Background and Purpose-Thermal stimulation (TS) is commonly used in orthopedic rehabilitation, but the role of TS in the facilitation of sensorimotor recovery in hemiplegic patients remains unknown. This study addressed the issue of TS intervention in the facilitation of functional outcomes. Methods-Forty-six stroke survivors were randomly assigned to standard rehabilitation treatment and standard treatment plus TS (30 minutes daily for 6 weeks). Twenty-nine patients completed the experiment. Six measures, including Brunnstrom stage, modified motor assessment scale, grasping strength, angles of wrist extension and flexion, sensation by monofilament, and muscle tone by modified Ashworth scale, were performed weekly to evaluate sensory and motor functional outcomes. Results-The performance of Brunnstrom stage and wrist extension and sensation were improved significantly after TS intervention. Recovery rates of 6 measures after TS were significantly higher than those of the control, except for grasping. Similar muscle tones were found in both groups.
Conclusion-TS
The results of this study suggest that the internal consistency reliability, interrater reliability, and construct validity of the BBS are adequate for measuring balance in community-dwelling older adults. Among all items in the BBS, the tandem stance and one-legged stance are the most challenging items. Further study of their applicability for screening use in the community is warranted.
Objectives
To evaluate the association between cataract and cataract surgery and risks of osteoporosis and fracture.
Design
Nationwide population‐based retrospective cohort study.
Setting
Taiwan's National Health Insurance Research Database.
Participants
Individuals with (n=57,972) and without (n=57,972) cataracts.
Measurements
Individuals with and without cataracts were matched 1:1 for age, sex, and index year. Those with cataracts were further divided into cataract surgery and nonsurgery groups. Incidences and hazard ratios (HR) for risks of developing osteoporosis and fracture were calculated using Cox proportional hazard regression models.
Results
During mean follow‐up of 6.4 years, 17,450 participants with cataracts and 12,627 without developed osteoporosis or fractures. Having cataracts was significantly associated with risk of developing osteoporosis or fracture (adjusted HR (aHR) = 1.29, 95% confidence interval (CI) = 1.25–1.32, p < .001). In analyses for each event, cataract was significantly associated with greater likelihood of all outcomes (osteoporosis: aHR = 1.43, 95% CI = 1.37–1.50, p < .001; hip fracture: aHR = 1.16, 95% CI = 1.07–1.26, p < .001; vertebral fracture: (aHR = 1.25, 95% CI = 1.18–1.33, p < .001; other fractures: aHR = 1.24, 95% CI = 1.20–1.28, p < .001). Participants who underwent cataract surgery were at significantly lower risk of osteoporosis or fracture (aHR = 0.58, 95% CI = 0.56–0.59, p < .001), than those who did not. Undergoing cataract surgery was also associated with lower risks of all individual events (osteoporosis; hip, vertebral, other fracture).
Conclusion
Cataract was independently associated with increased risks of osteoporosis and fracture. There might be an association between cataract surgery and lower risks of osteoporosis and fracture. J Am Geriatr Soc 67:254–260, 2019.
BackgroundRehabilitation can improve physical activity after stroke. However, patients may be more prone to falls and fractures because of balance and gait deficits. Few reports have studied the relationship between rehabilitation and subsequent fractures after ischemic stroke.ObjectiveTo investigate whether post-stroke rehabilitation affects fracture risk.MethodsWe conducted a population-based retrospective cohort study based on the Taiwan National Health Insurance Research Database. Patients with a newly diagnosed ischemic stroke between 2000 and 2012 were included. After propensity score matching, a total of 8,384 patients were enrolled. Half of the patients (4,192) received post-stroke rehabilitation within 1 month; the other half did not receive any post-stroke rehabilitation. Cox proportional hazards regression model was used to calculate hazard ratios (HRs) for fractures among patients with and without rehabilitation within 1 year after ischemic stroke. Patients were further stratified by sex and age (20–64 and ≥65 years).ResultsPatients receiving post-stroke rehabilitation had a higher incidence of fracture (6.2 per 100 person-years) than those who did not (4.1 per 100 person-years) after adjustment for sociodemographic and coexisting medical conditions [HR = 1.53, 95% confidence interval (CI) = 1.25–1.87, p < 0.001]. The analyses performed after stratifying for sex and age showed that only older women undergoing rehabilitation had a significantly higher risk of fracture (HR = 1.62, 95% CI = 1.21–2.17, p = 0.001).ConclusionRehabilitation after ischemic stroke is associated with an increased fracture risk in older women.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.