Functional Rehabilitation Research Articles

Outcomes of operative and nonoperative management of myotendinous Achilles tendon ruptures: a systematic review

BackgroundAchilles tendon ruptures are the most common lower extremity tendinous rupture. While there has been extensive research into the management of mid-substance Achilles tendon ruptures, there is a paucity of literature on the management of myotendinous Achilles tendon ruptures.MethodsThe aim of this systematic review is to compile all available literature on the treatment of myotendinous Achilles tendon tears. A systematic search of Web of Science, Embase, and Medline databases was performed for all studies published from database inception to April 13, 2024. All publications addressing the treatment of myotendinous Achilles ruptures of all levels of evidence were included. The PRISMA Checklist guided the reporting and data abstraction. Descriptive statistics are presented.ResultsA total of five studies with 70 patients were included for analysis. Sixty-seven patients underwent non-operative management with an average age ranging from 40.8 to 51.0 years. Three patients underwent operative management with ages of 16, 36, and 39. The majority of patients tore their Achilles tendon during sports. For nonoperatively treated patients, one group underwent immobilization for a total of 6 weeks and one study treated patients with functional rehabilitation. All patients were able to perform a single heel-raise, had good reported strength, and returned to work or sport. Nonoperative patients reported statistically significant improvements in subjective outcomes and high rates of satisfaction.ConclusionBoth nonoperative and operative management of myotendinous Achilles tendon ruptures demonstrated good outcomes after injury, although there is a limited amount of literature on this topic. Given that nonoperative treatment appears to yield good strength and return to activity, it may be preferred for the majority of patients. Operative management may be indicated in high level athletes. Imaging to determine the exact location of injury, quality of remaining tendon, and gap distance may further aid when considering treatment options. Higher level evidence studies are required to determine the optimal treatment of myotendinous Achilles tendon ruptures.Level of evidenceIV; Systematic review of Level IV-V studies.

FOXO3-engineered human mesenchymal stem cells efficiently enhance post-ischemic stroke functional rehabilitation.

FOXO3-engineered human mesenchymal stem cells efficiently enhance post-ischemic stroke functional rehabilitation.

Comparison of Functional Electrical Stimulation Cycle vs. Conservative Rehabilitation on Functional Status and Muscle Features in Stroke Patients

Background Functional Electrical Stimulation (FES) Cycle is used in the rehabilitation of stroke. Objective The aim of this study is to investigate the effects of CR and FES cycle therapy on the functional status and muscle features in stroke patients Methods The 1st Group(n = 15) received only CR for 6 weeks, and the 2nd Group(n = 15) received FES cycle 3 days a week for 4 weeks in addition to the CR treatment. Brunnstrom recovery staging(BRS), Fugl-Meyer lower extremity evaluation(FME); Berg Balance Scale(BBS), Functional Ambulation Classification(FAC), Barthel Index(BI), Fatigue Severity Scale(FSS), 6 min walk test(6mWT), knee extensor and knee flexor muscle strengths(KEMS, KFMS) in both groups were assessed before and after treatment(6th week). Pennate angle(PA) and rectus femoris muscle thickness(RFT) were measured. Results Significant improvement was detected in BBS, FAS, BI, FME, 6mWT, KEMS, RFT scores after intra-group treatment compared to before treatment in both groups. Only the 2nd Group showed a significant difference in KFMS, FSS, BRS lower extremity, PA values after treatment compared to before. No significant superiority of the groups over each other was detected. Conclusions CR and FES Cycle contribute to the improvement of the functional status of the patients, but their superiority over each other was not observed.

Muscle Contraction Is Essential for Tendon Healing and Muscle Function Recovery After Achilles Tendon Rupture and Surgical Repair.

