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Clinics in Sports Medicine Jan 2020Meniscal injury potentiates a sequence of events that leads to degenerative changes and early osteoarthritis. It is therefore imperative to preserve the meniscus... (Review)
Review
Meniscal injury potentiates a sequence of events that leads to degenerative changes and early osteoarthritis. It is therefore imperative to preserve the meniscus whenever possible. Given the expanding indications for meniscus repair, it is important to continually analyze and advance the understanding of rehabilitation and return to play following meniscal surgery. This article presents evidence-based rehabilitation and return-to-play guidelines as well as a brief review of return-to-play outcomes following isolated meniscus repair.
Topics: Humans; Muscular Atrophy; Physical Therapy Modalities; Postoperative Care; Quadriceps Muscle; Regional Blood Flow; Return to Sport; Tibial Meniscus Injuries
PubMed: 31767104
DOI: 10.1016/j.csm.2019.08.004 -
World Journal of Clinical Pediatrics Jan 2023Play is a pleasurable physical or mental activity that enhances the child's skills involving negotiation abilities, problem-solving, manual dexterity, sharing,... (Review)
Review
Play is a pleasurable physical or mental activity that enhances the child's skills involving negotiation abilities, problem-solving, manual dexterity, sharing, decision-making, and working in a group. Play affects all the brain's areas, structures, and functions. Children with autism have adaptive behavior, adaptive response, and social interaction limitations. This review explores the different applications of play therapy in helping children with autism disorder. Play is usually significantly impaired in children with autism. Play therapy is mainly intended to help children to honor their unique mental abilities and developmental levels. The main aim of play therapy is to prevent or solve psychosocial difficulties and achieve optimal child-healthy growth and development. Play therapy helps children with autism to engage in play activities of their interest and choice to express themselves in the most comfortable ways. It changes their way of self-expression from unwanted behaviors to more non-injurious expressive behavior using toys or activities of their choice as their words. Play therapy also helps those children to experience feeling out various interaction styles. Every child with autism is unique and responds differently. Therefore, different types of intervention, like play therapy, could fit the differences in children with autism. Proper evaluation of the child is mandatory to evaluate which type fits the child more than the others. This narrative review revised the different types of play therapy that could fit children with autism in an evidence-based way. Despite weak evidence, play therapy still has potential benefits for patients and their families.
PubMed: 36685315
DOI: 10.5409/wjcp.v12.i1.1 -
Journal of Sleep Research Aug 2022While sleep serves important regulatory functions for mental health, sleep disturbances, in particular insomnia, may favour a state of allostatic overload impairing... (Review)
Review
While sleep serves important regulatory functions for mental health, sleep disturbances, in particular insomnia, may favour a state of allostatic overload impairing brain neuroplasticity and stress immune pathways, hence contributing to mental disorders. In this framework, the aim of this work was to link current understanding about insomnia mechanisms with current knowledge about mental health dysregulatory mechanisms. The focus of the present work was on mood, anxiety, and psychotic disorders, which represent important challenges in clinical practice. Literature searches were conducted on clinical, neurobiological, and therapeutic implications for insomnia comorbid with these mental disorders. Given the complexity and heterogeneity of the existing literature, we ended up with a narrative review. Insomnia may play an important role as a risk factor, a comorbid condition and transdiagnostic symptom for many mental disorders including mood/anxiety disorders and schizophrenia. Insomnia may also play a role as a marker of disrupted neuroplasticity contributing to dysregulation of different neurobiological mechanisms involved in these different mental conditions. In this framework, insomnia treatment may not only foster normal sleep processes but also the stress system, neuroinflammation and brain plasticity. Insomnia treatment may play an important preventive and neuroprotective role with cognitive behavioural therapy for insomnia being the treatment with important new evidence of efficacy for insomnia, psychopathology, and indices of disrupted neuroplasticity. On the other hand, pharmacological pathways for insomnia treatment in these mental conditions are still not well defined. Therapeutic options acting on melatonergic systems and new therapeutic options acting on orexinergic systems may represents interesting pathways of interventions that may open new windows on insomnia treatment in mental disorders.
