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.
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.
Objective To summarize the best evidence for improving adherence to exercise therapy in non-surgical patients with knee osteoarthritis (KOA), so as to provide an evidence-based basis and reference for healthcare professionals, managers, patients, and caregivers. Methods Guidelines International Network, National Institute for Health and Care Excellence, Scottish Intercollegiate Guidelines Network, Registered Nurses Association of Ontario, National Guideline Clearinghouse, American College of Rheumatology, Osteoarthritis Research Society International, Turkish League Against Rheumatism, European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis, System for Information on Grey Literature in Europe, Cochrane Library, PubMed, Joanna Briggs Library, www.guide.medlive.cn, China National Knowledge Infrastructure, and WanFang Data were searched by computer for literature about improving exercise therapy compliance in non-surgical patients with KOA. The retrieval time limit was from January 1, 2017 to April 20, 2022. The quality of the included literature was evaluated by 2 researchers with evidence-based training, and ultimately evidence was extracted from the literature that met the quality evaluation criteria. Results A total of 12 publications were included, including 5 guidelines, 4 systematic reviews, and 3 expert consensuses, covering 6 aspects of multidisciplinary teamwork, development of individualized exercise plans, external support, interventions, health education, and follow-up management. A total of 18 best evidences for improving exercise therapy compliance in non-surgical patients with KOA were summarized, with 8 A-level recommendations and 10 B-level recommendations. Conclusions When applying the evidence, clinical staff should fully assess and develop exercise plans with individual patients, strengthen multidisciplinary communication and writing, make full use of external support resources and do health education and full follow-up management. Through comprehensive consideration and selection of the best evidence for implementation, the compliance of KOA non-surgical patients with exercise therapy can be improved.
Objective To observe the clinical characteristics of asthma patients with chronic duration stage combined with small airway dysfunction (SAD), and analyze the influencing factors of SAD and the cardiopulmonary function of such patients under exercise. Methods The patients with chronic duration of asthma admitted to Nanjing Affiliated Hospital of Traditional Chinese Medicine from July 2022 to April 2024 were divided into a SAD group and a non-SAD group according to the lung function results. Clinical data and relevant data of cardiopulmonary exercise test (CPET) were collected, the clinical data and cardiopulmonary function between the two groups were compared. The influencing factors of SAD were explored by multivariate logistic regression analysis. Results A total of 102 patients with chronic asthma duration, 59 (57.8%) in the SAD group and 43 (42.2%) in the non-SAD group were included. In the SAD group, age, body masss index, asthma duration were greater than those in the non-SAD group, and SAD score was lower than that in the non-SAD group; the proportion of patients with acute onset of asthma, history of smoking, allergic rhinitis, and asthma control test score were higher than those in the non-SAD group, the exhaled nitric oxide level of SAD group was higher than that in the non-SAD group, and the conventional lung function level was lower than that in the non-SAD group (P<0.05). CPET showed that the VE/VCO2 slope and CO2 equivalent in the SAD group were higher than those in the non-SAD group, and the peak kg oxygen uptake, peak heart rate, and respiratory reserve were lower than those in the non-SAD group, showing a statistically significant difference (P<0.05). Multivariate logistic analysis showed that age, increase of carbon dioxide equivalent at peak exercise, acute onset of asthma and allergic rhinitis were independent risk factors for SAD, and the increase of peak expiratory flow rate was the protective factor (P<0.05). Conclusions SAD in chronic persistent asthma is affected by various factors such as age, acute asthma attacks and history of allergic rhinitis. CPET indicates that patients with asthma who also have SAD have their cardiopulmonary function and aerobic capacity impaired to some extent.
This paper briefly introduces the basic concepts, development history, basic principles, main treatment and evaluation technologies, development status, existing problems and development trends of aquatic therapeutic exercise, and summarizes the new progress of aquatic therapeutic exercise in basic medical research and evidence-based medical research through literature analysis. It aims to provide a reference for clinical treatment, scientific research and medical education for practitioners in rehabilitation medicine and related fields by systematically analyzing the scientific principles, technical systems, application fields and evidence-based foundation of aquatic therapeutic exercise, and improve the awareness rate and application rate of aquatic therapeutic exercise in the fields of rehabilitation medicine, sports medicine, geriatrics, etc., promote the standardized development of aquatic rehabilitation.
