Significant Group-time Interaction Research Articles

The inertial-based gait normalcy index of dual task cost during turning quantifies gait automaticity improvement in early-stage Parkinson’s rehabilitation

BackgroundThe loss of gait automaticity is a key cause of motor deficits in Parkinson’s disease (PD) patients, even at the early stage of the disease. Action observation training (AOT) shows promise in enhancing gait automaticity. However, effective assessment methods are lacking. We aimed to propose a novel gait normalcy index based on dual task cost (NIDTC) and evaluate its validity and responsiveness for early-stage PD rehabilitation.MethodsThirty early-stage PD patients were recruited and randomly assigned to the AOT or active control (CON) group. The proposed NIDTC during straight walking and turning tasks and clinical scale scores were measured before and after 12 weeks of rehabilitation. The correlations between the NIDTCs and clinical scores were analyzed with Pearson correlation coefficient analysis to evaluate the construct validity. The rehabilitative changes were assessed using repeated-measures ANOVA, while the responsiveness of NIDTC was further compared by t tests.ResultsThe turning-based NIDTC was significantly correlated with multiple clinical scales. Significant group-time interactions were observed for the turning-based NIDTC (F = 4.669, p = 0.042), BBS (F = 6.050, p = 0.022) and PDQ-39 (F = 7.772, p = 0.011) tests. The turning-based NIDTC reflected different rehabilitation effects between the AOT and CON groups, with the largest effect size (p = 0.020, Cohen’s d = 0.933).ConclusionThe turning-based NIDTC exhibited the highest responsiveness for identifying gait automaticity improvement by providing a comprehensive representation of motor ability during dual tasks. It has great potential as a valid measure for early-stage PD diagnosis and rehabilitation assessment.Trial registration Chinese Clinical Trial Registry: ChiCTR2300067657

Effects of Sling-Suspension-Based Active Shoulder Joint Exercise on Shoulder Joint Subluxation, Pain, Muscle Strength, and Upper Limb Function in Patients with Subacute Stroke.

Background and Objectives: We investigated the effects of sling-suspension-based active shoulder joint exercise training on shoulder joint subluxation, pain, muscle strength, and upper extremity function in patients with subacute stroke. Materials and Methods: Twenty-eight patients with subacute stroke were randomly assigned to either the sling-suspension-based active shoulder joint exercise (SASE) group (n = 14) or the motorized upper extremity exercise (MUEE) group (n = 14). The SASE group actively performed shoulder joint flexion, extension, abduction, adduction, external and internal rotation, and horizontal abduction and adduction using a sling suspension system, whereas the MUEE group underwent an exercise program using a motorized upper extremity exercise machine. All participants underwent a 4-week intervention with 30 min of exercise once a day for 5 days a week. Additionally, both groups received general physical therapy and functional electrical stimulation for 30 min twice a day for 5 days a week. Shoulder joint subluxation was measured by radiographic examination before and after training, and pain was evaluated in the splenius, upper trapezius, and infraspinatus muscles using pressure parameters. In addition, a manual muscle tester was used to assess the muscle strength of the shoulder joint flexors, extensors, abductors, adductors, and external and internal rotators, and the Fugl-Mayer Assessment (FMA) and Manual Functional Test (MFT) were used to evaluate upper extremity function. Results: A significant group-time interaction was observed for pain, with F-values of F(1, 26) = 7.470, p < 0.011 for the splenius and F(1, 26) = 9.623, p < 0.005 for the upper trapezius. A significant time-group interaction was observed for the muscle strength of the shoulder, with F-values of F(1, 26) = 13.211, p < 0.001; F(1, 26) = 4.974, p = 0.035 and F(1, 26) = 9.674, p = 0.004 for flexors, abductors, and external rotators, respectively. A significant time-group interaction was observed in the FMA, with F-values of F(1, 26) = 13.243, p < 0.001. When comparing the interaction effects between time and group for MFT scores, a significant difference was observed, with F-values of F(1, 26) = 32.386, p < 0.001. Conclusions: This study confirmed that sling-suspension-based active shoulder joint exercises are effective in improving shoulder joint subluxation, pain, muscle strength, and upper extremity function in patients with subacute stroke.

Impact of a 12-wk physical conditioning program on the aerobic capacity of aviation cadets.

