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The Effects of Balance Training with Functional Electrical Stimulation on Balance and Gait in patients with chronic stroke

  • Kim, Eunji;Min, Kayoon;Song, Changho
    • Physical Therapy Rehabilitation Science
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    • v.10 no.1
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    • pp.55-63
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    • 2021
  • Objective: The purpose of this study was to examine the effects of balance training with Functional Electrical Stimulation (FES) on balance and gait in patients with chronic stroke. Design: A cross over design Methods: Nine patients with stroke were recruited into this study. They were measuring their balance ability and gait ability. The intervention "A" included 4 weeks of balance training with Functional Electrical Stimulation (FES) for 40 m/d, 3 d/wk. Intervention "B" included 4 weeks of balance training with placebo Functional Electrical Stimulation (FES) for 40 m/d, 3 d/wk. Of the 9 patients who completed the study, 5 were randomly assigned to" group A-B", and 4 to group B-A. The crossover occurred after 4 weeks. Results: Following are the specific results of balance training with Functional Electrical Stimulation (FES) on patients with chronic stroke. First, patients who received treatment A showed improvement compared with patients who received treatment B in static balance. There were significant decreases in anterioposterior, mediolateral postural sway extension and velocity moment (p<0.05) with their eyes opened and closed conditions. Second, they had significantly improved in dynamic balance (p<0.05). Lastly, there were also improvement in their gait velocity and cadence (p<0.05). Conclusions: These findings suggest that, the Functional Electrical Stimulation (FES) combined with balance training more effectively improves the balance and gait ability, I'm convinced that it could be actively used in clinics added to the conventional physical therapy in the future.

Effects of Transcranial Direct Current Stimulation and Virtual Reality Program Application on the Cognition and Depression of Mild Cognitive Impairment Patients (경두개 직류자극과 가상현실프로그램 적용이 경도인지장애 환자의 인지 및 우울에 미치는 영향)

  • Kim, Ko-Un;Kim, Bo-Ra;An, Tae-Gyu
    • Journal of The Korean Society of Integrative Medicine
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    • v.9 no.3
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    • pp.155-164
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    • 2021
  • Purpose : The purpose of this study is to investigate the effects of transcranial direct current stimulation and virtual reality program application on cognition and depression of patients with mild cognitive impairment, and to find an intervention method that can enhance active participation of patients with mild cognitive impairment. Methods : In this study, 50 mild cognitive impairment patients were divided into a treatment group (25 patients) and a control group (25 patients). The treatment group was applied with a transcranial direct current stimulation and a virtual reality program, while the control group received a placebo transcranial direct current stimulation and a virtual reality program. Both groups received five 50-minute sessions per week (one session per day) for six weeks (total of 30 sessions). NCSE was used to evaluate the cognitive functions of the patients before and after treatment intervention. Moreover, K-BDI was conducted to examine the depression of the patients. Results : As a result of the transcranial direct current stimulation and a virtual reality program intervention, the cognitive function of both treatment and control group significantly (p<.05) improved, and the depression of both treatment and control group significantly (p<.05) decreased. Moreover, the changes in cognitive functions and depression were significant between the two groups¸ treatment and control group (p<.05). Conclusion : The results of the study showed that the application of the transcranial direct current stimulation and virtual reality program significantly improved the cognitive function of mild cognitive impairment patients and decreased the depression of them. Therefore, it could be concluded that the transcranial direct current stimulation and virtual reality program was an intervention method which positively affects the cognitive function and depression of mild cognitive impairment patients.

Effectiveness of low-level laser therapy on recovery from neurosensory disturbance after sagittal split ramus osteotomy: a systematic review and meta-analysis

