Wu Wang

Growing evidence has underscored the adverse role of air pollutants in the pathogenesis of sarcopenia, while there lacks knowledge over the relationships b

Objective: To evaluate the clinical efficacy of a novel quantitative method using the Picture Archiving and Communication System (PACS) for multiplane assessment of supraspinatus muscle fatty infiltration (FI) and compare its reliability and accuracy with traditional single-plane visual evaluations (Under Direct Vision-FF) in preoperative planning for rotator cuff tear (RCT) patients.Methods: A retrospective analysis was conducted on patients undergoing arthroscopic rotator cuff repair (ARCR) between January and June 2023. Preoperative 3.0 T MRI scans were analyzed using PACS to measure FI in three sagittal planes (medial, Y-plane, lateral). Four orthopedic surgeons performed Goutallier classification and manual FI assessments under direct vision and via PACS. Intra- and interobserver reliability were evaluated using intraclass correlation coefficients (ICCs), while Bland-Altman analysis and paired t-tests compared measurement consistency and differences.Results: PACS-based measurements (PACS-FF) demonstrated superior reliability (intraobserver ICC: 0.973–0.996; interobserver ICC: 0.940–0.978) compared to direct vision assessments (intraobserver ICC: 0.538–0.967; interobserver ICC: 0.864–0.940). Significant discrepancies were observed between methods, with direct vision underestimating FI (p < 0.05–0.0001). Multiplane analysis revealed heterogeneous FI distribution, with lateral-plane FI significantly higher than medial and Y-plane values (p < 0.001). Bland-Altman analysis showed 60%–85% of direct vision measurements exceeded clinically acceptable limits of agreement (±10%).Conclusions: Quantitative multiplane PACS-based FI assessment improves accuracy and reliability over traditional single-plane visual evaluation, better reflecting heterogeneous fat distribution in the supraspinatus muscle. This method enhances preoperative risk stratification and surgical outcome prediction for RCT patients. Future integration of automated tools may further optimize clinical efficiency.

Background: Patients with stroke frequently experience walking dysfunction. Core training can help improve balance and walking function in patients with stroke. However, core training movements in clinical practice are numerous and differently targeted. Therefore, this study will investigate the improvement of walking function in patients with combined diaphragmatic breathing maneuver (DBM) and draw-in breathing technique (ADIM) training. Methods: This single-blind, randomized controlled preliminary will analyze the viability of DBM combined ADIM training versus routine rehabilitation therapy in patients with stroke with early to mid-stroke. Patients will be randomly assigned to either the DBM and ADIM training or the routine rehabilitation training. We will recruit 42 stroke inpatients from the Second Rehabilitation Hospital of Shanghai who meet the trial criteria and measure the balance and walking functions and improvement of that after 4 weeks of intervention. The primary outcome is the 10 m maximum walking test (10MWT). The secondary outcomes indices include the limits of stability test (LOS), Berg balance scale test (BBS), Functional Ambulation Categories test (FAC), Timed Up and Go test (TUG), trunk impairment scale test (TIS), ultrasound indicators of the diaphragm and transversus abdominis (UI), rhythmic weight shift test (RWS), walk across test (WA), Fugl-Meyer assessment of lower extremity (FMA-LE), and Barthel index of ADL test. Discussion: The primary objective of this project was to investigate the effects of DBM combined with ADIM on balance capacity and walking function for patients with early to mid-stroke. The outcomes of this study will hold significant implications for future clinical applications in rehabilitation. Trial registration: Chinese Clinical Trial Registry (ChiCTR), ID: ChiCTR2100054897. Registered on 28 December 2021.

Stroke is a disease with a high incidence and disability rate, resulting in changes in neural network and corticoid-subcortical excitability and various functional disabilities. The aim of the present study was to discuss the current status of research and limitations and potential direction in the application of noninvasive brain stimulation (NIBS) on post-stroke patients. This literature review focused on clinical studies and reviews. Literature retrieval was conducted in PubMed, Cochrane, Scopus, and CNKI, using the following keywords: Repeated transcranial magnetic stimulation, Transcranial direct current stimulation, Transcranial alternating current stimulation, Transcranial alternating current stimulation, Transcranial focused ultrasound, Noninvasive vagus nerve stimulation, Stroke, and Rehabilitation. We selected 200 relevant publications from 1985 to 2022. An overview of recent research on the use of NIBS on post-stroke patients, including its mechanism, therapeutic parameters, effects, and safety, is presented. It was found that NIBS has positive therapeutic effects on dysfunctions of motor, sensory, cognitive, speech, swallowing, and depression after stroke, but standardized stimulus programs are still lacking. The literature suggests that rTMS and tDCS are more beneficial to post-stroke patients, while tFUS and tVNS are currently less studied for post-stroke rehabilitation, but are also potential interventions.