Effects of a posture shirt with back active correction keeper on static and dynamic balance in Parkinson's disease

BackgroundPatients with Parkinson's disease (PD) suffer from postural disorders. This study aims at investigating the short- and medium-term effects of a shirt with appropriate tie-rods that allows to correct the posture of the trunk.MethodsThis is a longitudinal clinical study in which a pressure platform was used to assess the static and dynamic baropodometry and the static stabilometry of 20 patients with PD (70.95 ± 8.39 years old; 13 males, time from the onset of symptoms: 6.95 ± 4.04 years, Unified Parkinson's Disease Rating Scale score: UPDRS = 7.25 ± 6.26) without and with a shirt, specifically designed for improving posture, at baseline and after one month of wearing.ResultsThe results showed a significant improvement in symmetry of loads (p = 0.015) and an enlargement of the foot contact surface (p = 0.038). A significant correlation was found between the change in forefoot load and time spent daily in wearing the shirt (R = 0.575, p = 0.008), with an optimal value identified at 8 h per day.ConclusionThe use of a postural shirt in patients with PD symmetrized the postural load and enlarged the foot contact surface improving their balance.     

某院静脉滴注药品说明书滴速限制项标注情况分析

目的为药品生产厂家制订静脉滴注药品说明书及临床输液有效管理提供依据,保证患者用药安全。方法筛选某院可用于静脉滴注的注射剂药品说明书609份,对药品成分分类、药物作用系统、滴速限制项的描述方式及滴速要求等项目进行分别统计。结果 609份药品说明书中有264份(43. 35%)标注了滴速要求,其中中药类标注率为56. 10%,西药类标注率为42. 43%;消化系统用药、呼吸系统用药、抗感染药、心血管系统用药、神经系统用药的标注率相对较高;标注内容有5种描述方式;分别总结了不同滴速要求的药品种类。结论静脉输液时合理调整滴速对用药的安全性和有效性非常重要,通过医、药、护、患共同参与,加强药品说明书的管理和学习,加上药品生产厂家对静脉滴注药品说明书的不断完善,有利于提高用药安全。     

Achilles tendon loading patterns during barefoot walking and slow running on a treadmill: An ultrasonic propagation study

Measurement of tendon loading patterns during gait is important for understanding the pathogenesis of tendon “overuse” injury. Given that the speed of propagation of ultrasound in tendon is proportional to the applied load, this study used a noninvasive ultrasonic transmission technique to measure axial ultrasonic velocity in the right Achilles tendon of 27 healthy adults (11 females and 16 males; age, 26 ± 9 years; height, 1.73 ± 0.07 m; weight, 70.6 ± 21.2 kg), walking at self‐selected speed (1.1 ± 0.1 m/s), and running at fixed slow speed (2 m/s) on a treadmill. Synchronous measures of ankle kinematics, spatiotemporal gait parameters, and vertical ground reaction forces were simultaneously measured. Slow running was associated with significantly higher cadence, shorter step length, but greater range of ankle movement, higher magnitude and rate of vertical ground reaction force, and higher ultrasonic velocity in the tendon than walking (P < 0.05). Ultrasonic velocity in the Achilles tendon was highly reproducible during walking and slow running (mean within‐subject coefficient of variation < 2%). Ultrasonic maxima (P1, P2) and minima (M1, M2) were significantly higher and occurred earlier in the gait cycle (P1, M1, and M2) during running than walking (P < 0.05). Slow running was associated with higher and earlier peaks in loading of the Achilles tendon than walking.     

Relationship between sarcopenia,six‐minute walk distance and health‐related quality of life in liver transplant candidates

Sarcopenia, or loss of skeletal muscle mass, is associated with increased mortality and morbidity in liver transplant (LT) candidates. Six‐minute walk distance (6MWD) and health‐related quality of life (HRQOL) as assessed by short form 36 scores (SF‐36) also impact clinical outcomes in these patients. This study explored the relationship between the sarcopenia, 6MWD, and HRQOL in LT candidates. Sarcopenia was evaluated based on skeletal muscle mass index (SMI) quantified from abdominal computed tomography. Patients were followed until death, removal from the wait list or the end of the study period. Two hundred and thirteen patients listed for LT were included. The mean SMI, 6MWD and mean gait speed were 54.3 ± 9.7, 370.5 m and 1 m/s, respectively. Sarcopenia was noted in 22.2% of LT candidates. There was no correlation between sarcopenia, 6MWD, and SF‐36 scores. The 6MWD, but not sarcopenia, was an independent predictor of mortality (hazard ratio = 2.1 [0.9–4.7]). In summary, sarcopenia did not emerge as a significant predictor of waitlist mortality and also failed to correlate with either functional capacity or HRQOL in LT candidates. In patients with ESLD awaiting LT, 6MWD appears to be a more useful prognostic indicator than the presence of sarcopenia.     

