Advances In Rehabilitation Research Articles

The achilles tendon rupture: A deeper dive into its impact on professional and high-performance athletes

Background: The Achilles tendon rupture (ATR) is an injury that has been detrimental to professional athletes over the years, recently rising to unforeseen heights as the intensity of sports has increased. Methods: To obtain relevant statistics for this paper, a review of prior research, including original research and case studies, was conducted. Digital publications and clinical data were reviewed to dissect factors such as injury causes, operations, current initiatives, the role of technology, and future implications. Results: The data revealed a significant increase in documented ATRs in athletes and the National Football League (NFL) over the years; most recently, these injuries increased from 11 in the 2019-2020 season to 24 in the 2021-2022 season.3 Despite advancements in technology and recovery methods, dynamic changes involving training, conditioning, physicality, and intensity in sports have greatly contributed to the increased rates of injuries. With modernized resources such as advanced testing and rehabilitation procedures incorporating artificial intelligence (AI), specialists continue to search for new ways to treat injury and improve functional outcomes more effectively. Conclusion: This paper examines ATRs in athletes, its risk factors, current surgical methods for treatment, and modern rehabilitation methods. Future research should continue to develop comprehensive assessment and treatment methods to decrease the time to return to play, reduce the risk of re-injuries, and ensure cost-effective standards in implementing advanced rehabilitation modalities.

Effectiveness of physiotherapy rehabilitation approaches for Parkinson's disease: A Durrës case study.

The article's significance lies in the substantial rise in the risk of developing Parkinson's disease (PD), necessitating the exploration of various approaches to rehabilitation and medical treatment. The purpose of the article is to detect the direct effect of physiotherapy for patients with PD and to identify how it helps in slowing down cardio-pulmonary failure, improving the posture, balance, bradykinesia and tremor. The research utilised clinical data from 407 PD patients aged 30-100 years at the Central Polyclinic of Durrës, spanning 2011-2022, and included a systematic literature review and statistical analysis comparing physiotherapy outcomes with European Union standards. The research demonstrates the efficiency of physiotherapy in the short and long term in the treatment of PD for patients and medical personnel. All information can be used to increase the functional abilities of patients and minimise complications after physiotherapy and to estimate the effectiveness of different exercises in delaying PD. Older adults, particularly those aged 71-80, are most affected by PD, with males more likely to be diagnosed. Physiotherapy rehabilitation improves motor symptoms, posture, and balance in 30-80-year-olds, but its effectiveness declines with age. Advanced rehabilitation methods in Italy lead to better outcomes, suggesting the potential for improvement in Durres disease. The study emphasises the need for improved rehabilitation strategies for older patients by recommending tailored programs, advanced methods, standardisation, training, and long-term monitoring. Further research should concentrate on the long-term sustainability of physiotherapy benefits, the development of targeted interventions for older patients, and the integration of innovative therapeutic approaches.

Noninvasive Evaluation of Acupuncture-Induced Cortical Plasticity in Advanced Rehabilitation of Facial Paralysis.

Facial paralysis (FP), which resulted from head and neck cancer resection, significantly impacts patients' quality of life. Traditional assessments rely on subjective evaluations and electromyography, whereas functional magnetic resonance imaging offers a noninvasive alternative for enhanced rehabilitation. Acupuncture has shown promise in promoting cerebral cortex reorganization, yet the precise relationship between acupuncture-induced structural and functional changes remains unclear, necessitating further investigation into therapeutic mechanisms. Fifty-five patients afflicted with FP underwent evaluations using voxel-mirrored homotopic connectivity (VMHC) and tract-based spatial statistics and were divided into the acupuncture intervention group (n = 35) and pseudo intervention group (n = 20). Comparative analyses of metrics pre and postintervention were conducted to delineate therapy-induced modifications in acupuncture intervention. The postacupuncture effect between groups to verify the necessity of accurate positioning for the rehabilitation of FP. Patients with FP showed deficits in VMHC in regions of the postcentral, precentral, and parietal areas. Corpus callosum and internal capsule showed significantly increased fractional anisotropy of the white matter skeleton in tract-based spatial statistics after treatment. Comparison postintervention results between groups exhibited deficits in VMHC and increased fractional anisotropy in regions of the corpus callosum in the acupuncture intervention group. Early acupuncture intervention may suppress cortical hyperactivation and restore interhemispheric inhibition across the corpus callosum to inhibit maladaptive structural plasticity. Precise acupoint localization is crucial for effective therapy, highlighting the potential of postacupuncture cortical space data for refining therapeutic strategies.

