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Postoperative subacute static progressive stretch does not increase the risk of distal lower limb venous thromboembolism

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Chinese Journal of Traumatology 2023年第3期26卷 178-182页

作者： Jun-Kun Zhu Feng-Feng Wu Rui-Feng Yang Fen-Fen Xu Ya-Li Lin Miao-Fang Ye Orthopedics Rehabilitation Department Lishui Central HospitalLishuiZhejiang Province323020China Rehabilitation Department Huzhou Central HospitalHangzhou310020China Orthopedics and Trauma Department Lishui Central HospitalLishuiZhejiang Province323020China

Purpose:Static progressive stretch(SPS)can be applied to treat chronic joint stiffness.However,the impacts of subacute application of SPS to the distal lower limbs,where deep vein thrombosis(DVT)is common,on venous thromboembolism remain unclear.This study aims to explore the risk of venous thromboembolism events following subacute application of SPS.Methods:A retrospective cohort study was conducted on patients diagnosed with DVT following a lower extremity orthopedic surgery before being transferred to the rehabilitation ward from May 2017 to May 2022.Patients with unilateral lower limb comminuted para-articular fractures,transferred to rehabilitation ward for further treatment within 3 weeks after operation,followed up more than 12 weeks since initial manual physiotherapy,and diagnosed DVT by ultrasound before rehabilitation course were included in the study.Patients with polytrauma,without evidence of previous peripheral vascular disease or incompetence,had medication for thrombosis treatment or prophylaxis before the operation,detected with paralysis due to nervous system impairment,infected after operation during the regime,or with acute progression of DVT were excluded.The included patients were randomized to the standard physiotherapy and the SPS integrated groups for observation.Associated DVT and pulmonary embolism data were collected during the physiotherapy course to compare the groups.SSPS 28.0 and GraphPad Prism 9 were used for data processing.Aptherapy(p<0.001).Contingency analysis revealed the pulmonary embolism incidence(OR=0.703)in the SPS group compared to the mean physio

关键词： Trauma Deep vein thrombosis Rehabilitation Musculoskeletal manipulations physical therapy modalities

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A remote,fully oriented personalized program of physical exercise for women in follow-up after breast cancer treatment improves body composition and physical fitness

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Sports Medicine and Health Science 2023年第2期5卷 128-136页

作者： Edipo G.França-Lara Saulo H.Weber Ricardo A.Pinho JoséClaudio Casali-da-Rocha Selene Elifio-Esposito Graduate Program in Health Sciences School of Medicine and Life SciencesPontifícia Universidade Católica do ParanáCuritibaPRBrazil School of Medicine and Life Sciences Pontifícia Universidade Católica do ParanáCuritibaPRBrazil Oncogenetics Department A.C.Camargo Cancer CenterSão PauloSPBrazil Hospital Erasto Gaertner CuritibaPRBrazil

This study aimed to evaluate the efficacy of an individualized remote exercise program on the improvement of body composition and physical fitness of a heterogeneous group of patients who completed breast cancer treatment.This prospective study included 107 women aged 18 to 60,shortly after curative treatment for localized breast cancer,at the Erasto Gaertner Cancer Hospital(HEG)in Curitiba,PR,Brazil.Body composition,maximal oxygen consumption,and muscle resistance were evaluated after nine months of intervention while considering adherence to the program,level of physical activity,presence of binge eating disorder,tumor classification,and treatment type.Seventy-eight women(72.8%)adhered to the training program.Adherent participants showed significant changes in body mass([-4.3±3.6]kg;pphysical exercise programs can improve the body composition and physical fitness of women undergoing post-breast cancer surveillance,regardless of pathological history or treatment.

关键词： Breast neoplasm Exercise training physical therapy modalities Body weight changes physical functional performance

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Clinical research of postoperative comprehensive rehabilitation in treating brachial plexus injuries

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Chinese Medical Journal 2014年第9期127卷 1782-1784页

作者： Xu Xiaojun Zhou Junming Gu Yudong Department of Hand Surgery Huashan Hospital Fudan University Key Laboratory of Hand Reconstruction Ministry of Health Shanghai Key Laboratory of Peripheral Nerve and Microsurgery Shanghai 200040 China

Brachial plexus injury is regarded as one of the most difficult international medical problem. Microsurgery is an advanced technology and has progressed further on the operation, especially on the nerve repair.

