Effective Rehabilitation Research Articles

Progress in Research into the Effectiveness of Pulmonary Rehabilitation in Children with Asthma - A Narrative Review.

Asthma is the most common chronic respiratory disease in children. It has a serious impact on children's physical and mental health. Pulmonary rehabilitation is a multidisciplinary and comprehensive intervention for patients with chronic respiratory disease, whose major components include breathing training, inspiratory muscle training and exercise training. Pulmonary rehabilitation is a multidisciplinary and comprehensive intervention for patients with chronic respiratory diseases, the main components of which are breathing training, inspiratory muscle training and exercise training. Pulmonary rehabilitation can improve the physical and mental condition of patients with chronic respiratory diseases and promote healthy behaviors. However, there is little research on pulmonary rehabilitation in children with asthma. This review comprehensively evaluated the effect of pulmonary rehabilitation in children with asthma at home and abroad, aiming to provide reference for clinical research on pulmonary rehabilitation in children with asthma.

Investigating the Effects of Pitch Discrimination-based Rehabilitation on Indices and Results of Diagnostic Tests of Children Suspected of Auditory Processing Disorder

Objective Auditory processing disorder (APD) tests, based on the deviation of results from standard benchmarks, can distinguish children suspected of having APD. Some of these tests directly relate to the ability to discriminate sound pitch, while others may be indirectly affected. Accordingly, this study investigates the impact of pitch discrimination-based rehabilitation on diagnostic indices of APD tests. Materials & Methods In this study, we selected 19 children suspected of APD who were identified based on tests of pitch pattern, dichotic digits, and monaural selective auditory attention as the intervention group. These children received pitch discrimination-based training, for about three months, two to three sessions a week, each session up to 1 h. After completing the rehabilitation phases, diagnostic tests were administered again. We also selected 26 children with similar diagnostic criteria for APD as the control group. No intervention was applied to this group, and after a comparable period to the intervention group, diagnostic tests were re-administered. The results before and after the interventions were compared within the intervention group and with the 26 children in the control group. Results The rehabilitation showed significant improvements in the pitch pattern and monaural selective auditory attention tests. In the monaural selective auditory attention test, significant improvements were observed in both ears (P=0.001). In the pitch pattern test, effective improvements were also observed for both ears (P=0.001). The effects were such that nearly 37% of children suspected of APD, based on the diagnostic criteria used in the study, no longer met the criteria for this disorder. Hence, if the same tests are re-administered to them, these children will be diagnosed as having no auditory processing disorder. Conclusion Discrimination-based rehabilitation impacts the results of APD tests. Accordingly, some children who are classified as suspected auditory processing disorder with such tests, are removed from this subgroup after the intervention.

Pulmonary rehabilitation in follow-up and inpatient rehabilitation for Long COVID: twelve months of follow-up.

Individuals with persistent impairments due to Coronavirus disease 2019 (COVID-19) can receive pulmonary rehabilitation in Germany. To date, there is no evidence of the medium- or long-term effects of pulmonary rehabilitation on Long COVID. This study examined changes in health and occupational outcomes over time and described the therapeutic content of pulmonary rehabilitation and aftercare. This analysis also compared two rehabilitation groups after COVID-19 who had different levels of access to rehabilitation. Longitudinal observational study with multicenter and prospective data collection. Pulmonary rehabilitation in four different rehabilitation facilities in Germany. Individuals with a mild course of disease and long-lasting impairments (inpatient rehabilitation, IR) and patients with a severe course after hospitalization (follow-up rehabilitation, FuR). Participants had to be between 18 and 65 years of age. Written questionnaires were administered at the beginning and end of rehabilitation, as well as six and twelve months after rehabilitation. Health-related quality of life (HrQoL), fatigue, participation restrictions, COVID-19 symptoms, mental and physical health were assessed, as well as occupational outcomes and questions about rehabilitation and aftercare. IR patients were predominantly female (68.0%) and 52 years of age on average, while 66.1% of Long COVID rehabilitees in FuR were male and three years older. Over the course of rehabilitation, most COVID-19 symptoms decreased with statistical significance. The subjective health scales showed improvements with medium to large effect sizes (ES) over time in IR (P<0.01; ES between 0.55 (cognitive fatigue) and 1.40 (physical fatigue)) and small to large effects in FuR (P<0.01; ES between 0.45 (anxiety) and 1.32 (physical fatigue)). One year after rehabilitation, most effects remained at a moderate level. After twelve months, an increase in neurocognitive symptoms was observed in FuR patients. More than 80% of employed people returned to work one year after rehabilitation, although FuR patients returned to work a median of four weeks later (P<0.01). The comparative analysis showed that rehabilitees in different forms of rehabilitation attended rehabilitation with different impairments and rehabilitation goals, which are partly considered in treatment and aftercare. To provide needs-based rehabilitation to different rehabilitation groups with Long COVID, knowledge of their health histories and preferences is necessary.

