European journal of physical and rehabilitation medicine最新文献

{"title":"Dynamic suprahyoid muscle ultrasound in assessing oropharyngeal dysphagia in neurological disorders.","authors":"Joo Hye Sung, Seol-Hee Baek, Jin-Woo Park, Jung Hun Lee, Myeong Hun Son, Byung-Jo Kim","doi":"10.23736/S1973-9087.24.08216-9","DOIUrl":"10.23736/S1973-9087.24.08216-9","url":null,"abstract":"<p><strong>Background: </strong>Appropriate evaluation and management of dysphagia are essential in neurological disorders. However, there is currently a lack of a simple yet reliable method for dysphagia evaluation.</p><p><strong>Aim: </strong>This study aimed to investigate the usefulness of new dynamic M-mode ultrasonography (US) parameters of suprahyoid muscle (SHM) to evaluate dysphagia.</p><p><strong>Design: </strong>Prospective observational, cross-sectional study.</p><p><strong>Setting: </strong>Inpatient setting at neurology department of tertiary medical center.</p><p><strong>Population: </strong>A total of 89 patients with dysphagia and 175 healthy volunteers were enrolled in the study. Patients were subdivided into mild and severe dysphagia groups depending on the need for dietary changes and disease classification, which included amyotrophic lateral sclerosis, peripheral neuromuscular diseases, and stroke.</p><p><strong>Methods: </strong>Dynamic M-mode US was performed during swallowing to obtain the SHM thickness (the baseline thickness of the SHM), SHM displacement (peak-to-peak amplitude of SHM movement), SHM difference (SHM displacement - SHM thickness), SHM ratio (SHM displacement/SHM thickness), peak-to-peak time, and total duration. A videofluoroscopic swallowing study (VFSS) was performed.</p><p><strong>Results: </strong>Significant differences were found in SHM displacement and SHM difference according to dysphagia severity (P<0.001). The SHM ratio, total duration (P<0.001), and peak-to-peak time (P=0.001) differed significantly according to the patients' underlying diseases. The pharyngeal delay time and penetration-aspiration scale from the VFSS demonstrated significant negative correlations with SHM displacement and difference (P<0.001). By combining SHM difference and total duration, patients with dysphagia could be distinguished from healthy controls, with the highest negative predictive value of 95.6%.</p><p><strong>Conclusions: </strong>Dynamic M-mode US of the SHM provided added value in evaluating the severity of dysphagia and differentiating swallowing mechanics of dysphagia related to underlying neurological disorders.</p><p><strong>Clinical rehabilitation impact: </strong>Dynamic M-mode US of the SHM can serve as a supportive tool for rapid screening and repetitive follow-up of patients with dysphagia, which would contribute to dysphagia rehabilitation in patients with various neurological disorders.</p>","PeriodicalId":12044,"journal":{"name":"European journal of physical and rehabilitation medicine","volume":" ","pages":"233-244"},"PeriodicalIF":4.5,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11114157/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139706485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Repetitive peripheral magnetic stimulation for preventing shoulder subluxation after stroke: a randomized controlled trial.","authors":"Kenta Fujimura, Hitoshi Kagaya, Ryoka Itoh, Chiharu Endo, Hiroki Tanikawa, Hirofumi Maeda","doi":"10.23736/S1973-9087.24.08264-9","DOIUrl":"10.23736/S1973-9087.24.08264-9","url":null,"abstract":"<p><strong>Background: </strong>Shoulder subluxation caused by paralysis after stroke is a serious issue affecting shoulder pain and functional prognosis. However, its preventive treatment has not been fully investigated.</p><p><strong>Aim: </strong>To investigate the effects of repetitive peripheral magnetic stimulation (rPMS) on the prevention of shoulder subluxation.</p><p><strong>Design: </strong>A single-center, parallel-group, prospective randomized, open-blinded, end-point study.</p><p><strong>Setting: </strong>Convalescent rehabilitation ward.</p><p><strong>Population: </strong>We included 50 inpatients in the convalescent rehabilitation ward with post-stroke, having upper limb paralysis, and the acromio-humeral interval (AHI) was within 1/2 finger-breadth.</p><p><strong>Methods: </strong>A blinded computer-based allocation system was used to randomly assign patients into two groups: 1) conventional rehabilitation plus rPMS therapy (rPMS group, N=25); and 2) conventional rehabilitation alone (control group, N=25). Blinded assessors evaluated the patients before the intervention (T0), 6 weeks after (T1), and 12 weeks after (T2). The primary outcome was the change in AHIs from T0 to T1 between the groups. In contrast, the secondary outcomes were shoulder pain, spasticity, active range of motion, and Fugl-Meyer Assessment upper extremity (FMA-UE) score.