Search

Paretic side collisions frequently occur in stroke patients, especially while walking through narrow spaces. We determined whether training for walking through an opening (T-WTO) while entering from the paretic side would improve collision avoidance behavior and prevent falls after 6 months. Thirty-eight adults with moderate-to-mild hemiparetic gait after stroke who were hospitalized in a rehabilitation setting were randomly allocated to the T-WTO (n = 20) or regular rehabilitation (R-Control; n = 18) program. Both groups received five sessions of 40 min per week, for three weeks total. T-WTO included walking through openings of various widths while rotating with the paretic side in front, and R-Control involved normal walking without body rotation. Obstacle avoidance ability, 10-m walking test, timed Up and Go test, Berg Balance Scale, Activities-specific Balance Confidence, the perceptual judgment of passability, and fall incidence were assessed. Collision rate and time to passage of the opening in obstacle avoidance task significantly improved in the T-WTO group compared with those in the R-Control group. Contrast, T-WTO did not lead to significant improvements in other outcomes. T-WTO improved efficiency and safety in managing subacute stroke patients. Such training could improve patient outcomes/safety because of the paretic body side during walking. R000038375 UMIN000033926 Individuals with stroke often collide with the paretic side while walking through narrow spaces. Training for walking through a narrow opening from the paretic side improved an individual's ability to avoid obstacles in similar tasks. Moreover, such training could improve patient outcomes/safety because such interventions may temporarily increase attentional focus to the paretic side in specific tasks. [ABSTRACT FROM AUTHOR]

Background: There is insufficient study using Kinesio taping (KT) in bladder problems. Objectives: To investigate the effects of pelvic floor muscle training (PFMT) combined with KT on bladder symptoms, pelvic floor muscle strength, and quality of life in women with overactive bladder (OAB) syndrome and compare this combination with PFMT plus sham tape (ST). Methods: Women with OAB were randomly allocated into PFMT+KT and PFMT+ST groups. All patients were given PFMT for 6 weeks and applied taping according to groups. Before and after treatment, the OAB symptoms with the Overactive Bladder Assessment Form (OAB-V8) and Patients' Perception of Intensity of Urgency Scale (PPIUS), bladder function with a 3-day voiding diary, pelvic floor muscle strength with the Modified Oxford Scale, and quality of life with the King's Health Questionnaire (KHQ) were assessed. Results: OAB-V8, PPIUS, and KHQ scores decreased and the MOS improved in both groups (P <.05) after treatment. The intergroup comparisons revealed a further decrease in voids/day, voids/night, incontinence episodes/day, and personal limitation scores of the KHQ in the PFMT+KT group compared to the PFMT+ST group (P <.05). Conclusion: PFMT+KT was more effective in reducing the OAB symptoms compared to PFMT+ST. KT could be a complementary application for reducing symptoms in OAB. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to investigate the effect of Wii training on hand function in children with hemiplegic cerebral palsy. Methods: A randomized controlled trial was conducted in 40 children with hemiplegic cerebral palsy (8–12 years). The experimental group received Wii training involving four games for 40 minutes a day, three times a week for 12 weeks plus usual care. The control group received usual care alone. Outcomes were spasticity measured using the modified Ashworth scale, grip strength measured using dynamometry, and hand function measured using the Peabody developmental motor scale (2nd ed.). Outcomes were measured at baseline and after 12 weeks of intervention. Results: Spasticity in the experimental group decreased by 0.4 out of 4.0 (95% CI 0.1 to 0.8) more than the control group by 12 weeks. Power grip strength increased by 1.6 kg (95% CI 0.7 to 2.5) and pinch grip strength by 1.2 kg (95% CI 0.8 to 1.6) more than the control group by 12 weeks. Hand function increased by 6 out of 52 (95% CI 5 to 7) more than the control group by 12 weeks. Conclusion: Wii training plus usual care decreases spasticity and increases grip strength and hand function in children with hemiplegic cerebral palsy. [ABSTRACT FROM AUTHOR]

