ObjectiveTo investigate the mediating effect of life satisfaction between physical exercise behavior and depressive symptoms among middle-aged and elderly individuals, providing a reference for improving depressive conditions in this demographic group.MethodsData from 11,101 middle-aged and elderly individuals from the 2020 China Family Panel Studies (CFPS) were collected. STATA 17.0 was used for data cleaning, organization, and statistical analysis which includes univariate analysis, stepwise regression analysis, and mediation effect testing.ResultsAmong 11,101 individuals aged 45 years and above, 2,272 participated in physical exercise, accounting for 20.47%; 2,052 exhibited depressive symptoms, representing 18.48%. Physical exercise was positively correlated with life satisfaction and negatively correlated with depression. Depression scores also showed a negative correlation with life satisfaction. According to the results of the mediation effect study, life satisfaction accounted for 16.60% of the overall effect and had a mediating effect value of −0.099 on depression symptoms.ConclusionPhysical exercise and life satisfaction are factors influencing depressive symptoms, and life satisfaction acts as a partial mediator between physical exercise participation and depression among middle-aged and elderly adults.

Background:Post-stroke shoulder-hand syndrome (SHS) significantly impacts patients' quality of life and functional recovery. While both acupuncture and rehabilitation training have shown promise individually, their combined effect needs systematic evaluation. Methods:A comprehensive search was conducted across seven databases (PubMed, Embase, Cochrane Library, Web of Science, Sinomed, CNKI, and Wanfang) for randomized controlled trials comparing combined acupuncture-moxibustion-rehabilitation therapy vs. rehabilitation alone. The primary outcomes included Fugl-Meyer Assessment (FMA) scale, visual analog scale (VAS), and Barthel Index (BI) scores. Risk of bias was assessed using the Cochrane tool. Results:Twenty-seven randomized controlled trials involving 2,175 participants were included. Meta-analysis showed significant improvements in the combination therapy group compared to rehabilitation alone: VAS score (SMD = 1.62, 95% CI: 1.19-2.06), FMA scale (SMD = 1.78, 95% CI: 1.41-2.15), and BI/MBI scores (SMD = 1.01, 95% CI: 0.48-1.54). The combination therapy also showed superior effects on swelling reduction (SMD = -1.75, 95% CI: -2.08, -1.42) and total response rate (RR = 1.21, 95% CI: 1.01-1.44). Most studies demonstrated low to moderate risk of bias. Conclusion:The combination of acupuncture and moxibustion with rehabilitation training appears to be more effective than rehabilitation alone for post-stroke SHS, improving motor function, pain relief, and activities of daily living. However, high heterogeneity warrants careful interpretation and further high-quality studies.

ABSTRACTObjectiveConstruction nomogram was to effectively predict long‐term prognosis in patients with non‐small cell lung cancer (NSCLC).Materials and MethodsThe nomogram is developed by a retrospective study of 347 patients with NSCLC who underwent cardiopulmonary exercise testing (CPET) before surgery from May 2019 to February 2022. Cross‐validation divided the data into a training cohort and validation cohort. The discrimination and accuracy ability of the nomogram were proofed by concordance index (C‐index), calibration curve, receiver operating characteristic (ROC) curve, the area under the curve (AUC), and time‐dependent ROC in validation cohort.ResultsAge, intraoperative blood loss, VO2 peak, and VE/VCO2 slope were included in the model of nomogram. The model demonstrated good discrimination and accuracy with C‐index of 0.770 (95% CI: 0.712–0.822). AUC of 6 (AUC: 0.789, 95% CI: 0.726–0.851) and 12 months (AUC: 0.787, 95% CI: 0.724–0.850) were shown in ROC. Time‐independent ROC maintains a good effect within 12 months.ConclusionWe developed a nomogram based on CPET. This model has a good ability of discrimination and accuracy. It could help clinicians to make treatment decision in clinical decision.

