Safety Of Training Research Articles

Treatment of ADHD in preschool children

Attention-deficit hyperactivity disorder (ADHD) can be diagnosed in preschool children aged 3–5 years. Interventions for ADHD that are safe and effective, in the short and longer term, would be particularly relevant in the preschool-age period, to prevent or reduce the negative outcomes associated with the disorder. Efficacy and safety of methylphenidate and behavioural parent training for children aged 3–5 years with attention-deficit hyperactivity disorder: a randomised, double-blind, placebo-controlled, and sham behavioural parent training-controlled trialMethylphenidate was effective in reducing ADHD symptoms and improving functionality, and behavioural parent training was effective in improving functionality for preschool children with ADHD after 8 weeks of treatment. Full-Text PDF

Creatine Supplementation Improves Muscular Performance without Additional Impact on the Cardiovascular System in Trained Women

Creatine monohydrate supplementation in females is largely under-represented in the literature, and their potentially differential hemodynamic responses are unknown. Methods: Twenty-eight resistance-trained women (25.5 ± 6.1 years, 59.7 ± 6.3 kg, 163 ± 5 cm) were randomly assigned to the supplement creatine monohydrate (CRE; 5 g creatine monohydrate + 5 g dextrose) or placebo (PLA; 10 g dextrose) four times per day for 7 days in a double-blind fashion. Each subject subsequently completed resistance training sessions (3 × week) for four weeks with four sets to muscular failure of both half-squat and leg press exercises. The change in body mass (BM), exercise repetition number (REP), rated perceived exertion (RPE), and cardiovascular variables were assessed (sessions 1, 6, and 12). Statistical analyses were performed at a significance level of p ≤ 0.05. Results: Analyses revealed a significant CRE-specific BM increase (p = 0.013), as well as significantly greater half-squat (p = 0.006) and leg press (p = 0.017) REP per set versus PLA. Additionally, CRE demonstrated significantly lower relative RPE values at session 12 compared with previous sessions. Any significant main or interaction effects were observed for the studied cardiovascular variable. Conclusions: The present data substantiate the creatine’s efficacy to improve muscular performance in females while demonstrating the safety of combined creatine monohydrate supplementation and resistance training on cardiovascular parameters.

Safety and Efficacy of a Bodyweight Exercise Training Program in Symptomatic Patients With Severe Aortic Valve Stenosis

Conventional exercise therapy including aerobic and resistance training is desirable for cardiovascular disease, whereas it is generally considered contraindicated for symptomatic severe aortic valve stenosis (AS). This study aimed to evaluate the safety and efficacy of bodyweight resistance exercise training (BRET), which is low-intensity exercise training in symptomatic patients with severe AS. A BRET program consisting of 8 exercises was performed 3 times a week by patients with AS with physical therapists. For the 78 symptomatic patients with severe AS, the median aortic valve area and mean transaortic valve pressure gradient were 0.56 cm2 and 48.9 mm Hg, respectively; none showed any harmful changes in blood pressure or heart rate in 11 sessions of the BRET program. There were no adverse events during hospitalization. Meanwhile, Barthel's Index score significantly improved at the time of hospital discharge. In conclusion, the BRET program in this study did not appear to cause harmful changes in hemodynamics during the program or adverse events during hospitalization, and it improved activities of daily living in symptomatic patients with severe AS, allowing doctors and physical therapists to conduct it safely, with less emotional stress, for cardiac rehabilitation for such patients.

October 2022 Stroke Highlights.

October 2022 Stroke Highlights.

Are there differences in cardiothoracic surgery performed by trainees versus fully trained surgeons?

