Rehabilitation Exercises Research Articles

A Study on the Development of Information and Communication Technology-Based Oral Functional Rehabilitation Exercise Program Content for Elderly People.

Background/Objectives: This study was conducted to develop information and communication technology (ICT)-based oral functional rehabilitation exercise (OFRE) program content to effectively improve the oral function of the elderly people. Methods: After selecting evidence-based effective OFRE items through systematic review, the final items were constructed through the validity evaluation of detailed items through an expert Delphi survey. The items were composed in a simple content form that can be performed directly and applied to ICT-based mobile applications. Results: The final content items consisted of an oral functional motor-ability measurement, oral Pilates videos, and games. The first is to measure the maximum opening amount before and after exercise, and the opening amount was designed to be measured by eating the fruit displayed on the screen by opening and closing the lips. The second one consisted of eight exercises in the video, and each exercise was to be performed at least three times a day, with a total of two sets. The third is a salivary secretion function exercise that stimulates the salivary glands to stimulate the user's interest and enable them to perform oral movements on their own. It consists of a lip and respiratory muscle exercise that inflates the cheeks and bursts a balloon, and the image disappears when the word in the image presented on the screen is pronounced correctly. It consists of pronunciation exercises. Conclusions: This content development attempt can be expanded into new convergence research linked to ICT and can be used as basic data when developing related content as part of digital care for the elderly in the future.

Rotator cuff-related shoulder pain (RCRSP): semistructured patient interviews to explore the barriers and enablers to rehabilitation exercises

This study aimed to explore the barriers and enablers to physiotherapist-prescribed rehabilitation exercises for people with rotator cuff-related shoulder pain (RCRSP) and to guide the development of a theoretically informed...

EVALUATION OF AN ALLIED HEALTH PROFESSIONAL PREHABILITATION SERVICE IN NEURO-ONCOLOGY

Abstract AIMS The evidence base for the benefits of prehabilitation in the cancer population is increasing. So far, the focus has been on colorectal, breast and lung cancer sites with no current research into the effects in patients with primary or secondary brain tumours. It is hypothesised that patients with brain cancer would benefit from prehabilitation as current evidence demonstrates the positive effects of exercise, cognitive and language rehabilitation in this patient group. The aim of this project is to demonstrate the feasibility and impact of a two-year prehabilitation pilot service. The service comprises physiotherapy, occupational therapy and speech and language therapy for patients with brain cancer in the pre-operative phase. METHOD A pilot study was carried out at a tertiary UK neurosurgery centre. Patients over the age of 17 with a diagnosis of primary or secondary brain tumour awaiting surgery were eligible for the prehabilitation service. The impact was measured through Length of Stay, Quality of Life (EQ-5D-5L), emergency department attendances and admission rates 90 days post-surgery. RESULTS 128 patients were seen in prehabilitation from 01/11/2022 to 31/01/2024. Length of hospital stay post-surgery was lower for the prehabilitation group (0.9 days with 95% confidence interval) compared to control group. A mean improvement in the EQ-5D-5L Index from pre-operative assessment to post-surgery follow up was demonstrated CONCLUSION This study reveals data demonstrating the benefits of prehabilitaiton for patients with brain tumours. Prehabilitation for this patient group appears to improve clinical outcomes alongside patients’ quality of life. Future directions for the service will focus on expanding the provision to patients with spinal and benign tumours, where this is also a possibility of therapeutic need in the pre and post-operative phase.

Progress in neurosurgical treatment of neurofibromatosis type 1

To summarize the latest developments in neurosurgical treatments for neurofibromatosis type 1 (NF1) and explore therapeutic strategies to provide comprehensive treatment guidelines for clinicians. The recent domestic and international literature and clinical cases in the field of NF1 were reviewed. The main types of neurological complications associated with NF1 and their treatments were thorough summarized and the future research directions in neurosurgery was analyzed. NF1 frequently results in complex and diverse lesions in the central and peripheral nervous systems, particularly low-grade gliomas in the brain and spinal canal and paraspinal neurofibromas. Treatment decisions should be made by a multidisciplinary team. Symptomatic plexiform neurofibromas and tumors with malignant imaging evidence require neurosurgical intervention. The goals of surgery include reducing tumor size, alleviating pain, and improving appearance. Postoperative functional rehabilitation exercises, long-term multidisciplinary follow-up, and psychosocial interventions are crucial for improving the quality of life for patients. Advanced imaging guidance systems and artificial intelligence technologies can help increase tumor resection rates and reduce recurrence. Neurosurgical intervention is the primary treatment for symptomatic plexiform neurofibromas and malignant peripheral nerve sheath tumors when medical treatment is ineffective and the lesions progress rapidly. Preoperative multidisciplinary assessment, intraoperative electrophysiological monitoring, and advanced surgical assistance devices significantly enhance surgical efficacy and safety. Future research should continue to explore new surgical techniques and improve postoperative management strategies to achieve more precise and personalized treatment for NF1 patients.

