Home Exercise Program Research Articles

AHP SO01 - Establishing Physiotherapy led Prehabilitation for patients undergoing major hepatobiliary surgery in a Regional Centre - A Service Improvement

Abstract Background Prehabilitation is increasingly on the agenda for major surgical patients and will be an essential service in an ageing population with increasing cancer prevalence. By 2040 5.3 million people in the UK will be living with cancer physical fitness can have an impact on both treatment options and survival rates. Prehabilitation has been mentioned in both the Major Conditions Strategy and the Long-Term Plan. Currently within the trust, there are no established multiprofessional prehabilitation services. New funding allowed a service improvement project to develop a ‘model’ for a specialist physiotherapy prehabilitation pathway pilot in patients undergoing major hepatobiliary surgery. Method Patients undergoing major surgery complete Cardiopulmonary Exercise Testing, providing data indicating fitness levels and guides risk stratification. Patients deemed to be at high risk due to poor fitness, (anaerobic threshold 10.9 or below), were referred to the prehabilitation physiotherapist. Patients attended a 1:1 assessment with a Physiotherapist, were provided with an individualised home exercise programme, including cardio-vascular and muscle strengthening. Weekly follow up virtual follow was provided. Outcome measures taken at initial appointment included five sit to stand (5STS) time, Grip strength and EQ-5D. These were repeated before surgery, and after hospital discharge. Patients had the opportunity to provide feedback. Results Average improvement in all outcome measures was demonstrated. Outcome MeasuresPre-intervention averagePost intervention averageAverage changeEQ-5D Score8.17.30.8EQ-5D Health score687465 STS (seconds)14.711.5-3.1Grip (kg)29.831.31.5Sarcopenic 5 STS (seconds)20.913.1-7.9 Patient and staff feedback was positive, finding patients reported they felt prepared for the post operative period, and staff noted and increased in their patients preparedness. It is too early to say if Prehabilitation has had an impact on hospital length of stay or post operative complications, though early results are promising. Conclusion Physiotherapy led prehabilitation is beneficial for patients undergoing major HPB surgery, demonstrating improvements in physical strength and fitness following an individualised home exercise programme with regular virtual support, especially those who have sarcopenia.

Goal‐Directed Rehabilitation Versus Standard Care for Individuals with Hereditary Cerebellar Ataxia: A Multicenter, Single‐Blind, Randomized Controlled Superiority Trial

ObjectiveRehabilitation is thought to reduce ataxia severity in individuals with hereditary cerebellar ataxia (HCA). This multicenter, randomized controlled superiority trial aimed to examine the efficacy of a 30‐week goal‐directed rehabilitation program compared with 30 weeks of standard care on function, ataxia, health‐related quality of life, and balance in individuals with an HCA.MethodsIndividuals with an autosomal dominant or recessive ataxia (aged ≥15 years) were enrolled at 5 sites in Australia. Participants were randomized (1:1) to receive rehabilitation (6 weeks of outpatient physiotherapy followed by a 24‐week home exercise program) (n = 39) or continued their usual activity (n = 37). The primary outcome measure was the motor domain of the Functional Independence Measure (mFIM) at 7 weeks. Secondary outcomes included the Scale for the Assessment and Rating of Ataxia (SARA) and the SF‐36v2, assessed at 7, 18, and 30 weeks. Outcome assessors were blinded to treatment allocation.ResultsSeventy‐one participants (rehabilitation, 37; standard‐care, 34) were included in the intention‐to‐treat analysis. At 7 weeks, mFIM (mean difference 2.26, 95% confidence interval [CI]: 0.26 to 4.26, p = 0.028) and SARA (−1.21, 95% CI: −2.32 to −0.11, p = 0.032) scores improved after rehabilitation compared with standard care. Compared with standard care, rehabilitation improved SARA scores at 30 weeks (mean difference −1.51, 95% CI: −2.76 to −0.27, p = 0.017), but not mFIM scores (1.74, 95% CI: −0.32 to 3.81, p = 0.098). Frequent adverse events in both groups were fatigue, pain, and falls.InterpretationGoal‐directed rehabilitation improved function at 7 weeks, with improvement in ataxia and health‐related quality of life maintained at 30 weeks in individuals with HCA, beyond that of standard care. ANN NEUROL 2024

