1) The study evaluated the effects of high acceleration forces (9G) on visual performance and ocular responses in 14 men using a human centrifuge.
2) Transient visual acuity reduction and temporary corneal thickening were observed immediately after centrifugation. Prolonged increases in anterior chamber depth and pupillary dilation were also observed up to 30 minutes after.
3) Contrast sensitivity was found to decrease significantly at low and medium spatial frequencies and did not return to baseline levels within 30 minutes of centrifugation.
Does a standard outpatient physiotherapy regime improve the range of knee mot...FUAD HAZIME
This study investigated whether a standard outpatient physiotherapy regime improved range of knee motion after primary total knee arthroplasty (TKA). 150 patients were randomly assigned to either receive 6 weeks of outpatient physiotherapy after TKA (Group A) or no outpatient physiotherapy (Group B). Range of motion measurements found that while Group A achieved greater flexion than Group B, the difference was not statistically significant. The study concluded that outpatient physiotherapy does not improve range of knee motion after primary TKA.
This document discusses using robotics to evaluate and treat spasticity and mobility limitations in children with cerebral palsy (CP). It describes developing a robotic device that can precisely control joint movement speed and torque to quantify range of motion, stiffness, muscle activity and reflex responses. A study is described that tested 6 weeks of home-based robotic therapy for passive stretching and active movement training of the ankle joint in children with CP. Results showed improvements in spasticity, range of motion, strength and gait symmetry for both the home-based and lab-based robotic rehabilitation groups.
Artigo - Acupuncture on oxygen consumptionRenato Almeida
1) Auricular acupuncture had a significant effect on improving the oxygen consumption and recovery ability of boxing athletes.
2) The study found that VO2max, a key indicator of cardiovascular endurance, was significantly higher after auricular acupuncture stimulation compared to a control group.
3) Auricular acupuncture stimulation may enhance athletic performance by improving aerobic ability as shown by increased VO2max and VEmax, and faster recovery of heart rate and body temperature after exercise.
Goodwin efetividade da fisio supervisionada num período precGustavo Resek Borges
This randomized controlled trial evaluated the effectiveness of supervised physical therapy plus a home program versus a home program alone for 84 patients who underwent arthroscopic partial meniscectomy. Patients were randomly assigned to receive either 6 weeks of supervised physical therapy plus a home program or just a home program. Outcome measures were collected at 5 and 50 days post-surgery and found no differences between the groups, indicating that the supervised physical therapy used in this study provided no additional benefits in the early period after uncomplicated arthroscopic partial meniscectomy compared to a home program alone.
This study compared the outcomes of two rehabilitation protocols for patients with Achilles tendinopathy: an exercise training group that was allowed to continue tendon-loading activities like running and jumping, and an active rest group that was not allowed such activities during the first six weeks. Both groups followed the same progressive strengthening program after the initial period. The study found no significant differences in outcomes between the groups, as both showed significant improvements on patient-reported and functional measures from baseline to 12-month follow-up. The results suggest that continuing tendon-loading activity during rehabilitation, using a pain-monitoring model, does not have negative effects.
Determinants of function knee arthroplastyFUAD HAZIME
This research study examined 276 patients who received a primary total knee arthroplasty (TKA) to identify preoperative factors that predict functional status after surgery. Data on demographics, medical history, and knee function were collected before and 6 months after surgery. The results found that lower baseline function, use of a walking device, shorter walking distance, and more comorbid health conditions predicted poorer functional outcomes 6 months after TKA. Patients with more preoperative dysfunction may require more intensive physical therapy to achieve functional gains similar to less impaired patients.
Pro disc l replacement vs circumferential arthrodesis of spineQueen Mary Hospital
This study compared results of the ProDisc-L total disc replacement to circumferential spinal fusion for treating two-level lumbar degenerative disc disease. 256 patients were randomized to the two procedures. At 24 months, 143 patients received total disc replacement while 60 received spinal fusion. The total disc replacement group had significantly less operative time, blood loss, and shorter hospital stays. Clinical outcomes including ODI, SF-36, and pain/satisfaction scales were measured at multiple points up to 24 months. Radiographic outcomes were also assessed to analyze device success and fusion rates between the two procedures.
Does a standard outpatient physiotherapy regime improve the range of knee mot...FUAD HAZIME
This study investigated whether a standard outpatient physiotherapy regime improved range of knee motion after primary total knee arthroplasty (TKA). 150 patients were randomly assigned to either receive 6 weeks of outpatient physiotherapy after TKA (Group A) or no outpatient physiotherapy (Group B). Range of motion measurements found that while Group A achieved greater flexion than Group B, the difference was not statistically significant. The study concluded that outpatient physiotherapy does not improve range of knee motion after primary TKA.
This document discusses using robotics to evaluate and treat spasticity and mobility limitations in children with cerebral palsy (CP). It describes developing a robotic device that can precisely control joint movement speed and torque to quantify range of motion, stiffness, muscle activity and reflex responses. A study is described that tested 6 weeks of home-based robotic therapy for passive stretching and active movement training of the ankle joint in children with CP. Results showed improvements in spasticity, range of motion, strength and gait symmetry for both the home-based and lab-based robotic rehabilitation groups.
Artigo - Acupuncture on oxygen consumptionRenato Almeida
1) Auricular acupuncture had a significant effect on improving the oxygen consumption and recovery ability of boxing athletes.
2) The study found that VO2max, a key indicator of cardiovascular endurance, was significantly higher after auricular acupuncture stimulation compared to a control group.
3) Auricular acupuncture stimulation may enhance athletic performance by improving aerobic ability as shown by increased VO2max and VEmax, and faster recovery of heart rate and body temperature after exercise.
Goodwin efetividade da fisio supervisionada num período precGustavo Resek Borges
This randomized controlled trial evaluated the effectiveness of supervised physical therapy plus a home program versus a home program alone for 84 patients who underwent arthroscopic partial meniscectomy. Patients were randomly assigned to receive either 6 weeks of supervised physical therapy plus a home program or just a home program. Outcome measures were collected at 5 and 50 days post-surgery and found no differences between the groups, indicating that the supervised physical therapy used in this study provided no additional benefits in the early period after uncomplicated arthroscopic partial meniscectomy compared to a home program alone.
This study compared the outcomes of two rehabilitation protocols for patients with Achilles tendinopathy: an exercise training group that was allowed to continue tendon-loading activities like running and jumping, and an active rest group that was not allowed such activities during the first six weeks. Both groups followed the same progressive strengthening program after the initial period. The study found no significant differences in outcomes between the groups, as both showed significant improvements on patient-reported and functional measures from baseline to 12-month follow-up. The results suggest that continuing tendon-loading activity during rehabilitation, using a pain-monitoring model, does not have negative effects.
Determinants of function knee arthroplastyFUAD HAZIME
This research study examined 276 patients who received a primary total knee arthroplasty (TKA) to identify preoperative factors that predict functional status after surgery. Data on demographics, medical history, and knee function were collected before and 6 months after surgery. The results found that lower baseline function, use of a walking device, shorter walking distance, and more comorbid health conditions predicted poorer functional outcomes 6 months after TKA. Patients with more preoperative dysfunction may require more intensive physical therapy to achieve functional gains similar to less impaired patients.
