European journal of physical and rehabilitation medicine最新文献

{"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}

{"title":"Management of low back pain and lumbosacral radicular syndrome: the Guideline of the Royal Dutch Society for Physical Therapy (KNGF).","authors":"Adri T Apeldoorn, Nynke M Swart, Daniëlle Conijn, Guus A Meerhoff, Raymond W Ostelo","doi":"10.23736/S1973-9087.24.08352-7","DOIUrl":"10.23736/S1973-9087.24.08352-7","url":null,"abstract":"<p><strong>Background: </strong>Significant progress and new insights have been gained since the Dutch Physical Therapy guideline on low back pain (LBP) in 2013 and the Cesar en Mensendieck guideline in 2009, necessitating an update of these guidelines.</p><p><strong>Aim: </strong>To update and develop an evidence-based guideline for the comprehensive management of LBP and lumbosacral radicular syndrome (LRS) without serious specific conditions (red flags) for Dutch physical therapists and Cesar and Mensendieck Therapists.</p><p><strong>Design: </strong>Clinical practice guideline.</p><p><strong>Setting: </strong>Inpatient and outpatient.</p><p><strong>Population: </strong>Adults with LBP and/or LRS.</p><p><strong>Methods: </strong>Clinically relevant questions were identified based on perceived barriers in current practice of physical therapy. All clinical questions were answered using published guidelines, systematic reviews, narrative reviews or systematic reviews performed by the project group. Recommendations were formulated based on evidence and additional considerations, as described in the Grading of Recommendations Assessment, Development and Evaluation (GRADE) Evidence-to-Decision framework. Patients participated in every phase.</p><p><strong>Results: </strong>The guideline describes a comprehensive assessment based on the International Classification of Functioning, Disability and Health (ICF) Core Set for LBP and LRS, including the identification of alarm symptoms and red flags. Patients are assigned to three treatment profiles (low, moderate and high risk of persistent symptoms) based on prognostic factors for persistent LBP. The guideline recommends offering simple and less intensive support to people who are likely to recover quickly (low-risk profile) and more complex and intensive support to people with a moderate or high risk of persistent complaints. Criteria for initiating and discontinuing physical therapy, and referral to a general practitioner are specified. Recommendations are formulated for information and advice, measurement instruments, active and passive interventions and behavior-oriented treatment.</p><p><strong>Conclusions: </strong>An evidence based physical therapy guideline for the management of patients with LBP and LRS without red flags for physical therapists and Cesar and Mensendieck therapists was developed. Cornerstones of physical therapy assessment and treatment are risk stratification, shared decision-making, information and advice, and exercises.</p><p><strong>Clinical rehabilitation impact: </strong>This guideline provides guidance for clinicians and patients to optimize treatment outcomes in patients with LBP and LRS and offers transparency for other healthcare providers and stakeholders.</p>","PeriodicalId":12044,"journal":{"name":"European journal of physical and rehabilitation medicine","volume":" ","pages":"292-318"},"PeriodicalIF":4.5,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11112513/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139971477","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":"Evidence-based position paper on Physical and Rehabilitation Medicine (PRM) professional practice on telerehabilitation. The European PRM position (UEMS PRM Section).","authors":"Mauro Zampolini, Aydan Oral, Nikolaos Barotsis, Catarina Aguiar Branco, Helena Burger, Paolo Capodaglio, Fitnat Dincer, Alessandro Giustini, Xiaolei Hu, Ingebjorg Irgens, Stefano Negrini, Piotr Tederko, Iuly Treger, Carlotte Kiekens","doi":"10.23736/S1973-9087.24.08396-5","DOIUrl":"10.23736/S1973-9087.24.08396-5","url":null,"abstract":"<p><strong>Introduction: </strong>The evidence on the utility and effectiveness of rehabilitation interventions delivered via telerehabilitation is growing rapidly. Telerehabilitation is expected to have a key role in rehabilitation in the future.</p><p><strong>Aim: </strong>The aim of this evidence-based position paper (EBPP) is to improve PRM physicians' professional practice in telerehabilitation to be delivered to improve functioning and to reduce activity limitations and/or participation restrictions in individuals with a variety of disabling health conditions.</p><p><strong>Methods: </strong>To produce recommendations for PRM physicians on telerehabilitation, a systematic review of the literature and a consensus procedure by means of a Delphi process have been performed involving the delegates of all European countries represented in the UEMS PRM Section.</p><p><strong>Results: </strong>The systematic literature review is reported together with the 32 recommendations resulting from the Delphi procedure.