Conventional Rehabilitation Program Research Articles

Effects of a Tai Chi rehabilitation program implemented using a hybrid online and offline mode on oxidative stress and inflammatory responses in patients with coronary heart disease: a randomized controlled trial

BackgroundCoronary heart disease (CHD) is the leading cause of death in both developed and many developing countries. Exercise training is a fundamental component of cardiac rehabilitation programs for patients with CHD. This study aims to investigate the effects of a Tai Chi rehabilitation program, which is provided through a hybrid online and offline mode, on oxidative stress and inflammatory responses in patients with CHD.MethodsA total of 34 patients with coronary heart disease were randomly assigned to two groups: an experiment group (n = 14, age 62.07 ± 9.076 years) and a control group (n = 20, age 61.90 ± 9.700 years). The experiment group underwent a 12-week Tai Chi cardiac rehabilitation program (TCCRP), while the control group followed a conventional exercise rehabilitation program (CERP) consisting of 1-h sessions, 3 times per week, for a total of 36 sessions. Participants were studied at baseline and post-intervention. The main assessments include the levels of Malondialdehyde (MDA), Superoxide dismutase (SOD), Tumor necrosis factor (TNF-α) and Interleukin-10 (IL − 10) in blood samples. Pearson correlation analysis was used, and the differences between the two groups were subsequently tested using two-way repeated ANOVA. Statistical significance was defined as a two-sided p-value of <0.05.ResultsThe key finding of the study reveals that MDA was significantly reduced by 1.027 nmoL/mL. Additionally, the TCCRP showed significant improvements in SOD and IL-10, with values of 10.110 U/mL and 2.441 pg./mL, respectively. Notably, a significant positive correlation was found between SOD and IL-10 (r = 0.689, p = 0.006), while MDA showed a significant positive correlation with TNF-a (r = 0.542, p = 0.045). In contrast, the ECRP group only showed a significant improvement in SOD.ConclusionThe study conducted a 12-week program on TCCRP, which utilized a hybrid online and offline model for individuals with coronary heart disease. The program showed promising results in alleviating oxidative stress and inflammation, possibly by regulating the balance between oxidative and antioxidative factors, as well as pro-inflammatory and anti-inflammatory factors.

The psychological well-being index and quality of life after a cardiac rehabilitation program based on aerobic training and psychosocial support

BackgroundThis study aimed to investigate the physical and psychological benefits of an alternative cardiac rehabilitation program based on therapeutic groups during physical exercise sessions and to compare the results with those of a conventional cardiac rehabilitation program. MethodThe sample included 112 patients from the cardiac rehabilitation unit of a medical center, 91.1 % of whom were male. The control group consisted of 47 subjects, with a mean age of 57.89 ± 12.30 and the experimental group consisted of 65 subjects, with a mean age of M = 58.38 ± 9.86. Quality of life, psychological well-being, health-related quality of life, body mass index, blood pressure, abdominal circumference and resting heart rate were measured before starting and at the end of the cardiac rehabilitation program. ResultsThe experimental group improved significantly more than the control group in body mass index, systolic and diastolic blood pressure, abdominal circumference, and resting heart rate (p value < 0.005). In addition, the experimental group had significantly greater improvements in quality of life, psychological well-being, and health-related quality of life than the control group (p-value < 0.001). ConclusionsA cardiac rehabilitation program based on simultaneous aerobic training and psychosocial support improved the physical function, health-related quality of life and well-being.

Wound healing rates in COPD patients undergoing traditional pulmonary rehabilitation versus tailored Wound-Centric interventions.

