Frontiers in rehabilitation sciences最新文献

{"title":"Implementing psychosocial guidelines into specialized spinal cord injury rehabilitation services to strengthen person-centred health care: protocol for a mixed methods study.","authors":"Candice McBain, Anne Marie Sarandrea, Ilaria Pozzato, Mohit Arora, Daniel Myles, John Bourke, Yvonne Tran, Ian D Cameron, James W Middleton, Ashley Craig","doi":"10.3389/fresc.2025.1537890","DOIUrl":"https://doi.org/10.3389/fresc.2025.1537890","url":null,"abstract":"<p><strong>Background: </strong>Spinal cord injury (SCI) is a severe neurological disorder resulting in loss of movement and altered sensation with lifelong impacts on health, function, and social integration. Multidisciplinary SCI rehabilitation primarily focuses on enhancing function and independence while simultaneously managing secondary health conditions and providing psychosocial support. Therefore, a major goal in SCI rehabilitation should be strengthening patients' capacity to cope with and adjust to challenges they encounter. Using a mixed methods design, the primary aim of this study is to integrate psychosocial guidelines that promote psychological adjustment into SCI rehabilitation, and second, to evaluate facilitators and barriers to their successful implementation.</p><p><strong>Methods: </strong>To determine perceived depth of knowledge, beliefs, and attitudes about psychosocial care, and usage of psychosocial guidelines, healthcare professionals in the three specialist SCI services in New South Wales, Australia will be invited to complete a baseline survey. Following the survey, semi-structured one-to-one interviews and focus groups will be conducted with healthcare professionals representing different health disciplines to understand the context and generate ideas about how best to integrate these guidelines into clinical practice. Based on the surveys, interviews, and focus groups, an implementation intervention employing educational strategies, structural, and nudge (behavioural change) approaches will be designed and implemented over a period of 18-months to facilitate integration of the guidelines into the SCI services. A post-intervention survey with healthcare workers will then be conducted. Focus groups from each SCI service, with representation across the different healthcare professions, will also be conducted to identify facilitators and barriers to implementing the guidelines. Success of implementation will be determined by analyzing any shifts in perceived knowledge, attitudes, and behaviour of staff and cultural/structural processes observed through comparing baseline and post-intervention qualitative and quantitative data. To capture lived experience insight, 10 patients with SCI currently undergoing rehabilitation will be interviewed.</p><p><strong>Discussion: </strong>This study will establish the success of implementing psychosocial guidelines into three specialist SCI services. It is hypothesized that constructive changes will occur in the knowledge, attitudes, and behaviour of the SCI Unit healthcare professionals, leading to improved psychosocial practices and patient outcomes that will strengthen person-centred healthcare in SCI rehabilitation. This study has been retrospectively registered with the Australian New Zealand Clinical Trials Registry on the 7th of May 2024. The registration number is: ACTRN12624000581561.</p>","PeriodicalId":73102,"journal":{"name":"Frontiers in rehabilitation sciences","volume":"6 ","pages":"1537890"},"PeriodicalIF":1.3,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12009950/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medical accessibility and underreporting of occupational diseases: effect of travel distance and travel time.","authors":"Ping Hui Chen, Po-Ching Chu, Ching-Chun Huang, Chi-Hsien Chen, Yue Leon Guo, Ta-Chen Su, Pau-Chung Chen","doi":"10.3389/fresc.2025.1545460","DOIUrl":"https://doi.org/10.3389/fresc.2025.1545460","url":null,"abstract":"<p><strong>Objectives: </strong>Underreporting of occupational diseases (ODs) could be attributed to poor medical accessibility, which is rarely discussed previously. Our cross-sectional study aims to evaluate how OD reporting is impeded by long travel distance/time (TD/TT) to the nearest major occupational medicine clinics.</p><p><strong>Methods: </strong>Using data from the Network of Occupational Diseases and Injuries Service (NODIS), Taiwan's OD surveillance system, and the annual Manpower Survey from 2008 to 2018, we calculate each district's incidence rate of ODs (IROD) and expected IROD based on industries and job titles. Each town's TD/TT to the nearest major occupational medicine clinics is estimated by Google Maps' Distance Matrix API. The quasi-Poisson regression model is used to investigate the effect of TD and TT on IROD, while industries and job titles are adjusted by offsetting expected IROD. A subgroup analysis is then carried out to check the effect of employment status, sickness absence, and reporting years.