41 results on '"Sun, Shu-Fen"'
Search Results
2. Comparing efficacy of a single intraarticular injection of platelet-rich plasma (PRP) combined with different hyaluronans for knee osteoarthritis: a randomized-controlled clinical trial
- Author
-
Huang, Hung-Ya, Hsu, Chien-Wei, Lin, Guan-Chyun, Lin, Huey-Shyan, Chou, Yi-Jiun, Liou, I-Hsiu, and Sun, Shu-Fen
- Published
- 2022
- Full Text
- View/download PDF
3. Efficacy and Safety of a Single Intra-articular Injection of Platelet-rich Plasma on Pain and Physical Function in Patients With Ankle Osteoarthritis—A Prospective Study
- Author
-
Sun, Shu-Fen, Hsu, Chien-Wei, Lin, Guan-Chyun, Lin, Huey-Shyan, Chou, Yi-Jiun, Wu, Shin-Yi, and Huang, Hung-Ya
- Published
- 2021
- Full Text
- View/download PDF
4. Comparing efficacy of intraarticular single crosslinked Hyaluronan (HYAJOINT Plus) and platelet-rich plasma (PRP) versus PRP alone for treating knee osteoarthritis
- Author
-
Sun, Shu-Fen, Lin, Guan-Chyun, Hsu, Chien-Wei, Lin, Huey-Shyan, Liou, I.-H.siu, and Wu, Shin-Yi
- Published
- 2021
- Full Text
- View/download PDF
5. Using Virtual Reality–Based Rehabilitation in Sarcopenic Older Adults in Rural Health Care Facilities—A Quasi-Experimental Study.
- Author
-
Chen, Guan-Bo, Lin, Che-Wei, Huang, Hung-Ya, Wu, Yi-Jhen, Su, Hung-Tzu, Sun, Shu-Fen, and Tuan, Sheng-Hui
- Subjects
SKELETAL muscle physiology ,EXERCISE physiology ,RURAL hospitals ,EXERCISE intensity ,EXPOSURE therapy ,RESISTANCE training ,PRE-tests & post-tests ,WALKING ,RESEARCH methodology ,VIRTUAL reality therapy ,SARCOPENIA ,GRIP strength ,OLD age - Abstract
Because of a shortage of health care providers, providing rehabilitation in health care facilities is difficult. Virtual reality–based rehabilitation is effective in older populations. There are only a few studies among patients with sarcopenia. This is a quasi-experimental, single-group, pretest–posttest design evaluating the clinical effectiveness of virtual reality–based progressive resistance training among residents aged over 60 years with sarcopenia in rural care facilities. The authors used Oculus Rift with headsets to provide the virtual reality–based progressive resistance training. The authors administered the program twice per week, 30 min per session, for 12 weeks. The primary outcomes were dominant handgrip strength, walking speed, and appendicular skeletal muscle mass index. Data from 30 participants were analyzed. Significant improvements in handgrip strength and walking speed were observed. Although an increasing trend in appendicular skeletal muscle mass index was observed, it did not reach statistical significance. The authors concluded that the virtual reality–based progressive resistance training is partially effective in older sarcopenic adults in health care facilities. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
6. Comparison of Single Intra-Articular Injection of Novel Hyaluronan (HYA-JOINT Plus) with Synvisc-One for Knee Osteoarthritis: A Randomized, Controlled, Double-Blind Trial of Efficacy and Safety
- Author
-
Sun, Shu-Fen, Hsu, Chien-Wei, Lin, Huey-Shyan, Liou, I-Hsiu, Chen, Yin-Han, and Hung, Chia-Ling
- Published
- 2017
- Full Text
- View/download PDF
7. Combined Neuromuscular Electrical Stimulation (NMES) with Fiberoptic Endoscopic Evaluation of Swallowing (FEES) and Traditional Swallowing Rehabilitation in the Treatment of Stroke-Related Dysphagia
- Author
-
Sun, Shu-Fen, Hsu, Chien-Wei, Lin, Huey-Shyan, Sun, Hsien-Pin, Chang, Ping-Hsin, Hsieh, Wan-Ling, and Wang, Jue-Long
- Published
- 2013
- Full Text
- View/download PDF
8. Effect of high intensity laser therapy in the treatment of acute atlantoaxial rotatory subluxation: A case report.
- Author
-
Tuan, Sheng-Hui, Sun, Shu-Fen, Huang, Wan-Yun, Chen, Guan-Bo, Li, Min-Hui, and Liou, I-Hsiu
- Subjects
- *
ATLANTO-axial joint , *NECK pain , *SUBLUXATION , *LASER therapy , *TREATMENT effectiveness , *TORTICOLLIS , *COMPUTED tomography ,CERVICAL vertebrae radiography - Abstract
BACKGROUND: Sudden onset of acute torticollis in children is rare and is usually diagnosed as atlantoaxial rotatory subluxation (AARS). The common treatment for acute AARS without neurological symptoms is halter traction in conjunction with muscle relaxant and sedative agents, followed by cervicothoracic orthotic immobilization. To the best of our knowledge, a case of acute AARS treatment with high-intensity laser therapy (HILT) has not yet been reported so far. OBJECTIVE: We aimed to report a case of acute AARS treatment with HILT successfully and to discuss about the clinical effect of HILT in AARS. METHODS: We reported a 9-year-old girl with acute onset of torticollis visiting the rehabilitation outpatient department. RESULS: The physical examination revealed a typical cock robin position without neurological symptoms. A series of evaluations, including open-mouth odontoid radiograph and soft tissue sonography, confirmed the diagnosis of acute AARS. The patient received HILT over the left suboccipital and upper back muscle groups, which started on the day of the first rehabilitation clinic visit, once a week, for four weeks. Torticollis and neck pain improved gradually with each session of HILT, and the symptoms resolved completely after the fourth session. Dynamic computed tomography (CT) of the cervical spine showed no evidence of obvious AARS after the treatment. CONCLUSIONS: The patient had no complaints after HILT in a case of acute AARS resulting from a mechanical factor. Due to its pain-relief and muscle-release characteristics, HILT indicates the probable benefit of relaxation of spastic muscles for patients with AARS. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
9. Hyaluronic acid as a treatment for ankle osteoarthritis
- Author
-
Sun, Shu-Fen, Chou, Yi-Jiun, Hsu, Chien-Wei, and Chen, Wen-Ling
- Published
- 2009
- Full Text
- View/download PDF
10. A single intraarticular platelet-rich plasma improves pain and function for patients with early knee osteoarthritis: Analyses by radiographic severity and age.