</p><p><strong>Results: </strong>Twenty-two patients in the rPMS group and 24 in the control group completed T1, whereas 16 in the rPMS group and 11 in the control group completed T2. The change in AHI was significantly lower in the rPMS group than in the control group ([95% CI, -5.15 to -0.390], P=0.023). Within-group analysis showed that AHI in the rPMS group did not change significantly, whereas it increased in the control group (P=0.004). There were no significant differences between T1 and T2 within or between the groups. Moreover, AHI did not show differences in patients with severe impairment but decreased in the rPMS group in patients with mild impairment (P=0.001).</p><p><strong>Conclusions: </strong>The rPMS may be a new modality for preventing shoulder subluxation. The association between motor impairment and the sustained effect needs to be further examined.</p><p><strong>Clinical rehabilitation impact: </strong>Applying rPMS to the muscles of the paralyzed shoulder after a stroke may prevent shoulder subluxation.</p>","PeriodicalId":12044,"journal":{"name":"European journal of physical and rehabilitation medicine","volume":" ","pages":"216-224"},"PeriodicalIF":4.5,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11114152/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140119149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Which information derived from the Coma Recovery Scale-Revised provides the most reliable prediction of clinical diagnosis and recovery of consciousness? A comparative study using machine learning techniques.","authors":"Silvia Campagnini, Roberto Llorens, M Dolores Navarro, Carolina Colomer, Andrea Mannini, Anna Estraneo, Joan Ferri, Enrique Noé","doi":"10.23736/S1973-9087.23.08093-0","DOIUrl":"10.23736/S1973-9087.23.08093-0","url":null,"abstract":"<p><strong>Background: </strong>The Coma Recovery Scale-Revised (CRS-R) is the most recommended clinical tool to examine the neurobehavioral condition of individuals with disorders of consciousness (DOCs). Different studies have investigated the prognostic value of the information provided by the conventional administration of the scale, while other measures derived from the scale have been proposed to improve the prognosis of DOCs. However, the heterogeneity of the data used in the different studies prevents a reliable comparison of the identified predictors and measures.</p><p><strong>Aim: </strong>This study investigates which information derived from the CRS-R provides the most reliable prediction of both the clinical diagnosis and recovery of consciousness at the discharge of a long-term neurorehabilitation program.</p><p><strong>Design: </strong>Retrospective observational multisite study.</p><p><strong>Setting: </strong>The enrollment was performed in three neurorehabilitation facilities of the same hospital network.</p><p><strong>Population: </strong>A total of 171 individuals with DOCs admitted to an inpatient neurorehabilitation program for a minimum of 3 months were enrolled.</p><p><strong>Methods: </strong>Machine learning classifiers were trained to predict the clinical diagnosis and recovery of consciousness at discharge using clinical confounders and different metrics extracted from the CRS-R scale.</p><p><strong>Results: </strong>Results showed that the neurobehavioral state at discharge was predicted with acceptable and comparable predictive value with all the indices and measures derived from the CRS-R, but for the clinical diagnosis and the Consciousness Domain Index, and the recovery of consciousness was predicted with higher accuracy and similarly by all the investigated measures, with the exception of initial clinical diagnosis.</p><p><strong>Conclusions: </strong>Interestingly, the total score in the CRS-R and, especially, the total score in its subscales provided the best overall results, in contrast to the clinical diagnosis, which could indicate that a comprehensive measure of the clinical diagnosis rather than the condition of the individuals could provide a more reliable prediction of the neurobehavioral progress of individuals with prolonged DOC.</p><p><strong>Clinical rehabilitation impact: </strong>The results of this work have important implications in clinical practice, offering a more accurate prognosis of patients and thus giving the possibility to personalize and optimize the rehabilitation plan of patients with DoC using low-cost and easily collectable information.