We sought to assess the safety of training in cardiothoracic surgery comparing outcomes of cases performed by trainees versus fully trained surgeons. EmBase, Scopus, PubMed, and OVID MEDLINE were searched in August 2021 independently by two authors. A third author arbitrated decisions to resolve disagreements. Inclusion criteria were articles on cardiothoracic surgery reporting on outcomes for trainees. Studies were assessed for appropriateness as per CBEM criteria. Eight hundred and ninety-two results were obtained, 27 represented best evidence (2-meta-analyses, 1-RCT, and 24 retrospective cohort studies). In all 474,160 operative outcomes were assessed for 434,535 coronary artery bypass grafting(CABG) (431,329 on-pump vs. 3206 off-pump), 3090 AVR, 1740 MVR/repair, 26,433 mixed, 3565 congenital, and 4797 thoracic procedures. In all398,058 cases were performed by trainees and 75,943 by consultants. One hundred fifty-nine cases were indeterminate. There were no statistically significant differences in the patients' preoperative risk scores. All studies excluded extreme high-risk patients in emergency setting, patients with poor left ventricular function, and reoperation cases that were undertaken by consultants. There were no differences in cardiopulmonary bypassand clamp times for CABG. Times for valve replacement and repair cases were longer for trainees. There were no differences in the postoperative outcomes including perioperative myocardial infarction, resternotomy for bleeding, stroke, renal failure, intensive therapy unitlength of stay, and total length of stay. One study reported no differences on angiographic graft patency at 1 year. There were no differences in in-hospital or midterm mortality out to 5-years. Trainees can perform cardiothoracic surgery in dedicated high-volume units with outcomes comparable to those of fully trained surgeons.

Efficacy and safety of EXOWALK® on electromechanical-assisted gait training: study protocol for randomized controlled trial

BackgroundHigh-intensity repetitive task-specific practice might be the most effective strategy to promote motor recovery after stroke, and electromechanical-assisted gait training represents one of the treatment options. However, there is still difficulty in clarifying the difference between conventional gait training and electromechanically assisted gait training.MethodsThe study is a multicenter, randomized, parallel-group clinical trial for stroke patients. Three clinical research centers in Korea (Dongguk University Ilsan Hospital, Chungnam National University Hospital, and Seoul National University Bundang Hospital) will participate in the clinical trial and 144 stroke patients will be registered. Enrolled patients are assigned to two groups, an experimental group and a control group, according to a randomization table. In addition, patients are treated for half an hour (one session) five times a week for 4 weeks. Both groups carry out basic rehabilitation (central nervous system development therapy and strength exercise) and the experimental group executes robotic walking rehabilitation treatment, and the control group executes conventional gait rehabilitation treatment. The primary endpoint variable is the Functional Ambulation Category (FAC) that determines the degree of independent walking and is measured before, after, and after 4 weeks of treatment. Secondary endpoint variables are 11 variables that take into account motor function and range, measured at the same time as the primary endpoint variable.DiscussionThere are still insufficient data on the effectiveness of electromechanical-assisted gait training for stroke patients and large-scale research is lacking. Thus, the research described here is a large-scale study of stroke patients that can supplement the limitations mentioned in other previous studies. In addition, the clinical studies described here include physical epidemiological analysis parameters that can determine walking ability. The results of this study can lead to prove the generalizable effectiveness and safety of electromechanical-assisted gait training with EXOWALK®.Trial registrationClinical Research Information Service (CRIS), Republic of Korea KCT0003411, Registered on 30 October 2018

Feasibility and safety of Qigong training delivered from two different digital platforms in physically inactive adults: A pilot randomized controlled study

Qigong training has positive effects on various health outcomes. Asynchronous or video-conference-based digital platforms may be options to maintain physical activity at home. The aim of the study was to assess feasibility and safety of asynchronous and video-conference-based Qigong training. Thirty-four physically inactive adults were assigned to video-conference or asynchronous group. While subjects in the video-conference group followed the program through Zoom®, exercise videos were delivered to the participants in the asynchronous group via YouTube®. Both groups performed Qigong training with the same characteristics for 6 weeks, 3 days/week. The feasibility was assessed by retention rate and attendance rate. The program considered to be feasible if the retention rate was <80% and mean attendance rate was at least 15 out of 18 sessions. Safety was determined as any adverse events reported by the participants during the intervention period. Satisfaction from the interventions assessed using 5-points Likert Scale. The International Physical Activity Questionnaire-Short Form (IPAQ-SF), 1-minute sit-to-stand test (STS), Pittsburgh Sleep Quality Index (PSQI), Perceived Stress Scale (PSS), and Coronavirus Anxiety Scale were also assessed. No adverse events were observed in either group. Attendance rate was ≥15 sessions in both groups (asynchronous group= 18, video-conference group= 15.35±5.98). The retention rate was 100% in asynchronous and 88.2% in video-conference group. The satisfaction level obtained with the Qigong training in both groups was similar (p = 0.533, r=-0.106). Qigong training performed with the video-conference method or asynchronous videos appear to be safe, well tolerated, and feasible in physically inactive adults.

