Transcranial direct current stimulation (tDCS) is a neuromodulatory technique that delivers low-intensity direct current to cortical areas, thereby facilitating or inhibiting spontaneous neuronal activity. This study was designed to investigate changes in various sensory functions after tDCS. We conducted a single-center, single-blinded, randomized trial to determine the effect of a single session of tDCS with the current perception threshold (CPT) in 50 healthy volunteers. Nerve conduction studies were performed in relation to the median sensory and motor nerves on the dominant hand to discriminate peripheral nerve lesions. The subjects received anodal tDCS with 1 mA for 15 minutes under two different conditions, with 25 subjects in each groups: the conditions were as follows tDCS on the primary motor cortex (M1) and sham tDCS on M1. We recorded the parameters of the CPT a with Neurometer$^{(R)}$ at frequencies of 2000, 250, and 5 Hz in the dominant index finger to assess the tactile sense, fast pain and slow pain, respectively. In the test to measure CPT values of the M1 in the tDCS group, the values of the distal part of the distal interphalangeal joint of the second finger statistically increased in all of 2000 Hz (p=.000), 250 Hz (p=.002), and 5 Hz (p=.008). However, the values of the sham tDCS group decreased in all of 2000 Hz (p=.285), 250 Hz (p=.552), and 5 Hz (p=.062), and were not statistically significant. These results show that M1 anodal tDCS can modulate sensory perception and pain thresholds in healthy adult volunteers. The study suggests that tDCS may be a useful strategy for treating central neurogenic pain in rehabilitation medicine.
Background: Effect of cervical and lumbar tractions on the reduction in the angle of curvature and the effect of a correction exercise or a general traction method on balance, muscle strength, pain, and body alignment, however insufficient research has been undertaken on self traction exercises targeting patients with scoliosis. Purpose: To determine the effect of cervical and lumbar tractions on the reduction in the angle of curvature and the effect of a correction exercise or a general traction method on balance, muscle strength, pain, and body alignment. Design: Randomized controlled clinical trial (single blinded) Methods: Twelve adults(20s) with scoliosis were included in this study and performed a traction program that was composed of a 5-min warm-up exercise, a 15-min main exercise, and a 5-min cool-down exercise (25 minutes in total), three times a week for four weeks. The Chiro traction machine was used for the self-traction exercise. Vertebral alignment, muscle strength, and flexibility were compared before and after the intervention using the paired T-test. Results: The scoliosis angle, pelvic torsion, and lumbar extensor were significantly changed by intervention; however, there was no significant difference in flexibility. Conclusion: The results revealed that self-traction exercise activated blood flow through the extension and contraction of muscles, effectively increasing the function of the muscles around the vertebrae.
PURPOSE: This examined the effects of a sling exercise based on music on the cognition, physical performance of patients with dementia. METHODS: Thirty subjects with dementia volunteered to participate in this study. All subjects were allocated randomly to either the experimental group or control group, with 15 subjects in each group. All subjects underwent the exercise program for an average of 60 minutes per day for 16 weeks. The experimental group performed sling exercise based on music, and the control group performed the general exercise program. Assessments were made using the Korean version of mini-mental state examination (MMSE-K), 10 m walk test (10MWT), Tinetti mobility test (TMT), and Katz's Index of Independence in activity daily living (KIIADL) to detect changes in the cognitive level and physical performance before and after the 16-week training period. A paired t-test was conducted to compare the within-group change before and after the intervention. An independent t-test was performed to compare the between-group difference. The statistical significance level was set to α=.05 for all variables. RESULTS: The experimental group showed significant within-group changes in the MMSE-K, 10MWT, TMT, and KIIADL (p<.05). The control group showed a significant change in only the KIIADL (p<.05). A significant difference was observed between the experimental group and the control group regarding the change in MMSE-K and KIIADL after the interventions (p<.05). CONCLUSION: A music-based sling exercise program effectively improves cognition, physical performance, and ADL in patients with dementia. Further studies with a wider range of subjects and scientific equipment will be needed to strengthen the results of this study.
