Passive Exercise Research Articles

Physiotherapy and Rehabilitation in Geriatric Dogs and Cats

The word “geriatric” refers to the medicine of the elderly and it is used in veterinary medicine for animals that have completed 75% of their lifespan. As the size of an animal increases, the age at which they become geriatric decreases, therefore; geriatric age varies amongst different species and breeds. Homeostatic changes occur with increasing age and some diseases such as obesity, tumor formation, orthopedic disorders, cardiovascular disorders and neurological disorders are frequently seen. Some breeds are genetically predisposed to such diseases. Thus, regular screening tests and clinical examinations are important for early diagnosis. Geriatric physiotherapy is a developing field that is noninvasive and, in some cases, can be used as a form of primary treatment or supportive treatment. Physiotherapy prevents muscle atrophy and reduces pain caused by inflammation all the while improving the patient’s quality of life. There is a wide range of different methods used in physiotherapy; TENS and NMES devices, passive and active movement exercises, hydrotherapy, acupuncture, massage, laser therapy, ECSWT and cryotherapy. However, treatment protocols are tailored by physicians to fit each patient’s needs depending on the disease and severity of the disease to be treated.

Penerapan Range Of Mation (ROM) terhadap Peningkatan Kekuatan Otot dengan Kasus Stroke Non Hemoragik pada Ny. A Di UPT PSTW Jember

Background: Stroke remains a major health issue both in Indonesia and globally. Non-hemorrhagic stroke is a leading cause of physical disability, resulting in decreased muscle strength and motor function. Physical rehabilitation, including Range of Motion (ROM) exercises, plays a crucial role in the recovery of stroke patients by restoring muscle function and improving muscle strength. Objective: This study aims to evaluate the effectiveness of ROM exercises in improving muscle strength in non-hemorrhagic stroke patients with physical mobility impairment. Methods: A descriptive study with a case study approach was conducted on one non-hemorrhagic stroke patient who was given passive ROM exercises for 7 days, with a frequency of twice a day (morning and evening). The instruments used included Standard Operating Procedures (SOP) and a Manual Muscle Testing (MMT) observation sheet to assess muscle strength before and after the passive ROM intervention. Results: The study showed a significant increase in muscle strength after ROM exercises. Muscle strength consistently improved throughout the intervention, indicating that ROM exercises are effective in enhancing muscle strength in non-hemorrhagic stroke patients. Conclusion: Regular ROM exercises can increase muscle strength in non-hemorrhagic stroke patients. Initially, the patient's left extremity muscle strength was at a scale of 3, and after 7 days of ROM exercises, it improved to a scale of 4. This study provides evidence that ROM exercises are effective for stroke patients

Passive Rom Therapy to Improve Muscle Strength in Post-Op Upper/Lower Extremity Patients: a Case Study

Fractures are emergency conditions that must be treated quickly and accurately and in accordance with fracture management procedures. In general, clients with fractures must undergo surgery which in addition to causing pain also affects activity. After surgery, rehabilitation is needed to prevent contractures. Nursing care for patients with upper/lower extremity fractures must be prioritized and focused on providing comfort, preventing complications, and achieving optimal rehabilitation in rehabilitation. Patients are taught mobilization or movement exercises, namely Passive Range of Motion (ROM). Purpose: To determine the Effectiveness of Passive ROM Exercise in Postoperative Patients with Upper/Lower Extremity Fractures on Length of Stay at Sukoharjo Regional General Hospital. Design: This researcher studied the type of experimental research. The method used is a case study. Results: the results of the study showed that the majority of Active ROM respondents were treated for 2 days with a frequency of 5 respondents. Then the results showed that there was a difference in the effect of passive ROM on the length of stay for fracture patients at Sukoharjo Regional General Hospital.

