Frontiers in rehabilitation sciences最新文献

{"title":"Functional and perceptive differences between conventional and advanced ankle foot orthoses in community ambulators post-limb trauma: the injuries managed with advanced bracing of the lower extremity (IM ABLE) study.","authors":"M Jason Highsmith, Rebecca M Miro, Michael Kartel, Anita Ramrattan, Angela Courtade, Jeffrey T Heckman, Samuel L Phillips, Shane R Wurdeman, Thomas V DiBello, Dwiesha L England, Phillip M Stevens, James H Campbell, Michael J Hyre, Jason T Maikos, Owen T Hill, Stephanie L Carey","doi":"10.3389/fresc.2024.1277509","DOIUrl":"10.3389/fresc.2024.1277509","url":null,"abstract":"<p><strong>Introduction: </strong>Many military service members and civilians suffer from lower extremity trauma. Despite recent advancements in lower limb bracing technology, it remains unclear whether these newer advanced braces offer improved comfort and functionality compared to conventional options. The IDEO (Intrepid Dynamic Exoskeletal Orthosis), a type of \"advanced\" orthosis was developed to assist in maintaining high functional performance in patients who have experienced high-energy lower extremity trauma and underwent limb salvage surgeries.</p><p><strong>Methods: </strong>A cross-sector multi-site initiative was completed to study the efficacy of advanced ankle foot orthoses (AFO) for lower limb trauma and injury compared to a conventional AFO. Following fitting, training, and accommodation, the subjects were assessed in each AFO system for mobility, self-reported function, safety and pain, and preference.</p><p><strong>Results: </strong>They preferred the advanced over the conventional AFO and the mobility and exertion perception improved with the advanced AFO with no difference in pain or overall health status scores.</p><p><strong>Discussion: </strong>Thus, an advanced AFO is an option for trauma affecting the lower limb. Long-term studies are required to better understand the accommodation and learning process of using an advanced AFO.</p>","PeriodicalId":73102,"journal":{"name":"Frontiers in rehabilitation sciences","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11246986/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141621852","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":"Selective orthotic constraint of lower limb movement during walking reveals new insights into neuromuscular adaptation.","authors":"Christopher F Hovorka, Géza F Kogler, Young-Hui Chang, Robert J Gregor","doi":"10.3389/fresc.2024.1354115","DOIUrl":"10.3389/fresc.2024.1354115","url":null,"abstract":"<p><strong>Introduction: </strong>A concern expressed by the clinical community is that the constraint of motion provided by an ankle foot orthosis (AFO) may lead the user to become dependent on its stiffness, leading to learned non-use. To examine this, we hypothesized that using an experimental AFO-footwear combination (exAFO-FC) that constrains ankle motion during walking would result in reduced soleus and tibialis anterior EMG compared to free (exAFO-FC) and control (no AFO, footwear only) conditions.</p><p><strong>Method: </strong>A total of 14 healthy subjects walked at their preferred speed (1.34 ± 0.09 m·s-1) for 15 min, in three conditions, namely, control, free, and stop.</p><p><strong>Results: </strong>During the stance phase of walking in the stop condition, ipsilateral soleus integrated EMG (iEMG) declined linearly, culminating in a 32.1% reduction compared to the control condition in the final 5 min interval of the protocol. In contrast, ipsilateral tibialis anterior iEMG declined in a variable fashion culminating in an 11.2% reduction compared to control in the final 5 min interval. During the swing phase, the tibialis anterior iEMG increased by 6.6% compared to the control condition during the final 5 min interval. The contralateral soleus and tibialis anterior exhibited increased iEMG in the stop condition.</p><p><strong>Discussion: </strong>An AFO-FC functions as a biomechanical motion control device that influences the neural control system and alters the output of muscles experiencing constraints of motion.</p>","PeriodicalId":73102,"journal":{"name":"Frontiers in rehabilitation sciences","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11236798/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141592277","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":"Empowering sickle cell disease care: the rise of <i>TechnoRehabLab</i> in Sub-Saharan Africa for enhanced patient's perspectives.","authors":"Paul Muteb Boma, Suzanne Kamin Kisula Ngoy, Jules Mulefu Panda, Bruno Bonnechère","doi":"10.3389/fresc.2024.1388855","DOIUrl":"10.3389/fresc.2024.1388855","url":null,"abstract":"<p><p>Sickle-cell Disease (SCD) is a major public health problem in Africa, and there are significant obstacles to its comprehensive management, particularly in terms of access to appropriate healthcare. This calls for inventive approaches to improve patients' prospects. Among the major challenges to be met are the primary and secondary prevention of certain serious complications associated with the disease, such as neurocognitive, motor and respiratory functional disorders. This perspective argues for the rapid creation of specific, cost-effective, technology-supported rehabilitation centres to advance SCD care, identify patients at high risk of stroke and implement tailored rehabilitation strategies. The <i>TechnoRehabLab</i> in Lubumbashi illustrates this shift in thinking by using cutting-edge technologies such