Background: Implicit magnitudes and distribution of excessive contact pressures under hand orthoses hinder clinicians from precisely adjusting them to relieve the pressures. To address this, contact pressure under a hand orthosis were analysed using finite element method. Methods: This paper proposed a method to numerically predict the relatively high magnitudes and critical distribution of contact pressures under hand orthosis through finite element analysis, to identify excessive contact pressure locations. The finite element model was established consisting of the hand, orthosis and bones. The hand and bones were assumed to be homogeneous and elastic bodies, and the orthosis was considered as an isotropic and elastic shell. Two predictions were conducted by assigning either low (fat) or high (skin) material stiffness to the hand model to attain the range of pressure magnitudes. An experiment was conducted to measure contact pressures at the predicted pressure locations. Results: Identical pressure distributions were obtained from both predictions with relatively high pressure values disseminated at 12 anatomical locations. The highest magnitude was found at the thumb metacarpophalangeal joint with the maximum pressure range from 13 to 78 KPa. The measured values were within the predicted range of pressure magnitudes. Moreover, 6 excessive contact pressure locations were identified. Conclusions: The proposed method was verified by the measurement results. It renders understanding of interface conditions underneath the orthosis to inform clinicians regarding orthosis design and adjustment. It could also guide the development of 3D printed or sensorised orthosis by indicating optimal locations for perforations or pressure sensors.

Abstract Background Early non-invasive identification of patients at risk of developing postoperative sleep disorder (PSD), which is common after surgery, is an essential step in reducing surgery stress and an important part of enhanced recovery after surgery. Objective We used smart HRV patches to (1) explore different HRV parameters as potential PSD biomarkers and (2) develop and validate a prognostic model for the early prediction of PSD including change of autonomic function in early postoperative period. Methods This is a prospective cohort study where we assessed autonomic function in a separate sample of 51 patients who underwent DaVinci robotic/laparoscopic radical surgery for gastrointestinal cancer with and without insomnia. Results In this study, 22(43.137%) of 51 patients experienced PSD. Multivariate logistic regression analysis showed that ICU, POD3 nocturnal LF/HF and SD daytime pNN50 were risk predictors of postoperative sleep quality. The risk factor prediction model was established using ICU (P = 0.013, OR = 0.030), 120h SDNN (P = 0.072, OR = 0.954), POD3 daytime LF/HF (P = 0.096, OR = 3.894), POD3 nocturnal LF/HF (P = 0.025, OR = 1.235), POD2 24h LF/HF (P = 0.256, OR = 4.370), and SD daytime pNN50 (P = 0.039, OR = 0.828). The AUC was 0.969. Conclusion Circadian rhythm and activity of ANS was involved in PSD. HRV based on remote measurement technology and long-range monitor have potential as digital biomarkers for helping predict PSD.

BACKGROUND:Obesity influences the outcomes of orthopedic surgeries such as total knee arthroplasty and spinal surgery. However, the effect of obesity on the outcomes of rotator cuff repair is unknown. This systematic review and meta-analysis aimed to examine the effect of obesity on rotator cuff repair outcomes. METHODS:PubMed, EMBASE, Web of Science, and Cochrane Library databases were searched to identify relevant studies published from their inception till July 2022. Two reviewers independently screened titles and abstracts using the specified criteria. Articles were included if they indicated the effect of obesity on rotator cuff repair and the related outcomes after surgery. Review Manager 5.4.1 software was used to perform statistical analysis. RESULTS:Thirteen articles involving 85,497 patients were included. Obese patients had higher retear rates than nonobese patients (odds ratio [OR] 2.58, 95% confidence interval [CI] 1.23-5.41, P = .01), lower American Shoulder and Elbow Surgeons scores (mean difference [MD]: -3.59, 95% CI: -5.45 to [-1.74]; P = .0001), higher visual analog scale for pain (mean difference: 0.73, 95% CI: 0.29-1.17; P = .001), higher reoperation rates (OR 1.31, 95% CI 1.21-1.42, P < .00001), and higher rates of complications (OR 1.57, 95% CI 1.31-1.87, P = .000). Obesity did not affect the duration of surgery (MD: 6.03, 95% CI: -7.63 to 19.69; P = .39) or external rotation of the shoulder (MD: -1.79, 95% CI: -5.30 to 1.72; P = .32). CONCLUSION:Obesity is a significant risk factor for retear and reoperation after rotator cuff repair. Furthermore, obesity increases the risk of postoperative complications and leads to lower postoperative American Shoulder and Elbow Surgeons scores and higher shoulder visual analog scale for pain.