Infl uence of the exercise regime on the quality indicators of sperm production in breeding boars

In the pig breeding industry, the quality of sperm obtained from breeding boars plays an important role in the issue of reproduction. The purpose of the research was to investigate the eff ect of exercise regime on the quality indicators of sperm production in breeding boars. The research was carried out at the Tyumensky Pig Complex LLC in the Tyumen Region. For the research 3 groups of boars were formed with 10 heads in each. The control group did not receive exercise, the 1st experimental group received passive exercise, the 2nd experimental group received active exercise. It was found that the rectilinear motility of sperm, which aff ects the fertilizing ability of semen was in the 1st experimental group of boars 87.0 %, which was by 2.8 abs.% higher than in other groups. Also, more sperm doses were obtained from semen with high rectilinear motility with the same volume and concentration indicators In the groups of boars without exercise and with active exercise, 5.7 % of dead sperm were found, which was by 0.8 abs.% more than in the analogs that received passive exercise (p < 0,05). In the 1st experimental group of boars with passive exercise, the lowest percentage of sperm with defects was found, which aff ects the efficiency of insemination and the quality of the off spring. It was found that passive exercise had a more favorable eff ect on the qualitative indicators of sperm of the breeding boars of the 1st experimental group compared to active exercise (2nd experimental group) and its absence (control group). The use of passive exercise regime for breeding boars had a positive eff ect not only on the quantitative indicators of semen, but also on the quality of sperm and can be recommended at the enterprise when housing breeding boars.

Characteristics of rehabilitation protocols following operative treatment of terrible triad elbow injuries and the influence of early motion: A systematic review and meta-analysis

Background As no consensus exists on the optimal postoperative rehabilitation protocol in terrible triad injuries, we sought to characterize the reported protocols and relate them to postoperative range of motion (ROM) measures and Mayo Elbow Performance Score (MEPS). Methods A systematic review was performed by searching PubMed/MEDLINE, Embase, Web of Science, and Cochrane databases to identify articles on the operative treatment of terrible triad injuries reporting postoperative rehabilitation protocols were included. Included studies were descriptively summarized. Methodologic quality was assessed using the Methodological Index for Non-randomized Studies criteria. Meta-analysis compared postoperative ROM measures and the MEPS between patients initiating passive ROM exercises at ≤7 days vs. >7 days. Results Our review included 36 articles with 1123 elbows (66% male, mean age: 43 years, follow-up: 27 months). Of the studies reporting physical therapy protocols, it was most commonly initiated at 7 days postoperatively (6/36, 17%), passive ROM exercises at 7 days (3/25, 12%), and active ROM at 21 days (4/26, 15%). On meta-analysis, early passive ROM initiation was not associated with improved elbow ROM or MEPS. Discussion While rehabilitation protocols commonly advised passive ROM at one week post-operatively, meta-analysis did not support functional benefits of early passive ROM. Study design Systematic Review; Level of evidence, 4.

The effects of whole-body vibration therapy on immune and brain functioning: current insights in the underlying cellular and molecular mechanisms.

Whole-body vibration (WBV) therapy is a way of passive exercise in which subjects are exposed to mild and well-controlled mechanical vibrations through a vibrating platform. For a long time, studies have focused on the effects and applications of WBV to enhance musculoskeletal performance in athletes and patients suffering from musculoskeletal disorders. Recent evidence points toward the positive effect of WBV on the brain and its therapeutic potential in brain disorders. Research being done in the field gradually reveals cellular and molecular mechanisms underlying WBV affecting the body and brain. Particularly, the influence of WBV on immune and brain function is a growing field that warrants an up-to-date and integrated review. Immune function is closely intertwined with brain functioning and plays a significant role in various brain disorders. Dysregulation of the immune response is linked to conditions such as neuroinflammation, neurodegenerative diseases, and mood disorders, highlighting the crucial connection between the immune system and the brain. This review aims to explore the impact of WBV on the cellular and molecular pathways involved in immune and brain functions. Understanding the effects of WBV at a cellular and molecular level will aid in optimizing WBV protocols to improve its therapeutic potential for brain disorders.

Functional assessment and influencing factors after staged functional training in patients with ankle fractures.