  • Firoozi, Parsa;Keyhan, Seied Omid;Kim, Seong-Gon;Fallahi, Hamid Reza
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.42
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    • pp.41.1-41.11
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    • 2020
  • Background: Orthognathic surgery such as bilateral sagittal split ramus osteotomy (BSSRO) for the treatment of mandibular deformities is one of the most common procedures in maxillofacial operations that may lead to neurosensory disturbance. In this study, we aimed to evaluate the effectiveness of low-level laser therapy (LLLT) on augmenting recovery of neurosensory disturbance of inferior alveolar nerve (IAN) in patients who underwent BSSRO surgery. Methods: A comprehensive literature search was conducted by two independent authors in PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), Scopus, Embase, and Google Scholar electronic databases. Besides, a manual search of all textbooks and relevant articles were conducted. Searches took place in August 2020 and were limited to published and peer-reviewed articles from 2000 to 2020. All analysis was performed using the comprehensive meta-analysis (CMA) and the STATA MP (version:16) software. The weighted mean difference (WMD) using the inverse variance method and the standard mean difference (SMD) was considered for continuous variables. Results: Seventy-four papers were retrieved after removing duplicate studies and finally, eight studies were assessed for qualitative synthesis and five for meta-analysis. Totally, 94 patients were included in the meta-analysis. Based on the meta-analysis, it was shown that LLLT was not effective in a short interval (0 to 48 h) after surgery, but in a period of more than 1 month after surgery, the positive results of treatment can be observed strikingly. Also, LLLT side/group showed no significant difference in some aspects of neurosensory recovery such as thermal sensation compared to the placebo side/group. Conclusions: The meta-analysis of randomized controlled trials revealed that LLLT generally improves IAN sensory disturbance caused by BSSRO. Further high-quality clinical trials with longer follow-up periods and larger sample sizes are recommended.

Effect of sodium bicarbonate supplementation on two different performance indicators in sports: a systematic review with meta-analysis

  • Lino, Ramon Souza;Lagares, Laura Souza;Oliveira, Caio Victor Coutinho;Queiroz, Ciro Oliveira;Pinto, Lelia Lessa Teixeira;Almeida, Luiz Alberto Bastos;Bonfim, Eric Simas;dos Santos, Clarcson Placido Conceicao
    • Korean Journal of Exercise Nutrition
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    • v.25 no.1
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    • pp.7-15
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    • 2021
  • [Purpose] Sodium bicarbonate shows ergogenic potential in physical exercise and sports activities, although there is no strong evidence which performance markers show the greatest benefit from this supplement. This study evaluated the effects of sodium bicarbonate supplementation on time trial performance and time to exhaustion in athletes and sports practitioners. [Methods] A systematic review was conducted using three databases, including 17 clinical trials. Among these clinical trials, 11 were considered eligible for the meta-analysis according to the criteria for the assessment of methodological quality using the PEDro Scale. Time to exhaustion was assessed in six studies, while time trial performance was evaluated in five studies. [Results] A significant beneficial effect of supplementation on time to exhaustion was found in a random effects model (1.48; 95% confidence interval [CI], 0.49 to 2.48). There was no significant effect of supplementation on time trial performance in a fixed effects model (slope = -0.75; 95% CI, -2.04 to 0.55) relative to a placebo group. [Conclusion] Sodium bicarbonate has the potential to improve sports performance in general, especially in terms of time to exhaustion.

Effects of marine oligomeric polyphenols on body composition and physical ability of elderly individuals with sarcopenia: a pilot study

  • Kwon, Il-Su;Park, Deuk-Su;Shin, Hyeon-Cheol;Seok, Myung-Gyu;Oh, Jae-Keun
    • Korean Journal of Exercise Nutrition
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    • v.25 no.3
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    • pp.1-7
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    • 2021
  • [Purpose] We aimed to identify the effects of marine oligomeric polyphenol (MOP) intake in elderly individuals with sarcopenia. [Methods] Older adults (aged 65 years or older) were recruited based on the diagnostic criterion for sarcopenia and were randomly assigned to the MOP intake group (n=10) or the placebo (PBO) intake group (n=10). To determine the effect of MOP intake received for four weeks, the pre- and post-intake body composition (weight, skeletal muscle mass, and bone density) and senior fitness tests were assessed. [Results] Our results showed there were significant differences in the skeletal muscle mass (p=0.039), bone density (p=0.020), fat-free mass index (p=0.026), and 2.4 m up and go test (p=0.001) between pretest and post-test. There was a significant difference between the pre-test and post-test and an interaction effect for the one-leg stand test (p=0.010 and p=0.049, respectively). However, there were no significant differences in body fat percentage, calf circumference, grip strength, or the chair rise test. [Conclusion] Some variables exhibited significant differences in the pre- and post-assessments, and there was an interaction effect for the one-leg stand. However, this was insufficient to prove the effectiveness of MOP intake in improving sarcopenia. Therefore, additional studies are essential to examine the effects of MOP intake and exercise intervention on the body composition and fitness of patients over a longer period.