Pro disc l replacement vs circumferential arthrodesis of spineQueen Mary Hospital
This study compared results of the ProDisc-L total disc replacement to circumferential spinal fusion for treating two-level lumbar degenerative disc disease. 256 patients were randomized to the two procedures. At 24 months, 143 patients received total disc replacement while 60 received spinal fusion. The total disc replacement group had significantly less operative time, blood loss, and shorter hospital stays. Clinical outcomes including ODI, SF-36, and pain/satisfaction scales were measured at multiple points up to 24 months. Radiographic outcomes were also assessed to analyze device success and fusion rates between the two procedures.
Real-time visual feedback significantly improved performance on the star excursion balance test (SEBT) in the posterolateral direction for healthy subjects. Twenty participants performed the SEBT without and with visual feedback via video camera. Maximum reach distance increased significantly with feedback in the posterolateral direction but not other directions. This suggests visual feedback may enhance dynamic postural control and rehabilitation outcomes.
This systematic review and meta-analysis evaluated the efficacy of patellar taping for patellofemoral pain (PFP) and identified potential biomechanical mechanisms. The review included 20 studies on the effects of various taping techniques on pain and lower limb biomechanics in individuals with PFP. The main findings were: 1) Tailored (customized) patellar taping provided immediate large reductions in pain, while untailored taping provided small reductions; 2) Tailored taping was associated with earlier onset of vastus medialis oblique muscle contraction; 3) Limited evidence suggested tailored taping combined with exercise provided superior pain relief compared to exercise alone at 4 weeks. The review concluded tailored taping application is important
Postoperative platelet-rich plasma injections did not improve early tendon healing or functional recovery after arthroscopic supraspinatus tendon repair according to a randomized controlled trial. Magnetic resonance imaging at 16 weeks found no difference in structural integrity of the repaired tendon between patients who received two PRP injections and those who did not. Functional scores and range of motion measurements also did not differ between the groups at various time points up to 16 weeks postoperatively.
Effectiveness of physiotherapy exercise after knee arthroplasty for oa.FUAD HAZIME
This systematic review evaluated the effectiveness of physiotherapy exercise after knee arthroplasty for osteoarthritis. The review included 6 randomized controlled trials that compared physiotherapy exercise interventions to usual care or different exercise interventions after discharge. The review found small to moderate benefits of functional exercise for function, range of motion, and quality of life 3-4 months after surgery. However, benefits were no longer evident at 1 year, suggesting no long term benefit of physiotherapy exercise after knee arthroplasty.
Consensus statement on concussion in sportccicalifornia
This document provides a consensus statement on the definition and management of sports-related concussion by an international panel of experts. It summarizes the key points discussed and recommendations made by the panel regarding the definition of concussion, evaluation of acute injury including symptoms and signs, neurocognitive assessment, neuroimaging, and return to play guidelines. The panel aimed to build upon previous consensus statements to further the understanding of concussion using an evidence-based approach.
Prevention of Lower Extremity Stress FracturesJA Larson
This document summarizes a systematic review of the literature on preventing stress fractures in athletes and soldiers. It identifies 176 relevant studies, including 20 diagnostic case series, 66 clinical case series, 52 epidemiological studies, and 9 intervention trials. The review finds that bone scans are more sensitive but less specific than x-rays for diagnosing stress fractures. It also examines the reported incidence of stress fractures in military recruits and trainees. The goal of the review is to evaluate research on causes and risk factors of stress fractures, what is known about prevention, and make recommendations for future research.
2000 anti pronation tape_before_and_after_exercisepainfree888
1) The study evaluated the effects of antipronation tape and temporary orthotics on vertical navicular height before and after exercise compared to a control condition.
2) Both the tape and orthotic treatments significantly increased vertical navicular height after application compared to the control condition, but the effect diminished with exercise.
3) While diminished after exercise, the tape and orthotic conditions still performed better than the control at maintaining vertical navicular height, suggesting they provide some control of excessive foot pronation.
This randomized controlled trial investigated the effectiveness of pulsatile dry cupping therapy compared to no intervention for knee osteoarthritis. 40 patients were randomly assigned to receive either 8 cupping sessions over 4 weeks or no treatment. Outcome measures including pain, stiffness, physical function, and quality of life were assessed at 4 and 12 weeks. At 4 weeks, cupping resulted in significantly greater improvements in pain, physical function, and quality of life scores compared to the control group. Many benefits were still present at 12 weeks, though some scores were no longer significantly different. The study provides preliminary evidence that cupping may be an effective treatment for relieving symptoms of knee osteoarthritis.
Effect of Relaxation Therapy on Standing Balance and Mobility among Stroke Pa...ijtsrd
Motor impairment or unilateral weakness of the body, most commonly results from stroke in humans. Stroke is ” ˜Rapidly developing clinical signs of focal or global disturbance of cerebral function, due to ischemic or hemorrhagic injury.The purpose of study is to describe the effect of relaxation therapy on standing balance and mobility among stroke patients.Methods Study included 30 hemiplegic subjects divide in to two groups i.e, Group A Experimental and Group B Control randomly. A baseline assessment was done with outcome measures BBS and TUG test to obtain the pretest score of the subjects. After the pretest, all the subjects were undergone a therapeutic intervention. Participants in the experimental group received relaxation therapy earlier followed with conventional occupational therapy program for one hour of four sessions in a week with duration of total program for 6 weeks. The Participants in control group received only conventional occupational therapy program. After six weeks of intervention outcome measures were administered on both the groups to obtain the post score.Results This study suggests that relaxation Therapy with conventional occupational therapy can improve standing balance and mobility among stroke patients. The mean value of Berg balance scale, pre and post scores are, 42.866 and 49.733 respectively. The mean value of Time up and Go scale are, 27.094 and 15.930. On statistical analysis, the values were determined to be significant at 0.010 level for berg balance and 0.047 for time up and go scale table 5 which supports the alternate hypothesis suggesting relaxation therapy improved standing balance and mobility among stroke patients graph 1 . Conclusion This study concluded that relaxation therapy is effective in improving standing balance and mobility in Stroke patients Ravi Ranjan Kumar | Mr. Subrata Kumar Halder "Effect of Relaxation Therapy on Standing Balance and Mobility among Stroke Patients" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-1 , December 2020, URL: https://www.ijtsrd.com/papers/ijtsrd38210.pdf Paper URL : https://www.ijtsrd.com/medicine/other/38210/effect-of-relaxation-therapy-on-standing-balance-and-mobility-among-stroke-patients/ravi-ranjan-kumar
This document summarizes a project that compared the effects of prone lumbar traction versus supine lumbar traction when combined with an extension-oriented treatment approach for chronic low back pain. The project reviewed literature showing mixed results on the effectiveness of lumbar traction and a lack of evidence for supine traction. The project aimed to determine if prone traction was more effective for reducing pain and disability when combined with exercises to promote lumbar extension. Outcome measures of pain and disability were collected before and after treatment to evaluate the two approaches. The results were statistically analyzed to determine if prone traction provided greater benefits for patients with chronic low back pain.