关键词： brachial plexus neuropathies physical therapy modalities exercise therapy, nerve regeneration

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Efficacy of therapeutic ultrasound vs sham ultrasound on pain and physical function in people with knee osteoarthritis: A meta-analysis of randomized controlled trials

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World Journal of Meta-Analysis 2014年第3期2卷 78-90页

作者： Norma J Mac Intyre Ahmed Negm Adalberto Loyola-Sánchez Mohit Bhandari School of Rehabilitation Science Mc Master UniversityHamilton Department of Surgery Mc Master UniversityHamilton

AIM: To determine the efficacy of therapeutic ultrasound vs sham for improving pain and physical function immediately post-intervention in people with knee osteoarthritis(OA). METHODS: We hand searched meta-analyses on the topic published in 2010 and updated the search in three electronic databases(MEDLINE, EMBASE, CINAHL) January 1, 2009 to September 5, 2013 to identify relevant studies. The inclusion criteria were human randomized controlled trials published in the English language in which active therapeutic ultrasound was compared tosham ultrasound, data for people with knee OA were reported separately, participants were blinded to treatment allocation and outcomes assessed before and after treatment included pain, self-reported physical function and performance-based physical function. Two reviewers independently screened titles and abstracts retrieved in the search to identify trials suitable for full text review. Data extraction and risk of bias assessment of the identified trials were completed independently by two reviewers. Pooled analyses were conducted using inverse-variance random effects models.RESULTS: We screened 1013 titles and abstracts. Meta-analysis of pain outcomes from 5 small trials(281 participants/OA knees) showed that, compared to sham ultrasound, therapeutic ultrasound improves pain [standardized mean difference(SMD)(95%CI) =-0.39(-0.70--0.08); P = 0.01] but not physical function [self-reported in 3 trials(130 participants/OA knees): SMD(95%CI) =-0.21(-0.55-0.14), P = 0.24; walking performance in 4 trials(130 participants/OA knees): SMD(95%CI) =-0.11(-0.59-0.37), P = 0.65). For the walking performance outcome, the dispersion of the estimated effects exceeded that expected due to sampling error(χ2 = 8.37, P = 0.04, I 2 = 64%). Subgroup analyses of three trials that administered high dose ultrasound improved the consistency(I2 = 28%) but the treatment effect remained insignificant.CONCLUSION: Meta-analyzed double-blind placebocontrolled randomized trials provide low-strength evidence that

关键词： Ultrasonic therapy physical therapy modalities Osteoarthritis Double-blind method Evidence-based medicine

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Effect of supervised exercise on aerobic capacity in cancer survivors: Adherence and workload predict variance in effect

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World Journal of Meta-Analysis 2015年第1期3卷 43-53页

作者： Rhys Beaudry Calvin Kruger Yuan Yuan Liang Matthew Parliament Mark Haykowsky Margaret L Mc Neely Department of physical therapy University of Alberta Edmonton Alberta T6G 2G4 Canada School of Medicine Epidemiology and Biostatistics University of Texas San Antonio TX 78229 United States Margaret L Mc Neely Department of Oncology University of Alberta and Cross Cancer Institute Edmonton Alberta T6G 1Z2 Canada

AIM: To examine the efficacy of supervised aerobic exercise training on aerobic capacity in survivors of cancer.METHODS: We conducted a systematic search identifying randomized controlled trials of supervised aerobic exercise interventions among adult cancer survivors with aerobic capacity(VO2max/peak) as the primary outcome. We calculated pooled effect sizes and performed multiple regression moderator analysis. RESULTS: We identified 18 studies including 1149 survivors of cancer. Studies included mixed cancer groups(4 studies), breast cancer(10 studies), hematological cancers(2 studies), lung cancer(1 study) and liver cancer(1 study). Survivors of cancer who participated in supervised aerobic exercise training improved aerobic capacity(VO2peak) more than controls(18 comparisons, 1093 participants; standardized mean effect: 0.74; 95%CI: 0.52, 0.96; P < 0.001). However, there was significant heterogeneity among the included trials(I2: 63%; P < 0.001). Sixty-six percent of the between-study heterogeneity was explained by differences in exercise adherence and total exercise workload among studies(R2: 65.8%; P < 0.04). CONCLUSION: Supervised aerobic exercise training provides a moderate-to-large beneficial effect on aerobic capacity among survivors of cancer. Aerobic capacity was improved to a greater degree in exercise studies with better participant attendance and higher overall exercise workload.