This comparative cross-sectional study, conducted at Shanghai Pulmonary Hospital, aimed to evaluate the efficacy of tailored wound-centric interventions (TWCI) versus traditional pulmonary rehabilitation (TPR) in enhancing wound healing in patients with chronic obstructive pulmonary disease (COPD). Enrolling 340 patients with confirmed COPD, the study randomly assigned participants to either the TWCI or TPR group for a 12-week programme. The primary outcome measured was the rate of wound healing, with secondary outcomes including changes in pulmonary function tests (PFTs) and quality of life (QoL) scores. The TWCI group received a customized programme integrating standard pulmonary rehabilitation with specific wound care strategies, such as enhanced oxygen therapy, nutritional supplementation, and infection control measures. In contrast, the TPR group underwent a conventional pulmonary rehabilitation programme without targeted wound care interventions. Wound healing rates, PFTs, and QoL scores were assessed at the end of the intervention and 3 months post-intervention. The TWCI group demonstrated a statistically significant improvement in wound healing rates compared with the TPR group. The TWCI group had a 15% higher rate of reduction in wound size, a 10% rise in complete healing rates, and a 20% drop in infection rates (p < 0.05). Specifically, TWCI group exhibited higher rates of wound size reduction, complete healing, and decreased infection rates. Additionally, long-term pulmonary function and overall quality of life improvements were more pronounced in the tailored group, underscoring the benefits of a personalized approach to managing COPD and wound care. The study concluded that integrating wound-specific care strategies with pulmonary rehabilitation significantly enhances health outcomes in COPD patients with wounds. These findings supported the adoption of customized, multidisciplinary care plans, suggesting that tailored interventions can offer a comprehensive solution to the complex needs of COPD patients, potentially redefining best practices in chronic disease management.

Improvements of mid-thigh circumferences following robotic rehabilitation in hemiparetic stroke patients.

Stroke has emerged as the leading cause of disability globally. The provision of long-term rehabilitation to stroke survivors poses a health care burden to many countries. Robotic devices have created a major turning point in stroke rehabilitation program. Currently, the anthropometric evidence to support the benefit of robotic rehabilitation (RR) among stroke patients is scarce. Therefore, the aim of this study was to evaluate the impact of RR on the mid-thigh circumferences of the paretic limbs in stroke patients. Twenty stroke patients from conventional rehabilitation (CR) (n=10) and RR (n=10) groups were recruited through a purposive sampling method. Patients in the CR group received a two-hour session of a five-day-a-week home-based CR program for 4weeks. Patients in the RR group received a five-day-a-week of an hour combined physiotherapy and occupational therapy session and a one-hour robotic therapy session using the HAL® Cyberdyne lower-limb, for 4weeks. The mid-thigh circumferences of both limbs were measured on day 1 (baseline), week 2 and week 4 of rehabilitation program. The results revealed no statistically significant difference in the mid-thigh circumferences between the paretic (F1.05,9.44=1.96, p=0.20), and the normal (F1.05,9.44=1.96, p=0.20) sides in the CR group (n=10). For the comparison between the paretic and normal sides in the RR group (n=10), the paretic mid-thigh circumferences revealed significant time effect results (F2,18=11.91, p=0.001), which were due to changes between baseline and week 2, and baseline and week 4 measurements. Interestingly, the normal mid-thigh circumferences also revealed a significant time effect (F2,18=6.56, p=0.007), which is due to changes between baseline and week 4. One-way analysis of variance was employed to compare the mean average between groups due to the difference in the baseline measurements of the mid-thigh circumferences between the paretic side of the CR and the RR groups. With this adjustment, the average means mid-thigh circumferences after 4weeks of therapy were shown to be significantly different between the CR and RR groups (F1,18=12.49, p=0.02). Significant increments in the mid-thigh circumferences following RR were seen in the paretic limbs of stroke patients. Hence, this study may provide some insights into further potential research related to the benefits of RR in stroke patients.

IMPROVE study protocol, investigating post-stroke local muscle vibrations to promote cerebral plasticity and functional recovery: a single-blind randomised controlled trial

IntroductionSpasticity is a frequent disabling consequence following a stroke. Local muscle vibrations (LMVs) have been proposed as a treatment to address this problem. However, little is known about their clinical...

