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ABSTRACT: This study evaluated the effects of interactive video-game based (IVGB) training on the balance of older adults. The participants of the study included 30 community-living persons over the age of 65. The participants were divided into 2 groups. Group A underwent IVGB training for 6 weeks and received no intervention in the following 6 weeks. Group B received no intervention during the first 6 weeks and then participated in training in the following 6 weeks. After IVGB intervention, both groups showed improved balance based on the results from the following tests: the Berg Balance Scale (BBS), Modified Falls Efficacy Scale (MFES), Timed Up and Go (TUG) test, and the Sway Velocity (SV) test (assessing bipedal stance center pressure with eyes open and closed). Results from the Sway Area (SA) test (assessing bipedal stance center pressure with eyes open and closed) revealed a significant improvement in Group B after IVGB training. Group A retained some training effects after 6 weeks without IVGB intervention. Additionally, a moderate association emerged between the Xavix measured step system stepping tests and BBS, MFES, Unipedal Stance test, and TUG test measurements. In conclusion, IVGB training improves balance after 6 weeks of implementation, and the beneficial effects partially remain after training is complete. Further investigation is required to determine if this training is superior to traditional physical therapy.
Gait & posture 11/2012; · 2.58 Impact Factor
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ABSTRACT: AIMS: Diabetic cystopathy is typically manifested as bladder voiding dysfunction, and numerous patients are refractory to standard therapy. In this study, we determined whether electrical stimulation (ES) of the sensory branch of the pudendal nerve could engage an augmenting reflex and thereby improve bladder emptying in a diabetic animal model with cystopathy. METHODS: The efficiency of bladder emptying with ES of the sensory branch of the pudendal nerve at different stimulation intensities was measured in rats at 8 or 18 weeks after the induction of diabetes with streptozotocin. RESULTS: The voiding efficiency (VE) was reduced from 74 ± 4% to 30 ± 8% in rats with diabetes for 8 weeks and from 73 ± 6% to 20 ± 6% in rats with diabetes for 18 weeks. ES at lower intensities (0.025-0.05 mA) applied to the pudendal sensory nerve did not affect the VE in rats with diabetes for 18 weeks but increased the VE in rats with diabetes for 8 weeks. Subsequently, when the stimulation intensity was elevated to 0.1-0.3 mA, the VEs in rats with diabetes for both 8 and 18 weeks increased to 40-50%. CONCLUSIONS: The results of the present study are consistent with the essential role for pudendal sensory feedback in efficient bladder emptying, and electrical activation of the sensory branch of the pudendal nerve was efficient restoring the voiding function in diabetic animals with cystopathy. This could provide an approach to improve bladder emptying in diabetic patients with voiding dysfunction. Neurourol. Urodynam. © 2012 Wiley Periodicals, Inc.
Neurourology and Urodynamics 06/2012; · 2.96 Impact Factor
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ABSTRACT: This study examined the effects of a 5-HT(1A) receptor agonist (8-OH-DPAT) on external urethral sphincter (EUS) activity in urethane-anesthetized rats.
An EUS electromyogram (EMG) and intravesical pressure (IVP) were simultaneously recorded during continuous cystometrographic monitoring, to provide a quantitative evaluation of EUS activity and urethral urodynamics of voiding.
When examining the EUS burst activity, durations of the active (AP) and silent periods (SP) as a function of the time axis, respectively, exhibited concave- and convex-shaped curves. The burst discharges of the EUS-EMG were divided into nonvoiding and voiding burst activities based on the oscillation waves of the IVP, which were located in Phases 1 and 2 of the IVP. After 8-OH-DPAT treatment, the entire burst period in Phases 1 to 2 of the IVP was significantly prolonged. The average SP in both Phases 1 and 2 significantly increased but the average APs were not affected. Urodynamic results showed decreases in the volume threshold, contraction amplitude, and residual volume as well as an increase in the contraction duration. In addition, the amplitude of bladder high-frequency oscillatory waves in the IVP and the average urethral flow rate were reduced, but the entire voiding efficiency increased.
The influences of 8-OH-DPAT on EUS burst activity and urodynamics were exactly detected by the sophisticated EMG analytic design, and the results could be a reference for the pharmacological treatment of patients with lower urinary tract dysfunction.