Incomplete tendon healing and postponed muscle weakness after Achilles tendon rupture and surgical repair lead to poor performance in patient activities. Although the effectiveness of postoperative early functional rehabilitation has been proven, the priority and each effect of specific methods in early rehabilitation remain unclear. We hypothesized early muscle contraction exercises without joint motion would promote tendon healing and prevent calf muscle atrophy; in contrast, early static stretching after surgical repair would not contribute to tendon healing and induce calf muscle atrophy. C57Bl/6 mice underwent Achilles tendon rupture and suture repair, followed by different methods of post-surgery interventions: a non-exercise group, a Static stretching group, and an Electrical muscle stimulation group. 3 and 5 weeks after surgery, we assessed ex vivo tendon mechanical properties, collagen fiber alignment, and histological muscle properties. Electrical Muscle Stimulation restored the recovery of tendon mechanical properties and muscle strength more quickly than Static stretching. Static stretching had no additional effect on them compared to the non-exercise. Our results suggested that calf muscle contraction was essential as a post-surgery early functional rehabilitation to load tensile forces on tendons and improve Achilles tendon healing. Additionally, early muscle contractions naturally promote restoring muscle function after the rupture, but further research is needed to optimize muscle contraction protocols.

Deep Temporal Clustering of Pathological Gait Patterns in Post-Stroke Patients Using Joint Angle Trajectories: A Cross-Sectional Study.

Rehabilitation of gait function in post-stroke hemiplegic patients is critical for improving mobility and quality of life, requiring a comprehensive understanding of individual gait patterns. Previous studies on gait analysis using unsupervised clustering often involve manual feature extraction, which introduces limitations such as low accuracy, low consistency, and potential bias due to human intervention. This cross-sectional study aimed to identify and cluster gait patterns using an end-to-end deep learning approach that autonomously extracts features from joint angle trajectories for a gait cycle, minimizing human intervention. A total of 74 sub-acute post-stroke hemiplegic patients with lower limb impairments were included in the analysis. The dataset comprised 219 sagittal plane joint angle and angular velocity trajectories from the hip, knee, and ankle joints during gait cycles. Deep temporal clustering was employed to cluster them in an end-to-end manner by simultaneously optimizing feature extraction and clustering, with hyperparameter tuning tailored for kinematic gait cycle data. Through this method, six optimal clusters were selected with a silhouette score of 0.2831, which is a relatively higher value compared to other clustering algorithms. To clarify the characteristics of the selected groups, in-depth statistics of spatiotemporal, kinematic, and clinical features are presented in the results. The results demonstrate the effectiveness of end-to-end deep learning-based clustering, yielding significant performance improvements without the need for manual feature extraction. While this study primarily utilizes sagittal plane data, future analysis incorporating coronal and transverse planes as well as muscle activity and gait symmetry could provide a more comprehensive understanding of gait patterns.

Bioinspired Tunable Helical Fiber-Shaped Strain Sensor with Sensing Controllability for the Rehabilitation of Hemiplegic Patients.

Fiber-based strain sensors, as wearable integrated devices, have shown substantial promise in health monitoring. However, current sensors suffer from limited tunability in sensing performance, constraining their adaptability to diverse human motions. Drawing inspiration from the structure of the spiranthes sinensis, this study introduces a unique textile wrapping technique to coil flexible silver (Ag) yarn around the surface of multifilament elastic polyurethane (PU), thereby constructing a helical structure fiber-based strain sensor. The synergistic interaction between the elastic PU core and the outer helical Ag yarn enhances the mechanical strength and stretchability of the sensor, while the external helical Ag yarn offers high conductivity. By adjusting the spacing of Ag yarn coils on the surface of the fiber-based sensor, we achieve precise control over both sensing sensitivity and strain range. Specifically, experimental results show that with a pitch of 1.25 mm, the strain range reaches up to 150%, and the gauge factor (GF) is 2.6; when the pitch is adjusted to 5 mm, within a 60% strain range, the GF value significantly increases to 9.3. Based on these excellent performance metrics, we further apply the sensor as a conductor in ECG monitoring garments, successfully verifying its practicality in cardiac monitoring. Additionally, we developed a smart glove for hand function rehabilitation training, utilizing wireless signal transmission to promote hand function recovery in hemiplegic patients. The sensor is also capable of effectively monitoring respiratory rate and pulse, showing broad prospects in the fields of rehabilitation medicine and smart healthcare.