The Application of Rehabilitation Sentences for Narcotics Addicts (Case Study of North Jakarta District Court Decision Number 115/Pid.Sus/2023/PN Jkt. Utr)

The crime of narcotics offenses is considered an extraordinary crime. Law Number 35 of 2009 concerning Narcotics, Article 1 point 13, states that a Narcotics Addict is a person who uses or abuses Narcotics and is in a state of dependency on Narcotics, both physically and psychologically. Narcotic rehabilitation is one of the efforts to save addicts from the shackles of narcotics and the dangers that accompany them. There are three stages of narcotic rehabilitation in Indonesia: medical rehabilitation, non-medical rehabilitation, and advanced rehabilitation. The problem formulation in this study is how the rehabilitation punishment for narcotics addicts is applied and how the analysis of the considerations of the Panel of Judges of the North Jakarta District Court in imposing rehabilitation sanctions in decision number 1151/Pid.Sus/2023/PN Jkt.Utr. The type of research in this legal research proposal is normative legal research, focusing on the applicable legal norms, namely positive legal norms in the form of legislation. The results of the study show that the provisions for rehabilitation for narcotics addicts are stipulated in Articles 54 and 127 of Law Number 35 of 2009 concerning Narcotics. Meanwhile, the classification of user groups is regulated in the Circular of the Supreme Court No. 4 of 2010 concerning the Placement of Abusers, Victims of Abuse, and Narcotics Addicts in Medical and Social Rehabilitation Institutions. The judge's basis for sentencing the Defendant to undergo treatment and/or care at a medical/social rehabilitation institution refers to the provisions of Article 103 jo Article 127 paragraph 2 jo Article 54 of the Republic of Indonesia Law No. 35 of 2009 concerning Narcotics jo Circular of the Supreme Court of the Republic of Indonesia No. 4 of 2010 dated April 7, 2010, concerning the Placement of Abusers, Victims of Abuse, and Narcotics Addicts into Medical and Social Rehabilitation Institutions, as well as other legal facts revealed in the trial.

The Long-Term Impact of COVID-19 on Disability after Post-Acute Rehabilitation: A Pilot Study.

Background: The long-term effect of the 2019 coronavirus (COVID-19) pandemic is not fully known. Severe cases of COVID-19 have resulted in disability that can be assessed in a biopsychosocial manner with the International Classification of Functioning, Disability and Health with the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) questionnaire. This study aimed to evaluate the long-term effects on disability of COVID-19 three years after post-acute rehabilitation using WHODAS 2.0. Methods: This single-center cohort study included patients with severe COVID-19 who underwent immediate post-discharge post-acute rehabilitation intervention. Three years later, patients were assessed via telephone using the WHODAS 2.0 questionnaire. Results: Of the 69 patients identified in the hospital database, 27 responded. A total of 16 patients refused to respond due to emotional distress. The mean age was 63.4 ± 8.6 years, 81.5% were independent in the community, 55.3% had been previously admitted to the ICU, and the median rehabilitation hospitalization duration was 18 (11.5,24) days. Comorbidities included type 2 diabetes mellitus (DM) (55.5%), grade 2 high blood pressure (62.9%), pressure ulcers (37%), peripheral neurologic deficits (62.9%), and central neurological deficits (14.8%). ICU admission was significantly correlated with advanced rehabilitation needs (measured by the level of the rehabilitation (p < 0.01) and longer hospitalizations (measured by total days in the hospital (p < 0.001). The overall disability score was 35.09%, significantly influenced by DM and central neurological deficits. Conclusions: Central neurological deficits and DM are associated with higher disability scores. Tailored rehabilitation programs, ongoing medical assessment, integrated care models, and patient education are essential for improving long-term outcomes after COVID-19 disease.

The Impact of Gamified Auditory-Verbal Training for Hearing-Challenged Children at Intermediate and Advanced Rehabilitation Stages.