The effect of home exercises with kinesiotaping on pain, functionality, and work performance in bus drivers with non-specific neck pain

BACKGROUND: Clinical research on the management and rehabilitation of work-related upper spinal pain in bus drivers is sparse, indicating a gap in knowledge and treatment strategies. This highlights the growing need for innovative approaches to rehabilitation programs in this area. OBJECTIVE: To examine the effects of kinesio taping (KT) on pain, functionality, and work performance in bus drivers experiencing neck pain. METHODS: The study involved 44 participants who were randomised into two different groups: the exercise group (n= 22) and the kinesio tape group (n= 22), with participants in both groups undertaking exercise interventions. Evaluations were made before and after 6 weeks of treatment. At the end of the 6-week, the participants’ ROM, pain evaluations and functional scales were evaluated with disability, and work functionality. RESULTS: Neck pain severity decreased in both groups (p< 0.001 for each value), but there was no difference between the groups (p: 0.071). When disability scores were evaluated, improvement was noted in both groups (p: 0.001 for each value), but no statistically significant difference was found (p: 0.754). When the improvements in ROM values before and after the treatment were examined, the difference between the groups was recorded only in the neck extension ROM value (p: 0.011). Significant improvement was noted in all sub-steps of job performance in both groups (p< 0.05). CONCLUSION: KT added to ergonomic training and home exercise programmes is effective in controlling work-related musculoskeletal pain in drivers with neck pain. However, the addition of KT to exercise therapy was found to be no more effective than exercise therapy alone in improving pain control, functionality and work performance.

A PRELIMINARY ANALYSIS ON HOME EXERCISE PROGRAM ADHERENCE IN MIDDLE-AGED ADULTS USING THE EXERCISE ADHERENCE RATING SCALE (EARS) – A RETROSPECTIVE STUDY.

Background: Adherence to Home Exercise Program (HEP) is crucial for achieving an effective rehabilitation outcome, particularly among middle-aged adults (40-60 years) who have to face many challenges maintaining regular physical activities. Understanding the current adherence levels can inform strategies to enhance participation in HEP regimens. Objective: The study aims to find the level of adherence in middle-aged adults to HEP using the Exercise Adherence Rating Scale (EARS) through a patient report. Methods: The study was conducted with middle-aged adults who follow HEP for musculoskeletal conditions. Participants were asked to fill the EARS; to know the level of adherence they have towards home exercise program. Data were collected from patients who approached OPD following a musculoskeletal condition. Descriptive statistics are done with the data collected to analyze the adherence of subjects towards exercise. Result: From the EARS questionnaire it was analyzed that from a total of 94 subjects present in this study, 76 subjects showed a non-adherent value, and 18 subjects showed adherent value. The average mean value and standard deviation value of the non-adherent group is 11.8 ± 0.607 and 2.701, while for the adherent group it is 19.16 ± 0.385 and 0.833 respectively. Conclusion: From this study it is known that middle-aged adults are non-adherent to home exercise programs because of which the improvement in the rehabilitation program is not fulfilled.

Effects of Respiratory Training on Pulmonary Function, Cough, and Functional Independence in Patients with Amyotrophic Lateral Sclerosis

Background: Respiratory complications in patients with amyotrophic lateral sclerosis (ALS), due to the involvement of respiratory muscles, are the leading cause of death, and respiratory physiotherapy (RP) focuses on addressing these complications. Objectives: The objective was to evaluate the effectiveness of an RP intervention that combines the four specific techniques (inspiratory muscle training, lung volume recruitment, manually assisted coughing, and diaphragmatic breathing training) in patients with ALS. Methods: A quasi-experimental study was carried out, and a specific RP programme was implemented in 15 patients with ALS (12 sessions, 30 min/session, one session/week, duration of three months), based on directed ventilation techniques, lung volume recruitment, manually assisted coughing, and the use of incentive spirometry and a cough assist device, along with a daily home exercise programme. Respiratory functions were assessed (pre- and post-intervention, with follow-up at three months) using Forced Vital Capacity (FVC) and Peak Expiratory Cough Flow (PECF); functionality was assessed using the Revised ALS Functional Rating Scale (ALSFRS-R) and the Modified Barthel Index by Granger. Results: FVC experienced an increase after three months of the intervention initiation (p = 0.30), which was not sustained at the three-month follow-up after the intervention ended. All other variables remained practically constant after treatment, with their values decreasing at follow-up. Conclusion: A specific RP intervention could have beneficial effects on respiratory functions, potentially preventing pulmonary infections and hospitalisations in patients with ALS. It may improve FVC and help stabilize the patient's functional decline. Considering the progressive and degenerative nature of the disease, this finding could support the usefulness of these techniques in maintaining respiratory function.