Rehabilitation Intervention Is Associated With Improved Neurodevelopment and Modulation of Inflammatory Molecules in Children With Cerebral Palsy.

To evaluate the effects of systematic rehabilitation on both the neuropsychomotor development, and on the peripheral response from immunological and neuroplastic mediators in children with cerebral palsy. This is a prospective cohort study with 90 children with cerebral palsy at 18 months of age. Sixty children received rehabilitation for 6 months, and they were compared to 30 children that were placed in the waiting list. Peripheral biomarkers and neuropsychomotor parameters were compared between the Rehab vs the Nonrehab groups at baseline and at 6 months. Results showed higher Bayley III scores in the Rehab group, with significant differences in inflammatory and neurotrophic biomarkers between groups. Rehabilitation was associated to decreased levels of IL-12p70, IL-6, IL-1β, CXCL8 IL-8, and CXCL9/MIG and increased levels of BDNF and GDNF. Nonrehab children had stable immune molecule levels but decreased BDNF levels over time. Rehabilitation improved neurodevelopment parameters and modulated levels of inflammatory (↓) and neurotrophic (↑) biomarkers.

Effect of early pulmonary rehabilitation therapy on the pulmonary function of patients with stroke-associated pneumonia and analysis of its effectiveness.

This study aimed to evaluate the clinical effectiveness of early pulmonary rehabilitation (PR) treatment methods for stroke-associated pneumonia (SAP). This is a prospective, randomized controlled intervention study. Eighty SAP patients admitted to the rehabilitation department of Liuzhou People's Hospital from June 2020 to December 2021 were selected and divided into an intervention group (40 cases) and a control group (40 cases) using the random number table approach. Patients in both groups received conventional treatments. Patients in the intervention group received early PR interventions, while patients in the control group received conventional rehabilitation treatment. The clinical effectiveness and pulmonary function indexes were compared. The intervention group showed shorter durations of stay in the intensive care unit, relief from symptoms, and mechanical ventilation compared to the control group following treatment (P < 0.05). The total clinical efficacy after intervention in the treatment group was 82.50%, significantly higher than the control group's rate of 47.50% (P < 0.05). After 21 days of treatment, the forced expiratory volume in one second (FEV1)/predicted value in the intervention group was 64.92 ± 8.53, while it was 52.69 ± 7.08 in the other group. The FEV1/forced vital capacity in the intervention group was 59.73 ± 7.18, compared to 50.36 ± 6.54 in the control group. The intervention group had a clinical pulmonary infection score of 2.62 ± 1.13, while the control group had a score of 4.17 ± 2.08. The intervention group showed a significant improvement in lung function, with statistically significant differences compared to the other group (P < 0.05). Moreover, the intervention group had significantly lower levels of interleukin-4 and interleukin-10 compared to the control group, with statistical significance (P < 0.05). The average National Institute of Health Stroke Scale score of the intervention group was significantly lower than that of the control group in the second and third weeks after treatment (P < 0.05). Early comprehensive pulmonary rehabilitation can significantly enhance the pulmonary function and respiratory status of SAP patients and facilitate the early recovery of brain function. This approach archives significantly better outcomes compared to conventional PR; therefore, it is worth clinical implementation.

