Weeks Of Rehabilitation Research Articles

Study on the role of postoperative rehabilitation based on the ERAS concept for patients undergoing pancreaticoduodenectomy: Protocol for a randomized controlled clinical trial.

Pancreaticoduodenectomy (PD), an abdominal surgery, is known for its complexity, cost and inherent risks. Recently, there has been increasing interest in enhanced recovery after surgery (ERAS) as a therapeutic approach. However, the mechanisms underlying postoperative functional recovery remain uncertain, and there are limited data on the efficacy of ERAS in postoperative physiotherapy following complex PD. This study aims to examine the feasibility and effectiveness of conducting a large powered randomized controlled trial (RCT) to evaluate a 2-week postoperative rehabilitation program based on the ERAS concept for patients undergoing pancreaticoduodenectomy. This study is a RCT with a single treatment group. From June 2022 to June 2024, 28 PD patients will participate in the trial. Patients will be randomly assigned to either a control group receiving standard clinical care or an intervention group undergoing a 2-week postoperative rehabilitation program. Cardiopulmonary function will be assessed using the 6-minute walk test (6MWT), and gastrointestinal (GI) recovery will be evaluated using the Intake, Feeling nausea, Emesis, physical Exam, and Duration of symptoms (I-FEED) scoring system. Secondary outcomes, including changes in recovery quality post-surgery, will be evaluated using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ-C30) and the Quality of Recovery Questionnaire (QOR-40). Additional recorded items will include time to first flatus and feces, daily volume of stomach fluid, time to gastric tube removal, length of hospital stay (LOS), and postoperative complications. The study will utilize the I-FEED score, a novel tool for assessing GI function, to monitor the impact of a 2-week postoperative rehabilitation exercise program on patients. The primary outcome will focus on improvements in cardiopulmonary capacity following postoperative rehabilitation activities.

Evaluation of the impact of a 3-week specific-sport rehabilitation program on neuromotor control during single-leg countermovement-jump tests in professional soccer players with lower-limb injuries

Evaluation of the impact of a 3-week specific-sport rehabilitation program on neuromotor control during single-leg countermovement-jump tests in professional soccer players with lower-limb injuries

Effect of Exercise-Based Cardiac Rehabilitation on Patients With Chronic Heart Failure After Transcatheter Aortic Valve Replacement: A Randomized Controlled Trial.

The objective of this study was to assess the effect of exercise-based cardiac rehabilitation (CR) with individualized exercise prescription in patients with chronic heart failure (HF) undergoing transcatheter aortic valve replacement (TAVR) in a randomized controlled trial. A total of 60 patients with chronic HF who received TAVR treatment were randomly divided into the control group (n=30) and exercise training (ET) group (n=30). The control group was treated with conventional rehabilitation, and the ET group was given personalized exercise-based CR based on a cardiopulmonary exercise test (CPX). The CPX parameters, echocardiography, 6-minute walk test distance, and quality of life were evaluated in the two groups. All patients who completed symptom-restricted CPX showed no complications. After the 12-week rehabilitation period, the levels of anaerobic threshold, peak oxygen uptake, peak oxygen pulse, peak power, left ventricular ejection fraction, and 6-minute walk test distance in the ET group were significantly higher than those in the control group (P<.05). Scores on the Minnesota Life with Heart Failure Questionnaire in the ET group were lower than those in the control group (P <.05). Exercise-based CR significantly improves cardiopulmonary function, exercise tolerance, and quality of life in patients with chronic HF who undergo TAVR.

THE IMPACT OF CARDIAC REHABILITATION ON QUALITY OF LIFE AND 6 MINUTE WALK TEST IN POST GLENN PATIENTS

Background: Patients with congenital heart disease (CHD), particularly those with single ventricular physiology undergoing Glenn shunt, often experience limited functional capacity and decreased quality of life (QoL). This study evaluates the impact of a 12-week cardiac rehabilitation (CR) program on functional capacity, measured by the 6-minute walk test (6MWT), and QoL in post-Glenn (PG) patients. Methods: This randomized controlled trial included 35 PG patients aged 6 years and above, randomized into two groups: the CR group (n=15) participated in a 12-week CR program, while the control group (n=20) received standard care. Pre- and post-rehabilitation assessments included echocardiography, the 6MWT, and QoL evaluation using the Minnesota Living with Heart Failure Questionnaire (MLHFQ). Results: After 3 months, the CR group showed significant improvements in 6MWT distance, increasing from 378.67 ± 53.97 m to 411.00 ± 61.01 m (p &lt; 0.001), compared to a non-significant change in the control group. Heart rate (HR) decreased in the CR group (pre: 92.27 ± 8.02 bpm, post: 84.93 ± 8.48 bpm, p &lt; 0.05). QoL scores improved in the CR group, with a median MLHFQ score decrease from 19 (IQR 18-24) to 16 (IQR 12-21) (p &lt; 0.05). No significant changes in echocardiographic parameters were observed in either group. Conclusion: A 12-week CR program significantly improves functional capacity and QoL in PG patients. These findings support the implementation of CR programs in this population to enhance physical activity and overall well-being.