The efficacy of combined physiotherapeutic scoliosis-specific exercises and manual therapy in adolescent idiopathic scoliosis

BackgroundAdolescent idiopathic scoliosis (AIS) is a pathological condition characterized by vertebral curvature and associated trunk deformities in adolescents. The clinical efficacy of conservative treatment in alleviating spinal curvature of AIS remains a topic of ongoing debate. The objective of this study was to investigate the impact of combined physiotherapeutic scoliosis-specific exercises (PSSE) and manual therapy (MT) on trunk deformity, spinal function, mobility, and mental health in patients with AIS.MethodsThirty-one participants who were diagnosed with AIS whose Cobb angle was between 10–45°were enrolled in the study. Participants in the intervention group received 50 min of PSSE combined with 10 min of MT, while the control group performed 50 min of PSSE as their home exercise program. Both treatments were implemented three times a week for four weeks. Cobb angle, spinal mobility, trunk morphology (vertebral rotation angle, apical deviation, pelvic obliquity distance and angle), movement capability, and quality of life (QOL) were assessed at baseline and post intervention. The treatment effects between the intervention and control groups were analyzed using a two-way repeated measures ANOVA.ResultsFollowing a 4-week treatment period, Cobb angle was significantly reduced from 21.58° to 18.58° in intervention group and increased from 18.00° at baseline and 19.14° post intervention in the control group. Significant improvements were also observed in spinal mobility, movement capability, quality of life, and some of the trunk morphology indices in the intervention group compared to baseline (p < 0.05). Improvements were significantly higher in the intervention group than the control group.ConclusionCombining PSSE and MT shows potential benefits in alleviating AIS symptoms and improving QOL. Further studies to substantiate these findings are warranted.Trial registrationThe trial was retrospectively registered in the Chinese Clinical Trial Registry (https://www.chictr.org.cn) with the registration number: ChiCTR2300071357, (Date: 12/05/2023).

Predictors of dropping out from a home tele-exercise programme: A cohort study derived from a randomised controlled trial

Background: Online home exercises represent opportunities to increase physical activity levels. However, high dropout rates are commonly reported in such programmes. This study aimed to investigate the predictors of dropping out from an online home exercise programme. Methods: A total of 760 individuals from nine countries participated in this 8-week prospective cohort study derived from a randomised controlled trial. The participants were randomised into "4-week live-streamed exercise –&gt;4-week recorded exercise" or "4-week no intervention –&gt;4-week recorded exercise" group. Repeated measurements using weekly questionnaires were performed. Pain intensity, disability, mental well-being score, exercise motivation, sleep quality, impulsiveness/anxiety, and physical activity level were analysed. Results: A total of 53.8% (95% confidence interval [CI] 50.3%–57.3%) participants dropped out from the programme. The identified predictors of dropping out from the programme were: well-being (odds ratio [OR] 0.94, 95% CI 0.91–0.97) and disability (OR 1.02, 95% CI 1.002–1.04) at baseline considering the first 4 weeks; age (0.98; 95% CI 0.96–1.00) and baseline well-being (0.93; 95% CI 0.89–0.97) considering the entire follow-up (8 weeks); exercise motivation (0.92; 95% CI 0.87 to 0.97) and general impulsiveness/anxiety (1.04; 95% CI 1.01–1.07) repeated measured over time. Conclusion: About half of the participants dropped out from the online home exercise programme. Higher baseline scores in mental well-being and age predicted a reduction in dropping out. Higher baseline disability predicted an increase in dropping out. During the follow-up, higher exercise motivation was associated with a reduction in dropping out, and higher impulsiveness and anxiety were associated with an increase in dropping out.

Effect of video-based exercise on premenstrual symptoms: a randomized controlled trial.