</p>","PeriodicalId":12044,"journal":{"name":"European journal of physical and rehabilitation medicine","volume":" ","pages":"190-197"},"PeriodicalIF":4.5,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11114154/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139402500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Family caregivers improve the diagnostic accuracy of disorders of consciousness: from remote to near-bed auditory stimulation.","authors":"Pasquale Moretta, Cinzia Femiano, Nicola D Cavallo, Anna Lanzillo, Fabrizio Luciano, Cesario Ferrante, Antonio Maiorino, Gabriella Santangelo, Laura Marcuccio","doi":"10.23736/S1973-9087.24.08179-6","DOIUrl":"10.23736/S1973-9087.24.08179-6","url":null,"abstract":"<p><strong>Background: </strong>Family caregivers (FC) contribute to reducing the misdiagnosis rate in patients with disorders of consciousness (DOC). Unfortunately, the recent pandemic of COVID-19 imposed drastic restrictions that limited the access of FC to the sensory/cognitive stimulation protocols. Telemedicine approaches have been implemented to avoid discontinuity in care pathways and to ensure caregivers involvement in rehabilitation programs.</p><p><strong>Aim: </strong>The aim was to investigate whether the presence of FC remotely connected might help clinicians in eliciting higher cortically mediated behavioral responses in patients with DOC.</p><p><strong>Design: </strong>Cross-sectional study.</p><p><strong>Setting: </strong>Post-acute Unit of Neurorehabilitation.</p><p><strong>Population: </strong>DOC due to severe brain injury.</p><p><strong>Methods: </strong>Consecutive patients with DOC were assessed by means of the Coma Recovery Scale-Revised (CRS-R) by two expert examiners. Each patient underwent to five assessments in two weeks in three different conditions: 1) by the examiner only (standard); 2) with the verbal stimulation given by the FC remotely connected by PC tablet (caregiver in remote); and 3) with the verbal stimulation given by the FC physically present (caregiver in presence).</p><p><strong>Results: </strong>Thirty patients with DOC (VS/UWS=10; MCS=20; mean age: 51, range: 21-79; vascular: 16; anoxic: 6; TBI=8) and their FC were enrolled. Higher total scores of CRS-R were recorded both in \"caregiver in remote\" and in \"caregiver in presence\" than in standard condition (standard vs. remote, Z=2.942, P=0.003; standard vs. presence, Z=3.736, P<0.001). Furthermore, the administration of the CRS-R with a FC, elicited higher levels of behavioral responses in MCS patients, than CRS-R performed in standard condition. In particular, 2 patients out of 30 (6.66%) showed higher scores and better diagnosis when the CRS-R was administered with FC in remote. Similarly, 5 out of 30 patients (16.66%) showed better diagnoses when the CRS-R was administered with FC in presence. Five patients changed diagnosis between standard and presence conditions (3 MCS- were diagnosed as MCS+; 2 MCS+ were diagnosed as conscious).</p><p><strong>Conclusions: </strong>Our findings add new evidence regarding the beneficial role of family members in the diagnosis of DOC, even mediated by telemedicine approach.</p><p><strong>Clinical rehabilitation impact: </strong>In future guidelines, FC should have an active and supporting role in the diagnostic and rehabilitative process of DOC.</p>","PeriodicalId":12044,"journal":{"name":"European journal of physical and rehabilitation medicine","volume":" ","pages":"198-206"},"PeriodicalIF":4.5,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11114155/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139912405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Alterations in functional connectivity in patients with non-specific chronic low back pain after motor control exercise: a randomized trial.","authors":"Chanjuan Zhang, Zhou Zhang, Yuelong Li, Yi Yin, Chenyang Feng, Wenfeng Zhan, Ruochen Fu, Qiuhua Yu, Guihua Jiang, Chuhuai Wang","doi":"10.23736/S1973-9087.24.08087-0","DOIUrl":"10.23736/S1973-9087.24.08087-0","url":null,"abstract":"<p><strong>Background: </strong>Motor control exercise (MCE) is effective in alleviating non-specific chronic low back pain (NCLBP). Neuro-imaging research is warranted to explore the underlying neural mechanisms of MCE.</p><p><strong>Aim: </strong>We used resting-state functional magnetic resonance imaging (rs-fMRI) to explore the central mechanism underpinning the effects of MCE in patients with NCLBP.</p><p><strong>Design: </strong>A randomized, single-blinded, controlled trial.