Effectiveness Of Rehabilitation Treatment Research Articles

Effect of Multimodal Intensive Rehabilitation Treatment on the Optimization of Dopaminergic Therapies in Patients with Moderately Advanced Parkinson’s Disease

Effect of Multimodal Intensive Rehabilitation Treatment on the Optimization of Dopaminergic Therapies in Patients with Moderately Advanced Parkinson’s Disease

Advanced neuroimaging techniques to explore the effects of motor and cognitive rehabilitation in multiple sclerosis.

Progress in magnetic resonance imaging (MRI) technology and analyses is improving our comprehension of multiple sclerosis (MS) pathophysiology. These advancements, which enable the evaluation of atrophy, microstructural tissue abnormalities, and functional plasticity, are broadening our insights into the effectiveness and working mechanisms of motor and cognitive rehabilitative treatments. This narrative review with selected studies discusses findings derived from the application of advanced MRI techniques to evaluate structural and functional neuroplasticity modifications underlying the effects of motor and cognitive rehabilitative treatments in people with MS (PwMS). Current applications as outcome measure in longitudinal trials and observational studies, their interpretation and possible pitfalls and limitations in their use are covered. Finally, we examine how the use of these techniques could evolve in the future to improve monitoring of motor and cognitive rehabilitative treatments. Despite substantial variability in study design and participant characteristics in rehabilitative studies for PwMS, improvements in motor and cognitive functions accompanied by structural and functional brain modifications induced by rehabilitation can be observed. However, significant enhancements to refine rehabilitation strategies are needed. Future studies in this field should strive to implement standardized methodologies regarding MRI acquisition and processing, possibly integrating multimodal measures. This will help identifying relevant markers of treatment response in PwMS, thus improving the use of rehabilitative interventions at individual level. The combination of motor and cognitive strategies, longer periods of treatment, as well as adequate follow-up assessments will contribute to enhance the quality of evidence in support of their routine use.

Gamma oscillations induced by 40-Hz visual-auditory stimulation for the treatment of acute-phase limb motor rehabilitation after stroke: study protocol for a prospective randomized controlled trial

BackgroundThe incidence of hemiparetic limb dysfunction reaches 85% in stroke patients, emerging as a critical factor influencing their daily lives. However, the effectiveness of current rehabilitation treatments is considerably limited, particularly in patients with upper extremity impairment. This study aims to conduct a prospective clinical trial to validate the safety and effectiveness of gamma oscillations induced by 40-Hz visual-auditory stimulation in treating post-stroke upper limb dysfunction and to explore the relevant mechanisms.MethodsThis trial is a prospective, randomized controlled, double-blind study. All enrolled patients were randomly assigned to two groups. The experimental group received intervention through 40-Hz visual-auditory stimulation, while the control group underwent intervention with randomly matched visual-auditory stimulation frequencies. The primary efficacy endpoint is the change in motor function. Secondary efficacy endpoints include motor-evoked potentials, cerebral hemodynamic changes, neural network connectivity, and alterations in synaptic-related genes. Safety evaluation included major adverse events, all-cause mortality, and photosensitive epilepsy. Assessments will be conducted at baseline, after a 14-day treatment period, and during subsequent follow-up visits (at 3 and 6 months) post-treatment. The differences between the two groups will be compared.DiscussionThis study will evaluate the safety and efficacy of gamma oscillations induced by 40-Hz visual-auditory stimulation in treating patients with upper extremity dysfunction after an acute cerebral stroke. Concurrently, we will explore potential mechanisms, including changes in synaptic-related genes and neural network connectivity. This trial is expected to provide evidence for the effectiveness of this new technique in treating upper extremity dysfunction after a stroke and improving patients’ quality of life.Trial registrationThe study protocol has been registered with the Chinese Clinical Trial Registry (ChiCTR) under registration number ChiCTR2300076579 on October 12, 2023.

Feasibility of Computerized Visuomotor Integration System for Visual Field Defects and Spatial Neglect in Poststroke Patients.