Sexual dysfunction following low-dose-rate brachytherapy for prostate cancer

Prostate cancer (PCa) is one of the most prevalent forms of male malignancies globally, ranking second in terms of incidence and sixth in terms of mortality. Low-dose-rate brachytherapy (LDRT) represents a treatment modality for PCa, involving the implantation of permanent radioactive sources into the prostate tissue. The isotopes predominantly utilised are I–125 and Pd–103. LDRT demonstrates high rates of biochemical and clinical relapse-free survival, with cancer-specific and overall survival rates comparable to those achieved through radical prostatectomy. Despite the advantages associated with LDRT, evidence has accumulated regarding the potential complications accompanying this treatment approach, including sexual dysfunction and erectile dysfunction. Sexual satisfaction constitutes a critical concern for men undergoing PCa treatment. It is essential that both the patient and the healthcare provider prioritise not only erectile function but also the preservation of sexuality in its entirety. The present study endeavours to evaluate the accumulated material on the topic of diagnosing and treating sexual dysfunctions following low-dose-rate brachytherapy (LDRT). The analysis encompassed articles by foreign and domestic authors published between 2014 and 2024, as well as fundamental articles and literature dating back earlier. These works were devoted to sexual dysfunction, assessment, and rehabilitation of sexual function in patients with PCa who underwent LDRT. Our review confirmed the existing necessity for a detailed study of rational methods for diagnosing sexual dysfunctions prior to selecting a treatment method, as well as the possible prevention of disorders after LDRT. It is also essential to develop sexual and penile rehabilitation strategies following LDRT for PCa, which is currently widely employed.

Reorganization of cortical individualized differential structural covariance network is associated with regional morphometric changes in chronic subcortical stroke.

Patients with chronic subcortical stroke undergo regional and network morphometric reorganizations beyond the lesion site, but the interplay between network and regional reorganization remains poorly understood. We aimed to clarify the reorganization patterns of the individualized differential structural covariance networks (IDSCN) in chronic subcortical stroke and investigate their associations with regional gray matter volume (GMV) changes and functional recovery. Structural MRI from four datasets enrolled 112 patients with chronic subcortical stroke (81 male, age: 55.82±7.79) and 122 matched healthy controls (HC) (74 male; age: 55.28±7.54). Network-based statistics were employed to identify aberrant IDSCN, Spearman correlation was conducted to assess the association between IDSCN and regional GMV alterations, and partial correlation was utilized to investigate the association between abnormal IDSCN and functional recovery. We identified 133 connections with balanced increased and decreased IDSCN. Aberrant IDSCN involved more regions than local GMV alterations, local GMV alteration exhibited intricate correlations with IDSCN, which could explain partly IDSCN reorganization (p<0.05, corrected). Finally, abnormal IDSCN showed a weak association with long-term clinical recovery (p<0.01). These findings reinforce the theory of adaptive network reorganization post-stroke and suggest that IDSCN may provide further insights into cortical reorganization and functional rehabilitation beyond regional morphometric measures.

Effectiveness of Traditional Chinese Medicine in Psychological Rehabilitation After Lung Cancer Surgery: Systematic Review and Meta-Analysis protocol.

The incidence and mortality of lung cancer is the highest among malignant tumors worldwide, and it seriously threatens human life and health. Surgery is the primary radical treatment for lung cancer. However, patients often experience discomfort, changes in social roles, economic pressures, and other postsurgical challenges. These factors frequently cause various psychological disorders such as anxiety and depression, significantly diminishing the quality of life and elevating the risks of recurrence, metastasis, and mortality. Therefore, effective strategies for mental function rehabilitation should be urgently developed. Traditional Chinese medicine can significantly improve psychological function and physical symptoms after lung cancer surgery, and prolong patient survival. However, its effectiveness for mental function rehabilitation after lung cancer surgery remains unclear. This study aimed to investigate the effects of Chinese medicine on mental function recovery after lung cancer surgery through a systematic review and meta-analysis. This study will systematically search the following databases: PubMed, Cochrane Library, EMBASE, Web of Science, ClinicalTrials.gov, China National Knowledge Infrastructure, Wanfang database, VIP database, and Chinese BioMedical Literature database. Search for studies published from the inception of each database until April 22, 2024. This study will be limited to clinical randomized controlled trials (RCTs). The primary outcome will be depression or anxiety, as indicated by the scale score. Data analysis will be performed using RevMan 5. The Cochrane Risk of Bias Assessment Tool will be used to evaluate the quality of included studies. Finally, the quality of the evidence will be classified using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) System. This meta-analysis aims to offer comprehensive evidence of the effectiveness of traditional Chinese medicine in mental function rehabilitation after lung cancer surgery. The study will assess the quality of the reports and conduct a subgroup analysis based on various postoperative stages, intervention measures, intervention duration, and sex to gather more evidence to fill the gap in psychological function rehabilitation after lung cancer surgery. These data can be used to guide clinical practice and inform future studies. More importantly, the results of this study will provide evidence to support the development of expert consensus and clinical guidelines in the field of mental function rehabilitation after lung cancer surgery.

