Conventional Rehabilitation Protocols Research Articles

Study on correlation between Chinese medicine syndromes in stroke and neurological deficits during recovery phase: Perspective.

Stroke is a leading cause of long-term disability and mortality worldwide, necessitating effective rehabilitation strategies for successful recovery. Traditional Chinese medicine (TCM) has gained recognition as a complementary and alternative approach in stroke rehabilitation, owing to its unique syndromes that offer valuable insights for personalized treatment plans. This study aims to elucidate the correlation between TCM syndromes observed during the recovery phase of stroke and the associated neurological deficits. Syndromes such as Blood stasis, Phlegm-dampness, Qi deficiency, and Yin deficiency were systematically examined, while standardized neurological assessments, encompassing motor function, sensory perception, and cognitive abilities, were employed to evaluate the extent of neurological impairment. Rigorous statistical analyses were conducted to discern potential correlations between TCM syndromes and the severity of neurological deficits. The results revealed statistically significant positive associations between certain TCM syndromes, particularly Blood stasis and Phlegm-dampness, and heightened neurological deficits during the recovery phase post-stroke. These findings suggest that these syndromes may serve as indicators of more severe brain injury post-stroke, thereby guiding the development of tailored rehabilitation strategies. By establishing robust connections between TCM syndromes and neurological deficits, this study contributes to advancing our understanding of stroke recovery through an integrated approach that incorporates TCM principles. Moreover, it underscores the potential benefits of integrating TCM into conventional rehabilitation protocols, offering valuable insights for healthcare professionals and potentially improving patient outcomes.

Does Focused Gluteus Medius Muscle Stretching After Total Hip Arthroplasty Work? An Electromyographic Study

BackgroundThe hypothesis of this randomized prospective study was that focused stretching of the gluteus medius muscle, in addition to generalized physical therapy, is likely to improve muscle reaction time and positively impact the return to function of the patient after primary total hip arthroplasty. MethodsWe prospectively recruited 28 patients undergoing primary total hip arthroplasty from January 2021 to January 2023. The control group (13 patients) received a conventional rehabilitation protocol, while the intervention group (15 patients) received focused stretching exercises of the gluteus medius muscle in addition to the conventional rehabilitation protocol. Patients had preoperative and postoperative surface electromyography (sEMG) to assess muscle activity. ResultsPatients in the intervention group after surgery had better muscle activation according to sEMG during walking and during one leg stance compared to the control group. Also, patients from the intervention group had better strength of the gluteus medius muscle after surgery, but this did not reach statistical significance. ConclusionsThe present prospective study demonstrated that implementation of focused gluteus medius muscle stretching results in statistically significantly higher muscle activation as measured by sEMG. The strength of the gluteus medius muscle is also higher as measured using a dynamometer, albeit not reaching statistical significance. Based on the findings of this sEMG study, it appears that focused stretching and strengthening of abductors muscles are beneficial.

Functional outcomes of accelerated rehabilitation protocol for anterior cruciate ligament reconstruction in amateur athletes: a randomized clinical trial.

Anterior cruciate ligament (ACL) rupture is the most common knee injury among athletes, and can result in long-term complications and career-ending conditions for sportspeople. There is no consensus in the literature on the effectiveness of rehabilitation after ACL reconstruction, or the best protocol to follow for functional outcome improvement. To determine the impact of an accelerated rehabilitation protocol on knee functional outcomes in amateur athletes with anterior cruciate ligament reconstruction (ACLR). Two-arm, parallel-group randomized comparative design. A total of 100 amateur male athletes (mean age 22.01 ± 1.79 years) with ACLR were randomly divided into experimental and control groups (n = 50/group). An accelerated rehabilitation protocol and a conventional rehabilitation protocol were used for the experimental group. In contrast, only the conventional rehabilitation protocol was used for the control group. The rehabilitation was delivered in 5 weekly sessions for 22 weeks. The primary outcome measure, knee pain, was measured using a visual analogue scale (VAS). Extensive test batteries, for hop tests, Knee Injury and Osteoarthritis Outcome Score (KOOS), and knee effusion, were measured, aiming to add more objective criteria to determine functional performance. Both groups (n = 50/group) were well-matched (p = 0.816), with insignificant differences in their demographic characteristics (p > 0.05). A multivariate analysis of variance (MANOVA) test showed no significant difference between the 2 groups (p = 0.781) at baseline. A 2-way MANOVA (2 × 2 MANOVA) of within- and between-group variations indicated overall significant treatment, time, and treatment × time interaction effects (p < 0.001) in favour of the accelerated rehabilitation group. The accelerated rehabilitation protocol was more effective in improving functional outcomes than a conventional rehabilitation protocol in amateur athletes with ACLR.