Journal of the Formosan Medical Association 02/2012; 111(2):67-76. · 1.13 Impact Factor
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ABSTRACT: To determine whether bilateral electrical stimulation (BiES) of the transected pudendal sensory nerves could further enhance the voiding efficiency beyond that produced by unilateral electrical stimulation (UniES) of transected pudendal afferents in rats with urinary retention.
The efficiency of bladder emptying with either UniES or BiES of pudendal nerve afferents was measured after acute bilateral transection of the sensory branch of the pudendal nerve. The effects of UniES and BiES on voiding in a partially denervated bladder and acute spinal transection, respectively, were determined.
The voiding efficiency (VE) was reduced from 69 to 22% after bilateral transection of the sensory branch of the pudendal nerve. UniES or BiES increased the VE to 49-62%. Although in most instances BiES consistently generated more efficient bladder emptying than did UniES, these differences were not significant. Both UniES and BiES increased VE after unilateral pelvic nerve transection, demonstrating efficacy in a partially denervated bladder. The enhancement of VE by either UniES or BiES was preserved after acute T(9)-T(10), demonstrating the spinal origin of this augmenting reflex.
The results of the present study are consistent with an essential role for pudendal sensory feedback in efficient bladder emptying, and unilateral and bilateral electrical activation of pudendal nerve afferents are equally efficient in improving bladder emptying in an animal model of urinary retention. This could provide an approach to improve bladder emptying in patients with non-obstructive urinary retention.
BJU International 08/2011; 109(7):1051-8. · 2.84 Impact Factor
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ABSTRACT: This study investigated the effects of ultrasound (US) at different frequencies on fracture healing over a three-week period in a rabbit fibular fracture model. Forty-five adult New Zealand White rabbits were divided into five groups: a control group and four groups treated with US frequencies of 0.5, 1.0, 1.5 and 2.0 MHz (0.5 W/cm(2), 200-μs burst, pulsed 1:4). After anesthesia, transverse osteotomy was performed on the fibula bone. This was followed by intravital staining and fluorescence microscopic examination of new bone formation and biomechanical tests of torsional stiffness at the osteotomy site. Results showed that total new bone formation and torsional stiffness of the fibula were greater in all US-treated groups than in the control group. No significant difference was found between any of the four US-treated groups. The US treatment also enhanced bone growth of the sham-treated contralateral fracture site. These results suggest that US treatment at 0.5, 1.0, 1.5 or 2.0 MHz can enhance fracture healing in a rabbit model. Furthermore, the effects of US on fracture healing at present parameters might not be confined locally.
Ultrasound in medicine & biology 08/2011; 37(10):1635-43. · 2.02 Impact Factor
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ABSTRACT: To measure the changes in the total and regional body fat mass, and assess the clinical usefulness of the body mass index (BMI) in detecting overweight subjects with sequelae of poliomyelitis.
Prospective, cross-sectional study.
General community.
Subjects with poliomyelitis (n=17; age range, 42-57y; mean, 47y; 12 men, 5 women) and able-bodied people (n=17) matched by sex, age, body weight, and body height participated in the study.
Not applicable.
Total and regional body composition was measured with dual-energy x-ray absorptiometry. Clinical characteristics such as blood pressure, serum biochemical studies, and habitual behaviors (daily cigarette smoking, alcohol consumption, and exercise regimen) of all participants were evaluated.
Compared with able-bodied controls, subjects with poliomyelitis had a 50% greater total body fat mass, significant increases in the regional fat mass in every part of the body, and had the greatest increase of fat mass in the thorax. Nearly all the subjects (94%) with poliomyelitis were obese according to standards of body composition. However, one third of them had a BMI value of less than 25.0kg/m(2).
People with poliomyelitis have a higher prevalence of obesity and a significant increase in total and regional fat mass. Current BMI underestimates the total body fat mass percentage compared with the control; therefore, a population-specific BMI should be used to address the prevalence of obesity in postpolio survivors.
