Objective To objectively evaluate the effectiveness of Tai Chi in fall prevention and balance function in the elderly. Methods Databases such as PubMed, Web of Science, The Cochrane Library (Issue 8, 2012), EMbase, CBM, CNKI, VIP and WanFang Data were electronically searched to collect the randomized controlled trials (RCTs) published from 2000 to 2012, and the relevant references of the included articles were also manually searched. According to the inclusion and exclusion criteria, the literature was screened, the data were extracted and the methodological quality of the included studies was assessed. Then meta-analyses were performed by using RevMan 5.1 software. Results A total of 6 RCTs involving 2 796 participants were included. The results of meta-analyses showed that the Tai Chi group was superior to the control group in decrease of the incidence rate of fall (RR=0.82, 95%CI 0.73 to 0.92, P=0.000 6), Timed Up and Go Test (MD=0.71, 95%CI 0.29 to 1.12, P=0.000 9), Functional Reach Test (MD=0.78, 95%CI 0.33 to 1.23, P=0.000 7) and Berger Balance Scale (MD=2.45, 95%CI 1.47 to 3.43, Plt;0.000 01), and there were statistical differences. Conclusion Tai Chi can effectively reduce the risk of fall for the elderly and improve their balance function.
Objective To investigate clinical significanceand surgical protocols about the balance of the lower limb lengths in the total hip arthroplasty. Methods Forty-eight patients undergoing the unilateral primary total hip arthroplasty from March 2000 to October 2004 were retrospectively studied. In 12 hips, the prostheses were of the cement type; in 36 hips, of the mixture type. Thirty patients with an equal limb length had a fractured femoral neck, 10 patients had a shortened (1.0-2.0 cm) limb, 6 patients had a shortened (2.0-4.0 cm)limb, and 2 patients had a shortened (4.0-6.0 cm) limb. Based on the clinical measurement and radiographic examination, the surgical protocols were designed, the hip prosthesis type was chosen, and the neck length of the femoral prosthesis and the position of osteotomy were estimated. By the wearing of the acetabula properly, the best rotation point was found out during the operation. The cut plane of the femoral neck was adjusted according to the results of the radiographic and other examinations. The neck length was readjusted after the insertion of the prosthesis so as to achieve an intended limblength equalization. Results All the patients were followed up for 3-42 months.According to the Harris scoring system, clinical results were excellent in 30 patients, good in 12, fair in4, and poor in 2. Of the 30 patients with an equal limb before operation, 5 were lengthened 1.0-2.0 cm in their lower limbs, and 1 lengthened 2.5 cm postoperatively. Of the 18 patients with shortened limbs before operation, 10 returned to the same lengths in their lower limbs, 6 were lengthened 1.0-2.0 cm in their lower limbs, but 2 with seriously-shortened lower limbs for congenital dysplasia of the hipjoint were still shortened 2.0-3.0 cm in the limb length after operation. The Harris hip scores revealed an average of 92.3 points in the patients with an equal limb length, and 88.6 points in the patients with shortened limbs. 〖WTHZ〗Conclusion Many factors, such as surgical protocols, prosthesis type designs, and the management techniques during the operation, can affect the limb length after operation. As the limb length discrepancy will make the patients feel disappointed, the clinical measurements are very important before operation. Application of the comprehensive appraisal methods during the operation, use of the soft tissuebalance method, and skills for obtaining an equal limb length during the total hip arthroplasty are also important for improving the surgical result further.
Objective To compare the balance of simple randomization, stratified blocked randomization and minimization. Methods Monte Carlo technique was employed to simulate the treatment allocation of simple randomization, stratified blocked randomization and minimization respectively, then the balance of treatment allocation in each group and the balance for every prognostic factor were compared. Results The simulation demonstrated that minimization provides the best performance to ensure balance in the number of patients between groups and prognostic factors. Balance in prognostic factors achieved with stratified blocked randomization was similar to that achieved with simple randomization. Conclusion Minimization offers the best balance in the number of patients and prognostic factors between groups.
The balance ability is the basic guarantee for the human body to maintain the posture and complete every daily life activity, and it is also an important physical quality index for the elderly. Insufficient balance ability may lead to falls among the elderly, which may lead to fractures, long-term pain, craniocerebral trauma, disability, and even death and other serious adverse consequences. Under the background of China’s rapid aging population and the strong advocacy of the combination of medical care and nursing, improving the balance ability of the elderly is an effective way to prevent the elderly from falling down, and is of great significance to reduce the accidental injury for the elderly. In this paper, the methods and the latest progress of balance function evaluation and training for the elderly at home and abroad are reviewed in order to provide reference for the formulation of intervention programs to improve the balance function of the elderly, so as to improve the quality of life of the elderly and open up a new path for the realization of healthy aging.
