Effects of Fasting on the Physiological and Psychological Responses in Middle-Aged Men

Tracking changes in the body during fasting takes into account indicators of mental well-being and physiological parameters. The aim of the study was to measure psychological and physiological reactions, along with their mutual relations, caused by 8 days of water-only fasting. Fourteen men aged 35 to 60 participated in the study, divided into two groups, younger and elder. In addition to physiological parameters, psychological data were collected using four different tests. The obtained results confirmed reduction in body weight, systolic blood pressure, resting diastolic blood pressure and glucose level, and increase in resting heart rate, cortisol and β-hydroxybutyrate concentration. However, no significant psychological changes were observed under the influence of fasting intervention. A significant interaction effect occurred for the state anxiety variable determined before and after the fasting intervention for both groups. Moreover, negative correlations between physiological (cortisol) and psychological factors of subjectively assessed stress were revealed. The only effect on cognitive ability was seen when responding to simple tasks. The study confirmed the beneficial effect of 8 days of water-only fasting on physiological variables without affecting mental well-being. The relatively high level of well-being after fasting intervention was independent of the physiological indicators of stress.

Energy conversion in Textus Bioactiv Ag membrane dressings using Peusner's network thermodynamic descriptions

BACKGROUND

The Textus Bioactiv Ag membrane is an active dressing for the treatment of chronic wounds such as venous stasis ulcers and burns.

OBJECTIVES

Determination of the transport and internal energy conversion properties of the Textus Bioactiv Ag membrane using the Kedem-Katchalsky-Peusner model. This model introduces the coefficients Lij necessary to calculate the degree of coupling (lij, QL), energy conversion efficiency (eij), dissipated energy (S-energy), free energy (F-energy), and internal energy (U-energy).

MATERIAL AND METHODS

The research material was the Textus Bioactiv Ag membrane that is used as an active dressing in the treatment of difficult-to-heal wounds, and KCl aqueous solutions. The research methods employed Peusner's formalism of network thermodynamics and Kedem and Katchalsky's thermodynamics of membrane processes. To calculate the Lij coefficients, we used hydraulic conductivity (Lp), diffusion conductivity (ů) and reflection (ó) coefficients to perform experimental measurements in different conditions.

RESULTS

The Lp coefficient for the Textus Bioactiv Ag membrane is nonlinearly dependent on the average concentrations of the solutions. In turn, the ů and ó coefficients are nonlinearly dependent on the differences in osmotic pressures (Äđ). An increase in the Äđ causes the Textus Bioactiv Ag membrane to become more permeable and less selective for KCl solutions. The coefficients of Peusner (Lij), couplings (lij, QL), energy conversion efficiency (eij), S-energy, F-energy, and U-energy also depend nonlinearly on Äđ. Our results showed that for higher concentrations of KCl solutions transported through the Textus Bioactiv Ag membrane, the coupling and energy conversion coefficients were greater for larger Äđ up to their maximum values for large Äđ. Coupling of the membrane structure with the electrolyte flux through the membrane is observed for Äđ greater than 10 kPa.

CONCLUSIONS

Textus Bioactiv Ag membrane dressings possess the properties of a solution component separator as well as an internal energy converter.

Ground reaction force analysis for assessing the efficacy of focused and radial shockwaves in the treatment of symptomatic plantar heel spur

BACKGROUND

Extracorporeal shock wave therapy is among the conservative treatments for symptomatic heel spur.

OBJECTIVE

The purpose of this trial is to evaluate and compare the therapeutic effects of radial shock wave (RSWT) and focused shock wave (FSWT) applied in the treatment of symptomatic heel spur.

METHODS

Fifty-five participants were randomly divided into two comparative groups that were administered FSWT and RSWT, respectively. The severity of dysfunction (Foot Function Index, FFI), ground reaction forces (GRF) and walking temporal parameters were measured in all patients at baseline and at weeks 1, 3, 6, 12 and 24 after treatment.

RESULTS

In both groups, a gradual decrease in the FFI values occurred after treatment. The percentage reduction in the FFI was comparable for both groups. Statistically significant changes were only noted between some measurements of GRF and walking temporal parameters. The percentage changes in the values of the force and temporal parameters were similar between the groups.