Therapeutic effectiveness of virtual reality-based exercise through Oculus Quest 2 on balance, dizziness, nystagmus, and quality of life in patients with posterior canal benign paroxysmal positional vertigo - a randomized control trial protocol

BPPV (benign paroxysmal positional vertigo) is one of the most prevalent causes of vertigo.The clinical features include nausea, imbalance, nystagmus, light-headedness, dizziness, fear of fall. Various exercises and maneuvers have been proved to be beneficial till date. Many technologies had also contributed in the physical rehabilitation. Virtual rehabilitation using virtual reality (VR) is a novel innovation in therapy. Virtual reality is widely used in treating the patients and adding to get back to their day-to-day life. Occulus quest 2 is a VR device. Depending on the patient's motions, Oculus Quest enables you to interact genuinely while immersing yourself in a virtual reality. BPPV is a very common condition and Posterior canal BPPV (PC-BPPV) is commonest of all. Most of the available literature targets conventional treatment including Exercises for repositioning and adaptation of otoconia. Comparative studies between the conventional rehabilitation protocols have also been done. There is paucity of research on virtual rehabilitation in PC-BPPV. VR utilizing Oculus Quest 2, a device designed to incorporate VR environment can be used to mobilize the patients head position there by repositioning the otoconia. Lack of evidence related to Virtual rehabilitation and specifically Oculus Quest 2 emphasises the need to study its effects on BPPV outcomes like balance, dizziness, quality of life and nystagmus. In this study, an attempt is made to use the oculus quest 2 for BPPV rehabilitation in addition to standard treatment. Patients will be divided into 2 groups control and experimental. Control group will receive Brandt-droff exercise on the other hand experimental will receive occulus quest 2 game “Coaster combat” in adjunct to the conventional. Berg balance scale, nystagmus time quality of life, dizziness handicap index and vertigo symptom scale are the outcomes. Outcomes will be assed at baseline and after 4 weeks.

Functional Considerations in Bilateral, Simultaneous Tendon Injuries of the Upper Extremity

» Bilateral, simultaneous same-tendon injuries of the upper extremity are rarely encountered, yet their unique complexity poses a substantial challenge for treating orthopaedic surgeons.» In general, extremities with more tendon retraction should be repaired acutely while contralateral injuries can be treated in a staged or simultaneous manner depending on injury morphology, location, and anticipated functional impairment.» Combinations of accelerated and conventional rehabilitation protocols can be used for individual extremities to minimize the length of functional impairment.

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.

Sequential Changes in Posterior Tibial Translation After Posterior Cruciate Ligament Reconstruction: Risk Factors for Residual Posterior Sagging.

Background:Residual posterior sagging may occur after posterior cruciate ligament (PCL) reconstruction (PCLR), yet when it mainly occurs is not fully understood.Purpose:To elucidate sequential changes in radiographic posterior tibial translation (PTT) after PCLR.Study Design:Case-control study; Level of evidence, 3.Methods:The authors retrospectively investigated the radiographic findings from 22 patients who underwent bisocket double-bundle PCLR for isolated PCL injury with at least 2 years of follow-up (mean, 4.5 years; range, 2-10 years). Injury severity was assessed using PTT on lateral radiographs with gravity sag views and was stratified according to side-to-side difference in the tibial-femoral stepoff: grade 1 (<5 mm), grade 2 (5 to <10 mm), or grade 3 (≥10 mm). Measurements were taken preoperatively and then immediately, 3 months, 6 months, 1 year, and ≥2 years postoperatively. The authors also investigated the risk factors for residual posterior sagging, indicated when PTT was ≥5 mm (grade ≥2) at the minimum 2-year follow-up.Results:Preoperatively, 13 patients had a grade 2 injury, and 9 had grade 3 injury. The PTT, restored immediately after PCLR, significantly increased at 3 months (P < .001) but remained unchanged thereafter ≥2 years. There were 7 cases of postoperative PTT ≥5 mm on radiographs. Patients with residual posterior sagging had significantly larger mean PTT than did those without residual posterior sagging at all time points except for immediately postoperatively (preoperatively, 9.1 ± 1.6 vs 12.2 ± 2.3 mm; 3-month follow-up, 2.7 ± 1.6 vs 7.0 ± 1.8 mm; ≥2-year follow-up, 3.4 ± 1.0 vs 6.5 ± 1.4 mm; P < .001 for all). Multivariate logistic regression analysis showed that preoperative grade 3 injury was independently associated with residual posterior sagging (OR, 26.809; 95% CI, 1.257-571.963; P < .001).Conclusion:The initially reduced postoperative PTT significantly increased within 3 months using conventional rehabilitation protocols, but no progression was observed up to 4.5 years after PCLR. Preoperative grade 3 injury was independently associated with residual posterior sagging.