In vivo kinematics during step ascent: Changes to the knee associated with osteoarthritis

BackgroundStair climbing is a kinematically demanding activity, essential for maintaining independence and quality of life, yet is often impaired in patients with knee osteoarthritis (OA). The purpose of this study was to examine differences in kinematics of a step-up movement between participants with osteoarthritis and asymptomatic controls. MethodsThirty participants with end-stage OA awaiting total knee arthroplasty (TKA) and twenty-eight sex and age-similar asymptomatic participants were recruited. Participants performed a step-up task which was imaged via single-plane fluoroscopy. 3-dimensional prosthesis computer-aided design models were registered to the fluoroscopy, yielding in-vivo kinematic data. Kinematic variables of position, displacement, and rate-of-change in six degrees of freedom were compared between the two groups. ResultsOA knees exhibited significantly different kinematics to asymptomatic knees during step-up. Knees with OA demonstrated a reduced terminal extension angle, inferior translation and increased internal rotation throughout the movement compared to asymptomatic. OA participants exhibited more variability in kinematic parameters compared to asymptomatic controls, reflecting the heterogeneity within OA pathology. ConclusionThe findings of this study indicate that knee kinematics, particularly rotation, differ significantly between OA and asymptomatic knees during step-up. Optimising rotational profiles in OA knee management could help optimise patient function and inform rehabilitation and surgical protocols.

Traditional herbal medicine for Guillain-Barré syndrome: A systematic review and meta-analysis.

Guillain-Barré syndrome (GBS) is a rapid-onset disease caused by the immune system damaging the peripheral nervous system. Since most standardized treatments for GBS focus on acute phase treatment, there are limitations to the rehabilitation and management of general conditions. In East Asian countries, herbal medicine has been used to treat GBS and aid rehabilitation. Therefore, herbal medicine is considered a complementary treatment for GBS. Hence, the present study was conducted to investigate the clinical evidence of herbal medicine treatment for GBS and to provide a research strategy for the future. PubMed, Embase, Cochrane, CNKI, CiNii, and Science ON were searched from inception to December 4, 2024. Randomized controlled trials (RCTs) comparing conventional Western medicine (CWM) combined with herbal medicine (treatment group) and only CWM (control group), to evaluate the effects of herbal medicine combined with CWM as a treatment for GBS were included. All bibliographic data from the collected studies were summarized in Endnote X9 (Clarivate Analytics). The meta-analysis was conducted using Review Manager (Revman) 5.4.1. software. Effectiveness was assessed by Total Effective Rate (TER), Modified Barthel Index (mBI) score and Manual Muscle Testing (MMT) score. Safety was evaluated as the occurrence of a significant adverse events (AEs). Ten RCTs that comprised 764 participants were included. Based on the meta-analysis, TER was found to significantly improve in the treatment group compared with the control group (risk ratios: 1.14, 95% confidence interval: 1.09 to 1.20, p<0.00001). The mBI score and MMT score of upper limb and lower limb also significantly improved in the treatment group compared with the control group. No significant AEs were reported in any included study. The results of this study suggest that the combination of CWM and herbal medicine may be a better and safer method of physical function recovery and rehabilitation in patients with GBS. Further qualified studies are required to establish this hypothesis.