To develop a computerized visuomotor integration system for assessment and training of visual perception impairments and evaluate its safety and feasibility in patients with a stroke. Visual field defects and spatial neglect lead to substantial poststroke impairment. Most diagnostic assessments are anchored in traditional methods, and clinical effects of rehabilitation treatments are limited. The CoTras Vision system included two evaluations and four training modules. The evaluation modules were based on the Albert's test and Star cancellation test, and training modules were based on visual tracking, central-peripheral integration, and visuomotor perception techniques. Bland-Altman plots for agreement with the traditional paper-and-pencil test were performed, and the modified Intrinsic Motivation Inventory, Patient Satisfaction Questionnaire, and Simulator Sickness Questionnaire were conducted. Ten patients with acute stroke completed the study. Bland-Altman plots revealed good agreements for Albert's test (mean difference, -0.3±4.5) and Star cancellation test (mean difference, 0.3±0.7). The mean±standard deviation scores of the modified Intrinsic Motivation Inventory, Patient Satisfaction Survey, and Simulator Sickness Questionnaire were 84.7±30.6, 40.5±7.9, and 34.0±34.5 respectively. The CoTras Vision system is feasible and safe in patients with stroke. Most patients had a high degree of motivation to use the system and did not experience severe adverse events. Further studies are needed to confirm its usefulness in stroke patients with visual field defects and hemineglect symptoms. Furthermore, a large, well-designed, randomized controlled trial will be needed to confirm the treatment effect of the CoTras Vision system.

Clinical effects of early rehabilitation treatment after repair surgery of skin and soft tissue defects accompanied by extensor tendon injury on the back of hand

Objective: To explore the clinical effects of early rehabilitation treatment after repair surgery of skin and soft tissue defects accompanied by extensor tendon injury on the back of hand. Methods: This study was a retrospective non-randomized controlled study. From February 2015 to February 2023, 24 patients (15 males and 9 females, aged 12-55 years) with skin and soft tissue defects accompanied by extensor tendon injury on the back of hand, who met the inclusion criteria and were repaired with flap transplantation and tendon grafting or tendon anastomosis, were admitted to the First Affiliated Hospital of Air Force Medical University. According to different intervention time for postoperative rehabilitation treatment of patients, the patients were divided into conventional rehabilitation group and early rehabilitation group, with 12 cases in each group. Patients in early rehabilitation group received rehabilitation treatment immediately after surgery under the rehabilitation guidance of specialized rehabilitation physicians based on the characteristics of different postoperative periods. Patients in conventional rehabilitation group began rehabilitation treatment from the third week after surgery, and their rehabilitation treatment was the same as that of patients in early rehabilitation group from the second week after surgery. The patients in 2 groups were treated in the hospital until the sixth week after surgery. The occurrence of flap vascular crisis and tendon rupture were observed within 6 weeks after surgery. After 6 weeks of surgery, the manual muscle test was used to measure the pinching force between the index finger and thumb, lateral pinching force, three-point pinching force, and grip force of the affected hand; the total action motion method was used to evaluate the finger joint range of motion of the affected hand, and the excellent and good ratio was calculated; the Carroll upper extremity function test was used to score and rate the function of the affected hand. Results: Within 6 weeks after surgery, only 1 patient in conventional rehabilitation group suffered from venous crisis, and the flap survived after the second surgical exploration and anastomosis of blood vessels; there was no occurrence of tendon rupture in patients of 2 groups. After 6 weeks of surgery, there were no statistically significant differences in pinching force between the index finger and thumb, lateral pinching force, three-point pinching force, or grip force of the affected hand between the two groups of patients (P>0.05); the excellent and good ratio of the finger joint range of motion of the affected hand of patients in early rehabilitation group was 11/12, which was higher than 7/12 in conventional rehabilitation group, but there was no statistically significant difference (P>0.05); the affected hand function score of patients in early rehabilitation group was 90±6, which was significantly higher than 83±8 in conventional rehabilitation group (t=2.41, P<0.05); the function rating of the affected hand of patients in early rehabilitation group was obviously better than that in conventional rehabilitation group (Z=2.04, P<0.05). Conclusions: Early rehabilitation treatment for patients with skin and soft tissue defects accompanied by extensor tendon injury on the back of hand after repair surgery can improve hand function, but it would not increase surgery related complications, which is worthy of clinical promotion and application.