ObjectiveTo observe the effect of Baduanjin on the motor function and balance function in patients within 6 months after stroke.Methods Between July 2018 and March 2019, a total of 40 stroke patients were randomly divided into the Baduanjin group and the control group. Twenty patients in the Baduanjin group received the treatment of Baduanjin training and conventional rehabilitation, while the other 20 patients in the control group were treated with conventional rehabilitation only. The duration of the treatment was 3 weeks; then the motor function, balance ability and the ability of daily life in the two groups were assessed by the Fugl-Meyer Assessment (FMA), the 6-minute Walking Test (6MWT), the Berg Balance Scale (BBS), the balance tester and the Barthel Index (BI) respectively before and after treatment.ResultsAfter the 3-week treatment, the motor function, balance ability and the ability of daily life assessed by FMA, 6MWT, BBS, the balance tester, and BI were improved significantly in both groups (P<0.05). The post-treatment scores of FMA, BI, BBS and 6MWT distance in the Baduanjin group were more than those in the control group [72.25±20.91 vs. 57.90±20.25, 89.75±12.08 vs. 77.75±15.68, 53.25±5.74 vs. 47.80±9.77, (251.03±79.43) vs. (186.92±100.09) m; P<0.05]. In the sit-to-stand balance test, compared with those in the control group, the total trajectory length of center of gravity, average swing speed of center of gravity, and unit area trajectory length of center of gravity in standing stance in the Baduanjin group reduced significantly [(235.86±76.08) vs. (303.60±123.01) cm, (11.67±3.37) vs. (15.76±7.05) cm/s, (2.53±0.99) vs. (3.40±1.28) cm/cm2; P<0.05], and the total trajectory length of center of gravity, average swing speed of center of gravity, and unit area trajectory length of center of gravity in sitting stance in the Baduanjin group also reduced significantly [(246.59±98.79) vs. (334.05±155.87) cm, (7.69±2.29) vs. (11.13±6.41) cm/s, (4.10±1.38) vs. (6.25±4.21) cm/cm2; P<0.05].ConclusionConventional rehabilitation with or without Baduanjin can improve the motor function, balance function and the ability of daily life in patients after stroke, but the effect of rehabilitation with Baduanjin is better than conventional rehabilitation.
ObjectiveTo assess the methodological quality of systematic reviews of Tai Chi for preventing falls in the elderly and the quality of evidence for outcome indicators.MethodsPubMed, Web of Science, The Cochrane Library, EMbase, CNKI, WanFang Data, CBM and VIP databases were electronically retrieved. According to the inclusion criteria and exclusion criteria, the final articles were selected and the relevant literature information was extracted by reading the abstract and the full text. The methodological quality of the included systematic reviews was evaluated using AMSTAR 2 tool, and the quality of the outcome indicators of the included systematic reviews was further graded according to the GRADE system.ResultsA total of 11 systematic reviews/meta-analyses were included. The AMSTAR 2 evaluation showed that 10 studies were in critically-low methodological quality, and 1 study was in low methodological quality. The GRADE evaluation results showed that among the 36 outcome indicators included, there were 10 intermediate quality indicators, 20 low-level quality indicators and 6 extremely low-level quality indicators. Among the indicators of intermediate quality, single-leg stand test (MD = 5.33, 95%CI 3.35 to 7.32, P< 0.01; WMD = 1.76, 95%CI −7.00 to 10.52, P< 0.01), time up and go test (MD = 1.04, 95%CI 0.67 to 1.41, P< 0.01), the berg balance scale (MD = 2.18, 95%CI 0.93 to 3.43, P< 0.01), number of falls (RR = 0.82, 95%CI 0.73 to 0.92), P< 0.01), the incidence of 2-falls (OR = 0.69, 95%CI 0.49 to 0.97, P< 0.01) and the incidence of 3-falls (OR = 0.39, 95%CI 0.21 to 0.73, P< 0.01). The results of the above indicators were statistically significant, indicating that Tai Chi was better than control group.ConclusionsAt present, the methodological quality of relevant systematic reviews of Tai Chi for preventing falls in the elderly was relatively low and the quality of the evidence was not good, so it can’t be proved that Tai Chi can effectively prevent falls in the elderly, which needs to be further studied at a high level.
Pusher syndrome (PS) is a postural control disorder that occurs after stroke, which is mainly manifested as a balance dysfunction that is difficult to correct, leading to a significant decline in activity safety of stroke patients and hindering the process of rehabilitation treatment. Proper interventions are needed as soon as possible. Based on the research results of PS both domestic and foreign, this paper firstly summarizes the foundations of the mechanism of PS occurrence, and elaborates the existing disputes. Secondly, this paper systematically introduces the current mainstream assessment and treatment methods of PS, summarizes the problems in relevant clinical practice, and on this basis, gives some suggestions on the possible research directions in the future. The purpose is to provide reference for clinical application and future research directions.