Automatic Assist Level Adjustment Function of a Gait Exercise Rehabilitation Robot with Functional Electrical Stimulation for Spinal Cord Injury: Insights from Clinical Trials.

This study aimed to identify whether the combined use of functional electrical stimulation (FES) reduces the motor torque of a gait exercise rehabilitation robot in spinal cord injury (SCI) and to verify the effectiveness of the developed automatic assist level adjustment in people with paraplegia. Acute and chronic SCI patients (1 case each) performed 10 min of gait exercises with and without FES using a rehabilitation robot. Reinforcement learning was used to adjust the assist level automatically. The maximum torque values and assist levels for each of the ten walking cycles when walking became steady were averaged and compared with and without FES. The motor's output torque and the assist level were measured as outcomes. The assist level adjustment allowed both the motor torque and assist level to decrease gradually to a steady state. The motor torque and the assist levels were significantly lower with the FES than without the FES under steady conditions in both cases. No adverse events were reported. The combined use of FES attenuated the motor torque of a gait exercise rehabilitation robot for SCI. Automatic assistive level adjustment is also useful for spinal cord injuries.

Treatment of post-stroke fatigue with point-toward-point insertion of elongated needle and Tongdu Tiaoshen therapy of acupuncture: a randomized controlled trial

To observe the effect of point-toward-point insertion of elongated needle on post-stroke fatigue and explore its underlying mechanism. Sixty-four patients with post-stroke fatigue were randomly divided into an observation group (32 cases, 2 cases dropped out) and a control group (32 cases, 2 cases dropped out). In addition to the conventional treatment of western medicine and rehabilitation exercises, Tongdu Tiaoshen (regulating the governor vessel and the spirit) therapy of acupuncture was used in the control group, and acupuncture was applied to Baihui (GV 20), Sishencong (EX-HN 1), Shenting (GV 24), Fengfu (GV 16) and bilateral Fengchi (GB 20) and the needles were retained for 30 min in one treatment. In the observation group, besides the interventions as the control group, point-toward-point insertion of elongated needle was adopted. The needle was inserted from Zhiyang (GV 9) toward Dazhui (GV 14), from Shendao (GV 11) toward Yaoyangguan (GV 3) and from Yaoqi (EX-B 9) toward Yaoyangguan (GV 3); and the needles were retained for 30 min in one treatment. In the two groups, the acupuncture was delivered once daily, 6 times a week, consecutively for 4 weeks. The scores of the fatigue severity scale (FSS), Pittsburgh sleep quality index (PSQI), Hamilton anxiety scale (HAMA), Hamilton depression scale (HAMD), and Fugl-Meyer assessment (FMA) were observed before and after treatment completion in the two groups. Using ELISA, the levels of serum interleukin (IL)-1β, IL-6, IL-10, high-sensitivity C-reactive protein (hs-CRP), and homocysteine (Hcy) were detected before and after treatment completion; and clinical effect was evaluated. The scores of FSS, PSQI, HAMA and HAMD, as well as the levels of serum IL-1β, IL-6, hs-CRP and Hcy were reduced (P<0.05), and the scores of FMA and the levels of serum IL-10 were increased (P<0.05) after treatment in comparison with those before treatment in the two groups. Compared with the control group, in the observation group, the scores of FSS, PSQI, HAMA and HAMD, and the levels of serum IL-1β, IL-6, hs-CRP and Hcy were reduced (P<0.05, P<0.01), and the score of FMA and the level of serum IL-10 were increased (P<0.05). The total clinical effective rate was 83.3% (25/30) in the observation group, which was higher than 73.3% (22/30) of the control group (P<0.05). The point-toward-point insertion of elongated needle alleviates fatigue, anxiety and depression, and ameliorates sleep and motor function in the patients with post-stroke fatigue. It may be related to the attenuation of inflammatory responses.