Network Reorganization for Neurophysiological and Behavioral Recovery Following Stroke.

Stroke continues to be the main cause of motor disability worldwide. While rehabilitation has been promised to improve recovery after stroke, efficacy in clinical trials has been mixed. We need to understand the cortical recombination framework to understand how biomarkers for neurophysiological reorganized neurotechnologies alter network activity. Here, we summarize the principles of the movement network, including the current evidence of changes in the connections and function of encephalic regions, recovery from stroke and the therapeutic effects of rehabilitation. Overall, improvements or therapeutic effects in limb motor control following stroke are correlated with the effects of interhemispheric competition or compensatory models of the motor supplementary cortex. This review suggests that future research should focus on cross-regional communication and provide fundamental insights into further treatment and rehabilitation for post-stroke patients.

Effects of motor and cognitive complex training on obstacle walking and brain activity in people with Parkinson's disease: a randomized controlled trial.

The difficulties in obstacle walking are significant in people with Parkinson's disease (PD) leading to an increased fall risk. Effective interventions to improve obstacle walking with possible training-related neuroplasticity changes are needed. We developed two different exercise programs, complex walking training and motor-cognitive training, both challenging motor and cognitive function for people with PD to improve obstacle walking. To investigate the effects of these two novel training programs on obstacle walking and brain activities in PD. A single-center randomized, single-blind controlled study. University laboratory; outpatient. Individuals with idiopathic PD. Thirty-two participants were randomly assigned to the complex walking training group (N.=11), motor-cognitive training group (N.=11) or control group (N.=10). Participants in training groups received exercises for 40 minutes/session, with a total of 12-session over 6 weeks. Control group did not receive additional training. Primary outcomes included obstacle walking, and brain activities (prefrontal cortex (PFC), premotor cortex (PMC), and supplementary motor area (SMA)) during obstacle walking by using functional near-infrared spectroscopy. Secondary outcomes included obstacle crossing, timed up and go test (TUG), cognitive function in different domains, and fall efficacy scale (FES-I). The motor-cognitive training group demonstrated greater improvements in obstacle walking speed and stride length, SMA activity, obstacle crossing velocity and stride length, digit span test, and TUG than the control group. The complex walking training did not show significant improvement in obstacle walking or change in brain activation compared with control group. However, the complex walking training resulted in greater improvements in Rey-Osterrieth Complex Figure test, TUG and FES-I compared with the control group. Our 12-session of the cognitive-motor training improved obstacle walking performance with increased SMA activities in people with PD. However, the complex walking training did not lead such beneficial effects as the cognitive-motor training. The cognitive-motor training is suggested as an effective rehabilitation program to improve obstacle walking ability in individuals with PD.

Design and Investigation of a low-cost elbow rehabilitation tool

Electronic medical development focuses on creating an efficient rehabilitation device that will strengthen all surrounding muscles and enhance elbow performance. The elbow rehabilitation tool (ERT) provides sophisticated methods like exercise and motion analysis. The initiative is notable for its advanced assessment methods and adaptable training curricula, which offer users a thorough and successful therapeutic experience. The ERT includes elements like a stepper motor, variable resistor, steel wire, microcontroller, motor driver, and components created using a 3D printer. The experiment results show that the average systematic error percentage is about 82.857%, where seven healthy people have tested the ERT aged between 22 and 55 (five males and two females). The ERT also has achievement evaluation, which improves motivation and dedication to the recovery methods through an effective rehabilitation experience for users.