CONCLUSIONS

Both FSWT and RSWT are efficacious in the treatment of symptomatic heel spur and their therapeutic effects are comparable. Objective data registered by force platforms during walking are not useful for tracing the progress of treatment applied to patients with symptomatic heel spur between consecutive procedures.

Reliability of pelvic floor muscle surface electromyography (sEMG) recordings during synchronous whole body vibration

The primary aim of the study was to assess intraday and interday reliability of surface electromyography (sEMG) reflex activity of the pelvic floor muscles during synchronous whole-body vibration (S-WBV) of two intensities (30Hz/2mm; 40Hz/4mm) using band-stop filter and high-pass filter signal processing. The secondary aim of the study was to assess intraday and interday (test-retest) reliability of sEMG obtained from maximal voluntary contraction (MVC) test. We evaluated the intraday reliability of sEMG recordings obtained during sessions 1 and 2 performed on the same day. The sessions consisting of maximal voluntary pelvic floor muscle contraction and synchronous vibration sets with 1-hour rest in-between sessions 1 and 2 in healthy nulliparous women. The next intraday reliability was evaluated between the results of sessions 3 and 4 performed on the same day but followed at an interval of 4 weeks. to include the entire menstrual cycle. The interday reliability was determined based on the results of sessions 1 and 3 using the intraclass correlation coefficient (ICC 3,3). The intraday ICCs for band-stop filtered mean and median sEMG frequency and mean normalized sEMG_RMS amplitude of the 30Hz/2mm (ICC = 0.89–0.99) and 40Hz/4mm vibration (ICC = 0.95–0.99) indicated substantial reproducibility. The intraday reliability of high-pass filter at 100-450Hz for these parameters was also substantial (30Hz/2mm ICC of 0.92 to 0.98; 40Hz/4mm ICC of 0.88 to 0.98). The interday reliability (session 1 vs. session 3) of the mean normalized sEMG_RMS amplitude for band-stop filtered means of 40 Hz/4mm and 30Hz/2mm vibration recordings was substantial (ICC = 0.82 and 0.93). However, ICCs of the mean and median frequency were indicative of fair reliability (ICC of 0.43 to 0.59). The interday reliability of mean normalized sEMG_RMS amplitude for high-pass filter at 100-450Hz was substantial (30Hz/2mm ICC of 0.90; 40Hz/4mm ICC of 0.73) for the 30Hz/2mm S-WBV and moderate (ICC = 0.73) for the 40/4mm S-WBV. The ICCs for mean and median sEMG frequency ICCs indicated slight to fair reproducibility (ICC of 0.16 to 0.56). The intraday reliability of the strongest MVC contraction and average MVC turned out substantial (ICC = 0.91–0.98). The interday reliability coefficients of the strongest MVC contraction and average MVCs were 0.91 and 0.82, respectively. Concluded, the intraday reliability proved satisfactory for all variables; however, the interday comparison showed sufficient ICC levels only for the mean amplitude. We therefore recommend this parameter should be used when analyzing PFM sEMG recorded during vibration. ICCs of the mean and median frequency for both signal processing methods were indicative of insufficient reliability and did not reach the threshold for usefulness. Our study showed similar reliability of PFM sEMG during S-WBV in case of the two filtering methods used.

A comparative study of the efficacy of radial and focused shock wave therapy for tennis elbow depending on symptom duration

INTRODUCTION

In physical therapy, the duration and severity of pain complaints determine the choice of an appropriate physical agent and parameters needed. The aim of this study was to compare the therapeutic efficacy of focused and radial shock waves for tennis elbow with respect to the dysfunction period.

MATERIAL AND METHODS

The patients with acute (n = 27) and chronic (n = 31) tennis elbow were randomly assigned to a treatment arm: focused shock wave therapy (3 sessions, 2000 shocks, 4 Hz, 0.2 mJ/mm²) or radial shock wave therapy (3 sessions, 2000 shocks, 8 Hz, 2.5 bar). In order to objectivize therapy effects, the severity of pain complaints (Visual Analog Scale), strength of wrist flexors and extensors and grip strength were assessed. We performed pre-intervention measurements and short-term follow-up at 1, 6 and 12 weeks of therapy completion.