Efficacy of Portable Low Power Laser Therapy on Pain and Functions in Chronic Low Back Pain (만성 요통 환자에서의 휴대용 저출력 레이저 치료기의 통증 및 기능 효과)

  • Cho, Yeon Wook;Kim, Tae Hee;Lim, Oh Kyung;Lee, Ju Kang;Park, Ki Deok
    • Clinical Pain
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    • v.19 no.1
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    • pp.1-7
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    • 2020
  • Objective: A prospective, assessor-blinded, randomized controlled trial was conducted in patients with chronic low back pain to evaluate the efficacy of portable low power laser therapy (LPLT) and the effect when combined with exercise therapy on pain and functions. Method: 60 patients were recruited and 56 patients, excluding 4 dropouts, were randomly allocated to the LPLT group (Group 1: 19 patients), placebo laser therapy with exercise group (Group 2: 18 patients), and LPLT with exercise group (Group 3: 19 patients). Laser therapy and exercise was performed five times a week for 4 weeks. Visual analogue scale (VAS), Schober test, lumbar range of motion (ROM) measures (flexion, extension and lateral flexion), Oswestry Disability index (ODI) were measured at baseline, at 4 weeks after intervention, and at 6 weeks after 2 weeks of no intervention. Results: Statistically significant improvements were noted in all group by time interaction with respect to all outcome parameters (p<0.05). All parameters in each group improved not only in the period of treatment (4 weeks), but also in the final evaluation (6 weeks) 2 weeks after the end of treatment. Post-hoc analysis showed statistically significant difference between the LPLT with exercise group and the other groups in all outcome parameters except for the ODI at 4 weeks and at 6 weeks. Conclusion: Portable LPLT is effective treatment in reducing pain and improving lumbar ROM and with exercise is more effective than laser or exercise monotherapy for the chronic low back pain patients.

Effects of Applying Intensity on Muscle Activity and Muscle Hardness of Upper Trapezius Muscle in Adult Males applying Transcutaneous Electrical Nerve Stimulation (경피적전기신경자극 적용 시 적용강도가 성인남성의 위등세모근의 근활성도와 근경도에 미치는 영향)

  • Kim, Chung-Yoo;Bae, Won-Sik;Cha, Young-Joo
    • Journal of The Korean Society of Integrative Medicine
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    • v.10 no.1
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    • pp.129-136
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    • 2022
  • Purpose : The purpose of this study was to investigate the effect of applying intensity on the muscle activity and muscle hardness of the upper trapezius muscle in adult males when TENS (transcutaneous electrical nerve stimulation) was applied. In addition, this study intends to prepare the scientific basic data of TENS for the purpose of relaxation based on the experimental results. Methods : Eighty-seven healthy adult males participated in the experiment, and they were randomly divided into an experimental group and a control group. All subjects in this study were healthy subjects without musculoskeletal or nervous system damage. All subjects were subjects who voluntarily consented to the purpose and method of the experiment. All subjects were provided with a load by typing for 20 minutes, and muscle activity and muscle hardness of the upper trapezius muscle were measured immediately. Afterwards, TENS was given to each groups for 15 minutes, and the experimental group received stimulation at the motor threshold level, and the control group received a placebo stimulation. After stimulation, muscle activity and muscle hardness of the upper trapezius muscle were measured in the same method. The measured data were compared between groups through an independent t-test and dependent t-test. The statistical significance level was set at .05. Results : The application of TENS statistically significantly decreased the muscle activity and muscle hardness of the trapezius muscle in the experimental group, and the results showed a significant difference from the control group. Conclusion : Application of TENS significantly decreased the muscle activity and muscle stiffness of the upper trapezius muscle. The application of TENS of applying intensity that induces muscle contraction may induce relaxation by reducing the muscle activity and muscle hardness of the trapezius muscle.

