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Objective

To investigate the effects of various rehabilitative interventions aimed at enhancing poststroke motor recovery by assessing their effectiveness when compared with no treatment or placebo and their superiority when compared with conventional training program (CTP).

Data Source

A literature search was based on 19 Cochrane reviews and 26 other reviews. We also updated the searches in PubMed up to September 30, 2017.

Study Selection

Randomized controlled trials associated with 18 experimented training programs (ETP) were included if they evaluated the effects of the programs on either upper extremity (UE) or lower extremity (LE) motor recovery among adults within 6 months poststroke; included ≥10 participants in each arm; and had an intervention duration of ≥10 consecutive weekdays.

Data Extraction

Four reviewers evaluated the eligibility and quality of literature. Methodological quality was assessed using the PEDro scale.

Data Synthesis

Among the 178 included studies, 129 including 7450 participants were analyzed in this meta-analysis. Six ETPs were significantly effective in enhancing UE motor recovery, with the standard mean differences (SMDs) and 95% confidence intervals outlined as follow: constraint-induced movement therapy (0.82, 0.45-1.19), electrostimulation (ES)-motor (0.42, 0.22-0.63), mirror therapy (0.71, 0.22-1.20), mixed approach (0.21, 0.01-0.41), robot-assisted training (0.51, 0.22-0.80), and task-oriented training (0.57, 0.16-0.99). Six ETPs were significantly effective in enhancing LE motor recovery: body-weight-supported treadmill training (0.27, 0.01-0.52), caregiver-mediated training (0.64, 0.20-1.08), ES-motor (0.55, 0.27-0.83), mixed approach (0.35, 0.15-0.54), mirror therapy (0.56, 0.13-1.00), and virtual reality (0.60, 0.15-1.05). However, compared with CTPs, almost none of the ETPs exhibited significant SMDs for superiority.

Conclusions

Certain experimented interventions were effective in enhancing poststroke motor recovery, but little evidence supported the superiority of experimented interventions over conventional rehabilitation.  相似文献   
3.
The objective of this study was to verify that the [F-18]FDG PET synovial uptake is correlated with the synovial fluid (SF) TNF-alpha concentration. Two rabbit models of acute inflammatory arthritis induced by human interleukin-8 and lipopolysaccharide were used. Modified standard uptake values (MSUVs) obtained from PET images of the animals were compared with results of SF TNF-alpha measurements. Statistically significant correlations were found between the MSUVs and the SF TNF-alpha ratios. An equation to estimate the TNF-alpha ratio from a MSUV was also derived.  相似文献   
4.
AIM: This paper reports a study whose main aim was to understand the correlation between stages of exercise and health-related qualities of life among overweight and obese adults in Taiwan. BACKGROUND: Regular exercise has been shown to improve health-related quality of life in the general population and among patients with chronic diseases. Nevertheless, systematic investigations of the correlation between exercise stages and the health-related quality of life among overweight and obese adults are lacking in Taiwan. METHOD: A cross-section of people from the weight loss clinics of a medical centre in Taipei was recruited to the study. The Chinese version of the Stages of Exercise and the Taiwanese version of Short Form 36 questionnaires were used to collect data from those whose body mass indexes were equal to or >24 kg/m2. The data were collected in 2003. RESULTS: In total, 212 overweight and obese adults participated in the study. The majority were in the preparation (38.2%) or contemplation (31.6%) stages of exercise; relatively few were in the action (14.2%) or maintenance (11.3%) stages, and the smallest number (4.7%) were in the precontemplation stage. Although over 70% of respondents were not in the habit of taking regular exercise, their motivations were very high. For the Short Form 36 scales, the highest scores were for physical functioning (84.5 +/- 17.3), while the lowest were for general health (55.5 +/- 20.9), vitality (59.8 +/- 18.1), and mental health (MH) (66.0 +/- 17.9). Different stages of exercise showed statistically significant differences within the eight domains of Short Form 36 (Wilks = 0.733, P = 0.001); a statistically significant difference was also found for physical functioning (P < or = 0.001), general health (P = 0.003), and vitality (P = 0.005). CONCLUSION: Since stages of exercise are correlated with health-related quality of life among overweight and obese adults, healthcare providers need to understand what stages people are at in order to educate them to achieve a better quality of life and to motivate those who are inactive to do more exercise on a regular basis.  相似文献   
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6.

Background

Having motor impairment since childhood and being at risk of osteoporosis and falls, adults with polio would be more likely to suffer a hip fracture (HF) and may experience different epidemiological characteristics from the general population.

Objective

To estimate the risk and incidence of HF in adults with polio.

Design

Using a national database, we conducted a population-based cohort study. We identified patients with polio using the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) code of 138. For each patient with polio, we randomly selected five age- and sex-matched control subjects. Those subjects aged <40 years were excluded. We analyzed participants aged 40?64 years (middle-aged) and subjects aged ≥65 years (elderly) separately and recognized subjects who had an HF (ICD-9-CM code, 820) only when they received hospitalization to care for the illness from January 1, 2003 to December 31, 2008.