The recovery of limb function after ankle fracture surgery is a gradual process. The main purpose of implementing early functional exercise, joint mobility, muscle contraction function, passive ankle flexion and extension exercises, or physical factor therapy techniques is to achieve the rapid recovery of normal physiological limb function. However, currently the most effective rehabilitation training method is staged limb functional exercise, which promotes rapid recovery of limb function while preventing adverse consequences caused by overwork or insufficient training. Staged limb functional exercise divides the rehabilitation process into multiple stages, each of which has specific training objectives and contents. This method helps patients gradually restore limb function. Nevertheless, some patients still exhibit poor limb function after standardized exercise. Therefore, a functional evaluation should be performed to analyze the impact of staged functional training after ankle fracture surgery. To perform a functional evaluation and determine the influencing factors of staged functional training in patients with ankle fracture. A retrospective study enrolled 150 patients who underwent surgical treatment for ankle fracture from May 2020 to May 2022 at our hospital. Univariate and multivariate linear regression analyses were performed on general data, functional exercise compliance scale for orthopedic patients, Social Support Rating Scale (SSRS), American Orthopedic Foot and Ankle Score (AOFAS) Ankle-Hindfoot Score, and pain factors [serum bradykinin (BK), prostaglandin E2 (PGE2), 5-hydroxytryptamine (5-HT)]. Based on the AOFAS Ankle-Hindfoot Scale, the cases were divided into the excellent function (n = 111) and ordinary function (n = 39) groups. Univariate analysis revealed that monthly family income, education level, diabetes mellitus, functional exercise compliance scale of orthopedic patients score, SSRS, BK, PGE2, and 5-HT significantly influenced limb function after ankle fracture (P < 0.05); Multiple linear regression analysis showed that the functional exercise compliance scale score, SSRS, BK, PGE2, and 5-HT were independent risk factors affecting functional performance after staged functional exercise (P < 0.05). Exercise compliance, SSRS, and pain level are the independent risk factors affecting functional performance after staged functional training following ankle surgery. Clinical nursing care after ankle surgery should include analgesic and health education measures to ensure optimal recovery of limb function.

Influence of endogenous and exogenous hormones on the cardiovascular response to lower extremity exercise and group III/IV activation in young females.

Oral contraceptive (OC) use can increase resting blood pressure (BP) in females as well as contribute to greater activation of group III/IV afferents during upper body exercise. It is unknown, however, whether an exaggerated BP response occurs during lower limb exercise in OC users. We sought to elucidate the group III/IV afferent activity-mediated BP and heart rate responses while performing lower extremity tasks during early and late follicular phases in young, healthy females. Females not taking OCs (NOC: n = 8; age: 25 ± 4 yr) and those taking OCs (OC: n = 10; age: 23 ± 2 yr) completed a continuous knee extension/flexion passive stretch (mechanoreflex) and cycling exercise with subsystolic cuff occlusion (exercise pressor reflex), which was followed by a 2-min postexercise circulatory occlusion (PECO) (metaboreflex). Data collection occurred on two occasions: once during the early follicular phase (days 1-4) and once during the late follicular phase (days 10-14) of their menstrual cycle (NOC) or during the placebo and active pill phases (OC). Resting mean arterial BP and heart rate were not different between phases in NOC and OC participants (P > 0.05). Hemodynamic responses to metaboreflex, mechanoreflex, and collective exercise pressor reflex activation were not different between phases in both groups (P > 0.05). In conclusion, although OCs are known to increase BP at rest, our findings indicate that neither endogenous nor exogenous (OC) sex hormones modulate BP during large, lower limb muscle exercise with or without group III/IV afferent activation in young, healthy females.NEW & NOTEWORTHY Sex differences in the cardiovascular response to exercise have been demonstrated and may be dependent on sex hormone levels. Furthermore, oral contraceptives (OCs) have been shown to exaggerate the blood pressure response to upper extremity exercise. The results of this study indicate that neither endogenous nor exogenous (OC) sex hormones modulate BP during lower extremity dynamic exercise or with group III/IV afferent activation in young, healthy females.

Placental and Neonatal Serum Leptin Levels in Premature Infants After Phototherapy: Are They Determining Factors for the Safe Indication of Passive Exercises?

To analyze leptin levels in placental tissue and premature infants undergoing phototherapy and to evaluate the potential for prescribing passive exercise after phototherapy in this population. This analytical, longitudinal, prospective cohort study included 108 parturients and their respective premature infants. Variables examined included weight, gestational age, body mass index, sex, serum leptin levels in placental tissue, serum bilirubin levels, and reticulocyte count. When comparing each group to a leptin threshold, statistically significant differences were observed at all evaluated time points for placental leptin levels (p < 0.001). Additionally, reticulocyte count decreased in relation to rebound time (p < 0.004). No correlations were found between leptin/bilirubin levels, leptin/reticulocytes, onset of nutrition, and BMI/leptin levels. The findings regarding leptin levels suggest that prescribing passive exercises to premature infants undergoing phototherapy may be feasible because this intervention did not increase leptin levels.