ObjectivesTo systematically evaluate the impact of Tai Chi on the fall and balance function of middle-aged and the elderly.MethodsPubMed, EMbase, Web of Science, The Cochrane Library, CNKI and WanFang Data databases were electronically searched to collect randomized controlled trials (RCTs) on the influence of Tai Chi on the balance function and fall of middle-aged and the elderly from inception to August, 2019. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Meta-analysis was then performed by RevMan 5.3 software.ResultsA total of 20 RCTs involving 3 842 patients were included. The results of meta-analysis showed that the Tai Chi group was superior to the control group in the improvement of the fall rate (RR=0.82, 95%CI 0.75 to 0.90, P<0.000 01), single-leg standing test (MD=5.76, 95%CI 0.62 to 10.90, P=0.03), Berg balance scale (MD=1.04, 95%CI 0.23 to 1.85, P=0.01), timed up and go (MD=−0.71, 95%CI −0.88 to −0.54, P<0.000 01), chair stand test (MD=0.87, 95%CI 0.05 to 1.70, P=0.04) and other indicators, and the difference was statistically significant.ConclusionsThe current evidence shows that Tai Chi can improve the balance function of middle-aged and the elderly, reduce the fall rate, and have a certain preventive effect on falls. Due to limited quality and quantity of the included studies, more high quality studies are required to verify the above conclusion.
ObjectiveTo explore the effects of core stable training on cervical vertebrae pain, cervical function and balance ability in patients with neck type cervical spondylopathy (NTCS).MethodsFrom January to August 2018, 98 patients with NTCS were treated. According to the odd and even bed numbers, 49 patients were enrolled in the observation group and 49 were in the control group. The patients in the control group was given Kinesio tape treatment, and the observation group was given core stability training based on the treatment of the control group. Cervical vertebrae pain was assessed by Visual Analogue Scale (VAS), Clinical Assessment Scale for Cervical Spondylosis (CASCS) and Neck Disability Index (NDI); cervical vertebra activity were used to assess the cervical; the Berg Balance Scale (BBS) was used to assess patients’ balance before intervention and at the 4th week of intervention. The incidence of complications during the intervention and the effective of treatment 4 weeks after intervention were recorded. The recurrence rate 6 months after the intervention was recorded.ResultsThere were no significant difference in CASCS, NDI, VAS, and BBS scores between the two groups before intervention (P>0.05). At the 4th week of the intervention, the CASCS and BBS scores of the two groups were higher than those before the intervention, and the VAS and NDI scores were lower than those before the intervention (P<0.05); and the CASCS and BBS scores in observation group at the 4th week of the intervention were higher than that of control group, and VAS and NDI scores were lower than those of the control group (P<0.05). There was no significant difference in the activity of the cervical vertebrae before intervention in both of the two groups (P>0.05). At the 4th week of the intervention, the activity of the cervical vertebrae in all directions was bigger than that of before the intervention in both of the two groups (P<0.05), and that in observation group were bigger than that of the control group (P<0.05). The effective rate at the 4th week in the observation group (95.92%) was higher than that in the control group (81.83%)(P<0.05). The recurrence rate 6 months after intervention in the observation group (6.38%) was lower than that in the control group (22.50%) (P<0.05).ConclusionCore stability training can relieve cervical spondylosis in NTCS patients, and improve the cervical function and patients’ balance; it has high safety and stable efficacy.
ObjectiveTo evaluate the therapeutic efficacy of vitrectomy with internal limiting membrane (ILM) peeling and subretinal injection of balance salt solution (BSS) for refractory diabetic macular edema (DME).MethodsA retrospective case series study. From November 2017 to August 2018, 24 eyes of 19 patients affected with DME resistant to anti-VEGF therapy [central macualar thickness (CMT) more than 275 μm despite undergoing anti-VEGF therapy at least 3 times] in Ophtalmology Department of Central Theater Command General Hospital of Chinese People's Liberation Army were enrolled in this study. All the patients underwent 25G pars plana vitrectomy with ILM peeling and subretinal injection of BSS. The BCVA was measured using the international standard visual acuity chart, and the results were converted to the logMAR visual acuity. The CMT and the macular volume (MV) were assessed with swept-source optical coherence tomography at baseline and each month postoperatively. The differences in BCVA, CMT and MV before and after surgery were analyzed.ResultsThe mean BCVA was 0.74±0.29 at baseline, which increased significantly to 0.62±0.28, 0.56±0.25, 0.47±0.26, 0.46±0.23 at 2 weeks, 1 month, 3 months and 6 months after treatment respectively (F=4.828, P=0.001). At 6 months, BCVA improved by more than 0.3 logMAR units in 16 eyes (66.7%). The mean CMT was 554.58±102.86 μm at baseline, which reduced to 338.17±58.09 μm, 299.42±52.66 μm, 275.75±41.24 μm and 270.96±38.33 μm at 2 weeks, 1 month, 3 months and 6 months after treatment respectively (F=84.867, P＜0.001). The mean MV was 13.01±0.88 mm3 at baseline, which decreased to 11.50±0.73 mm3, 11.00±0.74 mm3, 10.68±0.61 mm3 and 10.52±0.56 mm3 at 2 weeks, 1 month, 3 months and 6 months after treatment respectively (F=47.364, P＜0.001). Macular edema recurred in 5 eyes (20.8%) 6 months after surgery. No severe systemic or ocular side effect was reported during the follow-up.Conclusions25G vitrectomy with ILM peeling and subretinal injection of BSS for refractory DME can improve the visual acuity, facilitate a rapid resolution of macular edema.