</p><p><strong>Conclusions: </strong>It is recommended that PRM physicians deliver rehabilitation services remotely, via digital means or using communication technologies to eligible individuals, whenever required and feasible in a variety of health conditions in favor of the patient and his/her family, based on evidence of effectiveness and in compliance with relevant regulations. This EBPP represents the official position of the European Union through the UEMS PRM Section and designates the professional role of PRM physicians in telerehabilitation.</p>","PeriodicalId":12044,"journal":{"name":"European journal of physical and rehabilitation medicine","volume":" ","pages":"165-181"},"PeriodicalIF":3.3,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11135123/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140109668","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":"Cognitive assessment to optimize prediction of functional outcome in subacute hip fracture: a short-term prospective study.","authors":"Marco DI Monaco, Maria Sgarbanti, Silvia Trombetta, Laura Gullone, Alessandra Bonardo, Patrizia Gindri, Carlotta Castiglioni, Francesca Bardesono, Edoardo Milano, Giuseppe Massazza","doi":"10.23736/S1973-9087.24.08203-0","DOIUrl":"10.23736/S1973-9087.24.08203-0","url":null,"abstract":"<p><strong>Background: </strong>Cognitive impairment is a long-known negative prognostic factor after hip fracture. Cognition is usually screened by a single easy-to-administer bedside tool, but recent studies have shown that screening tests may be not enough to rule out cognitive impairment with an unfavorable prognostic role. Unfortunately, data on outcome prediction by further cognitive assessments is sparse.</p><p><strong>Aim: </strong>We focused on patients with subacute hip fracture defined cognitively intact or mildly impaired on the screening evaluation performed by the Short Portable Mental Status Questionnaire (SPMSQ). We hypothesized that each of 3 further cognitive tests could independently predict activities of daily living, with optimal prediction of function obtained by performing all three the tests.</p><p><strong>Design: </strong>Short-term prospective study.</p><p><strong>Setting: </strong>Rehabilitation ward.</p><p><strong>Population: </strong>Inpatients with subacute hip-fracture.</p><p><strong>Methods: </strong>Three cognitive tests were performed on admission to rehabilitation in the patients who made ≤4 errors on the SPMSQ: Montreal Cognitive Assessment (MoCA), Rey Auditory Verbal Learning Test (RAVLT, immediate and delayed recall) and Frontal Assessment Battery (FAB). We assessed activities of daily living by the Barthel index. Successful rehabilitation was defined with a Barthel Index Score ≥85.</p><p><strong>Results: </strong>Each of the three cognitive tests assessed before rehabilitation significantly predicted the Barthel index scores measured at the end of the rehabilitation course in our sample of 280 inpatients. However, only the MoCA score retained its significant predictive role when the scores from the three tests were included together as independent variables in a multiple regression model, with adjustments for a panel of potential confounders (P=0.007). The adjusted odds ratio to achieve successful rehabilitation for a seven-point change in MoCA score was 1.98 (CI 95% from 1.02 to 3.83; P=0.042).</p><p><strong>Conclusions: </strong>Contrary to our hypothesis, MoCA but not RAVLT and FAB retained the prognostic role when the scores from the three tests were evaluated together as potential predictors of functional ability in activities of daily living.</p><p><strong>Clinical rehabilitation impact: </strong>In the presence of a normal (or mildly altered) score on the SPMSQ in subacute hip fracture, MoCA scores improve prediction of activities of daily living and should be routinely performed.</p>","PeriodicalId":12044,"journal":{"name":"European journal of physical and rehabilitation medicine","volume":" ","pages":"340-348"},"PeriodicalIF":4.5,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11112510/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140119147","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":"Walking test outcomes in adults with genetic neuromuscular diseases: a systematic literature review of their measurement properties.","authors":"Nawale Hadouiri, Isabelle Fournel, Christel Thauvin-Robinet, Agnès Jacquin-Piques, Paul Ornetti, Mathieu Gueugnon","doi":"10.23736/S1973-9087.24.08095-X","DOIUrl":"10.23736/S1973-9087.24.08095-X","url":null,"abstract":"<p><strong>Introduction: </strong>Neuromuscular diseases (NMDs) include a large group of heterogeneous diseases. NMDs frequently involve gait disorders, which affect quality of life. Several walking tests and tools have been described in the literature, but there is no consensus regarding the use of walking tests and tools in NMDs or of their measurement properties for walking outcomes. The aim of this review is to present an overview of walking tests, including their measurement properties when used in adults with inherited or genetic NMDs. The aim is to help clinicians and researchers choose the most appropriate test for their objective.