Effects of Cognitive Sensory Motor Training Versus Repetitive Facilitation Exercises of Upper Limb in Hemiparetic Patients

Stroke [CVA] is the sudden loss of neurological function caused by an interruption of blood flow to the brain. Large numbers of people who survive a stroke are left with permanent impairment of arm and hand function, even after completion of conventional rehabilitation programs. The standard neuro physiological facilitation technique use for hemiplegic upper limb have not been confirmed to promote functional recovery of hemiplegic limb. This promote that more research needs to be conducted for same. Cognitive Sensory Motor Training Therapy &amp; The repetitive facilitation exercises (RFEs) Both techniques will promote functional recovery of hemiparetic upper limb and hand by improving joint perception and realization of movement. Hence, this study aims to compare the effectiveness of cognitive sensory motor training versus repetitive facilitation exercises on quality of movement of upper limb, functional activity and Range of motion of upper limb in hemiparetic patients. A blinded randomized clinical trial was conducted 30 patients were divided into 2 groups (GROUP A and GROUP B)- those who performed cognitive Sensory Motor exercises(GROUP A- experimental group) and those who performed repetitive facilitation exercises (GROUP B-control group) Data for measures quality of movement performance of the hemiparetic arm and hand on MESUPES scale, Barthel Index (BI) measures the extent to which somebody can function independently and has mobility in their &amp;, goniometer measuring the joint ranges in each plane of the joint was collected on day 1 (pretreatment session), and on 190 day after the experiment. This study produced a stastically significant increase in overall on quality of movement, functional activity and range of motion in both the group of upper limb in hemiplegic patients. This research also provides evidence that training exercise may be a valuable and important tool in clinical practice and is consistent with the current use by clinical physiotherapist in the treatment of upper limb in hemiplegic patients.

Effects of scapulo-humeral training on ultrasonographic and clinical evaluations in stroke: a randomized controlled trial

ABSTRACT Background After stroke, the effects of focused scapulo-humeral training with simultaneous assessment of the changes in shoulder subluxation, related muscle thicknesses and upper limb performance have not been studied in the literature. Objectives This study aimed to investigate the effects of an 8-week scapulo-humeral training program in addition to conventional rehabilitation on upper extremity/trunk functions, shoulder pain, and sonographic measurements of the shoulder joint and periscapular muscles. Methods Thirty stroke individuals were randomly separated into two groups as Group I-scapulo-humeral training (5F/10 M) and Group II – control (5F/10 M). Conventional rehabilitation program was applied to both groups, and a scapulo-humeral training exercise protocol was added for the scapulo-humeral group. All the treatments were applied for 1 hour/day, 3 days/week, 8 weeks. Clinical evaluations were made using the Fugl Meyer Assessment-Upper Extremity(FMA-UE), Action Research Arm Test(ARAT), ABILHAND, Visual Analog Scale, and Trunk Impairment Scale(TIS). Ultrasound was used to measure serratus anterior/lower trapezius muscle thicknesses, and acromion-greater tubercule/acromio-humeral distances. Results FMA-UE, ARAT, ABILHAND and TIS scores increased in both groups, with greater increases in most parameters in the scapulo-humeral training group. Shoulder pain decreased only in the scapulo-humeral training group. Subacromial distances were decreased on the paretic side, and muscle thicknesses increased on both sides in the scapulo-humeral training group, and in the control group, only serratus anterior muscle thickness increased on the paretic side (p < 0.05 for all). Conclusions Additional scapulo-humeral exercises to conventional rehabilitation was seen to improve upper extremity/trunk performance and shoulder pain, and to increase scapula stabilizer muscle thicknesses in stroke individuals with mild-moderate upper extremity disability.