Achilles Tendon Mechanical But Not Morphological Properties Change with Rehabilitation in Patients with Chronic Midportion Achilles Tendinopathy

ABSTRACT Purpose Achilles tendinopathy (AT) is associated with altered tendon’s morphological and mechanical properties, yet it is unclear whether these properties are reversed upon mechanical loading to promote tendon healing. This study aims to determine the extent to which pathological tendon’s morphological and mechanical properties adapt throughout a 12-week eccentric rehabilitation protocol. Methods Forty participants with midportion AT were recruited and participated in a 12-week eccentric rehabilitation program. Function and symptoms were recorded through the Victorian Institute of Sports Assessment-Achilles (VISA-A) and hopping. The tendon’s morphological (i.e. volume, midportion cross-sectional area (CSA) and anteroposterior (AP) diameter) and mechanical (i.e. stiffness, Young’s modulus, and tendon non-uniform displacement) properties were measured at baseline and at 6 and 12 weeks of the intervention. Results Significant functional improvements were observed, with VISA-A scores and hopping results showing marked improvements (p &lt; 0.001). Morphologically, no significant changes in volume, midportion CSA, or AP diameter were found, although a trend toward decreased CSA between 30-70% of tendon length was noted. Mechanically, significant increases in Achilles tendon stiffness (p = 0.001) and Young’s modulus (p &lt; 0.001) were observed over the course of the rehabilitation program. No differences in tendon non-uniform displacement were found following a 12-week rehabilitation program. Conclusions These findings suggest that tendon adaptation in response to mechanical loading primarily involves changes in mechanical properties rather than morphology, highlighting the complexity and variability in tendon adaptation. Clinically, these mechanical properties could be considered in the load progression throughout rehabilitation as potentially higher strains will be induced when clinical improvements precede mechanical adaptations.

Impact of a dermatological rehabilitation program on cardiovascular risks of psoriasis patients.

Psoriasis vulgaris is a common chronic inflammatory skin disease, associated with multiple cardiovascular comorbidities, which can ultimately lead to increased mortality. Dermatological rehabilitation programs represent an additional therapeutic option in patients with psoriasis besides the classical outpatient or inpatient management. This study aimed to investigate the impact of dermatological rehabilitation on cardiovascular risk factors, cardiorespiratory fitness and quality of life at the Clinic of Dermatology, Bad Bentheim, Germany. This prospective study included 105 patients (age >18years) with known psoriasis and/or psoriasis (pustulosa) palmoplantaris committing to a 3-week long rehabilitation program. Various patient reported outcomes including dermatological life and quality index, patient global assessment, physical activity, pruritus and smoking and alcohol consumption history were captured. Body mass index (BMI) and physical fitness were also assessed. Study parameters were collected by telephone at baseline, at discharge, and at 3 and 6months. Significant improvements in cardiorespiratory fitness (p<0.001), BMI (p<0.001), quality of life (p<0.001), patients subjective estimation of disease severity (p<0.001) and psoriasis area and severity index (p<0.001) were shown. The findings emphasize the importance of a rehabilitation program for patients with psoriasis due to its positive and sustained effects on cardiovascular risk factors.

Factors Influencing the Attrition Rate of a 10-Week Multimodal Rehabilitation Program in Patients After Lung Transplant: A Neural Network Analysis.