The purposes of the study were (1) to evaluate the olfactory identification ability in those who have bad breath, (2) to determine the olfactory detection threshold for methyl mercaptan in normal subjects and those who have bad breath, and (3) to evaluate the effect of oral hygiene care on the olfactory detection threshold for methyl mercaptan. Sixteen male subjects with bad breath (male odor group), 9 male subjects without bad breath (male non-odor group), and 10 female subjects without bad breath (female non-odor group) were included for the study. Olfactory identification ability was assessed by administrating the Cross-Cultural Smell Identification Test (CC-SIT), and the olfactory detection threshold for methyl mercaptan was measured by two-alternative forced-choice single-staircase detection threshold procedure in a double-blinded condition. The geometric mean of the last four staircase reversal points of a total of seven reversals is used as the threshold. For the male odor group, after 1 month of intensive oral hygiene care for reducing oral volatile sulfur compounds (VSC) concentration, the olfactory detection threshold for methyl mercaptan was measured again and compared to the initial value. The ANOVA was used to test the group difference of olfactory threshold and olfactory identification ability and the paired t-test was used to test the difference of olfactory threshold between before and after reduction of oral VSC in male odor group. The results were as follows : 1. There was no significant difference in olfactory identification ability among those who have bad breath and normal male or female subjects. 2. The olfactory detection threshold for methyl mercaptan was about 8.4 ppb in normal male and female. 3. There was a tendency that male subjects with bad breath showed a higher olfactory detection threshold for methyl mercaptan when compared to those of no bad breath. 4. The olfactory detection threshold for methyl mercaptan returned to a normal level after 1 month of intensive oral hygiene care for reducing oral VSC.
TObjectives: Develop a sham moxibustion and determine whether subjects can distinguish a sham moxibustion from a real moxibustion. Design: Single-blinded, randomized, placebo-controlled clinical trial Methods: Sham and real moxibustion resemble each other in appearance, burning procedure, but the base of the sham moxibustion isolates the moxa-producing heat and smoke. This device was tested in a clinical trial in which subjects received moxibustion at Zhongwan(CV12), Mingmen(GV4), Quchi(LI11), Zusanli(ST36), Taichong(LR3)), Hegu(LI4). Volunteers(n=32) were given pre-treatment questionnaire to assess their experience in getting moxibustion therapy and performing it. They randomized into treatment(n=16) or sham controlled group(n=16), received moxibustion according their groups. After treatments, the effectiveness of blinding was assessed. Results: There were no significant differences between two groups in sex, age, moxibustion experience. In the treatment group and the sham group, the number of subjects who believed they received real moxibustion or sham is not different significantly.(P=.668) The consistency of a moxibustion type which subjects received actually and the their guess about that, isn't different significantly in two groups.(P=.465) Conclusion: The sham moxibustion was successfully validated in this study, The results demonstrate that this sham moxibustion blinds subjects and can be used as effective placebo-control in moxibustion clinical trials.
Purpose: This study was undertaken to develop and test a mastery learning program of nursing skills for undergraduate nursing students. Methods: In this methodological study, first, the preliminary draft of a mastery learning program to provide training for nursing skills was developed based on Bloom's framework for mastery learning. Second, to test the developed program, a single-blinded, nonequivalent control group nonsynchronized study was conducted on 50 senior nursing students in a University selected by convenient sampling. Thirteen students were assigned to a control group; 13, 12, and 13 of them were assigned to intravenous therapy, transfusion, and patient transfer groups, respectively. The achievement levels and performance scores of the selected nursing skills were measured before and after the completion of the program in all the groups. Lastly, the final program was confirmed based on the results of the program testing. Results: Intravenous therapy, transfusion, and patient transfer were selected as essential nursing skills for the program based on the priorities rated by clinical instructors and staff nurses. The achievement levels of selected nursing skills were determined by Angoff scores. After participating in the program, the proportion of passers and performance scores of the nursing skills in the experimental groups were significantly higher than those in the control group. The final program was confirmed which included a diagnostic test, enrichment activities for the passers and three repetitions of corrective activities and formative assessments for non-passers. Conclusion: The results suggest that a mastery learning program for undergraduate students can lead to better improvement and performance of essential nursing skills.
PURPOSE: This study compared two different techniques of treadmill gait training, and evaluated the outcomes on gait and respiratory function in patients with hemiplegic stroke. METHODS: This was a single-blinded, randomized, controlled, comparative study, enrolling a total of 21 stroke patients in a rehabilitation hospital. Subjects were randomly assigned to either the treadmill walking training group with gradual speed increase (GSI group, n = 10), or treadmill walking training group with random speed changing (RSC group, n = 11). All participants performed 60 min of comprehensive rehabilitation therapy (5 × / week for 6 weeks). In additional, each group received either GSI or RSC treadmill walking training for 20 min (5 × / week for 6 weeks, total 30 sessions). Gait and respiratory function were measured before and after the 6-week training. RESULTS: Both groups showed significant improvements in the 10-m walking test, 6-minute walking test, timed up and go test, forced vital capacity (FVC), forced expiratory volume in 1 second, and maximal voluntary ventilation after training (p < .05). The GSI group showed a significantly greater increase in the FVC than the RSC group (+14.8 L vs. +12.5 L, p < .05). CONCLUSION: Both training methods can be effective for improving the walking and respiratory functions of stroke patients. However, our results indicate that treadmill walking training with gradual speed increase might be a more effective method for improving the respiratory function (FVC) than treadmill walking training with random speed changing.