What is the force required to treat trismus in patients undergoing oral cavity free flap reconstruction?

Trismus therapy is often delayed after jaw reconstruction to avoid hardware failure or non-union. The aim of this study is to document the forces that have been applied to patients undergoing free flap reconstruction of the oral cavity in the 12 months following oral cavity reconstruction, and to analyze the associations between force and maximal interincisal opening (MIO) over time. Participants with trismus after free flap reconstruction of the oral cavity completed a 10-week jaw stretching program using Restorabite™. Primary outcome measures included the minimum and maximal force applied by a trismus device during rehabilitation, MIO, bone union, and health-related quality of life outcomes up to 12 months postoperatively. A mean of 20.6 Newtons (N) was used during passive exercises and 38.9 N during active exercises was used during trismus therapy. The mean increase in MIO for the 45 participants after 10 weeks, 6 months, and 12 months of therapy was 8.4 mm (p < 0.001), 12.6 mm (p < 0.001), 12.7 mm (p < 0.001), respectively. There was no significant difference in the mean minimal (p = 0.37) or mean maximal (p = 0.08) force applied between those who underwent osseous free flap reconstruction compared to fasciocutaneous only, respectively. In patients who underwent osseous reconstruction, 25 (67.6%) had complete bone union and 12 (32.4%) had partial union at 12 months postsurgery. In participants undergoing osseous free flap reconstruction, there was no association between the force applied to the rates of bone union. Further research to define safe and optimal loading may benefit patients undergoing jaw reconstruction.

An Ayurveda Approach Towards Acute Sciatica with Paraesthesia

Sciatica is pain or paraesthesia which is radiates path of the sciatic nerve and its branches from the lower back through the hips and buttocks and down to the leg. A 41-year-old female patient with an acute low back ache to radiate to left lower limb with paraesthesia for three months came to Kayachikitsa IPD of Vaidyaratnam Ayurveda College on 18/3/24. The pain was graded eight out of ten in the VAS pain scale and her overall Oswestry low back pain score is 32 which means severe functional disability. She underwent for Vatakapha hara chikitsa protocol. It includes Rookshana, Snigda sweda, Vata hara, and Brihmana chikitsa. Ayurvedic preparations like Aadarisahacharadi kasayam, Suntibaladi choornam Vyoshadi guggulu were given Swedam, Patrapoliswedam, and Pizhichil, Shastika pinda swedam, Yoga vasti along with passive exercise were given. After 30 days of treatment outcome of these treatments found to be very positive. There was a substantial recovery in walking duration, heaviness, touch temperature perception and pain relief was observed. Subjective parameters like, SLR test, Oswestry low back pain disability questionnaire, Sciatica bothersome index, Sciatica frequency index, Roland morris low back pain and disability questionnaire was taken for assessment parameters. The patient got relief in all parameters after treatment. It was proved significant improvement of patient’s primary symptoms. These therapies reduce pain, stiffness and improve circulation.

The Importance of Maintaining and Improving a Healthy Gut Microbiota in Athletes as a Preventive Strategy to Improve Heat Tolerance and Acclimatization.

Exposure to passive heat (acclimation) and exercise under hot conditions (acclimatization), known as heat acclimation (HA), are methods that athletes include in their routines to promote faster recovery and enhance physiological adaptations and performance under hot conditions. Despite the potential positive effects of HA on health and physical performance in the heat, these stimuli can negatively affect gut health, impairing its functionality and contributing to gut dysbiosis. Blood redistribution to active muscles and peripheral vascularization exist during exercise and HA stimulus, promoting intestinal ischemia. Gastrointestinal ischemia can impair intestinal permeability and aggravate systemic endotoxemia in athletes during exercise. Systemic endotoxemia elevates the immune system as an inflammatory responses in athletes, impairing their adaptive capacity to exercise and their HA tolerance. Better gut microbiota health could benefit exercise performance and heat tolerance in athletes. This article suggests that: (1) the intestinal modifications induced by heat stress (HS), leading to dysbiosis and altered intestinal permeability in athletes, can decrease health, and (2) a previously acquired microbial dysbiosis and/or leaky gut condition in the athlete can negatively exacerbate the systemic effects of HA. Maintaining or improving the healthy gut microbiota in athletes can positively regulate the intestinal permeability, reduce endotoxemic levels, and control the systemic inflammatory response. In conclusion, strategies based on positive daily habits (nutrition, probiotics, hydration, chronoregulation, etc.) and preventing microbial dysbiosis can minimize the potentially undesired effects of applying HA, favoring thermotolerance and performance enhancement in athletes.