2020 OA Vision: Emerging Therapeutics on the OA landscapeOARSI
Philip Conaghan MBBS PhD FRACP FRCP
Director, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds
Deputy Director, NIHR Leeds Biomedical Research Centre
Effect of Deep Oscillation as a Recovery Method after Fatiguing Soccer TrainingMary Fickling
This study investigated the effects of deep oscillation (DO) as a recovery method after soccer training. In a randomized crossover study with 8 male soccer players, measurements were taken before and 48 hours after a fatiguing soccer training session. Half of the players performed DO self-treatment twice daily for 15 minutes, while the other half received no intervention. After 4 weeks, groups crossed over. The study found significant effects of DO on maximum leg flexion strength and perceived exertion rate. Other measures like maximum leg extension strength, creatine kinase levels, and delayed onset muscle soreness showed non-significant trends favoring the DO group over the control. Overall, the results suggest DO may help accelerate muscle recovery and should be further investigated
Effects of Wii versus traditional supervised exercise on the functional fitne...spastudent
Effects of Wii versus traditional supervised exercise on the functional fitness of moderately frail Chinese population- A Pilot Study
Nanyang Polytechnic
Physiotherapy
Use of kirlian photography in fatigue assessmentClifford Stone
This document describes a research study that investigated the use of Kirlian photography to assess fatigue. Both mental and physical fatigue were examined. Mental fatigue was induced through graduate school lectures, while physical fatigue came from playing softball in hot, humid conditions. Corona diameter measurements from Kirlian photographs were used to indicate fatigue levels. Statistical analysis found the diameter significantly increased after physical activity and decreased after mental activity, showing Kirlian photography may be useful for measuring fatigue.
Analysis of Spinal Decompression via Surgical Methods and Traction TherapyPaige Barrett
This document summarizes various surgical and non-surgical methods for spinal decompression to treat back pain. For surgical decompression of the cervical spine, early surgery (<24 hrs) after spinal cord injury produces better outcomes than delayed surgery. Circumferential decompression and fusion is effective for cervical myelopathy. In the thoracic spine, posterior decompression with instrumented fusion improves neurological functioning for thoracic myelopathy. Video-assisted thoracoscopic surgery and percutaneous laser disc decompression are suitable minimally invasive options for the thoracic spine. For the lumbar spine, indirect decompression using an interbody cage is effective for degenerative lumbar stenosis, while decompression without fusion significantly decreases leg pain and disability. Minimally invasive
Comparison of PEMF Therapy of Various Duration in the Treatment of Subacromia...ijtsrd
Introduction Subacromial impingement syndrome SIS is commonest among various joint pains. Study is done in order to compose the efficacy of PEMF treatment of various duration for patients with SIS. Subject and Methods One hundred and eight patients who had been diagnosed with subacromial impingement syndrome by clinical examination. Patients were sequentially enrolled following informed consent were administered PEMF therapy for 15 minutes combined with exercise therapy. The second group received the same treatment except that each of the patients has received 30 minutes therapy the patients were evaluated before and after the treatment. Parameters examined were pain score, disability score and range of motion at shoulder joint. Result Second group was significantly improved in pain score, disability score and range of motion. Conclusion 30 minutes of PEMF therapy was shown to be more effective than 15 minutes of PEMF therapy. Anuja Pasari | Bismay Das | C. Monanty | Saurabh Singh | Sujoy Roy | T. B. Singh "Comparison of PEMF Therapy of Various Duration in the Treatment of Subacromial Impingement Syndrome" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-1 , December 2020, URL: https://www.ijtsrd.com/papers/ijtsrd38177.pdf Paper URL : https://www.ijtsrd.com/medicine/other/38177/comparison-of-pemf-therapy-of-various-duration-in-the-treatment-of-subacromial-impingement-syndrome/anuja-pasari
This systematic review analyzed 12 controlled trials that compared the effects of different insoles on postural balance. The insoles studied included vibrating insoles, textured insoles, insoles with different densities, and insoles with wedges or sensors. Most studies found that the insoles improved postural balance and reduced sway, especially in the anteroposterior direction. Textured insoles and vibrating insoles showed benefits by increasing sensory input from the feet. While insole rigidity did not influence balance, soft gel insoles and insoles with spikes were found to improve postural control. The review concluded that insoles can provide benefits that favor better postural balance and control.
This document summarizes research on the effects of COX-2 inhibitors on fracture healing and implications for patient recovery. The main points are:
1) Past research has found that COX-2 inhibitors like celecoxib can impair fracture healing in animal models by reducing callus strength and increasing nonunion rates.
2) A recent study in rats found celecoxib administration was associated with weaker fracture calluses, more nonunions, and duration of inhibition correlated with decreased healing.
3) The investigators concluded NSAID use after fractures may negatively affect healing in humans, though more research is needed, and COX-2 drug use should be avoided in fusion patients for now.
A guide to beginners helping writing thesis protocol.
Comparison between USG guided Suprascapular Nerve block and Interscalene Nerve Block post operative analgesia after arthroscopic shoulder surgery- a prospective randomized double blind study.
This document summarizes a study that assessed changes in nearwork-induced transient myopia (NITM) parameters and accommodative functions after 6 weeks of home-based accommodative training in 10 young adult progressing myopes. The study found that after training, several dynamic accommodative response functions improved significantly, including increased lens flipper and Hart chart rates. There was also a significant negative correlation between lens flipper rate and NITM decay duration, indicating faster decay. The training resulted in improved accommodative dynamics and a reduction in NITM, consistent with previous reports of improvement in symptomatic myopes with vision therapy.
This study assessed changes in nearwork-induced transient myopia (NITM) parameters and accommodative function after 6 weeks of home-based accommodative training in 10 progressing myopic young adults. At baseline and after 3 and 6 weeks of training, NITM magnitude, decay duration, near accommodative response, and clinical measures like lens flipper and Hart chart rates were evaluated. Several dynamic accommodative functions improved significantly with training, including increased lens flipper and Hart chart rates. There was also a significant negative correlation between lens flipper rate and NITM decay duration after training, suggesting training reduced NITM. The results demonstrate improved accommodative dynamics and reduced NITM in progressing myopes after home
Iris Publishers - journal of ophthalmology | Demystifying Role of Ultrasound ...IrisPublishers
Objectives: The aim of this study was to compare sonoelastographic findings in the retina– choroid–sclera (RCS) complex and vitreous in glaucomatous and healthy eyes.Methods: For this cross-sectional comparative study, 20 patients with primary open-angle glaucoma (POAG) and 20 healthy volunteers were recruited. Ultrasound elastography measurements were taken with a sonographic scanner of the RCS complex, anterior vitreous (AV), posterior vitreous (PV), retrobulbar fat tissue (RFT), optic disc, and optic nerve in each eye.Results: The elasticity index of the RCS complex, RFT, optic disc, optic nerve, AV, and PV were similar in both groups (p > 0.05), though the AV/PV strain ratio in the group of patients with glaucoma was significantly higher (p = 0.04).Conclusion: Glaucoma increases the AV/PV strain ratio. In providing reproducible and consistent values, the real-time elastography technique may be helpful in elucidating the mechanisms of glaucoma in some aspects.
Real-time visual feedback significantly improved performance on the star excursion balance test (SEBT) in the posterolateral direction for healthy subjects. Twenty participants performed the SEBT without and with visual feedback via video camera. Maximum reach distance increased significantly with feedback in the posterolateral direction but not other directions. This suggests visual feedback may enhance dynamic postural control and rehabilitation outcomes.