Resultados da imaginação motora no fortalecimento muscular em membro inferior de uma pessoa com sequela pós acidente vascular cerebral: estudo de caso

Motor Imagination (MI) is the mental representation of a motor act without the actual execution of the movement. It activates the same brain areas as real movement, even in the presence of paralysis, missing limb or vision, and can be used in the process of conserving and stimulating brain engrams in the process of motor recovery of a paralyzed limb. Method: We report a 34-year-old patient with right hemiplegia due to ischemic stroke. He performed exercises with a Physical Educator professional, twice a week, 50 minutes/session, for 19 weeks, in addition to the conventional multidisciplinary rehabilitation program. The intervention was based on MI for flexion and extension of the knee on the paralyzed side, followed by the attempt of the same active movement. Results: Active range of motion (ROM_A) of the right knee flexors started at 217° with the minimum equipment load (11 lbs). Then, the professional asked the patient to imagine that he was performing the movement and then try to perform it. After 19 weeks, ROM_A was 112° Conclusion: The ROM_A gain of 8.48° for knee flexion of the paralyzed hemibody represents a clinically important minimal difference in post-stroke patients. MI increases the cognitive demand on the brain's motor networks, increasing plasticity, resulting in motor gains that impact the prognosis of capacity and functionality, justifying its use as a training method in post-stroke recovery. MI associated with strength training in rehabilitation contributes to the recovery of post stroke sequelae.

Effect of functional electrical stimulation-based mirror therapy using gesture recognition biofeedback on upper extremity function in patients with chronic stroke: A randomized controlled trial

Background: Mirror therapy (MT) is an intervention used for upper extremity rehabilitation in stroke patients and has been studied in various fields. Recently, effective MT methods have been introduced in combination with neuromuscular electrical stimulation or with electromyography (EMG)-triggered biofeedback. The purpose of this study was to investigate the effects of functional electrical stimulation (FES)-based MT incorporating a motion recognition biofeedback device on upper extremity motor recovery to chronic stroke patients. Methods: Twenty-six chronic stroke patients with onset of more than 6 months were randomly assigned into experimental group (n = 13) and control group (n = 13). Both groups participated in conventional rehabilitation program, while the control group received conventional MT intervention and the experimental group received FES-based MT with motion recognition biofeedback device. All interventions were conducted for 30 min/d, 5 d/wk, for 4 weeks. Upper limb motor recovery, upper limb function, active-range of motion (ROM), and activities of daily living independence were measured before and after the intervention and compared between the 2 groups. Results: The Fugl-Meyer assessment (FMA), manual function test (MFT), K-MBI, and active-ROM (excluding deviation) were significantly improved in both groups (P &lt; .05). Only the experimental group showed significant improvement in upper extremity recovery, ulnar and radial deviation (P &lt; .05). There was a significant difference of change in Brunstrom’s recovery level, FMA, MFT, and active-ROM in the experimental group compared to the control group (P &lt; .05). Conclusion: FES-based MT using gesture recognition biofeedback is an effective intervention method for improving upper extremity motor recovery and function, active-ROM in patients with chronic stroke. This study suggests that incorporating gesture-recognition biofeedback into FES-based MT can provide additional benefits to patients with chronic stroke.

Effects of Neuromuscular Electrical Stimulation on Spasticity and Walking Performance among Individuals with Chronic Stroke: A Pilot Randomized Clinical Trial.