Despite the effectiveness of exercise and nutritional interventions to improve aerobic capacity and quality of life in lung transplant (LT) recipients, their compliance is low. Strategies to reduce the high attrition rate (participants lost over time) is a major challenge. Artificial neural networks (ANN) may assist in the early identification of patients with high risk of attrition. The main objective of this study is to evaluate the usefulness of ANNs to identify prognostic factors for high attrition rate of a 10-week rehabilitation program after a LT. This prospective observational study included first-time LT recipients over 18 years of age. The main outcome for each patient was the attrition rate, which was estimated by the amount of missing data accumulated during the study. Clinical variables including malnutrition, sarcopenia, and their individual components were assessed at baseline. An ANN and regression analysis were used to identify the factors determining a high attrition rate. Of the 41 participants, 17 (41.4%) had a high rate of attrition in the rehabilitation program. Only 23 baseline variables had no missing data and were included in the analysis, from which a low age-dependent body mass index (BMI) was the most important conditioning factor for a high attrition rate (p = 7.08 × 10-5), followed by end-stage respiratory disease requiring PT (p = 0.000111), low health-related quality-of-life (HRQoL) (p = 0.0009078), and low handgrip strength (p = 0.023). The prevalence of high attrition rate in LT recipients is high. The profile of patients with a high probability of attrition includes those with chronic obstructive pulmonary disease, low BMI and handgrip strength, and reduced HRQoL.

Return to Baseball Following an Anterior Shoulder Dislocation in a High School Baseball Pitcher: A Level 3 Case Report

A 17-year-old right-handed high school pitcher sustained a first-time anterior shoulder dislocation. The patient’s imaging revealed a small Hill–Sachs lesion; however, the clinical team’s decision was to manage it nonoperatively. In this case, the patient underwent 7 weeks of rehabilitation, which included general upper extremity strengthening exercises, a modified interval throwing program, and a pitching progression adapted specifically for the patient. After rehabilitation, the patient returned to live pitching with improvements in his pitching statistics. The uniqueness of this case is that it is a less common intervention approach posttreatment.

A study to explore the role of a low threshold, fitness focussed physical rehabilitation intervention with protein supplementation to target physical function and frailty in people with problematic substance use and homelessness: protocol for a single-arm pre-post intervention study.

People who are homeless are more likely to experience poor mental health and addiction as well as suffering from non-communicable diseases. There is evidence of frailty and accelerated physical ageing among people experiencing homelessness. Appropriate physical rehabilitation and nutritional supplementation strategies can stabilise or reverse frailty and general physical decline, but it is not known how this type of intervention would work in practice in this population. To evaluate the feasibility and pre-post intervention impact of a low threshold physical rehabilitation intervention with protein supplementation to target physical functioning and frailty in people with problematic substance use who are experiencing homelessness. The intervention will consist of a 12-week low threshold rehabilitation programme with protein supplementation. Participants will be service users of the Ballyfermot Advance Project, a day services centre for people with addiction issues and experiencing homelessness. Primary outcomes will be feasibility including numbers recruited, retention of participants and adherence to the exercise intervention and protein supplement. Any adverse events will be recorded. Secondary outcomes will be strength and muscular mass, physical performance and lower extremity physical function, pain, frailty and nutritional status. An immediate impact may be simply a distraction from difficult circumstances and potentially an improvement of physical health of participants, which can be a conduit for the emergence of other positive behaviours and recovery. Longer term, this study will generate preliminary data on which to inform the design of a definitive randomised controlled trial of physical rehabilitation and protein supplementation, if indicated. Ethical approval was granted by the Faculty of Health Sciences Research Ethics Committee in TCD. Study findings will be disseminated through publication into an international peer-reviewed journal and presented at national and international conferences.

The role of digital health intervention in improving physical activity in cardiac rehabilitation center: a randomised controlled trial