Archives of physical medicine and rehabilitation 07/2011; 92(7):1092-7. · 2.18 Impact Factor
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ABSTRACT: Although serotonergic agents have been used to treat patients with stress urinary incontinence, the characteristics of the external urethral sphincter (EUS) activity activated by 5-HT receptors have not been extensively studied. This study examined the effects of the 5-HT(1A) receptor agonist, 8-hydroxy-2-(di-n-propylamino)tetralin (8-OH-DPAT), on the EUS-electromyography and resistance of the urethra in a rat model with bilateral pudendal nerve injury (BPNI). Two measurements were utilized to assess the effects of the drug on bladder and urethral functions: the simultaneous recordings of transvesical pressure under isovolumetric conditions [isovolumetric intravesical pressure (IVP)] and urethral perfusion pressure, and the simultaneous recordings of IVP during continuously isotonic transvesical infusion with an open urethra (isotonic IVP) and EUS-electromyography. This study also evaluated the urethral continence using leak point pressure testing. The urethral perfusion pressure and leak point pressure measurements of BPNI rats reveal that 8-OH-DPAT significantly increased urethral resistance during the bladder storage phase, yet decreased resistance during the voiding phase. The entire EUS burst period was significantly prolonged, within which the average silent period increased and the frequency of burst discharges decreased. 8-OH-DPAT also improved the voiding efficiency, as evidenced by the detection of decreases in the contraction amplitude and residual volume, with increases in contraction duration and voided volume. These findings suggest that 8-OH-DPAT not only improved continence function, but also elevated the voiding function in a BPNI rat model.
AJP Regulatory Integrative and Comparative Physiology 04/2011; 301(1):R225-35. · 3.34 Impact Factor
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ABSTRACT: The efficacy and tolerability of 500-730 kDa sodium hyaluronate (Hyalgan®) for treatment of osteoarthritis (OA) pain has been established in clinical trials, but few data are available in the Asian population. We conducted a randomized, double-blind, multicenter, placebo-controlled study to evaluate the efficacy and tolerability of this preparation in a Taiwanese population.
Two hundred patients with mild to moderate OA of the knee were randomized to receive five weekly intra-articular injections of sodium hyaluronate or placebo. The primary efficacy outcome was the change from baseline to Week 25 in patients' evaluation of pain using a 100-mm visual analog scale (VAS) during the 50-foot walking test. Additional outcomes included Western Ontario and McMaster Universities (WOMAC) scores, time on the 50-foot walking test, patient's and investigator's subjective assessment of effectiveness, acetaminophen consumption, and the amounts of synovial fluid.
The Hyalgan® treatment group showed a significantly greater improvement from baseline to Week 25 in VAS pain on the 50-foot walking test than the placebo group (p = 0.0020). The Hyalgan® group revealed significant improvements from baseline to week 25 in WOMAC pain and function score than the placebo group (p = 0.005 and 0.0038, respectively) Other outcomes, such as time on the 50-foot walking test and subjective assessment of effectiveness, did not show any significant difference between groups. Both groups were safe and well tolerated.
The present study suggests that five weekly intra-articular injections of sodium hyaluronate are well tolerated, can provide sustained relief of pain, and can improve function in Asian patients with osteoarthritis of the knee.
Therapeutic study, Level I-1a (randomized controlled trial with a significant difference).
BMC Musculoskeletal Disorders 01/2011; 12:221. · 1.58 Impact Factor
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ABSTRACT: It is still unclear whether diabetic mellitus (DM) is associated with rotator cuff lesions. The object of this retrospective study was to compare the ultrasonographic (US) findings of rotator cuffs in diabetic patients with those of nondiabetic patients with chronic shoulder pain. In total, 419 patients (80 diabetic, 339 nondiabetic) who had chronic shoulder pain and had been referred to receive US examination between January 2005 and January 2008 in a medical center were included in this study. The US findings of rotator cuff lesions were classified into two main categories: rotator cuff tears (RCTs) and calcifying tendinopathy (CT). In total, 114 (25.2%) shoulders with CT of the rotator cuff and 160 (35.3%), 15 (3.3%) and 5 (1.1%) shoulders with supraspinatus, infraspinatus and subscapularis tears, respectively, were noted. No difference in the ratio of tears of RCTs was found on US examinations between two groups. The crude odds ratio (OR) for CT of diabetic patients was 1.85 (p = 0.014); however, the adjusted OR for CT in diabetic patients became insignificant after controlling for the other variables (OR = 1.59, p = 0.08). To our knowledge, this is the first study to explore US findings among diabetic and nondiabetic patients with chronic shoulder pain. Further study is advised to confirm our findings.