Persistent quadriceps activation failure reduces in ACL reconstructed patients submitted to strength training based on force steadiness and visual feedback

Background:Quadriceps activation failure after anterior cruciate ligament reconstruction (ACLr) is related to the inhibition of alpha-motor units and results in muscle weakness. The quadriceps activation failure limits the rehabilitation outcomes, especially strength gains that are essential to the return to sport and to minimize the risk for the onset of knee osteoarthritis. Exercises involving force steadiness could reduce the variability of motor unit discharge rate and contribute to the force enhancement. On the other hand, force steadiness during isometric contractions involves controlling the fluctuations in the force signals, which might be enhanced by visual feedback. Therefore, the combination of force steadiness and visual feedback could have potential benefits for patients with persistent quadriceps activation failure.Objectives:To determine the effect of strength training with force steadiness and visual feedback on knee extension torque, knee stability, and knee pain in patients with persistent quadriceps activation failure after ACLr.Methods:Twenty-five patients (43.7±12.2 years-old, 69.8±10.8 kg, and 1.69±0.09 m, 10 men) with persistent quadriceps activation failure after ACLr non-responders to a conventional rehabilitation protocol were included in this case series. All protocols were approved by the local institutional ethics board. Persistent quadriceps activation failure was diagnosed based on the clinical history, temporal diphase with physical therapy protocol, non-gain of quadriceps strength after around 20 sessions of physiotherapy in the 9th month of rehabilitation, quadriceps weakness in the clinical examination, and abnormal isokinetic assessment (peak extensor torque<100 Nm, asymmetry in peak extensor torque>50%, or asymmetry in peak torque>70 Nm). All patients were submitted to an ACLr surgery performed by the same surgeon with semitendinosus-gracilis autograft. The intervention considered three sessions/week and lasted until 20 sessions or auto-perception of functional knee stability. The intervention and torque measurements were performed with an isokinetic device. A warmed up for 10 minutes on a cycle ergometer without load (60 rpm) was performed. After, they performed knee extension following a trapezoid curve feedback. Due to strength unbalances between ACLr and non-ACLr limbs, we used five series of 8 and 5 repetitions, respectively. The training was performed at a workload between 60% and 70%. Knee extension peak torque was determined at baseline and after training protocol. Proportions of responders and non-responders were extracted considering a threshold of 25.02 Nm. Knee pain (any painful feeling at the knee developed between the last and new session) and stability (same knee stiff sensation when they had not suffered the ACL injury) were also assessed as a binary proportion. A mixed ANOVA with 2 factors [time (before and after intervention), and limb (ACLr and non-ACLr limb)] was performed to compare the knee extension peak torque. To compare the proportion of intervention responders, knee stability, and pain before and after intervention the 2-tailed McNemar test was performed.Results:Training improved knee extension peak torque in the ACLr limb (98.2±47.2 to 155.2±78.9, Δ=57.0 Nm, p=0.031) and the non-ACLr (169.6±86.9 to 209.5±101.8, Δ=39.9 Nm, p=0.178). At baseline, lower torque was found in the ACLr limb (169.6±86.9 vs. 98.2±47.2, Δ=71.4, p=0.003) and remain different after training protocol (209.5±101.8 vs. 155.2±78.9, Δ= 54.3, p=0.026). Most of the patients (84%) increased knee extension peak torque (p<0.001), 72% increased self-reported knee stability (p<0.001), and 52% decreased knee pain (p<0.001).Conclusion:Strength training with force steadiness and visual feedback was an effective intervention to improve knee extensor torque in ACLr patients with persistent quadriceps activation failure identified 9 months after an auto-graph ACL surgery. We found that 21 out of 25 patients were able to respond positively to the intervention. The intervention also improved the self-report of stability and pain. Although the difference in torque between limbs suggests that the asymmetries persisted after the intervention. This intervention might be the first rehabilitation stage in persistent quadriceps activation failure. The next rehabilitation stage to normalize the inter-limb strength needs to be explored.

