Postsurgical Rehabilitation Research Articles

Post-surgical Rehabilitation Of Shoulder Triple-tendon Transfer In A Fitness Athlete

Post-surgical Rehabilitation Of Shoulder Triple-tendon Transfer In A Fitness Athlete

Rehabilitation to Improve Outcomes after Cervical Spine Surgery: Narrative Review.

The increasing elderly patient population is contributing to the rising worldwide load of cervical spinal disorders, which is expected to result in a global increase in the number of surgical procedures in the foreseeable future. Cervical rehabilitation plays a crucial role in optimal recovery after cervical spine surgeries. Nevertheless, there is no agreement in the existing research regarding the most suitable postsurgical rehabilitation program. Consequently, this review assesses the ideal rehabilitation approach for adult patients following cervical spine operations. This review covers activities of daily living and encompasses diverse treatment methods, including physiotherapy, specialized tools, and guidance for everyday activities. The review is organized under three headings: (1) historical perspectives, (2) patient-reported functional outcomes, and (3) general and disease-specific rehabilitation. Rehabilitation programs are determined on the basis of patient-reported outcomes, performance tests, and disease prognosis. CSM requires strengthening of the neck and shoulder muscles that have been surgically invaded. In contrast, the CCI requires mobility according to the severity of the spinal cord injury and functional prognosis. The goal of rehabilitation for CCTs, as for CCIs, is to achieve ambulation, but the prognosis and impact of cancer treatment must be considered. Rehabilitation of the cervical spine after surgery is essential for improving physical function and the ability to perform daily activities and enhancing overall quality of life. The rehabilitation process should encompass general as well as disease-specific exercises. While current rehabilitation protocols heavily focus on strengthening muscles, they often neglect the crucial aspect of spinal balance. Therefore, giving equal attention to muscle reinforcement and the enhancement of spinal balance following surgery on the cervical spine is vital.

Current methods of postsurgical rehabilitation in benign brain tumor patients

Current methods of postsurgical rehabilitation in benign brain tumor patients

The Role of Wearable Devices in Chronic Disease Monitoring and Patient Care: A Comprehensive Review.

Wearable health devices are becoming vital in chronic disease management because they offer real-time monitoring and personalized care. This review explores their effectiveness and challenges across medical fields, including cardiology, respiratory health, neurology, endocrinology, orthopedics, oncology, and mental health. A thorough literature search identified studies focusing on wearable devices' impact on patient outcomes. In cardiology, wearables have proven effective for monitoring hypertension, detecting arrhythmias, and aiding cardiac rehabilitation. In respiratory health, these devices enhance asthma management and continuous monitoring of critical parameters. Neurological applications include seizure detection and Parkinson's disease management, with wearables showing promising results in improving patient outcomes. In endocrinology, wearable technology advances thyroid dysfunction monitoring, fertility tracking, and diabetes management. Orthopedic applications include improved postsurgical recovery and rehabilitation, while wearables help in early complication detection in oncology. Mental health benefits include anxiety detection, post-traumatic stress disorder management, and stress reduction through wearable biofeedback. In conclusion, wearable health devices offer transformative potential for managing chronic illnesses by enhancing real-time monitoring and patient engagement. Despite significant improvements in adherence and outcomes, challenges with data accuracy and privacy persist. However, with ongoing innovation and collaboration, we can all be part of the solution to maximize the benefits of wearable technologies in healthcare.

Postoperative rehabilitation exercise experiences of geriatric patients with femoral neck fractures based on the perspective of medical staff: a qualitative study