This systematic review and meta-analysis evaluated the efficacy of patellar taping for patellofemoral pain (PFP) and identified potential biomechanical mechanisms. The review included 20 studies on the effects of various taping techniques on pain and lower limb biomechanics in individuals with PFP. The main findings were: 1) Tailored (customized) patellar taping provided immediate large reductions in pain, while untailored taping provided small reductions; 2) Tailored taping was associated with earlier onset of vastus medialis oblique muscle contraction; 3) Limited evidence suggested tailored taping combined with exercise provided superior pain relief compared to exercise alone at 4 weeks. The review concluded tailored taping application is important
Postoperative platelet-rich plasma injections did not improve early tendon healing or functional recovery after arthroscopic supraspinatus tendon repair according to a randomized controlled trial. Magnetic resonance imaging at 16 weeks found no difference in structural integrity of the repaired tendon between patients who received two PRP injections and those who did not. Functional scores and range of motion measurements also did not differ between the groups at various time points up to 16 weeks postoperatively.
Effectiveness of physiotherapy exercise after knee arthroplasty for oa.FUAD HAZIME
This systematic review evaluated the effectiveness of physiotherapy exercise after knee arthroplasty for osteoarthritis. The review included 6 randomized controlled trials that compared physiotherapy exercise interventions to usual care or different exercise interventions after discharge. The review found small to moderate benefits of functional exercise for function, range of motion, and quality of life 3-4 months after surgery. However, benefits were no longer evident at 1 year, suggesting no long term benefit of physiotherapy exercise after knee arthroplasty.
Consensus statement on concussion in sportccicalifornia
This document provides a consensus statement on the definition and management of sports-related concussion by an international panel of experts. It summarizes the key points discussed and recommendations made by the panel regarding the definition of concussion, evaluation of acute injury including symptoms and signs, neurocognitive assessment, neuroimaging, and return to play guidelines. The panel aimed to build upon previous consensus statements to further the understanding of concussion using an evidence-based approach.
Prevention of Lower Extremity Stress FracturesJA Larson
This document summarizes a systematic review of the literature on preventing stress fractures in athletes and soldiers. It identifies 176 relevant studies, including 20 diagnostic case series, 66 clinical case series, 52 epidemiological studies, and 9 intervention trials. The review finds that bone scans are more sensitive but less specific than x-rays for diagnosing stress fractures. It also examines the reported incidence of stress fractures in military recruits and trainees. The goal of the review is to evaluate research on causes and risk factors of stress fractures, what is known about prevention, and make recommendations for future research.
2000 anti pronation tape_before_and_after_exercisepainfree888
1) The study evaluated the effects of antipronation tape and temporary orthotics on vertical navicular height before and after exercise compared to a control condition.
2) Both the tape and orthotic treatments significantly increased vertical navicular height after application compared to the control condition, but the effect diminished with exercise.
3) While diminished after exercise, the tape and orthotic conditions still performed better than the control at maintaining vertical navicular height, suggesting they provide some control of excessive foot pronation.
This randomized controlled trial investigated the effectiveness of pulsatile dry cupping therapy compared to no intervention for knee osteoarthritis. 40 patients were randomly assigned to receive either 8 cupping sessions over 4 weeks or no treatment. Outcome measures including pain, stiffness, physical function, and quality of life were assessed at 4 and 12 weeks. At 4 weeks, cupping resulted in significantly greater improvements in pain, physical function, and quality of life scores compared to the control group. Many benefits were still present at 12 weeks, though some scores were no longer significantly different. The study provides preliminary evidence that cupping may be an effective treatment for relieving symptoms of knee osteoarthritis.
Effect of Relaxation Therapy on Standing Balance and Mobility among Stroke Pa...ijtsrd
Motor impairment or unilateral weakness of the body, most commonly results from stroke in humans. Stroke is ” ˜Rapidly developing clinical signs of focal or global disturbance of cerebral function, due to ischemic or hemorrhagic injury.The purpose of study is to describe the effect of relaxation therapy on standing balance and mobility among stroke patients.Methods Study included 30 hemiplegic subjects divide in to two groups i.e, Group A Experimental and Group B Control randomly. A baseline assessment was done with outcome measures BBS and TUG test to obtain the pretest score of the subjects. After the pretest, all the subjects were undergone a therapeutic intervention. Participants in the experimental group received relaxation therapy earlier followed with conventional occupational therapy program for one hour of four sessions in a week with duration of total program for 6 weeks. The Participants in control group received only conventional occupational therapy program. After six weeks of intervention outcome measures were administered on both the groups to obtain the post score.Results This study suggests that relaxation Therapy with conventional occupational therapy can improve standing balance and mobility among stroke patients. The mean value of Berg balance scale, pre and post scores are, 42.866 and 49.733 respectively. The mean value of Time up and Go scale are, 27.094 and 15.930. On statistical analysis, the values were determined to be significant at 0.010 level for berg balance and 0.047 for time up and go scale table 5 which supports the alternate hypothesis suggesting relaxation therapy improved standing balance and mobility among stroke patients graph 1 . Conclusion This study concluded that relaxation therapy is effective in improving standing balance and mobility in Stroke patients Ravi Ranjan Kumar | Mr. Subrata Kumar Halder "Effect of Relaxation Therapy on Standing Balance and Mobility among Stroke Patients" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-1 , December 2020, URL: https://www.ijtsrd.com/papers/ijtsrd38210.pdf Paper URL : https://www.ijtsrd.com/medicine/other/38210/effect-of-relaxation-therapy-on-standing-balance-and-mobility-among-stroke-patients/ravi-ranjan-kumar
This document summarizes a project that compared the effects of prone lumbar traction versus supine lumbar traction when combined with an extension-oriented treatment approach for chronic low back pain. The project reviewed literature showing mixed results on the effectiveness of lumbar traction and a lack of evidence for supine traction. The project aimed to determine if prone traction was more effective for reducing pain and disability when combined with exercises to promote lumbar extension. Outcome measures of pain and disability were collected before and after treatment to evaluate the two approaches. The results were statistically analyzed to determine if prone traction provided greater benefits for patients with chronic low back pain.
2020 OA Vision: Emerging Therapeutics on the OA landscapeOARSI
Philip Conaghan MBBS PhD FRACP FRCP
Director, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds
Deputy Director, NIHR Leeds Biomedical Research Centre
Effect of Deep Oscillation as a Recovery Method after Fatiguing Soccer TrainingMary Fickling
This study investigated the effects of deep oscillation (DO) as a recovery method after soccer training. In a randomized crossover study with 8 male soccer players, measurements were taken before and 48 hours after a fatiguing soccer training session. Half of the players performed DO self-treatment twice daily for 15 minutes, while the other half received no intervention. After 4 weeks, groups crossed over. The study found significant effects of DO on maximum leg flexion strength and perceived exertion rate. Other measures like maximum leg extension strength, creatine kinase levels, and delayed onset muscle soreness showed non-significant trends favoring the DO group over the control. Overall, the results suggest DO may help accelerate muscle recovery and should be further investigated
Effects of Wii versus traditional supervised exercise on the functional fitne...spastudent
Effects of Wii versus traditional supervised exercise on the functional fitness of moderately frail Chinese population- A Pilot Study
Nanyang Polytechnic
Physiotherapy
Use of kirlian photography in fatigue assessmentClifford Stone
This document describes a research study that investigated the use of Kirlian photography to assess fatigue. Both mental and physical fatigue were examined. Mental fatigue was induced through graduate school lectures, while physical fatigue came from playing softball in hot, humid conditions. Corona diameter measurements from Kirlian photographs were used to indicate fatigue levels. Statistical analysis found the diameter significantly increased after physical activity and decreased after mental activity, showing Kirlian photography may be useful for measuring fatigue.