Early Intensive Inpatient Rehabilitation for Children Undergoing Hemispherotomy

Background: Hemispherotomy is the treatment of choice for children with refractory epilepsy. Although hemiplegia, sensory and motor impairments result from this surgical procedure, seizure control is effective as well as anticonvulsant dose reduction. Description of functional gains after rehabilitation of these children are still incomplete. Aims: To evaluate the effects of an early intensive rehabilitation program in the gross motor function of lower limbs after 30, 90, 180 and 360 days of surgery for the treatment of epilepsy (hemispherotomy), and compare to historic controls. Materials and Methods: prospective and longitudinal case series, with historic controls. Fourteen out of sixteen children who underwent hemispherotomy from January 2012 to February 2013 received an early rehabilitation protocol (ERP). Functional assessment included the Berg Balance Scale (BBS), Fugl-Meyer Scale (FMS) lower limb subscale, and Gross Motor Function System of Classification (GMFCS), as well as the need of wheelchairs and walking aids. A historical group of 13 children who received a conventional rehabilitation protocol (CRP) was used as control. Results: FMS and BBS improved in ERP subjects until 6 months after surgery and reached a plateau. One year after hemispherotomy, all children in the ERP group could walk independently and had mild limitations to mobility whereas, among those in the CRP subjects, there was a higher prevalence of musculoskeletal deformities and severe gait restrictions. Conclusions: ERP promotes rapid functional recovery during one-year follow-up and, as compared to the CRP group, the average functional capacity of the ERP group was considerably higher. These data support the beneficial effects of a specific, individualized and early rehabilitation approach for such patients.

Subakromiyal Ağrı Sendromunda Mulligan Hareketle Mobilizasyon Yöntemi ve Konvansiyonel Rehabilitasyon Protokolünün Omuz Ağrı ve Fonksiyonları Üzerine Olan Etkilerinin Karşılaştırılması: Prospektif Randomize Tek Kör Çalışma

Subakromiyal Ağrı Sendromunda Mulligan Hareketle Mobilizasyon Yöntemi ve Konvansiyonel Rehabilitasyon Protokolünün Omuz Ağrı ve Fonksiyonları Üzerine Olan Etkilerinin Karşılaştırılması: Prospektif Randomize Tek Kör Çalışma

Rehabilitation protocols following total knee arthroplasty: a review of study designs and outcome measures.

Total knee arthroplasty (TKA) is among the most common elective procedures performed worldwide. Recent efforts have been made to significantly improve patient outcomes, specifically with postoperative rehabilitation. Despite the many rehabilitation modalities available, the optimal rehabilitation strategy has yet to be determined. Therefore, this systematic review focuses on evaluating existing postoperative rehabilitation protocols. Specifically, this review analyses the study designs, rehabilitation methods, and outcome measures of postoperative rehabilitation protocols for TKA recipients in the past five years. The PubMed, EMBASE, and Cochrane Library databases were queried for studies evaluating rehabilitation protocols following primary TKA. Of the 11,013 studies identified within the last five years, 70 met the inclusion and exclusion criteria. After assessing for relevance and removing duplicates, a final count of 20 studies remained for analysis. Level-of-evidence was determined by the American Academy of Orthopaedic Surgeons (AAOS) classification system. Our findings demonstrated that continuous passive motion and inpatient rehabilitation may not provide additional benefit to the patient or healthcare system. However, early rehabilitation, telerehabilitation, outpatient therapy, high intensity, and high velocity exercise may be successful forms of rehabilitation. Additionally, weight-bearing biofeedback, neuromuscular electrical stimulation, and balance control appear to be beneficial adjuncts to conventional rehabilitation. Postoperative rehabilitation following TKA facilitates patient recovery and improves quality of life. This systematic review analyzed the existing rehabilitation protocols from the past five years. Some studies did not accurately describe the conventional rehabilitation protocols, the duration of therapy sessions, and the timing of these sessions. As such, future studies should explicitly describe their methodology. This will allow high-quality assessments and the conception of standardized protocols.