Topics: Cognitive Behavioral Therapy; Comorbidity; Humans; Mental Health; Sleep; Sleep Initiation and Maintenance Disorders
PubMed: 35506356
DOI: 10.1111/jsr.13628 -
Healthcare (Basel, Switzerland) Jul 2020Hospitalization disrupts children's lives and can produce feelings such as anxiety, fear, or pain. Playing is an important part of children's lives. Thus, it is... (Review)
Review
BACKGROUND
Hospitalization disrupts children's lives and can produce feelings such as anxiety, fear, or pain. Playing is an important part of children's lives. Thus, it is necessary to ensure holistic care during the process, including play therapy. The aim of this study was to analyze the effect of therapeutic play in hospitalized children.
METHODS
A systematic review was performed. The search was conducted in CINAHL (Cumulative Index of Nursing and Allied Health Literature), CUIDEN, and PubMed (Medline). The search equation was "pediatric nurs* AND play therapy". The search was performed in March 2020.
RESULTS
= 14 studies were included in the review. The studies reveal that the application of therapeutic play in hospitalized children decreases postoperative pain, improves behavior and attitude, and reduces anxiety during the hospital stay.
CONCLUSIONS
play therapy has a beneficial impact on the care of hospitalized children and should be implemented in pediatric units after assessing the resources and training needed for pediatric nurses.
PubMed: 32751225
DOI: 10.3390/healthcare8030239 -
Materia Socio-medica Dec 2021Play is an essential parameter of children's growth and expression and this is the reason of why the use of play therapy is considered as fundamental means of preventing... (Review)
Review
BACKGROUND
Play is an essential parameter of children's growth and expression and this is the reason of why the use of play therapy is considered as fundamental means of preventing and dealing with problems and difficulties presented to children.
OBJECTIVE
The aim of this paper is to review the parameters related to this issue, emphasizing the efficacy of this therapeutic approach to various problems of children.
METHODS
A review of the recent literature on the issue, searching through Greek and international databases (Medline, Heal-link), in English and Greek language.
RESULTS
The review shows that play therapy as a form of prevention and treatment is suitable mainly for preschool and school age children. It is addressed to children who are in a transition period of their lives (after a divorce, a loss), with difficulties in managing feelings, in socializing or children who have behavioral problems. It is also addressed to children who have been witnesses of domestic violence, who have suffered some form of abuse, children who are to undergo a major surgery or those who have speech disorders. Furthermore, it is suitable for children who have some kind of developmental disorder (autism or attention deficit / hyperactivity disorder). Its efficiency is demonstrated by numerous research papers reporting a significant decrease of negative emotions and behaviors by its use.
CONCLUSION
Play therapy is an alternative proposal of intervention on important issues related to children. Its implementation and value is widely known and is constantly expanding. The only condition for its implementation is the correct theoretical training of the professionals and the proper diagnosis.
PubMed: 35210953
DOI: 10.5455/msm.2021.33.293-297 -
Molecular Cancer Sep 2022Mesenchymal stem cells (MSCs) are multipotent stromal cells that can be obtained from various human tissues and organs. They can differentiate into a wide range of cell... (Review)
Review
Mesenchymal stem cells (MSCs) are multipotent stromal cells that can be obtained from various human tissues and organs. They can differentiate into a wide range of cell types, including osteoblasts, adipocytes and chondrocytes, thus exhibiting great potential in regenerative medicine. Numerous studies have indicated that MSCs play critical roles in cancer biology. The crosstalk between tumour cells and MSCs has been found to regulate many tumour behaviours, such as proliferation, metastasis and epithelial-mesenchymal transition (EMT). Multiple lines of evidence have demonstrated that MSCs can secrete exosomes that can modulate the tumour microenvironment and play important roles in tumour development. Notably, very recent works have shown that mesenchymal stem cell-derived exosomes (MSC-derived exosomes) are critically involved in cancer resistance to chemotherapy agents, targeted-therapy drugs, radiotherapy and immunotherapy. In this review, we systematically summarized the emerging roles and detailed molecular mechanisms of MSC-derived exosomes in mediating cancer therapy resistance, thus providing novel insights into the clinical applications of MSC-derived exosomes in cancer management.