</p><p><strong>Setting: </strong>The setting was out-patient and community.</p><p><strong>Population: </strong>Fifty-eight patients with NCLBP.</p><p><strong>Methods: </strong>Patients were randomized into the MCE or manual therapy (MT) group. All the participants completed pain-related clinical assessments and rs-fMRI scans before and after intervention. We performed exploratory whole-brain analyses in regional homogeneity (ReHo) and resting-state functional connectivity (rsFC) with significant post-pre differences in ReHo before and after intervention, and investigated associations between imaging and pain-related clinical assessments.</p><p><strong>Results: </strong>Compared with the MT group, a greater alleviation in pain intensity and disability was observed in the MCE group after intervention, and was sustained at the 6-month follow-up (P<0.001). Only the MCE group showed increased ReHo values in the right pre-central gyrus and decreased ReHo values in the bilateral posterior cerebellum (voxel level P<0.001, cluster-level FWE corrected P<0.05). Decreased rsFC of the right posterior cerebellum-left superior parietal gyrus and left insula were significantly positively associated with pain-related disability (voxel level P<0.001, cluster-level FWE corrected P<0.05).</p><p><strong>Conclusions: </strong>These findings demonstrated that MCE had superior effects in relieving pain and pain-related disability, which might be associated with its modulation of rsFC between the cerebellum and areas involved in sensory-discriminative processing of noxious and somato-sensory stimuli, affection, and cognition.</p><p><strong>Clinical rehabilitation impact: </strong>This study provided preliminary evidence that MCE might alleviate NCLBP through its modulation of the function of brain areas related to chronic pain and postural control. Those results support MCE's clinical application and help physiotherapists to provide better multidisciplinary interventions with the combination of MCE and other first-line treatments.</p>","PeriodicalId":12044,"journal":{"name":"European journal of physical and rehabilitation medicine","volume":" ","pages":"319-330"},"PeriodicalIF":4.5,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11112508/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139734864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of core sets for deafblindness: an international expert survey on functioning and disability of individuals living with deafblindness using the International Classification of Functioning, Disability, and Health.","authors":"Walter Wittich, Shirley Dumassais, Atul Jaiswal, Abinethaa Paramasivam, Shreya Budhiraja, Ricard Lopez, Sarah Granberg","doi":"10.23736/S1973-9087.24.08188-7","DOIUrl":"10.23736/S1973-9087.24.08188-7","url":null,"abstract":"<p><strong>Background: </strong>The development of International Classification of Functioning, Disability, and Health (ICF) Core Sets greatly enhances the global recognition of health conditions, thereby advancing research, education, and care provision. Aside from the work of researchers, and the viewpoint of persons with lived experience, the development of Core Sets for deafblindness needs to include the viewpoints of professionals with expertise unique to this condition.</p><p><strong>Aim: </strong>To represent the perspective of health and social service expert professionals in the development of ICF Core Sets for deafblindness.</p><p><strong>Design: </strong>Cross-sectional cohort study.</p><p><strong>Setting: </strong>Global online survey representing all six regions of the World Health Organization.</p><p><strong>Population: </strong>One hundred and five professionals providing and health or social service to individuals living with deafblindness with a minimum of 2 years of work experience with this population.</p><p><strong>Methods: </strong>An online survey was distributed through professional networks and social media for individuals working with persons living with deafblindness. Demographic items were summarized using descriptive statistics. Six open-ended questions explored the perceptions of body functions and structures that influence activities and participation, as well as environmental and personal factors that facilitate functioning. Data were linked to the ICF codes using established linking rules and procedures.</p><p><strong>Results: </strong>The 2934 survey response units were linked using IFC categories. Of the 421 unique categories, 133 were used by 5% or more of respondents. Most categories within the Activities and Participation component were equally emphasized. The most frequent Environmental factors were support and relationships, services, systems, and policies, as well as and the physical environment (e.g., hearing aids or noise). Mental functions, including higher level cognitive functions, temperament and personality were frequently emphasized.