Analysis of Spinal Decompression via Surgical Methods and Traction TherapyPaige Barrett
This document summarizes various surgical and non-surgical methods for spinal decompression to treat back pain. For surgical decompression of the cervical spine, early surgery (<24 hrs) after spinal cord injury produces better outcomes than delayed surgery. Circumferential decompression and fusion is effective for cervical myelopathy. In the thoracic spine, posterior decompression with instrumented fusion improves neurological functioning for thoracic myelopathy. Video-assisted thoracoscopic surgery and percutaneous laser disc decompression are suitable minimally invasive options for the thoracic spine. For the lumbar spine, indirect decompression using an interbody cage is effective for degenerative lumbar stenosis, while decompression without fusion significantly decreases leg pain and disability. Minimally invasive
Comparison of PEMF Therapy of Various Duration in the Treatment of Subacromia...ijtsrd
Introduction Subacromial impingement syndrome SIS is commonest among various joint pains. Study is done in order to compose the efficacy of PEMF treatment of various duration for patients with SIS. Subject and Methods One hundred and eight patients who had been diagnosed with subacromial impingement syndrome by clinical examination. Patients were sequentially enrolled following informed consent were administered PEMF therapy for 15 minutes combined with exercise therapy. The second group received the same treatment except that each of the patients has received 30 minutes therapy the patients were evaluated before and after the treatment. Parameters examined were pain score, disability score and range of motion at shoulder joint. Result Second group was significantly improved in pain score, disability score and range of motion. Conclusion 30 minutes of PEMF therapy was shown to be more effective than 15 minutes of PEMF therapy. Anuja Pasari | Bismay Das | C. Monanty | Saurabh Singh | Sujoy Roy | T. B. Singh "Comparison of PEMF Therapy of Various Duration in the Treatment of Subacromial Impingement Syndrome" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-1 , December 2020, URL: https://www.ijtsrd.com/papers/ijtsrd38177.pdf Paper URL : https://www.ijtsrd.com/medicine/other/38177/comparison-of-pemf-therapy-of-various-duration-in-the-treatment-of-subacromial-impingement-syndrome/anuja-pasari
This systematic review analyzed 12 controlled trials that compared the effects of different insoles on postural balance. The insoles studied included vibrating insoles, textured insoles, insoles with different densities, and insoles with wedges or sensors. Most studies found that the insoles improved postural balance and reduced sway, especially in the anteroposterior direction. Textured insoles and vibrating insoles showed benefits by increasing sensory input from the feet. While insole rigidity did not influence balance, soft gel insoles and insoles with spikes were found to improve postural control. The review concluded that insoles can provide benefits that favor better postural balance and control.
This document summarizes research on the effects of COX-2 inhibitors on fracture healing and implications for patient recovery. The main points are:
1) Past research has found that COX-2 inhibitors like celecoxib can impair fracture healing in animal models by reducing callus strength and increasing nonunion rates.
2) A recent study in rats found celecoxib administration was associated with weaker fracture calluses, more nonunions, and duration of inhibition correlated with decreased healing.
3) The investigators concluded NSAID use after fractures may negatively affect healing in humans, though more research is needed, and COX-2 drug use should be avoided in fusion patients for now.
A guide to beginners helping writing thesis protocol.
Comparison between USG guided Suprascapular Nerve block and Interscalene Nerve Block post operative analgesia after arthroscopic shoulder surgery- a prospective randomized double blind study.
This document summarizes a study that assessed changes in nearwork-induced transient myopia (NITM) parameters and accommodative functions after 6 weeks of home-based accommodative training in 10 young adult progressing myopes. The study found that after training, several dynamic accommodative response functions improved significantly, including increased lens flipper and Hart chart rates. There was also a significant negative correlation between lens flipper rate and NITM decay duration, indicating faster decay. The training resulted in improved accommodative dynamics and a reduction in NITM, consistent with previous reports of improvement in symptomatic myopes with vision therapy.
This study assessed changes in nearwork-induced transient myopia (NITM) parameters and accommodative function after 6 weeks of home-based accommodative training in 10 progressing myopic young adults. At baseline and after 3 and 6 weeks of training, NITM magnitude, decay duration, near accommodative response, and clinical measures like lens flipper and Hart chart rates were evaluated. Several dynamic accommodative functions improved significantly with training, including increased lens flipper and Hart chart rates. There was also a significant negative correlation between lens flipper rate and NITM decay duration after training, suggesting training reduced NITM. The results demonstrate improved accommodative dynamics and reduced NITM in progressing myopes after home
Iris Publishers - journal of ophthalmology | Demystifying Role of Ultrasound ...IrisPublishers
Objectives: The aim of this study was to compare sonoelastographic findings in the retina– choroid–sclera (RCS) complex and vitreous in glaucomatous and healthy eyes.Methods: For this cross-sectional comparative study, 20 patients with primary open-angle glaucoma (POAG) and 20 healthy volunteers were recruited. Ultrasound elastography measurements were taken with a sonographic scanner of the RCS complex, anterior vitreous (AV), posterior vitreous (PV), retrobulbar fat tissue (RFT), optic disc, and optic nerve in each eye.Results: The elasticity index of the RCS complex, RFT, optic disc, optic nerve, AV, and PV were similar in both groups (p > 0.05), though the AV/PV strain ratio in the group of patients with glaucoma was significantly higher (p = 0.04).Conclusion: Glaucoma increases the AV/PV strain ratio. In providing reproducible and consistent values, the real-time elastography technique may be helpful in elucidating the mechanisms of glaucoma in some aspects.
Avastin for Choroidal Neovascularization 2/2 ARMDeyedoc34
This study evaluated the effects of intravitreal bevacizumab injections on 266 eyes with choroidal neovascularization secondary to age-related macular degeneration. At 1 month following injection, mean visual acuity improved significantly and mean central retinal thickness decreased significantly. Improvements in visual acuity and retinal thickness were also seen at 2 and 3 months. Over 30% of patients experienced improved visual acuity at each time point measured. Adverse events were few and mild. These preliminary results suggest bevacizumab may provide anatomical and functional benefits for treating wet AMD. However, longer term studies are still needed given the retrospective study design.
This study evaluated the outcome of immediately loading 15 dental implants in 4 patients over a mean follow-up period of 4.8 months. The mean marginal bone loss from implant surgery to immediate loading was 0.03 ± 0.07 mm, and 0.16 ± 0.17 mm after 3 months of continued loading. No implants failed, resulting in a 100% survival rate. The results suggest that immediate loading of dental implants can achieve high success rates of up to 6 months. However, long-term clinical studies with larger sample sizes are still needed.
Clínica Rementería | http://www.cirugiaocular.com
COMPARATIVE STUDY OF CORNEAL THICKNESS MEASURES BY ULTRASOUND PACHYMETRY, CORNEAL TOPOGRAPHY AND ANTERIOR SEGMENT OPTICAL COHERENCE TOMOGRAPHY
Trabajo presentado en la pasada edición del OPTOM Meeting Malaga 2013 por Sara Fernandez Cuenca.
This study evaluated the early rehabilitation effects of percutaneous transforaminal endoscopic discectomy (PTED) for treating lumbar disc herniations. 91 patients underwent PTED and were followed for 6 months. Results showed significantly reduced low back and leg pain based on VAS and ODI scores after surgery compared to before. No significant differences in low back pain scores at 3 days, 3 months, and 6 months post-op were found. PTED resulted in less trauma, fewer complications, and markedly shortened postoperative rehabilitation time, demonstrating it is a safe and effective treatment for lumbar disc herniations.