Background: General movements assessment (GMA) is a non-invasive tool for early assessment of neonatal spontaneous movements. This study aimed to assess the effectiveness of GMA in predicting the neuromotor development outcomes of high-risk infants with neonatal respiratory distress syndrome (NRDS). Methods: The results of GMA at different phases in 80 children with NRDS expected to be born between September 2020 and July 2021 were collected, and the neuromotor development outcomes were verified by Peabody Developmental Motor Scales-2 (PDMS-2) follow-up from March 2022 to May 2022. The study used the screening method and the Chi-square test to analyze the predictive value of different phases of GMA. Results: The GMA writhing movements phase showed an accuracy of 70.00%, a sensitivity of 82.76%, a specificity of 62.75%, a positive predictive value of 55.81%, a negative predictive value of 86.49%, a Youden index of 0.46, and a positive likelihood ratio of 2.22. The GMA fidgety movements phase showed an accuracy of 95.00%, a sensitivity of 96.55%, a specificity of 94.12%, a positive predictive value of 90.32%, a negative predictive value of 97.96%, a Youden index of 0.91, and a positive likelihood ratio of 16.42. The differences between the specificity, accuracy and negative predictive values of GMA were statistically different (χ22 = 9.600, p2 < 0.005; χ23 = 17.316, p3 < 0.005; χ25 = 10.268, p5 = 0.001), while no statistically significant differences were found in the comparison of sensitivity and positive predictive values (p1 = 1.000; χ24 = 2.690, p4 = 0.101). Conclusions: GMA has a favorable predictive value for neuromotor development outcomes in children with NRDS. Clinical Trial Registration: ChiCTR2200061223.

Objective:The aim of this study was to evaluate the therapeutic effect of low-frequency repetitive transcranial magnetic stimulation (rTMS) on post-stroke cognitive impairment (PSCI).Methods:Thirty-six PSCI patients were randomly divided into treatment and control groups of equal size. Both groups were pre-treated with conventional cognitive rehabilitation training. Subsequently, the treatment group was exposed to 1 Hz low-frequency repetitive transcranial magnetic stimulations for 8 weeks, with 5 days per week. Meanwhile, the control group was treated with placebo stimulations. Patients were evaluated via the LOTCA scale assessments and changes in P300 latencies and amplitudes before and after 8 weeks of treatment.Results:Before treatment, there were no significant differences between the two groups in LOTCA scores, P300 latencies, and amplitudes (P > 0.05). After treatment, LOTCA scores for both groups improved (P < 0.05), and those of the treatment group were higher than those of the control (P < 0.05). For both groups, P300 latencies were not only shortened but also had greater amplitudes (P < 0.05), and those for the treatment group were significantly shorter and larger than those of the control (P < 0.05).Conclusion:As a therapy, rTMS improved cognitive function in PSCI patients, possibly via regulation of neural electrical activity of the cerebral cortex.

OBJECTIVE:To evaluate the effects of Transcutaneous Electric Nerve Stimulation (TENS) on pain, function, walking ability and stiffness in people with Knee osteoarthritis (KOA).DESIGN:Systematic review and meta-analysis of randomized controlled trials.METHODS:We searched MEDLINE, EMBASE, PubMed, Cochrane Central Register of Controlled Trials, Physiotherapy Evidence Database (PEDro), clinicaltrials.gov and Web of Science (last search November 2021) for randomized controlled trials. The Cochrane Risk of Bias Tool was used for the included studies, and Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) was used to interpret the certainty of results. Standardized Mean Differences (SMDs) and 95% confidence interval (CI) were calculated for meta-analysis.RESULTS:Twenty-nine studies were found (1398 people, age range 54-85, 74% are female) and fourteen were included in this review. Intervention duration was divided as short term (immediately after intervention), medium term (<four weeks) and long term (≥ four weeks). Active TENS showed greater improvement in Visual Analogue Scale (VAS) than sham TENS.Combining TENS with other interventions produced superior outcomes compared with other interventions for VAS in all the terms. In the meanwhile, TENS combined with other interventions was superior to other interventions for the pain subgroup of Western Ontario and McMaster Universities Arthritis Index in the medium term and long term. TENS combined with other interventions was superior to other interventions for function in the medium term and long term.CONCLUSION:TENS could significantly relieve pain, decrease dysfunction and improve walking ability in people with KOA, but it is not effective for stiffness.

