Exercise Rehabilitation In Patients Research Articles

Causes of Poor Incision Healing after Caesarean Section and Strategies to Prevent it

This study aims to investigate the causes of poor healing of uterine incision after caesarean section and the prevention and treatment strategies. By retrospectively analysing the clinical data of 800 patients who underwent new cesarean section between January 2021 and January 2023 in our hospital, it provides reference for improving the quality of healing. Methods: The clinical data of 800 patients with poor healing of uterine incision after cesarean section were retrospectively analysed, and the relevant influencing factors and prevention methods were summarised. Results：Factors affecting the healing of uterine incision after new type of cesarean section included age, body mass index, pregnancy and delivery, operation time, intraoperative bleeding, postoperative infection and nutritional status. Treatment included strengthening postoperative nutrition, preventing infection, and regular dressing changes. Most of the patients achieved good healing and no abnormality was seen at 2-month follow-up. Conclusion: Poor healing of uterine incision after new-style cesarean section is related to many factors, but the incidence can be reduced by preoperative preparation and postoperative care. For the poor healing that has occurred, timely and correct treatment measures can help promote incision healing and reduce complications. Attention should be paid to related factors and preventive and therapeutic measures should be taken to improve the quality of healing. It is also crucial to strengthen the training of healthcare professionals and rehabilitation exercises for patients.

Electromyographic analysis of selected shoulder muscles during shoulder rehabilitation exercises in patients after reversed shoulder arthroplasty

BackgroundReversed shoulder arthroplasty (RSA) aims to restore function in patients with rotator cuff failure and joint arthropathy. After surgery, patients are routinely referred to a rehabilitation specialist to regain range of motion, strength, and function. A key element in these programs is active exercises. The exercises are often selected based on assumed muscle activity, investigated by electromyography (EMG). In particular, in this patient population, activation of the deltoid and the scapular muscles is the focus of exercise therapy. Currently, most studies investigating muscle activity levels during exercises are performed on healthy individuals. To our knowledge, no study exists analyzing EMG activity during exercises in a population of shoulder arthroplasty patients. Therefore, the study aimed to analyze activity in the shoulder girdle muscles during 6 commonly used rehabilitation exercises 12 weeks after RSA surgery. MethodsForty-four patients (50 shoulders) participated in this cross-sectional study, 12 weeks postoperatively (mean 99.18±12.8 days), aged 68.9±7.75 years. Surface EMG activity was measured in 10 shoulder girdle muscles: the 3 trapezius parts, serratus anterior, the 3 deltoid parts, latissimus dorsi, and 2 pectoralis major parts during 6 exercises, 3 in a closed chain, and 3 open chain elevation exercises. ResultsGravity- minimized exercises (horizontal plane) show low activity for almost all muscles. Vertical closed kinetic chain exercises show an increased activity compared to horizontal plane exercises. Open kinetic chain exercises against gravity showed the greatest activity in Deltoid and Upper trapezius. For the other muscles no consistency in progression was found. ConclusionThis study offers a progression of exercises for patients after reversed shoulder arthroplasty based on increased muscle activity.

Research progress of exercise rehabilitation in patients undergoing percutaneous coronary intervention for acute myocardial infarction

Research progress of exercise rehabilitation in patients undergoing percutaneous coronary intervention for acute myocardial infarction

Cardiac output-mediated regulation of cerebral blood flow during exercise: Clinical perspectives on the indirect impact of muscle metaboreflex.

The muscle metaboreflex stimulates the elevation of arterial blood pressure, aiming to rectify the oxygen deficit by enhancing oxygen delivery to support muscle activity. Moreover, activating the muscle metaboreflex significantly increases cardiac output (CO) by increasingfactors such as heart rate, ventricular contractility, preload, stroke volume and mobilization of central blood volume. Previous studies indicate that ageing and cardiovascular diseases modify the muscle metaboreflex during exercise, limiting the ability to increase CO during physical activity. Alongside reduced exercise capacity, the attenuated rise in CO due to abnormal muscle metaboreflex in these patients impedes the increase in cerebral blood flow during exercise. Considering that CO plays a pivotal role in regulating cerebral blood flow adequately during exercise, this occurrence might contribute to an elevated risk of cerebral diseases, and it could also, at least, reduce the effective role of exercise in preventing cerebral disease and dementia among elderly individuals and patients with cardiovascular conditions. Therefore, it is important to consider this phenomenon when optimizing the effectiveness of exercise rehabilitation in patients with cardiovascular disease to prevent cerebral diseases and dementia.