Ultrasound in medicine & biology 11/2010; 36(11):1792-6. · 2.02 Impact Factor
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ABSTRACT: The effects of low-intensity pulsed ultrasound (LIPUS) on the differentiation of human mesenchymal stem cells (hMSCs) were investigated in this study. hMSCs were subjected to LIPUS with or without dexamethasone/transforming growth factor-beta1 (TD) or bone morphogenetic protein-2 (BMP-2) and the effects of this treatment were assessed. TD-treated hMSCs exhibited characteristic chondrogenic morphology and increased messenger RNA (mRNA) expression of chondrogenic markers and LIPUS enhanced the chondrogenic differentiation of hMSCs treated with TD. The expression of Runx2, an osteogenic transcription factor was not altered in either TD treatment group; however, a significant increase was detected in the LIPUS only group. The osteogenic appearance exhibited 3 days after LIPUS and/or BMP-2 treatment. Increases in the mRNA expression levels of osteogenic markers, Runx2 and ALP were also detected. There was no additive or altered effect with combined LIPUS and BMP-2 treatment. LIPUS alone can increase osteogenic differentiation of hMSCs and LIPUS enhances TD-mediated chondrogenic differentiation of hMSCs. Clinically, LIPUS may differentially influence bone vs. cartilage repair.
Ultrasound in medicine & biology 06/2010; 36(6):1022-33. · 2.02 Impact Factor
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ABSTRACT: To determine whether bone mineral density loss after spinal cord injury can be attenuated by an early intervention with functional electrical stimulation cycling exercises (FESCE) and to ascertain whether the effect persists after FESCE is discontinued.
A prospective study.
Twenty-four individuals with spinal cord injury, 26-52 days after spinal cord injury, were divided into FESCE or control groups.
FESCE was applied in the initial 3 months and then suspended in the subsequent 3 months. Bone mineral density in the femoral neck and distal femur was measured using dual energy X-ray absorptiometry before training, immediately after the initial 3 months of training, and at the end of the subsequent 3 months.
The bone mineral density decrease rate in the distal femur in the FESCE group was significantly less than that in the control group during the initial 3 months. However, there was no significant difference in the subsequent 3 months.
FESCE in the early stages of spinal cord injury can partly attenuate bone mineral density loss in the distal femur. However, bone mineral density loss in the distal femur cannot be ameliorated completely by FESCE. In addition, the effect on the attenuation of bone loss in the distal femur faded once FESCE was discontinued.
Journal of rehabilitation medicine: official journal of the UEMS European Board of Physical and Rehabilitation Medicine 02/2010; 42(2):150-4. · 1.88 Impact Factor
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ABSTRACT: This study attempted to use the eyesight range to quantify presyncope symptoms (PS), assess the relation between angle of head-up tilt, severity of injury on the American Spinal Injury Association (ASIA) scale, and PS on physiological signals, and determine the notable signals that represent PS in spinal cord injury (SCI) patients. Thirty-eight quadriplegic SCI subjects were recruited, in which the mean blood pressure (MBP), oxygen saturation (SpO(2)), heart rate (HR), and the low-frequency/high-frequency (LF/HF) ratio of the HR variability were measured during tilting up of the head. The SpO(2) and LF/HF differed significantly with the level of PS. These findings of the studied variables suggest that SpO(2) and LF/HF are the physiological signals that are most sensitive to detect in PS, and could be used for the optimal biofeedback design of tilt-table training systems aimed at overcoming posture hypotension in SCI patients.