目的 探讨悬吊训练(suspension training,SET)联合盆底功能锻炼治疗初产妇产后盆腔器官脱垂(pelvic organ prolapse,POP)的临床效果.方法 选取首次阴道分娩并参加产后42 d体检的初产妇100例,按照随机数字表法分为对照组(电刺激生物反馈疗法+凯格尔运动,50例)、试验组(电刺激生物反馈疗法+凯格尔运动+SET,50例).比较2组患者不同时刻POP分期、盆底肌力分级、腹横肌厚度及临床疗效.结果 第1次治疗前,2组患者POP分期、盆底肌力差异无统计学意义(P>0.05);第10次治疗前、第15次治疗后,2组POP分期、盆底肌力差异有统计学意义(P<0.05).2组腹横肌厚度均呈升高趋势,试验组幅度大于对照组,组间、时点间、组间·时点间交互作用差异有统计学意义(P<0.05).2组患者临床疗效优于对照组,总有效率显著高于对照组(P<0.05).结论 SET联合盆底功能锻炼治疗初产妇产后POP可有效改善症状,更快更好地恢复盆底肌力,增加腹横肌厚度,提高临床疗效.

Background Bracing and exercise methods were used in scoliosis rehabilitation and proven effective. There was little evidence about the efficacy of insoles on scoliosis. Objective This study aimed to investigate the effects of 3D personalized insoles on curve magnitude, postural stability, and quality of life (QOL) in moderate adolescent idiopathic scoliosis (AIS) patients. Methods Thirty-six volunteers with adolescent idiopathic scoliosis, who had moderate curves (20°-45°), were randomly divided into the experimental and control groups. The control group received traditional rehabilitation with bracing and exercises, and the experimental group received the insole interventions in addition to traditional rehabilitation. The outcome measures were Cobb angle, angle of trunk rotation (ATR), postural stability, and quality of life (Scoliosis Research Society-22 questionnaire). Measurements were conducted at baseline examination, two months and six months. Results After two and six months of treatment, the Cobb angle and ATR in both groups were significantly decreased as compared with the baseline ( p < 0.05), but no significant group difference in Cobb angle and ATR was found in the study ( p > 0.05). There was a significant difference in the sagittal balance index at six months compared to the control group ( p < 0.05), and a significant difference in the coronal balance index was observed at six months compared to baseline in the experimental group ( p < 0.05). Quality of life did not change in either group ( p > 0.05). Conclusion Combining bracing with exercise in patients with moderate AIS is effective. 3D personalized insoles cannot reduce the Cobb angle and angle of trunk rotation of patients with moderate AIS but might have the potential to improve postural stability.

BACKGROUND:Although muscle strength training is a prevalent treatment for patients with functional ankle instability (FAI), previous investigations on the efficacy have yielded conflicting results.OBJECTIVE:This study aims to compare the efficacy of 6-week isokinetic strength training and Thera-Band strength training on improving ankle strength, dynamic balance ability, and function in individuals with FAI.METHODS:Fifty-two FAI patients were randomized into two treatment groups: an isokinetic strength training (IST, n = 26) group and a Thera-Band resistance training (TBT, n = 26) group. The IST group engaged in isokinetic concentric strength training with inversion, eversion, dorsiflexion, and plantar flexion, whereas the TBT group engaged in progressive resistance training with Thera-Band three times per week for six weeks. Before and after the training, an isokinetic concentric strength test of the involved ankle joint, Star Excursion Balance Test (SEBT), and Cumberland Ankle Instability Tool (CAIT) function assessment were performed.RESULTS:After six weeks of intervention, the strength of inversion and eversion was significantly improved in both the IST and TBT groups (p < 0.05), with the IST group exhibiting a significant (p < 0.05) improvement when compared to the TBT group. The SEBT and CAIT results were significantly (p < 0.05) improved in the IST group compared to the TBT group.CONCLUSIONS:The six-week of isokinetic strength training is more effective than the Thera-Band progressive resistance training in improving the physical function of FAI patients.CLINICAL TRIAL REGISTRATION NUMBER:This randomized controlled clinical trial has been registered in the China Clinical Trial Registry (ChiCTR2100044444) https://www.google.com/search?client=firefox-b-d&q=ChiCTR2100044444.