Background: This study evaluated the efficacy of virtual reality (VR) distraction and counter-stimulation (CS) on dental anxiety and pain perception to local anesthesia in children. Methods: A prospective, randomized, single-blinded interventional clinical trial with a parallel design was used. Seventy children 7-11 years old who required local anesthesia (LA) for pulp therapy or tooth extraction were recruited and allocated to two groups with equal distribution based on the intervention. Group CS (n = 35) received CS and Group VR (n = 35) received VR distraction with ANTVR glasses. Anxiety levels (using pulse rate) were evaluated before, during, and after administration of local anesthesia, while pain perception was assessed immediately after the injection. Wong-Baker faces pain-rating scale (WBFPS), visual analog scale (VAS), and Venham's clinical anxiety rating scale (VCARS) were used for pain evaluation. Student's t-test was used to test the mean difference between groups, and repeated measures ANOVA was used to test the mean difference of pulse rates. Results: Significant differences in mean pulse rates were observed in both groups, while children in the VR group had a higher reduction (P < 0.05), and the mean VCARS scores were significant in the VR group (P < 0.05). Mean WBFPS scores showed less pain perception to LA needle prick in the CS group while the same change was observed in the VR group with VAS scores. Conclusions: VR distraction is better than CS for reducing anxiety to injection in children undergoing extraction and pulpectomy.
Background: Periodontitis is a chronic inflammatory condition associated with dysbiosis of the oral microbiota. The aim of the present clinical study was to explore the adjunctive effect of ozonized water irrigation in the circuits of ultrasonic scalers for the full-mouth decontamination of patients with periodontitis Stage I or II. Methods: The study was a randomized, single-blinded, parallel-group clinical trial. The test group (n=25) was treated with ultrasonic scalers irrigated with ozonized water, whereas the control group (n=25) received normal tap water irrigation within the ultrasonic scalers used during the professional mechanical debridement. Full mouth plaque score, bleeding score, probing pocket depth, and the gingival index were evaluated at baseline, two, and 4 weeks after treatment. The pain perceived and dental anxiety were also assessed after treatment by means of the visual analog scale (VAS). Results: All periodontal parameters resulted in significant improvement for both study groups. The effect of the treatment group on the gingival index was significant, in particular, patients in the test group experienced a greater reduction in this score. No significant differences could be observed with regards to the average probing depth, full mouth plaque index and bleeding score. Patients treated with ozonized water running in the circuits of ultrasonic scalers displayed also lower scores for pain and dental anxiety. Conclusion: The present study showed a significant clinical effect on gingival inflammation attributable to adjunctive ozone irrigation during nonsurgical periodontal therapy. Further studies, including patients with severe periodontitis and greater sample sizes, are recommended to test the clinical effect of ozonized water in the circuits of ultrasonic scalers.
Background: This study aimed to evaluate the efficacy of external vibrating devices and counterstimulation on a child's dental anxiety, apprehension, and pain perception during local anesthetic administration. Methods: This was a prospective, randomized, parallel-arm, single-blinded interventional, clinical trial. One hundred children aged 4-11 years, requiring pulp therapy or extraction under local anesthesia (LA), were recruited and allocated equally into two groups (1:1) based on the interventions used: Group BD (n = 50) received vibration using a Buzzy® device {MMJ Labs, Atlanta, GE, USA} as a behavior guidance technique; Group CS (n = 50) received counterstimulation for the same technique. Anxiety levels [Venham's Clinical Anxiety Rating Scale (VCARS), Venham Picture Test (VPT), Pulse oximeter {Gibson, Fingertip Pulse Oximeter}, Beijing, China)] were assessed before, during, and after LA administration, while pain perception [Wong-Baker Faces Pain Rating Scale (WBFPS), Visual Analogue Scale (VAS)] was evaluated immediately after injection. Statistical analysis was performed using the Student's t-test to assess the mean difference between the two groups and the repeated measures ANOVA for testing the mean difference in the pulse rates. Statistical significance was set at P < 0.05. Results: Significant differences in mean pulse rate values were observed in both groups. In contrast, the children in the BD group had higher diminution (P < 0.05), whereas the mean VCARS and VPT scores were conspicuous (P < 0.05). Based on the mean WBFPS and VAS scores, delayed pain perception after LA injection was more prominent in the BD group than in the CS group. Conclusion: External vibration using a Buzzy® device is comparatively better than counterstimulation in alleviating needle-associated anxiety in children requiring extraction and pulpectomy.
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