European journal of physical and rehabilitation medicine最新文献

{"title":"Comment on: \"Intensive bracing management combined with physiotherapeutic scoliosis-specific exercises for adolescent idiopathic scoliosis patients with a major curve ranging from 40-60° who refused surgery: a prospective cohort study\".","authors":"Tuğba Kuru Çolak, Burçin Akçay, Elif Elçin Dereli, İlker Çolak","doi":"10.23736/S1973-9087.24.08395-3","DOIUrl":"10.23736/S1973-9087.24.08395-3","url":null,"abstract":"","PeriodicalId":12044,"journal":{"name":"European journal of physical and rehabilitation medicine","volume":"60 3","pages":"544-545"},"PeriodicalIF":3.3,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11258904/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141579293","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":"Post-polio syndrome is not a dysimmune condition.","authors":"Isabelle Laffont, Claire Duflos, Christophe Hirtz, Karima Bakhti, Anthony Gelis, Claire Palayer, Valérie Macioce, Marion Soler, Fanny Pradalier, Florence Galtier, Alexandre Jentzer, Claire Lozano, Thierry Vincent, Raul J Morales","doi":"10.23736/S1973-9087.23.08158-3","DOIUrl":"10.23736/S1973-9087.23.08158-3","url":null,"abstract":"<p><strong>Background: </strong>Poliomyelitis is a global disabling disease affecting 12-20 million of people. Post poliomyelitis syndrome (PPS) may affect up to 80% of polio survivors: increased muscle weakness, pain, fatigue, functional decline. It relies on aging of an impaired neuro-muscular system with ongoing denervation processes. A late involvement of humoral or cellular pro-inflammatory phenomena is also suspected.</p><p><strong>Aim: </strong>To assess the dysimmune hypothesis of PPS by comparing lymphocyte subpopulations and humoral immune factors between PPS patients and controls.</p><p><strong>Design: </strong>Cross-sectional study.</p><p><strong>Setting: </strong>Montpellier University Hospital.</p><p><strong>Population: </strong>Forty-seven PPS and 27 healthy controls.</p><p><strong>Methods: </strong>PPS patients and controls were compared on their lymphocyte subpopulations and humoral immune factors (IL-1β, IL-6, IL-8, IL-17, IL-21, IL-22, IL-23, IFN-γ, TNF-α, GM-CSF, RANTES, MCP1, MIP-3a, IL-10, TGF-β, IL4, IL13). Patients were further compared according to their dominant clinical symptoms. Sample size guaranteed a power >90% for all comparisons.</p><p><strong>Results: </strong>PPS patients and controls were comparable in gender, age and corpulence. Most patients had lower limb motor sequelae (N.=45, 95.7%), a minority had upper limb motor impairment (N.=16, 34.0%). Forty-five were able to walk (94%), 35/45 with technical aids. The median of the two-minute walking test was 110 meters (interquartile range 55; 132). Eighteen (38%) required help in their daily life. Their quality of life was low (SF36). All described an increased muscular weakness, 40 (85%) a general fatigue, and 39 (83%) muscular or joint pain. Blood count, serum electrolytes, T and B lymphocyte subpopulations and cytokines were comparable between patients and controls, except for creatine phospho kinase that was significantly higher in PPS patients. None of these variables differed between the 20/47 patients whose late main symptoms were pain or fatigue, and other patients.</p><p><strong>Conclusions: </strong>Our results suggest that PPS is not a dysimmune disease.</p><p><strong>Clinical rehabilitation impact: </strong>Our results do not sustain immunotherapy for PPS. Our work suggest that PPS may be mostly linked to physiological age-related phenomena in a disabled neuromuscular condition. Thus, our results emphasize the role of prevention and elimination of aggravating factors to avoid late functional worsening, and the importance of rehabilitation programs that should be adapted to patients' specific conditions.</p>","PeriodicalId":12044,"journal":{"name":"European journal of physical and rehabilitation medicine","volume":" ","pages":"270-279"},"PeriodicalIF":4.5,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11112507/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139511780","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":"Physical and Rehabilitation Medicine: say relational or functional, not holistic.","authors":"Luigi Tesio, Stefano Scarano, Antonio Caronni","doi":"10.23736/S1973-9087.24.08309-6","DOIUrl":"10.23736/S1973-9087.24.08309-6","url":null,"abstract":"<p><p>Modern medicine tends to privilege disciplines promising \"objective\" laws governing body parts (from molecules to organs). Studies on a person's illness and disability are (apparently) confined to \"subjectivity.\" The Specialty of Physical and Rehabilitation Medicine is often regarded as a humanitarian approach, belonging at best to the family of \"soft,\" \"qualitative,\" or \"quasi-experimental\" sciences. This specialty often claims specificity by labelling itself as \"functional\" and \"holistic.\" However, it is shown here that the former term is acceptable, yet redundant, and the second misleading. When human behaviors and perceptions are at stake, \"function\" indicates a person's relationship with the outer world (already tackled by the definitional term \"physical\" from the Greek \"physis\"). The word \"holistic\" emphasizes mind-body unity and person-environment interdependence but, in current usage, overshadows the complementary need for an analytic, experimental approach to any function. Medicine aims at fighting disease and disability in single persons. This endeavor requires knowing body parts and mechanisms and understanding how interventions on \"parts\" affect the \"whole.\" This understanding rests on the experimental method. For instance, returning to a given societal role (participation) may require restoration of walking (activity), which may require reinforcement of weakened muscular groups (impairment). Working only on holistic bio-psycho-social \"wholes\" may miss the therapeutic mission of medicine.</p>","PeriodicalId":12044,"journal":{"name":"European journal of physical and rehabilitation medicine","volume":" ","pages":"182-189"},"PeriodicalIF":4.5,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11135122/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140119148","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":"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}