Flight cadets need to have good physical fitness to cope with the challenges of flying missions. The continuous development of science and technology has led to the constant upgrading of fighter jets and the improvement of their performance, which has resulted in new and higher requirements for the physical fitness of flight personnel. The traditional physical training mode, method, and assessment have been used for many years and do not meet current fitness needs. To investigate the impact of a 12-wk comprehensive anti-G fitness training program on the aerobic capacity of aviation cadets and to evaluate its effectiveness. Fifty-five cadets were randomly assigned to control and experimental groups using a randomized, single-blind design. The control group maintained their existing training regimen, while the experimental group participated in a 12-wk comprehensive training intervention. The training program comprised strength training twice per week, high-intensity interval training three times per week, and supplemental nutritional and psychological support. Maximal oxygen uptake (VO2max), lower limb strength, and hemoglobin levels were measured at baseline, at 6 wk and 12 wk post-intervention. Repeated measures analysis of variance revealed significant differences of both VO2max and relative VO2 in both groups across time points (P < 0.05). However, no significant time-group interaction was observed (P > 0.05). Paired t-tests comparing baseline and 12-wk results showed that VO2max and relative VO2 were significantly higher in the experimental group than the control group (P < 0.05). This suggests that the training program effectively enhanced the aerobic capacity of the experimental group. Key indicators of aerobic capacity, bilateral lower limb strength and hemoglobin levels, were also significantly different over time and between groups (P < 0.05). No significant differences were noted in heart-rate metrics (P > 0.05). A 12-wk comprehensive anti-G fitness training program significantly improved the aerobic capacity of aviation cadets, thereby enhancing their overall capacity and laying a physiological foundation for enduring high-G flights.

The effects of connective tissue massage and classical massage on pain, lumbar mobility, function, disability, and well-being in chronic low back pain: A three-arm randomized controlled trial

BackgroundChronic low back pain (CLBP) is a common musculoskeletal disorder. Effect of massage in the management of CLBP has been documented, but it is not clear which massage regimen is more effective. This study was carried out to compare the effect of connective tissue massage and classical massage on pain, lumbar mobility, function, disability, and well-being among patients with CLBP. MethodsThe study included 30 participants who were randomly assigned to one of three intervention groups: the connective tissue massage group (CTMG; n = 10), the classical massage group (CMG; n = 10), and a standard physiotherapy/control group (CG; n = 10). The interventions were administered three times a week for four consecutive weeks. Assessments were conducted at baseline and at the end of the fourth week. Pain severity (Visual Analog Scale), lumbar mobility (Modified Schober Test), function (Back Pain Functional Scale), disability (Roland Morris Disability Questionnaire), and well-being (Short Form-36/SF-36) was evaluated. ResultsAll groups exhibited improvements in pain, lumbar mobility, function, and disability after 4 weeks (p < 0.05). The CMG showed enhancements in physical function, bodily pain, role physical, and role emotional subgroups of SF-36. The CTMG demonstrated improvements in all subgroups of SF-36 except general health (p < 0.05), while the CG only improved in the physical function subgroup (p < 0.05). A 2-way repeated measures ANOVA revealed a significant group-time interaction for MST (p = 0.04), Bodily Pain (p = 0.025) and Role Physical (p = 0.015). ConclusionsThe findings obtained from this study showed that CTMG was superior to CMG and CG in increasing lumbar mobility, and both massage applications were superior to the CG in increasing the well-being.

Digital health program for patients with cancer to support self-management: A retrospective real-world analysis.

1570 Background: Sidekick Health’s 13-week digital health program was built to support cancer self-management. It was available free of charge to US-based cancer patients through commercial health insurance. The program includes disease education, mindfulness, medication adherence support, and asynchronous messaging with a care manager. We hypothesized that highly engaged users had reduced symptom frequency and severity, and improved quality of life (QoL) outcomes. Methods: In-app data were analyzed for registrations Aug 2021-Jan 2024: n(registered)=1286; n(retained ≥7 days)=795; n(QoL/symptoms)=284. QoL was defined as self-reported sleep quality, energy and stress (10-point scale, ≤4x/week). Symptoms were also self-reported (10-point scale, ≤7x/week). Generalized linear mixed models for repeated measures were used to investigate QoL, symptom frequency and severity changes over the program. Subgroup analysis: weekly iterative k-means clustering into highly- and less-engaged (based on total active days) to mitigate survival bias. Results: Diverse patients from 37 states engaged: mean age 58.0 years (SD=10.5), 71% female; 49% diagnosed &lt;6 months ago, 36% ≥12 months ago; 23% early-stage disease, 26% stable disease, 6% in remission and 2% terminal; 60% received chemotherapy, 24% radiation therapy, and 21% immunotherapy. Most (61%) registered users were active after 7 days and 29% after 90 days. Less-engaged users reported higher mean baseline weight (85.3kg (SD=26.7)) vs highly engaged (76.9kg (SD=18.3); p=0.010) but were otherwise similar (age, gender, height, time since diagnosis and treatment: p&gt;0.05). For QoL, highly engaged users had improved energy (p=0.013) and sleep (p=0.002), but not stress (p=0.164) vs less engaged. A significant time-group interaction for sleep (p&lt;0.001) showed highly engaged users had better sleep, and larger improvements over time vs less-engaged. Overall, users reported fewer symptoms over the program (IRR (95% CI)=0.965 (0.953, 0.978), p&lt;0.001). Symptom frequency decreased significantly for stress (p=0.034) and nausea (p=0.003), but not numbness (p=0.320) or fatigue (p=0.530). Highly engaged users’ symptom severity had a downward trajectory, compared with less-engaged, for fatigue (p=0.044) and nausea (p=0.001), but not stress (p=0.234) or numbness (p=0.680). Conclusions: Theprogram was accessed by a broad patient group and retention was high. Highly engaged users reported improved QoL (energy, sleep) and reduced symptom severity (fatigue, nausea). Total symptom frequency was reduced over the program, as well as for stress and nausea specifically. These findings indicate digital self-management is not only achievable for patients with cancer, but that higher engagement may improve patient-reported outcomes.