Transcranial Direct Current Stimulation as Adjuvant to Gamified Rehabilitation for Upper Limb Function in Paediatric Brain Damage (CHILDBOOST Project): A Study Protocol for a Triple-Blind Randomised Controlled Trial

(1) Background and objectives: Paediatric brain injuries can lead to motor and cognitive deficits. Effective rehabilitation is critical for enhancing independence. While virtual reality (VR) and transcranial direct current stimulation (tDCS) have independently demonstrated beneficial effects on motor and cognitive functions, their combined efficacy and its cognitive effects remain to be explored in this population. We aim to investigate the effects of integrating tDCS with VR training on upper limb (UL) functionality and cognitive outcomes through a triple-blind randomised trial. (2) Methods: Twenty-eight children with hemiparesis secondary to non-progressive brain damage will be randomly allocated into two groups: active anodal tDCS (2 mA) plus UL VR training, and sham tDCS with identical VR training. The tDCS will target M1 of the affected or most affected hemisphere for 20 min, simultaneous to VR training. The following four assessments will be carried out: pre-intervention, post-intervention, and three- and six-months follow-up. (3) Results: This study will explore motor and cognitive outcomes of a motor-based intervention in paediatric brain damage. We hypothesise that the experimental group will show significant improvements in UL function and cognition, enhancing their functional recovery. (4) Conclusions: We propose a multidisciplinary therapeutic approach combining neuromodulation and VR to potentiate functional recovery through enhancing motor and cognitive performance in paediatric brain damage.

A Case Report on Infant Aural Rehabilitation Using Korean Auditory, Language, and Cognitive Rehabilitation for Infants

The purpose of this paper is to report the effectiveness and significance of aural rehabilitation using the Korean Auditory, language, and cognitive Rehabilitation for Infants (KARI) program. The KARI program was administered to an infant diagnosed with hearing loss at 9 months of age. A total of 45 KARI sessions were conducted for 13 months. Four developmental areas, auditory, language and social communication, overall and vocal and articulatory were evaluated at 10, 15, and 18 months of age for initial, progress, and final tests. After aural rehabilitation with KARI, in the area of auditory development, the infant showed normal range. In the area of language and social communication, the infant exhibited normal receptive language and non-verbal communication skills but showed significant delays in speech due to the diagnosed submucous cleft palate. In the area of overall developmental screening, Korean Developmental Screening Test for Infants &amp; Children scores were at peer level in cognition and social skills. However, gross motor, fine motor, language, and self-help skills were in the range of needing further testing. In the areas of vocalization and articulation, vocalization showed normal range, but articulation development showed delayed development. Although development of expressive language and articulation was delayed due to submucous cleft palate, the overall results showed good progression with KARI in other areas. Therefore, it is hoped that the KARI would be used to promote aural rehabilitation for the infants with hearing impaired.

Cortical compensation mechanism for swallowing recovery in patients with medullary infarction-induced dysphagia.

This study aims to examine brain activity during different swallowing actions in patients with dysphagia caused by medullary infarction (MI) before and after treatment using blood oxygen level-dependent (BOLD) functional magnetic resonance imaging. Fifteen patients were enrolled in this study. Brain activation during saliva swallowing and effortful saliva swallowing was observed using BOLD imaging in the acute phase of stroke and after 4 weeks of rehabilitation training. Differences in the activation of brain regions during saliva swallowing before and after treatment, during effortful saliva swallowing before and after treatment, and between the two swallowing actions before and after treatment were compared. In the acute phase of stroke, only the bilateral precentral and left lingual gyrus were partially activated during saliva swallowing, and there was no obvious activation in the insula. Effortful saliva swallowing activated more brain regions than saliva swallowing before treatment, including the bilateral supplementary motor area (SMA), postcentral gyrus, and right insular cortex. The number of brain regions activated during saliva swallowing increased after treatment, including the bilateral precentral gyrus, postcentral gyrus, insula, thalamus, and SMA. Cortical activation increases after recovery from dysphagia, and the increased activation of the postcentral gyrus might play a functional compensatory role. Effortful saliva swallowing is a more effective rehabilitation training method for patients with dysphagia caused by MI.