RESULTS

At 6 and 12 weeks of therapy completion, all groups exhibited significantly reduced pain complaints (p < 0.05). The most noticeable changes in grip strength, wrist extensors and flexors strength were observed in the affected extremities of all experimental groups while changes within the unaffected extremities were slight. Grip strength as well as the strength of flexor and extensor muscles of the affected limb were significantly greater at 12 weeks of therapy completion compared to pre-intervention values (p < 0.05). At the same time point, percent changes of all study parameters were comparable for all groups (p > 0.05).

CONCLUSIONS

Focused and radial shock wave therapy tend to show a significant and comparable short-term therapeutic effect for acute and chronic tennis elbow.

The Rolf Method of Structural Integration on Fascial Tissue Stiffness, Elasticity, and Superficial Blood Perfusion in Healthy Individuals: The Prospective, Interventional Study

Introduction: There are multiple theories surrounding the physiological impact of structural integration (SI) with little evidence or research corroborating any of these. The aim of the study was to assess the effectiveness of 10 sessions of SI on fascial tissue (FT) superficial blood perfusion, stiffness, and elasticity in 13 healthy women.

Methods: This was a prospective, interventional study. The primary outcome measures were FTs’ superficial blood perfusion, stiffness, and elasticity of bilateral selected FT points on the body. Data were collected before and after 10 sessions of SI intervention. Statistical analysis was performed using the non-parametric Wilcoxon test (intragroup comparison).

Results: The superficial blood perfusion increased significantly in the most selected FT points on the body (p < 0.05). SI interventions produced significant decreases in selected points (brachioradialis, biceps brachii, and trapezius; p < 0.05) of FT stiffness and significant increases in elasticity (brachioradialis, biceps brachii, triceps surae, and trapezius; p < 0.05), especially in the FT of the right (dominant) upper limb.

Conclusion: A 10-session of SI demonstrated positive effects on increasing superficial blood perfusion contributed to a decrease in FT stiffness and an increase in elasticity properties in the dominant upper limb. Data collection for this study is currently underway, and the trial is registered at ISRCTN.com with the identifier: ISRCTN46707309.

Shockwave therapy in selected soft tissue diseases: a literature review

OBJECTIVE

The aim of our study is to present the current state of knowledge on the use of shockwave therapy (SWT) in the treatment of soft tissue wounds, by reviewing the available literature.

METHOD

Medical databases were searched for articles using the keywords: 'shockwave AND wound healing', 'shockwave AND ulcers', 'shockwave AND burns', 'shockwave AND bedsores', 'shockwave AND diabetic foot ulcer', 'ESWT AND wound healing', 'shock wave AND diabetic gangrene'.

RESULTS

A total of 14 scientific articles were included in the study which described the methodology of treatments and list the type of generator, physical parameters used during the procedure, number of treatments and the type of treated wounds. From these articles, 191 soft tissue wounds were analysed.

CONCLUSION

Evidence from the articles analysed in this study suggests a beneficial effect of SWT to treat diabetic foot ulcers, venous leg ulcers, pressure ulcers and burns. SWT can be used in combination with standard treatment in soft tissue wounds.

An assesment of body posture of children aged 3-6 years

Background: A posture defect may be defined as a syndrome of abnormalities occurring in a relaxed upright position of the body. Deviations from the typical body shape are specific for given age and gender. Life determinants and social situation have a very significant impact on the development of body posture in young people. Aim of the study: The aim of the study was to analyse the occurrence of spinal defects in children aged 3–6 years. Material and methods: The study included 75 children aged 3–6 years. The children were examined for spinal defects using the MORA computer system. Results: Boys in the study showed a correlation between height and the inclination of the upper thoracic segment, whereas no such correlation was observed in girls. A significant relationship was also demonstrated between BMI and compensation and inclination of the lumbar segment in all subjects. Overall height was also noted to be significantly related to both spine length and the length of its curvature. Conclusions: The occurrence of spinal defects is influenced by gender. BMI can have a significant impact on spinal morphology and the formation of body posture, even in pre-school age children.