Effects of rehabilitation treatments jointly considered by physiatrists and rehabilitation therapists in patients with severe burn injury

Rehabilitation treatments for patients with severe burn injury (SBI) are difficult owing to the lack of knowledge, skills, and experience among clinicians and physical and occupational therapists, resulting in serious patient disability. This study retrospectively evaluated the effectiveness of rehabilitation treatments jointly considered by physiatrists and rehabilitation therapists (Physiatrist and Registered therapist Operating rehabilitation: PROr) for patients with SBI admitted to our hospital’s burn intensive care unit (BICU). Eligible patients were classified into the PROr and standard rehabilitation (SR) groups. Contents of the rehabilitation program in the BICU, the functional ambulation categories (FAC), and the Barthel index at the first rehabilitation, BICU discharge, and hospital discharge were collected. Of the 184 patients with severe burns admitted to the BICU, 29 (PROr group, n = 16; SR group, n = 13) met the eligibility criteria. The PROr group received more types of exercise interventions for a longer time than the SR group. No significant differences in the FAC and Barthel index scores at the first time of rehabilitation were found between the two groups; however, the scores of FAC and Barthel index at BICU and hospital discharges were higher in the PROr group than in the SR group. The PROr program may help in the functional improvement of patients with SBI.

ST-elevation myocardial infarction in patients with type 2 diabetes mellitus. Influence of the SGLT2 inhibitor dapagliflozin

Background. Patients with type 2 diabetes mellitus (T2DM) have a 2-fold higher risk of deve­loping coronary heart disease and mortality than those without carbohydrate metabolism disturbances. The reason for such negative trends is the occurrence of metabolic stress due to hyperglycemia and insulin resistance, which causes disturbance in energy metabolism and ischemic damage to cardiomyocytes. The purpose of the study is to improve the effectiveness of rehabilitation treatment and assess the dynamics of quality of life in patients with ST-elevation myocardial infarction (STEMI) and T2DM who are at high risk of develo­ping cardiac complications during the inpatient treatment by including the sodium-glucose transport protein 2 (SGLT2) inhibitor dapagliflozin in the comprehensive therapy. Materials and methods. The study group consisted of 38 patients with STEMI and T2DM who received dapagliflozin in addition to percutaneous coronary intervention (PCI). The control group included 37 patients with STEMI and T2DM who received only standard protocol treatment after PCI. In addition to general clinical examinations and assessment of quality of life using the EuroQol Group EQ-5D-5L questionnaire (1990), echocardiography was performed to determine general and local myocardial contractility by the Simpson method; plasma levels of glucose, insulin were evaluated, and insulin resistance was determined by the HOMA-IR. Results. Patients with STEMI and T2DM after PCI most often developed reperfusion syndrome with left ventricular failure and rhythm disturbances. Under the influence of standard medical treatment, a significant clinical and functional improvement was observed, but postinfarction remodeling progressed with impaired systolic and diastolic function and the development of heart failure syndrome, as well as treatment-resistant atrial and ventricular fibrillation paroxysms, supraventricular and ventricular extrasystoles, and bundle branch block. In patients of the study group with STEMI and T2DM on the comprehensive treatment with the SGLT2 inhibitor dapagliflozin, a significant decrease in the frequency of rhythm and conduction disturbances was noted on the se­cond day of observation, as well as a decrease in postinfarction left ventricular remodeling, which ultimately manifested in a statistically significant improvement of myocardial contractility (ejection fraction increased by 6.7 %) and a decrease in diastolic dysfunction. There was also a significant decrease in the frequency and severity of reperfusion arrhythmias, which was achieved due to the cardiometabolic effect of the SGLT2 inhibitor dapagliflozin. Conclusions. The inclusion of the SGLT2 inhibitor dapagliflozin in the comprehensive treatment led to a significant improvement in central cardiac hemodynamic parameters and a decrease in the frequency and severity of reperfusion arrhythmias and acute left ventricular failure, which contributed to the improvement in quality of life.

Efficacy of acupuncture and rehabilitation therapy on brain function activation area and neurological function in ischemic stroke: A systematic review and meta-analysis.

