Vol 3-1 Systematic Review

The association between sarcopenia and the physical function of patients with stroke: A systematic review and meta-analysis

Irene J Su*, Yi Li, Li Chen

Shantou University Medical College, 22 Xinling Road, Shantou 515041, Guangdong Province, China

Objectives: The purpose of this study is to identify whether there is an association between sarcopenia and physical function outcomes of patients with stroke.

Methods: A systematic search of Pubmed, Web of Science, Cochrane Library, Embase, China National Knowledge Infrastructure (CNKI), and Wanfang database was conducted to identify studies in Chinese and English from the inception of the database to March 2021. Documents were checked for relevancy. Articles exploring the association between sarcopenia and the physical function of patients with stroke were included. The quality of the literature was evaluated using the Newcastle-Ottawa scale tool. Stata 15.0 software was used to conduct meta-analysis.

Results: Eight studies met the criteria for inclusion. A meta-analysis of four studies showed that sarcopenia was related to an increased risk of poor physical function of patients with stroke (total OR=3.11, 95% CI: 2.22-4.34, P<0.0001). Descriptive analysis was performed in the rest of studies. Overall, a correlation between the two factors was found in patients with stroke. Some studies suggested a difference based on gender and severity of the disease condition. The studies included in this review were of high methodological quality. The Egger's test (P=0.217) showed no publication bias.

Conclusions: This review concludes that sarcopenia is an independent predictive factor of physical function of patients with stroke. Clinicians should pay attention to gender differences and severity of disease condition. Therefore, screening, diagnosis, treatment, and prevention of sarcopenia should be part of the routine clinical practice when providing care to stroke patients.

DOI: 10.29245/2767-5122/2021/1.1123 View / Download Pdf
Vol 3-1 Mini Review Article

What did we learn from a Community Bone Health Promotion Project for People with Mental Retardation?

K.F. Cheng1, Lee Sze Nga2, P. C. Leung1,3*

1 Centre for Clinical Trials on Chinese Medicine, Institute of Chinese Medicine, The Chinese University of Hong Kong, Hong Kong

2 Grace Rehabilitation Service, Evangelical Lutheran Church Social Service - Hong Kong, Hong Kong

3 State Key Laboratory of Research on Bioactivities and Clinical Applications of Medicinal Plants (The Chinese University of Hong Kong), Hong Kong

Background: The Community Bone Health Promotion Project offered service to the individual Mentally Retarded person (MR) together with his/ her personal care-givers as a unit.  The MR tends to get old and suffer from chronic diseases much earlier than the general population. The care-giving parent is older by age and yet could serve as a “control” in the assessment exercises.

Methods: The project took a multidisciplinary approach participated by the social workers, medical experts, nurses and therapists to ensure support and compliance. The promotion of bone health was executed through ordinary physical exercises, machine-driven trainings and dietary support. A special dietary supplement with Traditional Chinese Medicine orientation was chosen for the clients who were expected to have extra appreciation because of the cultural heritage.

The project lasted 12 months after which the assessments included objective measurements of Bone Mineral Density (BMD) and subjective evaluation of Quality of Life (QoL).

Results: Of the 136 participants, 55 were patients with MR and 81 were caregivers. The average age of patients with MR was 52.7 years old, and that of caregivers was 62.2 years old. Compliance of the clients and their caregivers had been very good and great appreciations were expressed. The special dietary supplement with medicinal herb extracts was well loved by both MRs and caregivers. BMD, as expected, did not show significant change after 12 months although a trend of improvement was obvious among the more deficient individuals. Caregivers of older ages could be more responsive compared with the younger MRs.

In conclusion, it was a fruitful project endorsing the multidisciplinary approach in the planning, executions, supervision and assessment. The improvements in Physical functioning, Role physical and Role emotional were shown in the Quality of Life evaluation, further supported the enthusiasm and appreciation of the MRs and their caregivers.

DOI: 10.29245/2767-5122/2021/1.1119 View / Download Pdf
Vol 3-1 Policy Report

Global Certification: A Transformative Approach to Building the World’s Rehabilitation Health Workforce