ObjectiveTo analyze the research status of mini-clinical evaluation exercise (Mini-CEX) in medical and nursing education in the mainland of China, so as to provide a basis for optimizing medical and nursing teaching evaluation tools and promoting the reform of medical and nursing personnel training mode.MethodsPubMed, Embase, Wanfang, CQVIP, China National Knowledge Infrastructure, and China Biomedical Literature Database were searched. The key words were “mini-clinical evaluation exercise” or “mini-CEX” or “CEX” or “mini clinical exercise evaluation”. The languages were limited to Chinese and English. The address of the first author was in the mainland of China. The retrieval time was from the establishment of the databases to December 31st, 2020. The literature was analyzed bibliometrically after screening and duplicate removal.ResultsA total of 536 articles were included for analysis and summary. The articles originated from 28 provincial-level administrative divisions in China, among which Shanghai, Xinjiang, Guangxi, Liaoning, and Guangdong were the top five in terms of the number of papers published. The annual number of papers published exceeded 60 in 2017, and reached 112 in 2019 and 113 in 2020, respectively. A total of 397 hospitals and universities contributed to the literature, among which 49 institutions published more than 2 papers. The maximum number of articles published by a same author was 5. There were 530 journal papers published in 169 journals. Only 228 articles (42.54%) were supported by funds, and the research type was mainly experimental and quasi experimental research (56.71%). Under the key words co-occurrence network analysis, a total of 321 nodes and 1 013 connections were obtained, with an average of 3.21 connections per node. In addition to “mini-CEX” and “mini-clinical exercise evaluation”, the most prominent research directions were “clinical teaching” “standardized training” “resident” “scenario simulation” and “clinical ability”.ConclusionsThe number of mini-CEX-related medical and nursing articles is increasing year by year, but the distribution of research areas and institutions is uneven, the research quality needs to be improved, the application scope and research types need to be enriched, and the research content needs to be expanded. In the future, teachers and research teams of medical colleges and universities should be mobilized to apply Mini-CEX teaching method to the cultivation of medical and nursing talents in a whole and continuous way, so as to further standardize the localization application of mini-CEX in the mainland of China, and promote the in-depth development of formative evaluation of medical education.
ObjectivesTo evaluate the effects of physical exercises on the vision of students in China.MethodsTrials of the effects of physical exercises on students' vision were retrieved in databases of CNKI, WanFang Data, VIP, Web of Science, EBSCO, PubMed and The Cochrane Library from inception to September 2019. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies. Meta-analysis was carried out with RevMan 5.3 and Stata 13.0 software.ResultsA total of 8 studies including 681 students in the experimental group and 679 in the control group were included. The results of meta-analysis showed that physical exercises were beneficial to improving students' vision (SMD=1.02, 95%CI 0.90 to 1.13, P<0.000 01). The results of subgroup analysis showed that physical exercises in the elementary school students group (SMD=1.361, 95%CI 0.873 to 1.850, P<0.000 01), long period (>24 weeks) (SMD=1.502, 95%CI 0.984 to 2.019, P<0.000 01), medium frequency (3 times/week) (SMD=1.631, 95%CI 1.022 to 2.240, P<0.000 01), and short time (<90 min) (SMD=1.410, 95%CI 0.758 to 2.062, P<0.000 01) had superior results.ConclusionsPhysical exercises have beneficial effects on improving vision. Limited by quantity and quality of subjects, the above conclusions requires verification by more high-quality studies.