Update on intensive motor training in spinocerebellar ataxia: time to move a step forward?

Some evidence suggests that high-intensity motor training slows down the severity of spinocerebellar ataxia. However, whether all patients might benefit from these activities, and by which activity, and the underlying mechanisms remain unclear. We provide an update on the effect and limitations of different training programmes in patients with spinocerebellar ataxias. Overall, data converge of the finding that intensive training is still based either on conventional rehabilitation protocols or whole-body controlled videogames (“exergames”). Notwithstanding the limitations, short-term improvement is observed, which tends to be lost once the training is stopped. Exergames and virtual reality can ameliorate balance, coordination, and walking abilities, whereas the efficacy of adapted physical activity, gym, and postural exercises depends on the disease duration and severity. In conclusion, although a disease-modifying effect has not been demonstrated, constant, individually tailored, high-intensity motor training might be effective in patients with degenerative ataxia, even in those with severe disease. These approaches may enhance the remaining cerebellar circuitries or plastically induce compensatory networks. Further research is required to identify predictors of training success, such as the type and severity of ataxia and the level of residual functioning.

Paired associative stimulation after spinal cord injury: who should undergo?

Background: Paired associative stimulation (PAS) combines peripheral nerves stimulation (PNS) with transcranial magnetic stimulation (TMS) and it is believed to induce plastic changes in the human corticospinal tract after spinal cord injury (SCI). The aim of the present study was to investigate the advantages of PAS added to conventional rehabilitation protocol for patients with chronic SCI. Methodology: The study was monocentric sham-controlled and involved 11 patients with lower paraparesis 3-12 months after the trauma. TMS was delivered over vertex using a round coil with 150% of resting threshold. ESPN of both n. peroneous and n. tibialis was performed with supramaximal intensity at fossa poplitea for 5 minutes for each nerve. The interval between TMS and PNS was individually defined (around 35ms). The intervention consisted 30 sessions of 1Hz PAS in total. Results: After the intervention, the improvement of motor and sensory function (via ASIA impairment scale) was observed in both groups but the intergroup difference was insignificant (Mann–Whitney U test, p=0.0675). Spasticity (via modified Ashworth scale) was not changed significantly but 4 patients noticed more uncontrolled movements. Expectedly, patients with no peripheral M-response at the beginning do not demonstrated any improvements. The best functional outcome was found into patients with preserved MEP in the study group. Two patients with absent MEP at the beginning from the study group showed unstable MEP after a month. Conclusion: PAS could be seen as an additional tool to facilitate the recovery after chronic SCI. Patients with preserved MEP may benefit more from this technique. On the other hand, the absence of M response could be considered as an exclusion criterion while the selection of individuals for PAS. The choice of stimulation protocols is still arguable that can lead to diverse and controversial results.

Comparison of an Innovative Rehabilitation, Combining Reduced Conventional Rehabilitation with Balneotherapy, and a Conventional Rehabilitation after Anterior Cruciate Ligament Reconstruction in Athletes.