The probability of motor deficits after stroke is relatively high. At the same time many studies have reported that acupuncture and rehabilitation therapy have a significant effect on the treatment of stroke. This systematic review and meta-analysis aimed to evaluate the clinical value of acupuncture and rehabilitation therapy on brain eloquent areas and neurological function in ischemic stroke. Seven databases were electronically searched to screen randomized controlled trials (RCTs) of different intervention methods (acupuncture, rehabilitation) in the treatment of ischemic stroke. The search time is from January 1, 2000 to April 20, 2023, and the search languages are limited to Chinese and English. Two researchers independently screened literature and extracted data. The methodological quality of the studies was assessed using the Cochrane Handbook for Systematic Reviews of Interventions. A total of 17 randomized controlled studies were included, including 699 patients, with a maximum sample size of 144 cases and a minimum sample size of 11 cases. Among them, 3 studies reported the brain function in SM1 area. The effective rate of the experimental group was higher than that of the control group [relative risk (OR) = 3.24, 95%CI: 1.49 to 7.05, P < 0.05]. The FMA score of patients in the experimental group was higher than that in the control group [mean difference (MD) = 4.79, 95% CI: 3.86 to 5.71, P < 0.00001]. The NIHSS score of patients in the experimental group was lower than that in the control group [mean difference (MD) = -4.12, 95% CI: -6.99 to -1.26, P < 0.05].None of studies reported adverse events. Acupuncture rehabilitation for ischemic stroke can activate corresponding brain functional areas and improve neurological deficits. The therapeutic effect of acupuncture rehabilitation treatment is better than that of basic western medicine treatment, and it is more effective in improving neurological deficits. At the same time, clinical research needs to use high-quality randomized double-blind controlled trials with more detailed and larger sample designs, long-term efficacy evaluation and evidence-based research methods.

Symptomatic Tarlov cysts: A case series and effectiveness of multimodal rehabilitation plus pharmacological treatment

BackgroundTarlov cysts, or perineural cysts, are nerve root lesions most frequently found in the sacral region, and are generally asymptomatic. They are usually detected incidentally and their association with sexual, bladder, or bowel dysfunction is frequently ruled out. AimsWe describe the management of a series of patients with symptomatic Tarlov cysts using a protocol that combines multimodal rehabilitation (biofeedback+posterior tibial nerve stimulation+INDIBA® radiofrequency) and pharmacological treatment (Tiobec Dol® dietary supplement and/or acetazolamide) and evaluate the effect of this programme on pain and pelvic floor muscle strength. Material and methodsRetrospective study of 5 patients with urinary or faecal incontinence and pelvic pain or dyspareunia, who presented Tarlov cysts.The outcome variables were: (1) pain as measured with the visual analogue scale (0–10) and (2) maximal and mean pelvic floor muscle strength (in mm Hg) at baseline and after treatment completion. ResultsTreatment improved mean pelvic floor muscle contraction from 9.2±6.01mmHg to 10.6±5.2mmHg (P=.3111) and maximal pelvic floor muscle contraction from 41.2±21.98mmHg to 45.8±17.51mmHg (P=.4430), and decreased pain from 8±1.26 points to 4.6±2.65 points (P=.0343). ConclusionsTarlov cysts may cause pain and radiculopathy, although they are usually asymptomatic and, consequently, underdiagnosed. More rarely, they cause urinary, bowel, and sexual dysfunction. We describe the cases of 5 patients with Tarlov cysts presenting with incontinence and pain who were managed with multimodal rehabilitation plus pharmacological treatment. Cases of Tarlov cysts should be reported and studied; this will help to expand our understanding of their pathophysiology and to standardise effective multimodal treatment.

A Real-Time Control Method for Upper Limb Exoskeleton Based on Active Torque Prediction Model.

Exoskeleton rehabilitation robots have been widely used in the rehabilitation treatment of stroke patients. Clinical studies confirmed that rehabilitation training with active movement intentions could improve the effectiveness of rehabilitation treatment significantly. This research proposes a real-time control method for an upper limb exoskeleton based on the active torque prediction model. To fulfill the goal of individualized and precise rehabilitation, this method has an adjustable parameter assist ratio that can change the strength of the assist torque under the same conditions. In this study, upper limb muscles' EMG signals and elbow angle were chosen as the sources of control signals. The active torque prediction model was then trained using a BP neural network after appropriately extracting features. The model exhibited good accuracy on PC and embedded systems, according to the experimental results. In the embedded system, the RMSE of this model was 0.1956 N·m and 94.98%. In addition, the proposed real-time control system also had an extremely low delay of only 40 ms, which would significantly increase the adaptability of human-computer interactions.

The influence of bias in randomized controlled trials on rehabilitation intervention effect estimates: what we have learned from meta-epidemiological studies.