Gait Analysis after Anterior Cruciate Ligament Reconstruction: A Study in Morocco

Gait analysis is a valuable tool for understanding joint function, especially in knees with ligament defects. It allows for the identification and correction of deficits following ligament reconstruction. In this study, we analyze the knee kinematics of patients who have undergone anterior cruciate ligament (ACL) reconstruction and followed a rigorous rehabilitation protocol. Our goal is to evaluate the effectiveness of rehabilitation in these patients. We conducted a descriptive retrospective study on 20 patients at the Orthopedics and Traumatology Department B of Mohamed VI University Hospital in Marrakech, in collaboration with the Physical Medicine and Functional Rehabilitation Department and the Gait and Movement Analysis Laboratory. The study population had a mean age of 31.5 years, a mean height of 173 cm, and a mean body mass index of 24.14, with 85&amp;#37; of subjects being male (&lt;i&gt;n&lt;/i&gt; &amp;#61; 14). Gait analysis data revealed minimal deviations from normal reference values in spatio-temporal metrics, joint amplitudes, and ground reaction force. Our findings show that with adequate care and compliance to a comprehensive rehabilitation protocol, patients undergoing ACL reconstruction can regain a near-normal gait.

Factors affecting outcomes of functional rehabilitation treatment of Achilles ruptures.

Factors affecting outcomes of functional rehabilitation treatment of Achilles ruptures.

A delphi study on the feasibility of community-based oral function rehabilitation exercises and the dental hygienist workforce adequacy

A delphi study on the feasibility of community-based oral function rehabilitation exercises and the dental hygienist workforce adequacy

Applications of transcranial direct current stimulation over vagus nerve on dysphagia after stroke.

Vagus nerve stimulation (VNS) has been commonly employed for the functional rehabilitation of stroke patients. This study aimed to investigate the therapeutic effects of transcranial direct current stimulation on the vagus nerve (TDCSVN) in improving dysphagia in stroke patients. Patients experiencing dysphagia following a stroke were diagnosed with dysphagia by a water swallow test. Swallowing function was evaluated with the standard swallowing scale score and the functional dysphagia scale. Serum levels of interleukin (IL)-1β and IL-8 were measured with enzyme-linked immunosorbent assays. TDCSVN treatment resulted in a significantly greater reduction in both the standard swallowing scale and functional dysphagia scale scores compared to conventional treatment. Furthermore, TDCSVN treatment led to a notable increase in hemoglobin and albumin levels, suggesting a more substantial improvement in dysphagia compared to conventional methods. Additionally, TDCSVN treatment was more effective in decreasing serum levels of IL-1β and IL-8 in dysphagic patients after a stroke. TDCSVN treatment demonstrated a significant inhibitory effect on inflammatory cytokines, resulting in a more pronounced improvement in dysphagia among stroke patients.NEW & NOTEWORTHY The present study demonstrates that transcranial direct current stimulation on the vagus nerve (TDCSVN) treatment shows a significant inhibitory effect on the production of inflammatory factors, resulting in a more pronounced improvement in dysphagia among stroke patients.

Metaheuristic machine learning for optimizing sustainable interior design: enhancing aesthetic and functional rehabilitation in housing projects

Metaheuristic machine learning for optimizing sustainable interior design: enhancing aesthetic and functional rehabilitation in housing projects

Camera-based control system of a planar cable-driven parallel robot intended for functional rehabilitation

Abstract This paper investigates a closed-loop visual servo control scheme for controlling the position of a fully constrained cable-driven parallel robot (CDPR) designed for functional rehabilitation tasks. The control system incorporates real-time position correction using an Intel RealSense camera. Our CDPR features four cables exiting from pulleys, driven by AC servomotors, to move the moving platform (MP). The focus of this work is the development of a control scheme for a closed-loop visual servoing system utilizing depth/RGB images. The developed algorithm uses this data to determine the actual Cartesian position of the MP, which is then compared to the desired position to calculate the required Cartesian displacement. This displacement is fed into the inverse kinematic model to generate the servomotor commands. Three types of trajectories (circular, square, and triangular) are used to test the controller’s compliance with its position. Compared to the open-loop control of the robot, the new control system increases positional accuracy and effectively handles cable behavior, various perturbations, and modeling errors. The obtained results showed significant improvements in control performance, notably reduced root mean square error and maximal error in terms of position.