Instability of the knee, related to anterior cruciate ligament injury, is treated by surgical reconstruction. During recovery, a loss of proprioceptive input can have a significant impact. Few studies have evaluated the benefits of rehabilitation of the knee in aquatic environment on functional outcomes. This study aimed to compare an innovative rehabilitation protocol combining reduced conventional rehabilitation with aquatic rehabilitation, with a conventional rehabilitation, according to the National French Health Authority, in terms of kinetics, development of proprioceptive skills, and functional improvement of the knee. 67 patients, who were amateur or professional athletes, were randomized into two groups: 35 patients followed the conventional rehabilitation protocol (Gr1) and 32 patients followed the innovative rehabilitation protocol (Gr2). Patients were evaluated before surgery, and at 2 weeks, 1, 2, and 6 months after surgery using posturography, and evaluation of muscular strength, walking performance and proprioception. This study is multicenter, prospective, randomized, and controlled with a group of patients following conventional rehabilitation (level of evidence I). For the same quality of postural control, Gr2 relied more on somesthesia than Gr1 at 6 months. The affected side had an impact on postural control and in particular on the preoperative lateralization, at 2 weeks and at 1 month. Lateralization depended on the affected knee, with less important lateralization in Gr2 preoperatively and at 1 month. The quadriceps muscular strength was higher in Gr2 than in Gr1 at 2 and 6 months and muscle strength of the external hamstring was greater in Gr2 than in Gr1 at 6 months. The isokinetic test showed a greater quadriceps muscular strength in Gr2. Gr2 showed a greater walking distance than Gr1 at one month. Gr2 showed an improvement in the proprioceptive capacities of the operated limb in flexion for the first 2 months. The effectiveness of the innovative rehabilitation program permits faster recovery, allowing for an earlier return to social, sporting, and professional activities. Faster retrieval of knee function following aquatic rehabilitation would prevent both short-term risk of lesions of the contralateral limb due to overcompensation and long-term risk of surgery due to osteoarthritis. NCT02225613.

Effects of Kinesio taping for stroke patients with hemiplegic shoulder pain: A double-blind, randomized, placebo-controlled study.

To investigate the effects of Kinesio taping for stroke patients with hemiplegic shoulder pain. Double-blind, placebo-controlled clinical trial. Twenty-one stroke patients with hemiplegic shoulder pain within 6 months of stroke onset in the rehabilitation ward of a medical university hospital in Taiwan. A 3-week intervention involving a conventional rehabilitation protocol and therapeutic Kinesio taping was conducted with an experimental group of 11 stroke patients. A control group of 10 stroke patients underwent an identical conventional rehabilitation programme and sham Kinesio taping on the hemiplegic shoulder. Numerical rating scale scores, Shoulder Pain and Disability Index, ultrasound findings and pain-free passive range of motion of the affected shoulder, were evaluated before and after the intervention. Mann-Whitney test was used to compare within-group continuous variables before and after the intervention. Wilcoxon signed-rank test was used to analyse the differences and changes in values between study and control groups. There was no statistical difference in demographic variables between the 2 groups. Both groups showed improvement in passive range of motion of the shoulder, (mean numerical rating scale 2.36 (standard deviation (SD) 1.03)), and mean Shoulder Pain and Disability Index (16.64 (SD 2.62)) after the intervention (p < 0.001); however, no significant between-group differences were observed in the numerical rating scale score, pain-free passive ROM, and ultrasound findings for the shoulder after 3 weeks of treatment. Concerning the variables changes, the therapeutic Kinesio taping group showed more improvement in the numerical rating scale (p = 0.008), shoulder flexion (p = 0.008), external rotation (p = 0.006), internal rotation (p = 0.040), and Shoulder Pain and Disability Index (p < 0.001) than the sham Kinesio taping group. Stroke patients with hemiplegic shoulder pain can experience greater reductions in Shoulder Pain and Disability Index, pain, and improvement in shoulder flexion, external, and internal rotation after 3 weeks of Kinesio taping intervention compared with sham Kinesio taping. Kinesio taping may be an alternative treatment option for stroke patients with hemiplegic shoulder pain.

Use of three-dimensional gait analysis to assess the effectiveness of conventional rehabilitation protocols in people with Parkinson's disease

Massimiliano Pau , Federica Corona , Carlo Casula , Roberta Pili , Mauro Murgia , Marco Guicciardi . Department of Mechanical, Chemical and Materials Engineering, University of Cagliari, Cagliari, Italy; A.O. Brotzu, Cagliari, Italy; Department of Pedagogy, University of Cagliari, Cagliari, Italy; 4 Psychology, University of Cagliari, Cagliari, Italy; 5 Philosophy, University of Cagliari, Cagliari, Italy

Use of three-dimensional gait analysis to assess the effectiveness of conventional rehabilitation protocols in people with Parkinson's disease

Objectives: to assess the effectiveness of a 5-weeks rehabilitation protocol on people with Parkinson's Disease (PD) on the basis of spatio-temporal and kinematics parameters obtained from three-dimensional gait analysis.