Effects of multiple cold-water immersion during pre-season on recovery performance in under-20 male soccer players: A randomized controlled trial

IntroductionThis study was designed to evaluate the effects of multiple cold-water immersions performed daily during the preseason period on biochemical, clinical, and neuromuscular aspects of muscle damage of soccer players. MethodsThis two-arm, prospectively registered, randomized controlled trial, blinded to statistician and assessors, was conducted at professional football club facilities. Twenty-three under-20 semi-professionals male soccer players were randomly allocated into cold water immersion group (bathtub with water and ice at 10 °C ± 1 °C for 10 min) or control group (rest for 10 min), every day, after training sessions during a preseason. Primary outcome was change in creatine kinase (CK) concentration, and secondary outcomes were changes in vertical jump performance, strength and perception of recovery at baseline (T0) and after protocol training (T1). ResultsAnalysis of Covariance (ANCOVA) showed a statistically significant time-group interactions for CK concentration, with an average reduction of 280.39 U/L (CI95% = −519.14, −41.64; d = 0.55) in the cold-water immersion compared to the control group. No differences between groups were observed in any other measures. ConclusionMultiple cold-water immersions at 10 °C for 10 min decreases CK concentration but does not change any clinical and neuromuscular markers of muscle damage in soccer players during a 9-day preseason.

Cardiac Coherence and the Effectiveness of Cardiovascular Biofeedback in the Nursing Team: A Randomized Clinical Trial

Introduction: Through guided and conscious deep breathing, cardiovascular biofeedback, an innovative technological tool that enables improved cardiac coherence and activation of the parasympathetic nervous system, which are vital for recovering and maintaining homeostasis and psycho-emotional health. Objective: To verify the effect of cardiovascular biofeedback on heart rate variability parameters in nursing professionals. Materials and Methods: This is a randomized clinical trial conducted in two groups — biofeedback and placebo — with 115 nursing professionals working in clinical and surgical inpatient units at a university hospital, who presented an overall stress level higher than 1, according to the Stress Symptom Scale. The groups participated in nine appointments over three weeks. The outcome was assessed by rMSSD parameters and cardiac coherence at the end of each appointment, which were measured using EmWave Pro Plus®, which uses photoplethysmography to quantify physiological data related to the heartbeat. The analysis was performed using generalized estimation equations, considering α = 5 %. Results: There was a significant time-group interaction in cardiac coherence parameters; the intervention group presented an increase in the mean cardiac coherence parameters at all measurement times, when compared to the control group (p &lt; 0.001; r &gt; 0.98). There was no significant time-group interaction in the rMSSD parameters at any of the measurement times (p = 0.432). As a mind-body therapy, cardiovascular biofeedback proved to be useful and promising. By promoting parasympathetic activation and relaxation, it is possible to prevent the deleterious effects associated with occupational stressors. Conclusion: The intervention with cardiovascular biofeedback proved to be superior to placebo in improving cardiac coherence, resulting in the recovery of the body’s homeostasis.