Abstract Background Physical activity plays a crucial role in cardiac rehabilitation for secondary prevention. Despite its importance, participation rates in cardiac rehabilitation programs remain low. Telemedicine, particularly telerehabilitation, presents a viable solution by offering remote access to cardiac rehabilitation services. This innovative approach has the potential to significantly enhance patient outcomes. Purpose This study aimed to assess the effectiveness of digital health intervention in improving physical activity in cardiac rehabilitation center. Methods A prospective randomised controlled trial was conducted, enrolling 80 eligible cardiac rehabilitation patients. Participants were 1:1 randomised into two groups: a 12-week center-based cardiac rehabilitation program (control group), and a 12-week center-based cardiac rehabilitation program combined with a digital health intervention (intervention group). This digital health intervention consists of smartphone, web, and tablet applications to monitor physical activity outside of rehabilitation sessions and motivate patients to engage in more physical activities. Results Of the initial 80 patients, 70 completed the study, and the results are presented in Table 1. In the intervention group, there was a statistically significant improvement in peak rate of oxygen consumption (VO2 peak) (p &amp;lt; 0.01) and peak power output (W peak) (p &amp;lt; 0.01), as measured by cardiopulmonary exercise testing between the end and the beginning of the study at the significance level of 0.05. Similar improvements were also observed in the control group (p = 0.0002 for VO2 peak and p &amp;lt; 0.01 for W peak). After 12 weeks of intervention, significant between-group differences were found: We observe a greater improvement in VO2 peak, on average 1.39 (95% CI: 0.23-2.54) ml/kg, and in W peak, on average, 12.29 (95% CI: 4.12-20.45), higher in the intervention group compared to the control group. Regarding physical activity, the intervention group showed a significant improvement in step count (P = 0.002), measured by an accelerometer, whereas no significant improvement was observed in the control group (P = 0.9714). There is a statistically significant difference in the change of step count between the intervention and control group at the significance level of 0.05. We observe a greater improvement, on average 14 788 steps (95% CI: 4 246 – 25 331), in the intervention group compared to the control group. Conclusion This study shows that a combination of a digital health intervention based telerehabilitation with a center-based cardiac rehabilitation is more effective in increasing patient’s exercise capacity and physical activity compared with a center-based cardiac rehabilitation.Table 1:results

Feasibility and safety of two weeks of blood flow restriction exercise in individuals with spinal cord injury

Context Reduced muscle strength and function are common after spinal cord injury (SCI). While low-load blood flow restriction exercise (BFRE) enhances muscle strength in healthy and clinical populations, its safety and feasibility in individuals with SCI remain underexplored. Objectives To investigate the feasibility and safety of low-load BFRE in individuals with incomplete SCI. Study Design Case series. Setting SCI rehabilitation center. Participants Six participants with motor incomplete SCI were enrolled in the study. Intervention A two-week BFRE intervention for the lower limbs was conducted twice weekly at 40% total arterial occlusion pressure, using 30-40% of 1-repetition maximum loads. Outcome Measures Feasibility measures, specifically recruitment and eligibility rates and intervention acceptability, were collected. Blood pressure (BP) responses and specific coagulation markers for deep vein thrombosis (DVT) were assessed as safety measures. Results Recruitment and eligibility rates were 2.8% and 6.6% for individuals admitted for first-time rehabilitation (subacute SCI) and 8.3% and 13.9% for 4-week readmission rehabilitation stays (chronic SCI), respectively. Intervention acceptability was high, characterized by 95.8% training adherence and low-to-moderate self-reported pain levels. BP responses and changes in C-reactive protein, Fibrinogen, and D-dimer during the intervention remained within clinically acceptable levels. Conclusion BFRE was feasible in an SCI rehabilitation setting despite a low recruitment rate. BFRE imposed no heightened risk of DVT or severe BP fluctuations in the present case series. Additionally, no severe adverse events occurred, and only mild complaints were reported. More extensive safety considerations warrant larger-scale exploration. Trial registration ClinicalTrials.gov identifier: NCT03690700.

Differences in the Impact of Intensive Rehabilitation on Hereditary Ataxias and the Cerebellar Subtype of Multiple System Atrophy

Multiple system atrophy-cerebellar type (MSA-C) exhibits faster disease progression than does hereditary spinocerebellar degeneration (hSCD). In this study, we aimed to investigate the differences in the treatment effects and sustainability of intensive rehabilitation between patients with hSCD and those with MSA-C. Forty-nine patients (hSCD = 30, MSA-C = 19) underwent a 2- or 4-week intensive rehabilitation program. Balance function was evaluated using the scale for the assessment and rating of ataxia (SARA) and the balance evaluation systems test (BESTest) at pre-intervention, post-intervention, and 6-month follow-up. Notably, both groups demonstrated beneficial effects from the rehabilitation intervention. However, differences were observed in the magnitude and duration of these effects. In the hSCD group, the SARA scores at follow-up remained similar to those at baseline, indicating sustained benefits. However, the MSA-C group showed some deterioration in SARA scores compared with baseline scores but maintained improvements on the BESTest, demonstrating partial sustainability. Differences, mainly in sustainability, were observed between the hSCD and MSA-C groups. This may be due to varying rates of symptom progression. The findings of this study are significant when considering the frequency of follow-ups based on disease type.

Rehabilitation Response in Tremor- and Non-Tremor-Dominant Parkinson Disease: A Task-fMRI Study.

