Description of novel instrumented analysis of the Four Square Step Test with clinical application: A pilot study

BackgroundFalls are a common problem for adults in the United States raising concerns about injuries and the resulting economic burden. As a result, it is critical to develop objective measures to assess dynamic balance and the track progress related to interventions or disease progression over time.Research QuestionAre there differences in balance between individuals in the community, individuals post-stroke, persons with Multiple Sclerosis (MS), and individuals living with Parkinson’s Disease (PD) as measured with a new instrumented Four Square Step Test (i-FSST)?MethodsThe i-FSST was utilized to assess dynamic balance in 41 individuals (11 community dwelling adults and 10 individuals in each group of persons post stroke, with PD, and with MS). Outcome data including the overall duration of the FSST as well unique temporal-spatial stepping patterns through the test, timing of transitions between each quadrant, and the time in each quadrant prior to transitioning.ResultsOne-way ANOVAs were conducted to determine whether i-FSST duration, Over Double Support (ODS), and Changes in Main Support (CMS) differed by participants’ groups. There was a significant difference between groups in test Duration (F = 9.56, P = .000), ODS (F = 15.71, P = .001), and CMS (F = 7.03, P = .001). Further differences in these variables were found between various groups using Bonferroni post-hoc testing.SignificanceThe i-FSST is an innovative and potentially beneficial tool for quantitatively measuring the dynamics that occur in the traditional FSST including a general measure of dynamic balance as well as transition times and stability during the test. This technology can provide objective data on stability, weight shifting, and weight acceptance that may guide interventions and further assessment.     

精神障碍社区康复服务规范（DB 51/T 2697-2020）

本规范为四川省精神障碍社区康复服务地方标准,规定了精神障碍社区康复服务相关术语和定义,包括机构设置、管理制度、服务内容、服务流程、服务要求、基本管理服务、专业康复服务、质量控制和工作指标等内容。适用于四川省行政区域内为精神障碍患者开展精神康复训练、辅助就业培训、日间照料、过渡期宿舍、庇护就业、康复会所和长期康养的各类机构和社会组织。     

冠心病主动康复的今天和明天

2020年，欧洲预防心脏病学协会明确提出了以运动康复为主的心脏康复在心血管疾病和代谢疾病管理中的重要作用，并呼吁大家行动起来。本文从冠心病运动康复基础和临床研究进展、运动康复减少冠心病并发症、各国运动康复指南和新型冠状病毒肺炎疫情下运动康复的实施4个维度探讨冠心病个体化主动运动康复的现状和将来，以期为研究和临床工作的开展提供参考。     

Investigating the Effects of an Otago-Based Program among Individuals Living with Dementia

Abstract

Aim: To examine the impact of an Otago-based exercise program (OEP) on physical function in patients living with mild cognitive impairment (MCI) or dementia receiving home heath physical therapy.

Methods: 34 patients (mean age 88.3?years; 62% female; mean Mini-Cog 1.76) completed the following assessments: Four-Stage Balance test, Timed Up & Go, 30-Second Chair Stand test, and Tinetti Gait and Balance. Assessments were completed at baseline and an average of 4.79 (2.29) visits later, with a mean of 1.74 (0.79) months between assessments. The OEP-based exercises were individually tailored and progressed based on performance as recommended by the program protocol.

Results: A paired samples t-test revealed significant differences in scores for the Four-Stage Balance Test (p?<?0.001), the Timed Up & Go (p?=?0.002), and the Tinetti Gait and Balance (p?=?0.002).

Conclusion: The OEP can potentially be used for individuals living with cognitive impairments to improve performance outcomes such as balance and functional mobility.     

Home-based exercise is associated with improved cardiac functional performance in patients after acute myocardial infarction

ObjectiveTo evaluate the effects of home-based exercise and physical activity on cardiac functional performance in patients after acute myocardial infarction (MI) during the coronavirus disease 2019 (COVID-19) pandemic.MethodsThis retrospective study enrolled patients that received treatment of acute ST-segment elevation MI between and were followed-up 6 months later. The patients were divided into physically active and inactive groups based on their levels of home exercise after hospital discharge.ResultsA total of 78 patients were enrolled in the study: 32 were physically active and 46 were physically inactive. The baseline characteristics were comparable between the two groups. At the 6-month visit, left ventricular ejection fraction and six-minute walking test (6MWT) were significantly improved while the proportion of patients with a New York Heart Association (NYHA) functional III classification was decreased in the active patients, whereas these parameters were not significantly changed in the inactive patients. In addition, the 6MWT was greater while the proportion of patients with an NYHA III classification was lower in the active group than the inactive group at the 6-month visit.ConclusionMaintaining physical activity at home was associated with improved cardiac functional performance in patients after acute MI during the COVID-19 pandemic.     

Optimizing Rapid Recovery After Anterior Hip Arthroplasty Surgery: A Comparative Study of Fascia Iliaca Compartment Block and Local Infiltration Analgesia

BackgroundMultimodal pain therapy combining analgesics, local infiltration analgesia (LIA) and peripheral nerve blocks, such as fascia iliaca compartment block (FICB), can improve postoperative pain, nausea and vomiting (PONV) and ambulation in patients undergoing total hip arthroplasty (THA). We hypothesized that addition of FICB would decrease opioid requirements and length of stay (LOS) but could create a motor block.MethodsThis is a single center, prospective, blinded randomized controlled study of 152 patients undergoing elective THA via direct anterior approach from October 2019 till August 2021. Three patient groups were defined: patients receiving only spinal anesthesia (control group, n = 53); spinal anesthesia with LIA perioperatively (n = 50); and spinal anesthesia with FICB on the recovery unit (n = 49). Outcome measures consisted of postoperative pain scores, PONV, length of hospital stay, opioid requirements and mobility.ResultsOverall pain scores were low for all patient groups, with a lower pain score for LIA in comparison to the control group until 4 hours postoperatively (P < .05). Length of hospital stay, postoperative pain, nausea and vomiting (PONV) scores and quadriceps muscle strength did not differ significantly between groups. The control group showed higher scores at 12 hours postoperatively in comparison to FICB regarding rehabilitation potential, use of walking aids and activities of daily living (P < .05), but all groups reached the same endpoint 48 hours postoperatively. The LIA and FICB groups required less opioids until 24 hours postoperatively.ConclusionLIA is a beneficial adjuvant therapy to spinal anesthesia in THA patients as it may decrease pain scores and the need for opioid consumption. Adjuvant FICB only provided lower opioid requirements.