关键词： Exercise Neoplasms physical therapy modalities physical fitness Meta-analysis

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Addition of hip exercises to treatment of patellofemoral pain syndrome:A meta-analysis

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World Journal of Meta-Analysis 2015年第2期3卷 118-124页

作者： Kimberly M Morelli Maria Carrelli Maria A Nunez Caroline A Smith Gordon L Warren Department of physical therapy Georgia State University

AIM:To determine if the addition of hip-strengthening exercises decreases pain and improves function in patients with patellofemoral pain syndrome.METHODS:The authors completed a systematic reviewsearching eight databases(i.e.,Pub Med,Cochrane,CINHAL,MEDLINE,Sports Discus,EMBASE,APTA Hooked on Evidence,and PEDro).Two independent reviewers screened and excluded studies if they did not meet the following inclusion criteria:subjects had a primary diagnosis of patellofemoral pain syndrome(PFPS),intervention group included hip-strengthening exercises,control group included a traditional physical therapy intervention,study included outcome measures of pain and/or function,study used a randomized controlled trial design,PEDro score was ≥ 7,and study was published in a peer-reviewed journal.Primary outcome measures were subjective scales of pain and function.These measures were converted to standardized mean difference [effect size(ES)],and a random-effects model was used to calculate the overall ES.RESULTS:Two hundred eighty-three studies were screened for inclusion in our meta-analysis.Nine studies were deemed suitable for data extraction and analysis.A total of 426 subjects were used in the nine studies.Overall,there was a significant positive effect of hip-strengthening exercises on measures of pain and function in subjects with PFPS(ES = 0.94,P = 0.00004).None of the individual studies had a negative ES,with study ES ranging from 0.35 to 2.59.Because of the high degree of between-study variance(I2 = 76%;Q = 34.0,P physical therapy produced greater improvements in measures of pain and function.

关键词： Exercise therapy Systematic review Knee joint physical therapy modalities

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Neuromuscular Electrical Stimulation in Intensive Care Unit Patients:Integrative Review

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Modern Research in Inflammation 2019年第2期8卷 11-27页

作者： Miriam Viviane Baron Marcus Vinicius de Mello Pinto Janine Koepp Cristine Brandenburg Paulo Ricardo Martins Amanda Correa dos Santos Daniela Moraes Carolina Goncalves Pinheiro Nathália Ken Pereira Iketani Bartira Ercilia Pinheiro da Costa Nephrology Laboratory Department of Postgraduate of Medicine and Health SciencesSchool of MedicinePontifical Catholic University of Rio Grande do SulPorto AlegreBrazil Celulare Institute Rio de JaneiroBrazil Nursing Course Department of Nursing and DentistryUniversity of Santa Cruz do SulSanta Cruz do SulBrazil Postgraduate Program in Brazilian Education Department of Fundamentals of EducationFederal University of CearáFortalezaBrazil School of Medicine Pontifical Catholic University of Rio Grande do SulPorto AlegreBrazil Physiotherapy Course Department of PhysiotherapyVale do Salgado FacultyIcóBrazil Department of Physiotherapy Dom Luiz I Hospital-Portuguese Beneficent of BelemParaBrazil

Intensive care units’ acquired muscle weakness is present in approximately 50% of the patients. Although active muscle training can attenuate weakness, a large proportion of critical patients cannot participate in any active mobilization. Neuromuscular electrical stimulation may be an alternative strategy to reverse muscle weakness. The objective of the study was to review the scientific publications on the use of neuromuscular electrical stimulation and its parameters and the main results in patients hospitalized in intensive care units. This is an integrative review surveying studies in online databases. The studies were selected from the following descriptors: neuromuscular electrical stimulation AND parameters AND intensive care units AND muscle weakness. The inclusion criteria included articles that addressed the topic of neuromuscular electrical stimulation and the parameters used in patients admitted to intensive care units, aged 18 years or older. Exclusion criteria were studies involving animals, case reports, letters to the editor and book chapters. The search comprised articles in the Portuguese, English and Spanish languages from January 2013 to March 2019. Of the 185 articles identified, nine met the eligibility criteria. The studies were evaluated assessing the level of evidence, and the relevant information was presented in the table and discussed. The parameters of the neuromuscular electrical stimulation employed in the studies showed positive results for the maintenance of strength and muscle mass. There was evidence of benefits in the local and systemic microcirculation, potentially mobilizing endothelial stem cells, to prevent atrophy, to reduce mechanical ventilation time and stay in intensive care unit;and when incorporated into the usual physiotherapy care, proved to be more effective than usual care. Its use is safe and viable in critically ill patients.

关键词： Muscle Weakness Critical Illness Polyneuropathy Sepsis Electric Stimulation therapy physical therapy modalities

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