Effects of home-based exercise with telehealth guidance in lymphoma cancer survivors entering cardio-oncology rehabilitation: rationale and design of the tele@home study

BackgroundParticipation in cardio-oncological rehabilitation is low, and the effects incline to decrease after the initial rehabilitation term. Home-based exercise has the potential to enhance involvement in cardio-oncology rehabilitation and was demonstrated to be feasible, safe, and helpful in increasing short-term cardiorespiratory fitness. The lasting effects on cardiorespiratory fitness and physical activity are uncertain. Hence, a novel approach via telehealth management based on objectively measured exercise at home was proposed.ObjectivesTo improve self-monitoring, such as self-confidence, behavioral change, and goal setting for individual exercise, and afterward, increase long-term effects concerning cardiorespiratory fitness.DesignThis randomized controlled trial compares a 12-week guided home exercise telehealth intervention with a center-based exercise intervention of the same duration and intensity of exercise in lymphoma cancer survivors entering cardio-oncology rehabilitation after treatment. Participants will be instructed to exercise gradually at 60–85% of their maximum heart rate for 30–50 min 3 times a week. Participants will receive individual remote guidance (feedback about frequency, duration, and exercise intensity) by preferred contact (phone call, text message) once a week based on shared exercise data through the web platform. The primary outcome is a change in cardiorespiratory fitness expressed as maximal oxygen uptake assessed through cardiopulmonary exercise test at baseline, 12 weeks, and 1 year. Secondary objectives are quality of life, muscle strength, body composition, incidence of adverse events, and exercise adherence.SummaryThis study will determine whether a telehealth model is effective and safe compared to a center-based model in cancer survivors and whether exercise prescriptions are followed by participants. Additionally, an overview of the long-term effectiveness of telehealth cardio-oncology rehabilitation will be provided. This approach aligns with the trend of moving non-complex healthcare services into the patients’ home environment.Trial registrationClinicalTrials.Gov Identifier: NCT05779605

The Accessibility and Effect of Cardiac Rehabilitation in COVID-19 Pandemic Era.

To prospectively compare the efficacy of conventional center-based cardiac rehabilitation (CBCR) and home-based cardiac rehabilitation (HBCR) during the coronavirus disease 2019 (COVID-19) pandemic. Ninety Patients were divided into HBCR and CBCR groups based on cardiovascular risk stratification and individual preference. The CBCR group performed supervised in-hospital exercise training 2-3 times/week and subsequent self-exercise at home. The HBCR group performed self-exercise at home after one or two sessions of exercise education. The cardiopulmonary exercise test results at baseline and those at the 3-, 6-, and 12-month follow-ups were analyzed as primary outcome. The peak oxygen consumption (peak VO2, mL/kg/min) in the CBCR group was 20.1 and 24.0 at baseline and 12 months, respectively, showing significant improvement (p=0.006). In the HBCR group, it only increased from 24.4 to 25.5, showing suboptimal improvement. A significant increase in the Korean activity scale/index was confirmed only in the CBCR group (p=0.04). The cardiovascular outcome did not differ between the two groups, nor did the dropout rate or demographic factors. During the COVID-19 pandemic, only CBCR was associated with a significant improvement in peak VO2 and physical activity levels, a finding that differs from those of other studies and seems to be affected by COVID-19. Therefore, in situations where the importance of HBCR is emphasized, it is essential to introduce measures to monitor and enhance exercise adherence among participants.

Embodied Spatial Navigation Training in Mild Cognitive Impairment: A Proof-of-Concept Trial.