Background: Auditory-verbal training is essential for children with hearing challenges, and the gamification approach has become a promising direction for improving the rehabilitation experience and effect. However, the specific influence of the gamified training approach on participants at different rehabilitation stages has not been empirically studied, especially in the practical training effect caused by gamified interventions and the varying influence on children with different rehabilitation status. Objective: This article is thus intended to investigate the following research questions: (1) do the training performances of children at advanced rehabilitation stage differ before and after using the gamified training system? (2) Do the training performances of children at intermediate rehabilitation stage differ before and after using the gamified training system? (3) Do children enjoy the gamified training approach? Methods: For the purpose, a digital gamified auditory-verbal training system was originally developed, and a series of user experiments were organized. The training performance of 31 hearing-challenged children was assessed, and interviews with six professional therapists were conducted. Results: It can be found that generally the gamified training approach can effectively facilitate the training experience and help with the basic auditory memory and expression capabilities. Moreover, it is feasible to be applied in practical training due to the high customization of digital training contents, multimodal interactive training means, and highly enjoyable training experience. Conclusions: Regarding the specific influence, the gamified way can better improve the basic auditory-verbal performance of children at the intermediate stage since the focus is more on the ease of learning and adaption to the training system. While for children at the advanced rehabilitation stage, the precise training and professional training contents are more in demand, it is not easy to achieve quick improvements. These findings and conclusions can provide insights for further explorations and applications of the gamification approach in children's auditory-verbal rehabilitation. This study was approved by the Institutional Review Board (IRB) of Shanghai Jiao Tong University with the approval number H2022213P.

Exercising with a robotic exoskeleton can improve memory and gait in people with Parkinson’s disease by facilitating progressive exercise intensity

People with Parkinson’s disease (PwPD) can benefit from progressive high-intensity exercise facilitated with a lower-extremity exoskeleton, but the mechanisms explaining these benefits are unknown. We explored the relationship between exercise intensity progression and memory and gait outcomes in PwPD who performed 8 weeks (2 × per week) of progressive exercise with and without a lower-extremity powered exoskeleton, as the planned exploratory endpoint analysis of an open-label, parallel, pilot randomized controlled trial. Adults 50–85 years old with a confirmed diagnosis of PD participated. Twenty-seven participants randomized to exercise with (Exo = 13) or without (Nxo = 14) the exoskeleton were included in this exploratory endpoint analysis. Detailed exercise logs were kept and actigraphy was used to measure activity count*min−1 (ACPM) during all exercise sessions. Only the Exo group were able to progressively increase their ACPM over the entire 8-week intervention, whereas the Nxo group plateaued after 4 weeks. Exercise intensity progression correlated with change in the memory sub-scale of the SCOPA-COG and change in gait endurance from the 6MWT, consistent with the prevailing hypotheses linking high-intensity interval exercise to improved muscle and brain function via angiogenic and neurotrophic mechanisms. Facilitating high-intensity exercise with advanced rehabilitation technology is warranted for improving memory and gait endurance in PwPD.Registration: ClinicalTrials.gov, NCT 03583879 (7/10/2018).

The impact of digital healthcare systems on pain and body function in patients with knee joint pain: a systematic review and meta-analysis

The digital healthcare (DH) system has recently emerged as an advanced rehabilitation approach that promotes rehabilitation training based on virtual reality (VR) and augmented reality (AR). The purpose of this meta-analysis study is to review and assess the impact of DH systems on pain and physical function among patients diagnosed with knee joint pain. Between January 2003 and September 2023, studies that met the listed inclusion criteria were gathered from Scopus, PubMed, Web of Science, and EBSCO databases. The analysis of standardized mean difference (SMD) was carried out with 95% confidence interval (95% CI) (PROSPERO registration number: CRD42023462538). Nine research papers were selected, which collectively involved 194 males and 279 females. The meta-analysis outcomes revealed that DH intervention significantly improved balance (SMD, 0.41 [0.12, 0.69], p < 0.05) and pain level (SMD, − 1.10 [− 2.02, − 0.18], p < 0.05). The subgroup analysis of the pain level showed varied outcomes for the TKA (SMD, − 0.22 [− 0.49, 0.04], p = 0.10) or OA patients (SMD, − 2.80 [− 3.83, − 1.78], p < 0.05) Next, this study found no significant effect of DH intervention on knee joint range of motion (ROM) (SMD, 0.00 [− 0.76, 0.76], p = 1.00) and walking velocity (SMD, 0.04 [− 0.22, 0.29], p = 0.77) in patients with knee joint pain. The meta-analysis review conducted in this study revealed that DH intervention may potentially improve balance among the patients with knee joint pain. It may also alleviate the pain level particularly among OA patients.

