Static and dynamic postural control of postpartum women of different delivery methods

ObjectiveThe aim of this study was to determine whether there is a difference in postural control between nulligravida women and women who have given birth by vaginal or cesarean section.MethodsWomen who had only vaginal delivery in the previous 1–3 years were included in the vaginal delivery group (n = 27), those who had only cesarean delivery in the previous 1–3 years were included in the cesarean section group (n = 28), and those who had never given birth were included in the control group (n = 32). Evaluations were administered 6–8 days after the ovulation phase. Postural control of the participants was evaluated with the computerized dynamic posturography device.ResultsA total of 87 women with a mean age of 29.4 ± 4 years and a mean body mass index of 24.1 ± 3.1 kg/m² were included in the study. Antero-posterior somatosensory organization test values of the vaginal delivery group were lower than the control group (p = 0.0016). The cesarean delivery group had statistically lower antero-posterior somatosensory (p < 0.001 and p = 0.0013) and medio-lateral somatosensory (p = 0.002 and p = 0.017, respectively) test scores compared to the control group and the vaginal delivery group.ConclusionsIt was observed that women who birthed with vaginal or cesarean delivery had impaired somatosensory postural control. There is definitely a need for further studies with a long-term follow-up examining the effects of postural control during pregnancy and the postpartum period.     

Glycaemic control for patients with severe acute brain injury: Protocol for a systematic review

Background

Hyperglycaemia is common in patients with acute brain injury admitted to an intensive care unit (ICU). Many studies have found associations between development of hyperglycaemia and increased mortality in hospitalised patients. However, the optimal target for blood glucose control is unknown. We want to conduct a systematic review with meta-analysis and trial sequential analysis to explore the beneficial and harmful effects of restrictive versus liberal glucose control on patient outcomes in adults with severe acute brain injury.

Methods

We will systematically search medical databases including CENTRAL, Embase, MEDLINE and trial registries. We will search the following websites for ongoing or unpublished trials: http://www.controlled-trials.com/ , http://www.clinicaltrials.gov/ , www.eudraCT.com , http://centerwatch.com/ , The Cochrane Library's CENTRAL, PubMed, EMBASE, Science Citation Index Expanded and CINAHL. Two authors will independently review and select trials and extract data. We will include randomised trials comparing levels of glucose control in our analyses and observational studies will be included to address potential harms. The primary outcomes are defined as all-cause mortality, functional outcome and health-related quality of life. Secondary outcomes include serious adverse events including hypoglycaemia, length of ICU stay and duration of mechanical ventilation, and explorative outcomes including intracranial pressure and infection. Trial Sequential Analysis will be used to investigate the risk of type I error due to repetitive testing and to further explore imprecision. Quality of trials will be evaluated using the Cochrane Risk of Bias tool, and quality of evidence will be assessed using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach.

Discussion

The results of the systematic review will be disseminated through peer-reviewed publication. With the review, we hope to inform future randomised clinical trials and improve clinical practice.     

The effect of education given to type 2 diabetic individuals on diabetes self-management and self-efficacy: Randomized controlled trial

AimThis study used a randomized controlled trial design and was carried out to examine the effect of education on diabetes self-management and self-efficacy in patients with type 2 diabetes.MethodsThe study was carried out between July 2016–March 2017. Data were collected using information form, Diabetes Self-Management Questionnaire (DSMQ), self-efficacy scale for patients with type 2 diabetes (DSS).The individuals in the experimental group were given education. Both groups were reminded about the control time of their metabolic values on the phone in the 3rd and 6th months.ResultsThe average age of the individuals was 59.91 ± 8.93 (n = 78), 62.8% (n = 49) were female, 92.3% (n = 72), were married, 42.3% (n = 33) were high school graduates and their diabetes duration was 7.05 ± 3.9. There was a statistically significant difference in the 6th month metabolic values in the experimental group compared to the control group. When diabetes self-management and self-efficacy were examined, a statistically significant difference was found in the experimental group compared to the control group at 3rd and 6th months (p < 0.05, p < 0.01).ConclusionIn this study, a significant increase in diabetes self-management and self-efficacy and a significant decrease in metabolic values were observed as a result of education and phone reminders given to individuals with type 2 diabetes.     

