The modification of cortical reorganization and chronic pain by sensory feedback

Recent neuroscientific evidence has revealed that the adult brain is capable of substantial plastic change in areas such as the primary somatosensory cortex that were formerly thought to be modifiable only during early experience. We discuss research on phantom limb pain as well as chronic back pain that revealed functional reorganization in both the somatosensory and the motor system in these chronic pain states. In phantom limb pain patients, cortical reorganization is correlated with the amount of phantom limb pain; in low back pain patients the amount of reorganizational change increases with chronicity. We present a model of the development of chronic pain that assumes an important role of somatosensory pain memories. In phantom limb pain, we propose that those patients who experienced intense pain prior to the amputation will later likely develop enhanced cortical reorganization and phantom limb pain. We show that cortical plasticity related to chronic pain can be reduced by behavioral interventions that provide feedback to the brain areas that were altered by somatosensory pain memories.     

Autogenic training: a meta-analysis of clinical outcome studies

Autogenic training (AT) is a self-relaxation procedure by which a psychophysiological determined relaxation response is elicited. A meta-analysis was performed to evaluate the clinical effectiveness of AT. Seventy-three controlled outcome studies were found (published 1952–99). Sixty studies (35 randomized controlled trials [RCT]) qualified for inclusion in the meta-analysis. Medium-to-large effect sizes (ES) occurred for pre–post comparisons of disease-specific AT-effects, with the RCTs showing larger ES. When AT was compared to real control conditions, medium ES were found. Comparisons of AT versus other psychological treatment mostly resulted in no effects or small negative ES. This pattern of results was stable at follow-up. Unspecific AT-effects (i.e., effects on mood, cognitive performance, quality of life, and physiological variables) tended to be even larger than main effects. Separate meta-analyses for different disorders revealed a significant reduction of the heterogeneity of ES. Positive effects (medium range) of AT and of AT versus control in the meta-analysis of at least 3 studies were found for tension headache/migraine, mild-to-moderate essential hypertension, coronary heart disease, asthma bronchiale, somatoform pain disorder (unspecified type), Raynaud's disease, anxiety disorders, mild-to-moderate depression/dysthymia, and functional sleep disorders.     

Mitochondrial,sarcoplasmic membrane integrity and protein degradation in heart and skeletal muscle in exercised rats

Several different exercise regimens varied in the severity of tissue damage induced. Therefore, this study investigated the effects of a single bout of exercise versus endurance training in heart and skeletal muscles with different predominant fiber types on indices of mitochondrial, endoplasmic reticulum (ER) integrity and protein degradation. Male Wistar rats performed different treadmill exercise protocols: exhaustive, maximal exhaustive, eccentric, training and exhaustive exercise after training. The maximal and eccentric exercises resulted in a significant loss of integrity of the sarcoplasmic and ER muscle, while no changes were observed in cardiac muscle. Mitochondrial membrane fluidity measured by the fluorescence polarization method was significantly increased post-acute exercises in heart and oxidative muscles. Regular exercise can stabilize and preserve the viscoelastic nature of mitochondrial membranes in both tissues. The highest increase in carbonyl content was obtained in heart after exhaustive exercise protocol, from 1+/-0.1 to 3.6+/-0.14 nmol mg protein(-1), such increase were not found after regular exercise with values significantly decreased. Nitrate heart levels showed attenuated generation of nitric oxide after training. Muscle protein oxidation was produced in all exhaustive exercises including eccentric exercise.     