Effects of probiotic supplementation on 12 min run performance, mood management, body composition and gut microbiota in amateur marathon runners: A double-blind controlled trial

BackgroundProbiotic supplementation has a positive effect on endurance exercise performance and body composition in athletes, but the underlying mechanisms remain unclear. Gut microbiota can provide measurable markers of immune function in athletes, and microbial composition analysis may be sensitive enough to detect stress and metabolic disorders caused by exercise. MethodsNineteen healthy active amateur marathon runners (15 male and 4 female) with a mean age of 29.11 years volunteered to participate in this double-blind controlled study. Based on the performance of the Cooper 12-min running test (CRT), the participants were allocated into two groups to receive either a probiotic formulation comprising lactobacillus acidophilus and bifidobacterium longum (n = 10) or placebo containing maltodextrin (n = 9) for five weeks. Consistency of diet and exercise was ensured throughout the experimental period. Before and after the intervention, all participants were assessed for CRT, emotional stability and gastrointestinal symptoms, gut microbiota composition, body composition and magnetic resonance imaging (MRI) indicators of skeletal muscle microcirculation. ResultsCompared to before the intervention, the probiotics group showed an increase in CRT score (2.88 ± 0.57 vs 3.01 ± 0.60 km, P＜0.05), significant improvement in GSRS and GIQLI (9.20 ± 4.64 vs 7.40 ± 3.24, 118.90 ± 12.30 vs 127.50 ± 9.85, P＜0.05), while these indicators remained unchanged in the control group, with a significant time-group interaction effect on gastrointestinal symptoms. Additionally, some MRI metabolic cycling indicators of the thigh skeletal muscle also changed in the probiotics group (P＜0.05). Regarding microbiota abundance, the probiotics group exhibited a significant increase in the abundance of beneficial bacteria and a significant decrease in the abundance of harmful bacteria post-intervention (P＜0.05). ConclusionAs a sports nutritional supplement, probiotics have the potential to improve athletic performance by optimizing the balance of gut microbiota, alleviating gastrointestinal symptoms.

Effect of a Home-Base Core Stability Exercises in Hereditary Ataxia. A Randomized Controlled Trial. A Pilot Randomized Controlled Trial.

Core stability exercises (CSE) have been shown to be effective in improving trunk function in several neurological diseases, but the evidence is scarce on Hereditary Ataxias (HA). To evaluate the effectiveness of a 5-week home-based CSE program in terms of ataxia severity, trunk function, balance confidence, gait speed, lower limb motor function, quality of life, health status and falls rate in HA individuals at short- and long-term. This is an assessor-blind randomized controlled clinical trial parallel group 1:1. The individuals were divided in experimental group (EG) performed standard care in addition to CSE, and control group (CG) performed standard care alone. The CSE home-program was conducted 1-h/day, 5-day/week for 5-week. The assessment was performed at baseline, endpoint (5-week), and follow-up (10-week). The primary outcomes were ataxia severity assessed by the Scale for the Assessment and Rating of Ataxia and trunk function assessed by Spanish-version of Trunk Impairment Scale 2.0. The secondary outcomes were balance confidence assessed by Activities-specific Balance Confidence (ABC), gait speed by 4-meter walk test (4-MWT), the lower limb motor function by 30-s sit-to-stand, quality of life by EuroQol 5-dimension 5-level (EQ-5D-5L), health-status by EQ-5D and falls rate. Twenty-three HA individuals were recruited (51.8 ± 11.10 years). Statistically significant group-time interaction was shown in ABC (F:5.539; P = 0.007), EQ-5D-5L Total (F:4.836; P = 0.013), EQ 5D (F:7.207; P = 0.006). No statistical differences between groups for ataxia severity and trunk function were observed. However, were differences for balance confidence, gait speed, quality of life, and falls rate in HA individuals.

Effects of continuous supplementation of Acanthopanax senticosus Harms on the cardiac autonomic function of community-dwelling elderly individuals during resting and standing tests: a randomized controlled trial.

Cardiac autonomic function (CAF) decreases with aging, and Acanthopanax senticosus Harms (ASH) consumption reportedly induces anti-stress effects. This study aimed to assess the effect of continuous supplementation of ASH on CAF during resting and standing tests in the elderly population. This double-blind, randomized controlled trial was conducted in the morning in a laboratory setting and was carried out between June 2017 and July 2017 at Kambaikan, Doshisha University (Karasuma-higashi-iru, Imadegawa-dori, Kamigyo-ku, Kyoto 602-8580, Japan). In total, 28 community-dwelling elderly individuals (mean ± standard deviation = 72.5 ± 4.5 years) were included. Each subject was instructed to consume ASH or placebo supplements twice daily for 4 weeks. An autonomic reflex orthostatic tolerance recorder was used to measure CAF in pre- and post-intervention phases. Parameters were measured in a seated position and included coefficient of variation of R-R intervals (CVRR), low frequency (LF), high frequency (HF), LF/HF ratio, blood pressure, and heart rate (HR). Changes in each parameter were evaluated before and after standing. All parameters were defined as the difference between the mean value obtained in a standing position for 2 min and that obtained in a 2-min seated position. A two-way analysis of variance revealed a significant group-time interaction effect on CVRR, HF, and ΔLF/HF ratio. Following the intervention, CVRR, HF, LF/HF ratio, systolic blood pressure (SBP), HR, ΔLF/HF ratio, ΔSBP, and ΔHR improved significantly in the ASH group only. Four-week supplementation of ASH improved CAF in community-dwelling elderly individuals during resting and standing tests. https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000031218, UMIN Clinical Trials Registry (UMIN000027251).