Passive exercise provides a simultaneous and postexercise executive function benefit

IntroductionPassive exercise involves limb movement via an external force and is an intervention providing an immediate postexercise executive function (EF) benefit. It is, however, unknown whether EF is improved simultaneous with passive exercise—a salient question given the advent of passive (and active) exercise workstations designed to enhance productivity and wellbeing for individuals engaged in sedentary occupations.MethodsHere, participants (N = 23) completed separate 20-min conditions involving active (i.e., via volitional muscle activation) and passive (i.e., via mechanically driven cycle ergometer) cycle ergometry and a non-exercise control condition. EF was assessed prior to (i.e., preintervention), simultaneous with, and immediately after (post-intervention) each condition via the antipointing task. Antipointing involves a goal-directed limb movement mirror-symmetrical to a target and is an ideal tool for the current investigation given that the task is mediated via EF inhibitory control networks that show response-dependent changes following a single bout of exercise.Results and discussionResults showed that passive exercise produced a simultaneous and post-intervention reduction in antipointing reaction time (RT), whereas active exercise selectively produced a post-intervention—but not simultaneous—RT reduction. Thus, passive and active exercise elicited a postexercise EF benefit; however, only passive exercise produced a simultaneous benefit. That passive—but not active—exercise produced a simultaneous benefit may reflect that the intervention provides the necessary physiological or psychological changes to elicit improved EF efficiency without the associated dual-task cost(s) of volitional muscle activity.

MANUAL THERAPY TECHNIQUES FOR THE ACROMIOCLAVICULAR JOINT DYSFUNCTION – A NARRATIVE REVIEW

INTRO/BACK GROUND Ac joint dysfunction is a prevalent cause of shoulder discomfort. As far as we are aware, there are currently no published studies focused on the manual therapy management of AC joint dysfunction. However, manual physical therapy has proven successful in treating various other shoulder conditions. To address this, recent research has started to investigate whether manual techniques are more effective in treating ac joint dysfunction. OBJECTIVE Aim of this study on the literature review pointing on the available evidence for the manual therapy interventions in acromioclavicular joint dysfunction patients. METHODS Research involved a computerized data base used for searching articles were Science direct, Pedro, PubMed, goggle scholar search pertaining to studies that include the manual therapy among acromioclavicular joint dysfunction Patients RESULTS: These 10 studies were based on the inclusion exclusion criteria were included in this review the methods used in all these studies were strengthening exercises , transverse friction massage, joint mobilization, myofascial release techniques, active passive motion exercises, scapulothoracic exercises, peri joint muscle exercises, joint stability exercises with different sets of exercises for muscle activation and range of motion and function these manual therapy techniques aims to alleviate inflammation recover the shoulder pain free rom and restore the proper function of soft tissue and joint. CONCLUSION: We conclude from this review that a variety of manual treatment procedures have been shown to be useful and effective in treating patients with AC joint dysfunction. There is, however, a dearth of data on the use of manual therapy procedures or interventions to treat ac joint dysfunction. More investigation is required to determine the precise role that manual therapy strategies may play in managing ac joint dysfunction.

The Challenges of Changing Active to Passive Voice Towards the Third Grade Students of Muhammadiyah Tangerang University

Grammar seems to be an unavoidable challenge for most learners, especially when it comes to acquiring Active to Passive Voice. Active sentences are sentence patterns where the subject does work, and passive sentences are sentence patterns where the subject accepts work. This is a difficult time for English Education students at Muhammadiyah University, Tangerang. The purpose of this research is to find out students' challenges in learning Active to Passive Voice and how they deal with these problems. The selected participants were 12 students from the Intermediate English Grammar Class of 2022. The research method used was qualitative. Data collection was carried out through tests and interviews. The data shows that students have three major difficulties in changing Active to Passive Voice such as placing subjects and objects, using auxiliary verbs, and determining past participles. In addition, two strategies are used by students to overcome learning obstacles. Through understanding formulas to help them master active and passive learning and doing a lot of active and passive exercises to help them better understand the active and passive material.

