Correlation of the Cerebral Microvascular Blood Flow with Brain Temperature and Electro-Acupuncture Stimulation

ObjectiveTo investigate the relationship between the temperature and the microvascular blood flow of the cerebral cortex, and the influence of electro-acupuncture (EA) on the cortical microcirculation.MethodsHigh temperature spots on the anterior ectosylvian and low temperature spots on the posterior suprasylvian on the cortical surface of 20 cats were identified using cortical infrared thermography (CIT); the blood flow in the microcirculation on these spots was measured with laser-Doppler flowmetry. EA was given at Zusanli (ST 36) and changes in the blood flow in the cerebral cortex microcirculation were detected.Results1) The mean temperatures on the high (34.83±0.24°C) and low (32.28±0.27°C) temperature spots were significantly different (P<0.001); this was indicative of a temperature difference on the cortical surface; 2) The average blood flow in the microcirculation of the high (266.8±19.2 PU) and low (140.8±9.9 PU) temperature spots was significantly different (P<0.001). 3) On the cortical high temperature spots, the mean blood flow in the microcirculation significantly increased from 266.8±86.8 PU before EA, to 422.5±47.4 PU following 5 minutes of EA (58.35%; P<0.01), and 431.8±52.8 PU 5 minutes after ceasing EA (61.84%; P<0.01). 4) On the low temperature spots, there were no significant differences in blood flow following 5 minutes of EA (146.3±11.5 PU), and 5 minutes after ceasing EA (140.5±11.6 PU), when compared with that before acupuncture (140.8±9.9 PU; P>0.9).ConclusionThe high temperature spots of the cortex are active functional regions of neurons with higher blood flow and a stronger response to EA. EA induces a significant increase in blood flow in the high temperature spots of the cortex

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

ObjectiveElderly 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.MethodsThe EXPPLORE (using EXergame to Prevent and Postpone the LOss of muscle mass, muscle strength, and functional performance in Rural Elders) 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.DiscussionThis 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]

Repeated 100 Hz TENS for the Treatment of Chronic Inflammatory Hyperalgesia and Suppression of Spinal Release of Substance P in Monoarthritic Rats

Transcutaneous electrical nerve stimulation (TENS) has been shown to be an effective measure for pain relief. The aim of the present study was to determine the optimal intensity and interval of repeated 100 Hz TENS for the treatment of chronic inflammatory hyperalgesia in a monoarthritic pain model of the rat, and to assess the changes of the spinal substance P (SP) release in response to TENS treatment. A reliable, reproducible chronic monoarthritic pain model was produced by intra-articular injection of complete Freund's adjuvant (CFA) at single ankle joint. The efficacy of 100 Hz TENS treatments with different frequencies and intensities was compared. In the acute period (within 3 weeks) of monoarthritis, twice-a-week schedule of TENS reduced the swelling of the inflamed ankle significantly. In the stable period (4–9 weeks), however, once-a-week schedule produced a significantly better therapeutic effect on both inflammation and arthritic hyperalgesia than that of twice- or five-times-a-week schedule. Using three levels of intensity of TENS, we found that the weaker (1-1-2 mA) stimulation produced significantly better therapeutic effects. Repeated TENS produced a reduction of SP content in spinal perfusate in parallel with the progressive reduction of the arthritic pain scores. Our results suggest that (i) consecutive TENS treatments produced cumulative effect for chronic hyperalgesia, (ii) for chronic inflammatory hyperalgesia, a weaker intensity and more sparsely arranged treatment schedule may produce better therapeutic effect and (iii) a decrease in SP release may serve as one of the possible neurochemical mechanisms underlying the therapeutic effects of multiple TENS treatments on chronic inflammatory hyperalgesia