Egocentric and allocentric spatial memory impairments affect the navigation abilities of older adults with mild cognitive impairment (MCI). Embodied cognition research hints that specific aids can be implemented into virtual reality (VR) training to enhance spatial memory. In this study, we preliminarily tested 'ANTaging', an embodied-based immersive VR training for egocentric and allocentric memory, compared to treatment as usual (TAU) spatial training in MCI. MCI patients were recruited for this controlled trial. A cognitive battery was administered at pre-test, after ten sessions of ANTaging or TAU intervention, and at 3-month follow-up (FU). The primary outcomes were spatial cognition tests (Corsi supra-span, CSS; Manikin test, MT). VR egocentric and allocentric performance was also collected. We found that ANTaging significantly improved MT scores at FU compared to TAU. CSS slightly improved in both groups. Concerning secondary outcomes, auditory-verbal forgetting significantly improved at post-test in the ANTaging but not TAU group and significantly declined at FU in the TAU but not in the ANTaging group. Global cognition significantly improved at FU for TAU and remained stable for ANTaging. Other tests showed no improvement or deterioration. Clinical significance showed that ANTaging is effective for CSS. Virtual egocentric and allocentric memory performance improved across ANTaging sessions. ANTaging holds the potential to be superior for improving spatial cognition in MCI compared to TAU. Embodied cognition research provides insights for designing effective spatial navigation rehabilitation in aging.

Systematic review and meta-analysis of breathing exercises effects on lung function and quality of life in postoperative lung cancer patients.

Postoperative recovery in lung cancer patients is a complex process, where breathing exercises may play a crucial role in enhancing pulmonary function and quality of life (QoL). This study systematically reviews and meta-analyzes the impact of breathing exercises on post-surgical lung function and QoL in lung cancer patients. An extensive literature search was conducted across PubMed, Cochrane, Web of Science, and Embase databases using terms like "Lung Neoplasms", "breathing exercises", and "randomized controlled trial", supplemented by Medical Subject Headings (MeSH) and free words. The Cochrane risk of bias tool was used for quality assessment. A systematic review and meta-analysis on the effects of breathing exercises post-lung cancer surgery followed by data extraction and quality evaluation. From 384 retrieved studies, 10 met the inclusion criteria and were selected for detailed analysis. The main outcomes assessed were postoperative pulmonary function indices and QoL measures. The majority of studies were deemed 'low risk' for random sequence generation and allocation concealment. However, due to the nature of the interventions, blinding was a 'high risk' in most cases. The meta-analysis revealed significant improvements in key pulmonary function indices: forced vital capacity (FVC%) increased by an average of 1.73%, maximal voluntary ventilation (MVV) improved by 7.58 L/min, and maximal inspiratory pressure (MIP) enhanced by 0.95 cmH2O. Additionally, there was a notable alleviation of postoperative dyspnea and an enhancement in QoL, with anxiety scores decreasing by an average of 3.42 points and complication rates reducing correspondingly. However, the interventions did not significantly affect physical activity levels or performance on the 6-minute walk test (6WMT), with effect sizes for these outcomes being non-significant. This study indicates that breathing exercises significantly improve postoperative pulmonary function and QoL in lung cancer patients. Future research should delve into the mechanisms behind these exercises and evaluate their long-term rehabilitation effects. Customized programs could further optimize recovery and enhance patient QoL.

Application of a novel nested ensemble algorithm in predicting motor function recovery in patients with traumatic cervical spinal cord injury