</p><p><strong>Results: </strong>A total of 3,420 cases of definite ODs are included in our study. Using the quasi-Poisson regression model, after adjusting industry types and job titles, TD and TT have a significant effect on IROD. As TD/TT increases by 10 km/10 min, IROD decreases by 10.90%/10.73%. It is estimated that ∼200 OD cases per year or 40% of ODs are therefore underreported. In the subgroup analysis, only mildly sick workers are still significantly affected by TD and TT.</p><p><strong>Conclusions: </strong>Our study shows how poor medical accessibility leads to underreporting, especially for mildly sick cases, and up to 40% of ODs could be underreported. Using this method, we can evaluate the cost-effectiveness of adding reporting hospitals in areas with poor medical accessibility.</p>","PeriodicalId":73102,"journal":{"name":"Frontiers in rehabilitation sciences","volume":"6 ","pages":"1545460"},"PeriodicalIF":1.3,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12010169/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resilience and adaptations-insights from Norwegian adolescents with pediatric-onset spinal cord injury.","authors":"Wiebke Höfers, Kirsti Riiser, Vivien Jørgensen, Solveig L Hauger, Kirsti Skavberg Roaldsen","doi":"10.3389/fresc.2025.1526431","DOIUrl":"https://doi.org/10.3389/fresc.2025.1526431","url":null,"abstract":"<p><strong>Introduction: </strong>Pediatric-onset spinal cord injuries (SCIs) significantly impact adolescents' psychosocial and physical developments, posing unique challenges during a critical period of identity formation and progression toward independence. Despite the rarity of pediatric SCIs, the need for understanding how adolescents adapt to their SCIs is crucial. Thus, the aims of this study were to examine and describe the adaption and returning to daily life of adolescents with pediatric-onset SCIs.</p><p><strong>Methods: </strong>Eight adolescents (4 boys and 4 girls) with SCIs who were aged 11-16 years at the time of the injury were interviewed individually 1-6 years post injury using a semi-structured, strength-based thematic interview guide. The interviews were conducted face-to-face (<i>n</i> = 6) or digitally (<i>n</i> = 2). A thematic analysis was used to identify key themes in the transcribed data.</p><p><strong>Results: </strong>Three key themes were identified. Theme 1, \"integrating into social life,\" highlighted the importance of supportive social networks, with peers and family playing crucial roles. Theme 2, \"finding an identity as an adolescent,\" underscored the impact of the disability on the adolescent's identity and pursuit of independence. Theme 3, \"gaining a sense of control in life,\" illustrated strategies for self-care, socializing, and managing physical and psychological challenges.</p><p><strong>Discussion: </strong>The adolescents in this study who had pediatric-onset SCI demonstrated resilience, adaptability, and agency in navigating social integration, identity formation, and regaining control over their lives. This study emphasizes the importance of social networks and the desire for autonomy in daily life. The participants' experiences suggest an improvement in their involvement in making decisions concerning themselves and a need to inform health-care professionals and improve support for adolescents during and after rehabilitation.</p>","PeriodicalId":73102,"journal":{"name":"Frontiers in rehabilitation sciences","volume":"6 ","pages":"1526431"},"PeriodicalIF":1.3,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12003419/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144063453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of manual and semi-automated algorithm for measuring architectural features during different isometric knee extension intensities: a reliability and comparative study in novice raters.","authors":"Micheal J Luera, JoCarol E Shields, Emma Bozarth, Rob J MacLennan, Natalie P Walker, Jesus A Hernandez-Sarabia, Carlos A Estrada, Jason M DeFreitas, Scott K Crawford","doi":"10.3389/fresc.2025.1539804","DOIUrl":"https://doi.org/10.3389/fresc.2025.1539804","url":null,"abstract":"<p><strong>Introduction: </strong>Ultrasound is a cost-effective and reliable method to determine skeletal muscle architecture. However, manual analysis of fascicle length (FL) and pennation angle (PA) can be arduous and subjective among raters, particularly among novice raters. Alternatives to manual processing have been proposed that expedite the evaluation of muscle architecture and afford more consistency. While using algorithms has provided dependable results of muscle architecture, it has often focused on variables of passive range of motion and submaximal contractions. To fully understand the impact of muscle architecture using semi-automated analysis, an investigation of a broad range of contraction intensities is needed. The purpose of this study was to develop and determine the intra-rater and inter-rater reliability of a custom, semi-automated algorithm to extract measures of muscle thickness, pennation angle, and fascicle length, and second to compare the semi-automated measures to measures extracted manually from the same novice raters while accounting for differences between contraction intensities.