Tremor-dominant (TD) and nontremor-dominant (NTD) Parkinson's disease (PD) showed different responses to rehabilitation. However, the neural mechanism behind this remains unclear. This cohort study explores changes in motor function, brain activation, and functional connectivity following 2 weeks of rehabilitation in TD-PD and NTD-PD patients, respectively. A total of 11 TD-PD patients, 24 NTD-PD patients, and 21 age-matched healthy controls (HCs) were included. At baseline, all participants underwent functional magnetic resonance imaging (fMRI) while performing the foot tapping task. Motor symptoms, gait, balance, and task-based fMRI were then evaluated in patients before and after rehabilitation. Compared to HCs, TD-PD patients showed increased activity in the left inferior frontal gyrus and the right insula, and NTD-PD patients showed increased activations in the left postcentral gyrus and decreased within-cerebellar connectivity at baseline. Rehabilitation improved motor function in PD patients regardless of motor subtype. TD-PD patients showed increased recruitments of the sensorimotor cortex and the bilateral thalamus after rehabilitation, and NTD-PD patients showed increased cerebellar activation and within-cerebellar connectivity that was associated with better motor performance. This study demonstrated that rehabilitation-induced brain functional reorganization varied by motor subtypes in PD, which may have important implications for making individualized rehabilitation programs. ClinicalTrials.gov identifier: ChiCTR1900020771.

Early intervention of extracorporeal shockwave therapy sustained positive long-term effect on rotator cuff healing: A randomized controlled trial with 3-year follow-up

BackgroundThe long-term effects of extracorporeal shockwave therapy (ESWT) on rotator cuff repair are unknown. ObjectivesTo investigate the functional outcomes and structural changes of ESWT at 3-year follow-up after rotator cuff repair. MethodsA randomized clinical trial was conducted, including patients who underwent rotator cuff repair. The patients were assigned to two groups based on whether they underwent radial ESWT 3 months postoperatively. The ESWT Group received 5 weeks of rehabilitation and ESWT weekly, whereas the CONTROL Group received only rehabilitation. Visual analog scale (VAS) pain score and functional scores were analyzed at 3 months (baseline), 6 months, and 3 years follow-up. In addition, MRI and ultrasonography were used to assess tendon maturation, integrity, tendon quality, acromiohumeral distance (AHD), and muscle fatty infiltration. ResultsFinally, 32 participants completed all the assessments. At the final follow-up, 2 patients in the ESWT Group (16.5 %) versus one patient in the CONTROL Group (6.25 %) had rotator cuff failure (P = 0.176). The ESWT treatment showed similar clinical outcomes in VAS-pain score, functional scores, tendon quality, AHD, and muscle fatty infiltration versus the CONTROL Group (Ps > 0.05). MRI analysis indicated improved tendon healing after ESWT treatment at both 6-month (P = 0.036) and 3-year follow-up (P = 0.028). ConclusionEarly intervention with radial ESWT sustained long-term effects on the healing of the repaired rotator cuff and similar functional outcomes at long-term follow-up compared with standard rehabilitation.

Impact of Cardiac Rehabilitation Program on the Quality of Life of Young Adults versus Elderly Egyptians with Ischemic Heart Disease

Abstract Background Exercise-based cardiac rehabilitation is underutilized in patients after myocardial infarction, especially in the elderly population. The ageing biology of this senior population is definitely unique, and they are more likely to experience different consequences for which cardiac rehabilitation can be especially useful. Objective To investigate the impact of a 12-week completed cardiac rehabilitation program on the quality of life of two different age groups with recent myocardial infarction. Methods This non-randomized prospective cohort study was conducted on 50 patients, divided into two groups; 25 patients for each, group1 included those more than 60 years, group 2 from 18 to 60 years. Both groups underwent cardiac rehabilitation programs during the period of May 2018 to August 2020 at Ain Shams university hospitals. Quality of life assessment was performed via RAND-36 questionnaire, while depression screening was done via PHQ-9 questionnaire. Results Both groups showed improvement in the quality of life after completion of the cardiac rehabilitation program. The younger group achieved better improvement in the domains related to physical functioning, general health, role limitation due to physical health, energy/fatigue, and also showed better improvement in depressive symptoms, dyslipidemia and left ventricular Ejection fraction, whereas the senior group showed better improvement regarding role limitation due to emotional problems. Conclusion Exercise training in the context of comprehensive CR program improves quality of life in young as well as elderly patients. The young population improved mainly in the domains related to physical health while the elderly group improved regarding emotional domain in the quality of life questionnaires.