Traumatic cervical spinal cord injury (TCSCI) often causes varying degrees of motor dysfunction, common assessed by the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI), in association with the American Spinal Injury Association (ASIA) Impairment Scale. Accurate prediction of motor function recovery is extremely important for formulating effective diagnosis, therapeutic and rehabilitation programs. The aim of this study is to investigate the validity of a novel nested ensemble algorithm that uses the very early ASIA motor score (AMS) of ISNCSCI examination to predict motor function recovery 6 months after injury in TCSCI patients. This retrospective study included complete data of 315 TCSCI patients. The dataset consisting of the first AMS at ≤ 24 h post-injury and follow-up AMS at 6 months post-injury was divided into a training set (80%) and a test set (20%). The nested ensemble algorithm was established in a two-stage manner. Support Vector Classification (SVC), Adaboost, Weak-learner and Dummy were used in the first stage, and Adaboost was selected as second-stage model. The prediction results of the first stage models were uploaded into second-stage model to obtain the final prediction results. The model performance was evaluated using precision, recall, accuracy, F1 score, and confusion matrix. The nested ensemble algorithm was applied to predict motor function recovery of TCSCI, achieving an accuracy of 80.6%, a F1 score of 80.6%, and balancing sensitivity and specificity. The confusion matrix showed few false-negative rate, which has crucial practical implications for prognostic prediction of TCSCI. This novel nested ensemble algorithm, simply based on very early AMS, provides a useful tool for predicting motor function recovery 6 months after TCSCI, which is graded in gradients that progressively improve the accuracy and reliability of the prediction, demonstrating a strong potential of ensemble learning to personalize and optimize the rehabilitation and care of TCSCI patients.

Exploring circular RNAs as biomarkers for Parkinson's disease and their expression changes after aerobic exercise rehabilitation.

Circular RNAs (circRNAs) are circularized single-stranded ribonucleic acids that interacts with DNA, RNA, and proteins to play critical roles in cell biology. CircRNAs regulate microRNA content, gene expression, and may code for specific peptides. Indeed, circRNAs are differentially expressed in neurodegenerative disorders like Parkinson's disease (PD), playing a potential role in the mechanisms of brain pathology. The RNA molecules with aberrant expression in the brain can cross the blood-brain barrier and reach the bloodstream, which enable their use as non-invasive PD disease biomarker. Promising targets with valuable discriminatory ability in combined circRNA signatures include MAPK9_circ_0001566, SLAIN1_circ_0000497, SLAIN2_circ_0126525, PSEN1_circ_0003848, circ_0004381, and circ_0017204. On the other hand, regular exercises are effective therapy for mitigating PD symptoms, promoting neuroprotective effects with epigenetic modulation. Aerobic exercises slow symptom progression in PD by improving motor control, ameliorating higher functions, and enhancing brain activity and neuropathology. These improvements are accompanied by changes circRNA expression, including hsa_circ_0001535 (circFAM13B) and hsa_circ_0000437 (circCORO1C). The sensitivity of current methods for detecting circulating circRNAs is considered a limitation. While amplification kits already exist for low-abundant microRNAs, similar kits are needed for circRNAs. Alternatively, the use of digital PCR can help overcome this constraint. The current review examines the potential use of circRNAs as non-invasive biomarkers of PD and to assess the effects of rehabilitation. Although circRNAs hold promise as targets for PD diagnosis and therapeutics, further validation is needed before their clinical implementation.

A Study on the Effectiveness of VR Rehabilitation Training Content for Older Individuals with Total Knee Replacement: Pilot Study.

There is a paucity of research applying fully immersive virtual reality (VR) training to older adults with degenerative joint disease. This study investigated the effects of a training program utilizing fully immersive VR games on proprioception and gait ability in older patients with degenerative arthritis who had undergone total knee arthroplasty. This randomized controlled trial enrolled patients aged ≥65 years who were diagnosed with knee joint arthritis and had undergone knee arthroplasty followed by physical therapy. Participants were randomly assigned to an experimental group (receiving training using fully immersive VR games along with regular physical therapy) and a control group (receiving only regular physical therapy). The intervention was conducted five times a week for four weeks. Knee joint proprioception was measured using Biodex before and after the intervention. Spatial-temporal gait variables were collected using OptoGait for gait assessment. There was a significant decrease in the absolute error values of proprioception after the intervention in the experimental group, compared to before (p < 0.05), indicating improvement in proprioception. Gait speed, step count, and stride length improved significantly (p < 0.05, p < 0.01), demonstrating an enhancement in gait ability. The experimental group showed significantly greater improvements in gait speed, step count, and stride length than the control group (p < 0.01). Training using a fully immersive VR exercise program may have potential benefits for improving proprioception and gait parameters in patients who have undergone total knee arthroplasty. Fully immersive VR game-based training can be utilized as an effective rehabilitation intervention for patients undergoing knee arthroplasty in the future.

