Experimental before-after design.
The objectives of this study were to explore the effects of local cooling rates on perfusion of sacral skin under externally applied pressure in people with spinal ...cord injury (SCI).
Research laboratory.
Seventeen participants, including seven wheelchair users with SCI and ten able-bodied (AB) controls. Each participant underwent seven protocols, including pressure (60 mmHg) with local cooling (∆t = -10 °C) for 20 min at three cooling rates (-0.5, -4, -10 °C/min), pressure with local cooling for 40 min, pressure with local heating (∆t = +10 °C), local cooling without pressure, and pressure without temperature changes. Each protocol included a 10-min baseline, a 20-min (or 40-min) loading period and a 20-min recovery. A compound sensor head consisting of laser Doppler and heating and cooling probes was used to measure sacral skin blood flow and temperature in the prone position. Blood flow responses were characterized by peak blood flow, recovery time, and total blood flow in the recovery period.
The results demonstrated that the cooling rate at -10 °C/min resulted in smaller skin blood flow response compared with -0.5 °C/min (p < 0.05) but were not significantly different to the cooling rate at -4 °C/min. There was a significant difference in the recovery time between the 20-min cooling compared with the 40-min cooling for the SCI group (p < 0.05).
Our findings provide initial evidence that local cooling rates affect skin blood flow responses under externally applied pressure in people with SCI.
The objectives were to investigate whether cupping therapy improves muscle quality and the interaction between duration and negative pressure of cupping therapy affects muscle quality. A 2×2 ...factorial design with repeated measures was used to examine the efficacy of cupping therapy on improving muscle quality. The independent factors were cupping pressures at -225 and -300 mmHg and cupping durations at 5 and 10 min, and the dependent factor was texture of B-mode ultrasound image of the triceps. Four cupping protocols were applied to 12 participants at 4 different days. Texture analysis including contrast, correlation, energy, and homogeneity was applied to assess muscle quality from 480 ultrasound images. The two-way repeated measures ANOVA showed that there was an interaction between the pressure and duration factors on the superficial layer of the triceps in contrast (F = 5.434, P = 0.004) and correlation (F = 6.274, P = 0.029). In contrast texture, the superficial layer of the triceps showed a significant increase in three protocols: -225 mmHg for 5 min (1.0434 ± 0.130), -300 mmHg for 5 min (1.0339 ±0.1407), and -300 mmHg for 10 min (1.0563 ±0.1432) except -225 mmHg for 10 min (0.9704 ±0.0985). In correlation texture, the superficial layer of the triceps showed a significant decrease in all protocols: -225 mmHg for 5 min (0.9556 ± 0.07), -225 mmHg for 10 min (0.9831 ± 0.0708), -300 mmHg for 5 min (0.9976 ± 0.055), and -300 mmHg for 10 min (0.9406 ± 0.0809). The results indicate that the interaction between the pressure and duration factors of cupping therapy significantly increases contrast texture and significantly decreases correlation texture of the superficial layer of the triceps after cupping therapy. Cupping therapy decreases homogeneity among soft tissues of the treated muscle.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Background
The purpose of this study was to use laser Doppler flowmetry (LDF) with wavelet analysis to investigate skin blood flow control mechanisms in response to various intensities of cupping ...therapy. To the best of our knowledge, this is the first study to assess skin blood flow control mechanism in response to cupping therapy using wavelet analysis of laser Doppler blood flow oscillations.
Materials and Methods
Twelve healthy participants were recruited for this repeated‐measures study. Three different intensities of cupping therapy were applied using 3 cup sizes at 35, 40, and 45 mm (in diameter) with 300 mm Hg negative pressure for 5 minutes. LDF was used to measure skin blood flow (SBF) on the triceps before and after cupping therapy. Wavelet analysis was used to analyze the blood flow oscillations (BFO) to assess blood flow control mechanisms.
Results
The wavelet amplitudes of metabolic and cardiac controls after cupping therapy were higher than those before cupping therapy. For the metabolic control, the 45‐mm cupping protocol (1.65 ± 0.09) was significantly higher than the 40‐mm cupping protocol (1.40 ± 0.10, P < .05) and the 35‐mm cupping protocol (1.35 ± 0.12, P < .05). No differences were showed in the cardiac control among the 35‐mm (1.61 ± 0.20), 40‐mm (1.64 ± 0.24), and 45‐mm (1.27 ± 0.25) cupping protocols.
Conclusion
The metabolic and cardiac controls significantly contributed to the increase in SBF after cupping therapy. Different intensities of cupping therapy caused different responses within the metabolic control and not the cardiac control.
