Description of a multifaceted rehabilitation program including overground gait training for a child with cerebral palsy: A case report

ABSTRACT

This case describes the outcomes of a multifaceted rehabilitation program including body weight-supported overground gait training (BWSOGT) in a nonambulatory child with cerebral palsy (CP) and the impact of this treatment on the child's functional mobility. The patient is a nonambulatory 10-year-old female with CP who during an inpatient rehabilitation stay participated in direct, physical therapy 6 days per week for 5 weeks. Physical therapy interventions included stretching of her bilateral lower extremities, transfer training, bed mobility training, balance training, kinesiotaping, supported standing in a prone stander, two trials of partial weight-supported treadmill training, and for 4 weeks, three to five times per week, engaged in 30 minutes of BWSOGT using the Up n' go® gait trainer, Lite Gait Walkable^TM, and Rifton Pacer gait trainer. Following the multifaceted rehabilitation program, the patient demonstrated increased step initiation, increased weight bearing through bilateral lower extremities, improved bed mobility, and increased participation in transfers. The child's Gross Motor Functional Measure (GMFM) scores increased across four dimensions and her Physical Abilities and Mobility Scale (PAMS) increased significantly. This case report illustrates that a multifaceted rehabilitation program including BWSOGT was an effective intervention strategy to improve functional mobility in this nonambulatory child with CP.     

抗阻力运动在2型糖尿病治疗中的研究进展

运动在改善和控制2型糖尿病(Type 2 Diabetes Mellitus,T2DM)中起着不可替代的作用,其中有氧运动被认为是控制和改善T2DM的最佳运动治疗方式,而无氧运动被认为是糖尿病患者的禁忌。抗阻力运动又称阻力运动或力量运动,是一种无氧运动,主要包括负重抗阻运动、对抗性运动、克服弹     

Pilates training reduces blood pressure in older women with type 2 diabetes: A randomized controlled trial

IntroductionThe study investigated the effect of 12 weeks of pilates training on the hemodynamic responses of older women with type-2 diabetes (T2D). Methods: 22 individuals with T2D were randomly allocated into two groups: CONTROL (n = 11; 67.5 ± 6.3 years; 154.7 ± 6.1 cm; 73.5 ± 6.1 kg; calorie intake: 1487.5 ± 360.6 kcal/day) and PILATES (n = 11; 65.5 ± 5.5 years; 155.0 ± 4.5 cm; 66.2 ± 5.4 kg; calorie intake: 1289.3 ± 385.0 kcal/day). The PILATES group executed a 12-week PILATES training program at moderate intensity, 3x/week with each session lasting 60-min. Systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), and postprandial blood glucose were assessed at four timepoints: i) baseline; ii) 4th week; iii) 8th week; and iv) 12th week (s) of intervention. Two-way ANOVA for repeated measures and the Pearson's correlation coefficient were adopted. The alpha level was set at 0.05.ResultsA time1group interaction effect was found for SBP (F = 4.206; η² = 0.17; p = 0.02) and DBP (F = 2.624; η² = 0.12; p = 0.05) with significant reductions (mmHg) in the 4^ths and 8^ths in the PILATES (PILATES SBP baseline: 134.9 ± 27.6; 4^ths: 112.4 ± 15.7; 8^ths: 115.8 ± 18.3; 12^ths: 124.3 ± 19.1 vs. CONTROL SBP baseline: 126.5 ± 15.7; 4^ths: 126.3 ± 16.2; 8^ths: 124.5 ± 13.1; 12^ths: 126.3 ± 21.4 | PILATES DBP baseline: 72.9 ± 11.3; 4^ths: 65.1 ± 12.2; 8^ths: 65.8 ± 12.2; 12^ths: 67.6 ± 7.5 vs. CONTROL DBP baseline: 74.6 ± 12.0; 4^ths: 73.9 ± 11.5; 8^ths: 75.3 ± 11.9; 12^ths: 74.5 ± 9.2).ConclusionFour and eight weeks of PILATES training promotes reduction in the SBP and DBP of older women with T2D. The exercises performed in this study were mainly body weight exercises and required a few auxiliary materials, which turns this method of training accessible.     