AR-Based Upper Extremity Rehabilitation with Multimodal Feedback for Patients with Stroke and Parkinson’s Disease: A Scoping Review

Augmented Reality (AR) is increasingly used in various remote rehabilitation applications for patients with functional limitations. Providing multimodal feedback using auditory, visual, or haptic modalities can offer effective guidance to the patient while they perform self-supervised rehabilitation exercises. This review examines the current uses of AR with multimodal feedback in upper extremity rehabilitation applications built for stroke and Parkinson’s disease (PD) patients by synthesizing nine peer-reviewed studies. The review identified the improvement and engagement that AR-based rehabilitation provides to such patients. The current body of literature shows that AR-based rehabilitation with multimodal feedback is promising. However, technology and its application for rehabilitation use are still in their infancy. More research is required in selecting effective feedback modalities and clinically-relevant health outcome measures and in providing diverse rehabilitation tasks designed specifically for stroke survivors and PD population.

The Impacts of Cardiac Rehabilitation Exercise Therapy in Patients Following Percutaneous Coronary Intervention: Systematic Review

The Impacts of Cardiac Rehabilitation Exercise Therapy in Patients Following Percutaneous Coronary Intervention: Systematic Review

Analysis of muscle synergies and muscle network in sling exercise rehabilitation technique

The study assessed motor control strategies across the four sling exercises of supine sling exercise (SSE), prone sling exercise (PSE), left side-lying sling exercise (LLSE), and right side-lying sling exercise (RLSE) positions base on the muscle synergies and muscle network analyses. Muscle activities of bilateral transversus abdominis (TA), rectus abdominis, multifidus (MF), and erector spinae (ES) were captured via surface electromyography. Muscle synergies were extracted through principal components analysis (PCA) and non-negative matrix factorization (NNMF). Muscle synergies number, muscle synergies complexity, muscle synergies sparseness, muscle synergies clusters and muscle networks were calculated. PCA results indicated that SSE and PSE decomposed into 2.88 ± 0.20 and 2.82 ± 0.15 synergies respectively, while the LLSE and RLSE positions decomposed into 3.76 ± 0.14 and 3.71 ± 0.11 muscle synergies, respectively, which were more complex (P = 0.00) but less sparse (P = 0.01). Muscle synergies clusters analysis indicated common muscle synergies among different sling exercises. SSE position demonstrated specific muscle synergies with a strong contribution of the bilateral TA. LLSE-specific synergy has a strong contribution of the left erector spinae (ES). The RLSE-specific synergy has significant contributions from the right ES and multifidus. Muscle networks were functionally organized, with clustering coefficient (F(1.5, 24) = 6.041, P = 0.01) and global efficiency of the undirected network (F(1.5, 24) = 6.041, P = 0.01), and betweenness-centrality of the directed network (F(2.7, 44) = 6.453, P = 0.00). Our research highlights the importance of evaluating muscle synergies and network adaptation strategies in individuals with neuromuscular disorders and developing targeted therapeutic interventions accordingly.

Influence of Physical Exercise on the Rehabilitation of Volumetric Muscle Loss Injury Reconstructed with Autologous Adipose Tissue.

In volumetric muscle loss (VML) injuries, spontaneous muscle regeneration capacity is limited. The implantation of autologous adipose tissue in the affected area is an option to treat these lesions; however, the effectiveness of this therapy alone is insufficient for a complete recovery of the damaged muscle. This study examined the influence of treadmill exercise on the rehabilitation of VML injuries reconstructed with autologous adipose tissue, as a strategy to counteract the limitations of spontaneous regeneration observed in these injuries. Forty adult male Wistar rats were divided into eight groups of five individuals each: normal control (NC), regenerative control (RC), VML control (VML), VML injury reconstructed with fresh autologous adipose tissue (FAT), exercise-rehabilitated control (RNC), exercise-rehabilitated regenerative control (RRC), exercise-rehabilitated VML injury (RVML), and exercise-rehabilitated VML injury reconstructed with fresh autologous adipose tissue (RFAT). Histological and histochemical staining techniques were used for the analysis of structural features and histomorphometric parameters of the tibialis anterior muscle. Grip strength tests were conducted to assess muscle force. Exercise rehabilitation decreased the proportion of disoriented fibers in RFAT vs. FAT group. The percentage of fibrosis was significantly higher in FAT and RFAT groups versus NC and RNC groups but did not vary significantly between FAT and RFAT groups. Overall, muscle grip strength and fiber size increased significantly in the exercise-rehabilitated groups compared to control groups. To conclude, rehabilitation with physical exercise tended to normalize the process of muscle repair in a model of VML injury reconstructed with fresh autologous adipose tissue, but it did not reduce the intense fibrosis associated with these injuries.