Positive reinforcement training in rhesus macaques—training progress as a result of training frequency

Positive reinforcement training (PRT) efficiency was examined as a function of training frequency in 33 pair‐ or triple‐housed female rhesus macaques. The animals were trained three times a week, once a day or twice a day, using PRT and a clicker as a secondary reinforcer. All animals were trained on 30 sessions, with an average of 5 min per training session per animal. The behaviors, trained in succession, were Targeting (reliably touching and following a Target); Collaborating (dominant animals allowing subordinates to train while stationing); Box‐training (accepting being enclosed in a small compartment while responding to Target training) and initial Injection training. Fulfilled criteria for Targeting were obtained in 32/33 animals in a median of nine training sessions. Collaboration was obtained in 27/33 animals in a median of 15 training sessions. However, only four animals completed Box‐training during the 30 training sessions and started Injection training. When comparing training success in terms of number of training sessions, training twice a day was less efficient than the other two treatments. In terms of daily progress, our results suggest that from a management perspective, daily training is more conducive to quick training success than thrice weekly training. In addition, in this study no further advantages could be gained from training twice a day. Am. J. Primatol. 71:373–379, 2009. © 2009 Wiley‐Liss, Inc.     

Growth factors and glucose homeostasis in diabetic rats: effects of exercise training

To investigate the alterations of glucose homeostasis and variables of the insulin‐like growth factor‐1 (IGF‐1) growth system in sedentary and trained diabetic (TD) rats, Wistar rats were divided into sedentary control (SC), trained control (TC), sedentary diabetic (SD), and TD groups. Diabetes was induced by Alloxan (35 mg kg^?1 b.w.). Training program consisted of swimming 5 days week^?1, 1 h day^?1, during 8 weeks. Rats were sacrificed and blood was collected for determinations of serum glucose, insulin, growth hormone (GH), IGF‐1, and IGF binding protein‐3 (IGFBP‐3). Muscle and liver were removed to evaluate glycogen content. Cerebellum was extracted to determinate IGF‐1 content. Diabetes decreased serum GH, IGF‐1, IGFBP‐3, liver glycogen, and cerebellum IGF‐1 peptide content in baseline condition. Physical training recovered liver glycogen and increased serum and cerebellum IGF‐1 peptide in diabetic rats. Physical training induces important metabolic and hormonal alterations that are associated with an improvement in glucose homeostasis and serum and cerebellum IGF‐1 concentrations. Copyright © 2009 John Wiley & Sons, Ltd.     

入伍新训中膝关节损伤的特点与防治研究

目的：通过对某部新入伍官兵训练中膝关节损伤发生原因、特点进行流行性病学调查和分析,为合理训练,预防损伤发生和 治疗相关伤病提供指导依据。方法：对某部2013 年度450 名新入伍官兵的训练伤发病情况进行统计分析,重点分析膝关节损伤 发生率、伤病类型和致伤原因,并对其严重者进行关节镜治疗,观察和分析术后随访效果。结果：某部新兵的训练伤发生率为 20.0%。以关节急性扭伤最为多见,占81.1%。其中膝关节损伤共发生32 例,占训练伤发病率为7.1%,占训练伤发病率43.8%,其 中膝关节周围肌肉损伤20 例、交叉韧带损伤1 例、半月板损伤9 例、侧副韧带损伤2 例。致伤率最高的前3 位科目是5000 米负 重跑、跨越障碍训练、格斗训练,共27 例,占膝关节训练伤总数的84.4%。所有受伤患者中,12 例行手术治疗,20 例给予石膏、支具 固定、休息等保守治疗。经随访所有患者均得到较好的功能恢复。结论：对于新兵膝关节训练伤预防工作非常重要,避免致残;关 节镜手术技术的进步对于膝关节军事训练伤治疗有良好的效果。     

某坦克部队外训期间的膳食营养调查

目的:了解坦克部队官兵在野外驻训期间的膳食营养状况,为指导合理膳食提供参考依据。方法:膳食调查采用称重法,能量消耗采用生活观察法,体格检查指标包括体重和皮褶厚度。结果:每日人均禽肉、鱼虾、蔬菜等摄入水平未达到"军人食物定量"标准,而植物油摄入量则超过军标要求;VB1、VC、铁、锌、硒、碘等摄入量未达到"军人营养素供给量"标准要求;三大产能营养素供能比例不合理,脂肪摄入偏高,碳水化合物偏低;多数官兵野外驻训7 d后体重和皮褶厚度降低。结论:该部队在野外驻训期间膳食结构不够合理,部分营养素摄入量未达到军标要求,应调整膳食结构,改善官兵的营养状况。     

