ObjectiveTo analyze the effect of core stabilization exercise with unstable support surface on rehabilitation of patients with osteoporotic vertebral fracture.MethodsFrom January 2018 to January 2020, 66 patients with osteoporotic vertebral fractures in the Fifth Affiliated Hospital of Zhengzhou University were selected as the research objects. All patients were treated with percutaneous vertebroplasty. After operation, they were randomly divided into intervention group and control group by random number table method, with 33 cases in each group. Both groups were given routine rehabilitation intervention after operation, while the intervention group was given core stabilization exercise with unstable support surface at the same time. The vertebral height, shape, stability and gait of the two groups were compared 1 day before operation and 1 day after rehabilitation training.ResultsThere was no significant difference in gender, age, injured vertebral body, course of osteoporosis, years of education and marital status between the two groups (P>0.05). Before surgery, there was no statistically significant difference in the height ratio of the front edge of the injured vertebra, middle height ratio of the injured vertebra, back convex Cobb angle, track length when eyes were open, track length when eyes were closed, Romberg rate, track length per unit time when eyes were open, track length per unit time when eyes were closed, Romberg rate per unit time, deviation of the center of gravity on X-axis when eyes were open, deviation of the center of gravity on X-axis when eyes were closed, deviation of the center of gravity on Y-axis when eyes were open, deviation of the center of gravity on Y-axis when eyes were closed, stride length, step frequency or comfortable pace between the two groups (P>0.05). After training, the height ratio of the front edge of the injured vertebra [(79.26±12.15)% vs. (72.26±13.36)%], middle height ratio of the injured vertebra [(82.11±10.26)% vs. (75.64±9.56)%], back convex Cobb angle [(9.87±7.10) vs. (14.41±2.36)°], track length when eyes were closed [(1856.29±457.16) vs. (2358.48±786.45) mm], Romberg rate [(1.32±0.29)% vs. (1.87±0.54)%], track length per unit time when eyes were closed [(33.45±3.26) vs. (41.55±4.69) mm], Romberg rate per unit time [(1.41±0.30)% vs. (1.95±0.77)%], deviation of the center of gravity on X-axis when eyes were open [(11.06±1.36) vs. (16.54±2.22) mm], deviation of the center of gravity on X-axis when eyes were closed [(11.15±0.96) vs. (23.31±3.06) mm], deviation of the center of gravity on Y-axis when eyes were open [(12.57±1.84) vs. (15.56±2.06) mm], deviation of the center of gravity on Y-axis when eyes were closed [(15.69±2.05) vs. (18.96±3.56) mm], stride length [(0.57±0.12) vs. (0.49±0.10) m], step frequency [(1.09±0.29) vs. (0.94±0.20) step/s] and comfortable pace [(0.35±0.12) vs. (0.29±0.10) m/s] of the intervention group were better than those of the control group (P<0.05). There was no significant difference in the track length when eyes were open or track length per unit time when eyes were open between the two groups (P>0.05).ConclusionIn patients with osteoporotic vertebral body fractures, core stabilization exercise with unstable support surface on the basis of conventional rehabilitation interventions after surgery can effectively restore the height and shape of the vertebral body, and improve the stability and gait to a certain extent.
The detection of electrocardiogram (ECG) characteristic wave is the basis of cardiovascular disease analysis and heart rate variability analysis. In order to solve the problems of low detection accuracy and poor real-time performance of ECG signal in the state of motion, this paper proposes a detection algorithm based on segmentation energy and stationary wavelet transform (SWT). Firstly, the energy of ECG signal is calculated by segmenting, and the energy candidate peak is obtained after moving average to detect QRS complex. Secondly, the QRS amplitude is set to zero and the fifth component of SWT is used to locate P wave and T wave. The experimental results show that compared with other algorithms, the algorithm in this paper has high accuracy in detecting QRS complex in different motion states. It only takes 0.22 s to detect QSR complex of a 30-minute ECG record, and the real-time performance is improved obviously. On the basis of QRS complex detection, the accuracy of P wave and T wave detection is higher than 95%. The results show that this method can improve the efficiency of ECG signal detection, and provide a new method for real-time ECG signal classification and cardiovascular disease diagnosis.
Objective
To evaluate the effect of Otago exercise program (OEP) on fear of falling in central hemiplegia patients in communities.