Rehabilitation Outcomes in Diabetic Peripheral Neuropathy: An Evidence-Based Physiotherapy Approach for Functional Improvement – Case

Background: Diabetic Peripheral Neuropathy (DPN) is a prevalent and debilitating complication of diabetes mellitus (DM), affecting up to 70% of individuals with diabetes. DPN impairs motor and sensory functions, leading to pain, muscle weakness, and functional limitations that severely affect the quality of life. Effective rehabilitation strategies, including physiotherapy, are essential for improving these functional outcomes. Methods: This study assessed the effectiveness of a 12-week evidence-based physiotherapy rehabilitation program designed to improve the functional status of a 48-year-old female patient with DPN. The intervention included Transcutaneous Electrical Nerve Stimulation (TENS), range of motion (ROM) exercises, strengthening exercises, balance training, and gait improvement, administered over 45 physiotherapy sessions. Progress was measured using the Visual Analog Scale (VAS), Berg Balance Scale (BBS), and the Timed Up and Go (TUG) test. Results: Following the 12-week intervention, the patient reported significant improvements in pain reduction, with VAS scores decreasing from 9/10 to 4/10. Sensory function improved from impaired to intact, as assessed through light and deep touch sensation tests. Balance scores on the BBS increased from 22 to 48, indicating substantial gains in stability. Gait speed, measured using the TUG test, improved from 35 seconds to 13 seconds. Additionally, there were marked improvements in ROM, muscle strength, and overall functional abilities. Conclusion: The study demonstrates the effectiveness of a structured physiotherapy rehabilitation program in reducing neuropathic pain and improving functional outcomes in patients with DPN. TENS, combined with exercise-based interventions, significantly enhanced pain management, balance, and gait. Long-term monitoring and continued physiotherapy may further optimize the patient’s functional status and quality of life.

The Impact of Cardiac Rehabilitation on Quality of Life and 6 Minute Walk Test in Post Glenn Patients

Abstract Background The impact of cardiac rehabilitation on quality of life and 6 minute walk test in post Glenn patients. The present study conducted on 35 patients of both sex and age of 6 years old and above and at least 6 month after Glenn surgery at Ain Shams university Hospitals recruited during the period of 6 month. Objective To investigate the impact of a 12-week completed cardiac rehabilitation program on 6-minute walk test and quality of life in-patients of post Glenn shunt. Methods This was a 2-arm parallel prospective, randomized, controlled Study conducted on 35 patients of both sex and age of 6 years old and above and at least 6 month after Glenn surgery at Ain Shams university Hospitals recruited during the period of 6 month. Results We found that a significant improvement of Quality of life with reduced functional capacity in exercised group only after 3 months from enrollment in CR program, while control group didn’t show any improvement. Improvement was not only in quality of life but also there was a significant improvement in 6MWD in CR group when compared with control group (32.33 vs 2.25, p = 0.032 respectively). Conclusion Completed CR program improves quality of life and 6MWD in patients with post Glenn shunt with restricted physical activity.

The inertial-based gait normalcy index of dual task cost during turning quantifies gait automaticity improvement in early-stage Parkinson’s rehabilitation

BackgroundThe loss of gait automaticity is a key cause of motor deficits in Parkinson’s disease (PD) patients, even at the early stage of the disease. Action observation training (AOT) shows promise in enhancing gait automaticity. However, effective assessment methods are lacking. We aimed to propose a novel gait normalcy index based on dual task cost (NIDTC) and evaluate its validity and responsiveness for early-stage PD rehabilitation.MethodsThirty early-stage PD patients were recruited and randomly assigned to the AOT or active control (CON) group. The proposed NIDTC during straight walking and turning tasks and clinical scale scores were measured before and after 12 weeks of rehabilitation. The correlations between the NIDTCs and clinical scores were analyzed with Pearson correlation coefficient analysis to evaluate the construct validity. The rehabilitative changes were assessed using repeated-measures ANOVA, while the responsiveness of NIDTC was further compared by t tests.ResultsThe turning-based NIDTC was significantly correlated with multiple clinical scales. Significant group-time interactions were observed for the turning-based NIDTC (F = 4.669, p = 0.042), BBS (F = 6.050, p = 0.022) and PDQ-39 (F = 7.772, p = 0.011) tests. The turning-based NIDTC reflected different rehabilitation effects between the AOT and CON groups, with the largest effect size (p = 0.020, Cohen’s d = 0.933).ConclusionThe turning-based NIDTC exhibited the highest responsiveness for identifying gait automaticity improvement by providing a comprehensive representation of motor ability during dual tasks. It has great potential as a valid measure for early-stage PD diagnosis and rehabilitation assessment.Trial registration Chinese Clinical Trial Registry: ChiCTR2300067657

Pulmonary Rehabilitation Program Is an Effective Treatment Approach for Post-COVID-19 Syndrome Patients.