This study aims to investigate the impact of Pilates exercises on premenstrual syndrome (PMS) symptoms, perceived stress levels, and pain intensity. Forty-six women with PMS participated in this study and were assigned to the intervention and control groups based on their willingness to participate. The intervention group undertook Pilates practices via video recording twice a week for 8 weeks, while the control group did not engage in regular exercise during the same period. PMS symptoms were assessed using the Premenstrual Syndrome Scale (PMSS), premenstrual stress levels were evaluated using the Perceived Stress Scale (PSS), and premenstrual pain levels were assessed using the McGill Melzack Pain Questionnaire (MPQ) at both the beginning and end of the study. There was a significant difference observed in the PMSS, PSS and MPQ evaluations of the intervention group following their participation in Pilates practices (p < 0.05). Conversely, no significant difference was observed in the PMSS, PSS and MPQ evaluations of the control group at the end of the study (p > 0.05). There was no statistically significant difference between the two groups in PMSS evaluation (p > 0.05) at the end of the study. However, a statistically significant difference was detected in PSS and MPQ evaluations (p < 0.05). Pilates exercise can affectively decrease the perceived stress level and pain severity in PMS affected women. This study highlights the efficacy of Pilates for physiotherapists in PMS symptom reduction. Moreover, the implementation of a self-guided video-based home exercise program could provide patients with practical and time-efficient alternatives.

Home Transcutaneous Electrical Stimulation Rehabilitation Program for Patients With Ankylosing Spondylitis: Crossover Trial.

Maintaining physical function and preserving spinal flexibility have been challenging in managing ankylosing spondylitis (AS). Most rehabilitation programs, including manual therapy, massage, hydrotherapy, and acupuncture, cannot be performed at home. The effect of transcutaneous electrical nerve stimulation (TENS) was validated in treating AS, but no home TENS system has explored its efficacy to date. This study aims to evaluate the efficacy of a home TENS system with a novel treatment program for patients with AS. The modified WeHeal TS-200 TENS and galvanic response system provided home-based TENS treatment for patients with AS. Patients were divided into a 2-month course group and a 1-month course group. After the first treatment course, patients went through a washout period for the same duration of their treatment course. Participants could decide whether to accept the second course of treatment. The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), Schober test, finger-to-floor flexion test, enthesis score, cytokines, chemokines, inflammatory factors, and immunoglobulins were measured to evaluate its efficacy. The clinical trial protocol (1096607481) received approval from the Ministry of Health and Welfare in Taiwan. A total of 9 patients (5 in a 2-month course group and 4 in a 1-month course group) completed the first treatment course, and 5 patients (4 in a 2-month course group and 1 in a 1-month course group) completed the sequential treatment course. The weighted results showed that patients reported an improving BASFI score (mean difference -0.9, SD 1.7; P=.03) after treatment. Looking into the trajectories, declined BASFI and BASDAI scores were noticed during treatments; this score increased during the washout period. There were improving trends in the Schober test (mean difference 1.9, SD 4.9; P=.11) and finger-to-floor flexion test (mean difference -0.6, SD 9.5; P=.79), but the results were not statistically significant. The response of cytokines, chemokines, inflammatory factors, and immunoglobulins before and after treatment did not show a consistent trend, and all results were not statistically significant (all P>.05). The home TENS device demonstrated a potential role in AS management. It may improve accessibility and adherence for patients with AS and provide remote monitoring for clinicians. Further research can compare the effectiveness of electrotherapy at home or in a medical setting and focus on integrating the home TENS system and exercise program to enhance patients' physical functions and spinal flexibility.

Impact of telephone coaching supporting a physical maintenance exercise programme for older adults at risk of falls: a randomised controlled trial