- Author
-
Sun, Shu-Fen, Hsu, Chien-Wei, Lin, Huey-Shyan, Liou, I-Hsiu, Chou, Yi-Chun, Wu, Shin-Yi, and Huang, Hung-Ya
- Subjects
- *
KNEE osteoarthritis , *PLATELET-rich plasma , *PAIN , *CLINICAL trials , *FUNCTIONAL status , *AGE distribution , *PATIENT satisfaction , *SEVERITY of illness index , *INTRA-articular injections , *DESCRIPTIVE statistics , *EVALUATION - Abstract
BACKGROUND: Most studies use platelet-rich plasma (PRP) requiring multiple intraarticular injections for knee osteoarthritis (OA). OBJECTIVE: To investigate the efficacy of a single intraarticular PRP injection for patients with early knee OA and consider subgroup analyses of radiographic severity and age, respectively. METHODS: Forty-one patients with knee OA (Kellgren-Lawrence grade 1–2) received a single PRP injection into the target knee and were assessed at baseline and 1, 3, and 6 months postinjection. The primary outcome was the mean change from baseline in the visual analog scale (VAS) pain (0–100 mm) at 6 months postinjection. Secondary outcomes included the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Lequesne index, single leg stance test (SLS), use of rescue analgesics and patients' satisfaction. RESULTS: Thirty-eight patients completed the study. The mean pain VAS decreased significantly from 45.6 ± 13.0 mm at baseline to 16.9 ± 13.4 mm, 14.0 ± 13.1 mm and 15.5 ± 14.0 mm at 1, 3 and 6-month follow-ups (p < 0.001 for all). Significant improvements in WOMAC, Lequesne index, SLS and consumption of analgesics from baseline (p < 0.001 for all) were noted at each follow-up. Patients' satisfaction was high. No serious adverse events occurred. Subgroup analyses revealed that patients with grade 1 OA showed significantly greater VAS pain reduction at 3 months (p = 0.006) and 6 months (p = 0.005) than patients with grade 2 OA. The older-age group (age > 60) showed significantly greater improvements in VAS pain, WOMAC function subscale scores and total scores at 6-month postinjection, compared with the younger age-group (age ≤ 60). The younger-age group reported better satisfaction at 1 and 3-month postinjection. CONCLUSIONS: One injection of PRP improved pain and function for 6 months for patients with early knee OA. This study supports putting the one-injection regimen into clinical practice. Further research is needed for more definite conclusions. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
11. Efficacy of intra-articular hyaluronic acid in patients with osteoarthritis of the ankle: a prospective study
- Author
-
Sun, Shu-Fen, Chou, Yi-Jiun, Hsu, Chien-Wei, Hwang, Chiao-Wen, Hsu, Pei-Te, Wang, Jue-Long, Hsu, Ya-Wen, and Chou, Mei-Chia
- Published
- 2006
- Full Text
- View/download PDF
12. Hyaluronate improves pain, physical function and balance in the geriatric osteoarthritic knee: a 6-month follow-up study using clinical tests
- Author
-
Sun, Shu-Fen, Hsu, Chien-Wei, Hwang, Chiao-Wen, Hsu, Pei-Te, Wang, Jue-Long, Tsai, Shin-Lung, Chou, Yi-Jiun, Hsu, Ya-Wen, Huang, Chien-Ming, and Wang, Yu-Ling
- Published
- 2006
- Full Text
- View/download PDF
13. The Effect of Three Weekly Intra-Articular Injections of Hyaluronate on Pain, Function, and Balance in Patients with Unilateral Ankle Arthritis
- Author
-
Sun, Shu-Fen, Hsu, Chien-Wei, Sun, Hsien-Pin, Chou, Yi-Jiun, Li, Hung-Ju, and Wang, Jue-Long
- Published
- 2011
- Full Text
- View/download PDF
14. Water and Heat Transport in the Desert Soil and Atmospheric Boundary Layer in Western China
- Author
-
Niu, Guo-Yue, Sun, Shu-Fen, and Hong, Zhong-Xiang
- Published
- 1997
- Full Text
- View/download PDF
15. The Initial Response to Inhaled Nitric Oxide Treatment for Intensive Care Unit Patients with Acute Respiratory Distress Syndrome
- Author
-
Hsu, Chien-Wei, Lee, David Lin, Lin, Shoa-Lin, Sun, Shu-Fen, and Chang, Hsueh-Wen
- Published
- 2008
- Full Text
- View/download PDF
16. Comparison of the diuretic effect of furosemide mixed with human albumin or fresh frozen plasma for patients with hypoalbuminemia in the intensive care unit
- Author
-
Hsu, Chien-Wei, Lin, Shoa-Lin, Sun, Shu-Fen, Chu, Kuo-An, Chung, Hsiao-Min, and Chang, Hsueh-Wen
- Published
- 2006
17. Application of combined botulinum toxin type a and modified constraint-induced movement therapy for an individual with chronic upper-extremity spasticity after stroke
- Author
-
Sun, Shu-Fen, Hsu, Chien-Wei, Hwang, Chiao-Wen, Hsu, Pei-Te, Wang, Jue-Long, and Yang, Chia-Lin
- Subjects
Stroke (Disease) -- Case studies ,Health - Abstract
Background and Purpose. Constraint-induced movement therapy (CIMT) is a promising intervention for retraining upper-extremity function after a stroke. The purpose of this case report is to describe the use of a combination of botulinum toxin type A (BtxA) and a modified CIMT program for a patient with severe spasticity who was unable to use his right upper extremity. Case Description. The 52-year-old patient, who had a stroke 4 years ago, did not meet the minimum motor criteria for CIMT benefit. After receiving BtxA injections targeting the elbow, wrist, and finger flexors, he completed a 4-week program of modified CIMT followed by a 5-month home exercise program. Outcomes. The patient exhibited improvement in muscle tone (the velocity-dependent resistance to stretch that muscle exhibits) and in scores on several upper-extremity function tests (Modified Ashworth Scale, Motor Activity Log, Wolf Motor Function Test, Action Research Arm Test, and Fugl-Meyer Assessment of Motor Recovery). He also reported making much progress in the functional use of the involved upper extremity. Discussion. In a patient with severe flexor spasticity and nonuse of the dominant upper extremity after a stroke, a combined treatment of BtxA and modified CIMT may have resulted in improved upper-extremity use. Key Words: Botulinum toxin, Constraint-induced movement therapy, Spasticity, Stroke., Constraint-induced movement therapy (CIMT) has been shown to produce lasting improvements in upper-extremity movement following a stroke. (1-16) The basic components of CIMT involve restraint of the unaffected arm for [...]
- Published
- 2006
18. Serial cardiopulmonary exercise testing in an asymptomatic young female receiving percutaneous balloon dilatation for cor triatriatum sinistrum at an early age.