Central command activation during exercise is essential for the bradycardic response to diving

Mammalian diving response evokes complex cardiovascular adjustments, including bradycardia during sustained muscular activity. This is intriguing because voluntary exercise involves the activation of central command and skeletal muscle afferents, known to provoke tachycardia by reducing vagal outflow and increasing cardiac sympathetic activity. Nonetheless, it is currently unknown how diving-induced bradycardia can override the exercise tachycardia. Given this, we aimed to test the hypothesis that central and peripheral afferent mechanisms interact to modulate this physiological phenomenon. In three visits, 32 healthy subjects (15 women; 22±3 yr) were exposed to trigeminal nerve stimulation (i.e., facial cooling; TGS) to partially activate the diving reflex at rest (semi-recumbent position) and under three protocols: 1) during voluntary light (resting heart rate+20 beats.min−1) and moderate (resting heart rate+50 beats.min−1) steady-state cycling exercise; 2) during isolation of peripheral afferent reflexes via passive exercise (muscle mechanoreceptors) and cold pressor test (nociceptors; CPT), and; 3) during CPT with concurrent light exercise. The exercise intensities were assumed to provide different levels of central command activation, while both passive exercise and CPT were used to provide insights into the contribution of central command to diving bradycardia. TGS was performed for at least 90 seconds in all conditions. Beat-to-beat heart rate (HR, by electrocardiography) and blood pressure (finger photoplethysmography) were continuously measured, and surface electromyography was used to ensure the lack of volitional component during passive exercise. TGS elicited significant bradycardia at rest (Δ-12±0.9 beats·min−1; P&lt;0.001), and this response was increased during voluntary light exercise (Δ-15±1.2 beats·min−1; P=0.002), but unaffected during voluntary moderate exercise when compared to rest (Δ-11±1.3 beats·min−1; P=0.536). In contrast, compared to rest, the HR response to TGS during passive exercise was significantly attenuated (Δ-13±1.2 beats·min−1 vs. Δ-9±1.7 beats·min−1; P=0.039), whereas CPT completely abolish the diving bradycardic response (Δ0±1.6 beats·min−1; P&lt;0.001). However, when the volitional component was restored during CPT with concurrent light exercise, TGS provoked a significant bradycardic response, when compared to CPT condition (Δ1±1.6 beats·min−1 vs. Δ-10±2.1 beats·min−1; P=0.004). Notably, our findings were not affected by sex. In conclusion, these findings suggest that 1) central command activation during cycling exercise is essential for the bradycardic response to diving; 2) isolated peripheral afferent reflexes exert inhibitory feedback to modulate diving-induced bradycardia, and; 3) central and peripheral afferent feedback are important mechanisms by which exercise modulates the dive response. CNPq 307764/2022-2; CAPES (001). This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Combating With COPD by QiGong Physical and Mental Exercise.

Physical activity levels of patients with chronic obstructive pulmonary disease (COPD) are low due to the symptoms of COPD. The patients diagnosed with COPD are headed for complementary and alternative treatments to reduce the COPD symptoms, facilitate the treatment, and increase their physical activity. One of these treatments is QiGong, which is not yet common in our country. QiGong is a type of exercise based on ancient Chinese medicine, and mainly consists of active and passive exercises. These exercises open energy channels in the body, and thus prevent and/or heal diseases by establishing energy balance in the body through meditation, breath control, and bodily exercises. According to a literature review abroad, there are a small number of scientific studies related the therapeutic effect of QiGong exercises on symptom control, anxiety, reduction of stress and depression, increase in physical activity and quality of life, and the development of lung function of patients with COPD. By considering the educative role of nurses, it is important that the nurse has adequate knowledge of the treatment and care of patients with COPD. Therefore, this review is compiled to be informative about the effects of QiGong in the treatment of COPD, and assistance to subsequent studies.

Pain management In Total Knee Arthroplasty: Which helps in better post-operative outcomes?

