Effect of a Local Vibration Stimulus Training Programme on Postural Sway and Gait in Chronic Stroke Patients: A Randomized Controlled Trial.

Effect of a local vibration stimulus training programme on postural sway and gait in chronic stroke patients: a randomized controlled trial.

Clin Rehabil. 2013 Jul 1;
Lee SW, Cho KH, Lee WH

Objective:To investigate the effect of a local vibration stimulus training programme on postural sway and gait in stroke patients.Design:A randomized controlled trial with two groups: a local vibration stimulus training programme group and a sham group.Setting:Inpatient rehabilitation centre.Subjects:Thirty-one chronic stroke patients.Interventions:Both groups underwent a standard rehabilitation programme. The local vibration stimulus training programme group (n = 16) participated in the local vibration stimulus training programme for 30 minutes a day, five times a week, for six weeks. The sham group (n = 15) participated in a sham local vibration stimulus training programme for 30 minutes a day, five times a week, for six weeks.Main measures:A forceplate was used to measure postural sway under two conditions: standing with eyes open and eyes closed. Gait ability was measured using the GAITRite system.Results:In postural sway, greater improvements in the postural sway distance with eyes-open (-11.91 vs. 0.80) and eyes-closed (-20.67 vs. -0.34) conditions and postural sway velocity with eyes-open (-0.40 vs. 0.03) and eyes-closed (-0.69 vs. -0.01) conditions were observed in the local vibration stimulus training programme group, compared with the sham group (P < 0.05). In gait ability, greater improvement in gait speed (15.06 vs. 2.85), cadence (8.46 vs. 1.55), step length (7.90 vs. 3.64), and single limb support time (0.12 vs. 0.01) were observed in the local vibration stimulus training programme group, compared with the sham group (P < 0.05).Conclusions:These findings suggest that local vibration stimulus training programme is an effective method for improvement of the postural sway and gait ability of chronic stroke patients. HubMed – rehab

Relationship of health-related quality of life with fatigue and exercise capacity in patients with coronary artery disease.

Eur J Cardiovasc Nurs. 2013 Jul 1;
Staniute M, Bunevicius A, Brozaitiene J, Bunevicius R

Objective:The study objective was to evaluate the relationship of health-related quality of life (HRQoL) with fatigue and exercise capacity in coronary artery disease (CAD) patients.Methods:A total of 1072 consecutive CAD patients on admission to a cardiac rehabilitation program were evaluated for HRQoL (36-item Short Form Medical Outcome Questionnaire; SF-36), body mass index, clinical characteristics (New York Heart Association (NYHA) class, angina pectoris class, coronary interventions, treatment with beta blockers, hypertension and diabetes), symptoms of depression and anxiety (Hospital Anxiety and Depression Scale), fatigue (Multidimensional Fatigue Inventory-20; MFI-20), and exercise capacity (bicycle ergometer test).Results:In univariate regression analyses lower scores on all SF-36 domains were associated with greater scores on all MFI-20 subscales. Exercise capacity was associated with all SF-36 domains, except for social functioning and mental health domains. In multivariate regression analyses, after adjusting for age, gender, body mass index, NYHA class, angina pectoris class, hypertension, diabetes, coronary interventions, treatment with betablockers, and symptoms of depression and anxiety, greater limitation due to physical and due to emotional problems, poor social functioning, decreased energy/vitality, worse general health perception, reduced mental component summary and lower global SF-36 score were independently associated with higher MFI-20 general fatigue score. Reduced physical functioning, greater pain, and reduced physical component summary SF-36 scores were associated with greater MFI-20 physical fatigue score. Lower SF-36 mental health score was associated, with greater MFI-20 mental fatigue score.Conclusion:In CAD patients undergoing rehabilitation, poor HRQoL is associated with greater fatigue and decreased exercise capacity independently from mental distress and CAD severity score. HubMed – rehab

Cardiac rehabilitation after myocardial infarction: What influences patients’ intentions to attend?

Eur J Cardiovasc Nurs. 2013 Jul 1;
McKee G, Biddle M, O’ Donnell S, Mooney M, O’ Brien F, Moser DK

Background:Cardiac rehabilitation (CR) programmes have increased their availability and expanded their eligibility criteria. This study sought to identify current predictors and reasons influencing myocardial infarction patients’ pre-discharge intentions to attend CR.Methods:Patients in this longitudinal, prospective, five site study completed questionnaires that surveyed their intentions to attend, attendance and main reasons for non-attendance at CR.Results:84% of the 1172 patients indicated that they intended to attend CR. Multivariate analyses revealed that age, employment and earlier history of myocardial infarction were significant predictors of intention to attend CR, yet contributed to only a small proportion of the variance. The main reasons given for not intending to attend CR were lack of interest and perception that the programme would not be beneficial. Other obstacles included work, transport or time. A total of 708 (60%) patients responded at 12 months, and of these, 44% who did not intend to attend CR had attended.Conclusion:Patient sociodemographic and clinical profile, although significant, are not major predictors of intention to attend CR. Lack of interest and misconceptions regarding CR are cited as key barriers. Some of these seem to have been addressed post discharge as a good proportion of patients who had not intended to attend CR did change their minds and attended. Motivation of patients to participate in CR, including the identification of barriers and the provision of comprehensive information about the purpose and varied formats of CR programmes, could be used to help further address barriers to attendance. HubMed – rehab

Clinical observation on treatment of clearing the governor vessel and refreshing the mind needling in neural development and remediation of children with cerebral palsy.

Chin J Integr Med. 2013 Jul; 19(7): 505-9
Liu ZH, Qi YC, Pan PG, Ma MM, Qian XG, Fu WJ

To investigate the effects of clearing the Governor Vessel and refreshing the mind needling in neural development and remediation of children with cerebral palsy.A total of 200 cases of children with cerebral palsy were randomly assigned to the treatment group (100 patients) and the control group (100 patients). The treatment group was given the combined therapy of acupuncture and rehabilitation training, and the chosen acupoints were 13 points of the Governor Vessel, Shenshu (BL 23), Taixi (KI 3), Yanglingquan (GB 34), Zusanli (ST 36) and Sanyinjiao (SP 6), and points of refreshing the mind were also selected, which included puncturing Shenting (GV 24) toward Qianding (GV 21), puncturing Qianding (GV 21) toward Baihui (GV 20), puncturing Baihui (GV 20) toward Naohu (GV 17) and Sishencong (Ex-HN 1). The control group was only treated with rehabilitation training. A contrastive analysis of the therapeutic effect between acupuncture combined with rehabilitation training and rehabilitation training alone was made after a treatment course of 3 months. The Gross Motor Function Measure (GMFM) and Beijing Gesell Developmental Scale were adopted to assess the neural development and rehabilitation outcomes of the two groups. In addition, skull CT/MRI was adopted to evaluate the plerosis of injured cerebral nerve after treatment.The total effective rate in treatment group was 87% (87/100), significantly higher than the 55% (55/100) in the control group. The children’s development quotient (DQ) tested by Gesell Developmental Scale and scores tested by GMFM in the treatment group were obviously higher than those in the control group (P<0.01). The improving and curing rates presented by skull CT/MRI in the treatment group were higher than those in the control group (P<0.01).Clearing the Governor Vessel and refreshing the mind needling could accelerate the recovery of injured brain nerve and the reconstruction of brain function. The acupuncture therapy could ameliorate both the motor development and cognitive development. On the other hand, the forward curative effect of acupuncture combined with rehabilitation training was significantly better than the rehabilitation training alone. HubMed – rehab