BackgroundThe incidence of femoral neck fractures in older adults is increasing each year. Active and reasonable postoperative rehabilitation exercises can restore the activity of geriatric patients with femoral neck fractures to a great extent, while also avoiding bedridden complications and re-fractures. This study explores the perspectives, experiences, and recommendations of medical staff regarding the implementation status, existing problems, promoting factors, and hindering factors of post-surgical rehabilitation exercises for geriatric patients with femoral neck fractures. The ultimate goal is to further optimize rehabilitation exercise programs and to expedite this process for patients. MethodsA qualitative, descriptive phenomenological study was conducted. A total of 21 clinical medical staff were selected using the purposive sampling method for semi-structured interviews. A content analysis method was used to collate and analyze the collected interview data.ResultsA total of 2 themes and 6 sub-themes were defined. The themes consisted of multiple obstacles occurring during the implementation of rehabilitation exercises and the scientific cognition of medical staff on these exercises. Respondents found that patient initiative during rehabilitation exercises was insufficient, that the comprehensiveness and continuity of exercises could not be guaranteed, and that unification between textbook theory and clinical practice was incomplete. Moreover, respondents believed that their professional quality should be excellent, but that staffing and organizational management required optimization, and that support was required for the implementation of rehabilitation exercises.ConclusionThis study investigated the opinions and experiences of medical staff during postoperative rehabilitation exercises in geriatric patients with femoral neck fractures. Collaborative efforts should fully engage hospitals, communities, and families, enhance the alignment of health education with patient needs, advance the scientific development of an integrated medical model by refining the curriculum and teaching system, and significantly elevate the level of medical science and technology. This study will serve as a valuable reference for the establishment of future professional, and personalized rehabilitation programs tailored for geriatric patients with femoral neck fractures.

The Use of Platelet-Rich Plasma (PRP) in Surgery: Antibiotic Effects and PostSurgical Rehabilitation Benefits

Platelet-Rich Plasma (PRP) therapy has emerged as a promising adjunct in various surgical disciplines. This paper explores the multifaceted applications of PRP in surgery, focusing on its antibiotic effects and benefits during post-surgical rehabilitation. Comprehensive review and analysis of peer-reviewed studies reveal PRP’s potential in enhancing wound healing, reducing infection rates, and improving rehabilitation outcomes. The paper consolidates current evidence, addressing both the advantages and limitations of PRP therapy.

Customized Vestibular Rehabilitation for Vestibular Schwannoma Excision via Translabyrinthine Approach: A Single-Center Experience.

Objectives: To evaluate the effectiveness of intensive customized vestibular rehabilitation after vestibular schwannoma (VS) excision. Methods: 52 patients who underwent VS removal via a translabyrinthine approach from 2020 to 2022 were involved in this study. Bedside examination, video head impulse test (vHIT), functional head impulse test (fHIT), and the dizziness handicap inventory (DHI) were performed before and after the rehabilitation, which consisted of 10 sessions of specifically designed vestibular, visual, and physical integrated training. Results: After rehabilitation, the vHIT showed overall unchanged values on the affected and healthy side. In contrast, the scores of fHIT, which explores the higher connection of the vestibular system with visual and cerebellar pathways, improved on both the pathological and healthy sides after training (p-value 0.004 and 0.000, respectively). The effectiveness of the rehabilitation was reinforced by the DHI scores, which were considerably lower after training. Conclusions: To our knowledge, this is the first study to explore fHIT outcomes after removal of VS, estimating the impact of rehabilitation on the overall compensation process. The outcomes support the role of extensive postsurgical rehabilitation in the compensatory process, even just a few days after surgery.

Post-surgical Rehabilitation Guidelines for Triangular Fibrocartilage Complex Foveal Repair: A Survey of Australian Hand and Wrist Surgeons.

Background: To restore distal radioulnar joint stability following injury to the Triangular Fibrocartilage Complex (TFCC), foveal repair surgery may be necessary. Post-surgery rehabilitation is prescribed to restore wrist and hand function; however, no universally accepted or definitive rehabilitation protocol currently exists. The aim of this study was to survey hand and wrist surgeons regarding their recommended postoperative rehabilitation protocols following TFCC foveal repair surgery. Methods: Australian hand and wrist surgeons were invited to complete a descriptive survey containing 10 questions. Questions included clinical recommendations for wrist and forearm immobilisation, range of motion (ROM) exercise timeframes and surgeon experience of TFCC rupture. Descriptive statistics and between-group (TFCC rupture vs. no-rupture) comparisons (Pearson's Chi2) were calculated. Results: Thirty-one surgeons completed the survey. Recommendations for post-surgery immobilisation ranged from 'not required' to 8 weeks (mode 6 weeks). Wrist and forearm ROM commencement time ranged from 'immediately' to 'later than 8 weeks' (mode 6 weeks). The most recommended orthosis was a 'sugar-tong' (57%). Thirty-seven percent (37%) reported experience of post-surgery re-rupture. Conclusions: While surgeon recommendations varied, the majority recommended 4- to 6-week timeframe for immobilisation and ROM exercise commencement. Additional clinical research is recommended to evaluate whether postoperative rehabilitation decisions influence patient outcomes. Level of Evidence: Level V (Therapeutic).