- Author
-
Tuan, Sheng-Hui, Chen, Guan-Bo, Chen, Chia-Hsin, Liou, Ihsiu, Sun, Shu-Fen, Wu, Shin-Yi, and Lin, Ko-Long
- Subjects
EXERCISE tests ,METABOLIC equivalent ,CARDIOPULMONARY fitness ,CONGENITAL heart disease ,LEFT heart atrium ,CARPAL tunnel syndrome - Abstract
A young female was diagnosed as classic cor triatriatum sinistrum (CTS) at 38 months old incidentally and she received percutaneous catheter-based balloon dilatation twice at 41 and 48 months old. She took regular follow-up by echocardiography biannually with no re-stenosis of the orifice in the membrane between two chambers in the left atrium and she denied any cardiac-related symptoms. Serial cardiopulmonary exercise testing (CPET) by treadmill under Ramped-Bruce protocol was done at her 13, 19, and 23-year old. She could reach maximal effort and complete the three CPETs. No significant change of metabolic equivalent at anaerobic (MET) threshold, peak MET, and pulmonary function were noted in the serial CPETs and all of them were within normal limits comparing to the reference values of Chinese specific to her age. Our case report demonstrated that the concept of percutaneous catheter-based balloon dilatation of obstructive membrane for classic CTS without other associated congenital heart diseases is sound and feasible. The prognosis is well without re-obstruction and the cardiopulmonary fitness after that could be maintain as healthy peers for up to 18 years. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
19. Comparison of cardiorespiratory fitness between preschool children with normal and excess body adipose ~ An observational study.
- Author
-
Tuan, Sheng-Hui, Li, Chien-Hui, Sun, Shu-Fen, Li, Min-Hui, Liou, I-Hsiu, Weng, Tzu-Ping, Chen, I-Hsuan, and Lin, Ko-Long
- Subjects
PRESCHOOL children ,CARDIOPULMONARY fitness ,CHILDHOOD obesity ,EXERCISE tests ,TREADMILL exercise ,ANAEROBIC threshold ,BODY-weight-supported treadmill training - Abstract
Overweight and obesity in preschoolers might develop into childhood and even adulthood obesity. Overweight and obesity have been shown to be negatively related with cardiorespiratory fitness (CRF) in children and adults but few studies did among preschoolers. We aimed to evaluate whether excess body adipose is negatively associated with CRF in both the submaximal and maximal effort of preschool children in exercise testing and to examine if there is difference to achieve maximal effort during exercise testing between preschoolers with normal and excess body adipose. Data of 106 preschoolers aged 4–6 that received symptom-limited treadmill exercise testing was analyzed. Anthropometry was measured by vector bioelectrical impedance analysis. Excess body adipose was defined as (1) 'overweight' and 'obesity' by body mass index (BMI), (2) fat mass index (FMI) greater than the sex- and age-specific 75th percentile of whole subjects, and (3) fat-free mass index (FFMI) smaller than the sex- and age-specific 25th percentile. CRF was indicated by metabolic equivalent (MET) at anaerobic threshold (AT MET), peak MET, oxygen uptake efficiency slope (OUES) calculated by the 50% (OUES-50) and the entire (OUES-100) duration of the exercise testing. Preschoolers with excess body adipose by three different definitions (BMI, FMI, and FFMI) all had poorer ability to perform maximal effort (p = 0.004, 0.043, and 0.007, respectively). Preschoolers with excess body adipose by BMI and FFMI classifications had lower OUES-50 (p = 0.018, and 0.001, respectively), and lower OUES-100 (p = 0.004, and 0.001, respectively) than peers with normal body adipose during exercise testing while those with excess body adipose by FMI classification showed no significant differences from peers with normal body adipose in both OUES-50 and OUES-100. Preschoolers with excess body adipose had lower CRF significantly during treadmill exercise testing. Weight control and health promotion should start as early as possible. [ABSTRACT FROM AUTHOR]
- Published
- 2019
- Full Text
- View/download PDF
20. A Method for Coupling a Parameterization of the Planetary Boundary Layer with a Hydrologic Model
- Author
-
Lin, J. D. and Sun, Shu Fen
- Published
- 1986
21. Risk of osteoporotic fractures as a consequence of haemophilia: A nationwide population‐based cohort study.
- Author
-
Tuan, Sheng‐Hui, Hu, Li‐Yu, Sun, Shu‐Fen, Huang, Wan‐Yun, Chen, Guan‐Bo, Li, Min‐Hui, and Liou, I‐Hsiu
- Subjects
BONE density ,HEMOPHILIA ,OSTEOPOROSIS ,BONE fractures ,DISEASE incidence - Abstract
Aim: Low bone mineral density occurs more commonly in patients with haemophilia (PWH) than the general population. However, the risk of haemophilia‐related osteoporotic fractures has not been well established. We aim to explore the relationship between haemophilia and the development of osteoporotic fractures following haemophilia. Methods: This was a nationwide population‐based cohort study based on the data in the Taiwan National Health Insurance Research Database (TNHIRD). Patients who were diagnosed with haemophilia were selected. A comparison cohort was formed of patients without haemophilia who were matched according to age and sex. The incidence rate and the hazard ratios (HRs) of new‐onset osteoporotic fractures were calculated for both cohorts. Results: The haemophilia cohort consisted of 75 patients, and the comparison cohort comprised 300 matched control patients without haemophilia. The risk of osteoporotic fractures was higher in the haemophilia cohort than in the comparison cohort (HR = 5.41, 95% confidence interval [CI] = 2.42‐12.1, P < 0.001). After adjustments for age, sex, comorbidities, urbanizations and socio‐economic status, PWH were 4.37 times more likely to develop osteoporotic fractures (95% CI = 1.88‐10.17, P = 0.001) as compared to matched cohort. In addition, the incidence of newly diagnosed osteoporotic fractures was significantly increased after 5‐year follow‐up durations. Conclusion: Though our study by TNHIRD presented methodologic flaws by its design nature, we observed that haemophilia may increase the risk of osteoporotic fractures and the cumulative incidence was significantly higher for PWH diagnosed more than 5 years. Clinicians should pay particular attention to osteoporotic fractures following haemophilia in PWH as they age. [ABSTRACT FROM AUTHOR]
- Published
- 2019
- Full Text
- View/download PDF
22. Hyaluronate for the Treatment of Ankle Osteoarthritis
- Author
-
Sun, Shu-Fen
- Subjects
Medical / Immunology - Abstract
Hyaluronate for the Treatment of Ankle Osteoarthritis
- Published
- 2012
23. Non-traumatic anterior spinal cord infarction in a novice surfer: A case report
- Author
-
Chung, Hsin-Yeh, Sun, Shu-Fen, Wang, Jue-Long, Lai, Ping-Hong, and Hwang, Chiao-Wen
- Published
- 2011
- Full Text
- View/download PDF
24. Comparison of Single Intra-Articular Injection of Novel Hyaluronan (HYA-JOINT Plus) with Synvisc-One for Knee Osteoarthritis: A Randomized, Controlled, Double-Blind Trial of Efficacy and Safety.