Inner dialogue dysfunction and the abusive comments of the dominant hemisphere

ABSTRACT Inner dialogue and inner speech are normal systems of cerebral intrapersonal communication, crucial to self-awareness. Lesions affecting the cerebral network involved in these systems have been associated with the occurrence of Auditory Verbal Hallucinations (AVHs). These are regarde as a continuum phenomenon experienced by healthy, individuals, as well as those with psychiatric disorders. In this paper, two patients with left hemispheric lesions of different pathologies, vascular and tumor, respectively, who during their recovery of motor and sensory functions presented severe deregulation in their inner dialogue. In both cases, the damaged left dominant hemisphere adopted arrogant, demeaning, and abusive inner speech, while the right non-dominant side, which commands the rehabilitation of the lost functions, was subdued and quiet. This abusive unilateral inner dialogue was present until adequate recovery of independent functions was achieved for both patients.

Conservative Treatment of Neonatal Brachial Plexus Palsy: A Narrative Review.

Neonatal brachial plexus palsy (NBPP) is a flaccid paralysis of the upper limbs that occurs in about 0.4 percent of live births. This condition can produce permanent disabilities; to date, there is no consensus on protocols to be applied for the rehabilitation of children with this condition. The aim of this article is to provide a concise overview of conservative treatment beyond traditional physical therapy for the management of the child with NBPP and to offer a number of useful options for creating the most comprehensive and functional rehabilitation treatment possible. We conducted a narrative review after analyzing articles from the past 50 years on PubMed, Cochrane Library, Scopus, and Web of Science with the following search string [("neonatal brachial plexus palsy" OR "obstetric brachial plexus palsy" OR "birth brachial plexus palsy") AND ("rehabilitation" OR "physiotherapy" OR "conservative treatment")]. We identified a potential of 1275 articles, but only 11 were exclusively about conservative approaches. The most represented rehabilitation approaches in the literature were botulinum toxin, constraint-induced movement therapy (CIMT), virtual reality, neuromuscular electrical stimulation, and kinesiotaping. In conclusion, the various rehabilitation approaches for NBPP are promising, but none can be considered the best option when used alone. In light of the current evidence, a multimodal approach is needed.

Esthetic and Functional Rehabilitation: Retreatment of Anterior Fixed Dental Prothesis With Biologically Oriented Preparation Technique and Digital Workflow.

This clinical case describes a multidisciplinary retreatment of a patient with anterior fixed dental prostheses (FDPs) using minimally invasive restorations and a biologically oriented preparation technique (BOPT). A 56-year-old female patient, treated 30 years ago with a metal-ceramic FDP due to dental agenesis, presented a misfit prosthesis at the gingival margin, black spaces, and food retention at the pontics. Notably, tooth number 2.6 was absent, and she exhibited a left crossbite. Her chief complaint was the compromised esthetics of her restorations. Given her coagulation disorder, von Willebrand disease, she declined mucogingival surgery. A diagnostic wax-up and mock-up was performed to establish treatment goals. The initial phase involved periodontal, orthodontic, and implant treatment. The orthodontic treatment with aligners to correct the crossbite. Subsequently, bleaching and a second mock-up were conducted to guide prosthetic treatment. In the prosthodontic treatment, the abutment teeth were prepared using a vertical BOPT to remodel the gingival tissues, achieving the esthetic goal of repositioning the gingival margin without surgery. The provisional phase was critical for soft tissue remodeling and ensured clinical success. After stabilization of the soft tissues, a monolithic zirconia FDP was delivered, with a follow-up of 2 years. A multidisciplinary treatment plan, utilizing a digital workflow, resulted in stable clinical and esthetic outcomes at the two-year follow-up, effectively retreating an anterior bridge using BOPT in a patient with a coagulation disorder that contraindicated complex surgical interventions.