Improving Outcomes in People with Spinal Cord Injury: Encouraging Results from a Multidisciplinary Advanced Rehabilitation Pathway.

Spinal cord injury (SCI) consists of damage to any segment of the spinal cord extending to potential harm to nerves in the cauda equina. Rehabilitative efforts for SCI can involve conventional physiotherapy, innovative technologies, as well as cognitive treatment and psychological support. The aim of this study is to evaluate the feasibility of a dedicated, multidisciplinary, and integrated intervention path for SCI, encompassing both conventional and technological interventions, while observing their impact on cognitive, motor, and behavioral outcomes and the overall quality of life for individuals with SCI. Forty-two patients with SCI were included in the analysis utilizing electronic recovery system data. The treatment regimen included multidisciplinary rehabilitation approaches, such as traditional physiotherapy sessions, speech therapy, psychological support, robotic devices, advanced cognitive rehabilitation, and other interventions. Pre-post comparisons showed a significant improvement in lower limb function (Fugl Meyer Assessment-FMA < 0.001), global cognitive functioning (Montreal Cognitive Assessment-MoCA p < 0.001), and perceived quality of life at both a physical and mental level (Short Form-12-SF-12 p < 0.001). Furthermore, we found a significant reduction in depressive state (Beck Depression Inventory-BDI p < 0.001). In addition, we assessed patient satisfaction using the Short Form of the Patient Satisfaction Questionnaire (PSQ), offering insights into the subjective evaluation of the intervention. In conclusion, this retrospective study provides positive results in terms of improvements in motor function, cognitive functions, and quality of life, highlighting the importance of exploring multidisciplinary approaches.

РОЛЬ И ВЛИЯНИЕ РАЗВИТИЯ ПРОТЕЗОСТРОЕНИЯ ВЕРХНИХ И НИЖНИХ КОНЕЧНОСТЕЙ НА ПОЛНОМАСШТАБНУЮ СОЦИАЛЬНУЮ ИНТЕГРАЦИЮ ТРУДОСПОСОБНЫХ ИНВАЛИДОВ

The research touches upon the issues of legal and financial accessibility of upper and lower limb prostheses (hereinafter - ULP) provided at the expense of budgetary funds to disabled people of working age, their functional capabilities for domestic and labor activities, as well as the introduction of innovative technologies in the production of ULP and the impact of the market of assistive products on increasing the motivation of disabled people to be involved in labor inclusion, including by expanding the range of employment opportunities. The aim of the research is to highlight the importance of the development of domestic scientific and technologically innovative production of technical rehabilitation devices and prosthetic and orthopedic products (TSR and prosthetic devices), as well as a wide market for their provision, including as mandatory and compensatory tools to increase the participation of disabled people in the creation of products and services in the actively developing labor market. The object of the research is scientific and technological achievements, industries, and clusters involved in the development and creation of technologically advanced rehabilitation aids to increase the inclusion of disabled people. The subject of the study is the impact of assistive technologies on the reintegration of disabled people into society. The scientific hypothesis is an attempt to prove that with the development of domestic scientific and technical production of assistive technologies, including prosthetics, the level of inclusion of persons with disabilities in society and the labor market should increase, and the financial accessibility of their suspension should be ensured. In the process of the research, the method of analysis and structuring of domestic and foreign experience in the development and creation of multifunctional rehabilitation devices as an instrument of inclusive mechanism that helps persons with disabilities to socialize and realize their labor potential in the labor market was used. The following conclusions were made based on the results of the research: state guarantees of accessibility and quality of rehabilitation equipment products, and their constant innovative modernization are essential for the disabled, which has a positive impact on the reintegration of persons with disabilities into the actively developing society and labor market; authorities at all levels need immediately begin to create a labor market for the disabled in connection with the actively advancing robotization and digitalization, and the use of artificial intelligence.