as virtual reality (VR), serious games and mobile health to create a comprehensive and easily accessible rehabilitation framework. Diagnostic tools used to perform functional assessment can be used to identify cognitive, balance and walking deficits respectively. Transcranial Doppler enables early detection of sickle cell cerebral vasculopathy, making it possible to provide early and appropriate treatment. VR technology and serious games enable effective rehabilitation and cognitive stimulation, which is particularly advantageous for remote or community-based rehabilitation. In the context of African countries where there is a glaring disparity in access to digital resources, the <i>TechnoRehabLab</i> serves as a tangible example, demonstrating the flexibility and accessibility of technology-assisted rehabilitation. This perspective is an urgent call to governments, non-governmental organisations and the international community to allocate resources to the replication and expansion of similar facilities across Africa.</p>","PeriodicalId":73102,"journal":{"name":"Frontiers in rehabilitation sciences","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11236801/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141592275","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":"Participation as a means-implications for intervention reasoning.","authors":"Mats Granlund, Christine Imms","doi":"10.3389/fresc.2024.1399818","DOIUrl":"10.3389/fresc.2024.1399818","url":null,"abstract":"<p><strong>Introduction: </strong>The increased focus among researchers and professionals on participation as an explicit intervention outcome has prompted a paradigm shift in both thought and practice. However, much research centers on altering participation outcomes in specific life situations and stages. This discussion paper considers \"participation as a means\" in pediatric rehabilitation and special education interventions, emphasizing its role in achieving lasting outcomes.</p><p><strong>Method: </strong>This paper uses a Venn diagram approach to consider relations between three core concepts-participation, intervention, and outcomes-and their intersection. The paper's central theme revolves around the intersection of these concepts, wherein participation serves as a means to achieve enduring participation outcomes within the realms of rehabilitation and special education. The discussion is supported by contemporary empirical work and from literature identified in two recent scoping reviews focusing on the intervention process.</p><p><strong>Results: </strong>Achieving enduring participation outcomes through participation in the intervention process necessitates creating a learning experience, with children and families actively participating in every step: identifying participation issues, seeking explanations, prioritizing intervention goals, selecting methods, implementing interventions, and evaluating the process and outcomes.</p><p><strong>Discussion: </strong>This structured approach supports professionals and researchers to foster the skills and capacity required for lasting participation outcomes for children with impairments.</p>","PeriodicalId":73102,"journal":{"name":"Frontiers in rehabilitation sciences","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11236800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141592276","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":"Patient-reported outcome survey of user-experiences in the spinal cord injured-community with MPPT for treating wounds and pressure injuries and for controlling soft tissue infection caused by osteomyelitis.","authors":"Damian Smith, Mark Ridler","doi":"10.3389/fresc.2024.1386518","DOIUrl":"10.3389/fresc.2024.1386518","url":null,"abstract":"<p><strong>Background: </strong>People with spinal cord injury (SCI) are at high risk of developing pressure injuries. Reports in the SCI-community had indicated that a new class of wound treatment, MPPT (micropore-particle-technology), was effective in treating pressure injuries. The British Spinal Injuries Association therefore conducted a survey among MPPT-users to learn from their experiences.</p><p><strong>Methods: </strong>Online survey restricted to individuals with spinal cord injury. Participants were requested to identify themselves to permit validation of statement.</p><p><strong>Results: </strong>The survey had 41 respondents reporting on a total of 49 wounds of which the two main categories were wounds (<i>n</i> = 33), primarily pelvic pressure ulcers; and draining fistulas (<i>n</i> = 9) caused by osteomyelitis. All wounds reported had reached full closure. Median duration of MPPT use and time to closure were 3 and 4 weeks for acute wounds (<6 weeks old) and 8 and 10 weeks for chronic wounds, respectively. On draining fistulas, MPPT had been used to reduce wound size, remove soft tissue infection, avoid sepsis, reduce autonomic dysreflexia, improve overall health, and avoid bed rest, whilst waiting for surgery. Comments on MPPT were 84% highly positive, 11% positive, and 0% negative. No adverse events were reported.</p><p><strong>Conclusions: </strong>MPPT achieved a 100% closure rate of acute and chronic wounds, and, in draining fistulas, effectively controlled soft tissue infection resulting from osteomyelitis. MPPT does not require bed rest and is suitable for self-care and telemedicine, promoting independence and higher quality-of-life. The findings strongly agree with a recent clinical study of MPPT.