Resistance Training in Patients With Coronary Artery Disease, Heart Failure, and Valvular Heart Disease: A REVIEW WITH SPECIAL EMPHASIS ON OLD AGE, FRAILTY, AND PHYSICAL LIMITATIONS.

Current guidelines recommend individually adapted resistance training (RT) as a part of the exercise regime in patients with cardiovascular diseases. The aim of this review was to provide insights into current knowledge and understanding of how useful, feasible, safe, and effective RT is in patients with coronary artery disease (CAD), heart failure (HF), and valvular heart disease (VHD), with particular emphasis on the role of RT in elderly and/or frail patients. A review based on an intensive literature search: systematic reviews and meta-analyses published in 2010 or later; recent studies not integrated into meta-analyses or systematic reviews; additional manual searches. The results highlight the evaluation of effects and safety of RT in patients with CAD and HF with reduced ejection fraction (HFrEF) in numerous meta-analyses. In contrast, few studies have focused on RT in patients with HF with preserved ejection fraction (HFpEF) or VHD. Furthermore, few studies have addressed the feasibility and impact of RT in elderly cardiac patients, and data on the efficacy and safety of RT in frail elderly patients are limited. The review results underscore the high prevalence of age-related sarcopenia, disease-related skeletal muscle deconditioning, physical limitations, and frailty in older patients with cardiovascular diseases (CVD). They underline the need for individually tailored exercise concepts, including RT, aimed at improving functional status, mobility, physical performance and muscle strength in older patients. Furthermore, the importance of the use of assessment tools to diagnose frailty, mobility/functional capacity, and physical performance in the elderly admitted to cardiac rehabilitation is emphasized.

Power Training Prescription in Older Individuals: Is It Safe and Effective to Promote Neuromuscular Functional Improvements?

Muscle power has been reported to be critical in counteracting age-related declines in functional performance. Muscle power output in functional performance exercises can be greatly improved in a short period of time (i.e., ≤ 12weeks) using specific exercise interventions such as power training (i.e., exercises attempting to move loads ranging from 20 to 70% of 1-repetition maximum as fast as possible during the concentric muscle action, followed by a controlled, slower eccentric muscle action). Despite the widespread evidence on the effectiveness of power training in older adults (~ 300 scientific articles published on this topic in the past 10years), some scientists do not recommend the use of explosive-type muscular contractions during resistance training (i.e., power training) for the older population; indeed, some international guidelines do not mention this type of exercise for older people. The reasons underlying this absence of mention and recommendation for the use of power training as a fundamental exercise strategy for older people are still not well known. Therefore, we attempted to point out the main issues about safety, feasibility, and effectiveness of muscle power training to promote neuromuscular functional improvements in older people.

Effect of Long-term Exercise Training on Physical Performance and Cardiorespiratory Function in Adults With CKD: A Randomized Controlled Trial