Evaluating a Tailored 12-Week Post-Operative Rehabilitation Program for Younger Patients Following Total Knee Arthroplasty: Addressing a Growing Need

Background: The prevalence of total knee arthroplasties (TKA) is rising, especially among younger patients due to sports-related injuries and early osteoarthritis onset. Post-operative outcomes in younger patients show promise, but current rehabilitation approaches lack specificity for this group. This study aims to evaluate a post-operative rehabilitation program tailored for younger TKA recipients.; Methods: Patients from a single arthroplasty center who underwent TKA were age and sex-matched into two groups: Group A with an advanced 12-week rehabilitation program and Group B with a standard rehabilitation program. Eligibility required participants to be under 60 and ready for a specific TKA type, with assessments at baseline and 12 weeks post-operative using the KSS, KOOS, and the SF-36 scales. Results: At the 12-week follow-up, Group A, having received the advanced rehabilitation protocol, showed significantly higher KOOS (A: 85.1 ± 8.7 vs. B: 83.7 ± 11.1; p=0.042) and KSS (A: 82.9 ± 8.4 vs. B: 78.7 ± 9.2; p=0.020) scores than Group B. Both groups demonstrated marked improvements with an attendance rate of 88% (A) compared to 82% (B), although we found no significant difference in overall mean tolerability scores between the groups. Conclusions: Patients undergoing advanced rehabilitation after total knee arthroplasty showed significant improvements compared to standard protocols. Despite minor variations influenced by social determinants, the advanced protocol was more effective in post-operative recovery.

The Impact of Occupational Therapy on Motor Function and Activities of Daily Living in Stroke Survivors

The current study aims to examine the impact of occupational therapy on motor function and activities of daily living in stroke survivors. It presents a quasi-experimental study assessing the effect of occupational therapy on enhancing motor function and ADLs in stroke survivors. The study involved 30 participants divided into control and experimental groups. The measures include Fugl-Meyer Assessment (FMA) and Katz Index of Independence in Activities of Daily Living (ADL). Significant improvements were observed in the experimental group in both motor function and ADLs, as shown by ANOVA and post-hoc tests. The findings highlight the efficacy of occupational therapy in facilitating recovery and improving quality of life post-stroke, integrating traditional approaches with innovative technologies. The study also shows the necessity of occupational therapy in stroke rehabilitation and its holistic impact on physical recovery and patient well-being. For healthcare systems, these findings show the importance of allocating resources towards occupational therapy services for stroke survivors. This includes investing in advanced rehabilitation equipment and ensuring adequate staffing. Additionally, healthcare systems should consider developing collaborative models of care that involve multidisciplinary teams, including occupational therapists, to provide comprehensive and holistic treatment for stroke survivors.

Developing a Program forAdvanced Physical Therapist Practice inAmputation Care.

Over the past 20 years, military medicine made greatstrides in the medical management of traumatically injured patients. Significant advancements were made in the treatment and rehabilitation after limb loss. These advancements can be attributed to the large number of complex patients presenting to military treatment facilities and the demand for medical professionals to provide care to patients with complex injuries and multiple traumatic amputations. The concern now is to maintain the skills needed to be prepared for the next conflict. To meet this demand, the Extremity Trauma and Amputation Center of Excellence (EACE) initiated the documentation of knowledge, skills, and abilities (KSAs) to ensure that the skill sets needed to treat this unique population are not lost. The EACE developed KSAs to sustain advanced clinical practice for physical therapists, occupational therapists, and prosthetists and is in the process of developing KSAs for orthotists and physical medicine physicians. The learning objectives [terminal and enabling learning objectives (TLOs and ELOs)] derived from each set of KSAs will drive curricula development for enduring education, residencies, and fellowships. This article describes the KSAs and learning objectives for advanced physical therapist competencies in amputation care. Clinical subject matter experts (SMEs) convened from the Department of Defense (DoD) Advanced Rehabilitation Centers (ARCs) to draft the initial KSAs. All experts had specific expertise in treating individuals with highly complex lower and upper limb amputation. In a quasi-Delphi methodology, the initial draft KSAs underwent five cycles of review and comment by an additional 15 DoD, Veterans Affairs, and civilian institution experts from clinical practice, education, and research. The consensus KSAs were then transcribed into learning objectives with collaboration between clinical subject matter experts and doctoral-level educators. The final program document has 21 instructional modules with 30 TLOs and 157 ELOs. The KSAs and the learning objectives describe the skills expected of an advanced practice physical therapist treating patients with traumatic limb loss. Weaknesses of this document include the focus on traumatic amputation and military specific needs. However, many of the central advanced practices are universal to all physical therapists working in amputation. Thus, this document should serve as a starting point and can evolve to include dysvascular, oncology, and other etiologies. To our knowledge, this is the first paper to describe the KSAs for the advanced practice physical therapist working with traumatic limb loss population. This work will form the framework for physical therapist advanced practice training programs.