Effect of Pranayama (Yogic breathing) on lung function in traumatic thoracic spinal cord injury patients: an interventional study

Background: The incidence of Global Spinal cord injury is 40 to 80 new cases per million populations every year. With low to high levels of spinal cord injury, the respiratory muscles are affected gradually. Lung function worsens up to about 50% to 70%. Total rib cage inflation is not possible. Involvement of the intercostal muscles leads to paradoxical movement which increases the work of breathing. Due to the involvement of the abdominal muscles, the effectiveness of diaphragm and coughing ability are reduced. This leads to respiratory disorders. All this can lead to fatigue and respiratory failure which affects the lung function parameters. Pranayama – a part of YOGA is an art of controlling the life force – the breath. It producesmany systemic and psychophysical effects in the body, besides its specific effects on the respiratory functions. Hence, the present study is designed to assess the shortterm effects of Pranayama on the lung function parameters. Purpose: The purpose of the study was to determine the effect of Pranayama – Yogic breathing on lung function parameters among patients with thoracic spinal cord injury during their hospital stay. Methods: Patients (level D4 to D9) between the age group of 20 to 50 were selected as per the selection criteria. Both male and female having ability to sit were included with written informed consent. Patients were equally divided into two groups Group A and Group B. Patients who were non co-operative and/or with other severe complications, like autonomic dysreflexia, chest trauma and abdominal trauma were excluded. Baseline spirometry tests (FVC, FEV1, FEV1/FVC, PEFR) were performed for both the group at study entry and at completion with and without binder. All patients received their conventional rehabilitation protocol at the institute. Group A received of training of pranayama as form of breathing exercises which comprised of OMCHANTING PRANAYAMA for 3minutes per day, ANULOM VILOM PRANAYAMA for 6minutes and BHRAMARI PRANAYAMA for 3minutes per day. Only group A received this training for 12minutes per session, once in a day for 15 days. Post intervention spirometry parameters same as before were measured. Results: Both the groups demonstrated an increase in all the lung function parameters. Wilcosan sign rank test and Mann–WhitneyU tests apply accordingly. However a significant differencewas observed only in the participants ofGroup A, while changes in lung function parameters in Group B did not reach significance (p< 0.05). Inter group comparison revealed a significant improvement in Group A than Group B (p< 0.05).Within group comparison between pre with binder and post without binder show no significant difference in group A (p< 0.05). Conclusion(s): The study demonstrates that inclusion of pranayama in the rehabilitation of spinal cord injury patients can improve lung function parameters which reduces use of external supportive devises for lung in traumatic thoracic spinal cord injury patients. Implications: Regular practice of Pranayama helps to improve lung function, and became an alternative to aids so it should be included in the rehabilitation program in traumatic spinal cord injury patients with impaired lung functions.

Knee pain after anterior cruciate ligament reconstruction: evaluation of a rehabilitation protocol

Anterior knee pain (AKP) is a rare and difficult complication following anterior cruciate ligament (ACL) reconstruction. This disabling pain is persistent with conventional rehabilitation protocols. The aim of this work is to validate a new rehabilitation protocol that may improve the patients and allow return to daily activities including sports. Forty-three patients identified with functional AKP after ACL reconstruction was enrolled in the rehabilitation protocol between 2009 and 2011. The series included twenty-six patients with hamstring grafting and seventeen patients with patellar tendon transplant. This study compares the functional outcomes and pain scores before and after the isokinetic protocol until the last follow-up at an average of 25.7 months after surgery. The evaluation was performed according to the International Knee Documentation Committee (IKDC) and included a pain assessment using the visual analog scale. Statistical analysis used Student's t-test for unpaired data and the Pearson correlation test for the variables. The IKDC scores were compared by the Wilcoxon test. Functional outcomes and pain are significantly improved (p<0.0001). The average IKDC score improved with 28 points and the pain improved with 3.2 points on the visual analog scale (VAS). The results are correlated with the follow-up time (p=0.008) but not correlated with the delay between the surgery and the beginning of the isokinetic protocol. Isokinetic rehabilitation provides a significant improvement in the knee function as measured by the IKDC score and by the VAS, regardless of the painful period preceding the program. The function improvement continues after the end of the protocol, but the pain may not completely disappear. The isokinetic rehabilitation program may resume functional AKP related to muscular deficit and may be used as the starter of other physical therapy protocols. IV.