Background After discharge from a rehabilitation center the continuation of therapy is necessary to secure already achieved healing progress and sustain (re-)integration into working life. To this end, home-based exercise programs are frequently prescribed. However, many patients do not perform their exercises as frequently as prescribed or even with incorrect movements. The telerehabilitation system AGT-Reha was developed to support patients with shoulder diseases during their home-based aftercare rehabilitation. Objectives The presented pilot study AGT-Reha-P2 evaluates the technical feasibility and user acceptance of the home-based telerehabilitation system AGT-Reha. Methods A nonblinded, nonrandomized exploratory feasibility study was conducted over a 2-year period in patients' homes. Twelve patients completed a 3-month telerehabilitation exercise program with AGT-Reha. Primary outcome measures are the satisfying technical functionality and user acceptance assessed by technical parameters, structured interviews, and a four-dimensional questionnaire. Secondary endpoints are the medical rehabilitation success measured by the active range of motion and the shoulder function (pain and disability) assessed by employing the Neutral-0 Method and the standardized questionnaire “Shoulder Pain and Disability Index” (SPADI), respectively. To prepare an efficacy trial, various standardized questionnaires were included in the study to measure ability to work, capacity to work, and subjective prognosis of work capacity. The participants have been assessed at three measurement points: prebaseline (admission to rehabilitation center), baseline (discharge from rehabilitation center), and posttherapy. Results Six participants used the first version of AGT-Reha, while six other patients used an improved version. Despite minor technical problems, all participants successfully trained on their own with AGT-Reha at home. On average, participants trained at least once per day during their training period. Five of the 12 participants showed clinically relevant improvements of shoulder function (improved SPADI score > 11). The work-related parameters suggested a positive impact. All participants would recommend the system, ten participants would likely reuse it, and seven participants would have wanted to continue their use after 3 months. Conclusion The findings show that home-based training with AGT-Reha is feasible and well accepted. Outcomes of SPADI indicate the effectiveness of aftercare with AGT-Reha. A controlled clinical trial to test this hypothesis will be conducted with a larger number of participants.
Topical honey treatment has been shown to possess antimicrobial properties, promote autolytic debridement, stimulate growth of wound tissues to hasten healing, and to start the healing process in dormant wounds, stimulating anti-inflammatory activity that rapidly reduces pain, oedema and exudate production. This article provides an overview of the use of honey as a medicinal substance, particularly its use in wound treatment, and reviews the published data concerning honey as a form of complementary and alternative medicine in paediatric wound management. The literature reviewed was found by searching the PubMed, BIOSIS, and ISI Web of Science databases for the term honey. Exclusion criteria were articles where honey was used in a mixture with other therapeutic substances.
Background: There is an enormous economical significance of phytotherapy at least in Germany, the huge demand of patients was repeatedly proven. Simultaneously data exist for different application areas and ages as for younger children and pregnancy until birth. The actual neonatal period can be of interest because phytotherapy is used in younger children and until birth, it is not very likely that there is a gap in this period of life. Aim: To give an overview on the current literature on phytotherapy in neonatology. Methods: A systematic review was performed in the following databases: Cochrane, EM-BASE Alert, AMED, NCCAM, NLM, DIMDI, CAMbase, BIOSIS Previews, DAHTA, SciSearch, and Medline as well as in the archives of GMS, Karger, Kluwer, Thieme, Krause and Pachernegg, Wiley-Interscience/Phytotherapy Research, Springer and Merkurstab publishers. Keywords were neonatology, newborn, preterm, phytotherapy, phytomedicine, and herbal drugs in clinical randomized controlled studies. Results: We found 14 articles that fulfilled the inclusion criteria: 10 case control studies, 1 observational study, 1 study with interview, 1 with a questionnaire, and 1 retrospective study. Topics were aromatherapy, external applications, and internal effects of herbal teas. Conclusion: Indications, study design and explantory power of these publications were quite heterogeneous. Most promising was the study situation in aromatherapy. Due to the fact that phytotherapy is frequently used and there is a high demand of parents, methodologically excellent studies are needed to evaluate the significance of phytotherapy in the neonatal period. The aim is to fulfill scientific as well as economical needs. This review shows that there is no such evidence yet.
BackgroundPatients carrying pathogenic variants inGNAO1often present with early-onset central hypotonia and global developmental delay, with or without epilepsy. As the disorder progresses, a complex hypertonic and hyperkinetic movement disorder is a common phenotype. A genotype–phenotype correlation has not yet been described and there are no evidence-based therapeutic recommendations.MethodsTo improve understanding of the clinical course and pathophysiology of this ultra-rare disorder, we built up a registry forGNAO1patients in Germany. In this retrospective, multicentre cohort study, we collected detailed clinical data, treatment effects and genetic data for 25 affected patients.ResultsThe main clinical features were symptom onset within the first months of life, with central hypotonia or seizures. Within the first year of life, nearly all patients developed a movement disorder comprising dystonia (84%) and choreoathetosis (52%). Twelve (48%) patients suffered life-threatening hyperkinetic crises. Fifteen (60%) patients had epilepsy with poor treatment response. Two patients showed an atypical phenotype and seven novel pathogenic variants inGNAO1were identified. Nine (38%) patients were treated with bilateral deep brain stimulation of the globus pallidus internus. Deep brain stimulation reduced hyperkinetic symptoms and prevented further hyperkinetic crises. The in silico prediction programmes did not predict the phenotype by the genotype.ConclusionThe broad clinical spectrum and genetic findings expand the phenotypical spectrum ofGNAO1-associated disorder and therefore disprove the assumption that there are only two main phenotypes. No specific overall genotype–phenotype correlation was identified. We highlight deep brain stimulation as a useful treatment option in this disorder.
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