- Author
-
Shu-Fen Sun, Chien-Wei Hsu, Huey-Shyan Lin, I-Hsiu Liou, Yin-Han Chen, Chia-Ling Hung, Sun, Shu-Fen, Hsu, Chien-Wei, Lin, Huey-Shyan, Liou, I-Hsiu, Chen, Yin-Han, and Hung, Chia-Ling
- Subjects
OSTEOARTHRITIS ,HYALURONIC acid ,ANALGESICS ,VISUAL analog scale ,PATIENT satisfaction ,THERAPEUTIC use of hyaluronic acid ,COMPARATIVE studies ,INTRA-articular injections ,KNEE diseases ,RESEARCH methodology ,MEDICAL cooperation ,QUESTIONNAIRES ,RESEARCH ,EVALUATION research ,SOLUTION (Chemistry) ,PAIN measurement ,RANDOMIZED controlled trials ,TREATMENT effectiveness ,BLIND experiment ,THERAPEUTICS - Abstract
Background: Viscosupplementation has been widely used for the treatment of knee osteoarthritis. Because we found no well-controlled trial comparing single-injection regimens of hyaluronan for knee osteoarthritis, we compared the efficacy and safety of a single intra-articular injection of a novel cross-linked hyaluronan (HYA-JOINT Plus) with a single injection of Synvisc-One in patients with knee osteoarthritis.Methods: In a prospective, randomized, controlled, double-blind trial with a 6-month follow-up, 132 patients with knee osteoarthritis (Kellgren-Lawrence grade 2 or 3) were randomized to receive 1 intra-articular injection of 3 mL of HYA-JOINT Plus (20 mg/mL) (n = 66) or 6 mL of Synvisc-One (8 mg/mL) (n = 66). The primary outcome was the change from baseline in the visual analog scale (VAS) (0 to 100 mm) pain score at 6 months. Secondary outcome measures included the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC, Likert scale), Lequesne index, timed "Up & Go" (TUG) test, single-limb stance (SLS) test, use of rescue analgesics, and patient satisfaction.Results: A total of 121 patients were available for the intention-to-treat analysis at 6 months. Both groups had a significant improvement in the VAS, WOMAC, and Lequesne index scores at each follow-up visit (p < 0.001). Patients who received HYA-JOINT Plus experienced a significantly greater improvement in the VAS pain score at 1, 3, and 6 months compared with those treated with Synvisc-One (adjusted mean difference: -12.0, -8.5, and -6.6; p = 0.001, 0.033, and 0.045, respectively). There were no significant between-group differences in any of the secondary outcomes except the WOMAC stiffness scores at 6 months, which favored HYA-JOINT Plus treatment (p = 0.043). The TUG time did not change significantly in either group during the study (p > 0.05), but the SLS time improved significantly in both the HYA-JOINT Plus and the Synvisc-One group (p = 0.004 and p = 0.022, respectively). No significant between-group differences were observed with respect to patient satisfaction or consumption of analgesics. No serious adverse events occurred following the injections.Conclusions: A single injection of either HYA-JOINT Plus or Synvisc-One is safe and effective for 6 months in patients with knee osteoarthritis. HYA-JOINT Plus is superior to Synvisc-One in terms of reducing the VAS pain score at 1, 3, and 6 months and the WOMAC stiffness score at 6 months, with similar safety.Level Of Evidence: Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence. [ABSTRACT FROM AUTHOR]- Published
- 2017
- Full Text
- View/download PDF
25. Moderate glucose control results in less negative nitrogen balances in medical intensive care unit patients: a randomized, controlled study.
- Author
-
Hsu, Chien-Wei, Sun, Shu-Fen, Lin, Shoa-Lin, Huang, Hsiu-Hua, and Wong, Kam-Fai
- Subjects
GLUCOSE metabolism ,INSULIN ,NITROGEN excretion ,UREA ,SERUM albumin ,TRANSTHYRETIN - Abstract
Introduction: Hyperglycemia and protein loss are common in critically ill patients. Insulin can be used to lower blood glucose and inhibit proteolysis. The impact of moderate insulin therapy on protein metabolism in critically ill patients has not been evaluated. We compared urinary nitrogen excretion, nitrogen balance, serum albumin concentrations, prealbumin concentrations, and clinical outcomes between patients receiving moderate insulin therapy (MIT) and conventional insulin therapy (CIT) in a medical ICU.Methods: Patients were randomly divided into groups and treated with MIT (glucose target 120 to 140 mg/dl) or CIT (glucose target 180 to 200 mg/dl). Calories and protein intake were recorded each day. On days 3, 7 and 14, the 24-hour urinary nitrogen excretion, nitrogen balance, and serum albumin and prealbumin concentrations were measured. Clinical outcomes data were collected.Results: A total of 112 medical ICU patients were included, with 55 patients randomized to the MIT group and 57 patients randomized to the CIT group. Patients treated with MIT showed a trend towards increased nitrogen balance (P = 0.070), significantly lower urinary nitrogen excretion (P = 0.027), and higher serum albumin (P = 0.047) and prealbumin (P = 0.001) concentrations than patients treated with CIT. The differences between the two groups were most significant on day 3, when all factors showed significant differences (P < 0.05).Conclusions: Moderate glucose control results in less negative nitrogen balances in medical ICU patients. Differences are more significant in the early stages compared with the late stages of critical illness.Trial Registration: ClinicalTrial.Gov NCT 01227148. [ABSTRACT FROM AUTHOR]- Published
- 2012
- Full Text
- View/download PDF
26. Clinical Characteristics and Predictors of Mortality in Critically Ill Adult Patients with Influenza Infection.
- Author
-
Hong, Wei-Cheng, Sun, Shu-Fen, Hsu, Chien-Wei, Lee, David-Lin, and Lee, Chao-Hsien
- Published
- 2021
- Full Text
- View/download PDF
27. Monitoring sedation for bronchoscopy in mechanically ventilated patients by using the Ramsay sedation scale versus auditory-evoked potentials.