Medical & Biological Engineering 08/2008; 46(7):681-8. · 1.76 Impact Factor
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ABSTRACT: The purpose of this study was to develop a biofeedback tilt-table for automatic tilt-table training, helping patients with spinal cord injury (SCI) to recover more rapidly from orthostatic hypotension, and increasing safety to avoid syncope during training. This biofeedback tilt-table implemented automatic training maneuvers and included three closed feedback loops to monitor the acquisition of physiological signals from patients and the feedback of presyncope symptoms (PS) to regulate the angle of tilt. The results of clinical testing revealed that the mean blood pressure and oxygen saturation represented the most useful physiological signals for determining PS feedback and the quantitative criteria adopted were practicable and useful in describing the level of PS. This novel biofeedback tilt-table system offered higher patient throughput, faster training and safety in training of SCI patients to overcome their orthostatic hypotension than traditional tilt-table training, and could provide quantitative information of PS to assist medical staff in studying the mechanism of orthostatic syncope.
Medical & Biological Engineering & Computing 01/2008; 45(12):1223-8. · 1.88 Impact Factor
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ABSTRACT: The crystal structure of the particulate methane monooxygenase (pMMO) from Methylococcus capsulatus (Bath) has been reported recently [Lieberman, R. L., and Rosenzweig, A. C. (2005) Crystal structure of a membrane-bound metalloenzyme that catalyses the biological oxidation of methane, Nature 434, 177-182]. Subsequent work has shown that the preparation on which the X-ray analysis is based might be missing many of the important metal cofactors, including the putative trinuclear copper cluster at the active site as well as ca. 10 copper ions (E-clusters) that have been proposed to serve as a buffer of reducing equivalents to re-reduce the copper atoms at the active site following the catalytic chemistry [Chan, S. I., Wang, V. C.-C., Lai, J. C.-H., Yu, S. S.-F., Chen, P. P.-Y., Chen, K. H.-C., Chen, C.-L., and Chan, M. K. (2007) Redox potentiometry studies of particulate methane monooxygenase: Support for a trinuclear copper cluster active site, Angew. Chem., Int. Ed. 46, 1992-1994]. Since the aqueous-exposed domains of the 45 kDa subunit (PmoB) have been suggested to be the putative binding domains for the E-cluster copper ions, we have cloned and overexpressed in Escherichia coli the two aqueous-exposed subdomains toward the N- and C-termini of the subunit: the N-terminal subdomain (residues 54-178) and the C-terminal subdomain (residues 257-394 and 282-414). The recombinant C-terminal water-exposed subdomain is shown to behave like a Cu(I) sponge, taking up to ca. 10 Cu(I) ions cooperatively when cupric ions are added to the protein fragment in the presence of dithiothreitol or ascorbate. In addition, circular dichroism measurements reveal that the C-terminal subdomain folds into a beta-sheet structure in the presence of Cu(I). The propensity for the C-terminal subdomain to bind Cu(I) is consistent with the high redox potential(s) determined for the E-cluster copper ions in the pMMO. These properties of the E-clusters are in accordance with the function proposed for these copper ions in the turnover cycle of the enzyme.
Biochemistry 01/2008; 46(48):13762-74. · 3.42 Impact Factor
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ABSTRACT: To assess the change in bone mineral density (BMD) after spinal cord injury (SCI) and to evaluate whether BMD loss can be reversed with the intervention of functional electric stimulation cycling exercises (FESCE).
Fifteen males with SCI were included. Fifteen able-bodied males were also tested to compare BMD. In the SCI group, the FESCE was performed for six months, and then was discontinued in the subsequent six months. BMD was performed before the FESCE, immediately after six months of the FESCE, and at the end of the subsequent six months.
Before the FESCE, the BMD of the SCI subjects in every site, except the lumbar spine, was lower than that of the able-bodied subjects. After six months of FESCE, BMD of the distal femur (DF) and proximal tibia (PT) increased significantly, and BMD of the calcaneus (heel) showed a trend of increase. However, the BMD in the DF, PT, and heel decreased significantly after the subsequent six months without FESCE. The BMD of the femoral neck (FN) decreased progressively throughout the programme.
Our study showed site-specific BMD changes after FESCE. The BMD loss in the DF and PT was partially reversed after six months of FESCE, but the effect faded once the exercise was discontinued.
Disability and Rehabilitation 12/2005; 27(22):1337-41. · 1.50 Impact Factor