To allow or avoid pain during shoulder rehabilitation exercises for patients with chronic rotator cuff tendinopathy-Study protocol for a randomized controlled trial (the PASE trial)

BackgroundRotator cuff (RC) tendinopathy is the most reported shoulder disorder in the general population with highest prevalence in overhead athletes and adult working-age population. A growing body of evidence support exercise therapy as an effective intervention, but to date there are no prospective randomized controlled trials addressing pain as an intervention variable.MethodsA single-site, prospective, pragmatic, assessor-blinded randomized controlled superiority trial. Eighty-four patients aged 18–55 years with chronic (symptom duration over 3 months) RC tendinopathy are randomized 1:1 to receive shoulder exercise during which pain is either allowed or avoided. The intervention period lasts 26 weeks. During that period, participants in both groups are offered 8 individual on-site sessions with an assigned sports physiotherapist. Participants perform home exercises and are provided with a pain and exercise logbook and asked to report completed home-based exercise sessions and reasons for not completing sessions (pain or other reasons). Patients are also asked to report load and the number of sets and repetitions per sets for each exercise session. The logbooks are collected continuously throughout the intervention period. The primary and secondary outcomes are obtained at baseline, 6 weeks, 26 weeks, and 1 year after baseline. The primary outcome is patient-reported pain and disability using the Shoulder PAin and Disability Index (SPADI). Secondary outcomes are patient-reported pain and disability using Disability Arm Shoulder and Hand short-form (Quick DASH), and shoulder pain using Numeric Pain Rating Scale. Objective outcomes are shoulder range of motion, isometric shoulder muscle strength, pain sensitivity, working ability, and structural changes in the supraspinatus tendon and muscle using ultrasound.DiscussionThe results of this study will contribute knowledge about the treatment strategies for patients with RC tendinopathy and help physiotherapists in clinical decision-making. This is the first randomized controlled trial comparing the effects of allowing pain versus avoiding pain during shoulder exercises in patients with chronic RC tendinopathy. If tolerating pain during and after exercise proves to be effective, it will potentially expand our understanding of “exercising into pain” for this patient group, as there is currently no consensus.Trial registrationClinicalTrials.gov NCT05124769. Registered on August 11, 2021.

The Effectiveness of Blood Flow Restriction Technique Combined with Low-Resistance Exercise in the Postoperative Rehabilitation of Patients Following Knee Surgery: A Narrative Review and Update of Evidence-Based Physiotherapy Practice

<b>Background:</b> Blood flow restriction (BFR) therapy has emerged as a promising rehabilitation approach after knee surgery. The technique involves the use of a tourniquet or cuff to limit blood flow to the affected limb during low-resistance exercise, which creates a hypoxic environment thought to stimulate muscle growth and improve muscle function. <b>Objective:</b> Our scoping review aims to examine the current literature on the effectiveness of BFR combined with low-resistance exercise on rehabilitation after knee surgery. <b>Method: </b>The Google Scholar, PubMed, and PEDro databases were searched using relevant key-words. Studies that met the inclusion criteria were selected for analysis. The data from the selected studies were analyzed, categorized, and summarized to provide an overview of the findings. <b>Results:</b> In total, 12 studies met the inclusion criteria and were included in the review. Outcomes such as pain, strength, and range of motion were assessed. <b>Conclusion: </b>The results suggest that BFR and low-resistance exercise can be effective in improving patient outcomes following knee surgery. However, the heterogeneity of the studies made it difficult to determine the most effective approach. Further research is needed to identify the optimal dosage, frequency, and duration of BFR and low-resistance exercise for knee surgery rehabilitation.