The safety and efficacy of long-term exercise training in reducing physical functional loss in older adults with advanced CKD and comorbidity is uncertain. Multicenter, parallel group, randomized controlled trial. Adults 55 years and older with estimated glomerular filtration rate (eGFR) of 15 to<45 mL/min/1.73 m2 enrolled from centers in Baltimore and Boston. Twelve months of in-center supervised exercise training incorporating majority aerobic but also muscle strengthening activities or a group health education control intervention, randomly assigned in 1:1 ratio. Primary outcomes were cardiorespiratory fitness and submaximal gait at 6 and 12 months quantified by peak oxygen consumption (Vo2peak) on graded exercise treadmill test and distance walked on the 6-minute walk test, respectively. Secondary outcomes were changes in lower extremity function, eGFR, albuminuria, glycemia, blood pressure, and body mass index. Among 99 participants, the mean age was 68 years, 62% were African American, and the mean eGFR was 33 mL/min/1.73 m2; 59% had diabetes, and 29% had coronary artery disease. Among those randomized to exercise, 59% of exercise sessions were attended in the initial 6 months. Exercise was well tolerated without excess occurrence of adverse events. At 6 months, aerobic capacity was higher among exercise participants (17.9 ± 5.5 vs 15.9 ± 7.0 mL/kg/min, P= 0.03), but the differences were not sustained at 12 months. The 6-minute walk distance improved more in the exercise group (adjusted difference: 98 feet [P= 0.02; P= 0.03 for treatment-by-time interaction]). The exercise group had greater improvements on the Timed Up and Go Test (P= 0.04) but not the Short Physical Performance Battery (P= 0.8). Planned sample size was not reached. Loss to follow-up and dropout were greater than anticipated. Among adults aged≥55 years with CKD stages 3b-4 and a high level of medical comorbidity, a 12-month program of in-center aerobic and resistance exercise training was safe and associated with improvements in physical functioning. Government grants (National Institutes of Health). Registered at ClinicalTrials.gov with study number NCT01462097.

Post-COVID-19 Pulmonary Hypertension: How it May Physiologically Affect Exercise Training

Abstract: Exercise training is paramount in improving aerobic capacity, lung function, reducing the symptoms of dyspnea, and reconditioning the lean skeletal muscles. Many literature and guidelines have advocated the importance of exercise intervention in addressing the secondary impairment to post covid-19 infection, including home-based therapy and telerehabilitation. Pulmonary hyperten-sion (PH) was previously thought to be contraindicated by exercise training; however, exercise was later found to be beneficial and relatively safe in chronic PH. However, there is a lack of high-quality evidence on the safety and effectiveness of exercise training in post-COVID-19 infected in-dividuals with PH. Pulmonary hypertension has been documented to be one of the post-COVID-19 complications. PH occurred due to COVID-19 infection should be carefully considered before sub-jecting them to exercise training, especially in home-based therapy. This article aims to discuss the differing etiological factor, pathophysiological backgrounds, and the possible disease long-term outcomes that may compromise the safety of exercise training in post-COVID-19 patients compli-cated with PH. By understanding the risk of developing PH, risk assessment and stratification can be explicitly outlined for a safe exercise prescription through proper patient selections. Any possible complications can be anticipated; hence, proper preventive strategies can be instituted.

Breast cancer-related lymphoedema and resistance exercise: An evidence-based review of guidelines, consensus statements and systematic reviews.

Breast cancer-related lymphoedema (BCRL) is a side effect of cancer treatment and can be alleviated by resistance exercise. This systematic, evidence-based review examined the existing best evidence on resistance exercise for BCRL to accurately describe the current status of the field and offer recommendations for clinicians. This review adheres to the PRISMA guidelines. Clinical practice guidelines, consensus documents, systematic reviews and other related evidence-based resources about resistance exercise for BCRL were retrieved through the English databases and guideline websites. The publication data limit was set to December 2020. The following search terms were used: 'breast cancer/breast neoplasm/breast carcinoma/breast tumor/breast malignancy, lymphedema/swelling/edema/lymphoedema, resistance/weight/strength training, best practice/clinical practice/guideline/consensus documents'. The quality of the included studies was evaluated by two authors independently using AGREE II and AMSTAR II tools. Evidence-based recommendations on resistance exercise relevant for BCRL were synthesised and categorised. Twenty two articles (seven guidelines, four consensus documents and eleven systematic reviews) were included. The overall quality of the eleven eligible guidelines and consensus documents was moderate to high according to the AGREE II criteria. The quality of the eleven systematic reviews was critically low to high according to the AMSTAR criteria. Six clinical topics involving 43 recommendations were identified. Recommendations were categorised by safety of resistance training, effectiveness of resistance training, evaluation prior to resistance exercise, resistance exercise prescription, resistance training outcome index and points for attention. This study summarises 43 recommendations for resistance training for BCRL and provides guidance for clinicians. Based on randomised trials and systematic reviews published in recent years, there is an urgent need to update the guidelines and consensus documents in terms of topics, for example effectiveness of resistance training and resistance training outcome index.