</p><p><strong>Conclusions: </strong>Almost three quarters (73.3%) of the entire ICF classification categories were included in the expert survey results. This proportion emphasizes the importance of a multidimensional tool, such as the ICF, for assessing functioning and health for persons with deafblindness.</p><p><strong>Clinical rehabilitation impact: </strong>The representation of this professional perspective in Core Set development will improve standardized assessment and documentation, intervention planning, and facilitate interprofessional communication with the goal of improving person-centered care for persons living with deafblindness.</p>","PeriodicalId":12044,"journal":{"name":"European journal of physical and rehabilitation medicine","volume":" ","pages":"382-390"},"PeriodicalIF":4.5,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11131589/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140179509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Therapeutic approach to dysphagia in post-COVID patients in a rehabilitation unit: a descriptive longitudinal study.","authors":"Anna Guillen-Sola, Cindry Ramírez, Sonia Nieto, Esther Duarte, Marta Tejero, Christian Grillo, Helena Bel, Roser Boza","doi":"10.23736/S1973-9087.24.08234-0","DOIUrl":"10.23736/S1973-9087.24.08234-0","url":null,"abstract":"<p><strong>Background: </strong>A high rate of hospitalized patients for COVID-19 had dysphagia, frequently underdiagnosed, and not treated, inducing a prolonged dysphagia with protracted recovery. Specific treatments and protocols have not been well described yet.</p><p><strong>Aim: </strong>Given the potential benefits of respiratory muscle training (IEMT) and neuromuscular stimulation (NMES) in dysphagia treatment, this study aimed to assess the feasibility of the protocol used for treating dysphagia in patients who experienced prolonged hospitalization for COVID-19.</p><p><strong>Design: </strong>Observational, descriptive, prospective study.</p><p><strong>Setting: </strong>Department of Physical Medicine and Rehabilitation of a tertiary University hospital.</p><p><strong>Population: </strong>Fifty-eight COVID-19 patients were admitted for intensive rehabilitation (March 2020 to October 2021) were prospectively studied.</p><p><strong>Methods: </strong>Dysphagia was diagnosed using videofluoroscopy and treated with a 3-week protocol adapted from neuromuscular stimulation (NMES) in a motor threshold and inspiratory/expiratory muscle strength training (IEMST), five sets of five repetitions three times daily for 3 weeks. Feasibility was assessed with adherence, outcomes achieved, and occurrence of adverse/unexpected events. Respiratory function (peak cough flow, maximal inspiratory/expiratory pressures) and swallow function (Penetration-Aspiration Scale and Bolus Residue Scale measured by videofluoroscopy) were recorded descriptive statistics, Student's t test for numerical data, and Wilcoxon Test for ordinal variables were applied. SPPSS vs28 and STATA version 15.1 (StataCorp, College Station, TX, USA) were used for statistical analysis. P values 0.05 were considered significant.</p><p><strong>Results: </strong>Dysphagia was highly prevalent in severe COVID-19 patients (86.6%); all respiratory and swallow parameters improved after a 3-week intervention and 12 of 18 patients dependent on tube feeding resumed a normal diet (66.7%; McNemar P=0.03), and 84.09% attended a no restriction diet at discharge. Adherence to treatment was 85%. No significant adverse events were detected.</p><p><strong>Conclusions: </strong>We conclude that a structured swallowing-exercise training intervention based on IEMT and NMES is feasible and safe in prolonged hospitalization post-COVID patients.</p><p><strong>Clinical rehabilitation impact: </strong>To describe rehabilitation protocols used to treat dysphagia in post-COVID patients will help us to optimize the available techniques in each center and to induce a faster recovery avoiding potential complications.