</p><p><strong>Methods: </strong>Fifteen resistance-trained individuals (male: <i>n</i> = 6, female: <i>n</i> = 9) completed this study. Images were collected during four contraction intensities relative to maximal voluntary isometric contractions (MVIC) (at rest, 30%, 70%, and MVIC) and analyzed by three novice raters to compare the semi-automated algorithm and manual measurement in the vastus lateralis.</p><p><strong>Results: </strong>Intra-rater reliability for manual measures was poor for FL (ICCs: 0-0.30), poor to good for PA (ICCs: 0.46-0.77), and moderate to good for muscle thickness (MT) (ICCs: 0.55-0.84). For the semi-automated algorithm, the intra-rater reliability was good to excellent for FL (range: 0.90-0.99), PA (range: 0.88-0.99), and MT (range: 0.996-0.999) across all contraction intensities.</p><p><strong>Discussion: </strong>The findings of this study suggest that the reliability of manual measurement is lower when novice raters perform image analyses compared to the semi-automated method. Therefore, careful consideration and training should be provided when considering manual assessment of muscle architecture values, and standardized identification methods and features in algorithm development may be a better method for reproducibility.</p>","PeriodicalId":73102,"journal":{"name":"Frontiers in rehabilitation sciences","volume":"6 ","pages":"1539804"},"PeriodicalIF":1.3,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12003410/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and evaluation of Goal setting and Action Planning (G-AP) training to support person-centred rehabilitation practice.","authors":"Lesley Scobbie, Katie Elliott, Sally Boa, Lynn Grayson, Emily Chesnet, Iona Izat, Mark Barber, Rebecca Fisher","doi":"10.3389/fresc.2025.1505188","DOIUrl":"https://doi.org/10.3389/fresc.2025.1505188","url":null,"abstract":"<p><strong>Background: </strong>Stroke survivor's goals reflect their individual priorities and hopes for the future. Person-centred goal setting is recommended in rehabilitation clinical guidelines, but evidence-based training to support its implementation in practice is limited. We aimed to develop, describe and evaluate a new Goal setting and Action Planning (G-AP) rehabilitation training resource to support person-centred goal setting practice in community neuro-rehabilitation settings.</p><p><strong>Methods: </strong>A clinical-academic team, advisory group and web-design company were convened to co-develop the G-AP training resource. G-AP training was then delivered to multi-disciplinary staff (<i>n</i> = 48) in four community neuro-rehabilitation teams. A mixed methods evaluation utilising a staff questionnaire and focus group discussion was conducted to investigate staff experiences of G-AP training and their early G-AP implementation efforts. Questionnaire data were analysed descriptively; focus group data were analysed using a Framework approach. An integrated conceptual overview of data was developed to illustrate findings.</p><p><strong>Results: </strong>A fully online G-AP training resource comprising a training website and two interactive webinars was developed. Following training, 41/48 (85%) staff completed the online questionnaire and 8/48 (17%) participated in the focus group. Nearly all staff rated the training website as excellent (<i>n</i> = 25/40; 62%) or good (<i>n</i> = 14/40; 35%) and the webinars as excellent (<i>n</i> = 26/41; 63%) or good (<i>n</i> = 14/41; 34%). Following training, staff agreed they were knowledgeable about G-AP (37/41; 90%) and had the confidence (35/40; 88%) and skills (35/40; 88%) to use it in practice. Within one month of training, staff described implementing G-AP individually, but transitioning to implementation at a team level required more time to develop new working practices. Team context including staff beliefs about G-AP, leadership support and competing demands impacted (positively and negatively) on staff training engagement, learning experience and implementation efforts.</p><p><strong>Conclusions: </strong>The new G-AP training resource was positively evaluated and supported early G-AP implementation efforts. This study advances our understanding of training evaluation by highlighting the training-context interaction the temporal nature of training effects. A follow up study evaluating longer term G-AP implementation is underway.