STORMS: A Pilot Feasibility Study for Occupational TeleRehabilitation in Multiple Sclerosis.

Digital solutions in the field of restorative neurology offer significant assistance, enabling patients to engage in rehabilitation activities remotely. This research introduces ReMoVES, an Internet of Medical Things (IoMT) system delivering telemedicine services specifically tailored for multiple sclerosis rehabilitation, within the overarching framework of the STORMS project. The ReMoVES platform facilitates the provision of a rehabilitative exercise protocol, seamlessly integrated into the Individual Rehabilitation Project, curated by a multidimensional medical team operating remotely. This manuscript delves into the second phase of the STORMS pilot feasibility study, elucidating the technology employed, the outcomes achieved, and the practical, professional, and academic implications. The STORMS initiative, as the genesis of digital telerehabilitation solutions, aims to enhance the quality of life for multiple sclerosis patients.

Changes in shoulder function and muscle strength following rehabilitation exercise program in male patients with forward shoulder posture undergoing rotator cuff repair

BackgroundAbnormal posture is known to affect the efficacy of exercise therapy for musculoskeletal diseases. However, no studies to date have examined the effect of exercise programs should take into account the posture of the upper body in patients with rotator cuff disease. This study aimed to assess how rotator cuff and corrective exercises impact shoulder function and muscle strength post-arthroscopic rotator cuff repair surgery, providing tailored rehabilitation programs for patients with forward posture.MethodsNinety male patients who underwent arthroscopic rotator cuff repair participated in this study. The patients were randomly divided into three groups corrective exercise group (CEG, n = 29), rotator cuff exercise group (REG, n = 27), and control group (CG, n = 28). Each group was instructed to apply different exercise programs to correct posture and enhance rotator cuff strength. All patients were checked by the American Shoulder and Elbow Surgeons (ASES) score, Constant score and muscle strength, and range of motion preoperatively and postoperatively at 6 months and 1 year.ResultsASES shoulder function scores showed significant difference between the three groups (p = 0.002, F = 7.03), indicating that the corrective exercise program was more beneficial than rotator cuff exercises (p = 0.009, F = 3.78). A significant intergroup difference in mean Constant score was also noted (p = 0.025, F = 3.86), while a statistically significant interaction between time and group was observed (p = 0.032, F = 2.96).ConclusionsThese results suggested that a corrective exercise program can improve shoulder muscle strength and function after rotator cuff repair in male patients with a forward shoulder posture.

Identification of compensatory movements by a single low-cost inertial sensor during rehabilitation exercises

Identification of compensatory movements by a single low-cost inertial sensor during rehabilitation exercises

Long-term patient outcomes from a multidisciplinary cardiac rehabilitation programme with integrated nurse specialist support: A retrospective cohort study

