OBJECTIVE:The purpose of this study was to investigate the effects of virtual reality (VR) on postural control, posture, and kinesiophobia in patients with chronic neck pain (CNP). METHODS:Forty-one participants with CNP were randomly allocated to the VR and control groups. The VR group experienced VR with glasses for 20 minutes and then performed motor control (MC) exercises for 20 minutes. The control group received only MC exercises for 40 minutes. Both groups received 18 sessions over 6 weeks. Computerized dynamic posturography outcomes, including sensory organization test (SOT), limits of stability, and unilateral stance tests, gait speed, forward head posture (FHP), shoulder protraction (SP), cervical lordosis angle, kinesiophobia, and exercise compliance were recorded. RESULTS:The VR group had more effects regarding composite equilibrium (Cohen's d = 1.20) of SOT and kinesiophobia (Cohen's d = -0.96), P < .05). Also, the VR group was more effective in exercise compliance (P < .05). Contrary to these results, the control group was more effective in correcting FHP and SP (Cohen's d > 0.7, P < .05). CONCLUSION:Virtual reality seemed to have an effect on postural control, posture, and kinesiophobia in patients with chronic neck pain.
OBJECTIVES:This study aimed to investigate tibial nerve dynamics during the straight leg raise (SLR) test in patients with lumbar disc herniation (LDH) and the relationship between neurological symptoms and dynamics at the radiating pain-occurring (RPO) angle. METHODS:Participants with LDH were 20 adults (10 males, 10 females, average age of 58.4 years, average body mass index [BMI] of 21.9 kg/m2) who visited the orthopedic clinic between November 2019 and December 2020. The SLR test was performed at 20°, 40°, and the RPO angle for patients with LDH. In healthy participants, the test was performed at 20°, 40°, and the maximum elevation angle. The excursion and strain of the proximal and distal ends of the tibial nerve were compared using ultrasound imaging at each angle. Furthermore, the nerve dynamics at the RPO angle were compared between the LDH groups with and without neurological symptoms. RESULTS:Movement at the proximal and distal ends of the tibial nerves at 20° and 40° leg elevation was smaller in the LDH group than in the healthy group. No significant difference was observed in the amounts of strain at these two angles. In LDH, nerve strain at the RPO angle was lower in the group with neurological symptoms than in the group without. During the SLR test, excursion of the tibial nerve was less in LDH than in healthy participants, suggesting that the sciatic nerve was more strained in LDH. CONCLUSION:Our findings show an association between insufficient tibial nerve strain during SLR and neurological symptoms.
OBJECTIVE:The purpose of this study was to examine brain function activity changes in patients with left basal ganglia ischemic stroke (LBGIS) in order to identify the specific brain regions associated with motor function. METHODS:The study compared 35 patients with LBGIS and 34 healthy control participants (HCs). Functional connectivity density (FCD) was calculated to explore brain functional activity difference between the 2 groups of participants, and receiver operating characteristics (ROC) curve was used to test the specificity of these different regions. Pearson's correlation was employed to evaluate relationships between FCD values and clinical scores. RESULTS:In the LBGIS group, FCD values were increased in the left cerebellum 9 lobe (L_C9), right inferior temporal gyrus (R_ITG), left middle temporal gyrus (L_MTG), and right supplementary motor area (R_SMA) but decreased in the left calcarine sulcus (L_CS), right lingual gyrus (R_LG), right cuneus (R_C), right supramarginal gyrus (R_SG), right inferior frontal gyrus (R_IFG), and left inferior parietal gyrus (L_IPG). ROC curves demonstrated that these designated brain areas alone distinguished between the LBGIS and HC groups with high sensitivity and specificity. In patients with LBGIS, L_C9 and R_SMA displayed significant correlations with the Fugl-Meyer assessment and Barthel index scores. CONCLUSIONS:Patients with LBGIS exhibit changes in the functional activity of multiple brain regions, and L_C9 and R_SMA may be key areas to promote motor function in people with LBGIS.
OBJECTIVE:This study aimed to examine the responsiveness of bridge maneuvers in subjects with low back pain (LBP) with respect to these outcomes. METHODS:One hundred and thirty-nine patients with subacute and chronic LBP participated in a physical therapy program averaging 7.46 sessions of supervised exercises and home exercises to improve lumbar stability. At the beginning of the program and after the last session, participants completed the Oswestry Disability Index (ODI-I) and the Pain Numerical Rating Scale (NRS), and performed Supine Bridge test (SBT), Right Side Bridge Test (RBT), Left Side Bridge Test (LBT), and Prone Bridge Test (PBT). Global perception of effectiveness was measured with a 7-point Global Perceived Effect Questionnaire. RESULTS:The optimal cutoff points were approximately 38.5 seconds for the Prone Bridge Test (PBT), (44% sensitivity; 78% specificity), 29.5 seconds for the RBT (55% sensitivity; 67% specificity), and 142 seconds for the SBT (45% sensitivity; 67% specificity). The areas under curves ranged from 0.56 (SBT) to 0.61 (PBT and RBT). Low to moderate significant relationships (p < .01) among bridge maneuvers, pain and disability (-0.23 to -0.39) and high correlations among each bridge maneuver and each other (0.69-0.81) emerged. CONCLUSION:Although bridge maneuvers were responsive to changes in lumbar stability and correlated significantly with pain and disability, these measures were not sufficiently sensitive or specific at baseline to predict these outcomes.
OBJECTIVE:The purpose of this meta-analysis was to systematically review the effects of acupuncture with letrozole's effect on polycystic ovary syndrome (PCOS) ovulation and pregnancy outcomes. METHODS:We searched 7 electronic databases for clinical studies of acupuncture combined with letrozole for PCOS published until August 31, 2024. Meta-analysis was done using RevMan 5.4, while funnel plot symmetry was evaluated using Stata 16.0. RESULTS:Fifteen randomized controlled trials, encompassing 1311 cases, were included. The meta-analysis revealed that acupuncture combined with letrozole significantly improved the clinical efficacy rate (RR = 1.27, 95% CI [1.17, 1.37], P < .001), pregnancy rate (RR = 1.84, 95% CI [1.59, 2.13], P < .001), ovulation rate [RR = 1.30, 95% CI [1.18, 1.43], P < .001), endometrial thickness (MD = 1.05, 95% CI [0.76, 1.34], P < .00001), serum estradiol levels (MD = 8.34, 95% CI [6.71, 9.96], P < .001) and the rate of A-type endometrium (RR = 2.19, 95% CI [1.35, 3.55], P < .001). Additionally, it significantly reduced the miscarriage rate (RR = 0.20, 95% CI [0.08, 0.51], P < .001), serum luteinizing hormone levels (MD = -2.10, 95% CI [-3.58, -0.62], P < .001), serum testosterone levels (MD for treatment ≤3 menstrual cycles = -0.43, 95% CI [-0.49, -0.37], P < .001; MD for treatment >3 menstrual cycles = -3.06, 95% CI [-5.12, -0.99], P < .001), ovarian volume (MD = -2.21, 95% CI [-2.99, -1.43], P < .001), and TCM syndrome scores (MD = -4.33, 95% CI [-5.43, -3.24], P < .001). Begg's test for publication bias indicated some degree of bias (P ≤ .05). CONCLUSION:Current evidence suggests that acupuncture combined with letrozole may be more effective for PCOS than letrozole alone; however, the quality of this evidence is low, necessitating further high-quality research to confirm these findings. PROTOCOL REGISTRATION:Registered in PROSPERO on August 23 2024 (ID: CRD42024582344) .