Application of collateral-dredging tendon-strengthening exercise in postoperative rehabilitation of patients undergoing spinal surgery

Application of collateral-dredging tendon-strengthening exercise in postoperative rehabilitation of patients undergoing spinal surgery

Efficacy of exercise rehabilitation for managing patients with Alzheimer's disease.

Alzheimer's disease (AD) is a progressive and degenerative neurological disease characterized by the deterioration of cognitive functions. While a definitive cure and optimal medication to impede disease progression are currently unavailable, a plethora of studies have highlighted the potential advantages of exercise rehabilitation for managing this condition. Those studies show that exercise rehabilitation can enhance cognitive function and improve the quality of life for individuals affected by AD. Therefore, exercise rehabilitation has been regarded as one of the most important strategies for managing patients with AD. Herein, we provide a comprehensive analysis of the currently available findings on exercise rehabilitation in patients with AD, with a focus on the exercise types which have shown efficacy when implemented alone or combined with other treatment methods, as well as the potential mechanisms underlying these positive effects. Specifically, we explain how exercise may improve the brain microenvironment and neuronal plasticity. In conclusion, exercise is a cost-effective intervention to enhance cognitive performance and improve quality of life in patients with mild to moderate cognitive dysfunction. Therefore, it can potentially become both a physical activity and a tailored intervention. This review may aid the development of more effective and individualized treatment strategies to address the challenges imposed by this debilitating disease, especially in low- and middle-income countries.

Development and Validation of an Artificial Intelligence-Based Motion Analysis System for Upper Extremity Rehabilitation Exercises in Patients with Spinal Cord Injury: A Randomized Controlled Trial.

In this study, we developed an AI-based real-time motion feedback system for patients with spinal cord injury (SCI) during rehabilitation, aiming to enhance their interest and motivation. The effectiveness of the system in improving upper-limb muscle strength during the Thera band exercises was evaluated. The motion analysis program, including exercise repetition counts and calorie consumption, was developed using MediaPipe, focusing on three key motions (chest press, shoulder press, and arm curl) for upper extremity exercises. The participants with SCI were randomly assigned to the experimental group (EG = 4) or control group (CG = 5), engaging in 1 h sessions three times a week for 8 weeks. Muscle strength tests (chest press, shoulder press, lat pull-down, and arm curl) were performed before and after exercises. Although both groups did not show significant differences, the EG group exhibited increased strength in all measured variables, whereas the CG group showed constant or reduced results. Consequently, the computer program-based system developed in this study could be effective in muscle strengthening. Furthermore, these findings may serve as a valuable foundation for future AI-driven rehabilitation exercise systems.

Effectiveness of Different Telerehabilitation Strategies on Pain and Physical Function in Patients With Knee Osteoarthritis: Systematic Review and Meta-Analysis.

Knee osteoarthritis (OA) is a chronic, degenerative bone and joint disease. It can lead to major pressure to the quality of life and mental health of patients, and also brings a serious economic burden to society. However, it is difficult for patients with knee OA to access rehabilitation when discharging from the hospital. Internet-based rehabilitation is one of the promising telemedicine strategies for the improvement of knee OA, but the effect of different telerehabilitation strategies on knee OA is not clear. The aim of this systematic review and meta-analysis was to identify telerehabilitation strategies attributing to the improvement of pain and physical function outcomes in patients with knee OA. We reviewed and analyzed telerehabilitation strategies from randomized controlled trials (RCTs) comparing telerehabilitation with conventional treatment or usual care. For each strategy, we examined whether RCTs that applied the telerehabilitation strategy resulted in a significant improvement in pain or physical function compared with conventional treatment or usual care. We included 6 RCTs (n=734) incorporating 8 different telerehabilitation strategies. The duration of the interventions ranged from 1 to 48 weeks, and sample sizes ranged from 20 to 350 patients. The results showed that RCTs that provided telerehabilitation were found to be more effective than conventional treatments for improving pain (P=.003; standardized mean difference [SMD] -0.21, 95% CI -0.35 to -0.07), but not physical function (P=.24; SMD -0.09, 95% CI -0.25 to 0.06). Furthermore, this systematic review and meta-analysis indicated that there is no significant correlation between different telerehabilitation strategies and the pain and physical function of patients with knee OA. This systematic review and meta-analysis showed that telerehabilitation programs could relieve pain but not improve physical function for patients with knee OA. These results indicated that telerehabilitation is beneficial for the implementation of home rehabilitation exercises for patients with knee OA, thereby reducing the economic burden of health. However, there were limitations in terms of the number of search results and the number of studies that were eligible for this review and meta-analysis. Therefore, the results need to be interpreted with caution, and more high-quality studies with large samples are needed to focus on the long-term outcomes of telerehabilitation for patients with knee OA to address this limitation.