BackgroundCardiac rehabilitation programmes, while demonstrating benefits, face challenges in universal adoption, particularly in New Zealand. This study evaluates the long-term impact of cardiac rehabilitation participation and attendance on survival and readmission rates in the Auckland Health District. ObjectiveTo examine the impact of patient participation in nurse-led lifestyle rehabilitation and physiotherapy exercise rehabilitation on key outcomes, including all-cause mortality, and all-cause, cardiac-specific, and kidney disease readmission rates. DesignRetrospective cohort study. SettingAuckland Health District, New Zealand. Participants3331 patients registered in the Auckland cardiac rehabilitation programme between 2016 and 2020. MethodsData analysis included examining associations between attendance at nurse-led lifestyle and physiotherapy-led exercise sessions and outcomes at 12, 24 months, and 2022 year-end, including all-cause mortality, all-cause readmission, and cardiac-specific readmission rates. Analysis methods included survival analysis, Cox proportional regression, and logistic binary regression, controlling for confounders using propensity score weights and baseline factors. Results1363 (40.9 %) patients attended at least one lifestyle rehabilitation session (average 5.0 ± 2.9 sessions), 1121 (33.7 %) patients attended at least one exercise rehabilitation session (average 6.8 ± 7.4 sessions), and 649 (19.5 %) patients attended at least one lifestyle and one exercise rehabilitation session. Increased likelihood of participation in rehabilitation was explained by ethnicity, while current and historical tobacco use, history of heart failure, receiving an angiogram, PCI, or other treatment such as medical management or implantable devices were associated with lower odds of participation. Participation in rehabilitation (average 7.9 ± 6.1 sessions) was associated with a higher mean survival estimate (7.6 years vs. 6.4 years, p < 0.001) while Cox proportional hazard regression, controlling for baseline factors and propensity score weights showed that a single session of rehabilitation attended had a 2.1 % decreased risk of mortality (hazard ratio = 0.98, 95 % CI: 0.96 to 0.99, p = 0.29). The cumulative hazard ratio for average attendance (7.9 ± 6.1 sessions) was 0.85 (95 % CI: 0.83 to 0.86, p < 0.001) indicating a 15 % decreased risk of mortality during follow-up. 20 % lower kidney disease readmission rates were observed among participants over the next 24 months (p < 0.05). However, no differences in all-cause or cardiac-specific readmission rates were observed. ConclusionsThe study supports the effectiveness of cardiac rehabilitation in improving long-term survival for Auckland Health District patients. The positive impact of nurse-led interventions and integrated support throughout the cardiac rehabilitation process highlights the need for translating this model to other health districts in New Zealand to optimise patient care and outcomes.

Aerobic exercise prescription for patients after stroke: Current scenario and barriers perceived by Brazilian physical therapists

BackgroundGuidelines recommend incorporating aerobic exercise into stroke rehabilitation. However, implementing this is challenging due to safety concerns, institutional and patient characteristics, and unfamiliarity with aerobic exercise guidelines. No study has assessed the parameters used and perceived barriers among Brazilian physical therapists when prescribing aerobic exercise for individuals after stroke. ObjectivesThis study aimed to investigate how Brazilian physical therapists prescribe aerobic exercise for individuals after stroke and identify perceived barriers in clinical rehabilitation. MethodsA web-based cross-sectional observational study was performed, recruiting Brazilian physical therapists who had treated at least one individual after stroke in the last 3 months. The questionnaire was distributed via social networks. Results79 participants were included (76% female; mean age 34 ± 8.3 years; 63% from the Southeast). Almost all (n = 78; 99%) agreed on the importance of incorporating aerobic exercise into stroke rehabilitation. Overground walking was the most prescribed aerobic exercise (89%). Moderate intensity (40%–59% of heart rate reserve) was the most common (51%) prescription. However, some respondents were unaware of the prescribed intensity (11%). On average, participants prescribed aerobic exercise for 44 ± 17 min, typically twice a week. The most cited barrier was cognitive dysfunction in individuals after stroke (58%). Only two participants reported no barriers. ConclusionsMost Brazilian physical therapists recognize the importance of aerobic exercise in stroke rehabilitation. However, uncertainty regarding exercise intensity and multiple reported barriers challenge adequate prescription.

Beyond Guideline-Directed MedicalTherapy: Nonpharmacologic Management for Patients With HeartFailure.

Heart failure (HF) is a leading cause of cardiovascular morbidity, mortality, and health care expenditure. Guideline-directed medical therapy and device-based therapy in HF are well established. However, the role of nonpharmacologic modalities to improve HF care remains underappreciated, is underused, and requires multimodal approaches to care. Diet,exercise and cardiac rehabilitation, sleep-disordered breathing, mood disorders, and substance use disorders are potential targets to reduce morbidity and improve function of patients with HF. Addressing these factors may improve symptoms and quality of life, reduce hospitalizations, and improve mortality in heart failure. This state-of-the-art reviewdiscusses dietary interventions, exercise programs, and the management of sleep-disordered breathing, mood disorders, and substance use in individuals with heart failure. The authors review the latest data and provide optimal lifestyle recommendations and recommended prescriptions for nonpharmacologic therapies.