BackgroundEncouraging compliance with recommended levels of exercise for older adults is a public health challenge. A minimal-resource solution is telephone coaching.ObjectivesPrimary aim: to compare timed up and go (TUG) performance 6 months after beginning a home exercise program between a group of older individuals who received additional telephone coaching, and a control group performing the home exercise program alone. Secondary aims: to compare functional and fall-related outcomes between groups at 6 and 12 months.MethodsMulticentre, assessor-blinded, randomised, controlled, open label, prospective study. Inclusion criteria included age ≥ 65 years, ≥ 1 fall in the past year, and discharged home from hospital rehabilitation or outpatient physiotherapy. All participants received a home exercise booklet and were asked to perform a set of exercises as often as possible (daily). The coaching group additionally received a monthly telephone call (total 5 calls) from their previous physiotherapist. Primary outcome was TUG performance at 6 months. Outcomes were measured at inclusion, and at 6 and 12 months. The primary outcome was analysed using a linear mixed model adjusted for the baseline value.ResultsIn total, 99 individuals were included (coaching group n = 50, control group, n = 49; mean [SD] age 83.1 [5.8] years and 77% women). TUG performance did not differ between groups at 6 months (adjusted difference 1.37, SE 1.32, 95% CI 1.26 to 4.01, p = 0.30). Secondary outcomes did not differ between groups at 6 or 12 months except compliance to the exercise program was higher in the coaching than the control group at 6 months (adjusted difference 1.0, SE 0.5, 95% CI 0.02 to 2.0, p = 0.05).ConclusionsThe lack of difference between the groups in the time taken to complete the TUG at 6 months suggests that the monthly telephone coaching sessions did not improve the effectiveness of a home exercise programme in elderly people who had suffered at least one fall. The trial was registered on ClinicalTrials.gov (NCT02828826; 11th of july 2016, last modification 16th of September 2024).

Is Dorso-Volar Kinesiotape Added to the Home Exercise Program Effective in the Treatment of Carpal Tunnel Syndrome? Randomized Controlled Electrodiagnostic Study

Abstract Objective We aimed to compare the short- and medium-term efficacy of dorso-volar kinesiotape (KT) added to home exercises (HE) with sham-KT and HE alone in the treatment of mild or moderate carpal tunnel syndrome (CTS) in terms of pain, symptom severity, function, gripping strength, and electrophysiological parameters. Materials and Methods A total of 120 patients (99 females, 21 males) were divided into three groups dorso-volar KT and HE (n=40), sham-KT and HE (n=40), and HE (n=40). Pain (The visual analog scale [VAS]), symptom severity (Boston symptom severity scale [SSS]), functional status (Boston functional status scale [FSS]), nerve conduction study (NCS), hand, finger muscle strength were evaluated pretreatment, at the end of treatment (4th week), and in the third month posttreatment. Results There were statistically significant improvements in VAS (p&lt;0.001), Boston SSS (except HE group) (p&lt;0.001), and Boston FSS (p&lt;0.001) in all groups posttreatment compared to pretreatment, and more in the dorso-volar KT group than pretreatment and the posivite improvement continued at a decreasing rate in the third month posttreatment. At the end of treatment the dorso-volar KT group showed statistically significant improvement in Boston SSS (p&lt;0.001, p&lt;0.001) and Boston FSS (p&lt;0.001, p&lt;0.001) compared to the sham-KT and HE groups. Conclusions The combination of dorso-volar KT and HE program makes a more effective and durable contribution to the improvement of CTS symptom severity, pain and functional status, as well as handgrip strength and NCS parameters compared with sham-KT and HE program.

Home-Based Digital Exercise Training Program to Improve Physical Function of Older Sepsis Survivors: Protocol of the HEAL Sepsis Randomized Clinical Trial.

While sepsis, an exaggerated response to infection, can affect people of all age groups, it is more prevalent in middle-aged and older adults. Older adults suffer worse short-term and long-term outcomes than younger patients. Older sepsis survivors are commonly discharged to long-term acute care facilities, where they often die within 1 year. Those who return home from the hospital lose the momentum of physical function improvement after early inpatient rehabilitation, and often face exacerbation of comorbidities and decline in physical function. Additionally, patients who are discharged home often live at distant locations and are not able to commute to rehabilitation centers due to their poor health status. Therefore, remotely delivered exercise interventions tailored to this population hold promise to improve physical function safely and effectively after sepsis. However, this type of intervention has yet to be tested in this population. This study aims to assess the safety, feasibility, and ease of recruitment and retention of participants for a remotely delivered physical activity intervention for improving physical function in middle-aged and older sepsis survivors. The proposed intervention will be delivered through a digital health platform that comprises a patient-facing mobile app and a 12-week physical activity program specifically designed for middle-aged and older sepsis survivors with poor health status who may face challenges participating in traditional out-patient or community-based exercise interventions. This study is ongoing and plans to enroll 40 sepsis survivors aged 55 years and older who will be randomized to either a remotely delivered exercise intervention group or a control group (electronic health diary). Both groups will use a tablet containing the Health in Motion app (Blue Marble Health). The intervention group will receive a clinician-designed personalized avatar-guided home exercise program and reminders while the control group will self-report daily activities using the in-app health diary feature. This study is the first to use a home-based, remotely monitored 12-week exercise program to improve physical function in sepsis survivors. This study will evaluate the safety, feasibility, and efficacy, providing the necessary knowledge to design and calculate power for future larger trials. This study will provide important information for planning a future randomized clinical trial to test the efficacy of a remotely delivered exercise intervention in this high-risk population. ClinicalTrials.gov NCT05568511; https://clinicaltrials.gov/study/NCT05568511. DERR1-10.2196/60270.