- Studies show that lowering IOP reduces risk of glaucoma progression and maintaining a steady IOP level over time is important. IOP fluctuation is associated with progressive visual field loss and is a stronger predictor of progression than mean IOP. Higher IOP fluctuation during office hours and over 24 hours is seen in glaucoma patients compared to normal subjects.
- Educating patients about their condition and treatment through tools like perimetry, OCT/GDx imaging can help improve compliance which is important for minimizing IOP fluctuations and risk of further optic nerve damage. Compliance is better with once or twice daily dosing compared to multiple medications or more frequent dosing.
once upon a time 12345once upon a t..pptxMinaz Patel
This study evaluated the performance of the VL3 video laryngoscope for intubation. It observed 35 patients undergoing elective surgery requiring intubation. The mean intubation time was 24.7 seconds. Most patients (57%) had an intubation difficulty score of 0, indicating easy intubation. Most patients (86%) had a glottic view score of 100%, allowing full view of the vocal cords. Hemodynamic parameters like heart rate and blood pressure did not change significantly from baseline values during intubation. The study concluded that the VL3 provided quick and easy intubation without significant hemodynamic response.
Background: Nowadays, ICRS are a step in the treatment of keratoconus. The purpose of this study was to evaluate the refractive effect and the tomographic and biomechanical parameters in keratoconus patients implanted with Ferrara ICRS, and their stability after 18 months.
Topical dorzolamide for macular edema in the early phase after vitrectomy and...Avaleks-Kiev
Background: The purpose of this study was to evaluate prospectively the efficacy of a topical carbonic anhydrase inhibitor in macular edema after vitrectomy.
Цель: оценка перспективы использования топического ингибитора карбоангидразы для профилактики развития макулярного отека после витрэктомии.
http://ophthalmolog.kiev.ua/
Purpose: To evaluate the corneal volume (CV) before and after Ferrara intrastromal corneal ring segments (ICRS) implantation and its influence in clinical outcomes in keratoconus patients.
This study compared visual outcomes after cataract surgery using femtosecond laser-assisted cataract surgery (FLACS) versus conventional phacoemulsification (CPS) with implantation of an extended depth of focus (EDOF) intraocular lens (IOL). The study found that FLACS produced significantly less IOL decentration and tilt, lower wavefront aberrations, better contrast sensitivity, and fewer visual disturbances reported by patients. Therefore, FLACS may provide improved visual performance compared to CPS when using an EDOF IOL by achieving a more precisely centered IOL position. The study provides evidence that lens positioning is an important factor for optimal visual outcomes with EDOF IOLs.
Variability of Corneal Deformation Response in Normal, Keratoconic, and Post-...asclepiuspdfs
Purpose: The purpose of the study was to determine the repeatability of corneal biomechanical properties obtained with Corvis-ST in normal, keratoconic, and post-LASIK eyes and compare the results between groups. Material and Methods: A total of 30 eyes of 15 subjects in each of the normal, keratoconus, and post-LASIK groups underwent Corvis-ST measurements. The intra-observer intraclass correlation coefficient (ICC) and precision were calculated to evaluate the repeatability of measurements for each group. One-way ANOVA and post hoc test were used for comparison of precision between groups.
This document discusses the pre-operative evaluation and management of adult cataract patients. It covers types of cataract surgery, including ICCE and ECCE. The pre-operative evaluation involves assessing general health, medical history, ocular history, visual function testing, and external and internal eye examination. Key areas of focus include evaluating for other ocular conditions, optimizing medical comorbidities, and determining the visual impact of the cataract to guide surgical planning and post-operative expectations.
This document discusses the pre-operative evaluation and management of adult cataract patients. It describes the types of cataract surgery as ICCE and ECCE. ECCE has replaced ICCE due to better equipment and IOL implants. A thorough pre-operative evaluation includes medical history, ocular examination, measurements of visual function, and potential acuity tests to determine the contribution of the cataract to visual loss. Special tests can evaluate macular and retinal function when the cataract obscures fundus view.
This study examined the 1-year results of treating myopic choroidal neovascularization (CNV) with intravitreal bevacizumab injections. Twenty-nine patients received three initial monthly injections, with additional injections for persistent or recurrent CNV. At 1 year, visual acuity improved on average by 2.4 lines from baseline. Twenty-one patients (72.4%) gained over 2 lines of vision. Optical coherence tomography showed a reduction in central foveal thickness following treatment. The study demonstrates the long-term effectiveness of intravitreal bevacizumab for myopic CNV.
1) The document discusses OCT technology, including its principles and history of development. OCT uses low coherence interferometry to perform high-resolution cross-sectional imaging of biological tissues.
2) Time-domain OCT was initially developed but newer Fourier-domain OCT provides faster acquisition speed and higher resolution.
3) The document reviews various clinical applications of OCT in ophthalmology, including imaging of the retina, glaucoma, cornea, and cataracts. Common scanning patterns and what can be observed are described for retinal and glaucoma examination.
The clinical lab provides diagnostic test data to aid in the detection, diagnosis and treatment of disease. The lab is responsible for correct identification, collection and processing of patient specimens, accurate performance of testing, timely reporting of results, and communication with healthcare professionals. There are six main steps in how a sample flows through the lab: 1) test is ordered, 2) sample is collected, 3) sample is delivered to the lab, 4) sample is processed, 5) sample is analyzed, and 6) results are reported. Common specimen types include blood, urine, body fluids, sputum, stool, and tissue samples.
This document discusses hearing and assistive devices, from hearing aids to electronic ears. It begins by explaining the auditory system as an energy transformation system, where acoustic energy is transformed into mechanical, hydraulic, and bioelectric energy as it travels through the outer, middle, and inner ear. It then provides detailed descriptions of the anatomy and functions of the outer, middle, and inner ear. It also discusses various physical properties of sound including frequency, wavelength, amplitude, interference, resonance, and more. The document is an in-depth overview of the human auditory system and how assistive devices can help with hearing impairments.
The document provides information about cochlear implants, including:
1) Cochlear implants bypass damaged parts of the inner ear to electrically stimulate the auditory nerve. They allow access to sound and can help develop speech recognition and communication.
2) The history of cochlear implants dates back to the 18th century but modern multi-channel implants were developed in the 1980s and have improved performance.
3) Over 100,000 people worldwide have received cochlear implants, including over 6,000 procedures annually in the US. The number of recipients is growing as criteria have expanded to include milder and unilateral hearing losses.
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotesPsychoTech Services
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
share - Lions, tigers, AI and health misinformation, oh my!.pptxTina Purnat
• Pitfalls and pivots needed to use AI effectively in public health
• Evidence-based strategies to address health misinformation effectively
• Building trust with communities online and offline
• Equipping health professionals to address questions, concerns and health misinformation
• Assessing risk and mitigating harm from adverse health narratives in communities, health workforce and health system
Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Kat...rightmanforbloodline
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
2. IOVS, October 2009, Vol. 50, No. 10 Visual and Ocular Changes after High G-Force Exposure 4837
TABLE 1. The Cornea-Related Parameters before and after Gravitational Stress
Immediately After After
Before After 15 min 30 min
Sim K
Maximum 44.52 0.43 45.08 0.63 45.21 1.17 44.89 1.31
Minimum 43.91 0.67 44.57 0.81 44.32 0.61 44.21 0.87
Anterior BFS (D) 43.23 1.51 42.94 1.32 42.98 0.94 43.11 1.34
Posterior BFS (D) 52.37 2.03 52.02 2.21 52.11 0.97 52.29 1.47
CCT ( m) 553.7 21.7 591.2 20.6* 567.4 21.6 556.2 23.6
n 14 eyes.