Stroke and its associated complications are a major cause of long-term disability worldwide, with spasticity being a common and severe issue. Physical therapy, involving stretching exercises and electrical stimulation, is crucial for managing spasticity. Therefore, this study aimed to evaluate the effects of neuromuscular electrical stimulation (NMES) combined with a conventional rehabilitation program (CRP) on plantarflexor muscle spasticity and walking performance among individuals with chronic stroke. A pilot randomized clinical trial (RCT) with two groups (active NMES and placebo) was conducted at the physical therapy departments of King Fahad Specialist Hospital, Buraydah, and Sultan Bin Abdulaziz Humanitarian City, Riyadh, Saudi Arabia (November 2020). The assessor and participants were blinded for the group assignment. The active NMES group received exercise and stimulation at the dorsiflexor muscles on the paretic leg for 30 min for 12 sessions. The placebo group received exercise and sham stimulation at the same position and duration as the active group. Of interest were the outcomes for plantarflexor muscle spasticity measured by the modified Ashworth scale (MAS), gait speed measured by 10 m walk test (10-MWT), and functional mobility measured by functional ambulatory category (FAC). Nineteen participants were randomized into active NMES (n = 10) and sham NMES (n = 9) groups, with no significant baseline differences. Within the active NMES group, significant improvements were observed in MAS (p = 0.008), 10-MWT (p = 0.028), and FAC (p = 0.046), while only 10-MWT time improved significantly in the sham NMES group (p = 0.011). Between-group analysis showed that only MAS was significantly lower in the active NMES group (p = 0.006). Percent change analysis indicated a significantly higher increase in percent change for MAS in the active NMES group compared to the sham NMES group (p = 0.035), with no significant differences in other outcome measures. This study showed that NMES in the active group led to significant improvements in spasticity, walking performance, and functional ambulation. Further research is needed to determine the ideal parameters, protocols, and patient selection criteria for NMES interventions in stroke rehabilitation.

Immediate effects of kinesio taping and vibration therapy on manual dexterity in children with unilateral spastic cerebral palsy: a randomised controlled trial

Background/Aims In children with unilateral spastic cerebral palsy, the upper extremity is usually more affected than the lower extremity. Somatosensory, functional and developmental disorders cause difficulties in hand function. The aim of this study was to assess the immediate effects of kinesio tape and vibration therapy in addition to conventional physiotherapy on gross and fine manual dexterity in children with unilateral spastic cerebral palsy. Methods A total of 45 children aged 4–18 years with mild to moderate spasticity (at levels 0, 1, 1+, 2 according to the Modified Ashworth Scale) who could grip and release an object, and those who had hand function at levels 1, 2 and 3 according to the Manual Ability Classification System and were diagnosed with unilateral spastic cerebral palsy, were included in the study. The children were randomised into three groups: vibration therapy, kinesio taping and control, with 15 children in each group. While conventional physiotherapy was regularly continued in all three groups, the kinesio taping group had kinesio tape applied to the wrist extensors, with 50% tension on the wrist and thumb and 25% tension on the fingers at the beginning of the session. The vibration therapy group received vibration to the forearm extensor muscle group at the end of the session. Vibration was applied to the widest part of the forearm extensor muscles with a 7 cm tip at a frequency of 80 Hz, amplitude of 1 mm, vibration for 10 seconds and rest for 5 seconds, for a total of 10 minutes. Gross and fine dexterity were assessed by Box and Block Test and Nine-Hole Peg Test before and after treatment. Results When the groups were compared before and after the intervention, a significant improvement was found in the Nine-Hole Peg Test scores of the kinesio taping (105.11± 66.99 vs 86.22 ± 51.88, P&lt;0.05) and vibration therapy (61.70 ± 35.54 vs 57.29 ± 38.05, P&lt;0.05) groups and in the Box and Block Test scores of all three groups: kinesio taping group (25.13 ± 14.33 vs 28.40 ± 14.23, P&lt;0.05), vibration therapy group (35.00 ± 11.69 vs 39.07 ± 12.43, P&lt;0.05), control group (34.60 ± 11.74 vs 37.80 ± 11.22, P&lt;0.05). There was no significant difference in the Nine-Hole Peg Test scores between the groups, while a significant improvement was found in the Box-Block Test scores of the kinesio taping group compared to the vibration therapy and control groups (P&lt;0.05). Conclusions Kinesio taping and vibration have positive immediate effects on gross and fine manual dexterity in children with unilateral spastic cerebral palsy and can be used by physiotherapists to support conventional physiotherapy and rehabilitation programmes.