Methods
We collected the clinical data of 61 central hemiplegia patients in the Department of Neurology of Pangang General Hospital from January to June 2014. They were randomly divided into treatment group (n=30) and control group (n=31) after discharge. The treatment group had OEP, while the control group had not. After 20 weeks of follow-up, we evaluated fall self-efficacy, balance and mobility of patients in the two groups.
Results
The OEP adherence rate was 73.3% for the treatment group. In the treatment group, modified fall efficacy scale (MFES) score and Berg balance scale (BBS) score were significantly higher than those before intervention (P<0.05); time up and go test (TUGT) score was significantly lower than that before intervention (P<0.05). In the control group, MFES score, BBS score and TUGT score were not significantly changed (P>0.05). After intervention, MFES score and BBS score of the treatment group were significantly higher than those of the control group (P<0.05), but TUGT score was not significantly different (P>0.05).
Conclusion
OEP for central hemiplegia patients after discharge can reduce fall self-efficacy and increase balance ability of the patients.
Objective
To observe and study the effect of neuromuscular exercise (NEMEX) on pain and physical function in patients with knee osteoarthritis (KOA).
Methods
From December 2016 to December 2017, a total of 70 participants with degenerative KOA were randomly divided into the control group and the observation group, with 35 participants in each group. The participants in the observation group received 8-weeks NEMEX, and the ones in the control group received 8-week quadriceps strengthening. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain subscale and the WOMAC physical functional subscale were used to measure pain and physical function before treatment and after 1 week, 2 weeks, 4 weeks, and 8 weeks of treatment.
Results
The WOMAC pain scores of participants before treatment and after 1 week, 2 weeks, 4 weeks, and 8 weeks of treatment were 24.2±10.0, 23.4±9.1, 18.9±8.2, 15.0±6.3, 15.0±7.0, respectively in the observation group, and 25.6±9.8, 24.1±9.2, 20.2±8.8, 15.2±6.0, 11.4±5.3, respectively in the control group. After 1 week of treatment, neither group showed a significant change in pain than pretreatment (P>0.05), but after 2, 4, 8 weeks of treatment, both groups showed significant improvements in pain (P<0.05). There was no significant between-group difference in pain before treatment or after 1 week, 2 weeks, and 4 weeks of treatment (P>0.05), but after 8 weeks of treatment, statistically significant difference in WOMAC pain score was found between the two groups (t=2.439, P<0.05). The WOMAC physical function scores of participants before treatment and after 1 week, 2 weeks, 4 weeks, and 8 weeks of treatment were 94.3±31.0, 81.8±28.3, 68.9±22.1, 34.0±15.1, 22.0±8.0, respectively in the observation group, and 92.7±31.8, 82.6±29.3, 75.2±22.9, 52.2±20.0, 43.4±18.2 respectively in the control group. After 1 week, 2 weeks, 4 weeks and 8 weeks of treatment, both groups showed significant changes in WOMAC physical function scores than pretreatment (P<0.05). There was no statistically significant between-group difference before treatment or after 1, 2 weeks of treatment in physical function (P>0.05). The functional improvements in the observation group were significantly better than those in the control group after 4 and 8 weeks of treatment, and the differences were statistically significant (t=–4.287, –6.355; P<0.05).
Conclusion
NEMEX and quadriceps strengthening have similar effects in relieve pain in patients with KOA. And both exercises can effectively improve the physical function, and NEMEX is better than quadriceps strengthening on physical function improvement in patients with KOA.
