The intrinsic risk factors of rotator cuff disease (RCD) include degeneration, inflammation, oxidative stress, and circulation impairment. Both diabetes and hyperlipidemia are thought to increase these risk factors and therefore potentially enhance RCD development. However, few studies, and few longitudinal follow-up studies in particular, exist to prove this. Both diabetes and hyperlipidemia can increase a patient’s risk of developing RCD. Cohort study; Level of evidence, 3. A total of 498,678 participants, including 28,391 diagnosed with diabetes and 25,621 with hyperlipidemia in the year 2000, were followed for an 11-year period. Multivariate Cox proportional hazards models were used to explore the effect of (1) diabetes, (2) hyperlipidemia, (3) diabetes with/without insulin use, and (4) hyperlipidemia with/without statin use on the development of RCD. In the subgroup of patients with hyperlipidemia, multivariate Cox proportional hazards models were also performed to explore the relationship between statin use and RCD development. During an 11-year follow-up period, 26,664 patients developed RCD. The crude hazard ratio (HR) for RCD in patients with diabetes as compared with those without diabetes was 2.11 (95% CI, 2.02-2.20; P < .0001). The crude HR for RCD in patients with hyperlipidemia as compared with those without hyperlipidemia was 2.00 (95% CI, 1.92-2.08; P < .0001). Multivariate Cox proportional hazards analysis revealed that, in addition to older age and female sex, both diabetes and hyperlipidemia increased the risk of RCD (diabetes: HR, 1.47 [95% CI, 1.41-1.54]; P < .0001) (hyperlipidemia: HR, 1.48 [95% CI, 1.42-1.55]; P < .0001). An elevated risk still existed in patients with diabetes with/without insulin use (diabetes with insulin use: HR, 1.43 [95% CI, 1.35-1.51]; P < .0001) (diabetes without insulin use: HR, 1.64 [95% CI, 1.53-1.75]; P < .0001). An increased risk also existed in patients with hyperlipidemia with/without statin use (hyperlipidemia with statin use: HR, 1.16 [95% CI, 1.10-1.23]; P < .0001) (hyperlipidemia without statin use: HR, 2.01 [95% CI, 1.89-2.13]; P < .0001). In the subgroup of patients with hyperlipidemia, statin use was associated with a lower risk of developing RCD when compared with no statin use (rosuvastatin: HR, 0.41 [95% CI, 0.35-0.49]; P < .0001) (simvastatin: HR, 0.62 [95% CI, 0.54-0.71]; P < .0001) (other statins: HR, 0.66 [95% CI, 0.60-0.72]; P < .0001). The present longitudinal, population-based follow-up study showed that either diabetes or hyperlipidemia alone was an independent risk factor for RCD development. Statin use might provide protection against RCD in patients with hyperlipidemia.

Exercise tolerance and cardiac output have a major impact on the quality of life (QOL) of patients experiencing heart failure (HF). Home-based cardiac rehabilitation can significantly improve not only exercise tolerance but also peak oxygen uptake ( JOURNAL/medi/04.02/00005792-201801260-00011/math_11MM2/v/2018-01-24T161738Z/r/image-tiff peak), and the QOL in patients with HF. The aim of this prospective study was to evaluate the beneficial effects of home-based cardiac rehabilitation on the quality of medical care in patients with chronic HF. This study was a randomized prospective trial. HF patients with a left ventricular ejection fraction (LVEF) of less than 50% were included in this study. We randomly assigned patients to the control group (n = 18) and the interventional group (n = 19). Within the interventional group, we arranged individualized rehabilitation programs, including home-based cardiac rehabilitation, diet education, and management of daily activity over a 3-month period. Information such as general data, laboratory data, Cardiopulmonary Exercise Test (CPET) results, Six-minute Walk Test (6MWT) results, and the scores for the Minnesota Living with Heart Failure Questionnaire (MLHFQ) before and after the intervention, was collected from all patients in this study. Patients enrolled in the home-based cardiac rehabilitation programs displayed statistically significant improvement in JOURNAL/medi/04.02/00005792-201801260-00011/math_11MM3/v/2018-01-24T161738Z/r/image-tiff peak (18.2 ± 4.1 vs 20.9 ± 6.6 mL/kg/min, P = .02), maximal 6-Minute Walking Distance (6MWD) (421 ± 90 vs 462 ± 74 m, P = .03), anaerobic threshold (12.4 ± 2.5 vs 13.4 ± 2.6 mL/kg/min, P = .005), and QOL. In summary, patients receiving home-based cardiac rehabilitation experienced a 14.2% increase in JOURNAL/medi/04.02/00005792-201801260-00011/math_11MM4/v/2018-01-24T161738Z/r/image-tiff peak, a 37% increase in QOL score, and an improvement of 41 m on the 6MWD test. The 90-day readmission rate for patients reduced to 5% from 14% after receiving cardiac rehabilitation. Home-based cardiac rehabilitation offered the most improved results in functional capacity, QOL, and a reduced the rate of readmission within 90 days.

Recently, studies have reported that extracorporeal shock wave therapy (ESWT) is a safe, noninvasive, alternative treatment for spasticity. However, the effect of ESWT on spasticity cannot be determined, because most studies to date have enrolled small patient numbers and have lacked placebo-controlled groups and/or long-term follow-up. In addition, whether varying the number of ESWT sessions would affect the duration of the therapeutic effect has not been investigated in a single study. Hence, we performed a prospective, randomized, single blind, placebo-controlled study to investigate the long-term effect of radial ESWT (rESWT) in patients with poststroke spasticity and surveyed the outcome of functional activity.Sixty patients were randomized into 3 groups. Group A patients received 1 session of rESWT per week for 3 consecutive weeks; group B patients received a single session of rESWT; group C patients received one session of sham rESWT per week for 3 consecutive weeks. The primary outcome was Modified Ashworth Scale of hand and wrist, whereas the secondary outcomes were Fugl-Meyer Assessment of hand function and wrist control. Evaluations were performed before the first rESWT treatment and immediately 1, 4, 8, 12, and 16 weeks after the last session of rESWT.Compared to the control group, the significant reduction in spasticity of hand and wrist lasted at least 16 and 8 weeks in group A and B, respectively. Three sessions of rESWT had a longer-lasting effect than one session. Furthermore, the reduction in spasticity after 3 sessions of rESWT may be beneficial for hand function and wrist control and the effect was maintained for 16 and 12 weeks, respectively.rESWT may be valuable in decreasing spasticity of the hand and wrist with accompanying enhancement of wrist control and hand function in chronic stroke patients.

[Purpose] The aim of the present was to investigate the short-term effects of a program combining self-massage and home exercise for patients with myofascial pain dysfunction syndrome (MPDS). [Subjects and Methods] In this retrospective study, 63 patients were allocated to the experimental (n = 32) and control (n = 31) groups. Both groups received 6 sessions of treatment with physical modalities over the course of two weeks. The experimental group completed an additional program with a combination of self-massage and home exercise. The outcome measurements included a pain scale, pressure pain threshold (PPT), neck disability index (NDI), patient-specific functional scales (PSFS), and heart rate variability (HRV). The interactions between the groups and over time were analyzed using two-way repeated measures ANOVA. [Results] Only the experimental group demonstrated significant improvements in the pain scale with varying conditions. The PPTs of the trigger points increased significantly in the experimental group, and significant functional improvements in NDI and PSFS were observed in the same group. There were significant increases in high-frequency HRV and high-frequency % in the experimental group. [Conclusion] Treatment with physical modalities plus combination of self-massage and home exercise is more effective than the physical modalities treatment alone.