ObjectiveTo determine the ability of cardiopulmonary exercise testing (CPET) to distinguish chronic thromboembolic pulmonary hypertension (CTEPH) from chronic thromboembolic disease (CTED). MethodsFifty patients diagnosed with CTED and fifty-eight patients with CTEPH in the the First Affiliated Hospital of Guangzhou Medical University from April 2019 to February 2022 were retrospectively included. The basic characteristics including age, gender, body mass index, symptom duration, and N-terminal prohormone of brain natriuretic peptide (NTpro-BNP), parameters of arterial blood gas analysis, right heart catheterization, echocardiography, pulmonary function, and CPET were all compared between patients with CTED and those with CTEPH. ResultsPatients with CTEPH displayed longer symptom duration, increased NTpro-BNP, decreased arterial partial pressure of oxygen, larger right atrial and ventricular diameters, and impaired worse resting pulmonary diffusing function compared with those with CTED (P<0.05). However, there was no statistically significant difference in the resting pulmonary ventilation function between the two groups (P>0.05). Among the CPET parameters of the CTEPH group, peak exercise oxygen uptake per kilogram, oxygen uptake at anaerobic threshold, oxygen pulse, oxygen uptake efficiency slope and oxygen saturation were all decreased, while the minute ventilation-carbon dioxide production at anaerobic threshold (VE/VCO2@AT) and VE/VCO2 slope were increased (P<0.05). However, there was no statistically significant difference in heart rate reserve and breathing reserve (P>0.05). Furthermore, VE/VCO2@AT showed high accuracy for distinguishing CTEPH from CTED (sensitivity, 0.825; specificity, 0.860; and the area under the receiver operating characteristic curve 0.897). ConclusionsPatients with CTEPH showed more significant decreased exercise endurance, diffusion dysfunction, and hypoxemia during exercise and insufficient increase in cardiac output compared with CTED patients. Therefore, it is feasible to apply CPET as a new objective examination to distinguish CTED from CTEPH.
Objective To evaluate the clinical significance of operative indication in patients with lung cancer accompanied by lung dysfunction using cardiopulmonary exercise test (CPET). Methods Before operation, using CPET with step program, work rate(W%), maximal oxygen uptake(VO2%P), maximal oxygen uptake per kilogram(VO2/kg) and other indexes were tested in the end of load exercise in 195 patients with lung cancer accompanied by lung dysfunction. Chi-square test and logistic regression analysis were performed for the abnormal rate of indexes mentioned above in patients with or without postoperative respiratory failure. Results After pneumonectomy, W%,VO2%P, VO2/kg, metabolic equivalent (MET), minute ventilation(VE) and respiratory frequency(BF) in patients with postoperative respiratory failure were lower than those in patients with non-postoperative respiratory failure (Plt;0.05 or 0.01). Logistic regression analysis showed that VElt;30 L/min and (BFlt;30) times/min were more related to the morbidity of postoperative respiratory failure than other indexes. As for the patients with lung dysfunction treated by lobectomy, this indexes didn’t show any significant difference between patients with or without postoperative respiratory failure. However, this indexes decreased in patients with postoperative respiratory failure whose ratio of forced expiratory volume in one second to forced vital capacity (FEV1%) were lower than 60%(Plt;0.05 or 0.01). Logistic regression analysis showed that VO2%Plt;60% related to the morbidity of postoperative respiratory failure. Conclusion CPET is useful to evaluate the operative indication in patients with lung cancer accompanied by lung dysfunction. VO2%Plt;60% should be selected as a evaluating index.
ObjectiveTo understand the maintenance hemodialysis (MHD) patients’ intention to exercise rehabilitation and discuss the influencing factors.MethodsFrom January to March 2019, 141 MHD patients’ intention to exercise rehabilitation was investigated by cross-sectional survey, and the influencing factors of MHD patients’ intention to exercise rehabilitation were analyzed by multiple linear stepwise regression.ResultsA total of 141 questionnaires were issued and 139 valid ones were recovered. The mean score of exercise rehabilitation intention of MHD patients was 39.99±9.29, which was in the middle and high level. Age [unstandardized partial regression coefficient (b)=?5.277, 95% confidence interval (CI) (?8.640, ?1.915), P=0.002], educational level [b=2.412, 95%CI (1.161, 3.663), P<0.001], and 6-minute walking distance [b=3.526, 95%CI (0.032, 7.021), P=0.048] were the influencing factors of exercise rehabilitation intention of MHD patients.ConclusionMHD patients have high intension to exercise rehabilitation, and special attention should be paid to elderly patients and patients with low education level in clinical work to improve their intension to exercise rehabilitation.