</p>","PeriodicalId":12044,"journal":{"name":"European journal of physical and rehabilitation medicine","volume":" ","pages":"373-381"},"PeriodicalIF":4.5,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11112509/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140179513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"360° immersive virtual reality-based mirror therapy for upper extremity function and satisfaction among stroke patients: a randomized controlled trial.","authors":"Sungbae Jo, Hoon Jang, Hyunjin Kim, Changho Song","doi":"10.23736/S1973-9087.24.08275-3","DOIUrl":"10.23736/S1973-9087.24.08275-3","url":null,"abstract":"<p><strong>Background: </strong>Stroke is a leading cause of long-term disability worldwide; therefore, an effective rehabilitation strategy is fundamental. Mirror therapy (MT) has been a popular approach for upper extremity rehabilitation, but it presents some limitations. Recent advancements in virtual reality (VR) technology have introduced immersive VR-based MT, potentially overcoming these limitations and enhancing rehabilitation outcomes.</p><p><strong>Aim: </strong>This study aimed to evaluate the effectiveness of a novel 360° immersive virtual reality-based MT (360MT) in upper extremity rehabilitation for stroke patients, comparing it to traditional MT (TMT) and conventional physical therapy control group (CG).</p><p><strong>Design: </strong>A prospective, active control, assessor blinded, parallel groups, randomized controlled trial.</p><p><strong>Population: </strong>Forty-five participants with chronic stroke within six months of onset.</p><p><strong>Methods: </strong>The participants were randomly allocated to 360MT, TMT, or CG groups. Outcome measures included Fugl-Meyer Assessment for Upper Extremity (FMA-UE), Box and Block Test (BBT), and Manual Function Test (MFT). Additionally, patient experience and satisfaction in the groups of 360MT and TMT were assessed through questionnaires and interviews.</p><p><strong>Results: </strong>Results revealed that the 360MT group showed significantly greater improvements in FMA-UE, MFT and BBT compared to TMT (P<0.05) and CG (P<0.001) groups. Patient experience and satisfaction were more favorable in the 360MT group, with participants reporting higher engagement and motivation.</p><p><strong>Conclusions: </strong>360MT appears to be a promising approach for upper extremity rehabilitation in stroke patients, providing better outcomes and higher patient satisfaction. However, further research is needed to confirm these findings and strengthen the evidence base for 360MT in stroke rehabilitation.</p><p><strong>Clinical rehabilitation impact: </strong>360MT demonstrated notably enhanced upper extremity rehabilitation outcomes as well as better patient satisfaction among chronic stroke patients within six months of onset compared to traditional MT and conventional physical therapy. This novel approach not only fostered functional improvements but also elevated levels of engagement and motivation among participants, suggesting a promising future application in stroke rehabilitation framework.</p>","PeriodicalId":12044,"journal":{"name":"European journal of physical and rehabilitation medicine","volume":" ","pages":"207-215"},"PeriodicalIF":4.5,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11114156/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140119145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A wearable system for visual cueing gait rehabilitation in Parkinson's disease: a randomized non-inferiority trial.","authors":"Michelangelo Bartolo, Alberto Castelli, Marzia Calabrese, Giampiero Buttacchio, Chiara Zucchella, Stefano Tamburin, Andrea Fontana, Massimiliano Copetti, Alfonso Fasano, Domenico Intiso","doi":"10.23736/S1973-9087.24.08381-3","DOIUrl":"10.23736/S1973-9087.24.08381-3","url":null,"abstract":"<p><strong>Background: </strong>Gait disturbances represent one of the most disabling features of Parkinson's disease (PD).</p><p><strong>Aim: </strong>The aim of this study was to evaluate the non-inferiority of a new wearable visual cueing system (Q-Walk) for gait rehabilitation in PD subjects, compared to traditional visual cues (stripes on the floor).</p><p><strong>Design: </strong>Open-label, monocentric, randomized controlled non-inferiority trial.</p><p><strong>Setting: </strong>Outpatients.</p><p><strong>Population: </strong>Patients affected by idiopathic PD without cognitive impairment, Hoehn and Yahr stage II-IV, Unified Parkinson's Disease Rating Scale motor section III ≥2, stable drug usage since at least 3 weeks.</p><p><strong>Methods: </strong>At the enrollment (T0), all subjects underwent a clinical/functional evaluation and the instrumental gait and postural analysis; then they were randomly assigned to the Study Group (SG) or Control Group (CG). Rehabilitation program consisted in 10 consecutive individual sessions (5 sessions/week for 2 consecutive weeks). Each session included 60 minutes of conventional physiotherapy plus 30 minutes of gait training by Q-Walk (SG) or by traditional visual cues (CG). Follow-up visits were scheduled at the end of the treatment (T1) and after 3 months (T2).