</p>","PeriodicalId":73102,"journal":{"name":"Frontiers in rehabilitation sciences","volume":"6 ","pages":"1505188"},"PeriodicalIF":1.3,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11994713/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144045843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Establishment of emerging practices and research priorities for telerehabilitation in solid organ transplantation: meeting report and narrative literature review.","authors":"Dmitry Rozenberg, Sherrie Logan, Sahar Sohrabipour, Nicholas Bourgeois, Anita Cote, Robin Deliva, Astrid De Souza, Rienk de Vries, Maoliosa Donald, Manoela Ferreira, Donna Hart, Megha Ibrahim Masthan, Tania Jaundis-Ferreira, Sandrine Juillard, Michael Khoury, Afsana Lallani, Diana Mager, Istvan Mucsi, Ani Orchanian-Cheff, Jennifer L Reed, Puneeta Tandon, Karthik Tennankore, Elaine Yong, Lisa Wickerson, Sunita Mathur","doi":"10.3389/fresc.2025.1535138","DOIUrl":"https://doi.org/10.3389/fresc.2025.1535138","url":null,"abstract":"<p><p>Solid organ transplantation (SOT) is a life-saving procedure for those with end-stage organ dysfunction. The main goals of SOT are to improve quality of life and daily function, which are supported by pre- and post-transplant rehabilitation. In-person rehabilitation programs have traditionally been the standard-of-care for delivering rehabilitation for SOT patients. Many programs have adopted a virtual delivery model [telerehabilitation (TR)], an approach that has become increasingly used given restrictions to in-person delivery during the COVID-19 pandemic. Presently, TR programs are being used both clinically and in research with variable practices. A 2-day virtual meeting held in February 2023 brought together over 30 Canadian adult and pediatric researchers, clinicians, and patient and family partners across SOT. The meeting objectives were: (1) To facilitate knowledge exchange and dialogue in TR between patient partners, healthcare professionals, researchers, and key stakeholders, and (2) Identify gaps in clinical practice and research in TR. The discussion focused on delivery methods of TR, digital tools, facilitators and barriers of TR, and the effects of TR on physical and mental health in both adult and pediatric populations. This meeting report incorporates a narrative literature review of SOT and rehabilitation articles in the last 20 years. Future directions in TR are highlighted leading to the development of key research priorities targeted towards improved delivery of TR in SOT patients.</p>","PeriodicalId":73102,"journal":{"name":"Frontiers in rehabilitation sciences","volume":"6 ","pages":"1535138"},"PeriodicalIF":1.3,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11985446/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143999481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physical exercise for primary sarcopenia: an expert opinion.","authors":"Antimo Moretti, Federica Tomaino, Marco Paoletta, Sara Liguori, Silvia Migliaccio, Mariangela Rondanelli, Angelo Di Iorio, Raffaello Pellegrino, Davide Donnarumma, Daniele Di Nunzio, Giuseppe Toro, Francesca Gimigliano, Maria Luisa Brandi, Giovanni Iolascon","doi":"10.3389/fresc.2025.1538336","DOIUrl":"https://doi.org/10.3389/fresc.2025.1538336","url":null,"abstract":"<p><p>Sarcopenia is the age-related loss of skeletal muscle mass and function. Recently, research has focused on defining diagnostic criteria for this condition, now recognized as a muscle disease with a specific identifying code (ICD-10: M62.84). The diagnostic process for sarcopenia involves several stages, including the use of dedicated questionnaires and objective measurements of muscle strength and mass. According to international guidelines, therapeutic exercise is recommended to improve muscle mass, muscle strength, and physical performance. However, much of the supporting evidence comes from studies on non-sarcopenic elderly patients. Among types of therapeutic exercise, guidelines mainly emphasize muscle strengthening. The prescription of therapeutic exercise must consider the clinical and functional conditions of the patient (e.g., the presence of severe sarcopenia) and patient preferences. Muscle strengthening should target large muscle groups and include low-intensity resistance exercise for strength improvement, or high-intensity resistance exercise for additional benefits in muscle mass and function. Evidence suggests that an ideal therapeutic exercise program for sarcopenic patients should be multimodal, incorporating muscle strengthening, aerobic exercise, and balance control programs. This approach could enhance patient adherence by offering