Acute Effects of High Intensity Dual Task Training on Cognitive Workload in Young Adults

<h3>Research Objectives</h3> Dual tasking (DT) is necessary for daily living and requires intact cognitive and motor system functions. The cognitive workload is the combined mental and physical effort in response to the cognitive demand and time constraints of a task. The aim was to evaluate the short-term effects of high-intensity DT training on cognitive workload. <h3>Design</h3> Participants completed one session of high-intensity DT training. The training involved 6 bouts of 6 minutes of DT treadmill walking. <h3>Setting</h3> Laboratory for Advanced Rehabilitation Research in Simulation (LARRS), G042 of Olathe Pavilion at the University of Kansas Medical Center. <h3>Participants</h3> 40 healthy young adults with age = mean (Sd), 23.7 (1.4), 24 females (60%), The motor component of the DT program consisted of walking at 80% of self-selected overground speed and obstacle crossing on a virtual reality treadmill. <h3>Interventions</h3> The training involved 6 bouts of 6 minutes of DT treadmill walking. The motor component of the DT program consisted of walking at 80% of self-selected overground speed and obstacle crossing on a virtual reality treadmill. <h3>Main Outcome Measures</h3> The cognitive component consisted of working memory (2-back test). The cognitive workload was administered through self-report (NASA-TLX) and pupillometry (Index of Cognitive Activity; greater cognitive workload indexed by pupil dilation). <h3>Results</h3> Repeated Measures ANOVA showed significant improvements in walking speed, percentages of obstacles crossed, and the number of hits on the 2-back (p< 0.05). NASA-TLX scores decreased across training sessions, with the most significant changes observed in the first three bouts (p< 0.05). No changes in pupillary responses were observed. <h3>Conclusions</h3> Highly intense DT training on virtual reality treadmill training leads to decreased self-reported cognitive workload and improvements in motor and cognitive performance. Further studies should include more sessions of DT training to investigate whether short-term improvements in DT performance stem from decreased cognitive workload to attend to the tasks. <h3>Author(s) Disclosures</h3> Maryam Sadeghi, Joan Augustyn, Alexis Bieker, Erin Holtmeier, Kari Skinner, Jacob Sosnoff, Jeffrey Hausdorff, Hannes Devos

Hitting the Target? Achieving Optimal Cardiovascular Intensity for Persons With Spinal Cord Injury And Stroke

<h3>Research Objectives</h3> To investigate the feasibility of achieving the American Physical Therapy Association Locomotor Clinical Practice Guideline's cardiovascular intensity recommendations for persons with acute or sub-acute spinal cord injury (SCI) and acute or sub-acute cerebrovascular accident (CVA). <h3>Design</h3> A retrospective data-analysis from June 2020-June 2022. <h3>Setting</h3> 114 bed inpatient rehabilitation hospital. <h3>Participants</h3> 78 persons with acute/sub-acute spinal cord injury who participated in 253 locomotor sessions and 81 persons with acute/sub-acute stroke who participated in 222 locomotor sessions. <h3>Interventions</h3> Locomotor sessions were 30-60 minutes in duration and aimed to utilize advanced rehabilitation technology in order to achieve target heart rate recommendations within 60-80% heart rate reserve per the American Physical Therapy Association Locomotor Clinical Practice Guideline. <h3>Main Outcome Measures</h3> Average heart rate with activity, average maximum heart rate with activity, average target heart rate, average gait distance (feet), and rating of perceived exertion (RPE). <h3>Results</h3> 22.2% of persons with acute/sub-acute cerebrovascular accident achieved average target heart rate via average maximum heart rate, while 17.9% of persons with SCI achieved average target heart rate via average maximum heart rate. Average RPE was 15 for both SCI and CVA cohorts. Average session walking distance for persons with SCI and CVA were 1,250.95 feet and 1,313.45 feet, respectively. <h3>Conclusions</h3> Achievement of Locomotor Clinical Practice Guideline target heart rate values appear to be more feasible for persons with acute/sub-acute CVA than for SCI, although attainment of target heart rates were low for both groups. Gait distance and perceived exertion levels were similar between groups, although heart rate responses appeared to be different. <h3>Author(s) Disclosures</h3> None.