A web-based psychological support program for caregivers of children with rare chronic diseases: a randomized controlled trial

BackgroundApproximately 50% of rare diseases have symptom onset during childhood. A high level of nursing care and an often uncertain prognosis put caregivers of the affected children at high risk for psychological distress. At the same time, their caregivers have limited access to appropriate psychological care. The aim of this study was to evaluate a web-based psychological support program for caregivers of children with chronic rare diseases (WEP-CARE).MethodsGerman-speaking parents (recruited between May 2016 and March 2018) caring for children aged 0–25 years with a rare disease showing clinically relevant anxiety symptoms, were assigned to either the WEP-CARE (n = 38) or treatment as usual (n = 36) condition within a randomized controlled trial. The primary outcome measure was parental anxiety, assessed with the Generalized Anxiety Disorder Questionnaire (GAD-7). Secondary outcomes were fear of disease progression, depression, coping, quality of life and user satisfaction. The group differences were tested through repeated-measures analyses of variance. The WEP-CARE group was additionally followed up three months after the treatment.ResultsA significant time-group interaction was found for anxiety (F (1,35) = 6.13, p = .016), fear of disease progression (F (1,331) = 18.23, p < .001), depression (F (1,74) = 10.79, p = .002) and coping (F (1,233) = 7.02, p = .010), suggesting superiority of the WEP-CARE group. Sustainability of the treatment gains regarding anxiety, fear of disease progression and coping was confirmed at the 6-month follow-up assessment (p < .01). A significant interaction effect could not be found for quality of life (F(1,2) = 0.016; p = .899). Both participating parents and therapists were satisfied with WEP-CARE.ConclusionsOur results underline the efficacy and feasibility of WEP-CARE for parents of children with various rare diseases.

A 16-week school-based intervention improves physical fitness in Slovenian children: a randomized controlled trial.

Introduction: The aim of this study was to evaluate the effects of a 16-week school-based physical activity (PA) intervention on physical fitness (PF) (speed, hand-eye coordination, flexibility) of 8- to 9-year-olds. Methods: A total of seventy-eight boys and girls (boys: n = 45, aged 8.4 ± 4.9years; girls: n = 42, aged 8.6 ± 0.5years) from a school in Slovenia were randomly assigned to either a group with an after-school PA program (EXP) or a control group (CON) that participated exclusively in mandatory physical education (PE). The EXP group engaged in the extracurricular PA program for 60 min twice a week for 16 weeks, concurrent with regular PE classes. The program primarily involved elementary PE games that included elements of athletics (e.g., skipping, push- off running, hopping, crossstepping, and jumping) and gymnastics (e.g., handstand, forward roll, backward roll, hand support jumps, squat jump on a vault box, climbing on horizontal bars, incline benches and ropes, crawling, and jumping rope). Standardized tests appropriate for this age group were used to assess PF, including the sit and reach test (SAR), the 30-meter sprint, and the alternate hand wall toss test at distances of 1.0 and 2.0 m (AHWT 1.0 and 2.0). Results: There was a significant group-time interaction for SAR test (EXP group increase: +1.6 cm, +6.3%; CON group decrease: -0.1cm, -0.4%; p < 0.001, ηp2 = 0.361), and the 30m sprint (EXP group improvement: -0.4 s, -6.3%; CON group decrease: +0.1 s, +1.6%; p < 0.001, ηp2 = 0.193). Similarly, the EXP group improved by +2.1 points (+25.6%) in the 1.0 m wall throw with the alternating hand, while the CON group showed only minimal changes (-0.2 points, -2.4%; p < 0.001, ηp2 = 0.545). No significant interaction was found for the 2.0m toss (EXP and CON group both -0.1 points, -2.6%; p = 0.888, ηp2 = 0.001). Post-hoc analyses with paired t-tests revealed that the EXP group showed significant improvements in SAR test (p < 0.001), 30 m sprint (p < 0.001) and AHWT 1.0 test (p < 0.001), while the CON group showed no significant changes in SAR test (p = 0.533), 30 m sprint (p = 0.150), AHWT 1.0 test (p = 0.186) and AHWT 2.0 test (p = 0.430). Discussion: The results of the study showed that the extracurricular program with only two additional weekly sessions significantly improved the components of PF in 8- to 9-year olds. Significant improvements were observed in the areas of flexibility, speed and coordination, as shown in the SAR test, 30-meter sprint and 1.0-meter handwall toss tests. However, no similar improvements were observed in the 2.0-meter handwall toss, which illustrates the specific areas of impact of the program.