"Challenges to Normalcy"- Perceived Barriers to Adherence to Home-Based Cardiac Rehabilitation Exercise in Patients with Chronic Heart Failure.

The aim of this study was to explore perceived barriers to adherence to home-based cardiac rehabilitation exercise in patients with chronic heart failure. A qualitative descriptive study was conducted in this study from May to July 2023. A purposive sampling approach was adopted to select patients with chronic heart failure. Semi-structured interviews were completed to collect qualitative data for exploring the perceived barriers. In addition, information saturation and validation strategies were adopted to prove the adequacy of qualitative data. Transcripts were analysed using thematic analysis. A total of 16 patients with chronic heart failure were included in this study. Analysis of the data revealed five main barriers to adherence to home-based cardiac rehabilitation in patients with chronic heart failure. These include (1) lack of knowledge, (2) activity intolerance, (3) exercise fear, (4) role conflict, and (5) lower exercise self-efficacy. This study delved deeper into understanding the challenges faced by chronic heart failure patients in adhering to home-based cardiac rehabilitation exercise. The development of precise and effective management and intervention strategies based on these barriers is necessary to improve patient compliance with home-based cardiac rehabilitation exercise.

A behavioural driving model of adherence to home-based cardiac rehabilitation exercise among patients with chronic heart failure: A mixed-methods study.

To develop and validate a behavioural driving model for adherence to home-based cardiac rehabilitation exercise in patients with chronic heart failure, and to explain the potential driving mechanism of social support on exercise adherence. Despite the benefits of home-based cardiac rehabilitation exercise, adherence among patients with chronic heart failure remains suboptimal. Several factors contributing to adherence have been confirmed; however, the specific pathway mechanisms by which these factors impact exercise adherence have not been thoroughly explored. An exploratory sequential mixed-methods study was conducted in this study. A total of 226 patients with chronic heart failure were recruited using convenience sampling. Quantitative data were collected using a series of self-report questionnaires. Hierarchical regression analysis was performed to verify multiple pathways. Subsequently, 12 patients with chronic heart failure were drawn from the quantitative stage. The interview data were thematically analysed. This study followed the Good Reporting of a Mixed Methods Study (GRAMMS) guidelines (Appendix S1). Perceived social support had a direct positive predictive effect on exercise adherence. Importantly, exercise self-efficacy and exercise fear played a chain-mediating role between perceived social support and exercise adherence. As a result of the qualitative phase, scale, tightness and homogeneity of social support networks emerged as potential drivers of the effectiveness of social support on exercise adherence. This study reveals a potential pathway mechanism for social support to improve adherence to home-based cardiac rehabilitation exercises. Social support network plays a crucial role in the effect of social support on exercise adherence. To enhance exercise adherence in home-based cardiac rehabilitation for patients with chronic heart failure, establishing a social support network is recommended. This strategy has the potential to promote exercise self-efficacy and alleviate exercise fear. None.