我国西北地区康复治疗师的现状调查及分析

目的:调查我国西北地区康复治疗师的现状,为规范康复治疗师培养的改革提供依据。方法:采用抽样调查的方法,向西北五个省区部分康复医疗单位发放调查问卷共200份,由单位负责人填写,调查内容包括该单位康复治疗师的数量、专业、学历、从业时间、职称、持证情况和对培训的需求情况等,填写完成后进行数据统计分析。结果:康复治疗师中从事神经康复方向的治疗师比例最高,约为45.04%。大部分的治疗师从业时间都在5年以内,从业时间大于5年的比例只占13.68%。77.60%的治疗师为医学相关专业毕业,多数治疗师为本科以下学历,硕士和博士学历仅占0.48%,而获得康复治疗师资格证书的人员比例仅为39.35%。治疗师的职称也大多为初、中级(92.49%),高级职称治疗师仅占7.51%,78.81%的治疗师希望得到高水平的培训或进修。结论:西北地区康复治疗师整体从业时间较短,学历较低,缺乏高职称的治疗师,康复治疗师人才队伍培养体系亟待改善。     

术前量化训练方法对腰椎间盘突出患者术后锻炼依从性及康复效果的影响

目的：探讨术前量化训练方法对腰椎间盘突出患者术后锻炼依从性及康复效果的影响。方法：将84 例腰椎间盘突出患者随 机分为观察组及对照组各42 例,对照组围手术期间实施常规性护理,观察组围手术期间实施术前量化训练,对比分析两组患者 负性情绪、术后锻炼依从性及康复情况。结果：观察组干预后汉密尔顿焦虑量表（HAMA）评分、汉密尔顿抑郁量表（HAMD）评分 低于对照组（P<0.05）。观察组术后锻炼依从率、满意率高于对照组（P<0.05）,而并发症发生率低于对照组(P<0.05)。观察组术后疼 痛评分低于对照组（P<0.05）,观察组术后下床活动时间及平均住院时间短于对照组（P<0.05）。结论：对腰椎间盘突出患者术前进 行适应手术训练可有效改善患者负性情绪,提高患者术后锻炼依从性,有利于患者术后康复,提高患者康复效果。     

血栓通配合康复训练对缺血性脑卒中恢复期患者肢体康复的疗效

目的:探究血栓通配合康复训练对缺血性脑卒中(cerebral arterial thrombosis,CAT)恢复期患者肢体康复的疗效情况。方法:选取2011年3月-2013年3月我院收治的84例CAT患者按数字表法随机分为观察组和对照组,各42例。对照组单纯采用康复训练治疗,观察组在对照组康复训练的基础上服用血栓通配合治疗,分别观察治疗前、治疗后1个月、3个月、6个月的各项基本指标并对比研究。结果:两组患者治疗前和治疗1月后Barthel评分无明显差异(P0.05);观察组治疗后3、6个月Barthel评分显著高于对照组,差异有统计学意义(P0.05),两组患者治疗前和治疗1月后肢体Fugl-Meyer评分无明显差异(P0.05);观察组治疗后3、6个月肢体Fugl-Meyer评分显著高于对照组,差异有统计学意义(P0.05),且对照组出院时上肢依然未完全恢复。通过对对照组和观察组患者的生活质量评分比较,观察组生活质量的各项评分均明显高于对照组,两组比较差异有统计学意义(P0.05)。结论:对缺血性脑卒中恢复期患者采用血栓通药物配合适当的康复训练疗效较好,术后肢体恢复理想,值得作为治疗CAT的首选方法在临床上推广应用。