Objectives: To investigate the effect of transcutaneous electrical acupoint stimulation (TEAS) combined with proprioceptive neuromuscular facilitation (PNF) on postural stability, muscle strength and pain in patients with tibial plateau fracture. Method: A 3-arm randomized controlled trial was conducted in 60 patients with tibial plateau fracture. Participants received one of the following interventions: standard treatment (ST group, n = 20), ST + PNF training (ST + PNF group, n = 20), ST + PNF training + TEAS intervention (ST + PNF + TEAS group, n = 20). All treatments lasted for six weeks. Participants' postural stability, muscle strength and pain were evaluated at baseline, after 3 and 6 weeks of intervention. Results: After 3 weeks of intervention, Between-group comparisons showed that both the ST + PNF group and ST + PNF + TEAS group showed significantly greater performance than the ST group in the postural stability measure (P < 0.02) and pain score(P < 0.05). The peak torque of quadriceps extensors and flexors at the velocity of 60 degrees/s was significantly higher in the ST + PNF + TEAS group than in the ST group (P < 0.02). After 6 weeks of intervention, only the ST + PNF + TEAS group was superior to the ST group in postural stability measure(P < 0.04) and in pain score (P < 0.05). The ST + PNF + TEAS group was significantly higher than the ST + PNF group and the ST group in the peak torque of quadriceps extensors at the velocity of 60 degrees/s and 180 degrees/s (P < 0.01). Conclusion: PNF training could improve dynamic postural stability and relieve pain at three weeks, while TEAS combined with PNF was more effective in relieving pain, strengthening muscle strength and improving dynamic postural stability at six weeks post-intervention.

Background Adolescent idiopathic scoliosis (AIS) is the most common form of scoliosis. However, the underlying mechanisms linking spinal curvature in AIS to foot characteristics and walking performance remain unclear. Objective This study aimed to compare walking performance between adolescents with mild, moderate, and severe scoliosis and matched healthy peers with foot posture as covariates. Methods This cross-sectional study of 96 adolescents was conducted between April 2020 to October 2020 in China, with 32 healthy peers in the control group and 64 patients in the AIS group. Foot posture and morphology, plantar pressure distribution, and gait characteristics were analyzed. One-way analysis of variance with Bonferroni correction and a post hoc comparison of the mean differences between the different groups was performed. Multiple analyses of covariance adjusted for age, sex, body mass index, foot posture index (FPI), arch index (AI), and walking speed were performed. Results Of the 64 adolescents with scoliosis, 18 had mild AIS, 32 had moderate AIS, and 14 had severe AIS. The AI and FPI were much higher in the moderate and severe AIS groups (p = 0.018) and the severe AIS group (p<0.001), respectively, than in the control group. The severe AIS group had advanced and longer midstance (p = 0.014) and delayed propulsion phase (p = 0.013) than the control group. Patients with moderate and severe AIS had asymmetrical gait periods in the left and right limbs (p<0.05). Significant differences in the center-of-pressure excursion index (CPEI) were found between the moderate and severe AIS and control groups (p = 0.003). Conclusion Moderate and severe AIS significantly influenced walking performance; however, no significant differences were observed between adolescents with mild AIS and healthy controls. Thus, early intervention could target the prevention of specific functional deficits and prevent it from progressing to a severe state.

Customized static orthoses in rehabilitation clinics often cause side effects, such as discomfort and skin damage due to excessive local contact pressure. Currently, clinicians adjust orthoses to reduce high contact pressure based on subjective feedback from patients. However, the adjustment is inefficient and prone to variability due to the unknown contact pressure distribution as well as differences in discomfort due to pressure across patients. This paper proposed a new method to predict a threshold of contact pressure (pressure limit) associated with moderate discomfort at each critical spot under hand orthoses. A new pressure sensor skin with 13 sensing units was configured from FEA results of pressure distribution simulated with hand geometry data of six healthy participants. It was used to measure contact pressure under two types of customized orthoses for 40 patients with bone fractures. Their subjective perception of discomfort was also measured using a 6 scores discomfort scale. Based on these data, five critical spots were identified that correspond to high discomfort scores (>1) or high pressure magnitudes (>0.024 MPa). An artificial neural network was trained to predict contact pressure at each critical spot with orthosis type, gender, height, weight, discomfort scores and pressure measurements as input variables. The neural networks show satisfactory prediction accuracy with ${R}^{{2}}$ values over 0.81 of regression between network outputs and measurements. This new method predicts a set of pressure limits at critical locations under the orthosis that the clinicians can use to make orthosis adjustment decisions.