Julia To Dutka1*, Mark Kovic2, Kristen Mauk3, Richard E Oliver4

1CGFNS International, Inc., Pennsylvania, USA

2Midwestern University, Illinois, USA

3Colorado Christian University, Colorado, USA

4University of Missouri, Columbia, Missouri, USA

To meet the needs of the 2.41 billion people seeking rehabilitation care, the world’s health workforce must be sustainable and scalable.  In 2021, the WHO launched its Rehabilitation Competency Framework (RCF) to help countries build local rehabilitation ecosystems by focusing on high-level priorities.  A top priority is the development of a health workforce that is sustainable and scalable to meet local needs.  To capitalize on existing health workforce resources, countries need to focus on the specialists and on other members of the rehabilitation team who can assume targeted responsibilities for delivering care. To support these efforts, CGFNS International, Inc., an assessment organization for health professionals worldwide, is developing two exam-based global certifications, one for rehabilitation health workers and one for registered nurses working in rehabilitation settings. These global certifications assess the knowledge and competencies of individual rehabilitation health workers and nurses and certify those who meet the standards.  For consumers, global certification attests to the competence of local service providers and helps ensure quality care.  For health workers and nurses, global certification confers a credential that recognizes their expertise and supports their continuing professional development and career goals.  And for policymakers, global certification provides useful information for managing care delivery.  This article provides the rationale behind global certification, describes the methodology for creating these certifications, and shows how their underlying constructs and those of the WHO’s RCF align.  This alignment helps consumers, health workers and nurses, and local authorities use all available tools to make informed decisions advancing rehabilitation care.

DOI: 10.29245/2767-5122/2021/1.1126 View / Download Pdf
Vol 3-1 Review Article

Pulmonary Rehabilitation Exercise Assessments and Training Methods for Patients with COPD: A Literature Review

Li Chen1, Jing Su2*

1Department of Nursing, Shantou University Medical College, Guangdong, China

2Director of Department of Nursing, Shantou University Medical College, China

Pulmonary rehabilitation (PR) is an important part of the management of COPD, which can reduce symptoms of dyspnea, times of hospitalizations, and improve exercise capacity and health-related quality of patients. As a key element of PR, PR exercise training consists of exercise assessment and training methods. Exercise assessments should include the evaluation of dyspnea, exercise capacity, and health-related quality of life. Following a thorough assessment of patients, individualized exercise training programs, including endurance, resistance, and other exercise training methods, should be developed based on physiologic requirements and individual demands of patients. Although there have been many studies on the types of exercise for patients with COPD, there are still no conclusions about how to develop the best exercise prescription. Choosing the most appropriate methods for patients with COPD to calculate the situation is crucial. Therefore, this review aims to summarize the common methods of exercise assessments and exercise trainings in PR.

DOI: 10.29245/2767-5122/2021/1.1124 View / Download Pdf
Vol 3-1 Mini Review

A call for research on soft tissue manipulation (STM) as a bone anabolic therapy

Aric Anloague1,4, Devanshi Patel1,4, Stephanie Henderson1,4, Hillary Rolfs1,4, Mackenzie Powell1,4, Sunny B Patel2,4, Nicole M LaFave1,4, Vincent R Marshall1,4, Bryan G Wacker1,4, Collin M Young1,4, Julia M Hum3,4, Kevin Gries3,4,5, Jonathan W Lowery3,4*

1Marian University College of Osteopathic Medicine, 3200 Cold Spring Road, Indianapolis, Indiana, USA 46222

2William Carey University College of Osteopathic Medicine, 710 William Carey Parkway, Hattiesburg, Mississippi, USA 39401

3Division of Biomedical Science, Marian University College of Osteopathic Medicine, 3200 Cold Spring Road, Indianapolis, Indiana, USA 46222

4Bone & Muscle Research Group, Marian University, 3200 Cold Spring Road, Indianapolis, Indiana, USA 46222

5Program in Exercise & Sports Science, Marian University, 3200 Cold Spring Road, Indianapolis, Indiana, USA 46222

Individuals with osteoporosis, i.e., low bone mass, are at enhanced risk for fracture, disability, and death. Hospitalizations for osteoporotic fractures exceed those for heart attack, stroke, and breast cancer. Osteoporosis rates are predicted to increase due to an aging global population yet there are limited pharmacological treatment options for osteoporosis, particularly for long-term management of this chronic condition. Moreover, the drug development pipeline is relatively bereft of new strategies and drug candidates, creating an urgent need for developing new therapeutic strategies for treating osteoporosis. In this mini-review, we speculate about the potential for non-invasive soft tissue manipulation (STM) to exert anabolic effects on the skeleton that may provide therapeutic benefit for individuals with low bone mass. Our rationale is premised on work by us and others showing that STM leads to decreased levels of chemokines and pro-inflammatory cytokines (such as Interleukin (IL)-3, IL-6, and IL-8) known to restrict the differentiation and/or activity of bone-forming osteoblasts. However, there are no published studies examining whether STM impacts bone mass, potentially limiting the widespread use of this non-invasive and non-pharmacological intervention in the worldwide treatment of patients with osteoporosis, individuals with low bone mass due to being bed-ridden or otherwise mobility-limited, and persons subjected to spaceflight-related bone loss.

DOI: 10.29245/2767-5122/2021/1.1125 View / Download Pdf