D-STGCNT: A Dense Spatio-Temporal Graph Conv-GRU Network based on transformer for assessment of patient physical rehabilitation

This paper tackles the challenge of automatically assessing physical rehabilitation exercises for patients who perform the exercises without clinician supervision. The objective is to provide a quality score to ensure correct performance and achieve desired results. To achieve this goal, a new graph-based model, the Dense Spatio-Temporal Graph Conv-GRU Network with Transformer, is introduced. This model combines a modified version of STGCN and transformer architectures for efficient handling of spatio-temporal data. The key idea is to consider skeleton data respecting its non-linear structure as a graph and detecting joints playing the main role in each rehabilitation exercise. Dense connections and GRU mechanisms are used to rapidly process large 3D skeleton inputs and effectively model temporal dynamics. The transformer encoder’s attention mechanism focuses on relevant parts of the input sequence, making it useful for evaluating rehabilitation exercises. The evaluation of our proposed approach on the KIMORE and UI-PRMD datasets highlighted its potential, surpassing state-of-the-art methods in terms of accuracy and computational time. This resulted in faster and more accurate learning and assessment of rehabilitation exercises. Additionally, our model provides valuable feedback through qualitative illustrations, effectively highlighting the significance of joints in specific exercises.

Validation of a Wearable System for Lower Extremity Assessment.

Remote assessment and diagnosis of functional impairment caused by osteoarthritis (OA) of the knee can achieve early intervention of patients' functional impairment, prevent the deterioration of OA of the knee, and provide functional remote screening for patients with knee OA. This study introduced an inertial measurement unit (IMU) sensor-based system to assess lower extremity function and perform gait analysis. Then, we compared its accuracy to gold-standard motion capture and gait measurement systems. Nine adults were selected to participate in a comparative study of gait assessment outcomes using an IMU sensor-based wearable system, a gold-standard motion capture system, and a pressure-based gait analysis system. The subject walked on a path that incorporated all three systems. Data analysis was performed on spatiotemporal gait parameters, including velocity, cycle time, cadence, and stride length. This was followed by gait phases, including stance, swing, double stance, and single limb support phases. Data were processed using the data processing software of each system. An independent sample t-test was conducted for inter-group comparison to analyze the data. The spatiotemporal gait parameters of the systems demonstrated excellent consistency, and the gait phases showed high consistency. Compared to the gold-standard pressure-based gait analysis system (the GATERite system), the mean gait cycle time results were 1.124 s vs. 1.127 s (p = 0.404); cadence was 93.333 steps/min vs. 94.189 steps/min (p = 0.482); stance phase was 60.89% vs. 63.26% (p < 0.001); swing phase was 39.11% vs. 36.74% (p < 0.001); stride length was 1.404 m vs. 1.420 m (p = 0.743); speed was 1.093 m/s vs. 1.110 m/s (p = 0.725). Compared to the gold-standard video-based motion capture system, the root mean square error was 2.7° for the hip angle and 2.6° for the knee angle. This IMU-based wearable system delivered precise measuring results to evaluate patients with knee OA. This technology can also be used to guide rehabilitation exercises for patients with knee OA.

Effect of Exercise Rehabilitation in Patients With Acute Heart Failure: A Systematic Review and Meta-analysis.

Exercise rehabilitation is conducive to increasing functional ability and improving health outcomes, but its effectiveness in patients with acute heart failure (AHF) is still controversial. In this study, our aim was to systematically examine the efficacy of exercise rehabilitation in people with AHF. A search was conducted for randomized controlled trial studies on exercise rehabilitation in patients with AHF up to November 2021. Two investigators conducted literature selection, quality assessments, and data extractions independently. The primary outcome was 6-minute walk distance, and the secondary outcomes were left ventricular ejection fraction, quality of life, Short Physical Performance Battery, readmission, and mortality. RevMan (version 5.3) software was used for the meta-analysis. Twelve studies with 1215 participants were included. Exercise rehabilitation significantly improved the 6-minute walk distance (mean difference [MD], 33.04; 95% confidence interval [CI], 31.37-34.70; P < .001; I2 = 0%), quality of life (MD, -11.57; 95% CI, -19.25 to -3.89; P = .003; I2 = 98%), Short Physical Performance Battery (MD, 1.40; 95% CI, 1.36-1.44; P < .001; I2 = 0%), and rate of readmission for any cause (risk ratio, 0.48; 95% CI, 0.26-0.88; P = .02; I2 = 7%), compared with routine care. However, no statistically significant effects on left ventricular ejection fraction (MD, 0.94; 95% CI, -1.62 to 3.51; P = .47; I2 = 0%) and mortality (risk ratio, 1.07; 95% CI, 0.64-1.80; P = .79; I2 = 0%) were observed. Compared with routine care, exercise rehabilitation improved functional ability and quality of life, reducing readmission in patients with AHF.