Background: Evaluation of clinical skills is critically important for nursing students. However, the quality of evaluation tools is poor. Objectives: To evaluate the effectiveness of Direct Observation of Procedural Skills (DOPS) and Mini-Clinical Evaluation Exercise (Mini-CEX) on clinical skills of nursing students. Methods: This study was conducted among 108 senior nursing students. Mini-CEX and DOPS were utilized to evaluate clinical skills in the intervention group. Results: The mean of students' scores in all of the five procedures was significantly higher in the intervention group compared to control group.. Students' scores for the procedures significantly raised through the first stage of DOPS and Mini-CEX to the third stage. Conclusions: Utilization of DOPS and Mini-CEX for evaluation of clinical skills in nursing students effectively enhance their learning ability. Implementing of such assessment methods lead to promoting clinical skills of students which eventually help them to provide high quality care for their patients. [ABSTRACT FROM AUTHOR]

Objectives. The objectives of this study were to determine the efficacy and safety of aripiprazole for treatment of psychosis, retention and abstinence in patients with methamphetamine dependence. Methods. This was a double-blind study where 37 methamphetamine dependent patients with history of psychosis were randomly assigned to receive aripiprazole (5-10 mg daily, N = 19) or placebo ( N = 18) for 8 weeks. Follow-up evaluation was scheduled on day 7, 14, 28, 42 day 56 after enrolment. Results. Participants on aripiprazole were retained significantly longer in treatment (48.7 days, SD =4.0) compared to placebo (37.1 days, SD =5.0). The Kaplan-Meier survival analysis showed that participants on aripiprazole were less likely to drop out of the study than the placebo group ( P =0.02, χ2 =5.3). Psychotic symptoms significantly decreased among those on aripiprazole as compared to placebo ( P < 0.05). However, no statistically significance was found between the two groups in maintaining abstinence (generalised estimation equation (GEE) analysis, P = 0.41). No serious adverse events were reported in either group. Conclusion. Aripiprazole was no more effective than placebo in maintaining abstinence from methamphetamine use. However, it facilitated treatment retention and reduced the severity of psychotic symptoms. Aripiprazole was found to be generally safe and well tolerated. [ABSTRACT FROM AUTHOR]

Objective To compare the results of treating chronic dorsal wrist pain with lidocaine (placebo) versus lidocaine/dextrose (dextrose) injection. Methods Of the 98 patients screened, 39 were entered into the trial. Patients were assessed at baseline, 3 and 12 months post-treatment with Patient Rated Wrist Evaluation (PRWE), range of motion, and grip strength. Injections were completed monthly, up to a total of six treatments. Injections to the periscaphoid, and perilunate ligaments, using a peppering technique, for a total of 1 ml at each site, with 1% lidocaine or a mixture of 0.60% lidocaine and 20% dextrose were given. Blinding was done at all stages of the trial for the patient, study coordinator, prolotherapist, patient outcome measures, and statistician. Results Twenty patients were assigned to the dextrose solution, and 19 patients were assigned to the placebo solution. There was no statistically significant difference in the PRWE change scores between the dextrose group and the placebo group (P = 0.483) at 3 months. At 12 months, the adjusted mean reduction in scores was 31.0 for patients treated with dextrose, and 20.9 for those treated with the placebo solution. This difference of 10.1 was a statistically significant effect, with a P-value of 0.043, but is smaller than the minimal clinically important difference of 20 points defined by MacDermid et al. Grip strength and range of motion showed no statistically significant difference between the two treatment groups throughout study. Conclusions Due to the large treatment effect in the placebo group, it was very unlikely with further enrollment that a clinically significant change of greater than 20 on the PRWE would be found and the trial was discontinued. The efficacy of prolotherapy injections with an active agent relative to a control solution, therefore, has not yet been established. Further studies are needed to compare a treatment group with a non-injection group, subcutaneous needle injection, or dry needling. [ABSTRACT FROM AUTHOR]