The Effect of Cognitive Behavioral Therapy on Insomnia in Patients with Schizophrenia: A Randomized Controlled Trial

Abstract Background: Insomnia is a common feature of schizophrenia. Patients with schizophrenia also encounter the problem of insomnia, which impairs their cognitive functioning, quality of life, mental well-being, and functional recovery. Studies support pharmacological treatment of insomnia with certain drugs; however, these hypnotic medications also have adverse effects. There are no grounded recommendations about insomnia treatment in this clinical setting and research in nonpharmacological areas is sparse. To the best of our knowledge, this is the first study to see the effect of cognitive behavioural therapy for insomnia (CBT-I) in schizophrenia patients in an Indian population. Aims: To evaluate the effects of CBT-I in schizophrenia patients. Materials and Methods: It is a randomized controlled study. Forty schizophrenic patients were recruited and were randomly allocated into two groups. The CBT-I group (n = 20) received four sessions of CBT-I in addition to treatment as usual, whereas the control group (n = 20) received. no additional intervention. The Insomnia Severity Index (ISI) and Pittsburgh Sleep Quality Index (PSQI) were administered at baseline, week 4, and week 8. Results: Both the groups showed significant time–group interactions on the ISI and PSQI. Post hoc testing showed that, compared to the control group, the CBT-I group showed significant reductions in ISI at both week 4 and week 8. Conclusion: CBT-I was effective for reducing insomnia symptoms in patients with schizophrenia and the effect lasted for 4 weeks after the intervention.

Scapular stabilization exercise training improves treatment effectiveness on shoulder pain, scapular dyskinesis, muscle strength, and function in patients with subacromial pain syndrome: A randomized controlled trial

IntroductionSubacromial pain syndrome (SPS) is a common cause of shoulder pain, and is associated with functional limitation, workdays lost, disability, and poor quality of life. PurposeOur purpose was to investigate the effects of scapular stabilization exercises in patients with SPS. MethodSixty-four patients with SPS who also exhibit observable scapular dyskinesis defined by the scapular dyskinesis test were recruited and randomized to scapular stabilization exercise training group or to control group. All participants received the same rehabilitation protocol including glenohumeral and scapular mobilization, pendulum exercises, shoulder stretching, range of motion exercises, strengthening, and proprioceptive exercises. Patients in the scapular stabilization exercise training group performed additional scapular stabilization exercises. The presence of scapular dyskinesis, shoulder pain severity, motion, muscle strength, scapular upward rotation, and shoulder disability were assessed before and after the four-week rehabilitation program. ResultsThe scapular stabilization exercise training group had better improvement in scapular dyskinesis, pain, muscle strength, and shoulder disability compared to the control group (p < 0.05). However, there was no statistically significant time-group interaction regarding shoulder motion and scapular upward rotation (p > 0.05). ConclusionsScapular stabilization exercises added to the shoulder mobilization, stretching, and strengthening are effective in improving scapular dyskinesis, reducing pain, increasing muscle strength and shoulder function in patients with SPS accompanied by scapular dyskinesis.

The Effects of the Situated Simulation Program on the Cultural Competence of Hemodialysis Nurses: A Quasi-Experimental Study.

The rise in the number of hemodialysis (HD) patients underscores the importance of culturally competent HD nurses. This study aimed to examine the effectiveness of a situated simulation program on HD nurses' cultural competence. This was a quasi-experimental pilot study with a total of 40 participants who met the inclusion criteria from an HD center in northern Taiwan. Participants took part in two separate 3 h education programs. The first program focused on the basic concepts of cultural competence, while the second program involved situated simulations utilizing the Gather-Analyze-Summarize (GAS) method of debriefing. The generalized estimating equations (GEEs) were employed to estimate the intervention effect. The baseline scores were divided into low-score and high-score groups using the median score for subgroup analysis. The subgroup analysis revealed that a significant group-time interaction was identified regarding cultural competence and subscale, verifying the situated simulation's immediate effect. In this study, an integration of the GAS method of debriefing and situated simulation teaching was implemented. The results showed that this approach empowered HD nurses with the ability to foster positive attitudes and demonstrate professional expertise in an organized manner when facing similar clinical scenarios in the future.