Development of Stride Detection System for Helping Stroke Walking Training

Walking is a popular post-stroke rehabilitation exercise for patients. Stroke walking training is a sort of physical therapy that aims to help people who have had a stroke improve their walking ability. The goal of this research is to classify stride length and include it into a mobile application. The accelerometer sensor on a smartphone can be used to construct a stride detection system to aid in stroke walking training. This application was created for Android-powered smartphones. A binder must be used to secure the smartphone device to the patient's thigh. This application reads the accelerometer sensor included into the smartphone. In this study, a stride detection model is designed to increase the performance of stride length and circumduction detection. The accelerometer is read and saved by the application as the participant walks on the specific path. After the signal has been pre-processed and its feature extracted, the data is used to create the stride detection model. The performance is good, as evidenced by accuracy, precision, recall, and f-measure values of 88.60%, 88.60%, 88.60%, and 88.60%, respectively. When utilized on a stride detection system, the decision tree algorithms function admirably. The model is then loaded into the Android walking app.

Triceps surae muscle forces during dynamic exercises in patients with Achilles tendinopathy: A cross-sectional study.

The aim of this study was to investigate the individual triceps surae muscle forces during the execution of six different functional movements and rehabilitation exercises in patients with Achilles tendinopathy compared to a control group. Triceps surae muscle forces of 15 participants with Achilles tendinopathy (AT) and 15 healthy controls were estimated through a combination of experimental data and musculo-skeletal modeling. Three-dimensional motion capture and force plates were used to collect the ankle and knee joint angles and moments during three functional movements (walking, heel walking, and toe walking) and three rehabilitation exercises (bilateral heel drop, unilateral heel drop with extended knee and with flexed knee). A dynamic optimization method was used to obtain the modeled triceps surae muscle forces. Force-sharing strategies were calculated at the peak triceps surae muscle force and compared between groups. Lower peak triceps surae forces were obtained for the AT group during dynamic exercises. Across all exercises, the average contribution of the soleus (SOL) to the total triceps surae muscle force was the largest (60.83 ± 13.89% [AT] > 56.90 ± 16.18% [healthy]), followed by the gastrocnemius medialis (29.87 ± 10.67% [AT] < 32.19 ± 12.90% [healthy]) and the gastrocnemius lateralis (9.30 ± 4.31% [AT] < 10.91 ± 4.66% [healthy]). The triceps surae force-sharing strategy was different for the toe walking, heel walking, and the bilateral and unilateral heel drop with extended knee. This study provides evidence for altered triceps surae muscle force-sharing strategies during dynamic tasks in patients with AT. The influence of altered muscle force-sharing on the subtendon nonuniformity and/or the tendon loading should be explored in future work.

Efficacy of auricular acupuncture combined with electro-acupuncture and physiotherapy exercise in motor rehabilitation after ischemic stroke

Auricular acupuncture (AA) is a method of Traditional Medicine that has been used for a long time to treat many diseases, including stroke. This study aimed to examine the effect of auricular acupuncture combined with electro-acupuncture and physiotherapy exercise in the motor rehabilitation of patients with ischemic stroke. 128 patients after ischemic stroke participated in this RCT, then were randomly assigned to either the AA-study group (auricular acupuncture combined with electro-acupuncture and conventional therapy) or the CT - control group (sham auricular acupuncture combined with electro-acupuncture and conventional therapy). They were treated and monitored for six consecutive weeks. Clinical outcomes were measured using the Barthel Index (BI), Fugl Meyer Assessment (FMA), and Motricity Index (MI) scales at two-time points, including before and six weeks after initiation of the intervention. After six weeks, FMA, BI, and MI scores were significantly higher than before treatment (p &lt; 0.05) in both groups. Specifically, the study group had a statistically significant improvement compared to the control group (p &lt; 0.05). This study shows that auricular acupuncture in combination with electro-acupuncture and physiotherapy exercise was more effective than electro-acupuncture and physiotherapy exercise in improving motor function in patients after ischemic stroke.