Radial shockwave and ultrasound in the treatment of lateral epicondylitis – a preliminary report

Introduction: Lateral epicondylitis can be resistant to treatment that usually involves the use of conservative therapies, including physical modalities such as radial shockwave and ultrasound. Studies show that both modalities are efficacious but their results are inconsistent. The optimal parameters for applying them are also yet to be determined. This trial was designed to analyse and compare the efficacy of radial shock wave and ultrasound as therapies for treating patients with lateral epicondylitis. Material and methods: The trial was conducted with 26 patients with lateral epicondylitis divided into two comparative groups (A and B), each consisting of 13 patients. The groups were treated with radial shockwave and ultrasound, respectively. In both of them, changes in patients’ rest pain, night pain, pain during activity, and hand grip strength were evaluated, as well as the efficacy of both therapies. Results: The intensity of all types of pain decreased over the course of the study in both groups and patients’ grip strength gradually improved. The groups were comparable in terms of percentage change in the analysed parameters and the distribution of patients’ self-assessments of treatment efficacy. Conclusions: Radial shockwave and ultrasound show comparable efficacy in treating lateral epicondylitis. They are particularly effective in reducing pain intensity and increasing the hand grip strength of the affected extremity.

Failure of low-level laser therapy to boost healing of venous leg ulcers in surgically and conservatively treated patients

Objective: To evaluate in a randomized open-label clinical trial the ability of adjuvant low-level laser therapy (LLLT) to improve healing of venous leg ulcers in surgically and conservatively treated patients. Patients and methods: Eighty three patients with venous leg ulcers were included in this study. Patients in groups 1 and 2 were treated surgically while patients in groups 3 and 4 were treated conservatively. Patients in groups 1 and 3 were additionally treated with the LLLT (GaAlAs laser, 810 nm, 4 J/cm2, 65 mW) once daily, 6 times a week for 7 weeks. Results: After therapy comparison of completely healed wounds, statistically significant differences were seen between groups 1 and 3 (p=0.02), 1 and 4 (p= 0.02), 2 and 3 (p= 0.02), 2 and 4 (p=0.02) in favor of groups 1 and 2. Comparison of the relative change of wound total surface area indicated statistically significant differences between groups 1 and 3 (p=0.002), 1 and 4 (p=0.002), 2 and 3 (p=0.002), 2 and 4 (p=0.002) in favor of groups 1 and 2. Comparison of the other parameters also demonstrated a more efficient therapy effects in groups 1 and 2 than in group 3 and 4. There were no statistical differences in all examined parameters between groups 1 and 2 (p>0.05), 3 and 4 (p>0.05). Conclusion: The application of the LLLT does not enhance healing of venous leg ulcers in surgically and conservatively treated patients. A well conducted surgical operation is much more efficient than conservative pharmacological procedures.

Randomized, controlled clinical pilot study of venous leg ulcers treated with using two types of shockwave therapy

Background. Venous leg ulcers are difficult to heal wounds. The basis of their physiotherapeutic treatment is compression therapy. However, for many years, the search for additional or other methods to supplement the treatment of venous ulcers, which would shorten the duration of treatment, is underway. One of such methods is the shockwave therapy. Methods. The purpose of our study was to compare radial shockwave therapy (R-ESWT) with focused shockwave therapy (F-ESWT) in venous leg ulcers treatment. Patients were randomly assigned to tree groups. In the first group the radial shockwave therapy (0.17mJ/mm², 100 impulses/cm², 5 Hz), in the second group the focused shockwave therapy (0.173mJ/mm², 100 impulses/cm², 5 Hz) was used and in third group standard care was used. Patients in shockwave therapy groups were given 6 treatments at five-day intervals. Total area, circumference, Gilman index, maximum length and maximum width of ulcers were measured. The patients from the third group wet gauze dressing with saline and gently compressing elastic bandages were used (standard wound care SWC). Results. Analysis of the results shows that a complete cure of ulcers was achieved in 35% of patients who were treated with radial shockwave, 26% of patients with focused shockwave used. There is statistically significant difference between the standard care and radial shockwave therapy as well as between the standard care and focused shockwave therapy. There is no statistically significant difference between the use of radial and focused shockwave in the treatment of venous leg ulcers (p> 0.05). Conclusion. There is no statistically significant difference between the use of radial and focused shockwave in the treatment of venous leg ulcers. Treatment of venous leg ulcers with shockwaves is more effective than the standard wound care.