Background: Individuals exhibit variations in pain perception and pain threshold, and these differences exist between the right and left limbs, resulting in biases related to inter-cerebral pain variability and inter-patient pain variability. Currently, there is limited available data comparing adductor canal block (ACB) with femoral nerve block (FNB) in individuals who have undergone bilateral total knee arthroplasty (TKA). Methods: We conducted a prospective, non-randomized, controlled study involving patients scheduled for bilateral total knee arthroplasty (TKA) under central neuraxial anesthesia. Following surgery, patients received intermittent 12-hourly boluses of 15 mL ropivacaine 0.5% through two distinct peripheral nerve blocks (adductor canal block - ACB and femoral nerve block - FNB) in either of the lower limbs. The primary objective was to evaluate the postoperative Visual Analog Scale (VAS) score, while the secondary outcomes included the assessment of quadriceps muscle strength and the degree of flexion at the knee joint. Results: Out of the 70 patients evaluated for eligibility, 63 were enrolled, and 60 were included in the final analysis. Visual Analog Scale (VAS) scores after both blocks during periods of rest at 30 minutes, 6 hours, 12 hours, and 48 hours post-operatively did not exhibit any significant differences. However, VAS scores during rest at 24 hours and during exercise at 24 hours and 48 hours demonstrated a notable disparity. Furthermore, there was a significant difference in favour of adductor canal block (ACB) over femoral nerve block (FNB) regarding quadriceps muscle strength and the degree of knee flexion at 24 hours and 48 hours post-operatively. Conclusions: Adductor canal block (ACB) delivers comparable pain relief to femoral nerve block (FNB) both at rest and during passive exercise for up to 48 hours after surgery. ACB notably maintains the motor strength of quadriceps muscles when contrasted with FNB, and this preservation comes without introducing any additional complications.

Enhanced external counterpulsation in cardiac rehabilitation in patients with coronary heart disease: a literature review

Enhanced external counterpulsation (EECP) is a non-invasive, outpatient, pulsatile-assisted circulation technique that has been used in many diseases, such as diabetes, stroke, and coronary heart disease (CHD). EECP can improve blood flow dynamics, vascular endothelial function, atherosclerosis outcomes, and other cardiovascular attributes through synchronous cardiac systolic and diastolic movements, thus playing a therapeutic role. EECP has been widely used in the treatment of refractory angina pectoris and plays a significant role in the treatment and rehabilitation of patients with CHD. As a passive aerobic exercise, it enables new ways for patients with cardiovascular disease who cannot carry out exercise rehabilitation to perform aerobic exercise. EECP will become increasingly important as the incidence of chronic disease increases and the rehabilitation discipline develops. With increasing attention being focused on EECP, the literature has grown rapidly. To help researchers gain a comprehensive understanding of this area, this review focuses on the progress made in applying EECP to CHD cardiac rehabilitation globally, including a brief history of EECP, the working principle of EECP, etc. This review will help researchers grasp the research outline and gaps in the literature regarding EECP and will provide a reference for them in future studies.

Clinical effect of allogeneic peroneal bone marrow support combined with plate fixation for the treatment of Neer type Ⅳ proximal humeral fractures

To explore clinical effect of allogeneic peroneal bone marrow support combined with plate internal fixation in treating Neer type Ⅳproximal humeral fractures. From December 2017 to December 2020,12 patients with Neer type Ⅳ proximal humeral fractures were treated with allogeneic peroneal bone marrow support combined with plate internal fixation,including 7 males and 5 females,aged from 56 to 78 years old;the time from injury to operation ranged from 1 to7 days. Operative time,fracture healing time and complications during follow-up were observed,and clinical efficacy was evaluated by Constant-Murley score at the latest follow-up. All patients were obtained follow up for 20 to 29 months. All patients got bone healing and incisicons were healed at stageⅠ,operative time ranged from 95 to 138 min,blood loss ranged from 210 to 275 ml,fracture healing time ranged from 14 to 18 weeks. Two patients occurred postoperative shoulder stiffness and recovered after 2 weeks of passive exercise. There were no complications such as infection,poor wound healing,and failure (fracture and loosening) of internal fixators occurred. Constant-Murley shoulder function score ranged from 69 to 89 at the latest follow up,2 patients got excellent results,9 good and 1 fair. The application of allogeneic fibular bone marrow placement could provide effective support for medial humerus,which is conducive to assisting reduction of fracture end,reducing occurrence of internal fixation failure caused by collapse of humerus head and screw perforation,and significantly improving function of shoulder joint.