•Skin blood flow oscillations have been assessed using wavelet transform.•Five characteristics frequencies are observed between 0.0095 and 2 Hz.•Time-series skin blood flow oscillations can be ...converted to 2-D time–frequency images for classification.•CNN-based deep learning can be used to detect changes in skin blood flow in people with spinal cord injury with active and sedentary lifestyles.
Skin blood flow (SBF) has been assessed using the time domain and time–frequency domain methods. However, these methods require prior knowledge of selecting appropriate parameters for characterizing SBF responses. Deep learning has been successful on classification of medical images, and could be a promising tool for assessing SBF in various pathophysiological conditions. In this study, we proposed a deep learning-based framework for converting 1-dimensional time-series SBF into 2-dimensional time–frequency SBF for convolutional neural networks (CNNs). Thirty-seven participants were recruited into this study, including 21 people with spinal cord injury (SCI) and 16 healthy able-bodied controls. Laser Doppler flowmetry was used to measure sacral SBF. Continuous wavelet transform was used to obtain time–frequency representations of SBF. The whole frequency (WF, 0.0095–2 Hz), high frequency (HF, 0.138–2 Hz), and low frequency (LF, 0.0095–0.138 Hz) regions of the wavelet amplitudes were partitioned into the nonoverlapping patches. Four CNNs including AlexNet, Vgg-19, GoogLeNet, and ResNet-18 were employed to classify the patches. The results showed that the time-domain biphasic thermal index could not differentiate SBF in all groups. Time-frequency wavelet analysis showed differences in myogenic and cardiac controls between people with SCI who were active and sedentary (p < 0.01). CNNs results showed that all participants could be correctly classified based on the WF patches (100% of accuracy) compared to the HF (50–100%) and LF (66.7–100%) patches and five individual oscillation components (50–57.1%). Our study demonstrated that the classifiers could detect subtle changes in SBF function that cannot be revealed by the traditional methods.
The electric stair-climbing wheelchair is a beneficial mobile assistance device for older adults and disabled persons with poor walking ability, as it reduces the daily walking and climbing burden. ...In this paper, 11 older adults were tested when using a stair-climbing wheelchair in three environments: flat ground, slopes, and stairs. The kinematic and dynamic parameters of the lower limb joints were simulated by AnyBody 7.2 human model simulation software using Vicon 3D infrared motion capture, a 3D force table, and analyzed by ANSYS 19.2 Workbench. The joint force, joint moment, and muscle strength did not change significantly under the three environments when using the wheelchair. Through finite element analysis of the mechanical properties of the human body, when using the wheelchair, no significant differences in the overall stress distributions of the fifth lumbar spine, hip bone, or femur were found among the three environments, no significant differences in deformation and displacement were found, and the stress distribution was relatively stable. Therefore, the human body is stable enough to use the electric stair-climbing wheelchair in the three test environments, all of which will be commonly encountered in daily life.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Cupping therapy has been widely used to manage musculoskeletal impairment. However, the effects of pressure and duration of cupping therapy on the hemodynamic activity of the muscle have not been ...investigated. A 2 × 2 repeated measures factorial design was used to examine the main effect and interaction of pressure (−225 and −300 mmHg) and duration (5 and 10 min) on biceps muscle blood flow using near‐infrared spectroscopy in 18 participants. The results showed that a significant interaction is between pressure and duration on deoxy‐hemoglobin (p = 0.045). A significant main effect of pressure is on oxyhemoglobin (p = 0.005) and a significant main effect of duration is on oxyhemoglobin (p = 0.005). Cupping therapy at −300 mmHg for 10 min results in a higher oxyhemoglobin (6.75 ± 2.08 μM) and deoxy‐hemoglobin (1.71 ± 0.78 μM) compared to other three combinations. Our study provides first evidence that the pressure and duration factors of cupping therapy can significantly affect muscle blood volume and oxygenation.
A multi‐channel near‐infrared spectroscopy was used to assess the effect of pressure and duration of cupping therapy on muscle hemodynamic responses. A significant main effect of pressure and duration of cupping therapy on oxyhemoglobin was observed. Our study provides first evidence that the pressure and duration factors of cupping therapy can significantly affect muscle blood volume and oxygenation.
