Kanokwan Watcharasaksilp

Effects of Tai Chi on Cognition and Fall Risk in Older Adults with Mild Cognitive Impairment: A Randomized Controlled Trial.

To examine whether combined center‐ and home‐based Tai Chi training can improve cognitive ability and reduce physiological fall risk in older adults with amnestic mild cognitive impairment (a‐MCI).

Effectiveness of physiotherapy for seniors with recurrent headaches associated with neck pain and dysfunction: a randomized controlled trial

BACKGROUND CONTEXT A previous study demonstrated that in seniors, the presence of cervical musculoskeletal impairment was not specific to cervicogenic headache but was present in various recurrent headache types. Physiotherapy treatment is indicated in those seniors diagnosed with cervicogenic headache but could also be adjunct treatment for those with cervical musculoskeletal signs who are suspected of having transitional headaches. PURPOSE This study aimed to determine the effectiveness of a physiotherapy program for seniors with recurrent headaches associated with neck pain and cervical musculoskeletal dysfunction, irrespective of the headache classification. STUDY DESIGN This is a prospective, stratified, randomized controlled trial with blinded outcome assessment. PATIENT SAMPLE Sixty-five participants with recurrent headache, aged 50-75 years, were randomly assigned to either a physiotherapy (n=33) or a usual care group (n=32). OUTCOME MEASURES The primary outcome was headache frequency. Secondary outcomes were headache intensity and duration, neck pain and disability, cervical range of motion, quality of life, participant satisfaction, and medication intake. METHODS Participants in the physiotherapy group received 14 treatment sessions. Participants in the usual care group continued with their usual care. Outcome measures were recorded at baseline, 11 weeks, 6 months, and 9 months. This study was funded by a government research fund of

A randomized controlled study of intravenous fluid in acute ischemic stroke

6,850. No conflict of interest is declared. RESULTS There was no loss to follow-up for the primary outcome measure. Compared with usual care, participants receiving physiotherapy reported significant reductions in headache frequency immediately after treatment (mean difference -1.6 days, 95% confidence interval [CI] -2.5 to -0.6), at 6-month follow-up (-1.7 days, 95% CI -2.6 to -0.8), and at 9-month follow-up (-2.4 days, 95% CI -3.2 to -1.5), and significant improvements in all secondary outcomes immediately posttreatment and at 6- and 9-month follow-ups, (p<.05 for all). No adverse events were reported. CONCLUSIONS Physiotherapy treatment provided benefits over usual care for seniors with recurrent headache associated with neck pain and dysfunction.

Prognostic Factors of Functional Recovery from Left Hemispheric Stroke

OBJECTIVE To compare the outcome of patients with acute ischemic stroke who received or did not receive intravenous fluid. PATIENTS AND METHODS This study was a prospective, multicenter, randomized, open-label trial with blinded outcome assessment. We enrolled acute ischemic stroke patients without dehydration aged between 18 and 85 years with NIH Stroke Scale score (NIHSS) score from 1 to 18 who presented within 72h after onset. Patients were randomly assigned to receive 0.9% NaCl solution 100ml/h for 3days or no intravenous fluid. RESULTS On the interim unblinded analysis of the safety data, significant excess early neurological deterioration was observed among patients in the non-intravenous fluid group. Therefore, the study was prematurely discontinued after enrollment of 120 patients, mean age 60 years, 56.6% male. Early neurological deterioration (increased NIHSS ≥3 over 72h) not of metabolic or hemorrhagic origin was observed in 15% of the non-IV fluid group and 3.3% of the IV fluid group (p=0.02). Predictors of neurological deterioration were higher NIHSS score, higher plasma glucose, and increased pulse rate. There was no difference in the primary efficacy outcome, NIHSS≤4 at day 7, 83.3% vs 86.7%, p=0.61 or secondary efficacy outcomes. CONCLUSION Administration of 0.9% NaCl 100ml/h for 72h in patients with acute ischemic stroke is safe and may be associated with a reduced risk of neurological deterioration. These study findings support the use of intravenous fluid in acute ischemic stroke patients with NIHSS less than 18 who have no contraindications.

Structural changes of the cervical muscles in elder women with cervicogenic headache

Although lateralization of the brain affects some specialized cortical functions, there are still limited data to address its influence on clinically important outcomes. This study aimed to reveal the prognostic variables that relate to functional recovery in stroke patients with a left-sided hemispheric lesion during 6 months of follow-up. Data from 167 left-sided and 183 right-sided hemispheric strokes were reviewed retrospectively. Outcomes in this study included walking capacity and functional recovery, assessed by the modified Rankin Scale (mRS). In order to obtain independent predictive variables, this study used the step-backward method of multivariable regression analysis of parameters. The final model demonstrated that motor function of the hemiparetic leg was the strongest independent predictor for both walking ability and functional recovery (risk ratio (RR) of 2.41, 95% CI: 1.61–3.60, and p < 0.001 and RR of 1.83, 95% CI: 1.03–3.26, and p = 0.04, resp.). Therefore, lateralization did not seem to be involved. Understanding predictable variables that are associated with recovery can guide the rehabilitation team in setting priority and appropriate treatment for stroke patients.