</p>","PeriodicalId":73102,"journal":{"name":"Frontiers in rehabilitation sciences","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11222669/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141536133","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 review of evidence on mechanical properties of running specific prostheses and their relationship with running performance.","authors":"Leila Rahnama, Kimberly Soulis, Mark D Geil","doi":"10.3389/fresc.2024.1402114","DOIUrl":"10.3389/fresc.2024.1402114","url":null,"abstract":"<p><strong>Background: </strong>Although mechanical properties of running specific prostheses (RSPs) can affect running performance, manufacturers do not consistently report them. This study aimed to review existing literature on RSP mechanical and structural properties and their relationship with running performance.</p><p><strong>Methods: </strong>A comprehensive search was conducted using keywords related to mechanical properties of RSPs and running performance. Search terms included stiffness and hysteresis, as well as performance outcomes including metabolic cost and running speed. Non-peer-reviewed and non-English publications were excluded.</p><p><strong>Results: </strong>Twenty articles were included in the review. Sixteen studies used a material testing machine to measure RSP material properties, and four articles used other techniques including 2D/3D video capture and force platforms. Both measurement techniques and reporting of outcomes were inconsistent, which limits the ability to draw broad conclusions. Additionally, several studies did not report the numerical data for material properties despite measuring them. Relatively few articles measured both material properties and running performance and assessed correlations.</p><p><strong>Conclusion: </strong>Several articles connected prosthesis properties to running performance. However, inconsistent measurement and reporting of mechanical properties, along with the multifactorial nature of the athlete-prosthesis system, limit the ability to draw broad conclusions regarding the relationship between material and structural properties and athlete performance. Current evidence may be useful for clinicians seeking ways to optimize RSP stiffness in a case-by-case basis; however, clinicians would benefit from more consistent and systematic comparisons of the attributes of different RSPs and their role in performance.</p>","PeriodicalId":73102,"journal":{"name":"Frontiers in rehabilitation sciences","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11220186/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141499779","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":"Nil per os in the management of oropharyngeal dysphagia-exploring the unintended consequences.","authors":"Michelle Cimoli, Jennifer Gibney, Mathew Lim, Jo Castles, Pedro Dammert","doi":"10.3389/fresc.2024.1410023","DOIUrl":"10.3389/fresc.2024.1410023","url":null,"abstract":"<p><p>Nil per os (NPO), also referred to as Nil by Mouth (NBM), is a health-related intervention of withholding food and fluids. When implemented in the context of a person with dysphagia, NPO aims to mitigate risks of aspiration. However, evidence demonstrating that NPO is beneficial as an intervention for people with dysphagia is lacking. This paper explores the theoretical and empirical evidence relating to the potential benefits and adverse effects of NPO and asserts that NPO is not a benign intervention. This paper argues for applying an ethics framework when making decisions relating to the use of NPO as an intervention for dysphagia, in particular addressing informed consent and a person's right to self-determination.</p>","PeriodicalId":73102,"journal":{"name":"Frontiers in rehabilitation sciences","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11217566/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141494521","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":"Acrobatic training prevents learning impairments and astrocyte remodeling in the hippocampus of rats undergoing chronic cerebral hypoperfusion: sex-specific benefits","authors":"Ana Paula Rodrigues Martini, Lívia Machado Schlemmer, Joelma Alves Lucio Padilha, R. Fabres, N. S. C. Couto Pereira, Lenir Orlandi Pereira, Carla Dalmaz, C. A. Netto","doi":"10.3389/fresc.2024.1375561","DOIUrl":"https://doi.org/10.3389/fresc.2024.1375561","url":null,"abstract":"Chronic cerebral hypoperfusion (CCH) leads to memory and learning impairments associated with degeneration and gliosis in the hippocampus. Treatment with physical exercise carries different therapeutic benefits for each sex. We investigated the effects of acrobatic training on astrocyte remodeling in the CA1 and CA3 subfields of the hippocampus and spatial memory impairment in male and female rats at different stages of the two-vessel occlusion (2VO) model.Wistar rats were randomly allocated into four groups of males and females: 2VO acrobatic, 2VO sedentary, sham acrobatic, and sham sedentary. The acrobatic training was performed for 4 weeks prior to the 2VO procedure. Brain samples were collected for morphological and biochemical analysis at 3 and 7 days after 2VO. The dorsal hippocampi were removed and prepared for Western blot quantification of Akt, p-Akt, COX IV, cleaved caspase-3, PARP, and GFAP. GFAP immunofluorescence was performed on slices of the hippocampus to count astrocytes and apply the Sholl's circle technique. The Morris water maze was run after 45 days of 2VO.Acutely, the trained female rats showed increased