Background/Objectives: Patients with post-COVID-2019 syndrome may have reduced functional capacity and physical activity levels. The pulmonary rehabilitation program (PRP)-an exercise training program-is designed to restore these functions and has been shown to improve dyspnea, exercise capacity, and other measures in these patients. This study aimed to analyze the effects of the RP on post-COVID-19 syndrome patients with respect to objective and subjective functional capacity, balance, and musculoskeletal strength. Methods: A prospective interventional trial was conducted before and after this phase. Patients were referred to the hospital with a confirmed diagnosis of SARS-CoV-2 and subsequently directed to the RP. These patients underwent an 8-week pulmonary rehabilitation program (45-min sessions 3 times/week). Each session consisted of stationary cycle-ergometer and resistance musculoskeletal exercises tailored to individuals' performance. They were evaluated pre- and post-PRP using the maximal handgrip strength (HGS) test, timed up-and-go test, 6-min walk test and its derived variables, and Duke Activity Status Index questionnaire. Results: From 142 hospitalized patients admitted with a diagnosis of SARS-CoV-2 infection, 60 completed the program, with an attendance rate of 85%. Nineteen patients were categorized as severe/critical, with a significantly higher hospital stay, compared to mild/moderate patients, and there were no differences in terms of sex distribution, age, or BMI between groups. Compared to the pre-PRP evaluation, both groups showed significant (p < 0.001) improvements in TUG, HGS, DASI D6MWT, 6MWS, and DSP variables after the PRP conduction. In addition, the groups exhibited similar improvement patterns following PRP (intragroup analysis), with no intergroup differences. Conclusions: RPs promote both objective and subjective functional capacity in patients with post-COVID-19 syndrome, with no difference in improvement regardless of the severity of the initial infection.

Atrial Fibrillation Status and Physical Rehabilitation in Older Patients With Acute Decompensated Heart Failure: An Analysis From the REHAB-HF Trial.

The REHAB-HF (Rehabilitation Therapy in Older Acute Heart Failure Patients) trial demonstrated that a transitional, tailored, progressive rehabilitation intervention improved physical function, 6-minute walk distance, frailty, quality-of-life, and depression in older patients hospitalized for acute decompensated heart failure. This analysis assessed the impact of atrial fibrillation (AF) on intervention benefits. Of 349 enrolled patients hospitalized for acute decompensated heart failure (mean age 72.7±8.1 years), 176 (50.4%) had AF. Participants were randomly assigned to 12-week rehabilitation intervention or attention control. The primary outcome was Short Physical Performance Battery score at 3 months. Participants with AF were older (74.4±8.3 versus 70.8±7.5, P<0.0001) and had higher prevalence of heart failure with preserved ejection fraction (58.5% versus 47.4%, P=0.037). Patients with and without AF had similar improvement in Short Physical Performance Battery score (mean difference between rehabilitation intervention and attention control, 1.5 [95% CI, 0.6-2.3] versus 1.5 [95% CI, 0.7-2.3]; P<0.001). Those with AF had significant improvement in 6-minute walk distance (all P<0.05) and each of the Short Physical Performance Battery domains: balance, 4-meter walk, and chair rise. Kansas City Cardiomyopathy Questionnaire score significantly improved in patients with AF (P<0.05) but not those without AF (P>0.05). Interaction P values for 3-month outcomes by AF status were not significant (P>0.1). No significant differences were observed in deaths, all-cause rehospitalizations, or heart failure hospitalizations at 6 months. In older, hospitalized patients with acute decompensated heart failure, the presence of AF did not significantly affect the benefit of the rehabilitation intervention on physical function and quality of life. The intervention appears safe and effective regardless of AF status. URL: https://www.clinicaltrials.gov; Unique Identifier: NCT02196038.