Postural balance and oculomotor control are influenced by neck kinaesthetic functions in elite ice hockey players

BackgroundResearch indicates that neck kinaesthetic awareness plays an important role in oculomotor and balance control, however the relationship has not been studied in athletes. As performance in ice hockey demands visual perception acuity during skating, while constantly shifting between unilateral and bilateral stances in sports specific posture more in-depth relationship should be studied.Research questionWhat is the relationship between neck kinaesthetic awareness, postural balance and eye movement control in professional ice hockey players and non-trained individuals?MethodsIn this observational study, centre-of-pressure was measured using force plate in twenty-eight hockey players and thirty non-trained participants during different stances in eyes-opened and eyes-closed conditions. Butterfly test and Head-to-Neutral Relocation test were performed to assess neck kinaesthesia. Horizontal smooth pursuit eye movements were measured using video-oculography. Linear regression was used to determine the relationship between neck kinaesthesia, body sway and oculomotor control.ResultsTime-on-target in Butterfly test was able to predict low to medium proportions of variance in amplitude and velocity parameters for single leg stances in hockey players (R² = .220–.698). Head-to-Neutral Relocation test was able to predict low to medium proportion of variance in average eye movement velocity during first 100 milliseconds of smooth pursuit initiation for both groups (R² = .262–.541).SignificanceFindings from our study suggest that cervical spine afferent input plays an important role in maintaining unilateral postural balance in hockey players, with less evidence presented in controls. Sports specific posture or upper body loading could lead to adaptations in neck proprioception, not frequently considered when searching for balance related injury risk factors or performance deficits. Our study suggests, that in addition to balance control, neck kinaesthesia can also affect oculomotor performance which was present in both groups. This is especially evident when initiating changes in eye movement direction.     

Motor dysfunction in mild cognitive impairment as tested by kinematic analysis and transcranial magnetic stimulation

ObjectivePrevious studies have demonstrated voluntary movement alterations as well as motor cortex excitability and plasticity changes in patients with mild cognitive impairment (MCI). To investigate the pathophysiology of movement abnormalities in MCI, we tested possible relationships between movement abnormalities and primary motor cortex alterations in patients.MethodsFourteen amnestic MCI (aMCI) patients and 16 healthy controls were studied. Cognitive assessment was performed using clinical scales. Finger tapping was recorded by a motion analysis system. Transcranial magnetic stimulation was used to test the input/output curve of motor evoked potentials, intracortical inhibition, and short-latency afferent inhibition. Primary motor cortex plasticity was probed by theta burst stimulation. We investigated correlations between movement abnormalities, clinical scores, and cortical neurophysiological parameters.ResultsMCI patients showed less rhythmic movement but no other movement abnormalities. Cortical excitability measures were normal in patients, whereas plasticity was reduced. Movement rhythm abnormalities correlated with frontal dysfunction scores.ConclusionOur study in MCI patients demonstrated abnormal voluntary movement and plasticity changes, with no correlation between the two. Altered rhythm correlated with frontal dysfunction.SignificanceOur results contribute to the understanding of pathophysiological mechanisms of motor impairment in MCI.     

品管圈对缩短结直肠癌患者术后胃肠功能恢复时间的效果观察

目的探讨品管圈对结直肠癌患者术后胃肠功能恢复时间的临床效果。方法选取2019年4月至5月间上海市健康医学院附属嘉定区中心医院收治的52例结直肠癌术后患者为改进前组,2019年6月至7月52例患者为改进后组。检查改进前组患者平均排气时间、排便时间及腹胀发生率,采用品管圈对改进后组患者进行干预,比较两组患者胃肠道功能和相关无形成果。结果改进后组患者排气时间、排便时间和腹胀发生率均低于改进前组,差异均有统计学意义(均P<0.05)。通过品管圈活动,圈员们责任心、自我价值、团队精神、科研能力、沟通能力和解决问题能力均提升。结论品管圈可缩短结直肠癌患者术后排气时间和排便时间,降低腹胀发生率,提高圈员综合素质,值得推广。