Palatal Stent Following Tumor Ablative Surgery.

Mucoepidermoid carcinoma is one of the most prevalent malignant tumors of the salivary glands. Resection of this tumor can result in postsurgical morbidity, affecting the patient's quality of life and normal oral functioning. This study aimed to present a successful case of postsurgical rehabilitation following mucoepidermoid carcinoma resection in the palate. Following tumor ablative surgery, the 32-year-old patient experienced impairments in both speech and feeding due to the surgical wound. A protective stent that covered the entire extent of the palate and teeth was made. This esthetic device was fabricated in a single session and provided sealing and protection of the surgical site, ensuring comfort, functionality, and, consequently, a higher quality of life during the postoperative period. The simplicity and low cost of the custom palatal stent make it applicable for use in a diverse range of postsurgical oncology patients, providing protection for surgical wounds and reducing postoperative morbidity.

Impact of postsurgical rehabilitation on outcomes for degenerative cervical myelopathy.

Despite widespread use, there is limited evidence to support postsurgical rehabilitation to enhance neurological recovery after surgery for degenerative cervical myelopathy (DCM). Outcomes research for DCM seldom accounts for the effect of postsurgical rehabilitation. The aim of this study was to quantify the impact of postsurgical rehabilitation on outcomes after surgery for DCM. This was a retrospective analysis of prospectively collected data from a single center. The study enrolled 66 patients who underwent spinal surgery for DCM. In addition to patient demographic, imaging, and surgical data, chart review was performed to document the timing, type, duration, and outcomes of postsurgical rehabilitation therapy. Outcomes were collected prospectively, including the modified Japanese Orthopaedic Association (mJOA) score, Neck Disability Index (NDI) score, and SF-36 physical component summary (PCS) score. Linear regression models were created to determine the independent effects of type and timing of postsurgical occupational therapy (OT) and physical therapy (PT) on outcomes. A total of 66 patients were included in the analysis. Multivariate regression analysis showed that postsurgical OT was associated with significantly greater improvement in 12-month SF-36 PCS scores (p = 0.009) and mJOA scores (p = 0.019). In the subset of patients who received therapy, delayed therapy (> 42 days after surgery) compared to early therapy (< 42 days after surgery) was associated with less improvement in SF-36 PCS scores (p = 0.03). Postsurgical outpatient rehabilitation was independently associated with improved postsurgical outcomes within the 1st year after surgery for DCM, and early therapy (< 42 days) was associated with superior outcomes compared to delayed therapy. This is one of the first studies to use a prospective database to demonstrate an independent effect for postsurgical rehabilitation on outcomes after surgery for DCM.

Post-surgical Rehabilitation Protocol and Outcome in Tendoachilles Rupture with Large Defect: A Case Series

Abstract Achilles tendon (AT) is the strongest and one of the commonly ruptured tendons. For AT rupture with large defect, surgery is arguably better option than conservative one. However, rehabilitation protocol and outcome after surgery for AT rupture with larger defects is not mentioned well in the literature. In this series, 11 cases of AT rupture with large defect are studied retrospectively from the hospital records. All of the cases received uniform structured rehabilitation and orthotic management following repair surgery and were followed up at 6 months and 1 year. Significant improvement in pain, function and strength was noted and temporal association is found between symptomatic change and day of presentation. However, there was no report of re-rupture and there was no difference in outcome with intraoperative platelet-rich plasma injection.

Comparison of Functional Outcomes after Anterior Cruciate Ligament Reconstruction with Meniscal Repair for Unstable versus Stable Meniscal Tears.