SPECIFICITIES OF PHYSICAL DEVELOPMENT OF CHILDREN WITH CEREBRAL PARALYSIS IN A FAMILY-ORIENTED MODEL OF INTERVENTIONS

Families with a child with cerebral palsy (CP) face a number of medical, economic, legal, educational and psychological problems from the moment of birth. The main responsibility for the child's development lies with families, as it is there that key aspects of the child's personality are formed. There is a clear dependence of a child's psychological and physical health on the psychological climate of the family. Children with such disorders need to be provided with favorable conditions that will help compensate for the consequences of their disabilities. They need the support of qualified specialists and, most importantly, a warm and friendly attitude from their parents and the environment [1]. It should be emphasized that there are a number of factors that contribute to the psychological maladjustment of children with cerebral palsy in the family environment, which should be known to the child's relatives. First and foremost, it is the inadequate assessment of physical and mental development by parents, as well as the psychological atmosphere in the family. These factors cause deformation of the child's psyche and complicate his or her social adaptation, and negatively affect motor activity and treatment and rehabilitation processes. There are two sides to this situation: on the one hand, parents who find it difficult to understand the complexity of the situation and the child who needs special care, treatment and education. Physical rehabilitation requires the active participation of the person being rehabilitated, but with children, especially young children, this process is too complex for quality rehabilitation and requires the participation of parents. It is also important to take into account the role of the family in the development of motor skills, as it helps to integrate therapeutic techniques into the child's daily life. The aim of the study was to analyze the latest research and approaches to determine the peculiarities of cooperation between a physical therapist and families raising children with cerebral palsy. Using the Internet search databases and the bibliosemantic method, the peculiarities of applying a family-centered approach, motor training, principles of neuroplasticity and home exercise programs to improve the motor activity of children with cerebral palsy were determined. This article describes some peculiarities of physical therapist's work with patients suffering from cerebral palsy. The peculiarity is that these patients are children and when working with children, unlike adults where motivation comes first, intervention approaches in children are formed on the basis of pleasure. Accordingly, various specialists should be involved at all stages to ensure the normal functioning and development of the child. However, the role of parents in this process remains no less important, as they should be the main link that connects these processes for the well-being of the child. The review analyses research on motor training and home exercise programs. The family-centred approach to physical rehabilitation for children with cerebral palsy emphasizes the role of the family as a key factor in achieving goals and improving the child's quality of life. Involving the family in physical therapy helps to integrate therapeutic techniques into the daily life of the child and his or her family. Conclusions. The family-centred approach is characterised by the active participation of the family in the rehabilitation process. This is important because the family plays a crucial role in supporting and motivating the child during treatment. This approach not only provides treatment, but also provides the family with the knowledge, skills and resources to continue to help the child in their daily lives. This approach aims not only to improve the child's functioning, but also to help the child become part of the wider family and social environment. This promotes greater integration and independence. Thus, the family-centred approach to physical rehabilitation of children with cerebral palsy demonstrates the importance of family support and integration during treatment, contributing to the comprehensive improvement of both the physical and psychosocial condition of the child.