</p><p><strong>Evidence acquisition: </strong>A systematic review was conducted after consulting MEDLINE (via PubMed), EMBASE, Science direct, Google Scholar and Cochrane Central Register of Controlled Trials databases for published studies in which walking outcome measurement properties were assessed. The validity, reliability, measurement error and responsiveness properties were evaluated in terms of statistical methods and methodological design qualities using the COnsensus-based Standards for the selection of health Measurement Instruments (COSMIN) guidelines.</p><p><strong>Evidence synthesis: </strong>We included 46 studies in NMDs. These studies included 15 different walking tests and a wide variety of walking outcomes, assessed with six types of walking tools. Overall, the 6MWT was the most studied test in terms of measurement properties. The methodological design and statistical methods of most studies evaluating construct validity, reliability and measurement error were \"very good.\" The majority of outcome measurements were valid and reliable. However, studies on responsiveness as minimal important difference or minimal important change were lacking or were found to have inadequate methodological and statistical methods according to the COSMIN guidelines.</p><p><strong>Conclusions: </strong>Most walking outcomes were found to be valid and reliable in NMDs. However, in view of the growing number of clinical trials, further studies are needed to clarify additional measurement properties.</p>","PeriodicalId":12044,"journal":{"name":"European journal of physical and rehabilitation medicine","volume":" ","pages":"257-269"},"PeriodicalIF":4.5,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11114158/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139650590","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":"Safety of dry needling in stroke patients: a scoping review.","authors":"Iris Malfait, Sabien Gijsbers, Annemie Smeets, Britta Hanssen, Anton Pick, Koen Peers, Fabienne Schillebeeckx","doi":"10.23736/S1973-9087.24.08224-8","DOIUrl":"10.23736/S1973-9087.24.08224-8","url":null,"abstract":"<p><strong>Introduction: </strong>Spasticity is a common problem in stroke patients. Treatments of spasticity often have side effects or are insufficiently effective. Dry needling (DN) has been proposed as a potential additional option to consider in the multimodal treatment of post-stroke spasticity, although questions about its safety remain. The goal of this study is to assess the safety of DN in stroke patients.</p><p><strong>Evidence acquisition: </strong>A systematic search in Medline, Embase, The Cochrane Library, Web of Science, CIHNAL and PEDro was conducted in June 2023. Two reviewers independently screened abstracts according to the eligibility criteria.</p><p><strong>Evidence synthesis: </strong>Twenty-five articles were included in this review. Only six studies reported adverse events, all of which were considered minor. None of the included studies reported any serious adverse events. In four of the included studies anticoagulants were regarded as contra-indicative for DN. Anticoagulants were not mentioned in the other included studies.</p><p><strong>Conclusions: </strong>There is a paucity of literature concerning the safety of DN in stroke patients. This review is the first to investigate the safety of DN in stroke patients and based on the results there is insufficient evidence regarding the safety of DN in stroke patients.</p><p><strong>Clinical rehabilitation impact: </strong>Although DN could be a promising treatment in post-stroke spasticity, further research is indicated to investigate its mechanism of action and its effect on outcome. However, before conducting large clinical trials to assess outcome parameters, the safety of DN in stroke patients must be further investigated.</p>","PeriodicalId":12044,"journal":{"name":"European journal of physical and rehabilitation medicine","volume":" ","pages":"225-232"},"PeriodicalIF":3.3,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11114159/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140179512","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":"Exercise-based cardiac rehabilitation for patients with coronary heart disease: a systematic review and evidence mapping study.","authors":"Zijun Li, Ke Guo, Yongqi Yang, Yuxi Shuai, Rui Fan, Yanfei Li, Jiawei DU, Junqiang Niu, Kehu Yang","doi":"10.23736/S1973-9087.23.08165-0","DOIUrl":"10.23736/S1973-9087.23.08165-0","url":null,"abstract":"<p><strong>Introduction: </strong>Exercise-based cardiac rehabilitation (CR) plays a critical role in coronary heart disease (CHD) management. There is a heritage in the effect of exercise-based CR with different exercise programs or intervention settings. This study developed an evidence matrix that systematically assesses, organizes, and presents the available evidence regarding exercise-based CR in CHD management.