Proceedings of the 2022 "Lifestyle Intervention for Epilepsy (LIFE)" symposium hosted by Cleveland Clinic.

Lifestyle interventions are strategies used to self-manage medical conditions, such as epilepsy, and often complement traditional pharmacologic and surgical therapies. The need for integrating evidence-based lifestyle interventions into mainstream medicine for the treatment of epilepsy is evident given that despite the availability of a multitude of treatments with medications and surgical techniques, a significant proportion of patients have refractory seizures, and even those who are seizure-free report significant adverse effects with current treatments. Although the evidence base for complementary medicine is less robust than it is for traditional forms of medicine, the evidence to date suggests that several forms of complementary medicine including yoga, mindfulness meditation, cognitive behavioral therapy, diet and nutrition, exercise and memory rehabilitation, and music therapy may have important roles as adjuncts in the treatment armamentarium for epilepsy. These topics were discussed by a diverse group of medical providers and scientists at the "Lifestyle Intervention for Epilepsy (LIFE)" symposium hosted by Cleveland Clinic. PLAIN LANGUAGE SUMMARY: There are many people with epilepsy who continue to have seizures even though they are being treated with medication or brain surgery. Even after seizures stop, some may experience medication side effects. There is research to suggest that certain lifestyle changes, such as yoga, mindfulness, exercise, music therapy, and adjustments to diet, could help people with epilepsy, when used along with routine treatment. Experts discussed the latest research at the "Lifestyle Intervention for Epilepsy (LIFE)" symposium hosted by Cleveland Clinic.

A case report of cardiac rehabilitation in coronary artery aneurysm combined with acute ST segment elevation myocardial infarction.

Coronary artery aneurysm (CAA), marked by diffuse or localized dilation of artery, can cause life-threatening complications in acute coronary syndrome. This report presents a case of CAA combined with acute ST-segment elevation myocardial infarction, successfully treated with cardiac rehabilitation exercise therapy, offering insights for clinical practice.

Early Rehabilitation Activity and Rehabilitation in ICU Wards in Central China: A Cross-Sectional Survey.

Patients in Intensive Care Units (ICUs) face high risks of physical, functional, cognitive, and mental impairments. Early rehabilitation activities are crucial for reducing mortality and complication rates. This survey investigates the characteristics, current implementation, and detailed status of early rehabilitation activities in ICUs across Central China. A cross-sectional survey was conducted involving 158hospitals, with 131 responding. Data on institutional characteristics and early rehabilitation activities were collected through questionnaires. Descriptive statistical analysis described the current status, and a univariate regression model identified factors associated with the implementation of early rehabilitation measures. A total of 131 ICUs completed the survey, with a response rate of 82.91% (131/158). Results indicated that 82.44% (108/131) of ICUs implemented early rehabilitation activities, but only 65 (49.62%) had explicit early rehabilitation exercise protocols or standards/procedures. Before implementing early rehabilitation activities, approximately 89.97% (110/131) of ICUs conducted assessments, and 46.56% (61/131) regularly held structured interdisciplinary rounds to discuss early activity measures and goals. More than half of the participating adult ICUs reported screening patients for swallowing function (64.89%; 85/131), and 55.73% (73/131) of adult ICUs reported having a nutrition therapy specialist conduct regular consultations/visits. Only 26.72% (35/131) of adult ICUs reported having a speech therapist conduct consultations/visits. A total of 81.68% (107/131) of ICUs believed that the current implementation of early rehabilitation activities was insufficient. In the analysis of influencing factors, the presence of rehabilitation therapists in the ICU was a significant factor for the implementation of early rehabilitation activities (P<0.05). The majority of ICUs in hospitals in central China have implemented early rehabilitation activities; however, less than half have explicit early rehabilitation exercise protocols or standards/procedures. The presence of professional rehabilitation therapists in the ICU is a key factor in the implementation of early rehabilitation activities in ICUs in hospitals in Central China.

ICT-based oral functional rehabilitation exercise content development

ICT-based oral functional rehabilitation exercise content development