Effect of rapid rehabilitation nursing on improving clinical outcomes in postoperative patients with colorectal cancer.

Surgical resection is the cornerstone treatment for colorectal cancer. Rapid rehabilitation care predicated on evidence-based medical theory aims to improve postoperative nursing care, subsequently reducing the physical and mental traumatic stress response and helping patients who undergo surgery recover rapidly. To assess the effect of rapid rehabilitation care on clinical outcomes, including overall postoperative complications, anastomotic leaks, wound infections, and intestinal obstruction in patients with colorectal cancer. We searched the PubMed, Web of Science, Embase, Elsevier Science Direct, and Springer Link databases from January 1, 2010, to January 1, 2024, to screen eligible studies on rapid rehabilitation care among patients who underwent colorectal cancer surgery. Patients were screened based on the inclusion and exclusion criteria. RevMan 5.4 software was used for statistical analysis of the data. Twelve studies were enrolled, which included 2420 patients. The results showed that rapid rehabilitation care decreased the incidence of overall postoperative complications (OR: 0.44, 95%CI: 0.26-0.74, P = 0.002), anastomotic leaks (OR: 0.68, 95%CI: 0.41-1.12, P = 0.13), wound infections (OR: 0.45, 95%CI: 0.29-0.72, P = 0.0007), and intestinal obstruction (OR: 0.54, 95%CI: 0.34-0.86, P = 0.01) compared to conventional care. Further trials and studies are needed to confirm these results. Rapid rehabilitation care decreased the occurrence of postoperative complications, anastomotic leaks, wound infections, and intestinal obstruction compared to conventional care in patients who underwent colorectal surgery. Therefore, promoting the application of rapid rehabilitation care in clinical practice cannot be overemphasized.

Factors influencing implementation of digital cardiac rehabilitation: A qualitative analysis of health workers perspectives.

Despite growing evidence for the effectiveness of digital cardiac rehabilitation (CR) uptake of this technology remains low. Understanding the factors that influence implementation of digital CR in clinical practice is a growing area of research. The aim of this nested qualitative study was to explore health worker perspectives on factors influencing implementation of a digital CR programme. Using convenience sampling, semi-structured interviews were conducted with health workers, including health care professionals (nurses, dietitians, physiotherapists) and those in administrative and managerial roles who were involved in delivering and referring patients to Croí MySláinte, a 12-week digital CR intervention delivered during the Coronavirus 2019 pandemic. The updated Consolidated Framework for Implementation Research (CFIR) guided data collection and framework analysis. Interviews were conducted with 14 health workers. Factors influencing implementation of Croí MySláinte were multiple, with some operating independently and others in combination. They related to: (i) characteristics of individuals (e.g., senior leadership support, commitment and motivation of Health workers to meet patient needs, technical capability, workload and perceived fit with role); (ii) features of the programme (e.g., accessibility and convenience for patients, the digital platform, patient self- monitoring tools, the multidisciplinary team and core components); (iii) the external environment (e.g., partnership and connections between organisations, broadband and COVID-19); (iv) the internal environment (e.g., organisational culture, teamwork, resources including funding, digital infrastructure and staffing); and (v) the implementation process (e.g., engaging patients through provision of technical support). The study findings suggest that factors influencing implementation of digital CR operate at multiple levels. Therefore, multi-level implementation strategies are required if the true potential of digital health in improving equitable cardiac rehabilitation access, participation and patient outcomes is to be realised.