Synergy-based functional electrical stimulation and robotic-assisted for retraining reach-to-grasp in stroke: a study protocol for a randomized controlled trial

BackgroundStroke survivors have long-term upper limb impairment, which impacts the quality of life (QOL) and social reintegration, but there is lack of effective therapeutic strategies and novel technologies. Customized multi-muscle functional electrical stimulation (FES) based on the muscle synergy of healthy adults and robotic-assisted therapy (RAT) have been proved efficacy respectively. Synergy-based FES combined with RAT can be a novel and more effective therapy for upper limb recovery of stroke survivors from the perspective of synergistic enhancement. However, few studies have examined the effectiveness of combined synergy-based FES and RAT, especially for motor control evaluated by reach-to-grasp (RTG) movements. The main objective of the following research protocol is to evaluate the effectiveness and efficacy, as well as adoptability, of FES-RAT and FES or RAT rehabilitation program for upper limb function improvement after stroke.MethodsThis will be an assessor-blinded randomized controlled trial involving a 12-week intervention and a 6-month follow-up. Stratified randomization will be used to equally and randomly assign 162 stroke patients into the FES + conventional rehabilitation program (CRP) group, RAT + CRP group and FES-RAT + CRP group. Interventions will be provided in 5 sessions per week, with a total of 60 sessions. The primary outcome measurements will include the Fugl-Meyer Assessment and Biomechanical Assessment of RTG movements. The secondary outcome measurements will include quality of life and brain neuroplasticity assessments by MRI. Evaluations will be performed at five time points, including at baseline, 6 weeks and 12 weeks from the start of treatment, and 3 months and 6 months following the end of treatment. A two-way analysis of variance with repeated measures will be applied to examine the main effects of the group, the time factor and group-time interaction effects.DiscussionThe results of the study protocol will provide high quality evidence for integrated synergy-based FES and RAT, and synergy-based FES alone and guide the design of more effective treatment methods for stroke rehabilitation.Trial registrationChiCTR2300071588.

Virtual Reality Technology to Enhance Conventional Rehabilitation Program: Results of a Single-Blind, Randomized, Controlled Pilot Study in Patients with Global Developmental Delay.

Global developmental delay (GDD) is a complex disorder that requires multimodal treatment involving different developmental skills. The objective of this single-blind, randomized, controlled pilot study is to evaluate the feasibility and effectiveness of conventional rehabilitation programs integrated with the BTs-Nirvana virtual reality system. Patients with GDD aged 12 to 66 months were enrolled and treated for a 48-session cycle. Patients were randomized into two groups, (1) conventional treatment and (2) conventional treatment supplemented with the use of BTs-Nirvana, in a 1:1 ratio. Before and after treatments, areas of global development were tested with the Griffiths-III Mental Developmental Scale and the clinical indicator of global improvement were measured with the Clinical Global Impressions-Improvement (CGI-I). Feasibility was confirmed by the high retention rate. The experimental group presented a significantly improvement in General Quotient (GQ) after treatment (GQ, p = 0.02), and the effect of the two treatments was significantly different in both the GQ (t =2.44; p = 0.02) and the Foundations of Learning subscale (t =3.66; p < 0.01). The overall improvement was also confirmed by the CGI-I (p = 0.03). According to these preliminary data, virtual reality can be considered a useful complementary tool to boost the effectiveness of conventional therapy in children with GDD.

Proprioceptive Exercises in Hemiplegia Improve Balance and Spatiotemporal Parameters