The Addition of Exercise to High-Intensity Laser Therapy Improves Treatment Effectiveness on Pain and Muscle Strength in Patients with Subacromial Pain Syndrome: A Randomized Trial

Abstract Objective To assess the efficacy of adding exercise to high-intensity laser therapy (HILT) in improving treatment effectiveness for clinical outcomes in patients with subacromial pain syndrome. Methods Thirty patients with subacromial pain syndrome were randomly assigned to the HILT-only group (n=15) or HILT&amp;Exercise group (n=15). The primary outcome was shoulder function and disability. Secondary outcomes were pain, range of motion, proprioception (joint position sense), and muscle strength. Results Shoulder function and disability, pain, range of motion, joint position sense, and some muscle strength improved in both groups (p&lt;0.05). There was no significant time-group interaction for the Constant-Murley Score, Shoulder Pain and Disability Index, rest pain, range of motion, and joint position sense (p&gt;0.05). Time-group showed significant effects for activity pain and strength in favor of the HILT&amp;Exercise group. Middle trapezius, lower trapezius, and supraspinatus strength increased after HILT plus exercise (p&lt;0.05), activity pain, upper trapezius, serratus anterior, and subscapularis strength improved more compared to HILT (p&lt;0.05). Conclusions We found no clinically important differences between HILT and HILT-plus exercise in shoulder function and disability, rest pain, mobility, and proprioception, in patients with subacromial pain syndrome. The addition of exercise to HILT was superior to HILT for improving activity pain and muscle strength.

Transcendental Meditation for Women Affected by Domestic Violence: A Pilot Randomised, Controlled Trial

Abstract Purpose Domestic and family violence is a major public health issue impacting one in three women worldwide. The implications of such violence are considerable. Transcendental Meditation® (TM) represents a promising treatment option for women impacted by domestic violence given its demonstrable effects on mental and trauma-related symptoms. This study set out to compare the effectiveness of TM to group support, on quality of life, perceived stress and mood in female survivors of domestic violence. Methods This 16-week pilot randomised controlled trial recruited women from metropolitan Adelaide, who survived any type of domestic violence in their lifetime. Outcomes included health-related quality of life, severity of depression, anxiety and perceived stress, symptoms of post-traumatic stress disorder, and subjective experience. Data were analysed by intention-to-treat using linear mixed-effects models. Results Forty-two women were randomly assigned to the TM (n = 21) and support (n = 21) groups. Adjusting for random effects, TM was shown to be significantly more effective than support at improving Australian Quality of Life (AQoL-8D) utility scores (p = .011), and Depression Anxiety and Stress Scale (DASS-21) severity scores for depression (p = .029), anxiety (p = .017) and stress (p = .021) over the 16 weeks. There was no statistically significant time-group interaction effect for PTSD Checklist for DSM-5 (PCL-5) total symptom severity scores. Conclusions TM is shown to have promising effects on quality of life, perceived stress and mood among women exposed to domestic violence, suggesting that it may represent an effective alternative to group support. Trial Registration ACTRN12620000467932 (09/04/2020).

Feasibility and effects of cognitive–motor exergames on fall risk factors in typical and atypical Parkinson’s inpatients: a randomized controlled pilot study

BackgroundPeople with Parkinson`s disease (PD) often suffer from both motor and cognitive impairments. Simultaneous motor and cognitive training stimulates neurobiological processes which are important especially for people with PD. The aim of this study is to test the feasibility and effects of simultaneous cognitive–motor training in form of exergames in the setting of inpatient rehabilitation of persons with PD.MethodsForty participants (72.4 ± 9.54 years; Hoehn and Yahr stage 1–4) were randomly assigned to either the intervention group, which trained five times a week in addition to the conventional rehabilitation program, or the control group, which underwent the standard rehabilitation treatment only. Primary outcome was feasibility (measured by adherence rate, attrition rate, occurrence of adverse events, system usability scale (SUS), and NASA TLX score). In addition, various cognitive (Go/No-Go test, reaction time test (RTT), color word interference test (D-KEFS) and Trail Making Test A and B (TMT)) and motor (preferred gait speed, maximum gait speed, dual-task gait speed, Short Physical Performance Battery (SPPB), Timed Up and Go (TUG) and 5 times Sit-to-Stand (5xStS)) tests were conducted before and after the intervention phase in order to determine training effectsResultsAdherence rate was 97%, there were just two dropouts due to reasons unrelated to the study and there were no adverse events. The mean NASA TLX value was 56.2 and the mean value of the SUS was 76.7. Significant time–group interaction effects were observed for the 5xStS, the SPPB, the RTT, the Go/No-Go test and the D-KEFS 2.DiscussionExergaming, as applied in this study, showed to be feasible, safe and likely effective for the improvement of cognitive and motor functions of PD inpatients. Because of this future randomized controlled trials with a main focus on testing the efficacy of this new intervention are warranted.Trial registration: The study has been registered at ClinicalTrials.gov (ID: NCT04872153).