- Author
-
Hsu, Chien-Wei, Sun, Shu-Fen, Chu, Kuo-An, Lee, David Lin, and Wong, Kam-Fai
- Subjects
PROPOFOL ,ANESTHESIA ,ARTIFICIAL respiration ,AUDITORY evoked response ,BRONCHOSCOPY ,LONGITUDINAL method ,PATIENT monitoring ,THERAPEUTICS - Abstract
Background: Appropriate sedation benefits patients by reducing the stress response, but it requires an appropriate method of assessment to adjust the dosage of sedatives. The aim of this study was to compare the difference in the sedation of mechanically ventilated patients undergoing flexible bronchoscopy (FB) monitored by auditory-evoked potentials (AEPs) or the Ramsay sedation scale (RSS).Methods: In a prospective, randomized, controlled study, all patients who underwent FB with propofol sedation were monitored and their sedation adjusted. During FB, one group was monitored by AEP and another group was monitored by RSS. The propofol dosage was adjusted by the nursing staff during examination to maintain the Alaris AEP index (AAI) value between 25 and 40 in the AEP group and the RSS at 5 or 6 in the RSS group. Before FB and during FB, the AAI, heart rate (HR), and mean arterial pressure (MAP) were recorded every 5 min. The percentages of time at the sedation target and the propofol dosages were calculated.Results: Nineteen patients received AEP monitoring and 18 patients received RSS monitoring. The percentage of time at the sedation target during FB was significantly higher in the AEP monitoring group (51.3%; interquartile range [IQR], 47.0-63.5%) than in the RSS group (15.4%; IQR, 9.5-23.4%), (P < 0.001). During FB, the RSS group had a significantly higher AAI (P = 0.011), HR (P < 0.001), and MAP (P < 0.001) than the AEP group.Conclusions: In mechanically ventilated patients undergoing FB, AEP monitoring resulted in less variation in AAI, HR, and MAP, and a higher percentage of time at the sedation target than RSS monitoring. [ABSTRACT FROM AUTHOR]- Published
- 2014
- Full Text
- View/download PDF
28. Effect of rehabilitation on a child with atlantoaxial rotatory fixation.
- Author
-
Hsu, Pei-Te, Liou, I-Hsiu, Sun, Shu-Fen, Hwang, Chiao-Wen, and Wang, Jue-Long
- Published
- 2013
- Full Text
- View/download PDF
29. One-dimensional snow water and energy balance model for vegetated surfaces
- Author
-
Dickinson, Robert E., Gao, Xiaogang, Sorooshian, Soroosh, Yang, Zong-Liang, Bales, Roger, Jin, Jiming, Sun, Shu-Fen, and Wu, Guo-Xiong
- Subjects
HYDROLOGY ,MATHEMATICAL analysis ,MODELING (Sculpture) - Abstract
We developed and evaluated a three-layer snow model for application in general circulation models. This one-dimensional snow model has many features of the detailed physically based model SNTHERM, yet is computationally much simpler. We have also extended the point model to vegetated areas using the parameterization concepts of the Biosphere-Atmosphere Transfer Scheme (BATS). Results of model applications for two types of vegetated fields - a short grassland in the French Alps and an old aspen forest in the southern study area of BOREAS - were presented. The results, on one hand, indicate the suitability of the model structure and parameter setting; on the other hand, the results explore the limitation of using point field observations to evaluate an area model. [ABSTRACT FROM AUTHOR]
- Published
- 1999
30. Efficacy of lateral stair walking training in patients with chronic stroke: A pilot randomized controlled study.
- Author
-
Huang, Wan-Yun, Li, Min-Hui, Lee, Chao-Hsien, Tuan, Sheng-Hui, Sun, Shu-Fen, and Liou, I-Hsiu
- Subjects
- *
STAIR climbing , *STROKE , *GAIT in humans , *ACTIVITIES of daily living , *RANDOMIZED controlled trials - Abstract
Background: Patients with chronic stroke have reduced capacity for performing activities of daily living (ADLs) and are at increased risk for falls during walking due to long-term changes to muscle tone and force, as well as movement control.Research Question: To investigate the efficacy of lateral stair walking training on muscle strength of affected lower extremities, balance, ADLs, and gait ability in patients with chronic stroke.Methods: The experimental group received 15 min of lateral stair walking exercise along with 15 min of traditional physiotherapy, whereas the control group received only traditional physiotherapy for 30 min. Both groups received the intervention once a week for 12 weeks. Outcome measurements included muscle strength, postural assessment scale for stroke patients (PASS), Fugal-Meyer assessment for lower extremity (FMA-LE), Barthel index (BI), timed up and go test (TUG), and the gait parameters which were determined by the Reha-Watch system.Results: A total of 24 participants completed the study. The experimental group showed significant improvements in hip extensor, flexor, and abductor strength of the affected limb, FMA-LE, BI, TUG, and gait parameters of stride length, velocity, and cadence. Significant differences in affected limb ankle plantar strength (p = 0.024), PASS (p = 0.017), BI (p = 0.039), TUG (p = 0.049), and gait velocity (p < 0.001) were observed between the 2 groups.Significance: Lateral stair walking training alongside physical therapy resulted in significant improvements in hip muscle strength and gait parameters in patients with chronic stroke. Our results support the incorporation of lateral stair walking training into clinical rehabilitation programs. Lateral stair walking training in patients with chronic stroke can be used as an effective treatment to improve gait, balance performance, and ADLs. [ABSTRACT FROM AUTHOR]- Published
- 2021
- Full Text
- View/download PDF
31. Assessing the Clinical Effectiveness of an Exergame-Based Exercise Training Program Using Ring Fit Adventure to Prevent and Postpone Frailty and Sarcopenia Among Older Adults in Rural Long-Term Care Facilities: Randomized Controlled Trial.
- Author
-
Tuan SH, Chang LH, Sun SF, Li CH, Chen GB, and Tsai YJ
- Subjects
- Humans, Aged, Male, Female, Long-Term Care methods, Aged, 80 and over, Rural Population statistics & numerical data, Taiwan, Middle Aged, Video Games, Frail Elderly statistics & numerical data, Resistance Training methods, Exercise, Sarcopenia therapy, Frailty, Exercise Therapy methods, Exercise Therapy statistics & numerical data
- Abstract
Background: Frailty and sarcopenia are geriatric syndromes of increasing concern and are associated with adverse health outcomes. They are more prevalent among long-term care facility (LTCF) users than among community dwellers. Exercise, especially multicomponent and progressive resistance training, is essential for managing these conditions. However, LTCFs, particularly in rural areas, face challenges in implementing structured exercise programs due to health care professional shortages. Moreover, older adults often become bored with repetitive exercise training and may lose interest over time. The Nintendo Switch Ring Fit Adventure (RFA) exergame is a novel exergame that combines resistance, aerobic, and balance exercises and offers a potential solution by boosting motivation in an immersive manner and reducing staff intervention needs., Objective: We aimed to evaluate the clinical effectiveness of an exergame-based exercise training program delivered via RFA (exergame-RFA) in improving muscle mass and functional performance among older adult LTCF users., Methods: This was a randomized controlled trial conducted from August 2022 to September 2023 and involved older adult LTCF users (aged ≥60 y) in rural southern Taiwan. Participants were randomized into an intervention group (exergame-RFA plus standard care) or a control group (standard care alone). The intervention, conducted seated with arm fit skills and trunk control exercises using the RFA, lasted 30 minutes twice weekly over 12 weeks. The primary outcomes measured were the Study of Osteoporotic Fractures index (serving as an indicator of frailty status) and the diagnostic criteria for sarcopenia (appendicular skeletal muscle mass index, handgrip strength, and gait speed). The secondary outcomes included functional performance (box and block test as well as maximum voluntary isometric contraction of the dominant upper extremity), muscle condition (muscle thickness measured using ultrasonography), activities of daily living (Kihon checklist), health-related quality of life (Short Form Health Survey-36), and cognitive function (brain health test). We used an intention-to-treat analysis, incorporating a simple imputation technique in statistical analysis. A mixed ANOVA, with time as a within-participant factor and intervention as a between-participant factor, was used to compare the training effects on outcomes., Results: We recruited 96 individuals, of whom 60 (62%) underwent randomization. Of these 60 participants, 55 (92%) completed the study. Significant group×time interactions were observed in the intervention group in all primary outcomes (all P<.001, except P=.01 for handgrip strength) and most secondary outcomes, including maximum voluntary isometric contraction of the biceps (P=.004) and triceps brachii (P<.001) muscles, biceps muscle thickness measured using ultrasonography (P<.001), box and block test (P<.001), Kihon checklist (physical function: P=.01, mood status: P=.003, and total: P=.003), and brain health test (P<.001)., Conclusions: The exergame-RFA intervention significantly improved muscle mass, strength, and functional performance among older adult users of rural LTCFs, offering a novel approach to addressing frailty and sarcopenia., Trial Registration: ClinicalTrials.gov NCT05360667; https://clinicaltrials.gov/study/NCT05360667., International Registered Report Identifier (irrid): RR2-10.3389/fmed.2022.1071409., (©Sheng-Hui Tuan, Lin-Hui Chang, Shu-Fen Sun, Chien-Hui Li, Guan-Bo Chen, Yi-Ju Tsai. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 18.07.2024.)