Abstract Objective It was planned to investigate the effects of proprioceptive exercises applied to patients with hemiplegia on muscle tone, balance, perception, posture, mobility, and spatiotemporal parameters. Materials and Methods 70 participants with hemiplegia were randomized to an experimental group (conventional stroke rehabilitation program+proprioceptive exercise, 30 sessions) and a control group (conventional stroke rehabilitation program, 30 sessions). Timed Up and Go (TUG) Test, Modified Ashworth Scale (MAS), Posture Assessment Scale for Stroke Patients (PASS), Mini-Mental State Examination (MMSE), Rivermead Mobility Index (RMI), Spatiotemporal parameters (cadence, maximum plantar pressure, total weight transfer, step cycle duration, swing phase, step length and foot angle), and Berg Balance Scale (BERG) were applied on all participants before and after treatment. Results When the intra-group values were compared before and after the treatment, TUG, PASS, MMSE, RMI and BERG values increased significantly. MAS upper extremity and MAS lower extremity values decreased significantly. (p&lt;0.01). In the comparison between the groups, one of the spatiotemporal parameters, cadence, total weight transfer, and maximum plantar pressure values, increased significantly after the treatment. Step cycle duration, swing phase, step length and foot angle values decreased significantly after the treatment. (p&lt;0.01) Conclusion Unlike the literature, proprioceptive exercises that we add to the conventional rehabilitation program can be used to improve muscle tone, balance, perception, postural control, mobility, and spatiotemporal parameters.

Effects of Motor Rehabilitation on Balance and Functional Activities in Elderly Patients with Peripheral Neuropathy and Recurrent Falls.

To date, little is known about the effects of motor rehabilitation in peripheral neuropathy (PN) patients with a history of recurrent falls (RFH). This study aimed to assess balance and the activities of daily living (ADLs) in elderly lower limb PN patients with and without RFH and to verify the effects of motor rehabilitation on balance and ADLs in these patients. We collected data from 64 lower limb PN patients, who underwent a conventional motor rehabilitation program: 35 patients had a history of recurrent falls, and 29 did not. The Berg Balance Scale (BBS) and motor FIM, before and after rehabilitation, were the outcome measures. After rehabilitation, lower limb PN patients with RFH had significantly higher scores in BBS and motor FIM (p < 0.001, for both) than at entry. The final BBS score and effectiveness in the BBS score of lower limb PN patients with RFH were lower than those of patients without RFH (p < 0.05 and p = 0.009, respectively). The study shows that conventional motor rehabilitation improves both balance and ADLs in patients, but balance improvement is lower in those with RFH. Thus, motor rehabilitation can be a therapeutic option for the management of these patients.

Effects of adding interactive videogames to conventional rehabilitation program on radiological progression and upper extremity motor function in patients with hemiplegic stroke: a preliminary study

Objectives To investigate the effects of adding interactive videogames to conventional rehabilitation programmes on radiological progression and upper extremity functional status. Patients and Methods A total of 18 patients with hemiplegic stroke were randomized into two groups as conventional rehabilitation (control) group (n = 9), and the conventional rehabilitation + interactive videogames (intervention) group (n = 9). Each group received a 4-week program (5 days/week). Radiological progression (diffuse tensor imaging), and upper extremity functional status (upper extremity motor functioning part of the Fugl Meyer Assessment, self-care part of the Functional Independence Measure (FIM), and Motor Activity Log) were assessed at baseline and 4-week later. Results While no changes were detected in radiological status in the intervention group (p > 0.05), some regions on the affected side were improved significantly in the control group (p < 0.05). Total upper extremity motor functioning part of the Fugl Meyer Assessment scores and the self-care part of the FIM scores significantly improved in both groups (p < 0.05). No differences were detected in the amount of changes between groups (p > 0.05). Conclusion According to our results, adding videogames to a conventional rehabilitation program does not seem enhancing the radiological progression or the functional status of the upper extremities.

Shoulder Rehabilitation Exercises With Kinematic Biofeedback After Arthroscopic Rotator Cuff Repair: Protocol for a New Integrated Rehabilitation Program.