Effects of Exercise Frequency with Complex Contrast Training on Measures of Physical Fitness in Active Adult Males.

Complex contrast training (CCT) is an exercise modality that utilizes both high-load resistance activity and low-load plyometric activity in a set-by-set fashion within a single exercise session. Such a combination of exercises targets multiple aspects of the force−velocity curve and may thus lead to improvement of various components of physical fitness. However, no previous study has attempted to compare the effects of load-equated two vs. three CCT sessions per week on measures of physical fitness. Forty-five male participants aged 21.4 ± 2.0 years were randomly assigned to either two weekly CCT sessions (CCT-2; n = 15), three weekly CCT sessions (CCT-3; n = 15), or an active control group (CG; n = 15). Selected measures of physical fitness were assessed pre- and post-six weeks of training. The tests included the assessment of 15 and 30 m linear sprint speeds, upper (medicine ball throw) and lower limb muscle power (standing long jump and countermovement jump with arm thrust), muscle strength (isokinetic peak knee extensor/flexor torque), and change-of-direction speed (modified agility T-test (MAT)). Significant group−time interactions were observed for all dependent variables (all p < 0.001, ɳp2 = 0.51−0.78) using ANOVA. Post hoc tests indicated significant performance improvements for the CCT-2 and CCT3 groups for all dependent variables (Hedge’s g = 0.28−3.26, %Δ = 2.4−16.7), including the 15 and 30 m linear sprint speeds (p < 0.001), medicine ball throw (p < 0.001), standing long jump (p < 0.001), countermovement jump with arm thrust (p < 0.001), right leg knee extensor (p < 0.001) and flexor peak torque (p < 0.001), left leg knee extensor (p < 0.001) and flexor peak torque (p < 0.001), and change-of-direction speed (p < 0.001). The CCT-3 group showed greater improvements in MAT compared to the CCT-2 group (g = 3.26 vs. 0.70, p < 0.001). In conclusion, compared to active controls, the load-equated CCT-2 and CCT-3 programs provided similar effects on measures of physical fitness in active adult males. However, an athlete’s goal is to improve their MAT score, the CCT-3 program may elicit greater improvements compared with the CCT-2 program.

Change of Direction Ability as a Sensitive Marker of Adaptation to Different Training Configurations, and Different Populations: Results from Four Experiments.

This article includes four separate experiments. In the first experiment male beach handball players (n = 24) were randomly assigned to regular training (n = 12) or plyometric and sprint training (n = 12). In the second experiment, male players were assigned to a handball practice only (n = 12), a plyometric training (n = 12), or an eccentric-overload (e.g., versa-pulley machine) training group (n = 12). In the third experiment, participants were assigned to padel training (n = 12) or specific on-court neuromuscular technical actions (n = 12). In the fourth experiment, females between 50-59 years (n = 25), 60-64 years (n = 25), and 65-70 years (n = 25) completed 10 weeks of bench stepping training involving jumps, and were compared to age-matched controls (n = 45). The COD ability was assessed with the 10-m COD ability test (experiments one and two), the COD ability test with 90º and 180º turns (third experiment), and with the timed-up-and-go test (fourth experiment). In experiment one, greater COD improvement was noted in the experimental group compared to the control group (p < 0.05). In experiment two, both intervention groups similarly improved COD when compared to the control group (p < 0.05). In experiment three, although no significant group-time interactions were observed for COD, the experimental group improved all COD measures pre-post-training (p < 0.05), with a larger effect size for COD with 180° turn to the right compared to the control group (effect size = 0.8 vs. 0.3). In experiment four, the three training groups improved COD ability compared to the control group (p < 0.05). In conclusion, COD is a sensitive marker of adaptation to different training configurations in these diverse groups.