Efficacy of Robots-Assisted Therapy in Patients With Stroke: A Meta-analysis Update.

Robot-assisted therapy (RAT) could address an unmet need to relieve the strain on healthcare providers and intensify treatment in the context of an increasing stroke incidence. A comprehensive meta-analysis could provide firmer data about the topic by considering methodology limitations discovered in previous reviews and providing more rigorous evidence. This meta-analysis study identifies RAT's efficacy for patients with stroke. A systematic search of the 7 databases from January 10 to February 1, 2022, located relevant publications. We used the updated Cochrane risk-of-bias checklist for 52 trials to assess the methodologic quality of the included studies. The efficacy of RAT for patients with stroke was estimated using a pooled random-effects model in the Stata 16 software application. The final analysis included 2774 patients with stroke from 52 trials. In those patients, RAT was proven to improve quality of movement (mean difference, 0.15; 95% confidence interval, 0.03-0.28) and to reduce balance disturbances (mean difference, -1.28; 95% confidence interval, -2.48 to -0.09) and pain (standardized mean difference, -0.34; 95% confidence interval, -0.58 to -0.09). Robot-assisted therapy seems to improve the quality of mobility and reduce balance disturbances and pain for patients with stroke. These findings will help develop advanced rehabilitation robots and could improve health outcomes by facilitating health services for healthcare providers and patients with stroke.

Socialization and Physiotherapy Services to Youth Drugs Rehabilitation in Tanon Village, Sragen

Tanon is a sub-district in Sragen Regency, Central Java Province, Indonesia. Drug rehabilitation is one of the efforts to save addicts from the shackles of drugs and the dangers that accompany them; there are three stages of drug rehabilitation in Indonesia, namely medical, non-medical, and advanced rehabilitation. The implementation of the examination activities for adolescents was carried out using a descriptive method, namely providing an explanation of the benefits of physical examination exercises and introducing the role of physiotherapy to adolescents. In this study, the authors included age and health status characteristics in adolescent rehabilitation at the Indonesian Lentera Bangsa Foundation. Drug rehabilitation is one of the efforts to save addicts from the shackles of drugs and the dangers that accompany them; there are three stages of drug rehabilitation in Indonesia, namely medical, non-medical, and advanced rehabilitation. Specific data presenting a physical examination includes an examination of body conditions such as tests of balance, endurance, and agility of adolescents aged 16-25 years before a physical examination and after being given a physical examination, as well as the level of knowledge of adolescents about the function and role of physiotherapy. The results of data from respondents or adolescents indicate that the average level of knowledge about the role of physiotherapy and the benefits of providing physical exercise is in the "less" category due to the lack of physiotherapy graduates in the area where the author took this research.

