Earticle

Flipped learning, abbreviated as “FL” is a new pedagogical approach that reverses the order of a typical lecture. It was developed to com-pensate for the shortcomings of a typical teaching method. Students learn by watching video clips before class and continue to learn through peer discussion in the classroom. The educational benefits of FL like student’s positive attitude were revealed in the previous studies. FL can be a valuable alternative to the existing classes in the untact age of coronavirus disease 2019.

Professionals use foam rollers to improve range of motion (ROM). Re-cently, a vibrating foam roller (VFR) that combines the vibration function with a foam roller (FR) has been used. The purpose of this systematic review and meta-analysis was to determine the effects of a VFR on the improvement of ROM in healthy individuals. A systematic literature search was carried out in five international databases: PubMed, Em-base, PEDro, Cochrane Library, and Google Scholar. Eight clinical stud-ies, composed of six randomized controlled trials and two randomized crossover trials that involved 230 healthy participants were selected for analysis. Methodological quality was identified using the PEDro scale. The mean scores, 4.75±0.71, of the eight included studies, were classi-fied as fair. The results demonstrated that the VFR achieved better gains than the FR in improving ROM (standardized mean difference [SMD], 0.53; 95% confidence intervals [CIs], 0.29–0.77; I 2=55%). The VFR was more effective in improving the ROM than the FR in the hip and knee joints (hip: SMD, 0.56; 95% CI, 0.28–0.85; I 2=0%; knee: SMD, 0.86; 95% CI, 0.42–1.30; I 2=79%). The VFR may be an additional option to improve the ROM in healthy adults and athletes.

Memory state of rat pups born to old and obese mother rats and the ef-fect of a treadmill running of mother rats on the memory of rat pups were studied. The radial 8-arm maze test was performed to detect spa-tial learning memory, and the level of tumor necrosis factor-α, interleu-kin (IL)-1β, and IL-6 in the hippocampus was measured by enzyme- linked immunoassay. Western blotting was performed for the expres-sion of nuclear factor kappa-light-chain-enhancer (NF-κB), nuclear factor of kappa light polypeptide gene enhancer in B-cells inhibitor, al-pha (IκB-α), B-cell lymphoma 2 (Bcl-2), Bcl-2-associated X protein (Bax), matrix metalloproteinase (MMP)-9, and immunohistochemistry for caspase-3 was conducted. The newborn rats were classified into fol-lowing groups: pups born to old mother rats, pups born to old mother rats with exercise, pups born to old and obese mother rats, and pups born to old and obese mother rats with exercise. Exercise of mother ameliorated spatial learning memory impairment, inhibited proinflam-matory cytokines production, NF-κB expression, and IκB-α phosphory-lation of the pups born to old and obese mother rats. Maternal exercise suppressed Bax expression, the number of caspase-3, the level of MMP-9, and enhanced Bcl-2 expression of the pups born to old and obese mother rats. When the maternal exercise was performed, the impairment of spatial learning memory in pups was ameliorated. There-fore, it can be seen that exercise during pregnancy of older and obese mothers is an important factor in fetal health management.

This study evaluated the impact of motor impairment (MI) on exercise capacity and quality of life in patients with Parkinson disease (PD). One hundred ninety-two patients (≥50 years old) were divided according to the Hoehn and Yahr stages in: mild (stage I), mild to moderate (stage II), moderate (stage III), and advanced MI (stage IV). Exercise capacity (6-min walk test [6MWT]) and quality of life (Parkinson’s Disease Ques-tionnaire [PDQ-39]) were obtained. In this context, 6MWT was progres-sively worse with increasing the severity of MI (P<0.01). Patients with advanced MI achieved 39% of predicted 6MWT of healthy subject, while subjects with mild MI achieved 83% of healthy subject (P<0.01). In addition, patients with advanced MI presented higher (i.e., worse) PDQ-39 scores in summary index, cognition, mobility and activities of daily live domains compared to other groups (P<0.01). Patients with moderate MI also presented worse scores in PDQ-39 summary index, mobility and activities of daily live domains in comparison with mild MI patients (P<0.01). Higher MI was correlated with worse exercise ca-pacity (6MWT: r=-0.46, P<0.01), with worse PDQ-39 summary index and the mobility and activities of daily live domains scores (r=0.38, r=0.46, and r=0.43, P<0.01). In conclusion, MI is related to lower exercise ca-pacity and quality of life (i.e., PDQ-39 summary index and mobility and activities of daily live domains) in patients with PD.

This study determined the effectiveness of a 3-month group-based mul-ticomponent exercise program in the mobility, balance confidence, and muscle performance of older adults. A total of 40 participants (mean age=70.60±6.25 years completed pre- and posttest clinical intervention measures of mobility using the Timed Up and Go (TUG) test, balance confidence using the Activities-specific Balance Confidence scale, up-per limb strength (handgrip dynamometer), and lower limb function (30-sec chair rise test). Data were analyzed using paired t-test and based on TUG criteria for risk of fall (low- and high-risk groups). Signifi-cant improvements were found in all measures (All P<0.05) following the 3-month program. Measures according to the risk of fall categories were also significantly improved (P<0.01), except the left handgrip strength (P>0.05). The low-risk group showed a higher improvement in mobility (14.87% vs. 11.74%), balance confidence (34.21% vs. 26.08%), and lower limb function (96.87% vs. 21.20%) but was not significantly different from the high-risk group (P>0.05). A group-based multicompo-nent exercise program benefited the physical functions of older adults at low- or high risk of falls.