ObjectiveTo investigate the static pulmonary function and cardiopulmonary exercise function of convalescent patients with coronavirus disease 2019 (COVID-19) after discharge.MethodsPulmonary function and cardiopulmonary exercise capacity of COVID-19 patients who admitted to our hospital from January to March 2020 were analyzed. The patients were divided into a non-critical group (3 cases of moderate illness, 2 cases of severe illness) and a critical group (5 cases of critical illness). Five of the 10 patients completed spirometry on day 14 after discharge. All patients performed spirometry, diffusion capacity and cardiopulmonary exercise test around 28 days post-discharge. Ten healthy subjects were used as a control group.ResultsForced expiratory volume in one second of percent predicted (FEV1%pred), forced vital capacity of percent predicted (FVC%pred), the FEV1/FVC ratio (FEV1/FVC), peak expiratory flow of percent predicted (PEF%pred) and mean forced expiratory flow between 25% and 75% of percent predicted (FEF25%-75%%pred) of COVID-19 group were all within normal ranges, and there were no significant difference between COVID-19 group and the healthy group (P>0.05). Diffusion capacity (the carbon monoxide diffusion capacity of percent predicted, DLCO%pred) decreased in 3 patients. The peak oxygen uptake of percent predicted (PeakVO2%pred), oxygen uptake efficiency slope (OUES), Oxygen pulse of percent predicted (VO2/HR%pred) in COVID-19 group decreased and were statistically significantly lower than the control group (P<0.05), but there was no significant difference in ventilatory equivalents for carbon dioxide at anaerobic threshold (VE/VCO2@AT) and the slope of ventilatory equivalent for carbon dioxide (VE/VCO2 slope) between the two groups (P>0.05). Compared to the non-critical group, the critical group displayed significantly lower FVC%pred and VO2/HR%pred (P<0.05). A decrease in PeakVO2%pred was observed in critical group, but the difference did not reach statistical significance (P>0.05). The FVC%pred and PEF%pred were significantly improved in 5 COVID-19 convalescents on Day 28 after discharge when comparing with day 14 (P<0.05).ConclusionsIn the first month after discharge, recovered COVID-19 patients mainly presented decreased exercise endurance in cardiopulmonary function tests.There are also some survivors with reduced diffusion function, but the impaired lung function of COVID-19 patients might return over time.
Objective To investigate the correlation between pectoralis muscle CT attenuation value (PMT) and cross-sectional area (PMA) with clinical characteristics, exercise tolerance, and respiratory failure in patients with chronic obstructive pulmonary disease (COPD), providing a new perspective for COPD assessment. Methods A total of 120 COPD patients (67 in stable phase, 53 in acute exacerbation phase) admitted between January 2020 and December 2023 and 60 healthy controls in the same period were included. All participants underwent chest CT scans for the measurement of PMA and PMT. Pulmonary function indices, 6-minute walk distance (6MWD), and quality of life scores were also collected from COPD patients. Statistical analysis was conducted to explore the relationship between PMA and PMT with clinical characteristics of COPD patients, and their predictive value for exercise tolerance in stable COPD patients and respiratory failure in acute exacerbation COPD patients was evaluated. Results Both PMA and PMT were significantly lower in the COPD patients compared with the control group (P<0.05) and were significantly correlated with pulmonary function, exercise capacity, and quality of life (P<0.05). PMA was identified as an independent risk factor for exercise intolerance in stable COPD patients (OR=1.261, 95%CI 1.075-1.496, P=0.004). Receiver operating characteristic (ROC) curve analysis revealed an area under curve (AUC) of 0.849 with a cut-off value of 23.72 cm2 for PMA. Both PMA (OR=1.141, 95%CI 1.002-1.299, P=0.046) and PMT (OR=1.178, 95%CI 1.085-1.293, P<0.001) were independent risk factors for respiratory failure in acute exacerbation COPD patients. The ROC curve analysis showed an AUC of 0.804 with a cut-off value of 24.15 cm2 for PMA and an AUC of 0.831 with a cut-off value of 37.65 Hu for PMT. Conclusions Pectoralis muscle PMA and PMT can serve as effective indicators for assessing the severity and prognosis of COPD. A lower pectoralis muscle PMA is a risk factor for exercise intolerance in patients with stable COPD, while lower pectoralis muscle PMA and PMT are risk factors for the development of respiratory failure in patients with acute exacerbations of COPD.
Objective To systematically review the association between Chinese eye exercises and myopia onset in children and adolescents to provide a theoretical basis for clinical prevention of myopia. Methods The PubMed, Web of Science, EMbase, The Cochrane Library, CNKI, VIP, WanFang Data and CBM databases were searched from inception to March 2022 to collect observational studies about the association between Chinese eye exercises and myopia onset in children and adolescents. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias of the included studies. Meta-analysis was then performed using RevMan 5.3 software. Results A total of 28 studies were included, including 217 112 subjects. The results of meta-analysis showed that doing eye exercises, doing eye exercises ≥2 times per day, doing eye exercises regularly or consistently, doing eye exercises seriously and doing eye exercises correctly and normatively were the protective factors of myopia onset in children and adolescents. Conclusion Current evidence shows that doing eye exercises, doing eye exercises ≥2 times per day, doing eye exercises regularly or consistently, doing eye exercises seriously, doing eye exercises correctly and normatively can prevent myopia onset in children and adolescents. Due to the limited quantity and quality of the included studies, more high-quality studies are needed to verify the above conclusion.