This study aimed to synthesize evidence from studies that addressed the influence of bias domains in randomized controlled trials on rehabilitation intervention effect estimates and discuss how these findings can maximize the trustworthiness of an RCT in rehabilitation. We screened studies about the influence of bias on rehabilitation intervention effect estimates published until June 2023. The characteristics and results of the included studies were categorized based on methodological characteristics and summarized narratively. We included seven studies with data on 227,806 RCT participants. Our findings showed that rehabilitation intervention effect estimates are likely exaggerated in trials with inadequate/unclear sequence generation and allocation concealment when using continuous outcomes. The influence of blinding was inconsistent and different from the rest of medical science, as meta-epidemiological studies showed overestimation, underestimation, or neutral associations for different types of blinding on rehabilitation treatment effect estimates. Still, it showed a more consistent pattern when looking at patient-reported outcomes. The impact of attrition bias and intention to treat has been analyzed only in two studies with inconsistent results. The risk of reporting bias seems to be associated with overestimation of treatment effects. Bias domains can influence rehabilitation treatment effects in different directions. The evidence is mixed and inconclusive due to the poor methodological quality of RCTs and the limited number and quality of studies looking at the influence of bias and treatment effects in rehabilitation. Further studies about the influence of bias in RCTs on rehabilitation intervention effect estimates are needed.

WEARABLE GAIT DEVICE FOR LONG-TERM MONITORING

This study describes a low-cost and easy to deploy gait monitoring system that uses an ESP32 microcontroller and an ICM-20948 module. The ESP32 microcontroller collects data from the ICM-20948 module and these data are used to train a convolutional neural network (CNN) to classify gait patterns into two categories: normal and pathological. The results show that the system can achieve a high accuracy for binary gait classification, being able to correctly classify 97.05% of the normal gait samples and 84.54% of the pathological gait samples. The power consumption of the devive was measured using a calibrated and dual-acquisition digital multimeter. The estimated operating time was around 12 hours, with a battery capacity of 1800 mAh LiPo type. Therefore, it could be used to track the gait of patients with neurological disorders or to assess the effectiveness of gait rehabilitation treatments.

Effects of sports rehabilitation plus platelet-rich plasma treatment on knee cartilage injuries and the expression of inflammatory factors in synovial fluid: A cartilage injury model

This research examined the efficacy of sports rehabilitation training plus platelet-rich plasma (PRP) for cartilage injuries of the knee (CIK) in athletes and its influence on the expression of inflammatory factors (IFs) in synovial fluid in a cartilage injury model. One hundred and four athletes with CIK were selected as the study population, and the selection time was between October 2019 and October 2022. The research (n = 53) and control (n = 51) groups underwent sports and traditional rehabilitation training interventions, respectively. Concurrently, PRP was injected into the affected knee joints of all patients in the research group. The curative effect, knee function (Hospital for Special Surgery [HSS] Knee Scoring System), and motor function (Tegner Activity Scale) in both groups were observed and compared. Furthermore, a rabbit CIK model was established. Hematoxylin and eosin staining and enzyme-linked immunosorbent assay were performed to identify pathological conditions and synovial fluid IFs (tumor necrosis factor [TNF]-α and interleukin [IL]-1β), respectively. The analysis revealed a remarkably higher total effective rate of treatment and notably elevated post interventional HSS and Tegner scores in the research group than in the controls. After modeling, the model group exhibited significant pathological conditions of CIK with overexpressed IFs (IL-1β and TNF-α) in synovial fluid. Conversely, pathologic conditions were obviously ameliorated and IFs were markedly suppressed after undergoing sports rehabilitation training, with better outcomes than traditional rehabilitation training. Therefore, sports rehabilitation training plus PRP can significantly improve CIK in athletes and consequently, knee and motor functions, while considerably mitigating and inhibiting the pathological effects of IFs in synovial fluid in the cartilage injury model.

Combined effect of medical therapy and rehabilitation in Chronic Ataxic Neuropathy with anti-Disialosyl IgM Antibodies (CANDA): a case report.

Chronic Ataxic Neuropathy with anti-Disialosyl IgM Antibodies (CANDA) is a rare form of immune-mediated sensory ataxic neuropathy. We describe the case of a 45-year-old man, who was diagnosed with CANDA in October 2018. Since then, he has been treated with monthly courses of intravenous immunoglobulin administration (IV Ig) and, in October 2022, he underwent plasmapheresis, reporting a sudden worsening of clinical and motor picture. After a new IV Ig cycle admission, the patient was hospitalized to perform intensive rehabilitation, involving two individual sessions per day (90 minutes each) for 5 days a week. During hospitalization it was registered a relevant improvement in the muscle strength of the lower limbs (LLs). Furthermore, progressive improvements were recorded both in patient's motor performance and in his level of autonomy in activities of daily living. These results had a positive impact on his quality of life and made it possible to reduce the frequency of IV Ig treatments. This is the first case in literature reporting the combined effect of rehabilitation treatment and medical therapy in CANDA neuropathy.