This study aimed to compare functional outcomes including knee muscle strength in the quadriceps and hamstrings, and proprioception, assessed through dynamic postural stability (overall stability index [OSI]) and self-reported outcomes in the operated and non-operated knees between anterior cruciate ligament reconstruction (ACLR) with meniscal repair for unstable (root and radial tears) and stable (longitudinal, horizontal, and bucket handle tears) meniscal tears. A total of 76 patients were randomly selected (41 with ACLR with meniscal repair for unstable meniscal tears and 35 with ACLR with meniscal repair for stable meniscal tears) at three different time points (preoperative, 6 months, and 12 months). Repeated measures analysis of variance was used to investigate the differences in outcomes for between-subject and within-subject factors. In the operated knees, there were no significant differences for functional outcomes between the two groups (all p > 0.05). In the non-operated knees, a significant difference was observed for the OSI between the two groups, which was significantly higher in ACLR with meniscal repair for unstable meniscal tears than for stable meniscal tears at 6 months (p < 0.001). Multiple linear regression analysis showed that age (p = 0.027), preoperative OSI in the operated knees (p = 0.005), and postoperative OSI in the operated knees at 6 months (p = 0.002) were significant and independent predictors for OSI in the non-operated knees at 6 months postoperatively. Therefore, while no differences were observed in functional outcomes between the two groups in the operated knees, dynamic postural stability was poorer at 6 months postoperatively in the non-operated knees of patients with ACLR with meniscal repair for unstable meniscal tears. Furthermore, a significant correlation was observed between preoperative/postoperative dynamic postural stability in the operated knees and postoperative dynamic postural stability in the non-operated knees. Hence, we recommend incorporating balance exercises for both knees in post-surgical rehabilitation, particularly for patients with unstable meniscal tears.

Rehabilitation and return-to-sport after anterior cruciate ligament injury and reconstruction: Exploring physical therapists’ approaches in Argentina

ObjectivesTo investigate the current clinical practice regarding pre- and post-surgical rehabilitation and return to sport (RTS) criteria following anterior cruciate ligament reconstruction (ACLR). DesignCross-sectional design. Online survey. SettingSurvey platform. ParticipantsArgentinian physical therapists (PTs). Outcome measuresThe survey consisted of a combination of 39 open- and closed-ended questions, divided across 3 sections: (1) demographic and professional information, (2) clinical practice and rehabilitation strategies, and (3) return-to-running (RTR) and RTS. ResultsA total of 619 PTs completed the survey. Considerable variability was observed in preoperative rehabilitation, criteria used for rehabilitation progression and RTS decision-making criteria used by PTs. From the total surveyed, 336 (54.3%) carried out RTS assessment in their clinical practice. Most of PTs (53.3%) use visual estimation to assess knee range of motion. Only 20% of the PTs reported incorporating patient-reported outcome measures in their decision-making. From PTs who use strength assessment as a criterion of RTS (68.8%), 16.6% extrapolate this from jump tests and 15.3% use manual muscle testing. Less than the 50% of the PTs recommended nine months or more to allow patients to RTS. ConclusionsCurrent rehabilitation practices of Argentinian PTs following ACLR are largely variable and not aligned with current evidence and scientific guidelines. To achieve better rehabilitation and RTS practices better knowledge dissemination and implementation are required.

Brain Mapping – Neuromuscular correlations in long-term Postsurgical rehabilitation of Adult Brachial Plexus Palsies