Changes in Neuropsychological Functioning with Progression of HIV-1 Infection: Results of an 8-Year Longitudinal Investigation

Despite the advent of more effective treatments for HIV-1 infection, cognitive impairment is still frequent and questions remain regarding which areas of impairment are more common in the different disease stages. This study investigated cognitive performance over an 8-year period of time in 59 HIV-1 seropositive (HIV-1+) men who were clinically asymptomatic at study entry, in comparison to a cohort of 55 HIV-1 seronegative (HIV-1-) men. Every 6 months we examined cognitive functioning in 5 domains-fine motor speed, attention, verbal memory, executive functioning, and speed of information processing. We found that patients with AIDS scored significantly worse on fine motor speed and speed of information processing than HIV-1- individuals and the HIV-1+ non-AIDS patients. In addition, the HIV-1+ non-AIDS patients performed more poorly than the HIV-1- group on speed of information processing. Depressive symptoms were also associated with diminished performance on measures of attention, executive functioning, and speed of information processing. Further research is needed to examine the effects of disease stage and depression on cognitive impairment in the era of new HIV treatments.     

出院后营养管理对新生儿肠道手术后生长速度的影响

目的：探讨出院后科学的营养管理对新生儿肠道术后生长速度的影响。方法通过营养门诊对113例肠道手术后患儿进行出院后营养喂养指导,统计每月生长速度（体质量、身长和头围）,对照正常参考值,分析落后的体格何时出现生长加速。结果新生儿肠道手术后1月时出现体格增长速度低于正常参考值,以男性为著（体质量P＝0．000;身长P＝0．041;头围P＝0．010）。生长加速出现在术后2～3月,男性出现身长的生长加速（月增长值[（4．53±1．22） cm比（3．1±0．4） cm, P＝0．013],女性出现体质量[（1．51±0．76） kg比（0．83±0．39） kg, P＝0．028]和头围[（2．50±0．93） cm比（1．2±0．7） cm, P＝0．021]的生长加速。结论科学的出院后营养管理有助新生儿术后体格生长加速,术后2～3月是生长加速的关键时期。     

平衡训练系统辅助特定任务性平板步行训练对卒中患者下肢运动功能的影响

目的探讨Biodex平衡训练系统辅助特定性平板步行训练对卒中后下肢运动功能的影响。方法选取卒中后平衡和下肢运动功能障碍的偏瘫患者40例,按病例号奇偶数分为平衡训练组和常规训练组,每组20例。常规训练组给予常规康复治疗及传统的平衡训练,平衡训练组在常规康复治疗的基础上,应用Biodex平衡训练系统辅助特定任务性平板步行训练。于治疗前及治疗后4周评价两组患者的下肢稳定性指数、Berg平衡量表评分(BBS)、"起立-行走"计时(TUGT)、最大步速和步长、Fugl-Meyer运动功能量表(下肢部分)评分(FMA-L)、改良Barthel指数(MBI)及功能性步行量表评分(FAC),综合评定患者的平衡和下肢运动功能。结果治疗前,两组患者的各项指标比较,差异均无统计学意义(P0.05)。治疗后,两组患者各项指标均较治疗前好转,差异有统计学意义(P0.01);平衡训练组与常规训练组比较,稳定性指数(分别为6.5±1.3、8.5±2.1)、BBS评分[分别为(49±4)、(34±3)分]、TUGT[分别为(13.5±3.2)、(22.3±2.8)s]、最大步速[分别为(60±23)、(50±21)m/min]、最大步长[分别为(54±12)、(42±11)m]、FMA评分[分别为(31±4)、(24±5)分]、MBI评分[分别为(81±14)、(70±11)分]及FAC分级评分[分别为(4.31±0.39)、(3.21±0.19)分]改善程度均优于常规训练组,差异有统计学意义(P0.01或P0.05)。结论应用Biodex平衡训练系统辅助特定任务性平板步行训练对卒中后患者的平衡和下肢运动功能有很好的改善作用。     

Heart Rate Recovery in the First Minute at the Six-Minute Walk Test in Patients with Heart Failure

Background

Heart rate recovery at one minute of rest (HRR₁) is a predictor of mortality in heart failure (HF), but its prognosis has not been assessed at six-minute walk test (6MWT) in these patients.

Objective

This study aimed to determine the HRR₁ at 6MWT in patients with HF and its correlation with six-minute walk distance (6MWD).

Methods

Cross-sectional, controlled protocol with 161 individuals, 126 patients with stable systolic HF, allocated into 2 groups (G1 and G2) receiving or not β-blocker and 35 volunteers in control group (G3) had HRR₁ recorded at the 6MWT.

Results

HRR₁ and 6MWD were significantly different in the 3 groups. Mean values of HRR₁ and 6MWD were: HRR₁ = 12 ± 14 beat/min G1; 18 ± 16 beat/min G2 and 21 ± 13 beat/min G3; 6MWD = 423 ± 102 m G1; 396 ± 101m G2 and 484 ± 96 m G3 (p < 0.05). Results showed a correlation between HRR₁ and 6MWD in G1(r = 0.3; p = 0.04) and in G3(r = 0.4; p= 0.03), but not in G2 (r= 0.12; p= 0.48).

Conclusion

HRR₁ response was attenuated in patients using βB and showed correlation with 6MWD, reflecting better exercise tolerance. HRR₁ after 6MWT seems to represent an alternative when treadmill tests could not be tolerated.