Topics: Adipocytes; Exosomes; Humans; Mesenchymal Stem Cells; Neoplasms; Tumor Microenvironment
PubMed: 36100944
DOI: 10.1186/s12943-022-01650-5 -
Frontiers in Immunology 2020Microglia originate from myeloid progenitors in the embryonic yolk sac and play an integral role in central nervous system (CNS) development, immune surveillance and... (Review)
Review
Microglia originate from myeloid progenitors in the embryonic yolk sac and play an integral role in central nervous system (CNS) development, immune surveillance and repair. The role of microglia in multiple sclerosis (MS) has been complex and controversial, with evidence suggesting that these cells play key roles in both active inflammation and remyelination. Here we will review the most recent histological classification of MS lesions as well as the evidence supporting both inflammatory and reparative functions of these cells. We will also review how microglia may yield new biomarkers for MS activity and serve as a potential target for therapy.
Topics: Antirheumatic Agents; Biomarkers; Demyelinating Diseases; Genetic Diseases, Inborn; Humans; Immunologic Surveillance; Macrophages; Microglia; Multiple Sclerosis; Neurodegenerative Diseases; Neuroimaging; T-Lymphocyte Subsets
PubMed: 32265902
DOI: 10.3389/fimmu.2020.00374 -
Allergy Dec 2020In the past decade, research in the molecular and cellular underpinnings of basic and clinical immunology has significantly advanced our understanding of allergic... (Review)
Review
In the past decade, research in the molecular and cellular underpinnings of basic and clinical immunology has significantly advanced our understanding of allergic disorders, allowing scientists and clinicians to diagnose and treat disorders such as asthma, allergic and nonallergic rhinitis, and food allergy. In this review, we discuss several significant recent developments in basic and clinical research as well as important future research directions in allergic inflammation. Certain key regulatory cytokines, genes and molecules have recently been shown to play key roles in allergic disorders. For example, interleukin-33 (IL-33) plays an important role in refractory disorders such as asthma, allergic rhinitis and food allergy, mainly by inducing T helper (Th) 2 immune responses and clinical trials with IL-33 inhibitors are underway in food allergy. We discuss interleukin 4 receptor pathways, which recently have been shown to play a critical role among the allergic inflammatory pathways that drive allergic disorders and pathogenesis. Further, the cytokine thymic stromal lymphopoietin (TSLP) has recently been shown as a factor in maintaining immune homeostasis and regulating type 2 inflammatory responses at mucosal barriers in allergic inflammation and targeting TSLP-mediated signalling is considered an attractive therapeutic strategy. In addition, new findings establish an important T cell-intrinsic role of mucosa-associated lymphoid tissue lymphoma translocation protein 1 (MALT1) proteolytic activity in the suppression of autoimmune responses. We have seen how mutations in the filaggrin gene are a significant risk factor for allergic diseases such as atopic dermatitis, asthma, allergic rhinitis, food allergy, contact allergy, and hand eczema. We are only beginning to understand the mechanisms by which the human microbiota may be regulating the immune system, and how sudden changes in the composition of the microbiota may have profound effects, linked with an increased risk of developing chronic inflammatory disorders, including allergies. New research has shown the important but complex role monocytes play in disorders such as food allergies. Finally, we discuss some of the new directions of research in this area, particularly the important use of biologicals in oral immunotherapy, advances in gene therapy, multifood therapy, novel diagnostics in diagnosing allergic disorders and the central role that omics play in creating molecular signatures and biomarkers of allergic disorders such as food allergy. Such exciting new developments and advances have significantly moved forth our ability to understand the mechanisms underlying allergic diseases for improved patient care.
Topics: Asthma; Cytokines; Dermatitis, Atopic; Filaggrin Proteins; Food Hypersensitivity; Humans; Inflammation; Rhinitis, Allergic
PubMed: 33068299
DOI: 10.1111/all.14632 -
Occupational Therapy International 2022This paper presents a research design for an integrated intervention using sensory integration training fused with social sports games for the treatment of children with...