- Published
- 2024
- Full Text
- View/download PDF
32. Using exergame-based exercise to prevent and postpone the loss of muscle mass, muscle strength, cognition, and functional performance among elders in rural long-term care facilities: A protocol for a randomized controlled trial.
- Author
-
Tuan SH, Chang LH, Sun SF, Lin KL, and Tsai YJ
- Abstract
Objective: Elderly individuals in long-term care facilities (LTCFs) have a higher prevalence of sarcopenia than those in the community. Exercise is the gold standard for preventing and treating sarcopenia. Regarding exercise, multicomponent exercises, including progressive resistance training (PRT), are beneficial. However, developing routine, structured exercise programs for the elderly in LTCFs is difficult because of a shortage of healthcare providers, particularly in rural regions. Exergame-based exercises can increase a player's motivation and reduce staff time for an intervention. Nintendo Switch RingFit Adventure (RFA) is a novel exergame that combines resistance, aerobic, and balance exercises. In this study, we aim to investigate the clinical effectiveness of RFA on muscle and functional performance parameters among the elderly in LTCFs., Methods: The EXPPLORE (using EX ergame to P revent and P ostpone the LO ss of muscle mass, muscle strength, and functional performance in R ural E lders) trial is a single-center randomized controlled trial involving elderly individuals (≥60 years) living in LTCFs in rural southern Taiwan. The participants will be equally randomized to the intervention group (exergame-based exercise plus standard care) or the control group (standard care alone). Both groups will receive standard care except that the intervention group will receive exergame-based exercises at the time previously scheduled for sedentary activities in the LTCFs. The exergame-based exercise will be performed using RFA in the sitting position with a specialized design, including arm fit skills and knee assist mode. Each session of the exercise lasts 30 mins and will be performed two times per week for 12 weeks. The primary outcomes will be the osteoporotic fracture index, appendicular skeletal muscle mass index, dominant handgrip strength, and gait speed. Meanwhile, the secondary outcomes will be the dexterity and agility, muscle strength and thickness, range of motion of the joints of the dominant upper extremity, Kihon checklist, Medical Outcomes Study 36-Item Short-Form Health Survey, and Brain Health Test., Discussion: This trial will provide valuable knowledge on whether exergames using RFA can counteract physical decline and improve quality of life and cognition among the elderly in LTCFs., Clinical Trial Registration: [www.ClinicalTrials.gov], identifier [NCT05360667]., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Tuan, Chang, Sun, Lin and Tsai.)
- Published
- 2022
- Full Text
- View/download PDF
33. Serial Exercise Testing and Echocardiography Findings of Patients With Kawasaki Disease.
- Author
-
Lin KL, Liou IH, Chen GB, Sun SF, Weng KP, Li CH, and Tuan SH
- Abstract
Objective: Kawasaki disease (KD) is the most common form of pediatric vasculitis. We evaluated the influence of KD on cardiopulmonary function and analyzed the echocardiographic findings of patients with KD through serial follow-ups from childhood to adolescence., Methods: This was a retrospective study. We recruited patients with KD after the acute stage who underwent at least two (with >1-year interval between visits) cardiopulmonary exercise testing (CPET) and echocardiographic examinations in the last 10 years. Cardiopulmonary function was determined through CPET on a treadmill. The maximum Z score (Max- Z ) of the proximal left anterior descending coronary artery or right coronary artery was determined using echocardiography. Healthy peers matched for age, sex, and body mass index with serial CPET and echocardiographic data were recruited as a control group., Results: Each group consisted of 30 participants with comparable basic characteristics. No significant differences in the variables of the first CPET were observed between the two groups. In the final CPET, the control group had a higher percentage of measured oxygen consumption (Vo
2 ) at the anaerobic threshold (AT) to the predicted peak Vo2 ( p = 0.016), higher percentage of measured peak Vo2 to the predicted peak Vo2 ( p = 0.0004), and higher Vo2 at AT ( p < 0.0001) than those of the KD group. No significant difference in the percentage of distribution of Max- Z was observed between the first and final echocardiographic examinations., Conclusions: Children with a history of KD had comparable exercise capacity to their healthy peers. However, in the follow-up, the aerobic metabolism and peak exercise load capacities of adolescents with KD were significantly lower than those of control adolescents., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Lin, Liou, Chen, Sun, Weng, Li and Tuan.)- Published
- 2022
- Full Text
- View/download PDF
34. Successful management of a tooth with endodontic-periodontal lesion: A case report.
- Author
-
Alshawwa H, Wang JF, Liu M, and Sun SF
- Abstract
Background: Endodontic-periodontal lesion is a commonly encountered dental condition. However, the prognosis of the condition varies from good to poor. Some cases are associated with a poor prognosis that requires tooth extraction. This report presents a case of an endodontic-periodontal lesion in a tooth that was successfully treated by root canal treatment., Case Summary: A 51-year-old female patient with no medical history complained about persistent pain and discomfort in her left mandibular first molar. Clinical examination showed the left mandibular first molar with poor restoration. It was also associated with underlying necrotic pulp and periodontal involvement. Radiographic examination revealed visible bone defects in the apical and periodontal areas. Based on the findings, the patient was diagnosed with a primary endodontic lesion. A root canal treatment for the endodontic lesion was performed. The patient received a coronal all-ceramic endocrown restoration. A follow-up was arranged to check the prognosis. At the 3 mo follow-up, the clinical and radiography evaluations showed complete disappearance of signs and symptoms and an increase in the radiopacity of the root area., Conclusion: Despite the poor prognosis associated with many endodontic lesions, this case report highlights that a good prognosis is still possible for an endodontic lesion with apical and periodontal bone loss. In this case, it was achieved via successful root canal treatment without the need for periodontal or surgical intervention., Competing Interests: Conflict-of-interest statement: The authors declare that they have no conflict of interest., (©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.)