Results

We identified 403 adults with polio (mean age?±?standard deviation, 47.2?±?8.6 years). Compared to the controls, patients with polio had a higher incidence of HF (all, 4.1 vs. 1.1/1000 person-years, p?=?0.002; middle-aged, 2.3 vs. 0.3/1000 person-years, p?<?0.001; male, 6.2 vs. 0.9/1000 person-years, p?<?0.001); had a younger mean age (±standard deviation) of fracturing a hip (61.0±14.9 vs. 74.4±9.3 years, p?=?0.015); had a lower cumulative HF-free probability (±standard error) before the age of 65 years (0.970±0.017 vs. 0.988±0.007, p<0.001) and throughout the study duration (0.415?±?0.296 vs. 0.682?±?0.158, p<0.001); and had a higher risk of HF, yielding an adjusted hazard ratio (95% confidence interval) of 3.58 (1.45?8.79, p?=?0.006). Patients with polio aged >48.2 years were likely to experience an HF.

Conclusions

Adults with polio are at risk of HF. A customized HF prevention program is important for people with polio. The program should be started early in middle-age and should include men.  相似文献   
7.
Chang K-H, Lai C-H, Chen S-C, Hsiao W-T, Liou T-H, Lee C-M. Body composition assessment in Taiwanese individuals with poliomyelitis.

Objectives

To measure the changes in the total and regional body fat mass, and assess the clinical usefulness of the body mass index (BMI) in detecting overweight subjects with sequelae of poliomyelitis.

Design

Prospective, cross-sectional study.

Setting

General community.

Participants

Subjects with poliomyelitis (n=17; age range, 42–57y; mean, 47y; 12 men, 5 women) and able-bodied people (n=17) matched by sex, age, body weight, and body height participated in the study.

Interventions

Not applicable.

Main Outcome Measures

Total and regional body composition was measured with dual-energy x-ray absorptiometry. Clinical characteristics such as blood pressure, serum biochemical studies, and habitual behaviors (daily cigarette smoking, alcohol consumption, and exercise regimen) of all participants were evaluated.

Results

Compared with able-bodied controls, subjects with poliomyelitis had a 50% greater total body fat mass, significant increases in the regional fat mass in every part of the body, and had the greatest increase of fat mass in the thorax. Nearly all the subjects (94%) with poliomyelitis were obese according to standards of body composition. However, one third of them had a BMI value of less than 25.0kg/m2.

Conclusions

People with poliomyelitis have a higher prevalence of obesity and a significant increase in total and regional fat mass. Current BMI underestimates the total body fat mass percentage compared with the control; therefore, a population-specific BMI should be used to address the prevalence of obesity in postpolio survivors.  相似文献   
8.
ObjectiveEffects of monounsaturated fatty acid (MUFA) and polyunsaturated fatty acid consumption on regulating body fat accumulation and body weight gain are controversial between animal and human studies.MethodsWe designed a 2 × 2 factorial study, with two levels of MUFAs (60% and 30%) and two levels of polyunsaturated-to-saturated fatty acid (P/S) ratio (5 and 3) to prepare four kinds of experimental oils consisting of 60% MUFAs with a high or low P/S ratio (HMHR or HMLR, respectively) or 30% MUFAs with a high or low P/S ratio (LMHR or LMLR, respectively). Thirty-two male golden Syrian hamsters were randomly divided into four groups and fed the experimental diets containing 15% (w/w) fat for 12 wk.ResultsNo difference was observed in the mean daily food intake. Hamsters fed the LMLR diet had increased weight gain, epididymal and retroperitoneal white adipose tissues, plasma non-esterified fatty acids, insulin, hepatic acetyl coenzyme A carboxylase and malic enzyme activities, and mRNA expressions of peroxisome proliferator-activated receptor-α and sterol regulatory element-binding protein-1c among all groups (P < 0.05). Hamsters fed the HMHR diet had lower plasma insulin levels and hepatic acetyl coenzyme A carboxylase activities among groups (P < 0.05) and elevated hepatic acyl coenzyme A oxidase and carnitine palmitoyltransferase-I activities compared with those fed the LMLR diet (P < 0.05).ConclusionHamsters fed the LMLR diet had increased weight gain and body fat accumulation, whereas the HMHR diet appeared to be beneficial in preventing white adipose tissue accumulation by decreasing plasma insulin levels and increasing hepatic lipolytic enzyme activities involved in β-oxidation.  相似文献   
9.
Objective. To evaluate the contribution to glucose intolerance and metabolic syndrome of obesity combined with the diagnostic criteria of polycystic ovary syndrome (PCOS). Design. Prospective study. Setting. University teaching hospital from 31 August 2010 to 31 August 2011. Population. Two hundred and twenty women with PCOS and seventy normal control women. Methods. The clinical and biochemical characteristics of women with PCOS and control women were evaluated. Main outcome measures. The impact of obesity, hyperandrogenism, oligo-anovulation and polycystic ovary morphology on impaired glucose tolerance and metabolic disturbances. Results. Obese women with PCOS had significantly higher insulin resistance than obese normal control women. Logistic regression analysis showed that obesity was the only factor that predicted impaired glucose tolerance and metabolic syndrome. Use of the area under the receiver operating characteristic curve (AUROC) for the body mass index to predict impaired glucose tolerance and metabolic syndrome was more accurate than AUROCs for serum total testosterone level and the average menstrual interval. Conclusions. Body weight status was the major factor determining the risk of impaired glucose tolerance and metabolic syndrome in women with PCOS. Obesity should be treated as the major factor determining long-term health consequences associated with PCOS.  相似文献   
10.
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