Introduction Both physical and mental disorders may be exacerbated in patients with COVID-19 due to the experience of receiving intensive care; undergoing prolonged mechanical ventilation, sedation, proning and paralysis. Pulmonary rehabilitation is aimed to improve dyspnoea, relieve anxiety and depression, reduce the incidence of related complications, as well as prevent and improve dysfunction. However, the impact of respiratory rehabilitation on discharged patients with COVID-19 is currently unclear, especially on patients who have been mechanically ventilated over 24 hours. Therefore, we aim to investigate the efficacy of respiratory rehabilitation programmes, initiated after discharge from the intensive care unit, on the physical and mental health and health-related quality of life in critical patients with COVID-19. Methods and analysis We have registered the protocol on PROSPERO and in the process of drafting it, we strictly followed the checklist of Preferred Reporting Items for Systematic Review and Meta-Analysis Potocols. We will search the PubMed, EMBASE, Web of Science, the Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure, WanFang, VIP information databases and Chinese Biomedical Literature Database. Additionally, ongoing trials in the WHO International Clinical Trials Registry Platform, ClinicalTrials.gov and ISRCTN registry will be searched as well. Studies in English or Chinese and from any country will be accepted regardless of study design. Two review authors will independently extract data and assess the quality of included studies. Continuous data are described as standard mean differences (SMDs) with 95% CIs. Dichotomous data from randomised controlled trials are described as risk ratio(RR) with 95% CIs; otherwise, it is described as odds ratio(OR) with 95% CIs. I-2 and the Cochrane's Q statistic will be used to conduct heterogeneity assessment. The quality of evidence of main outcomes will be evaluated according to the Grading of Recommendations, Assessment, Development and Evaluation(GRADE) criteria. When included studies are sufficient, we will conduct subgroup analysis and sensitivity analysis; the publication bias will be statistically analysed using a funnel plot analysis and Egger's test. Ethics and dissemination Our review, planning to include published studies, does not need the request to the ethical committee. The final results of this review will be published in a peer-reviewed journal after completion. Patient and public involvement No patient involved. PROSPERO registration number CRD42020186791.

Background Chronic low back pain (CLBP) is a common and often disabling musculoskeletal condition. Yoga has been proven to be an effective therapy for chronic low back pain. However, there are still controversies about the effects of yoga at different follow-up periods and compared with other physical therapy exercises. Objective To critically compare the effects of yoga for patients with chronic low back pain on pain, disability, quality of life with non-exercise (e.g. usual care, education), physical therapy exercise. Methods This study was registered in PROSPERO, and the registration number was CRD42020159865. Randomized controlled trials (RCTs) of online databases included PubMed, Web of Science, Cochrane Central Register of Controlled Trials, Embase which evaluated effects of yoga for patients with chronic low back pain on pain, disability, and quality of life were searched from inception time to November 1, 2019. Studies were eligible if they assessed at least one important outcome, namely pain, back-specific disability, quality of life. The Cochrane risk of bias tool was used to assess the methodological quality of included randomized controlled trials. The continuous outcomes were analyzed by calculating the mean difference (MD) or standardized mean difference (SMD) with 95% confidence intervals (CI) according to whether combining outcomes measured on different scales or not. Results A total of 18 randomized controlled trials were included in this meta-analysis. Yoga could significantly reduce pain at 4 to 8 weeks (MD = -0.83, 95% CI = -1.19 to -0.48, p<0.00001, I2 = 0%), 3 months (MD = -0.43, 95% CI = -0.64 to -0.23, p<0.0001, I2 = 0%), 6 to 7 months (MD = -0.56, 95% CI = -1.02 to -0.11, p = 0.02, I2 = 50%), and was not significant in 12 months (MD = -0.52, 95% CI = -1.64 to 0.59, p = 0.36, I2 = 87%) compared with non-exercise. Yoga was better than non-exercise on disability at 4 to 8 weeks (SMD = -0.30, 95% CI = -0.51 to -0.10, p = 0.003, I2 = 0%), 3 months (SMD = -0.31, 95% CI = -0.45 to -0.18, p<0.00001, I2 = 30%), 6 months (SMD = -0.38, 95% CI = -0.53 to -0.23, p<0.00001, I2 = 0%), 12 months (SMD = -0.33, 95% CI = -0.54 to -0.12, p = 0.002, I2 = 9%). There was no significant difference on pain, disability compared with physical therapy exercise group. Furthermore, it suggested that there was a non-significant difference on physical and mental quality of life between yoga and any other interventions. Conclusion This meta-analysis provided evidence from very low to moderate investigating the effectiveness of yoga for chronic low back pain patients at different time points. Yoga might decrease pain from short term to intermediate term and improve functional disability status from short term to long term compared with non-exercise (e.g. usual care, education). Yoga had the same effect on pain and disability as any other exercise or physical therapy. Yoga might not improve the physical and mental quality of life based on the result of a merging.