Abstract: Background: Correlations of Transcranial magnetic stimulation (TMS) mapping of the cortical area and electromyography (EMG) + dynamometric testing may demonstrate active neuroplas-ticity events that are reliant on rehabilitation therapy (RT) compliance in adult postsurgical brachial plexus (BP) injuries. Material and Methods: On the right (dominant) arm of two patients with chronic operated BP lesions, we evaluated the progress of functional recovery. The trau-matic event was dated more than 10 years ago for both patients. The first patient (male, 50 years old) and the second one (female, 58 years old) had a history of several microsurgical neurotiza-tion and muscle transfer procedures, with less amelioration of the motor deficit, especially re-lated to elbow flexion (MRC 1/5 and 2/5, respectively). We followed up their evolution by EMG parameters, dynamometry, MRC scaling, and TMS. The motor region of the limb was mapped using TMS to assess the amplitudes of the motor evoked potentials (MEP), on a 4-axis protocol. The patients were assessed twice, with the second examination performed after RT had just fin-ished. TMS findings were compared with EMG and dynamometric results. Results: Higher MEP amplitudes were associated with improved MEP latency during stimulation of the left cerebral hemisphere's cortical area, as well as at the cervical level. EMG findings, both nerve conduction and needle EMG studies showed nonsignificant improvements, as well as muscle strength (as measured by the hydraulic dynamometer). The best results for the first patient showed an in-crease in MEP’s amplitude increase from 1.08 mV to 1.49 mV (in the hotspot), which correlated with measurable latencies, as compared to the first TMS (when no response was obtained at cer-vical stimulation). The second patient also had improvements in latencies: from 37.1 msec. to 36.3 msec. (cervical stimulation with recording at bicipital level) and from 39.2 msec. to 37.9 (cervical stimulation recording at the first interosseous), with a hotspot increase from 1.35 mV to 1.98 mV. The results demonstrate cortical region reactivity in regard to therapeutic techniques. Central modifications do not correlate with visible EMG and dynamometric improvements. Pa-tients with traumatic BP palsy may receive several microsurgical reconstructive procedures, nevertheless, the rehabilitation of the upper limb’s functionality may sometimes still be limited. This increases the risk of discontinuity of the neuromotor RT. We aim to prove that in spite of little correlations with clinical and EMG findings, mapping the cortical area using TMS provides proof of ongoing neuroplasticity phenomena, dependent on adherence to RT. Conclusion: The evidence of continued brain activity supports the requirement for long-term adherence to treatment guidelines and long-term study protocols.

ASSESSMENT OF COGNITIVE FUNCTIONS IN PATIENTS WITH BRAIN TUMOR

Brain tumors is leading to an extreme influence on life quality and an increase in mortality, are becoming as common diagnose in the world. The identification of individual differences in cognition and well-being along with integration of modern approaches in early diagnosis of brain tumors, presurgical preparation and postsurgical rehabilitation significantly impact on the treatment of brain tumors. Existing literature showed that individual differences and personality profile influence cognitive functions preservation after surgery rehabilitation. Along with various methodological approaches to the study of brain tumors at the structural, functional, behavioral, psychophysiological levels we used psychometric measurements of cognitive functions and well-being in patients with brain tumors. In our empirical part of the study the reliability parameters of psychometric tests in Russian and Kazakh languages were analyzed. The relationships between the parameters of emotional well-being and mental state were found: the higher the emotional well-being than the lower the likelihood of problems with thinking and understanding. The results obtained can be used for better planning of postsurgical rehabilitation of brain tumor patients.

Lesão da Placa Plantar: a Importância do Diagnóstico Diferencial

Plantar plate lesions are a common cause of metatarsalgia, a prevalent symptom among the general population and athletes. The plantar plate is a fibrocartilaginous structure located in the plantar side of the feet, that is partly responsible for articular stability. High-impact activities and overuse contribute to plantar plate lesions. The diagnosis is mainly clinical but magnetic resonance imaging and ultrasound can be useful for differential diagnosis. Generally, conservative management, which includes analgesia, shoe adaptation and rehabilitation, is the preferred first treatment option. Surgi¬cal treatment is indicated for severe cases or refractory cases, and post-surgical rehabilitation is mandatory for prognostic optimization.

Ab. No. 121 Digital Therapy During Anterior Cruciate Ligament (ACL) Rehabilitation Through Evidence-Based Feedback Using Wearable Device Pheezee®, A Case Study