Radial Extracorporeal Shock Wave Therapy Enhances Graft Maturation at 2-Year Follow-up After ACL Reconstruction: A Randomized Controlled Trial

Graft maturation is an important prognostic factor for hamstring autograft anterior cruciate ligament reconstruction (ACLR). It remains unclear whether extracorporeal shock wave therapy (ESWT) can promote graft healing after ACLR. To evaluate the therapeutic and graft maturation effects of ESWT in hamstring autograft ACLR. Randomized controlled trial; Level of evidence, 1. Between May 18, 2019, and September 20, 2019, we randomly assigned 30 patients who met study inclusion criteria to 2 groups. Patients in the control group followed a 5-week advanced rehabilitation training program (30 minutes/session, 5 times/week) starting at 3 months postoperatively. In the ESWT group, together with the 5-week advanced rehabilitation training, radial ESWT was applied once a week for 5 weeks. Functional scores (Lysholm, International Knee Documentation Committee, and Tegner scores), KT-1000 arthrometer knee laxity measurement, and magnetic resonance imaging scans were assessed at 3 months (baseline), 6 months, and 24 months postoperatively. To evaluate graft maturation, we assessed the graft signal-to-noise quotients (SNQs) of the tibial, intra-articular, and femoral sides on magnetic resonance imaging scans. Data were compared between the ESWT and control groups. In total, 26 patients (13 with ESWT, 13 controls) were assessed. There were no significant between-group differences on any assessment at baseline, and no significant within-group or between-group differences were found in knee laxity at any point. At 24-month follow-up, the ESWT group had significantly higher Lysholm and Tegner scores compared with the controls (P = .012 and .017, respectively). Regarding graft maturation, at 6-month follow-up, the SNQ of the tibial intraosseous graft was significantly lower in the ESWT group versus controls (P = .006), but no differences were detected at the femoral intraosseous graft (P = .321) or the intra-articular graft (P = .314). At 24-month follow-up, the SNQs of the femoral intraosseous graft and intra-articular graft were significantly lower in the ESWT group versus controls (P = .020 and .044, respectively) but no difference was found at the tibial intraosseous graft (P = .579). Both enhanced graft maturation and improved functional scores at 24-month follow-up were seen in patients who received radial ESWT during rehabilitation after hamstring autograft ACLR. ChiCTR1900022853 (Chinese Clinical Trial Registry).

Deep Convolution Generative Adversarial Network-Based Electroencephalogram Data Augmentation for Post-Stroke Rehabilitation with Motor Imagery.

The motor imagery brain-computer interface (MI-BCI) system is currently one of the most advanced rehabilitation technologies, and it can be used to restore the motor function of stroke patients. The deep learning algorithms in the MI-BCI system require lots of training samples, but the electroencephalogram (EEG) data of stroke patients is quite scarce. Therefore, the expansion of EEG data has become an important part of stroke clinical rehabilitation research. In this paper, a deep convolution generative adversarial network (DCGAN) model is proposed to generate artificial EEG data and further expand the scale of the stroke dataset. First, multichannel one-dimensional EEG data is converted into a two-dimensional EEG spectrogram using EEG2Image based on the modified S-transform. Then, DCGAN is used to artificially generate EEG data based on MI. Finally, the validity of the generated artificial EEG data is proved. This paper preliminarily indicates that generating artificial stroke data is a promising strategy, which contributes to the further development of stroke clinical rehabilitation.

A Hybrid Method Integrating A Musculoskeletal Model with Long Short-Term Memory (LSTM) for Human Motion Prediction.

So far, it shows a growing interest in the biomechanics community in the development of wearable technologies and their clinical applications, which enables the diagnosis of movement disorders and design of the rehabilitation interventions. To provide reliable feedback in the human-machine interface for advanced rehabilitation devices, methods to predict motion intention was developed which aim to generate future human motion based on the measured motion. An inertial measurement unit (IMU) is a promising device for motion tracking, with the advantages of low cost and high convenience in sensor placement to measure motion in almost every environment. However, it reveals that few contributions have been devoted to human motion prediction with pure IMU data. Thus, we propose a hybrid method integrating a musculoskeletal (MSK) model and the long short-term memory (LSTM) artificial neural network (ANN) to predict human motion. The proposed method was capable to predict motion in the daily tasks (stand-to-sit-to-stand and walking) for healthy participants: the predicted knee joint angles had an RMSE of 2.93° when compared to measured knee joint angles from the IMU data. The proposed method outperformed the methods based on the ANN/MSK model (RMSE of 31.15°) and LSTM without the integration of the MSK model (RMSE of 31.26°) in the motion prediction. Clinical Relevance- This proposed model based on IMU data alone has the great potential to become a low-cost, easy-to-use alternative in motion prediction to interact with advanced rehabilitation devices in clinical practice.