* Statistically significant difference (P 0.05).
tory of ocular or systemic disease, such as hypertension, diabetes, itational stress. All data were collected and analyzed. Fundus
glaucoma, cataract, or uveitis, were excluded from the investiga- examination was performed 2 hours after centrifugation. Throughout
tion. the experiment, blood pressure (BP) and pulse rate were monitored by
All examinations were performed at the Air Force Health Exam- a digital BP monitor (HDM 704 cm; Omron, Tokyo, Japan). All results
ination and Physiological Training Center, Kan-Shan Armed Forces are expressed as the mean SD. A paired t-test was used to compare
Hospital, Taiwan. All subjects had remained at sea level for the the physiological parameters before and after centrifugation. P 0.05
previous month. Before centrifugation, each subject underwent a was accepted as significant.
complete ocular examination that included tests of visual acuity
(Early Treatment of Diabetic Retinopathy [ETDRS] logMAR chart)
and refraction (AR310; Nidek, Tokyo, Japan) and examination with
RESULTS
the biomicroscope. The letter stimuli of the ETDRS logMAR chart in One subject withdrew from the study because of nausea after
this study are printed on an illuminated cabinet (background lumi- the centrifugation. All data were collected from 14 eyes. Most
nance, 350 cd/ m2). The chart has five letters per row ranging in size of the ocular-related parameters, such as anterior BFS, poste-
from 1.0 to 0.30 logMAR. Visual acuity was tested at 4 m rior BFS, and Sim K, did not change significantly from before to
distance. The corneal topography system (Orbscan II; Bausch & after centrifugation. However, the CCT increased significantly
Lomb) was used to assess the various ocular responses including immediately after centrifugation compared with the value be-
Sim K (maximum K and minimum K values), anterior best-fit sphere fore centrifugation (553.7 21.7 vs. 591.2 20.6, P 0.05),
(BFS), posterior BSF, ACD, pupillary diameter (PD), and central but this was not maintained beyond 15 minutes after high
corneal thickness (CCT). Macular responses such as metamorphop- gravitational stress (Table 1).
sia were detected by using the Amsler grid test, and visual perfor- ACD increased considerably immediately after (3.19 0.26
mance was assessed further by testing CS with the CS was tested mm vs. 4.53 0.34 mm, P 0.05) and 15 minutes after
monocularly before and after 9-Gz exposure by a CS test chart (4.39 0.27, P 0.05) 9-Gz force stress. ACD returned to
(VCTS 6500; Vistech Consultants, Inc., Dayton, OH). The chart the pretest value by 30 minutes after exposure to acceleration
consists of 45 circular targets with gratings of different size and (3.24 0.29, P 0.05; Table 2).
contrast. The target size in the distance test is 7.5 cm. The gratings PD enlarged significantly immediately after (3.54 0.73
in the targets are vertical or 15° left or right from the vertical mm vs. 5.76 0.61 mm; P 0.05) and 15 minutes (5.56
direction. In the test chart, the contrast decreases horizontally from 0.67 mm; P 0.05) after centrifugation. PD remained enlarged
left to right, and gratings become smaller vertically from top to 30 minutes after exposure to acceleration (5.47 0.59 mm;
bottom (from 1.5 to 18 cyc/deg; from target A to target E). The P 0.05; Table 3).
subject began at the top horizontal line A and stated whether the In the tests of visual performance, transient visual acuity
gratings in targets 1 to 9 are vertical, left, or right. The last target decreased immediately after the gravitational stress (0.02
that the subject reported correctly was marked down on a result 0.04 vs. 0.19 0.07, P 0.05; Table 4). CS reduction was also
paper provided by the test. The same procedure was repeated in all observed at 30 minutes after exposure to acceleration, and
the other horizontal test lines from B to E. At measurement time, the significant depression of CS was found at low and medium
room luminance was approximately 200 cd/m2 and the test dis- frequencies. CS in the right eye decreased at 1.5 (P 0.05), 3.0
tance, 3 m. (P 0.05), and 6.0 cyc/deg (P 0.05; Fig. 1). Refraction
After these examinations, the subject entered the human centri- remained stable at 30 minutes after gravitational stress (Table
fuge and donned an aviation helmet with a microphone attached so 4). The Amsler grid examination revealed no particular finding
that he could communicate with the aerospace physician outside. A such as metamorphopsia in any subject.
TV monitor was mounted outside the human centrifuge to monitor Throughout the experiment, ocular posterior segment re-
the status of each subject. When the setting was complete, a vealed no specific observations. In addition, no particular oc-
gravitational stress of 9-Gz force was established with a human ular finding was noted such as hyphema, lens dislocation, or
centrifuge which also applied G-forces parallel to the subject’s retinal hemorrhage.
body. The technician outside the centrifuge accelerated the speed
until it reached 9 Gz and held this constant for 15 seconds. The
operating protocol to induced 9 Gz in this experiment was as TABLE 2. Anterior Chamber Depth before and after
follows. The centrifuge was accelerated to 2 G/s from 1 to 1.4 G for Gravitational Stress
15 seconds, then accelerated to 2 G/s from 1.4 to 4 G and held
Immediately After After
constant for 20 seconds, and then reduced to 1.4 G for 30 seconds. Before After 15 min 30 min
The centrifuge was then accelerated rapidly to 6 G/s and then to 9
G for 15 seconds before slowing to 2 G/s and finally to 1 G.4,11 ACD (mm) 3.19 0.26 4.53 0.34* 4.39 0.27* 3.24 0.29
Visual acuity was checked and the corneal topographer was ap-
plied again immediately, 15 minutes, and 30 minutes after the centrif- n 14 eyes.
ugation. Refraction and CS were measured 30 minutes after the grav- * Statistically significant difference (P 0.05).
3. 4838 Tsai et al. IOVS, October 2009, Vol. 50, No. 10
TABLE 3. Pupillary Diameter before and after Gravitational Stress
Immediately After After
Before After 15 min 30 min
PD (mm) 3.54 0.73 5.76 0.61* 5.56 0.67* 5.47 0.59*
n 14 eyes.
* Statistically significant difference (P 0.05).
