O–Order of the Interventions, R–Repetitions, R–Rest period between sets and between sessions, E–Exercise at home, C–Cognitive domain, T–Total dose and re-evaluation plans, should be considered. The purpose of this paper was to describe the updated dynamic and evidence based FITT-CORRECT principle of EP and demonstrates its application using a case study. Results: Literatures, related to EP, clinical reasoning and clinical decision-making, were critically reviewed. Established evidence is summarized to describe an updated dynamic and evidence-based principle of EP. The gaps within the FITT and other related principles of EP are addressed. The FITT-CORRECT principle was introduced and an effective outcome of the updated principle was demonstrated using a case study. The FITT-CORRECT principle integrates many components that are missing in the FITT and other related EP principles. Based on the reported case study, the FITT-CORRECT principle of EP should optimize patients’ intervention outcomes. Physiotherapists can potentially improve their EP by utilizing the FITT-CORRECT in clinical practice.

Prospective study of pain and psychological symptoms of first-year university students

Background: Even if pain and psychological symptoms experienced by university students are common, the prognosis of these symptoms is unknown. Objective: To examine the incidence and the outcome of frequent musculoskeletal and psychological symptoms in a 4-year follow-up of first-year university students. Methods: In 2008, a national random sample (N=2750) of Finnish university students completed a questionnaire concerning pain and psychological symptoms. Of the 416 first-year students, 123 responded to the same questionnaire also in their fourth study year in 2012. Results: Of the first-year university students with frequent pain or psychological symptoms, ­one half (47% - 65%) reported frequent symptoms also four years later. Almost all (78% – 95%) of the symptom-free first-year students were symptom-free also in their fourth study year. Conclusion: Our findings indicate that pain and psychological symptoms in university students are rather persistent during the first four study years. On the other hand, as half of those with frequent symptoms become symptomless and as the prognosis of symptom-free students is favourable, there is still need for further cohort studies on this issue.

Efficacy of transcranial direct current stimulation and over-ground walking task on functional mobility and quality of life of stroke survivors

Introduction: High proportion of stroke survivors have impaired functional mobility and decrease in overall quality of life (QoL). Transcranial direct current stimulation (tDCS) (non-invasive brain stimulation) and over-ground walking task (OGWT) (functional task-oriented training) have been suggested to improve functional mobility and QoL of stroke survivors. Hence, this study determined the efficacy of tDCS (anodal and cathodal) with OGWT on functional mobility and QoL of stroke survivors. Materials and methods: Seventy eight (78) stroke survivors were randomised into three groups: anodal group (anodal tDCS with OGWT); cathodal group (cathodal tDCS with OGWT) and control group (OGWT only). Participants had two sessions of intervention per week for six weeks. Functional mobility was assessed using 10 meter walk test (10MWT) measuring steps, time and velocity while QoL was measured using Stroke Specific QoL (SSQoL) scale. Significance level was set at p < 0.05. Results: Participants (46 males) were aged 56.78 ± 10.24 years. The groups were matched for functional mobility and QoL at baseline and only work/productivity domain of SSQoL showed statistically significant difference (p = 0.028). Each group showed statistically significant improvement between baseline and post-intervention scores of items in functional mobility (p ≤ 0.001) and total SSQoL (p ≤ 0.001). Anodal group showed better statistically significant improvement in step (p = 0.008), time (p = 0.024), velocity (p = 0.001) and total SSQoL (p = 0.016) among the groups when the mean differences were compared. Conclusion: tDCS with OGWT is efficacious in improving functional mobility and QoL of stroke survivors. Specifically anodal tDCS with OGWT showed better clinical improvement in step, time, velocity and QoL in stroke survivors.

Lower-body negative pressure/ergometer exercise in bed rest: Effects on female orthostatic tolerance

Introduction: Alternatively using gradient lower-body negative pressure (LBNP) and ergometer exercise (LBNP + ergo) under a flight schedule framework was explored to detect its orthostatic capacity maintenance effects in female subjects after 15 days of -6° head-down bed rest (HDBR). Methods: Twenty-two female university students were divided into a control group (n = 8), an LBNP group (n = 7), and an LBNP + ergo group (n = 7). Ergometer exercise consisted of an interval exercise protocol with 2 min intervals alternating between 41% and 70% VO2max. Gradient LBNP was decompressed in 10 mm Hg intervals to -40 mmHg every 5 min. intermittent ergometer exercise and LBNP were alternatively performed. Tilt test was performed 2 days before HDBR (R-2), on the day of HDBR termination (R+1), and 5 days after HDBR (R+5). Results: Fifty percent of the participants (11/22) did not pass the tilt test on R+1. The orthostatic tolerance time decreased from 20 to 16.1 ± 2.1 min in the control group, to 10.0 ± 2.7 min in the LBNP group (p = 0.01) and to 16.3 ± 2.0 min in the LBNP + ergo group. The HRs and BPs were at similar level among three groups during tilt test on different test days. Compared with the control group, the LBNP + ergo group had higher SV and CO percentage changes at R+1(p < 0.023) and R+5 (p < 0.00001) during the tilt test. Conclusion: LBNP combined with ergometer exercises fails to prevent orthostatic intolerance but it induced some positive hemodynamic changes during tilt test after 15 days HDBR.