variety. Although multimodal therapeutic exercise improves muscle mass and function, these benefits can be lost during prolonged physical inactivity. Therefore, the exercise prescription must define intensity, volume (repetitions and sets), frequency, rest intervals, and duration, tailored to the type of exercise. Aerobic training programs improve endurance and optimize mitochondrial function. Balance training, important for reducing the risk of falls, should be done at least three times a week. Muscle strengthening should be done at least two days a week, starting at 50%-60% of 1 repetition maximum (RM) and progressing to 60%-80% of 1 RM, with approximately 10 exercises per session. Adopting comprehensive prescription protocols, such as those proposed in this paper, can significantly aid in the functional recovery and well-being of patients with sarcopenia.</p>","PeriodicalId":73102,"journal":{"name":"Frontiers in rehabilitation sciences","volume":"6 ","pages":"1538336"},"PeriodicalIF":1.3,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11985514/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143999403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A seated virtual exercise program to improve cardiovascular function in adults with chronic neurological impairments: a randomized controlled trial.","authors":"Devina S Kumar, Amy Bialek, Ayushi A Divecha, Rachel M Garn, Lydia E J Currie, Kathleen M Friel","doi":"10.3389/fresc.2025.1477969","DOIUrl":"https://doi.org/10.3389/fresc.2025.1477969","url":null,"abstract":"<p><strong>Background: </strong>Individuals with chronic neurological impairments often face significant barriers to regular exercise such as limited access to facilities, transportation challenges, and safety concerns. Tele-exercise has emerged as a potential solution to these challenges, particularly in the context of the COVID-19 pandemic. This study aimed to investigate the effects of a seated home-based tele-exercise regimen on cardiovascular function in adults with chronic neurological impairments.</p><p><strong>Methods: </strong>In this virtual randomized controlled trial, 63 participants with Chronic Neurological Impairments were randomized into either a synchronous group that attended live online exercise sessions via Zoom, or an asynchronous group that accessed pre-recorded exercise sessions. Both groups completed three 45 min sessions per week focused on moderate to high-intensity seated exercises over 12 weeks. Primary outcomes including Heart Rate (HR) Recovery (HRR), HR at Rest (HR Rest) and HR at peak exercise (HR Max) were averaged across three sessions at baseline, mid-study, and end of study. Secondary outcomes, including satisfaction with the equipment and virtual format were assessed using custom-designed surveys, while exercise motivation, enjoyment, and quality of life were measured using standardized instruments.</p><p><strong>Results: </strong>The analysis of HRR across the pre (<i>p</i> = 0.57), mid (<i>p</i> = 0.7), and post time points (<i>p</i> = 0.61) revealed no statistically significant differences between the synchronous and asynchronous groups. HR Rest and HR Max did not change over time. The synchronous group showed higher exercise motivation compared to the asynchronous group (<i>p</i> = 0.0001). Satisfaction with the virtual format was high, with 90% of participants reporting satisfaction with the use of the Polar heart rate monitor and 84% with Zoom.</p><p><strong>Conclusion: </strong>While no significant cardiovascular improvements were observed, the study highlights the feasibility of a virtual, seated exercise program for individuals with chronic neurological impairments. The higher reported exercise motivation in the synchronous group suggests that live, interactive sessions may be more engaging for participants. These findings underscore the potential of tele-exercise programs to provide accessible, home-based interventions, though further research is necessary to assess their long-term impact on cardiovascular health and overall well-being.</p><p><strong>Clinical trial registration: </strong>identifier (NCT04564495).</p>","PeriodicalId":73102,"journal":{"name":"Frontiers in rehabilitation sciences","volume":"6 ","pages":"1477969"},"PeriodicalIF":1.3,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11979118/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143993750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case Report: Robot-assisted gait training with the wearable cyborg hybrid assistive limb 2S size in three children with cerebral palsy.","authors":"Kazushi Takahashi, Hirotaka Mutsuzaki, Tomohiro Nakayama, Mayumi Matsuda Kuroda, Kazunori Koseki, Kenichi Yoshikawa, Junko Nakayama, Haruka Oguro, Ryoko Takeuchi, Masafumi Mizukami, Hiroki Watanabe, Aiki Marushima","doi":"10.3389/fresc.2025.1545105","DOIUrl":"10.3389/fresc.2025.1545105","url":null,"abstract":"<p><strong>Introduction: </strong>Recently, robot-assisted gait training (RAGT) has attracted attention as a rehabilitation method to efficiently improve walking function. The purpose of this case report is to examine whether there is a change in gait function after RAGT with HAL in children with cerebral palsy (CP).