DISCUSSION
In this study, we observed a 10% increase in CCT after 9-Gz
force exposure. We assume that the transient hydrostatic pres-
sure increase may explain this finding. The ocular anterior
chamber in the eye is full of aqueous humor.12,13 An exposure
to high gravity may increase hydrostatic pressure in the ante-
rior chamber and increase the tendency for fluid to flow across
the corneal endothelium into the stroma, which would in- FIGURE 1. Mean CS before and after 9-Gz force exposure. *Signifi-
crease the corneal thickness.14 The CCT returned to its initial cant differences at P 0.05.
value within 15 minutes, suggesting that the corneal endothe-
lium was not compromised by high gravitational exposure,
even at 9-Gz force. An interesting observation was that a 10% stress.12,13 When subjects are under high-gravity stress, the aque-
increase in CCT occurred without significant concomitant ous hydrostatic pressure in the anterior and posterior chambers
changes in the corneal curvature. Our data are consistent with may increase toward the gravity direction. Because the volume is
those of Rom et al.,15 who found no significant correlation greater in the anterior chamber than in the posterior chamber, the
between corneal thickness and curvature, even when the cor- aqueous humor pressure is also greater in the anterior chamber
neal thickness increases up to 16%. during high G-force exposure.12,13 The greater hydrostatic pres-
PD increased significantly after high G-force exposure in our sure in the anterior chamber may push the iris toward the poste-
study. Before the stress, PD was 3.54 0.73 mm, and the marked rior chamber and cause the ACD to increase. At the same time,
pupillary dilation persisted for 30 minutes after the stress. The size this iris diaphragm may rest on the lens surface and trap fluid in
of the pupil is regulated by the autonomic nervous system, which the anterior chamber. When the hydrostatic pressure is relieved,
is influenced by many environmental, physiological, and psycho- the trapped aqueous humor maintains the ACD, which may ex-
logical factors. Previous studies show that gravitational stress can plain the prolonged deepening of the anterior chamber. The
increase sympathetic tone to prevent body fluid shifting down- trapped aqueous humor drains with time, and the ACD returns to
ward with gravity.16 This transient sympathetic tone elevation baseline.12,13,19 We also observed that the refractive power did
may account for the early pupil dilation immediately after centrif- not reveal a significant finding at 30 minutes after 9-Gz expo-
ugation. However, an increase in sympathetic activity cannot sure. This observation suggests that axial length did not change at
clarify completely why the pupil enlargement persisted for 30 30 minutes after gravitational stress. However, further research is
minutes. Tran et al.17 reported that high G-force exposure causes necessary to confirm this finding.
a persistent reduction in parasympathetic activity. This prolonged In our study, visual acuity showed a transient reduction imme-
reduction in parasympathetic activity may also explain the persis- diately after centrifugation and returned to baseline at 15 minutes.
tent pupil enlargement after gravitational stress. Neurohormonal We assume that temporary corneal edema plays a role, because a
regulation is another possible explanation for this persistent pupil study has shown that corneal edema can disturb visual acuity.20
dilation. Gravitational stress increases the blood somatostatin con- However, the Amsler grid examination revealed no specific find-
centration. Yamaji et al.18 found that somatostatin may induce ings in our study, suggesting that the macular structure was not
mydriasis by attenuating cholinergic neurotransmitter release. compromised even after the high G-force exposure. For clarifica-
Therefore, neurohormonal regulation may also be involved in this tion of our supposition, further study may be helpful, such as
prolonged pupil enlargement. pinhole, potential acuity testing, and laser interferometry. Visual
In our experiment, the ACD increased immediately and 15 acuity is usually evaluated with the ETDRS visual chart, a basic
minutes after 9-Gz force exposure but returned to baseline method of evaluating visual performance by estimating the visual
within 30 minutes after gravitational stress. Pupil enlargement response to black-and-white contrast. However, performance on
may explain the increase in ACD at 15 minutes after gravitational the ETDRS chart represents one extreme of CS, and in reality,
stress, but it cannot explain why the ACD returned to baseline objects and their surroundings are of varying contrasts. The CS
when mydriasis persisted 30 minutes after centrifugation. We test was developed based on the measurement of visual resolution
believe that the increase in hydrostatic pressure caused by the for a wide range of contrasts. The CS test is useful for evaluating
9-Gz force explains this finding. The aqueous humor in the eye visual quality more precisely, by plotting the reciprocal of the
may shift toward the gravity direction under gravitational threshold contrast for sinusoidal gratings as a function of their
TABLE 4. Visual Acuity and Refraction before and after Gravitational Stress
Immediately After After
Before After 15 min 30 min
VA (logMAR) 0.02 0.04 0.19 0.07* 0.05 0.06 0.04 0.07
Refraction (D) 0.37 0.47 0.23 0.51
n 14 eyes.
* Statistically significant difference (P 0.05).
4. IOVS, October 2009, Vol. 50, No. 10 Visual and Ocular Changes after High G-Force Exposure 4839
spatial frequency. It thus gives information on visual performance 5. Simons R, Krol J. Visual loss from bungee jumping. Lancet. 1994;
for a range of object scales.21 343:853.
In this investigation, we observed remarkable CS loss after 6. Emerson MV, Jakobs E, Green WR. Ocular autopsy and histopatho-
gravitational stress and that more than 30 minutes was needed for logic features of child abuse. Ophthalmology. 2007;114:1384 –
recovery. Several ocular anterior chamber reactions observed in 1394.
the study may account for this finding, including corneal clarity 7. Schneider S, Guardiera S, Kleinert J, et al. Centrifugal acceleration
to 3Gz is related to increased release of stress hormones and
and pupillary mydriasis. Hess and Garner21 reported that corneal
decreased mood in men and women. Stress. 2008;11:339 –347.
edema leads to depression of CS. Other researchers have also
8. Elias PZ, Jarchow T, Young LR. Incremental adaptation to yaw
demonstrated that pupil mydriasis may compromise CS func- head turns during 30 RPM centrifugation. Exp Brain Res. 2008;
tion.22,23 However, the changes of ocular anterior segment reac- 189:269 –277.
tion cannot fully elucidate why the CS was significantly reduced at 9. Sahin A, Yildirim N, Basmak H. Two-year interval changes in
low and medium but not at high spatial frequency at 30 minutes Orbscan II topography in eyes with keratoconus. J Cataract Re-
after gravitational stress. Factors other than ocular anterior seg- fract Surg. 2008;34:1295–1299.
ment response are thought to explain this observation. We as- 10. Wei RH, Lim L, Chan WK, Tan DT. Evaluation of Orbscan II corneal
sume that the changes in neuroretinal function may play a role in topography in individuals with myopia. Ophthalmology. 2006;
this phenomenon. Ossard et al.24 have demonstrated that gravi- 113:177–183.
tational stress can cause body fluid to shift toward the lower body, 11. Balldin UI, O’Connor RB, Isdahl WM, Werchan PM. Pressure breath-
which decreases ocular blood flow and leads to hypoxia. Several ing without a counter-pressure vest does not impair acceleration
studies have reported that hypoxia may compromise neuroretinal tolerance up to 9 G. Aviat Space Environ Med. 2005;76:456 – 462.
function and lead to prolonged CS reduction.25–27 Visual acuity 12. Fitt AD, Gonzalez G. Fluid mechanics of the human eye: aqueous
was coupled to changes in microcirculation in the retina such as humour flow in the anterior chamber. Bull Math Biol. 2006;68:
53–71.
retinal capillary density and the size of the free avascular zone
13. Brubaker RF. The flow of aqueous humor in the human eye. Trans
(FAZ). In a past study, Arend et al.26 showed that CS is a more Am Ophthalmol Soc. 1982;80:391– 474.
sensitive examination for detecting the change of microcircula- 14. Muir KW, Jin J, Freedman SF. Central corneal thickness and its
tion in retina. DiLeo et al.28 reported that hypoxia may affect relationship to intraocular pressure in children. Ophthalmology.
magnocellular ganglion cells more severely than parvocellular 2004;111:2220 –2223.
ganglion cells. The magnocellular ganglion cells are more sensi- 15. Rom ME, Keller WB, Meyer CJ, et al. Relationship between corneal
tive to low-contrast stimuli, whereas parvocellular ganglion cells edema and topography. CLAO J. 1995;21:191–194.
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