Top-down and bottom-up stimulation techniques combined with action observation treatment in stroke rehabilitation: a perspective.

Stroke is a central nervous system disease that causes structural lesions and functional impairments of the brain, resulting in varying types, and degrees of dysfunction. The bimodal balance-recovery model (interhemispheric competition model and vicariation model) has been proposed as the mechanism of functional recovery after a stroke. We analyzed how combinations of motor observation treatment approaches, transcranial electrical (TES) or magnetic (TMS) stimulation and peripheral electrical (PES) or magnetic (PMS) stimulation techniques can be taken as accessorial physical therapy methods on symptom reduction of stroke patients. We suggest that top-down and bottom-up stimulation techniques combined with action observation treatment synergistically might develop into valuable physical therapy strategies in neurorehabilitation after stroke. We explored how TES or TMS intervention over the contralesional hemisphere or the lesioned hemisphere combined with PES or PMS of the paretic limbs during motor observation followed by action execution have super-additive effects to potentiate the effect of conventional treatment in stroke patients. The proposed paradigm could be an innovative and adjunctive approach to potentiate the effect of conventional rehabilitation treatment, especially for those patients with severe motor deficits.

Decision-making for intensive rehabilitation in patients with Trousseau syndrome: Insights from a case series.

Patients with Trousseau syndrome, a common complication of advanced cancer, typically have poor survival. For that reason, there is a need to determine the effectiveness of rehabilitation treatment and develop a comprehensive treatment strategy earlier than that in the general stroke population. We investigated the relationship between physical function and its outcome 1 month after the start of intensive rehabilitation treatment in patients with Trousseau syndrome, to obtain insights for determining the indications for intensive rehabilitation in these patients. The development of Trousseau syndrome may worsen the performance status (PS), often necessitating a reevaluation of the indications for treatment of the primary cancer. Furthermore, the primary cancer may progress during rehabilitation therapy. These patients were diagnosed with Trousseau syndrome. All patients underwent training under the supervision of a therapist for 2 to 3 hours per day, 7 days per week, with a focus on exercise therapy. The functional independence measure (FIM) 1 month after admission to the convalescent rehabilitation ward, modified Rankin scale (mRS) score on admission and on the date of last assessment, and its outcome was examined. The time from stroke onset to admission to rehabilitation ranged from 22 to 60 days. Primary cancers were lung, bladder, prostate, ovarian, uterine, and unknown primary. Four patients had advanced cancer with distant metastasis. Two patients were discharged to home with independent activities of daily living (ADL) status. Two patients were transferred to palliative care, and 3 patients died. The 2 patients with independent ADL status had a mean motor score of 90 and a mean cognitive score of 30 on FIM, while the other 5 patients had a mean motor score of 29 and a mean cognitive score of 21 at 1 month of admission. Patients with mRS > 3 on admission did not have independent ADL status at 1 month. Intensive rehabilitation therapy may be indicated for patients with Trousseau syndrome who are expected to improve physical function after approximately 1 month of rehabilitation. Palliative care should be considered if recovery is inadequate.

Haloaerosoltherapy and complex recovery treatment based on it as methods of physical rehabilitation for patients with chronic obstructive pulmonary disease

Rehabilitation programs for patients with COPD are based on physical exercises usage, but accounting low tolerance to physical activity, this is not always a real task. The aim is to study the effect of haloaerosoltherapy (HAT) and complex rehabilitation treatment based on it on functional recovery of COPD patients. Materials and methods: 133 patients with COPD (GOLD II-III) beyond acute period were examined. Bronchial obstruction, intensity of clinical manifestations, disturbances of cardiovascular system were investigated. The 6-minute walk test was conducted. Results: Before treatment, it has been shown that exercise tolerance significantly depended on severity of bronchial obstruction, intensity of clinical manifestations and degree of cardiovascular risk. Treatment was carried out according to three treatment complexes (TC). TC-1 was based on HAT usage with certain concentration and dispersion of aerosol, 18-20 seances per course. In TC-2, singlet oxygen therapy was included, in TC-3 mineral water was administered as drinking use and inhalation. After course of treatment, walking distance covered in 6 minutes has been increased in patients of all groups. When using complex treatment, these changes were more pronounced. Con-clusions: HAT with appropriate dispersion and concentration of haloaerosol promotes in-creasing tolerance to physical activity and may be used as a stage of physical rehabilitation with possible subsequent therapeutic physical exercises. Notably pronounced positive dy-namics of studied data was noted in COPD patients convalescents after COVID-19.