Effect of modified constraint-induced movement therapy along with bimanual massed practice on upper extremity functions in tetraplegics: a pilot study

Background and objectiveConstraint-induced movement therapy is a widely used rehabilitation program in the stroke population, but its application in spinal cord injury is limited. The objective of the study is to determine the feasibility of modified constraint-induced movement therapy (mCIMT) in incomplete tetraplegia exhibiting upper limb weakness and activities of daily living (ADLs) difficulty.MethodThis is a quasi-experimental one-group pilot study, consisting of 12 subjects diagnosed with incomplete tetraplegia. They received 2-h sessions of modified constraint-induced movement therapy of the weaker hand along with a 1-h session of bimanual massed practice, 5 days a week for 3 weeks. Apart from this, they were asked to do 3 h of constrained-induced movement therapy daily 5 days a week for 3 weeks at their home as a part of a home exercise program. Box and block test (BBT) and Spinal Cord Independence Measure version III (SCIM-III) were taken as the primary measure, and manual function test (MFT) and capabilities for upper extremity (CUE) were used as secondary measures to access hand functions and ADLs. Subjects were examined during pre-intervention and post-intervention.ResultsAfter 3 weeks of intervention, the mean change of the score for the trained hand showed significant changes in the scores of the box and block test (p = 0.03), manual function test (p = 0.02), SCIM-III (p = 0.03), and CUE (p = 0.02).ConclusionThis preliminary study revealed that modified CIMT may be a feasible and effective alternative for hand rehabilitation in incomplete tetraplegia.

Post-rehabilitation programme to support upper limb recovery in community-dwelling stroke survivors: a mixed methods cluster-feasibility controlled trial

BackgroundLess than 50% of stroke survivors regain their pre-stroke level of upper limb function, compounded with a lack of long-term rehabilitation options available. The Graded Repetitive Arm Supplementary Programme (GRASP)...

Balanced: An Evaluation Of A Newly Established Older Adult Exercise Class

Abstract Background Falls are common in older adults and one of the leading causes of morbidity and mortality globally. Evidence based falls exercise programme have been proven to reduce the risk of falling in community dwelling older persons. This study aimed to evaluate the impact of a new falls exercise class for community dwelling older adults. Methods This class was based on the Falls Management Exercise (FaME) programme model, implemented by a trained Physiotherapist and Exercise Instructor. It consisted of a twenty-six-week programme which included a once weekly supervised group exercise class (1hour) supplemented by a twice weekly home exercise programme. Participants were recruited from primary care services based in the local region. Those who met the inclusion criteria were assessed by a physiotherapist who collected basic demographic data. A range of outcome measures were completed pre and post intervention, assessing motor and behavioural domains. Participant feedback was collected. Data was analysed using SPSS. Results Eleven participants completed this programme. The mean age was 78 years old and 73% of participants were female. Participants completed an average of 22 out of 26 classes. The number of falls reported reduced from 0.8 pre intervention to 0.1 post intervention (p 0.03). Timed Up and Go improved from a mean of 11.28 seconds pre intervention to 9.06 seconds post intervention (p 0.02). Mean Health Today Score was 73.2% pre intervention improving to 82.3% post intervention (p 0.05). Participant feedback was positive. Conclusion This study demonstrated the significant positive impact of an evidence-based exercise class on our participants functional ability, quality of life and reducing falls. This is a preliminary evaluation and analysis of further data is essential. These classes may assist in reducing demands on acute healthcare services and should continue to run and be further investigated.

Single‐centre experience of implementing physiotherapist‐led prehabilitation for chimeric antigen receptor T cell therapy

AbstractIntroductionThis report outlines the evaluation of physiotherapist‐led prehabilitation/rehabilitation for recipients of chimeric antigen receptor T (CAR‐T) cell therapy.MethodsA hybrid approach was used, incorporating in‐person assessment of quality of life and functional capacity (6‐min walk test and timed sit‐to‐stand test), and a personalised home exercise programme with remotely delivered physiotherapist support pre/post‐admission.ResultsFunctional deficits were prevalent at referral for CAR‐T. Prehabilitation and rehabilitation were highly acceptable to patients, and improvements in functional capacity were documented pre‐admission.ConclusionThis data highlights the importance of pre‐CAR‐T functional assessment and prehabilitation to optimise preparation and recovery.

Efficacy of the mHealth-Based Exercise Intervention re.flex for Patients With Knee Osteoarthritis: Pilot Randomized Controlled Trial.