</p><p><strong>Results: </strong>Fifty-two subjects were enrolled in the study, 26 in each group. The within-groups analysis showed a significant improvement in clinical scales and instrumental data at T1 and at T2, compared to baseline, in both groups. According to the between-group analysis, Q-Walk cueing system was not-inferior to the traditional cues for gait rehabilitation. The satisfaction questionnaire revealed that most subjects described the Q-Walk cueing system as simple, motivating and easily usable, possibly suitable for home use.</p><p><strong>Conclusions: </strong>Data showed that motor rehabilitation of PD subjects performed by means of the new wearable Q-Walk cueing system was feasible and as effective as traditional cues in improving gait parameters and balance.</p><p><strong>Clinical rehabilitation impact: </strong>Wearable devices can act as an additional rehabilitation strategy for long-term and continuous care, allowing patients to train intensively and extensively in household settings, favoring a tailor-made and personalized approach as well as remote monitoring.</p>","PeriodicalId":12044,"journal":{"name":"European journal of physical and rehabilitation medicine","volume":" ","pages":"245-256"},"PeriodicalIF":4.5,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11114153/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140119146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"System for Tracking and Evaluating Performance (Step-App®): validation and clinical application of a mobile telemonitoring system in patients with knee and hip total arthroplasty. A prospective cohort study.","authors":"Lorenzo Lippi, Francesco Desimoni, Massimo Canonico, Gregorio Massocco, Alessio Turco, Marco Polverelli, Alessandro de Sire, Marco Invernizzi","doi":"10.23736/S1973-9087.24.08128-0","DOIUrl":"10.23736/S1973-9087.24.08128-0","url":null,"abstract":"<p><strong>Background: </strong>Technological advances and digital solutions have been proposed to overcome barriers to sustainable rehabilitation programs in patients with musculoskeletal disorders. However, to date, standardized telemonitoring systems able to precisely assess physical performance and functioning are still lacking.</p><p><strong>Aim: </strong>To validate a new mobile telemonitoring system, named System for Tracking and Evaluating Performance (Step-App^®), to evaluate physical performance in patients undergone knee and hip total arthroplasty.</p><p><strong>Design: </strong>Prospective cohort study.</p><p><strong>Methods: </strong>A consecutive series of older adults with knee and hip total arthroplasty participated in a comprehensive rehabilitation program. The Step-App^®, a mobile telemonitoring system, was used to remotely monitor the effects of rehabilitation, and the outcomes were assessed before (T0) and after the rehabilitation treatment (T1). The primary outcomes were the 6-Minute Walk Test (6MWT), the 10-Meter Walk Test (10MWT), and the 30-Second Sit-To-Stand Test (30SST).</p><p><strong>Results: </strong>Out of 42 patients assessed, 25 older patients were included in the present study. The correlation analysis between the Step-App^® measurements and the traditional in-person assessments demonstrated a strong positive correlation for the 6MWT (T0: r²=0.9981, P<0.0001; T1: r²=0.9981, P<0.0001), 10MWT (T0: r²=0.9423, P<0.0001; T1: r²=0.8634, P<0.0001), and 30SST (T0: r²=1, P<0.0001; T1: r²=1, P<0.0001). The agreement analysis, using Bland-Altman plots, showed a good agreement between the Step-App^® measurements and the in-person assessments.</p><p><strong>Conclusions: </strong>Therefore, we might conclude that Step-App^® could be considered as a validated mobile telemonitoring system for remote assessment that might have a role in telemonitoring personalized rehabilitation programs for knee and hip replacement patients.</p><p><strong>Clinical rehabilitation impact: </strong>Our findings might guide clinicians in remote monitoring of physical performance in patients with musculoskeletal conditions, providing new insight into tailored telerehabilitation programs.</p>","PeriodicalId":12044,"journal":{"name":"European journal of physical and rehabilitation medicine","volume":" ","pages":"349-360"},"PeriodicalIF":4.5,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11131591/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139650589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}