Pengaruh Latihan Kegel Terhadap Frekuensi Inkontinensia Urine Pada Lansia Di Unit Rehabilitasi Sosial Margo Mukti Rembang

The purpose of this study was to determine the influence of the Kegel exercise on frequency of urinary incontinence in the elderly. This study used a quasi -experimental with one group pre and post test study design, conducted on 27 respondents selected by purposive sampling technique. Respondents were divided into three groups which were the first group with frequency of exercise 2 times, the second group with 3 times and the third group 4 times a day for six weeks. Data on the frequency of urinary incontinence were collected in pre and post intervention Kegel exercise. Data were analyzed using t-test (paired t-test).The results of the study revealed that group I , II & III in sequence value of t-count 21.92, t=11,418 and t=15.307 with P values p=0, 00. Further comparisons between the three groups showed group III showed the mean frequency of urinary incontinence at least. It can be concluded that Kegel exercises affect the decrease in the frequency of urinary incontinence in the elderly, and it is suggested that Kegel exercises should be done regularly

Stem cell transplantation in traumatic spinal cord injury:a systematic review and meta-analysis of animal studies

Spinal cord injury (SCI) is a devastating condition that causes substantial morbidity and mortality and for which no treatments are available. Stem cells offer some promise in the restoration of neurological function. We used systematic review, meta-analysis, and meta-regression to study the impact of stem cell biology and experimental design on motor and sensory outcomes following stem cell treatments in animal models of SCI. One hundred and fifty-six publications using 45 different stem cell preparations met our prespecified inclusion criteria. Only one publication used autologous stem cells. Overall, allogeneic stem cell treatment appears to improve both motor (effect size, 27.2%; 95% Confidence Interval [CI], 25.0%-29.4%; 312 comparisons in 5,628 animals) and sensory (effect size, 26.3%; 95% CI, 7.9%-44.7%; 23 comparisons in 473 animals) outcome. For sensory outcome, most heterogeneity between experiments was accounted for by facets of stem cell biology. Differentiation before implantation and intravenous route of delivery favoured better outcome. Stem cell implantation did not appear to improve sensory outcome in female animals and appeared to be enhanced by isoflurane anaesthesia. Biological plausibility was supported by the presence of a dose-response relationship. For motor outcome, facets of stem cell biology had little detectable effect. Instead most heterogeneity could be explained by the experimental modelling and the outcome measure used. The location of injury, method of injury induction, and presence of immunosuppression all had an impact. Reporting of measures to reduce bias was higher than has been seen in other neuroscience domains but were still suboptimal. Motor outcomes studies that did not report the blinded assessment of outcome gave inflated estimates of efficacy. Extensive recent preclinical literature suggests that stem-cell-based therapies may offer promise, however the impact of compromised internal validity and publication bias mean that efficacy is likely to be somewhat lower than reported here

Systematic review and meta-analysis of therapeutic hypothermia in animal models of spinal cord injury

Therapeutic hypothermia is a clinically useful neuroprotective therapy for cardiac arrest and neonatal hypoxic ischemic encephalopathy and may potentially be useful for the treatment of other neurological conditions including traumatic spinal cord injury (SCI). The pre-clinical studies evaluating the effectiveness of hypothermia in acute SCI broadly utilise either systemic hypothermia or cooling regional to the site of injury. The literature has not been uniformly positive with conflicting studies of varying quality, some performed decades previously.In this study, we systematically review and meta-analyse the literature to determine the efficacy of systemic and regional hypothermia in traumatic SCI, the experimental conditions influencing this efficacy, and the influence of study quality on outcome. Three databases were utilised; PubMed, ISI Web of Science and Embase. Our inclusion criteria consisted of the (i) reporting of efficacy of hypothermia on functional outcome (ii) number of animals and (iii) mean outcome and variance in each group.Systemic hypothermia improved behavioural outcomes by 24.5% (95% CI 10.2 to 38.8) and a similar magnitude of improvement was seen across a number of high quality studies. The overall behavioural improvement with regional hypothermia was 26.2%, but the variance was wide (95% CI -3.77 to 56.2). This result may reflect a preponderance of positive low quality data, although a preferential effect of hypothermia in ischaemic models of injury may explain some of the disparate data. Sufficient heterogeneity was present between studies of regional hypothermia to reveal a number of factors potentially influencing efficacy, including depth and duration of hypothermia, animal species, and neurobehavioural assessment. However, these factors could reflect the influence of earlier lower quality literature.Systemic hypothermia appears to be a promising potential method of treating acute SCI on the basis of meta-analysis of the pre-clinical literature and the results of high quality animal studies

Meta-analysis of pre-clinical studies of early decompression in acute spinal cord injury:a battle of time and pressure

The use of early decompression in the management of acute spinal cord injury (SCI) remains contentious despite many pre-clinical studies demonstrating benefits and a small number of supportive clinical studies. Although the pre-clinical literature favours the concept of early decompression, translation is hindered by uncertainties regarding overall treatment efficacy and timing of decompression.We performed meta-analysis to examine the pre-clinical literature on acute decompression of the injured spinal cord. Three databases were utilised; PubMed, ISI Web of Science and Embase. Our inclusion criteria consisted of (i) the reporting of efficacy of decompression at various time intervals (ii) number of animals and (iii) the mean outcome and variance in each group. Random effects meta-analysis was used and the impact of study design characteristics assessed with meta-regression.Overall, decompression improved behavioural outcome by 35.1% (95%CI 27.4-42.8; I(2)=94%, p<0.001). Measures to minimise bias were not routinely reported with blinding associated with a smaller but still significant benefit. Publication bias likely also contributed to an overestimation of efficacy. Meta-regression demonstrated a number of factors affecting outcome, notably compressive pressure and duration (adjusted r(2)=0.204, p<0.002), with increased pressure and longer durations of compression associated with smaller treatment effects. Plotting the compressive pressure against the duration of compression resulting in paraplegia in individual studies revealed a power law relationship; high compressive forces quickly resulted in paraplegia, while low compressive forces accompanying canal narrowing resulted in paresis over many hours.These data suggest early decompression improves neurobehavioural deficits in animal models of SCI. Although much of the literature had limited internal validity, benefit was maintained across high quality studies. The close relationship of compressive pressure to the rate of development of severe neurological injury suggests that pressure local to the site of injury might be a useful parameter determining the urgency of decompression