Haloaerosoltherapy and complex recovery treatment based on it as methods of physical rehabilitation for patients with chronic obstructive pulmonary disease

Haloaerosoltherapy and complex recovery treatment based on it as methods of physical rehabilitation for patients with chronic obstructive pulmonary disease

The effect of intensive rehabilitation treatment on sleep disorder in children with motor delays

BackgroundAlthough the importance of sleep problems has been increasingly emphasized due to the effects on children's development and children's and families' daytime behaviors, physical health, and quality of life, they have been overlooked in clinical practice. However, there have been few studies on the effects of rehabilitation on sleep problems. Therefore, in this study, we investigated the effects of an intensive rehabilitation program on sleep problems in children with developmental delays (DD).MethodsWe included 36 children with DD (30 outpatients, 6 inpatients) and their caregivers who completed all items on the Sleep Disturbance Scale for Children. Of the children with DD, 19 (59.3%) had cerebral palsy (CP) and 13 (40.7%) had DD of non-CP origins, of which 6 (18.8%) had prematurity, 4 (12.5%) had genetic causes, and 3 (9.4%) had an unknown origin. Changes in sleep problems after the intensive rehabilitation program were evaluated using a paired or unpaired t-test, depending on the distribution of the continuous variables.ResultsAfter the intensive rehabilitation program, in 36 children with DD, there was a significant improvement in the difficulty in initiating and maintaining sleep (DIMS) sub-score (p < 0.05). However, there was no significant improvement in the total score or other sub-scores, such as those for sleep breathing disorders (SBD), disorders of arousal (DA), sleep–wake transition disorders (SWTD), disorders of excessive somnolence (DOES), and sleep hyperhidrosis (SH). In the subgroup analysis according to the cause of DD, children with CP had a significant improvement in DIMS and DOES sub-scores (p < 0.05).ConclusionThe intensive rehabilitation program, consisting of more than two sessions per day, effectively alleviated sleep problems in children with DD, especially in those with CP. Among the sleep problems, the intensive rehabilitative program was most effective at improving the DIMS. However, further prospective studies with a larger number of patients with DD and a more standardized protocol are necessary to generalize this effect.

Sonoelastography and Lumbopelvic Muscle Stiffness in Patients with Low Back Pain: A Systematic Review:.

This study aimed to systematically review studies conducted on the application of sonoelastography (SE) to evaluate lumbopelvic muscle stiffness in patients with low back pain (LBP). All relevant articles were retrieved from the available electronic databases, including PubMed, Web of Science, Scopus, EMBASE, Cochrane library, and CINAHL, using the keywords "Sonoelastography", "Elasticity Imaging Technique", "Muscle Stiffness", "Modulus Elasticity", "Low Back Pain". After initial searches, studies that met the inclusion criteria (i.e., published in English and sonoelastography were used to assess lumbopelvic muscle stiffness in both patients with LBP and healthy individuals) were enrolled. Also, any animal research, abstract of the seminar and/or conference, and/or non-English-language article were excluded. The quality of the studies was assessed using the Physiotherapy Evidence Database (PEDro) scale. In total, eight relevant studies were selected for review. Three studies were considered to have excellent quality, and five were considered fair quality using the PEDro scale. All reviewed studies have reported that SE can be considered a non-invasive method for quantifying changes in lumbopelvic muscle stiffness. Muscle stiffness was significantly higher in LBP patients compared to healthy persons, as well as across subgroups of LBP patients in various test postures (P˂0.05). Only one study was conducted on the reliability of SE in healthy individuals, while another examined the validity of SE imaging. The results of the present systematic review indicated that SE imaging is a reliable and valid tool to identify muscle changes that occur in patients with LBP and evaluate the effects of rehabilitation treatment.