The Effect of a Formal Nonoperative Management Program Combining a Hip Injection With Structured Adjunctive Exercise Rehabilitation in Patients With Symptomatic Femoroacetabular Impingement Syndrome

Background: Although the initial treatment recommendations for femoroacetabular impingement syndrome (FAIS) may include nonsurgical therapies such as injections and rehabilitation, many patients undergo isolated injections or a rudimentary exercise regimen. Purpose: To investigate the benefit of an intra-articular hip injection and concomitant structured exercise rehabilitation program in patients with symptomatic FAIS ≥6 months. Study Design: Case series; Level of evidence, 4. Methods: For this study we recruited 49 patients with a mean age of 32.8 years (range, 16-56 years) and symptoms ≥6 months (range, 6-250 months) associated with FAIS, as confirmed via magnetic resonance imaging and radiography. After a guided intra-articular injection of corticosteroid and local anesthetic, patients underwent a structured 12-week rehabilitation program. Patients were assessed before and after injection (8 weeks and 4, 6, 12, and 24 months) with a range of patient-reported outcome measures (PROMs), including the 33-item International Hip Outcome Tool, Hip Outcome Score, modified Harris Hip Score, the Tegner Activity Score, a visual analog scale assessing the frequency and severity of hip pain, and a Global Rating of Change scale. Range of motion, peak isometric hip strength, and hop tests were assessed. Absolute scores and limb symmetry indices were calculated. The percentage of patients transitioning toward surgery over the period was evaluated. Results: Of the 44 patients who underwent the injection and completed the initial 8-week rehabilitation component, 14 (31.8%) progressed toward surgical intervention over the 24-month postinjection period owing to dissatisfaction and/or symptom recurrence. Patients who progressed toward surgery, as compared with those who did not, reported significantly worse (P < .05) PROMs presurgery and more pain within the first 4 weeks after injection. In the nonoperative cohort, a significant improvement (P < .05) in all PROMs was observed, with 93% of these patients satisfied overall. The Global Rating of Change did not improve, although this was measured only after the injection, reflecting no further significant perceived global change from 8 weeks to 24 months. A significant increase (P < .05) in all hip range of motion and most isometric strength measures was observed at 8 weeks after injection, with these improvements largely sustained until 24 months. Bilateral improvements in hop capacity were observed, with hop test LSIs significantly improving for the single (p = 0.009), triple (p = 0.029) and triple crossover (p = 0.005) hop tests for distance. Conclusion: Although 32% of patients progressed toward surgery, significant improvement in hip pain, symptoms, and physical function was observed in the majority of patients with symptomatic FAIS as a result of a targeted nonoperative management pathway consisting of an intra-articular injection and a structured exercise program.

The development of split-treadmill with a fall prevention training function.

The weakening of the ability of the elderly to perform gait is becoming a major cause of the increase in the frequency of falls. In this study, we designed and manufactured a treadmill capable of restraining walking by providing a sudden repulsive force on the left and right legs of a pedestrian when walking for the fall prevention training of the elderly. Through this, it is possible for the elderly person to strengthen the lower extremity muscles to prevent and prepare for falling through the fall prevention training similar to the fall environment that may occur in daily life. The development system includes a motor for generating a driving force in the form of a left and a right driving system and a belt separated from each other, an electromagnetic clutch for rapidly stopping the running belt of the motor transmitted to the running belt to stop the running belt, and a controller for controlling the driver. In order to evaluate the development system, the motor driving ability test and the power transmission, connection and shut-off performance of the electromagnetic clutch were carried out. The subject's muscle activity of the lower extremity muscles was evaluated when the running belt stopped at the beginning of the right folding. It is expected that the developed dual function system would be helpful for the fall prevention exercise as well as the rehabilitation exercise for patients who have recovered from surgery or hemiplegic patients.