</p><p><strong>Evidence acquisition: </strong>A comprehensive literature search was conducted across six databases. Two reviewers screened the identified literature, extracted relevant data, and assessed the quality of the studies. An evidence-mapping framework was established to present the findings in a structured manner. Bubble charts were used to represent the included systematic reviews (SRs). The charts incorporated information, exercise prescriptions, outcome indicators, associated P values, research quality, and the number of original studies. A descriptive analysis summarized the types of CR, intervention settings, influential factors, and adverse events.</p><p><strong>Evidence synthesis: </strong>Sixty-two SRs were included in this analysis, focusing on six exercise types in addition to assessing major adverse cardiovascular events (MACE), cost and rehabilitation outcomes. The most commonly studied exercise types were unspecified (28 studies, 45.2%) and aerobic (11 studies, 17.7%) exercises. All-cause mortality was the most frequently reported MACE outcome (22 studies). Rehabilitation outcomes primarily centered around changes in cardiac function (135 outcomes from 39 SRs). Only 8 (12.9%) studies were rated as \"high quality.\" No significant adverse events were observed in the intervention group. Despite some variations among the included studies, most SRs demonstrated the benefits of exercise in improving one or more MACE or rehabilitation outcomes among CHD patients.</p><p><strong>Conclusions: </strong>The proportion of high-quality evidence remains relatively low. Limited evidence is available regarding the effectiveness of specific exercise types and specific populations, necessitating further evaluation.</p>","PeriodicalId":12044,"journal":{"name":"European journal of physical and rehabilitation medicine","volume":" ","pages":"361-372"},"PeriodicalIF":3.3,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11112512/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139722188","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":"Mirror visual feedback as therapeutic modality in unilateral upper extremity complex regional pain syndrome type I: randomized controlled trial.","authors":"Stanislav Machač, Ludmila Chasáková, Soroush Kakawand, Jiří Kozák, Lubomír Štěpánek, Jan Vejvalka, Pavel Kolář, Rudolf Černý","doi":"10.23736/S1973-9087.23.07625-6","DOIUrl":"10.23736/S1973-9087.23.07625-6","url":null,"abstract":"<p><strong>Background: </strong>There is growing evidence for the effectiveness of mirror therapy (MT) on pain reduction in patients with type I complex regional pain syndrome (CRPS I).</p><p><strong>Aim: </strong>To evaluate the efficacy of MT on pain reduction and hand function in subjects with unilateral upper extremity CRPS I.</p><p><strong>Design: </strong>Randomized controlled trial with control group cross-over (half cross-over design).</p><p><strong>Setting: </strong>Subjects with CRPS I were outpatients of a university hospital and cooperating centers. All patients carried out the daily exercise at home.</p><p><strong>Population: </strong>Subjects with unilateral upper extremity CRPS I meeting the Budapest diagnostic criteria.</p><p><strong>Methods: </strong>Subjects were randomly divided into two groups. Group A (N.=13) carried out a ten-minute MT exercise daily, for a total duration of six weeks. Group B (N.=14) acted as a control group for six weeks followed by six weeks of MT with the same characteristics as Group A. Upper extremity active range of motion, strength, dexterity, limb volume, affected-to-unaffected hand temperature difference, and health-related quality of life were evaluated before and after each period. Daily records on the visual analogue scale were used for pain evaluation. Effectiveness was calculated using mixed-effects modelling for between-group comparisons and within-group variability, and identification of significant predictors.</p><p><strong>Results: </strong>Twenty-three females and four males with an average age of 56.1±9.6 years completed the study. Except for the affected-to-unaffected hand temperature difference, both groups consistently demonstrated significant or near-significant improvements in measured parameters after MT period. The improvements were evident upon an intergroup comparison of Group A and the control period of Group B as well as longitudinally within Group B. No significant improvement was found during the control period.</p><p><strong>Conclusions: </strong>Principles focused on mirror visual feedback to the central nervous system can sustain promising therapeutic potential as part of the treatment for pain reduction and hand function in CRPS I patients.</p><p><strong>Clinical rehabilitation impact: </strong>MT can be considered as part of the therapeutic regimen employed for the treatment of CRPS I.</p>","PeriodicalId":12044,"journal":{"name":"European journal of physical and rehabilitation medicine","volume":" ","pages":"280-291"},"PeriodicalIF":4.5,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11112506/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139402499","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}