Application of Machine Learning and Information Coverage Centralized Genetic Method in Safety Management of Football Training.

In recent years, China's competitive sports have developed rapidly. Among them, football is a sport with high energy consumption, high intensity, strong antagonism, and high speed. As a result, injuries are common in football practice. It is impossible to do adequate football training in order to avoid such incidents. At the moment, football injury incidents are common, severely limiting the full growth of the sport in China. This work investigates the safety management of football training using machine learning and an information coverage-centralized genetic technique. To begin, this article describes in detail the machine learning and information coverage-centralized genetic algorithm, summarizes the classification of machine learning models, and introduces the verification and evaluation process of machine learning models and trusted information coverage models as an important theoretical basis for football training safety management. Then, the genetic algorithm based on information coverage concentration is used in football training to analyze the safety risk of football training and the analysis of training speed type. The results show that the human factor accounts for the highest proportion in football training safety accidents, accounting for 28.75%. In the analysis of football training speed, the average passing time of medium strength accounts for the highest proportion of 39.75%. In football training, in order to ensure the safety of training, the combination of medium strength and high strength can be adopted to avoid training injury.

Feasibility, Safety, and Preliminary Efficacy of Very Low-Volume Interval Training in Advanced Cancer Patients.

ABSTRACTPurposeHigh-intensity interval training (HIIT) has been shown to improve cardiorespiratory fitness (CRF) and health-related outcomes in various chronic diseases, including cancer. However, data on feasibility and efficacy of HIIT in advanced cancer patients are still sparse, presumably because of safety concerns, like suspected immunosuppression after vigorous exercise. This randomized, sham-intervention controlled study aimed to investigate feasibility, safety, and preliminary efficacy of very low-volume HIIT (LOW-HIIT) in advanced cancer patients.MethodsTwenty-seven patients (55.4 ± 13.2 yr) with different advanced cancers (Union for International Cancer Control [UICC] III/IV) were randomly allocated to LOW-HIIT (n = 13), consisting of 5 × 1 min cycle ergometer intervals (14 min per session total duration) at 80% to 95% HRpeak (two sessions per week for 12 wk), or a sham intervention (n = 14) performing light physical mobilization exercises (SHAM). Primary outcomes were attrition and attendance rates, with values of ≤25% and ≥80%, respectively, considered acceptable. Secondary outcomes were safety, protocol fidelity, physiological (including CRF measures) and patient-reported outcomes (including fatigue and quality of life).ResultsOne of 13 patients (8%) receiving LOW-HIIT dropped out. Mean attendance rate was ~93%. The prescribed minimum exercise intensity was consistently reached by all patients. Low-volume HIIT was well tolerated and not associated with any serious adverse event nor with increased infection susceptibility. There were no biochemical signs of acute immunosuppression after LOW-HIIT. Contrarily, differentiation and degranulation of natural killer cells was acutely increased postexercise. Low-volume HIIT improved CRF measures including peak oxygen uptake, self-reported fatigue, physical, and social functioning. No significant changes occurred in the SHAM group.ConclusionsLow-volume HIIT can be regarded as feasible and safe in advanced cancer patients. Our preliminary data indicate favorable acute effects on NK-cells and beneficial chronic adaptations in CRF, fatigue, and aspects of quality of life.

Feasibility and cost description of highly intensive rehabilitation involving new technologies in patients with post-acute stroke—a trial of the Swiss RehabTech Initiative