Side effects caused by excessive contact pressure such as discomfort and pressure sores are commonly complained by patients wearing orthoses. These problems leading to low patient compliance decrease the effectiveness of the device. To mitigate side effects, this study describes the design and fabrication of a soft sensor skin with strategically placed 12 sensor units for static contact pressure measurement beneath a hand and wrist orthosis. A Finite Element Model was built to simulate the pressure on the hand of a subject and sensor specifications were obtained from the result to guide the design. By testing the fabricated soft sensor skin on the subject, contact pressure between 0.012 MPa and 0.046 MPa was detected, revealing the maximum pressure at the thumb metacarpophalangeal joint which was the same location of the highest pressure of simulation. In this letter, a new fabrication method combining etching and multi-material additive manufacture was introduced to produce multiple sensor units as a whole. Furthermore, a novel fish-scale structure as the connection among sensors was introduced to stabilize sensor units and reinforce the soft skin. Experimental analysis reported that the sensor signal is repeatable, and the fish-scale structure facilitates baseline resuming of sensor signal during relaxation.

Most post-stroke patients experience upper limb functionality challenges. Emergent therapies using upper limb-based robot machines present opportunities to resolve the limitations inherent in Occupational therapy such as increased therapist-patient exhaustion, monotonous methods, and so forth. The aim of this parallel trial was to compare the effects of the upper limb robotic training with matched Occupational therapy training on upper limb function and independence-related quality of life in post-stroke patients within the Brunnstrom arm motor recovery stages 1 to 4. During one-year (2018-2019), 50 post-stroke patients were enrolled and randomly assigned to 2 groups; robot and Occupational therapy (n = 25) and Occupational therapy (n = 25). Both groups were trained for 50-70 minutes per day, 5 days a week for 6 weeks. The Chinese-adapted Fugl-Meyer Assessment-Upper Extremity (FMA-UE) was the primary outcome measure. The secondary outcome measures were the Brunnstrom Recovery Stages Scale (BRS) and the Chinese-adapted Barthel Index (BI). The treatment effect sizes of both groups were large in the following variables; transfers (1), BI total score (2.2), FMA-UE upper limb (1.1), wrist (1.8), elbow (1), fingers (0.9), and FMA-UE total scores (1.4). The treatment group in comparison to the control group had larger BRS changes, significant improvements in upper limb function, and partial independence in activities of daily living during the baseline to post-treatment period. Robotic-assisted training with occupational therapy may improve the upper limb movement foundation blocks; however, it does not translate into complete functional independence and improved quality of life. This study has been registered at the ISRCTN registry,

The delayed delivery, poor fitting and discomfort of customised orthoses are reported in rehabilitation clinics as resulting in more invasive interventions. The current practice of orthosis customisation relies heavily upon the experience and fabrication processes of therapists. In order to better understand the current practice, and thus identify data that is required for better comfort moving towards a data-driven customisation, this article describes a study generating working models of therapists. Customisations of hand and wrist orthoses for 18 patients were observed. Verbal protocol analysis was employed to extend the current understanding of fabrication processes. Working models of four therapists were established with quantitative evaluation on major phases, interactive activities and iterations of performing tasks during fabrication, revealing different working models between in- and out-patient departments (e.g. fabrication for in-patients was more complex and focussed on ergonomic fitting whereas fabrication for out-patients paid attention to durability) which were qualitatively explained. Practitioner summary: Fit and comfort are imperative for orthosis design and fabrication, however the current practice of customisation of an orthosis relies upon the experience of individual hand therapist. The article presents working models of hand therapists, and relevant data that would enable customisation of orthosis for better fit. Abbreviations: VPA: verbal protocol analysis; h&w: hand and wrist; LTT: low temperature thermoplastic; ANOVA: analysis of variance.