有氧运动结合抗阻练习对缺乏运动中年人体质健康的影响

目的:探讨有氧运动结合抗阻练习对中年人各方面身体能力的影响。方法:募集上海某区无专业运动经验,40~60岁的89名受试者,分为A组(每周运动次数3次)和B组(每周运动次数≥3次)。在8周运动干预前后进行11项体质测试,包括体脂率、骨密度等。干预期间不进行饮食监控,也无强制性集中运动。结果:运动干预8周后,2组男、女性体重和BMI与干预前比较差异无统计学意义;B组体脂率较干预前及A组下降明显(P0.05)。男性B组握力、伸膝肌力、坐位体前屈及闭眼单脚站立时间均较干预前明显增加(P0.05),且伸膝肌力较A组明显增加(P0.05);女性B组伸膝肌力、坐位体前屈及闭眼单脚站立时间均较干预前明显增加(P0.05),且坐位体前屈较A组明显增加(P0.05)。男、女性B组最大摄氧量及女性B组骨密度均较A组显著提高(P0.05)。A组各项指标干预前后比较均差异无统计学意义。结论:长期坚持规律性的运动锻炼,有助于中年人降低体脂率;改善身体素质,增强上下肢肌力,提高有氧能力和维持正常骨密度水平。     

老年2型糖尿病患者健康体适能的影响因素分析

目的：分析老年2型糖尿病（T2DM）健康体适能的影响因素及与有氧运动的关系,为老年T2DM运动疗法提供参考。方法：选择2021年1月至2022年6月在我院参加体检的老年T2DM患者125例为调查对象,分析有氧运动（方法、等级）、健康体适能评分,采用单多重线性回归分析老年T2DM患者健康体适能的影响因素。结果：125例老年T2DM患者器官功能、活动功能、躯体调适能力、健康体适能评分分别为（54.43±8.35）、（51.54±7.26）、（57.36±8.42）、（54.42±8.26）分。不同性别、年龄、病程、家庭经济状况、运动时间、运动频率、运动强度老年T2DM患者健康体适能评分比较,差异有统计学意义（P＜0.05）。影响老年T2DM患者器官功能的因素为年龄、经济状况、运动时间、运动频率（P＜0.05）;活动功能的影响因素为性别、年龄、运动时间、运动频率、运动强度（P＜0.05）;躯体调适功能的影响因素为年龄、病程、经济状况、运动时间、运动频率（P＜0.05）;健康体适能的影响因素为性别、年龄、经济状况、运动时间、运动频率（P＜0.05）。结论：老年T2DM患者健康体适能影响因素包括有氧运动时间与运动频率。开展运动时间＞60 min/d、运动频率＞5次/周、中等强度运动疗法有利于提高老年T2DM患者健康体适能。     

Contrast-induced nephropathy in a patient with type 2 diabetes and coronary artery disease: a case report

Contrast-induced nephropathy (CIN) is the impairment of kidney function defined as a serum creatinine increase of 25% or 44 µmol/L compared with baseline, usually occurring 24 to 48 hours after the use of intravenous contrast. Important risk factors for CIN include female sex, advanced age (>65 years), type 2 diabetes (T2D), kidney disease, advanced heart failure, and intravascular volume depletion. We herein present a male patient with T2D, moderately reduced renal function, no albuminuria, and a positive echocardiography stress test. He underwent percutaneous coronary intervention (PCI), and two drug-eluting stents (in the left anterior descending coronary artery) and three bare-metal stents (in the right coronary artery) were implanted. Despite adequate rehydration (0.9% intravenous NaCl with 8.4% sodium bicarbonate) before and after the procedures, he developed irreversible kidney injury after coronary angiography and PCI. This case report demonstrates the unpredictable clinical course of CIN. Patients with T2D are at high risk for the occurrence of CIN, so careful clinical assessment is recommended with global renal functional reserve evaluation.     