ated with functional impairment and disability of the shoulder. The aim of this study was to evaluate the efficacy of Vojta therapy (VT) tech-niques compared with standard therapy (ST) in patients with subacro-mial IS. A randomized controlled trial was performed, with 60 patients with IS (mean age, 61±12 years) randomized into two groups: ST (n=30) and ST plus Vojta therapy (SVT, n=30). Both received 15 treatment ses-sions over 4 weeks. Outcome measures included pain intensity, func-tionality, joint range of motion (RoM), strength, and quality of life mea-surements. The efficacy of both treatments was analysed, both com-paratively and separately, immediately after completion of treatment and after 3 months. After the intervention, both groups showed statisti-cally significant differences in visual analogue scale (P=0.001), RoM (P<0.01), and strength (P<0.001), which were also seen 3 months after the intervention. SVT is more efficient in both the short and medium term in reducing pain, improving functionality, increasing articular RoM and strength, and offering a better quality of life in IS patients.

The purpose of this study is to identify the effects of aqua walking exer-cise on the joint range of motion (ROM), muscular strength, and pain in patients who have limited knee ROM from surgery or joint fixation. Ten subjects were participated in this study and divided into two groups: continuous passive motion (CPM) therapy+walking exercise on dryland (CWD) and CPM+aqua walking exercise (CAW) groups. The repeated measures analysis of variance was used to verify the difference be-tween the groups and the duration of the program. A paired t-test was used to verify the significance of the observed difference within the groups, and an independent t-test was used to verify the significance of the observed difference between different groups. In this study, ROM in the knee flexion showed interaction effect between the two groups. CAW had a significant increase of knee flexion angle compared to those in CWD. Also, strength on the knee flexors showed interaction ef-fect between the two groups. CAW had a significant increase of knee flexion angle compared to those in CWD, while strength on the knee extensors showed no significant interaction effect between groups. Vi-sual analogue scale (VAS) score showed interaction between the two groups. CAW had a significant increase of the VAS scores compared to those in CWD. Given these findings reported in present study, aqua walking exercise for patients with osteoarthritis is a very safe and ef-fective therapeutic strategies that can move the joint in the optimal ROM.

High altitude sojourn is a risk factor for hypobaric hypoxemia and sub-sequent altitude sickness. The aim of this study was to analyze the ef-fect of new type of yogic breathing—Maheshwarananda’s new Modi-fied Bhujangini Pranayama performed by active yoga practitioners—on the arterial haemoglobin saturation of oxygen (measured by the pulse oximetry - SpO2) and the heart rate compared to normal sponta-neous resting breathing. A pilot prospective study was conducted in the Himalayas at an altitude of 3,650 m. We monitored SpO2 and pulse rate in 34 experienced yoga practitioners. Within the 3 measurement days at the altitude of 3,650 m, the mean value of SpO2 increased from 89.11± 4.78 to 93.26±4.44 (P<0.001) after the yogic breathing exercise. No sig-nificant changes were observed in pulse rate (P<0.230) measured be-fore and after yogic breathing. The new Yogic breathing—Maheshwa-rananda’s Modified Bhujangini Pranayama—is increasing the arterial haemoglobin saturation compared to normal resting spontaneous breath-ing. The heart rate was not affected by this type of yogic breathing.

Effective methods to detect old people cognitive decline in early stages are needed in Korea, which is the fastest aging country in the world. This study aimed to develop a brief cognitive function measurement, Vi-sual-Motor Integration Scale for the Korean elderly (VMIS-KE). In this methodological research, 16 preliminary items on visual-motor integra-tion for the old people were chosen after literature review and expert validation. One hundred eighty participants aged 20–79 years were re-cruited to verify the validity and reliability of this measurement from community sources in Daegu city. The collected data were analyzed by exploratory factor analysis and confirmative factor analysis using SPSS and AMOS 18.0 program. The three factors (figure cognition, memory, and spatial cognition) with 12 items were finally extracted. Goodness of the fit was confirmed through confirmatory factor analysis. The Cron-bach α was 0.867. The scores of overall VMIS-KE and every subcatego-ry significantly decreased with age, especially in the 70s. VMIS-KE is the first valid and reliable measurement to assess cognitive decline of the Korean old people through visual motor integration, and can easily and quickly detect high-risk groups of dementia regardless of their edu-cational level.

The purpose of this study was to explore the feasibility of a urination management system by developing a smart band-based algorithm that recognizes the urination interval of women. We designed a device that recognizes the time and interval of urination based on the patient’s spe-cific posture and posture changes. The technology used for recognition applied the Radial Basis Function kernel-based Support Vector Ma-chine, a teaching and learning method that facilitates multidimensional analysis by simultaneously judging the characteristics of complex learning data. In order to evaluate the performance of the proposed recognition technique, we compared actual urination and device- sensed urination. An experiment was performed to evaluate the perfor-mance of the recognition technology proposed in this study. The effica-cy of smart band monitoring urination was evaluated in 10 female pa-tients without urination problems. The entire experiment was performed over a total of 3 days. The average age of the participants was 28.73 years (26–34 years), and there were no signs of dysuria. The final accuracy of the algorithm was calculated based on clinical guidelines for urologists. The experiment showed a high average accuracy of 91.0%, proving the robustness of the proposed algorithm. This urination behavior recogni-tion technique shows high accuracy and can be applied in clinical set-tings to characterize urination patterns in female patients. As wearable devices develop and become more common, algorithms that detect specific sequential body movement patterns that reflect specific physi-ological behaviors could become a new methodology to study human physiological behavior.