</p><p><strong>Methods: </strong>Three children with CP participated in this study. Case 1 was an 8-year-old boy with Gross Motor Function Classification System (GMFCS) level II. Case 2 involved a 9-year-old girl with a class IV GMFCS. Case 3 was that of a 10-year-old boy with class IV GMFCS. RAGT was conducted once a day for 20 min for a total of 11-12 sessions. Gait was assessed before and after RAGT. We assessed using three-dimensional motion analysis and surface electromyography (sEMG). The sEMG signals were recorded from the bilateral tensor fascia lata, gluteus maximus, semitendinosus, and rectus femoris.</p><p><strong>Results: </strong>All cases showed changes in the joint angle and muscle activity in the lower limbs before and after RAGT. In Case 1, the maximum hip extension angle increased from -10.6° to -4.1° at the terminal stance, and the average muscle activity of the gluteus maximus in the right stance phase increased from 22.4% to 30.2%. In Case 2, the maximum extension angle of the left knee joint increased from -43.0° to -26.9°. In Case 3, the maximum hip extension angle increased from -39.9° to -25.9° on the left side and from -35.1° to -18.7° on the right side; the maximum knee extension angle increased from -55.7° to -38.8° on the left side and from -52.1° to -36.9° on the right side.</p><p><strong>Discussion: </strong>A Case 1 had significant hip flexion during gait, but RAGT with HAL emphasized hip extension motion and enabled an efficient gait. As a result, the maximum hip extension angle increased, and the activity of the gluteus maximus muscle in the stance phase increased. Cases 2 and 3 had greater hip and knee joint flexion angles, however increased knee extension angles after RAGT. The increased hip and knee joint extension angles during the stance phase increased the propulsive force propelling the walker forward.</p>","PeriodicalId":73102,"journal":{"name":"Frontiers in rehabilitation sciences","volume":"6 ","pages":"1545105"},"PeriodicalIF":1.3,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11973097/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inducing asymmetric gait in healthy walkers: a review.","authors":"Gert Van Der Velde, Henri Laloyaux, Renaud Ronsse","doi":"10.3389/fresc.2025.1463382","DOIUrl":"10.3389/fresc.2025.1463382","url":null,"abstract":"<p><p>Gait symmetry between both legs is a typical hallmark of healthy walking. In contrast, several pathologies induce asymmetry in the gait pattern, regarding both spatial and temporal features. This can be due to either an asymmetrical change of the body morphology-e.g., after an amputation or an injury-or a damage in the brain-such as stroke or cerebral palsy. This deficit in gait symmetry usually induces higher metabolic effort in locomotion and might further accelerate severe comorbidities such as osteoarthritis and low back pain. Consequently, several assistive devices-such as active exoskeletons or prostheses-are currently developed to mitigate gait asymmetry and restore a healthier gait pattern. Typically, the development of such devices requires extensive tests and validations, and it is practically and ethically not always desirable to recruit disabled patients to run these tests in the preliminary stages of development. In this review paper, we collect and analyse the different reversible interventions described in the literature that can induce asymmetry in the gait pattern of healthy walkers. We perform a systematic literature research by exploring five databases, i.e., Pubmed, Embase, Web of Science, Google Scholar, and Scopus. This narrative review identifies more than 150 articles reporting 16 different interventional methods used to induce asymmetric gait pattern in healthy walkers or with the potential to do so. These interventions are categorized according to their mode of action, and their effects on spatiotemporal parameters, joint kinematics and kinetics are summarized adopting a macroscopic viewpoint. Interventions are compared in terms of efficacy, maturity of the results, and applicability. Recommendations are provided for guiding researchers in the field in using each of the identified manipulations in its most relevant research contexts.</p>","PeriodicalId":73102,"journal":{"name":"Frontiers in rehabilitation sciences","volume":"6 ","pages":"1463382"},"PeriodicalIF":1.3,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11955677/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}