有氧运动联合低强度抗阻运动训练在重度慢性阻塞性肺疾病患者中的应用

目的 探讨有氧运动联合抗阻运动对重度慢性阻塞性肺疾病患者的肺功能、运动能力及生活质量的影响.方法 选择2017年1月-2018年12月在我院治疗的120例重度慢性阻塞性肺疾病患者,采用随机数字表法将其分为对照组和观察组,每组各60例.2组患者均给予常规药物治疗和护理,对照组给予适度有氧运动;观察组实施有氧运动联合渐进式...     

Meta分析联合运动与有氧运动对2型糖尿病患者血糖控制及并发症危险因素的影响

目的 比较有氧运动联合抗阻训练(combined training,CT)与单纯有氧运动(aerobic training,AT)改善2型糖尿病患者血糖控制和并发症危险因素的效果.方法 检索PubMed、EMBASE 等资源,收集比较CT与AT应用于2型糖尿病患者的效果的随机对照实验,以RevMan5.1软件进行统计处理.结果 纳入文献6篇.CT在控制血糖、减少腹部脂肪、改善血脂方面的作用优于AT,两者对血压的影响差异无统计学意义.结论 CT对2型糖尿病患者的干预效果优于AT.     

2型糖尿病合并周围神经病变内皮素及一氧化氮水平监测

目的探讨血浆内皮素(ET)及血清一氧化氮(NO)在2型糖尿病合并周围神经病变时的浓度变化。方法糖尿病合并周围神经病变组36例,糖尿病无周围神经病变组30例,正常对照组30例。结果DPN组ET水平显著高于DM组(P<0·001),DM组ET水平显著高于正常对照组(P<0·001)。DPN组NO水平显著低于DM组(P<0·001),DM组NO水平显著低于正常对照组(P<0·001)。直线相关分析显示ET与NO呈负性相关。结论ET、NO的检测作为血管内皮受损的指标,对DPN的发生及病情的判断有参考价值。     

荞麦化学成分对2型糖尿病患者相关并发症的预防

目的 探讨荞麦化学成分对2型糖尿病患者相关并发症的预防效果。方法 选取确诊的2型糖尿病患者102例。将患者分为观察组及对照组。根据糖尿病膳食标准定量摄入,观察组使用荞麦粉作为主食,对照组使用小麦粉为主食。比较两组干预前后血糖、血压、血脂及抗氧化能力等情况。结果 干预后观察组收缩压、总胆固醇（TC）明显低于对照组（P＜0.05）;观察组高密度脂蛋白（HDL C）高于对照组（P＜0.05）;干预后观察组空腹血糖（FPG）、餐后2h血糖（2 hPG）、糖化血红蛋白（HbA1c）及丙二醇（MDA）均低于干预前及对照组（P＜0.05）;干预后观察组患者超氧化物歧化酶（SOD）活性显著高于对照组及干预前（P＜0.05）。结论 荞麦可能通过改善患者血糖水平、血脂血压情况及降低MDA含量、升高SOD活性预防2型糖尿病患者并发症的发生。     

EXCEL药物洗脱支架降低冠心病合并2型糖尿病患者PCI远期再狭窄研究

目的分析EXCEL药物洗脱支架(DES)在冠心病合并2型糖尿病(DM)患者中介入治疗(PCI)12个月的安全性及再狭窄发生率。方法连续入选2006-03-2009-09来大连医科大学附属二院首次接受PCI治疗的395例冠心病合并2型糖尿病(DM)患者,其中裸金属支架(BMS)组172例、EXCEL组223例,分析患者在住院期间以及随访12个月的临床相关情况。结果 EXCEL组随访再狭窄率明显低于BMS组(8.3%vs 36.5%,P<0.01),主要心脏不良事件(MACE)发生率亦明显低于BMS(8.0%vs 16.1%,P<0.05)。结论冠心病合并2型糖尿病患者植入EXCEL药物洗脱支架安全性高,远期再狭窄率明显降低。     