Recent Progress in Immunotherapy for Gastric Cancer

  • Jeesun Yoon;Tae-Yong Kim;Do-Youn Oh
    • Journal of Gastric Cancer
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    • v.23 no.1
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    • pp.207-223
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    • 2023
  • Gastric cancer (GC) is the fourth leading cause of cancer-related deaths worldwide. Under the standard of care, patients with advanced GC (AGC) have a median survival time of approximately 12-15 months. With the emergence of immunotherapy as a key therapeutic strategy in medical oncology, relevant changes are expected in the systemic treatment of GC. In the phase III ATTRACTION-2 trial, nivolumab, a monoclonal anti-programmed cell death 1 (PD-1) antibody, as a third- or later-line treatment improved overall survival (OS) compared with placebo in patients with AGC. Furthermore, nivolumab in combination with 5-fluorouracil and platinum as a first-line treatment improved OS in patients with human epidermal growth factor receptor-2 (HER2)-negative AGC in the global phase III CheckMate-649 study. Another anti-PD-1 antibody, pembrolizumab, in combination with trastuzumab and cytotoxic chemotherapy as a first-line treatment, significantly improved the overall response rate in patients with HER2-positive AGC. Therefore, immune checkpoint inhibitors (ICIs) are essential components of the current treatment of GC. Subsequent treatments after ICI combination therapy, such as ICI rechallenge or combination therapy with agents having other modes of action, are being actively investigated to date. On the basis of the success of immunotherapy in the treatment of AGC, various clinical trials are underway to apply this therapeutic strategy in the perioperative and postoperative settings for patients with early GC. This review describes recent progress in immunotherapy and potential immunotherapy biomarkers for GC.

Three Case Reports on Patients with Facial Asymmetry Treated Using Korean Medicine Mainly Using Cervical Chuna Manipulation Treatment and Functional Cerebrospinal Technique (경추 추나 및 기능적 뇌척주요법(FCST) 등의 한의학적 치료로 개선된 안면비대칭 환자 3례 증례보고)

  • Jumi Lee;Eunwoo Kim;Yunhyung Jo;Jeongmin Shin;Hye In Jeong;Kyeong Han Kim
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.17 no.2
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    • pp.81-89
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    • 2022
  • Objectives This report aimed to investigate the possibility of correcting facial asymmetry using cervical Chuna manipulation treatment and functional cerebrospinal technique and introduce meaningful additional improvement of systemic symptoms of non-surgical Korean medicine treatments through three case studies. Methods Three patients with facial asymmetry were treated using Korean medicine treatments. The effects of the treatments were all measured using photographs, lateral cephalograms, and whole-body radiogram and Likert scale. Results After Korean medicine treatment, there were significant correction effects of asymmetry in photography, cephalography, and whole-body radiogram and meaningful score of Likert scale. Conclusions This study suggested that Korean medicine treatments may be effective in facial asymmetry. Improving muscular asymmetry, including soft tissue asymmetry and functional asymmetry, has meaningful effects on maintaining an overall balance of the body. Facial asymmetry should be treated by making an alignment of the whole body and there should be further well-designed, randomized, and placebo-controlled trials to verify these results.

Effectiveness of the Shugan Jieyu Capsule against Psychiatric Symptoms in Epilepsy: a protocol for systematic review and meta-analysis

  • Sejin Kim;Yunna Kim;Seung-Hun Cho
    • Journal of Pharmacopuncture
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    • v.26 no.1
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    • pp.38-43
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    • 2023
  • Objectives: Psychiatric symptoms in epilepsy are very common, and the most common symptoms are depression, insomnia, and anxiety. These symptoms not only lower the quality of life of epilepsy patients, but also elevate the risk of epileptic seizures. There are no specific criteria for the available antiepileptic drugs to ameliorate these symptoms in patients with epilepsy, and there is a lack of evidence to support the efficacy and safety of existing drugs. The Shugan Jieyu capsule (SJC) is a traditional herbal medicine composed of Acanthopanax senticosus and Hypericum perforatum and is reported to be effective in relieving psychiatric symptoms. The purpose of this study was to assess the efficacy of SJC as a treatment for psychiatric symptoms in epilepsy patients. Methods: Electronic databases will be investigated for publications in English, Korean, Japanese, and Chinese. The participants of the study are epilepsy patients with psychiatric symptoms diagnosed using any validated criteria. All types of controls will be compared-placebo, conventional treatments, and no treatment-to groups treated with SJC or modified SJC. We will measure the degree of improvement in psychiatric symptoms and check epileptic symptoms, such as the frequency of seizures. The study selection and data extraction will be performed by two independent reviewers, who will also assess methodological quality using the risk-of-bias tool by Cochrane. We will use Review Manager software (RevMan) to carry out all statistical analyses. Results: This systematic review and meta-analysis will be performed in accordance with the PRISMA-P statement. Conclusion: This systematic review is the first study to assess the efficacy and safety of SJC for the treatment of psychiatric symptoms in epilepsy. We expect that this study will provide clinically applicable evidence for patients with epilepsy when selecting drug treatments.