Exercise therapy is recommended by international guidelines as a core treatment for patients with knee osteoarthritis. However, there is a significant gap between recommendations and practice in health care. Digital exercise apps are promising to help solve this undersupply. This study aims to evaluate the efficacy of a 12-week fully automated app-based exercise intervention with and without a supporting knee brace on health-related outcomes, performance measures, and adherence in patients with knee osteoarthritis. This closed user group trial included participants with moderate to severe unicondylar painful knee osteoarthritis. Randomization was 1:1:2 into an intervention group (IG) with 2 subgroups (app-based training [IG A] and app-based training and a supportive knee brace [IG AB]) and a control group (CG). The intervention included a 12-week home exercise program with 3 sessions per week. Instructions for the exercises were given via the app and monitored using 2 accelerometers placed below and above the affected knee joint. Participants in the CG did not receive any study intervention but were allowed to make use of usual care. Osteoarthritis-specific pain (Knee Injury and Osteoarthritis Outcome Score) was defined as the primary outcome, and secondary outcomes included all other Knee Injury and Osteoarthritis Outcome Score subscales, general health-related quality of life (Veterans RAND 12-item Health Survey), psychological measures (eg, exercise self-efficacy), performance measures (strength and postural control), and the monitoring of adherence and safety. Outcomes were assessed at baseline and after 12 weeks. Intervention effects were calculated using baseline-adjusted analysis of covariance for the joint comparison of IG A and IG AB versus the CG using a per-protocol approach. Subgroup analyses were conducted for each IG separately. A total of 61 participants were included (IG: n=30, 49%; CG: n=31, 51%; male: n=31, 51%; female: n=30, 49%; mean age 62.9, SD 8.5 years; mean BMI 27.7, SD 4.5 kg/m2). Analysis revealed statistically significant effects in favor of the IG for pain reduction (P<.001; effect size [ES]=0.76), improvements in physical function (P<.001; ES=0.64), improvements in symptoms (P=.01; ES=0.53), improvements in sport and recreation activities (P=.02; ES=0.47), improvements in knee-related quality of life (P<.001; ES=0.76), and improvements in the physical component of general health-related quality of life (P<.001; ES=0.74). Mean differences ranged from 6.0 to 13.2 points (scale range 0-100). ESs indicated small to medium effects. No effects were found for psychological and performance measures. Participants adhered to 92.5% (899/972) of all scheduled exercise sessions. Individuals with knee osteoarthritis undergoing a 12-week sensor-assisted app-based exercise intervention with or without an additional knee brace experienced clinically meaningful treatment effects regarding pain relief and improvements in physical function as well as other osteoarthritis-specific concerns compared to controls. German Clinical Trials Register (DRKS) DRKS00023269; https://drks.de/search/de/trial/DRKS00023269.

Investigating the Devices that Measure and Improve Grip Strength Through Telerehabilitation: A Scoping Review

Introduction: Grip strength is a vital hand function skill required to perform everyday tasks. Diseases and conditions deteriorate grip strength. Repetitive exercises can improve grip strength, but people are non-compliant with home exercise programs. Gamification of exercises can increase home exercise compliance. A device is needed to measure and rehabilitate grip strength and to deliver exercises remotely. A preliminary search on that topic did not provide any review literature on grip-strength devices. Accordingly, this scoping literature review (SLR) explores various electronic devices and sensors used to measure grip strength. Materials and Methods: Five electronic databases, namely PubMed, IEEE, Scopus, ACM digital library, and Web of Science, were searched. Modified preferred reporting items for systematic literature review and meta-analysis guidelines were used, with population/disease, intervention, comparison, and outcome framework employed to identify keywords and frame the research questions. Results: The results of the search yielded 3546 articles, and after elimination, 15 articles met the inclusion criteria for this review. Hence, this review has categorized various devices and sensors that measured grip strength, along with their wireless communication and gamification capabilities. Conclusion: The categorization presented in this review can help researchers use this information for future directions by emphasizing research gaps and designing telerehabilitation devices.

Adherence and Compliance of Different Delivery Methods of Home Exercise in Individuals With Nonspecific Low Back Pain

Autonomous exercise within nonspecific low back pain rehabilitation is a necessary tool to treat low back pain. The purpose of this study was to quantify adherence and compliance during two different 6-week home-exercise programs. Forty adults were randomly allocated to a gamified and packet group. Adherence, compliance, and system usability assessments occurred after 3 and 6 weeks. Packet group adherence was similar at 3 weeks and at 6 weeks. System usability was significantly greater at 6 weeks than at 3 weeks in the packet group. Adherence or compliance was not influenced. The usability of the intervention methodology was considered great by both groups.