Introduction: The outcome following Anterior Cruciate Ligament (ACL) repair depends largely on post-surgical rehabilitation protocol. Recovery map is generally quantified using ROM of knee, outcome score, and seldom muscle activity is considered. The aim is to bring about objective outcome measures during ACL rehabilitation programs where evidence-based feedback assists clinicians to develop dynamic treatment protocols and encourages remote personalized patient care. This study advocates physiotherapists to integrate ROM, sEMG in ACL rehabilitation, establishing a comprehensive technologically advanced approach. Methods: This study includes a single participant who experienced ACL injury, underwent reconstruction surgery followed by post rehabilitation regime, and was remotely monitored using the wearable device. In this case study, ROM and sEMG data were acquired using a novel app-based wearable device Pheezee®. The study employed quantitative analysis of prehab to post-surgical rehabilitation for one year. The objective data was interpreted and compared from the pre-operative to post-operative stages. Results: A satisfactory flexion of 139º and extension of 4º was achieved during post-op, which was comparable to the pre-op range. This is also reflected in the weekly muscle strength trend, where the quadriceps muscles have drastically improved (especially Vastus Lateralis), responsible for knee extension. Conclusion: Knee joint movement is improved from pre- to post-surgical states by adhering to Pheezee® based weekly assessments and exercise protocols. We observed that the acquired data is beneficial for both the physiotherapist and the participant in achieving their goals and making informed clinical decisions leading to modifications in the exercise protocols, use of brace, and walking aids. Further studies are required to determine correlation of subjective perceptions with objective outcomes. Implications: Real-time data helps in making informed clinical decisions, and tailor-made interventions insisting on an evidence-based approach and technology-enabled rehabilitation for effective, comprehensive, and personalized patient care.

Post-surgical efficacy of early motion on intra-articular distal radius fracture and the effect of osteoporosis on outcomes

Aim: Post-surgical rehabilitation of intra-articular distal radius fractures in osteoporotic patients is still controversial. The aim of our study is to compare the effectiveness of early and late motion in intra-articular distal radius fractures in osteoporotic and non-osteoporotic patients. Materials and Methods: Eighty patients were included in our study. The patients were divided into two groups according to osteoporosis (OP), (OP +, OP -). Each group was also divided into 2 groups according to initiation of motion ((Early motion subgroup (E-MOT), Late motion subgroup (L-MOT)). Quick Disabilities of the Arm, Shoulder and Hand (Q-DASH), Patient-Rated Wrist Evaluation (PRWE) scores, Range of Motion (ROM) and grip strength were evaluated at final follow-up. Results: No significant difference was found among the groups in terms of age, gender ratio, right hand–left hand ratio, hand dominance, follow-up duration, or fracture classification. Contrary, the range of motion and functional results of OP+,E-MOT group were found to be more successful than the OP+,L-MOT group, there was no significant difference between the OP-,EMOT group and the OP-,L-MOT group. Conclusion: Early motion has a positive effect on the results in osteoporotic patients compared to late motion, while it does not significantly affect outcomes in non-osteoporotic patients. Early motion after surgery for intra-articular distal radius fractures is crucial for osteoporotic patients, but less so for non-osteoporotic patients.

Effectiveness of postsurgical rehabilitation following lumbar disc herniation surgery: A systematic review

Effectiveness of postsurgical rehabilitation following lumbar disc herniation surgery: A systematic review

Lack of Fall Prevention Education in Patients Experiencing Fall-Related Hip Fracture: A Qualitative Study

Introduction We aimed to describe patient awareness regarding fall prevention and education, perceived causes of falls, and changes in attitude after experiencing a fall through interviews with older Korean patients who experienced falls with resultant hip fractures. Materials and Methods We conducted face-to-face semi-structured in-depth interviews with 11 patients who were admitted to Kangbuk Samsung Hospital for hip fractures caused by falls and were referred to the Department of Rehabilitation Medicine for postsurgical rehabilitation between June 2022 and June 2023. The data were analyzed using the phenomenological method developed by Colaizzi. Results Before hip fracture, none of the patients had received fall prevention education or perceived its necessity; however, they recognized its necessity retrospectively. Participants described the causes of falls as carelessness, actions taken at the time of the fall, environmental factors, and decreased physical function. Most participants believed that falls could be prevented through personal caution and activity restrictions. Some mentioned fall prevention education, exercise, wearing appropriate shoes, environmental adjustments, and seeking assistance from others as methods of preventing future falls. Most patients reported adopting a safety-seeking attitude after experiencing hip fracture. Many patients had negative thoughts such as guilt or thoughts of death, whereas only a few reported increased interest in education and exercise. Conclusions We observed a lack of fall prevention education, misunderstanding regarding the cause of falls, and negative psychological changes after experiencing hip fractures due to falls in older Korean individuals. Recognizing and managing patient perceptions is crucial for effective fall prevention, requiring both healthcare provider awareness and active participation from patients and caregivers.