BackgroundThere is a need to provide highly repetitive and intensive therapy programs for patients after stroke to improve sensorimotor impairment. The employment of technology-assisted training may facilitate access to individualized rehabilitation of high intensity. The purpose of this study was to evaluate the safety and acceptance of a high-intensity technology-assisted training for patients after stroke in the subacute or chronic phase and to establish its feasibility for a subsequent randomized controlled trial.MethodsA longitudinal, multi-center, single-group study was conducted in four rehabilitation clinics. Patients participated in a high-intensity 4-week technology-assisted trainings consisting of 3 to 5 training days per week and at least 5 training sessions per day with a duration of 45 min each. Feasibility was evaluated by examining recruitment, intervention-related outcomes (adherence, subjectively perceived effort and effectiveness, adverse events), patient-related outcomes, and efficiency gains. Secondary outcomes focused on all three domains of the International Classification of Functioning Disability and Health. Data were analyzed and presented in a descriptive manner.ResultsIn total, 14 patients after stroke were included. Participants exercised between 12 and 21 days and received between 28 and 82 (mean 46 ± 15) technology-assisted trainings during the study period, which corresponded to 2 to 7 daily interventions. Treatment was safe. No serious adverse events were reported. Minor adverse events were related to tiredness and exertion. From baseline to the end of the intervention, patients improved in several functional performance assessments of the upper and lower extremities. The efficiency gains of the trainings amounted to 10% to 58%, in particular for training of the whole body and for walking training in severely impaired patients.ConclusionsHighly intensive technology-assisted training appears to be feasible for in- and outpatients in the subacute or chronic phase after stroke. Further clinical trials are warranted in order to define the most comprehensive approach to highly intensive technology-assisted training and to investigate its efficacy in patients with neurological disorders.Trial registrationClinicalTrials.gov Identifier: NCT03641651 at August 31st 2018

The efficacy and safety of acupuncture combined with language training for motor aphasia after stroke: study protocol for a multicenter randomized sham-controlled trial

BackgroundMotor aphasia after stroke is a common and intractable complication of stroke. Acupuncture and language training may be an alternative and effective approach. However, the efficacy of acupuncture and language training for motor aphasia after stroke has not been confirmed. The main objectives of this trial are to evaluate the effectiveness and safety of acupuncture and low-intensity, low-dose language training in treating ischemic motor aphasia after stroke from 15 to 90 days.MethodsThis is a multicenter randomized sham-controlled clinical trial. We will allocate 252 subjects aged between 45 and 75 years diagnosed with motor aphasia after stroke with an onset time ranging from 15 to 90 days into two groups randomly in a 1:1 ratio. Patients in the experimental group will be treated with “Xing-Nao Kai-Qiao” acupuncture therapy plus language training, and those in the control group will be treated with sham-acupoint (1 cun next to the acupoints) acupuncture therapy plus language training. All the patients will be given acupuncture and language training for 6 weeks, with a follow-up evaluation 6 weeks after the end of the treatment and 6 months after the onset time. The patients will mainly be evaluated using the Western Aphasia Battery and Chinese Functional Communication Profile, and the incidence of treatment-related adverse events at the 2nd, 4th, and 6th weeks of treatment will be recorded. The baseline characteristics of the patients will be summarized by group, the chi-squared test will be used to compare categorical variables, and repeated measures of analysis of variance or a linear mixed model will be applied to analyze the changes measured at different time points.DiscussionThe present study is designed to investigate the effectiveness and safety of traditional acupuncture therapy and language training in ischemic motor aphasia after stroke and explore the correlation between the treatment time and clinical effect of acupuncture. We hope our results will help doctors understand and utilize acupuncture combined with language training.Trial registrationChiCTR ChiCTR1900026740. Registered on 20 October 2019

Mobility training for increasing mobility and functioning in older people with frailty.

Mobility training for increasing mobility and functioning in older people with frailty.

Investigation of the Effectiveness and Safety of the Rehabilitation Program for Patients with Long Covid Using Aquatic Training