Visual guided motor imagery (MI) is commonly used in stroke rehabilitation, eliciting event-related desynchronization (ERD) in EEG. Previous studies found that immersion level and visuo-tactile ...stimulation could modulate ERD during visual guided MI, and both of two factors could also improve sense of ownership (SOO) over target limb (or body). Additionally, the relationship was also reported between the performance of MI and SOO. This study aims to investigate whether immersion and visuo-tactile stimulation affect visual guided MI through the SOO over virtual body in stroke patients. Nineteen stroke patients were recruited. The experiment included two phases (i.e., SOO induction and visual guided MI with SOO) that was manipulated across four conditions in a within-subject design: <inline-formula> <tex-math notation="LaTeX">{2}\times {2} </tex-math></inline-formula>, i.e., immersion (VR, 2D monitor display) <inline-formula> <tex-math notation="LaTeX">\times </tex-math></inline-formula> multisensory stimulation (visuo-tactile stimulation, observation without tactile stimulation). Results found peaks ERD amplitude during MI were significantly higher in stronger SOO conditions than weaker SOO conditions. Interestingly, the ERD during visual guided MI under the condition of vision only in VR and visuo-tactile stimulation in 2D monitor are similar, which indicates that SOO may be an important factor behind this phenomenon (due to the similar SOO between these two conditions). A moderate correlation was also found between SOO scores and peaks ERD amplitude during MI. This study discussed the possible factor underlying the effects of immersion and multisensory stimulation on visual guided MI in post-stroke patients, identifying the effect of SOO in this process, and could be referred in future studies for coming up with better MI paradigms for stroke rehabilitation.
ABSTRACTThe objectives of this study were to examine the effectiveness of different types of exercise on risk factors of diabetic foot ulcers, including glycated hemoglobin, peripheral arterial ...disease, and diabetic peripheral neuropathy, in people with type 2 diabetes mellitus. PubMed, Web of Science, Cochrane Library, Scopus, and CINAHL were searched from inception to January 2018 for relevant articles. Eligible studies were randomized controlled trials that examined effects of exercise on the selected risk factors. Twenty randomized controlled trials with 1357 participants were included in the meta-analyses. The differences in postintervention values of glycated hemoglobin and ankle brachial index between exercise and control groups were synthesized, yielding mean differences of −0.45% (P < 0.00001) and 0.03 (P = 0.002), respectively; the differences in within-group changes in glycated hemoglobin were synthesized, yielding mean differences of −0.19% (P = 0.1), −0.25% (P = 0.0006), and −0.64% (P = 0.006) for aerobic versus resistance, combined versus aerobic, and combined versus resistance exercise, respectively. Exercise has a significant effect on reducing glycated hemoglobin, whereas combined exercise is more effective compared with aerobic or resistance exercise alone. Exercise also improves ankle brachial index. However, evidence regarding the association between exercise and peripheral neuropathy and risks of diabetic foot ulcers in people with type 2 diabetes mellitus remains insufficient.
OBJECTIVECupping therapy may reduce muscle stiffness for managing fatigue. However, there is no scientific evidence showing changes of muscle stiffness after cupping therapy. Furthermore, it is ...unclear whether the cup size of cupping therapy affects the change of muscle stiffness. The objective of this study was to compare the effect of cup size of cupping therapy on muscle stiffness.
DESIGNA repeated measures design with a counterbalanced design was used to test three cup sizes (45, 40, and 35 mm in inner diameter) in 12 healthy participants. Strain elastography was used to measure stiffness of the triceps before and after cupping therapy at 300 mmHg for 5 minutes. Strain elastogram was converted to the grayscale for the quantification of stiffness.
RESULTSThe overall stiffness of triceps significantly reduced after cupping therapy with the 45-mm (106.2±7.7, p<0.05) and 40-mm (109.6±7.1, p<0.05) cups, but not the 35-mm cup (115.5±10.3, non-significant) compared to before cupping (115.8±13.5). The stiffness of superficial layer did not show significantly difference in all three sizes of cup. The stiffness of deep layer significantly reduced after the cupping therapy with the 45-mm and 40-mm cups.
CONCLUSIONSThis is the first study demonstrating that cupping therapy significantly reduced muscle stiffness, especially at the deep layer.
The purpose of this study was to predict and visualize pressure ulcer risks by using a novel approach of extracting computational features from seating interface pressures in people with spinal cord ...injury (SCI). In conventional clinical practice, seating interface pressure assessments rely on descriptive statistics of pressure magnitude. In this study, rank-2 nonnegative matrix factorization (NMF) was applied to the seating interface pressure maps during loading and pressure-relieving conditions in 16 people with SCI. The NMF basis images were used for visual interpretation and computational prediction of pressure ulcer risks. The two NMF basis images encapsulated pressure concentration and pressure dispersion, respectively. The first basis converged on the ischial tuberosity under both seating conditions, whereas the second basis converged anterior to the ischial tuberosity during loading and converged on the coccyx during unloading. The classification yielded 81.25% overall accuracy. In general, higher ulceration risk was associated with higher and lower activations of the first and second bases, respectively. The NMF pipeline yielded promising performance. Basis visualization affirmed the importance of lower ischial pressure and higher distribution dispersion while also revealing that clinical practice may currently be underestimating the importance of coccygeal pressure in response to pressure-relieving activities.
Graphical abstract
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