Conectar
by Shuhong Zheng, Renxiu Bian, Haixin Song, Zhiping Liao, Ting Gao, Min Yan, Heqing Huang, Zuodong Lou, Fangchao Wu, Jianhua Li
BackgroundLow-intensity focused ultrasound (LIFU) is a non-invasive neuromodulation technique with high spatial precision and the ability to reach deeper brain regions, offering potential advantages for post-stroke rehabilitation. Repetitive transcranial magnetic stimulation (rTMS) is a widely adopted non-invasive brain stimulation technique that modulates cortical excitability to promote neuroplasticity. However, direct head-to-head comparisons between these two modalities for post-stroke motor recovery remain limited.
ObjectiveTo perform a secondary head-to-head comparison of LIFU and repetitive transcranial magnetic stimulation (rTMS) for motor recovery after stroke, based on a prospectively registered randomized controlled trial.
MethodsThis secondary analysis included patients with subacute stroke who received two weeks of standard rehabilitation combined with either LIFU (n = 25) or rTMS (n = 25) targeting the ipsilesional primary motor cortex. LIFU parameters: 0.5 MHz, spatial-peak pulse-average intensity (ISPPA) 10.2 W/cm² (free-field), pulse duration 0.2 ms, duty cycle 20%, 20 minutes per session, five days per week for two weeks (10 sessions total). rTMS parameters: 10 Hz, 80% resting motor threshold, 1,000 pulses per session (20 trains of 5 seconds), 20 minutes per session, five days per week for two weeks (10 sessions total). Motor outcomes were assessed using the Fugl–Meyer Assessment (FMA; upper and lower extremities), Modified Barthel Index (MBI), and Brunnstrom stages. Resting-state functional near-infrared spectroscopy (fNIRS) was used to evaluate cortical activity and functional connectivity before and after the intervention. Primary analyses were conducted in the intention-to-treat (ITT) population (n = 50), with completer analyses (n = 43) performed as sensitivity analyses.
ResultsBoth groups showed significant within-group improvements in FMA and MBI after the intervention (all p 0.05), and completer analyses yielded consistent between-group conclusions. In contrast, change-from-baseline analyses demonstrated greater improvements in FMA scores in the LIFU group compared with the rTMS group (ΔFMA upper limb: median 7 [IQR 3–10.5] vs. 2 [1–3], p = 0.001; lower limb: 3 [1–4.5] vs. 1 [0–1.5], p Conclusion
LIFU and rTMS were associated with comparable short-term motor outcomes in subacute stroke. Differences observed in change-from-baseline motor improvements and exploratory neuroimaging measures suggest potential divergence in recovery dynamics and cortical modulation, warranting further investigation in larger, longitudinal studies.
Trial registrationThis study was derived from a prospectively registered, three-arm randomized controlled trial in the Chinese Clinical Trial Registry (ChiCTR2500114687). The present manuscript reports a secondary head-to-head comparison between the two neuromodulation intervention arms.
To examine the relationship between work–family enrichment and two contextual factors (job support and family support), together with two personal factors (family boundary flexibility and prosocial motivation) among Chinese nurses assisting Wuhan in its fight against the Coronavirus Disease 2019 (COVID-19) pandemic.
The COVID-19 pandemic was first reported in Wuhan, China, and has now spread worldwide, which has brought attention to the pivotal role of nurses in public health emergencies. Work–family enrichment is a bidirectional structure, including work-to-family enrichment and family-to-work enrichment, that can yield many mutually beneficial results in both work and family domains among clinical nurses. However, few studies have investigated work–family enrichment and its influential factors among front-line nurses during public health emergencies.
A cross-sectional research design was adopted with a snowball sample of 258 Chinese nurses assisting Wuhan's anti-pandemic efforts. Data were collected from 21 March 2020 until 10 April 2020 through a battery of online questionnaires. Descriptive, univariate and hierarchical linear regression analyses and a Pearson correlation test were performed. A STROBE checklist was used to report findings.
The results showed that prosocial motivation, family support and job support predicted high work-to-family enrichment in those nurses, while prosocial motivation, family support and family boundary flexibility predicted high family-to-work enrichment.
The study confirmed the importance of paying attention to the work–family enrichment of front-line medical workers during the COVID-19 pandemic, so that they could concentrate on their anti-pandemic work and maintain their enthusiasm for disaster nursing.
The findings can help health administrators in affected countries around the world identify the influential factors of work–family enrichment among front-line nurses during infectious disease outbreaks, specifically in the areas of mobilising nurses’ prosocial motivation and giving sufficient job support.
To develop the Preschool Children eHealth Cardiac Rehabilitation programme based on the Interaction Model of Client Health Behaviour, and to evaluate its effects on children after congenital heart surgery.
A parallel two-arm randomised controlled trial was conducted.
A total of 84 participants were recruited from July 2022 to June 2023 and randomly assigned to either the intervention group (n = 40) or control group (n = 44). The intervention group participated in a 3-month eHealth Cardiac Rehabilitation programme, while the control group received routine care. Outcomes were measured at baseline, 3 months post baseline (intervention endpoint), and 6 months post baseline. Eighty participants completed the study.
Compared to the intervention group, the control group demonstrated significantly worse outcomes at both 3 and 6 months, including a higher risk of heart failure, lower left ventricular ejection fraction scores, and shorter 6-min walk distance tests. The intervention group engaged in significantly more vigorous physical activity. Significant between group differences were also observed in parental knowledge, attitudes, behaviours and trust levels. Additionally, the proportion of parents experiencing anxiety decreased significantly more in the intervention group by 6 months post baseline.
This pioneering eHealth programme transforms home-based rehabilitation for preschool children with congenital heart disease, addressing a critical gap in accessible and long-term paediatric cardiac rehabilitation care.
The use of eHealth programmes is valuable for improving paediatric cardiac rehabilitation by empowering parents, enhancing care continuity, and reducing barriers to accessing specialised services in paediatric care, especially in areas with limited medical resources.
This study establishes the first validated eHealth framework for family-centred cardiac rehabilitation in preschool children following congenital heart surgery, addressing the critically low uptake of previously home-based rehabilitation. It also provides clinicians with a scalable solution for delivering care in underserved regions lacking access to specialised cardiac services.
This study adhered to the CONSORT checklist guidelines for reporting randomised controlled trials.
This study did not include patient or public involvement in its design, conduct, or reporting.
This study was a randomised controlled clinical trial. The research protocol was registered with the China Clinical Trial Registration Center (registration number: ChiCTR2200062022; https://www.chictr.org.cn/showproj.html?proj=174261).
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