PARP expression, and the 2VO-trained rats of both sexes presented increased GFAP levels in Western blot. Training, mainly in males, induced an increase in the number of astrocytes in the CA1 subfield. The 2VO rats presented branched astrocytes, while acrobatic training prevented branching. However, the 2VO-induced spatial memory impairment was partially prevented by the acrobatic training.Acrobatic training restricted the astrocytic remodeling caused by 2VO in the CA1 and CA3 subfields of the hippocampus. The improvement in spatial memory was associated with more organized glial scarring in the trained rats and better cell viability observed in females.","PeriodicalId":73102,"journal":{"name":"Frontiers in rehabilitation sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141348300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypotussic cough in persons with dysphagia: biobehavioral interventions and pathways to clinical implementation","authors":"Justine Dallal-York, M. Troche","doi":"10.3389/fresc.2024.1394110","DOIUrl":"https://doi.org/10.3389/fresc.2024.1394110","url":null,"abstract":"Cough is a powerful, protective expulsive behavior that assists in maintaining respiratory health by clearing foreign material, pathogens, and mucus from the airways. Therefore, cough is critical to survival in both health and disease. Importantly, cough protects the airways and lungs from both antegrade (e.g., food, liquid, saliva) and retrograde (e.g., bile, gastric acid) aspirate contents. Aspiration is often the result of impaired swallowing (dysphagia), which allows oral and/or gastric contents to enter the lung, especially in individuals who also have cough dysfunction (dystussia). Cough hyposensitivity, downregulation, or desensitization- collectively referred to as hypotussia- is common in individuals with dysphagia, and increases the likelihood that aspirated material will reach the lung. The consequence of hypotussia with reduced airway clearance can include respiratory tract infection, chronic inflammation, and long-term damage to the lung parenchyma. Despite the clear implications for health, the problem of managing hypotussia in individuals with dysphagia is frequently overlooked. Here, we provide an overview of the current interventions and treatment approaches for hypotussic cough. We synthesize the available literature to summarize research findings that advance our understanding of these interventions, as well as current gaps in knowledge. Further, we highlight pragmatic resources to increase awareness of hypotussic cough interventions and provide support for the clinical implementation of evidence-based treatments. In culmination, we discuss potential innovations and future directions for hypotussic cough research.","PeriodicalId":73102,"journal":{"name":"Frontiers in rehabilitation sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141352564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementing neuropsychological rehabilitation following severe traumatic brain injury in a low-to-middle income country: a case report","authors":"Alexa Caitlin Soule, Taryn Jane Fish, Jill Winegardner, Leigh Schrieff-Brown","doi":"10.3389/fresc.2024.1393302","DOIUrl":"https://doi.org/10.3389/fresc.2024.1393302","url":null,"abstract":"TBI incidence and distribution are largely overrepresented in low- to middle-income countries (LMICs), such as South Africa (SA), with substantial associated human and financial costs. However, access to rehabilitation for the public is severely limited and not standard practice in SA. Given this background, studies demonstrating the successful implementation of neuropsychological rehabilitation in a LMIC setting are important. Published studies of this nature are generally lacking in this context. Further, there is a need to evaluate interventions that can be implemented at a low cost. To this end, we report on a neuropsychological rehabilitation program for an individual with severe TBI in a LMIC context, aimed at improving his capacity for activities of daily living.A 33-year-old, South African male who sustained a severe traumatic brain injury (TBI) partook in a neuropsychological intervention aimed at remediating functional deficits and enhancing independent functioning. The intervention utilised principles of Goal Management Training and external memory aids, with reliance on procedural memory and errorless learning, to target the participant's impairments in executive functioning and memory through the use of assistive technology—namely smart device applications.Data collected pre- and post-intervention on formal neuropsychological measures demonstrated no significant change in cognition. However, observational data and qualitative feedback from the participant's family indicated notable improvement in performance on everyday tasks with reduced number of errors and reduced need for external prompting whilst completing intervention tasks across sessions.In the context of severe TBI, neuropsychological rehabilitation can facilitate gains in independent functioning. This study provides support for the value of neurorehabilitation especially for interventions that can be rolled out at low cost and should serve as impetus for further such research in South Africa, where neuropsychological rehabilitation infrastructure and services are lacking.","PeriodicalId":73102,"journal":{"name":"Frontiers in rehabilitation sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141353887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}