Objective To evaluate the effects of enhanced external counterpulsation (EECP) on exercise capacity and quality of life in patients with chronic heart failure. Methods PubMed, The Cochrane Library, EMbase, CNKI, Wanfang Data, VIP and CBM databases from January 1, 2010 to October 1, 2022 were searched by computer for the randomized controlled trial (RCT) about the intervention of EECP in patients with heart failure. Two researchers independently screened literature and extracted data. The meta-analysis was performed by RevMan 5.3. Results Nineteen RCTs were included. After EECP treatment, 6-minute walk distance (MD=57.37, 95%CI 40.89 to 70.85, P<0.001) and left ventricular ejection fraction improved (SMD=0.85, 95%CI 0.55 to 1.14, P<0.001). B-type natriuretic peptide decreased significantly (SMD=?0.67, 95%CI ?1.09 to ?0.25, P=0.002). The left ventricular end diastolic diameter (MD=?7.77, 95%CI ?11.49 to ?4.04, P<0.001), and the left ventricular end systolic diameter were significantly reduced (MD=?8.53, 95%CI ?13.47 to ?3.60, P<0.001). The quality of life of patients was improved (MD=16.34, 95%CI 0.59 to 32.10, P=0.04). Conclusion EECP can improve the exercise ability and the quality of life in patients with heart failure. However, more and larger well-designed RCTs are still needed to verify this conclusion.
Objective To compare the early and mid-term results between Fontan operation and anatomic correction for congenitally corrected transposition of the great arteries (ccTGA). Methods The clinical data of 53 patients with ccTGA who underwent anatomic correction and Fontan operation from January 2009 to September 2021 in our hospital were reviewed, including 41 males and 12 females with a mean age of 55.02 (3-168) months. They were divided into an anatomic correction group (16 patients) and a Fontan operation group (37 patients) according to the operation. The hospitalization mortality, survival rate, postoperative complications, and free rate from re-intervention between the two groups were compared. Another 180 healthy children were recruited as a control group, and 14 children were matched with the propensity score matching method as a Fontan control group. The results of cardiopulmonary exercise testing (CPET) between the Fontan operation group and the Fontan control group were compared. Results There were 2 (12.5%) early deaths and 3 (18.8%) early re-intervention in the anatomic correction group, while 1 death and 2 re-intervention in the Fontan operation group. In addition, there were 9 patients (56.3%) in the anatomic correction group and 6 (16.2%) patients in the Fontan operation group suffering from arrhythmia after operation, respectively. Compared with the anatomic correction group, cardiopulmonary bypass time, aortic cross-clamping time, intubation time and ICU stay were significantly shortened in the Fontan operation group (P<0.05). CPET results showed that, percent predicted max VO2 in the Fontan operation group was lower than that in the Fontan control group (0.84±0.11 vs. 0.99±0.12, P＜0.05). The patients were followed up for 0.5-126.0 months. Two patients were lost in the Fontan operation group. There was no death and 1 re-intervention in the anatomic correction group, while no death or re-intervention in the Fontan operation group. The 1-year, 5-year and 10-year transplant-free survival rate of the anatomic correction group and the Fontan operation group was 87.5%, 87.5%, 87.5% and 97.3%, 97.3%, 97.3%, respectively (P＞0.05). The 48 patients were classified as grade Ⅰ-Ⅱ in cardiac function in the last follow-up. Conclusion There is no statistical difference in the transplant-free survival rate between the anatomic correction and the Fontan operation group. The postoperative complications in the Fontan operation group are decreased than those in the anatomic correction group. The Fontan operation is also a good choice, even though the patients with ccTGA meet the condition of the procedure of anatomic correction.
Hip fracture in the elderly is a disease with a high mortality rate and a high complication rate. Its main treatment method is surgery. The concept of enhanced recovery after surgery runs through the perioperative period of elderly patients with hip fracture. Elderly patients with hip fracture should be scheduled for surgery as soon as possible after admission to enhance postoperative functional recovery. Preoperative ambulation and postoperative exercise can reduce postoperative complications and mortality, shorten the length of hospital stay, and promote functional recovery.