- Published
- 2020
- Full Text
- View/download PDF
35. Glycemic variability in critically ill patients: risk factors and association with mortality.
- Author
-
Hsu CW, Sun SF, and Lin HS
- Subjects
- Blood Glucose, Humans, Risk Factors, Critical Illness, Hyperglycemia
- Published
- 2020
- Full Text
- View/download PDF
36. Efficacy of intraarticular botulinum toxin A and intraarticular hyaluronate plus rehabilitation exercise in patients with unilateral ankle osteoarthritis: a randomized controlled trial.
- Author
-
Sun SF, Hsu CW, Lin HS, Chou YJ, Chen JY, and Wang JL
- Abstract
Background: There was an increasing requirement for novel treatments of osteoarthritis (OA). The aim was to compare the efficacy of intraarticular Botulinum toxin type A (BoNT-A) and intraarticular hyaluronate plus rehabilitation exercise in patients with ankle OA., Methods: This was a prospective, randomized, assessor-blinded study with a 6-month follow-up period, conducted in the outpatient rehabilitation department at a university-affiliated tertiary care medical center. Seventy-five patients with symptomatic ankle OA (Kellgren-Lawrence grade 2) were randomized to receive either a single 100-unit BoNT-A injection into the target ankle (n = 38) or a single hyaluronate injection plus 12 sessions of rehabilitation exercise (30 minutes/day, 3 times/week for 4 weeks) (n = 37). The primary outcome measure was the Ankle Osteoarthritis Scale (AOS). Secondary outcome measures included American Orthopedic Foot and Ankle Society (AOFAS) Ankle/Hindfoot Score, visual analog scale (VAS) for ankle pain, single leg stance test (SLS), Timed "Up-and-Go" test (TUG), consumption of rescue analgesics and global patient satisfaction., Results: There were no significant between-group differences in total AOS scores, pain subscale and disability subscale scores (adjusted mean difference AMD = -0.2, 95% CI = (-0.5, 0.2), p = 0.39; AMD = -0.1, 95% CI = (-0.5, 0.3), p = 0.57; AMD = -0.2, 95% CI = (-0.6, 0.2), p = 0.36). The 2 groups showed no significant differences in AOFAS, VAS, SLS, TUG scores and consumption of rescue analgesics at each follow-up visit, except that the hyaluronate group improved more in SLS than the BoNT-A group at 1-month follow-up. Patients' satisfaction rate was high, with no serious adverse events. There was no difference in adverse events between the two groups (p = 1.00)., Conclusions: Treatment with intraarticular BoNT-A or hyaluronate injection plus rehabilitation exercise was associated with improvements in pain, physical function and balance in patients with ankle OA. These effects were rapid at 2 weeks and might last for at least 6 months. There was no difference in effectiveness between the two interventions., Trial Registration: The trial was registered at clinical trials.gov (Registry number NCT01760577).
- Published
- 2014
- Full Text
- View/download PDF
37. Iatrogenic pneumothorax related to mechanical ventilation.
- Author
-
Hsu CW and Sun SF
- Abstract
Pneumothorax is a potentially lethal complication associated with mechanical ventilation. Most of the patients with pneumothorax from mechanical ventilation have underlying lung diseases; pneumothorax is rare in intubated patients with normal lungs. Tension pneumothorax is more common in ventilated patients with prompt recognition and treatment of pneumothorax being important to minimize morbidity and mortality. Underlying lung diseases are associated with ventilator-related pneumothorax with pneumothoraces occurring most commonly during the early phase of mechanical ventilation. The diagnosis of pneumothorax in critical illness is established from the patients' history, physical examination and radiological investigation, although the appearances of a pneumothorax on a supine radiograph may be different from the classic appearance on an erect radiograph. For this reason, ultrasonography is beneficial for excluding the diagnosis of pneumothorax. Respiration-dependent movement of the visceral pleura and lung surface with respect to the parietal pleura and chest wall can be easily visualized with transthoracic sonography given that the presence of air in the pleural space prevents sonographic visualization of visceral pleura movements. Mechanically ventilated patients with a pneumothorax require tube thoracostomy placement because of the high risk of tension pneumothorax. Small-bore catheters are now preferred in the majority of ventilated patients. Furthermore, if there are clinical signs of a tension pneumothorax, emergency needle decompression followed by tube thoracostomy is widely advocated. Patients with pneumothorax related to mechanical ventilation who have tension pneumothorax, a higher acute physiology and chronic health evaluation II score or PaO2/FiO2 < 200 mmHg were found to have higher mortality.
- Published
- 2014
- Full Text
- View/download PDF
38. Impact of disease severity on gastric residual volume in critical patients.
- Author
-
Hsu CW, Sun SF, Lee DL, Lin SL, Wong KF, Huang HH, and Li HJ
- Subjects
- Aged, Enteral Nutrition, Gastric Emptying physiology, Humans, Intubation, Gastrointestinal, Male, Prospective Studies, Survival Rate, Critical Illness, Severity of Illness Index, Stomach anatomy & histology
- Abstract
Aim: To investigate whether illness severity has an impact on gastric residual volume (GRV) in medical critically ill patients., Methods: Medical intensive care unit (ICU) patients requiring nasogastric feeding were enrolled. Sequential Organ Failure Assessment (SOFA) score was assessed immediately preceding the start of the study. Acute Physiology and Chronic Health Evaluation (APACHE) II scores were recorded on the first, fourth, seventh, and fourteenth day of the study period. GRV was measured every 4 h during enteral feeding. The relationship between mean daily GRV and SOFA scores and the correlation between mean daily GRV and mean APACHE II score of all patients were evaluated and compared., Results: Of the 61 patients, 43 patients were survivors and 18 patients were non-survivors. The mean daily GRV increased as SOFA scores increased (P < 0.001, analysis of variance). Mean APACHE II scores of all patients correlated with mean daily GRV (P = 0.011, Pearson correlation) during the study period. Patients with decreasing GRV in the first 2 d had better survival than patients without decreasing GRV (P = 0.017, log rank test)., Conclusion: GRV is higher in more severely ill medical ICU patients. Patients with decreasing GRV had lower ICU mortality than patients without decreasing GRV.
- Published
- 2011
- Full Text
- View/download PDF
39. Combined botulinum toxin type A with modified constraint-induced movement therapy for chronic stroke patients with upper extremity spasticity: a randomized controlled study.