The recovery of scapular and humeral physiological kinematic parameters, as well as the sensorimotor control of movement, plays a primary role in the rehabilitation process after arthroscopic rotator cuff repair. A highly customized rehabilitation approach is required to achieve this aim. Biofeedback can be a useful tool, but there is poor evidence of its application in the rehabilitation after arthroscopic rotator cuff tear repair. The aim of this paper is to outline an innovative exercise-based rehabilitation program exploiting visual biofeedback for the recovery of patients arthroscopically treated for rotator cuff repair. For establishment of the innovative program, a multidisciplinary team involving experts in shoulder surgery, rehabilitation medicine, physical therapy, and biomedical and clinical engineering was formed. Starting from a conventional rehabilitation program, the team selected a set of exercises to be integrated with a biofeedback tool, named the INAIL (National Institute for Insurance against Accidents at Work) Shoulder and Elbow Outpatient program (ISEO program). ISEO is a motion analysis system based on inertial wearable sensors positioned over the thorax, scapula, humerus, and forearm. ISEO can return a visual biofeedback of humerus and scapula angles over time or of the scapula-humeral coordination, with possible overlap of patient-specific or asymptomatic reference values. A set of 12 progressive exercises was defined, divided into four groups based on humerus and scapula movements. Each group comprises 2-4 of the 12 exercises with an increasing level of complexity. Exercises can require the use of a ball, stick, rubber band, and/or towel. For each exercise, we present the starting position of the patient, the modality of execution, and the target position, together with notes about the critical factors to observe. The type of visual biofeedback to adopt is specified, such as the coordination between angles or the variation of a single angle over time. To guide the therapist in customizing the patient's rehabilitation program, a list of operative guidelines is provided. We describe various applications of the ISEO exercise program in terms of frequency and intensity. An innovative rehabilitation program to restore scapular and humeral kinematics after rotator cuff repair based on kinematic biofeedback is presented. Biofeedback is expected to increase patient awareness and self-correction under therapist supervision. Randomized controlled trials are needed to investigate the potential effect of the exercise-based biofeedback in comparison with conventional rehabilitation programs. DERR1-10.2196/35757.

Transcranial direct current stimulation combined with bodyweight support–tai chi footwork for motor function of stroke survivors: a study protocol of randomised controlled trial

IntroductionOur previous studies have proposed the bodyweight support–t’ai chi (BWS-TC) footwork training for stroke survivors with severe motor dysfunction and fear of falling, and have proven its positive effects for...

Evaluation of the impact of a smartphone application on adherence to home exercise program for people with chronic low back pain: research protocol for a pilot randomised controlled trial

IntroductionMultidisciplinary rehabilitation programmes are highly recommended for individuals with the most disabling low back pain (LBP). However, the long-term adherence to regular home exercise is often poor. We aim to...

Enhanced Recovery after Surgery Rehabilitation Protocol in the Perioperative Period of Orthopedics: A Systematic Review

Enhanced recovery after surgery (ERAS) is a surgical rehabilitation protocol of increasing interest to clinicians in recent years, with the aim of faster and better recovery of patients after surgery. Our main focus in this review is to analyze the effectiveness of ERAS rehabilitation protocols in orthopedic surgery. By comparing the post-operative recovery of patients receiving the ERAS rehabilitation program with that of patients receiving the conventional rehabilitation program, we observed whether the patients who have received the ERAS rehabilitation program could recover better and faster, thereby achieving the aim of a shorter hospital stay and reducing the incidence of complications. We conducted the literature searches in PubMed, MEDLINE, Web of Science, Cochrane Reviews, EMBASE and other databases on clinical studies related to orthopedic surgery regarding the effectiveness of rehabilitation using ERAS rehabilitation protocols compared with conventional rehabilitation protocols. A systematic review was performed in accordance with the Preferred Reporting Items of Systematic Reviews and Meta-analysis (PRISMA) statement. If there was variability in the rehabilitation data of the patients between the two subgroups, it was considered that there was a difference in the rehabilitation effect of the ERAS rehabilitation protocol and the conventional rehabilitation protocol on the patients. The application of ERAS rehabilitation protocols can shorten patients' hospital stay and reduce their expenses. In addition, patients with ERAS rehabilitation protocols will have fewer postoperative complications, while patients will have less postoperative pain than those with conventional rehabilitation, facilitating better postoperative recovery.