This paper presents a research design for an integrated intervention using sensory integration training fused with social sports games for the treatment of children with autism. This study used a multiple baseline cross-subject design in a single-subject experiment, with structured play as the independent variable and expressive language skills of children with autism spectrum disorders as the dependent variable, with three phases of intervention: baseline, intervention period, and maintenance period. The expressive language ability was examined in terms of both oral expression and gestural expression, where the intervention effect of the oral expression was analyzed in terms of four components: the total number of words, the total number of sentences, average sentence length, and vocabulary complexity of oral expression, and the intervention effect of the gestural expression was analyzed in terms of changes in the frequency of children's gestural expression behaviors. For the categories classified by sensory integration ability, there are corresponding specific training programs that combine various physical exercises and play equipment to train the various abnormal functions of children with autism. Stereotyped behavior is a repetitive, self-imposed, and purposeless physical action, usually in the form of continuous and repetitive movements, sounds, and so on. 4 times a week, 25 minutes each time, the activity of recognizing pictures and familiar objects is carried out first, and then the children choose the structured game model and the initiative to build and take turns with the researchers to build. Stereotypic behaviors cause a great deal of distress in the lives of children with autism, and it is necessary to explore how to implement positive and effective interventions. Subjects' play abilities developed after receiving effective critical response training. The subjects' practice and symbolic play showed good immediate and maintenance intervention effectiveness; their associative and functional play showed no significant intervention effectiveness. The enhancement of the sensory integration skills of children with autism through sensory integration training resulted in a relative reduction of stereotypic behavior about the stimulus-seeking function, which had a positive effect on the intervention of stereotypic behavior.
Topics: Autism Spectrum Disorder; Autistic Disorder; Child; Humans; Language; Occupational Therapy
PubMed: 36110198
DOI: 10.1155/2022/9693648 -
Physical Therapy Feb 2021Our objective was to evaluate the efficacy of the Sitting Together and Reaching to Play (START-Play) intervention in young infants with neuromotor disorders. (Comparative Study)
Comparative Study Randomized Controlled Trial
OBJECTIVE
Our objective was to evaluate the efficacy of the Sitting Together and Reaching to Play (START-Play) intervention in young infants with neuromotor disorders.
METHOD
This randomized controlled trial compared usual care early intervention (UC-EI) with START-Play plus UC-EI. Analyses included 112 infants with motor delay (55 UC-EI, 57 START-Play) recruited at 7 to 16 months of age across 5 sites. START-Play included twice-weekly home visits with the infant and caregiver for 12 weeks provided by physical therapists trained in the START-Play intervention; UC-EI was not disrupted. Outcome measures were the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley); the Gross Motor Function Measure; reaching frequency; and the Assessment of Problem Solving in Play (APSP). Comparisons for the full group as well as separate comparisons for infants with mild motor delay and infants with significant motor delay were conducted. Piecewise linear mixed modeling estimated short- and long-term effects.
RESULTS
For infants with significant motor delay, positive effects of START-Play were observed at 3 months for Bayley cognition, Bayley fine motor, and APSP and at 12 months for Bayley fine motor and reaching frequency outcomes. For infants with mild motor delay, positive effects of START-Play for the Bayley receptive communication outcome were found. For the UC-EI group, the only difference between groups was a positive effect for the APSP outcome, observed at 3 months.
CONCLUSION
START-Play may advance reaching, problem solving, cognitive, and fine motor skills for young infants with significant motor delay over UC-EI in the short term. START-Play in addition to UC-EI may not improve motor/cognitive outcomes for infants with milder motor delays over and above usual care.
IMPACT
Concepts of embodied cognition, applied to early intervention in the START-Play intervention, may serve to advance cognition and motor skills in young infants with significant motor delays over usual care early intervention.
LAY SUMMARY
If you have a young infant with significant delays in motor skills, your physical therapist can work with you to develop play opportunities to enhance your child's problem solving, such as that used in the START-Play intervention, in addition to usual care to help your child advance cognitive and motor skills.
Topics: Child Development; Cognitive Dysfunction; Disability Evaluation; Exercise Therapy; Female; Humans; Infant; Male; Motor Skills Disorders; Nervous System Diseases; Problem Solving; Surveys and Questionnaires
PubMed: 33382406
DOI: 10.1093/ptj/pzaa232