An attempt at objective and subjective evaluation of the therapeutic efficacy of focused and radial shockwave applied to symptomatic heel spur

PURPOSE

The experiment was designed to evaluate and compare the efficacy of focused shockwave and radial shockwave in symptomatic heel spur treatment. Postural balance tests were used to ensure the objectivity of evaluations.

METHODS

Forty three patients with symptomatic heel spur were divided into two comparative groups that received respectively focused shockwave therapy (the FSWT group; 2000 impulses, 4 Hz, 0.4 mJ/mm2) and radial shockwave therapy (the RSWT group; 2000 impulses, 8 Hz, 5 bars + 2000 impulses, 8 Hz, 2.5 bars). Each patient received 5 treatments at weekly intervals. Before therapy started and 1, 3, 6 and 12 weeks after it ended, the intensity of pain experienced by the patients was assessed and static balance tests were performed on a force platform.

RESULTS

Successive measurements showed that the intensity of all kinds of pain under consideration was decreasing gradually and statistically significantly in both groups. The percentage reduction in pain intensity was similar between the groups. The standard deviation of the COP in the anterior-posterior and medial-lateral directions, 95% confidence ellipse area and COP velocity kept varying throughout the experiment, but in none of the groups changes were statistically significant.

CONCLUSIONS

Focused shockwave therapy and radial shockwave therapy improve the well-being of patients with symptomatic heel spur significantly and comparably. Posturography cannot deliver unambiguous data for tracking changes that the two therapies induce in these patients.

The effects of treatment the avascular necrosis of the femoral head with extracorporeal focused shockwave therapy

Background.Avascular necrosis of the femoral head continues to represent a major challenge for the orthopaedist and trauma surgeon. A fully effective method of treatment is yet to be introduced. After femoral head collapse, only total hip replacement can help the patient. Our study aims to assess the effects of treatment of avascular necrosis of the femoral head with extra corporeal focused shockwave therapy.Material and methods. A prospective study was carried out in patients with avascular necrosis of the femoral head, ARCO stage I-III, diagnosed by MRI imaging. Shock waves are applied under x-ray guidance. Four points are marked on the skin above the lesion. Each spot receives a dose of 1500 pulses at an energy flux density of 0.4 mJ/mm2 and a frequency of 4 Hz. Each patient undergoes 5 therapy sessions. A posturometric and stabilometric assessment is carried out before and after the therapy. Other examinations include a tensometric evaluation of the strength of the treated limb, and an assessment of pain intensity (VAS scale)and hip function (Harris hip score). Follow-up visits are scheduled at 6 weeks and 3, 6 and 12 months post-treatment.Results. Nine patients were treated with shockwave therapy at the Department of Orthopaedics and Musculoskeletal Traumatology, Medical Faculty, Medical University of Silesia, between 5 May 2011 and 1 June 2012. The patients demonstrated pain reduction and improved mobility of the treated joint (VAS score decreasing from 6.75 +/- 0.71 to 2.5 +/- 1.7; Harris hip score increasing from 55.21 +/- 15.45 to 89.21 +/- 8.26). Tensometric platform testing carried out after the treatment revealed a statistically significant difference between mean velocity of the centre of pressure (CoP) movement when walking with eyes open and closed (p<0.05) and mean CoP movement along the x (walking with eyes closed) and y (free standing with eyes closed) axes.Conclusions. 1. Extracorporeal focused shockwave therapy resulted in considerable improvement in the patients' quality of life at 6 weeks' follow-up. 2. At 6 months some patients reported intensified pain and worse hip function.

Using high-voltage electrical stimulation in the treatment of recalcitrant pressure ulcers: results of a randomized, controlled clinical study 