Effects of combined aerobic and resistance training on the glycolipid metabolism and inflammation levels in type 2 diabetes mellitus

[Purpose] To investigate the effects of combined aerobic and resistance training on glycolipid metabolism and inflammation levels in type 2 diabetes mellitus patients. [Subjects and Methods] Forty-two diabetes patients were randomized to the conventional therapy group (n = 20) or intensive therapy group (n = 22). The control group contained 20 healthy people. The conventional therapy group received routine drug therapy and diet control, while the intensive therapy group additionally underwent combined aerobic and resistance training for 12 weeks. The oral glucose tolerance test and cardiopulmonary exercise testing were performed. Toll-like receptor 4 and NF-κBp65 protein and mRNA expressions were determined by qPCR and western blotting. ELISA was used to determine the expression levels of interleukin-18, interleukin-33, pentraxin-related protein 3, and human cartilage glycoprotein 39. [Results] After exercise training, the intensive therapy group had significantly lower postprandial blood glucose, postprandial insulin, and glycated hemoglobin level and insulin resistance index than the conventional therapy group. The intensive therapy group had significantly lower toll-like receptor 4 and NF-κBp65 protein and mRNA expressions, and serum interleukin-18 levels but significantly higher serum interleukin-33 levels. [Conclusion] Combined aerobic and resistance training can improve glycolipid metabolism and reduce low-grade inflammation in patients with diabetes mellitus patients.Key words: Type 2 diabetes mellitus, Exercise therapy, Inflammation     

间歇式高强度运动训练管理在2型糖尿病患者中的应用

目的 观察间歇式高强度运动训练管理在2型糖尿病者中的应用效果。方法 选取2020年1月-9月笔者所在医院收治的2型糖尿病患者94例为研究对象,将其随机分为对照组和观察组,各47例,对照组按常规模式进行运动,观察组接受间歇式高强度运动训练管理,对2组干预后的各观察指标进行比较。结果 观察组血糖控制评价指标显著优于对照组(P＜0.05),运动依从性高于对照组(χ²=8.339,P=0.004)。结论 采用间歇式高强度训练管理对2型糖尿病患者进行干预,可显著改善该类患者的血糖控制效果和运动依从性。     

护骨素在老年2型糖尿病不同并发症中的临床意义

目的探讨护骨素(OPG)在老年2型糖尿病不同并发症中的临床意义。方法选择177例老年2型糖尿病不同并发症患者,其中合并大血管病变组(DMM)45例、合并神经病变组(DPN)43例、合并视网膜病变组(DR)42例和合并肾病变组(DN)47例,同时选择同期健康对照者46例,采用ELISA法测定患者血清OPG水平。结果 DMM组、DPN组、DR组和DN组各组老年2型糖尿病合并症患者血清OPG与对照组相比均显著升高(P0.01),但各组患者间比较差异无统计学意义(P0.05)。老年2型糖尿病患者血清OPG与并发症在DMM组(r=0.348,P0.01)、DPN组(r=0.275,P0.01)、DR组(r=0.287,P0.01)和DN组(r=0.241,P0.01)均呈明显正相关。结论老年2型糖尿病患者血清OPG与糖尿病大血管病变和微血管病变相关,可能在并发症的发生中起一定作用。     

幼年黄色肉芽肿合并神经纤维瘤病1例报告并文献复习

目的报告1例幼年黄色肉芽肿合并神经性纤维瘤病。方法通过详细的问病史,体格检查及病理检查,该患者最终诊断为:幼年黄色肉芽肿合并神经纤维瘤病。结果确诊1例幼年黄色肉芽肿合并神经纤维瘤病患者。结论详细的病史询问、体格检查及病理检查是诊断疑难皮肤病的方法之一。