Water use and feeding patterns of the marsupial western grey kangaroo (Macropus fuliginosus melanops) grazing at the edge of its range in arid Australia, as compared with the dominant local livestock, the Merino sheep (Ovis aries)

Western grey kangaroos (Macropus fuliginosus melanops) are large, foregut fermenting herbivores common to Australia\u27s southern woodlands and shrublands, but they extend well into semiarid habitats at the north-eastern edge of their range. At this range boundary, western grey kangaroos occupy open chenopod (saltbush) shrubland, along with Australia\u27s other large native kangaroos, as well as with extensive pastoral stock, primarily the wool-breed merino sheep. In this habitat, within a large naturally vegetated enclosure (16 ha), western grey kangaroos grazing sympatrically with merino sheep spent much of the day resting under shade trees, and fed mainly during the evening and early morning, mainly on grasses and flat-leaved chenopods. On this diet, western grey kangaroos had water turnovers similar to those of red kangaroos, at 1.1 L d−1. Sheep, however, used 7.7 L of water each day. Thus, although the sheep were twice the average body mass of kangaroos, the sheep used more than seven times as much water. This level of water use by sheep was almost half that previously reported for sheep at the same site feeding mainly on salt-laden chenopods (ca. 12 L d−1), but was consistent with other studies showing lower water usage by sheep feeding on trees and low-salt shrubs; foregut (rumen) contents of our sheep comprised 35% tree browse. Overall, our data do not support suggestions that western grey kangaroos are limited mainly by water at this arid range-boundary. Notably, the western grey kangaroos’ feeding behaviours were consistent with those of other arid-zone kangaroos, highlighting distinctive differences in the ecological physiology of the foregut fermenting kangaroos and the ruminant sheep

Field metabolic rate, movement distance, and grazing pressures by western grey kangaroos (Macropus fuliginosus melanops) and Merino sheep (Ovis aries) in semi-arid Australia

Details of the energy (food) requirements of wild herbivores are essential for understanding their role in ecosystems generally, and for evaluating their potential impact on co-occurring domestic herbivores, as in the case for Australia\u27s largest grazing herbivores, the marsupial kangaroos, which co-exist with domestic livestock, particularly the wool breed Merino sheep. Using the doubly labelled water method we compared the field metabolic rate (FMR) of the western grey kangaroo (Macropus fuliginosus melanops) with that of the merino sheep, grazed sympatrically in a large naturally-vegetated enclosure. We combined our FMR studies with fine-scale GPS-monitoring to reveal important and significant impacts of daily movement patterns on the energetics of western grey kangaroos, but not the sheep. The daily FMR was substantially higher for kangaroos with longer daily movements. These individuals elevated their FMRs relative to predicted basal or minimal metabolic rates (i.e. FMR:BMR) by 4-5 times that expected for mature, non-reproductive mammals. Notably, those kangaroos that exhibited FMR:BMRs typical of mammals generally (around 2-3 times) had daily energy requirements around 6245 kJ. This level of energy expenditure was less than one third of that of the domestic sheep (22,799 kJ d−1). Even when compared on a common body mass of 35 kg, the western grey kangaroo energy expenditure was only 0.46 that of the merino sheep. Moreover, for typically-sized mature females kangaroos (25 kg), which make the bulk of kangaroo populations, the comparative energy requirement was just 0.31 that of a mature, non-breeding merino ewe

Heterogeneity within systemic hypothermia experiments.

<p>Effect of neurobehavioural scale used on effect size reported for experiments employing systemic hypothermia. The shaded gray bar represents the 95% confidence limits of the global estimate. The vertical error bars represent the 95% confidence intervals for the individual estimates. The width of each bar reflects the log of the number of animals contributing to that comparison. Each stratification accounts for a significant proportion of the heterogeneity observed between studies.</p

Line graph exploring the relationship between compressive duration and compressive pressure.

<p>(A) The association between the duration of compression producing severe neurological injury and the compressive pressure in those studies in which there was an initial injury to the spinal cord followed by compression. The data demonstrates a close correlation and again obeys a power law relationship (y = 829.06x^-0.459) with a linear distribution on a log-log plot of the variables (upper inset). (B) Power law (y = 144.62x^-0.248) relationship between compressive pressure and duration in studies employing an initial injury to the spinal cord followed by narrowing of the spinal canal to induce compression. These models had lower estimated pressures and longer durations of compression were necessary to produce paraplegia.</p

Risk of bias within included studies.

<p>Effect of (<b>A</b>) random allocation to treatment groups, (<b>B</b>) blinded induction of ischaemia and, (<b>C</b>) blinded assessment of outcome on improvement in neurobiological score. The shaded gray bar represents the 95% confidence limits of the global estimate. The vertical error bars represent the 95% confidence intervals for the individual estimates. The width of each bar reflects the log of the number of animals contributing to that comparison.</p

Publication bias.

<p>(<b>A</b>) Eggar regression showing publication bias within the included studies. (<b>B</b>) Funnel plot showing the regional data in black and the systemic data in grey. No additional studies were suggested by trim and fill analysis.</p