Aim. To evaluate the effectiveness and safety of aquatic training in diluted sodium chloride bromine brine in restoring the functional state of the organism of patients with portcovid syndrome in comparison with aquatic training in fresh water. Material and methods. Specialists of the National Medical Research Centre of Rehabilitation and Balneology of the Ministry of Health of Russia conducted an open, prospective, randomized study to evaluate the effect of a course of aquatic training in a bromine sodium chloride brine pool. The study included 28 subjects, who were divided into 2 equal groups. Patients in both groups were comparable for gender (χ2 =0.45; p=0.31) and age (U=99.5; p=0.7) and all had post COVID-19 (U 09.9) as their primary diagnosis. The intervention group received a course of aquatic training (7 treatments) in a pool with bromine sodium chloride brine (well No. 69, 32 Novy Arbat Street, Moscow) with mineralization of 120 g/dm3 and its preliminary dilution to 40 g/m3. Control group – a course of aquatic-exercises (7 treatments) in a fresh water pool. Patients, after signing informed consent, underwent load tests: 6-minute walking test, laser Doppler flowmetry (“LASMA ST”, Russia), cardiointervalography (“Health Reserves-R”, Russia). Results and discussion. These data confirm the “null” hypothesis of a more favorable effect of the chemical composition of the diluted brine that acts during aquatic training on the patient’s body compared to fresh water, especially in the presence of microcirculation disorders after suffering COVID-19. The group of patients who received aquatic training in the pool with bromine sodium chloride brine revealed a significant decrease in excessive sympathetic nervous system activity (T-11.0; p=0.02) at the end of the study. According to LAZMA-ST data, there was a twofold increase in the oxidative metabolism of the cell (IOM T-16.0; p &lt;0.01), an increase in exercise tolerance (6-minute walk test T-10.0; p =0.01). IOM increased statistically significantly threefold (U-32.0; p&lt;0.001), mean microcirculation doubled (U 120.0; p&lt;0.05) and BMI decreased by 20.0% (U-58.0; p&lt;0.05) in the intervention group compared with the control group. There were no significant differences between patient groups on safety parameters (χ2= 1.36; p&gt;0.05). These data confirm the “null” hypothesis of a more favorable effect of the chemical composition of the diluted brine that acts during aquatic training on the patient’s body compared to fresh water, especially in the presence of microcirculation disorders after suffering COVID-19. Conclusion. Aquatic training in sodium chloride bromide brine effectively reduces the sympathetic nervous system activity, increases oxidative metabolism and improves microcirculation compared to aquatic training in fresh water.

The Safety of Hydrogen Jet-flame Suppression Training

The purpose of this study was to reproduce hydrogen gas leakage and jet flame accidents that can occur in hydrogen gas storage facilities to obtain basic data and apply the gained knowledge to firefighter training facilities, thereby improving safety and the response to accidents. A total of 11 scenarios were explored. In scenarios 1∼5, the hydrogen leakage and jet flame types for high (70 MPa), medium (55 MPa), and low pressures (40 MPa) were visualized with the Schlieren system. With the aid of a high-speed camera, it was confirmed that the spraying angle and length were 18∼20° and approximately 10∼12 m, respectively. In addition, in scenarios 4 and 5, the damage caused by the radiant heat was recorded to be slightly higher in the arm/hand and thigh/leg regions. The noise of jet flames was measured in scenarios 6∼11 using a sound level meter, indicating a 10 dB louder flame at medium pressure (52 MPa, 130 dB) than at low pressure (17 MPa, 120 dB) Therefore, long-term exposure is may damage hearing.

Development of a Wearable Upper Limb Rehabilitation Robot Based on Reinforced Soft Pneumatic Actuators

Dyskinesia of the upper limbs caused by stroke, sports injury, or traffic accidents limits the ability to perform the activities of daily living. Besides the necessary medical treatment, correct and scientific rehabilitation training for the injured joint is an important auxiliary means during the treatment of the effected upper limb. Conventional upper-limb rehabilitation robots have some disadvantages, such as a complex structure, poor compliance, high cost, and poor portability. In this study, a novel soft wearable upper limb rehabilitation robot (SWULRR) with reinforced soft pneumatic actuators (RSPAs) that can withstand high pressure and featuring excellent loading characteristics was developed. Driven by RSPAs, this portable SWULRR can perform rehabilitation training of the wrist and elbow joints. In this study, the kinematics of an SWULRR were analyzed, and the force and motion characteristics of RSPA were studied experimentally. The results provide a reference for the development and application of wearable upper limb rehabilitation robots. An experimental study on the rotation angle of the wrist and the pressure of the RSPA was conducted to test the effect of the rehabilitation training and verify the rationality of the theoretical model. The process of wrist rehabilitation training was tested and evaluated, indicating that SWULRR with RSPAs will enhance the flexibility, comfort, and safety of rehabilitation training. This work is expected to promote the development of wearable upper-limb rehabilitation robots based on modular reinforced soft pneumatic actuators.