 The use of electrical stimulation has been studied in a variety of wounds emphasizing different variables with regard to provision of therapy. The purpose of this prospective, randomized, controlled clinical study was to evaluate the effect of high-voltage electrical stimulation (HVES) on nonhealing, lower-extremity, Stage II and Stage III pressure ulcers. Patients admitted for care and eligible to participate in the study received standard supportive care and topical treatments covered with wet-to-moist dressings. Patients assigned to the treatment arm of the study also received HVES (100 V; 100 μs; 100 Hz) continuously for 50 minutes once daily, five times per week. Patients were followed until healing for a maximum of 6 weeks. Wound tracings and measurements were obtained weekly. Over a 4-year period, 26 patients were enrolled in the treatment and 24 in the control group. Ulcers had existed for an average of 3.17 and 2.83 months in the treatment and control groups, respectively. Most were classified as Stage II (17 in the treatment and 16 in the control group) with an average baseline size of 4.54 cm2 and 3.97 cm2, respectively. Wound areas and linear measurements decreased significantly in both groups (P <0.05), but increases in granulation tissue were significant in the treatment group only (P = 0.006). Wound area, linear measurement, wound volume, and granulation tissue changes were statistically significantly greater in the treatment than in the control group starting in the second week of treatment. Week 6 surface area change was 88.9% (SD 14) in the treatment and 44.4% (SD 63.1) in the control group (P = 0.00003). Correlation coefficients between changes in wound surface area, longest length, and longest width were R = 0.96 and R = 0.98 in the treatment and R = 0.94 and R = 0.89 in the control group. HVES improved the healing rate of recalcitrant Stage II and Stage III pressure ulcers. Research to compare the effectiveness of using cathodic and anodal stimulation combined or alone and to determine the optimal duration of these two types of electrical stimulation is warranted.

Early and long-term results of physical methods in the treatment of venous leg ulcers: randomized controlled trial

OBJECTIVE

To estimate early and long-term results of physical methods in the treatment of venous leg ulcers.

METHOD

In group A after surgical operation, 40 patients were treated with the high-voltage stimulation (HVS) (100 µs, 100 Hz, 100 V) and drug therapy. In group B after operation, 37 patients were treated with ultrasound (0.5 W/cm(2), 1 MHz) and drug therapy. In group C after operation, 33 patients were treated with low-level laser therapy (LLLT) (810 nm, 65 mW) and drug therapy. In group D after operation, 35 patients were treated with the compression stockings (25-31 mmHg) and drug therapy. In group E after operation, 37 patients were only treated with drug therapy. Group F consisted of 32 patients, conservatively treated with the HVS and drug therapy. Group G consisted of 20 patients, conservatively treated with ultrasound and drug therapy. Group H consisted of 21 patients, conservatively treated with LLLT and drug therapy. Group I consisted of 30 patients, conservatively treated with compression and drug therapy. Group J consisted of 27 patients only treated with drug therapy.

RESULTS

Both short and long term parameters showed that compression therapy is the most efficient in ulcer healing. The electrical and ultrasound methods are less effective. The laser therapy ared useless.

CONCLUSION

Superficial venous surgery in addition to compression therapy is the most efficient treatment of venous leg ulcers. The compression therapy should be continued both surgically and conservatively treated patients with healed ulcers. In special cases after superficial venous surgery (isolated superficial reflux) compression therapy could be applied only to the time of ulcer closure without continuing it longer. HVS and ultrasound therapy are useful methods in conservative treatment of venous leg ulcers. For surgically-treated patients these physical therapies are efficient only in superficial plus deep reflux cases. HVS and ultrasound can be alternative methods, but are less effective in recurrence risk. LLLT is not an efficient physical method in treatment of venous leg ulcers.

The use of therapeutic ultrasound in venous leg ulcers: a randomized, controlled clinical trial

Objectives

To estimate the usefulness of therapeutic ultrasound for healing of venous leg ulcers.

Methods

Eighty-one patients were included in this study. Patients in groups 1 and 2 were treated surgically. Patients in groups 3 and 4 were treated conservatively. Patients in groups 1 and 3 were additionally treated with the ultrasound (1 MHz, 0.5 W/cm2) once daily, six times a week for seven weeks.

Results

Comparison of the number of complete healed wounds indicated statistically significant differences between groups 1 and 4 ( P = 0.03), 2 and 4 ( P = 0.03), 3 and 4 ( P = 0.03) in favour of groups 1, 2 and 3. Comparison of the other parameters also demonstrated more efficient therapy effects in groups 1, 2 and 3 than in group 4. There were no statistical differences in all examined parameters between groups 1, 2 and 3 ( P > 0.05).

Conclusions

The ultrasound is an efficient and useful method only in conservatively treated venous leg ulcers. There are no special reasons for application of the ultrasound in surgically treated patients. A well-conducted surgical operation is much more effective for a healing process than conservative pharmacological procedures.