- Author
-
Sun SF, Hsu CW, Sun HP, Hwang CW, Yang CL, and Wang JL
- Subjects
- Botulinum Toxins, Type A adverse effects, Chronic Disease, Combined Modality Therapy, Female, Follow-Up Studies, Humans, Male, Middle Aged, Motor Activity, Muscle Spasticity drug therapy, Muscle Spasticity rehabilitation, Musculoskeletal Manipulations adverse effects, Neuromuscular Agents adverse effects, Patient Satisfaction, Prospective Studies, Recovery of Function, Severity of Illness Index, Stroke drug therapy, Stroke Rehabilitation, Time Factors, Treatment Outcome, Arm, Botulinum Toxins, Type A therapeutic use, Muscle Spasticity therapy, Musculoskeletal Manipulations methods, Neuromuscular Agents therapeutic use, Stroke therapy
- Abstract
Background and Objective: Botulinum toxin type A (BtxA) injection and modified constraint-induced movement therapy (mCIMT) are both promising approaches to enhance recovery after stroke. The combined application of these 2 promising modalities has rarely been studied. The aim was to investigate whether combined BtxA and mCIMT would improve spasticity and upper extremity motor function more than BtxA plus conventional rehabilitation in chronic stroke patients with upper extremity spasticity., Methods: In a prospective, randomized controlled, observer-blinded trial with 6-month follow-up, 32 patients (>or=1 year after stroke) with ability to actively extend >10 degrees at metacarpophalangeal and interphalangeal joints and 20 degrees at wrist of the affected upper limb were randomized to receive BtxA + mCIMT (combination group) or BtxA + conventional rehabilitation (control group) for 2 hours/day, 3 days/week for 3 months.The primary outcome assessed spasticity on the Modified Ashworth Scale. Secondary outcomes assessed real-world arm function (Motor Activity Log), laboratory motor activity (Action Research Arm Test), and patients' global satisfaction., Results: A total of 32 stroke patients were recruited, and 29 completed the study. Spasticity significantly improved in all subjects at 4 weeks and 3 months postinjection without between-group differences.The combination group showed significantly greater improvements in elbow, wrist, and finger spasticity (P = .019, P = .019, and P < .001, respectively), affected upper extremity real-world arm function (P < .001) and laboratory motor activity (P < .001) than the control group at 6-month postinjection. Patients reported considerable satisfaction and no serious adverse events occurred., Conclusions: Combining BtxA and mCIMT is an effective and safe intervention for improving spasticity and motor function in chronic stroke patients. The results are promising enough to justify further studies. We recommend future research to address the likely need for including rehabilitation with BtxA to improve function in patients with poststroke spasticity.
- Published
- 2010
- Full Text
- View/download PDF
40. Duodenal versus gastric feeding in medical intensive care unit patients: a prospective, randomized, clinical study.
- Author
-
Hsu CW, Sun SF, Lin SL, Kang SP, Chu KA, Lin CH, and Huang HH
- Subjects
- Aged, Duodenum, Female, Humans, Male, Prospective Studies, Stomach, Enteral Nutrition methods, Intensive Care Units
- Abstract
Objective: To determine whether medical intensive care unit (ICU) patients receiving nasoduodenal (ND) feedings achieve optimal nutritional support and better clinical outcomes compared with patients receiving nasogastric (NG) feedings., Design: A prospective, randomized, clinical study., Setting: Medical ICU of a university-affiliated tertiary medical center., Patients: One hundred twenty-one medical ICU patients required enteral feeding., Interventions: Patients were randomized to receive enteral feeding. One group received ND feedings and the other group received NG feedings. All patients followed the same protocol., Measurements and Main Results: The primary outcome of optimal nutritional support was assessed by measurement of time to goal tube feed rate and daily calorie and protein intake. Secondary clinical outcomes included number of ICU, hospital and ventilator days, number of the days in the study, blood-glucose levels, incidence of vomiting, diarrhea, gastrointestinal bleeding, tube replaced, tube clogged, fever, bacteremia, and ventilator-associated pneumonia (VAP), and mortality rate. Results showed that the ND group had a higher average daily calorie and protein intake compared with NG group and achieved nutritional goals earlier. In terms of clinical outcomes, patients in the ND group had a lower rate of vomiting and VAP. The other clinical outcomes such as number of ICU days, hospital days, ventilator days, blood-glucose level, tube replaced or clogged, diarrhea, gastrointestinal bleeding, fever, bacteremia, and mortality rate were not significantly different between two groups., Conclusions: Patients who received ND feedings achieved nutritional goals earlier than those who received NG feeding. ND feeding group also has a lower rate of vomiting and VAP in the medical ICU setting.
- Published
- 2009
- Full Text
- View/download PDF
41. The recovery of elbow range of motion after treatment of supracondylar and lateral condylar fractures of the distal humerus in children.
- Author
-
Wang YL, Chang WN, Hsu CJ, Sun SF, Wang JL, and Wong CY
- Subjects
- Activities of Daily Living, Child, Female, Fracture Fixation methods, Humans, Male, Recovery of Function, Retrospective Studies, Casts, Surgical, Elbow Joint physiopathology, Fracture Fixation instrumentation, Humeral Fractures therapy, Range of Motion, Articular
- Abstract
Objectives: To investigate the time required for elbow range of motion (ROM) recovery after supracondylar and lateral condylar fractures in children and to analyze the relationship between the ROM recovery and the related factors., Design: Retrospective study., Setting: Tertiary pediatric orthopaedic care unit at a general hospital., Patients/participants: Forty-five children with distal humerus supracondylar fractures and 16 children with lateral condylar fractures were followed. Twenty-seven children with distal forearm fractures, which were immobilized with long arm casts, were used as a control group to study elbow flexion-extension recovery after immobilization without elbow fracture., Main Outcome Measurements: Elbow ROM was measured with a goniometer in a series of follow-up visits after cast removal until 90% ROM of the uninjured side had been reached. Morrey's definition was used to define ROM required for functional activity of daily living., Results: The supracondylar fracture group took 29.5, 39.0, 6.1, and 11.0 days to achieve 90% ROM in extension, flexion, supination, and pronation directions. The lateral condylar fracture group needed 30.2, 35.6, 2.3, and 8.9 days, respectively, in 4 directions. In the distal forearm fracture group, the elbow total flexion-extension angle required less than 2 weeks to reach a total arc of 135 degrees. The supination range was easier to recover than the pronation motion. The flexion recovered last among 4 directions in supra- and lateral condylar fractures., Conclusions: In the uncomplicated distal humerus supracondylar and lateral condylar fractures, it takes 5 weeks to restore original elbow ROM after removal of long arm cast without physical therapy. This information could be applied in the education material to caregivers of children with elbow injuries.
- Published
- 2009
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.