Rehabilitation Outcomes Research Articles

Evaluating the Efficacy of Artificial Intelligence Using Machine Learning Models in Predicting Functional Recovery Post-Stroke

Abstract Background: Stroke is a significant health problem in India, with an uneven prevalence and high early mortality rates. Worldwide, stroke is the second leading cause of death. In the initial months post-stroke, motor impairment is a primary concern, in addition to various other deficits. Predicting recovery after a stroke is crucial for optimizing resource allocation. Utilizing machine learning offers the potential to enhance therapeutic decision-making and predict individual recovery outcomes in stroke rehabilitation. Objectives: We aimed to employ machine learning algorithms to predict functional recovery after stroke by estimating Barthel Index scores, identifying patterns and correlations within the dataset, and determining the most effective machine learning model among the five algorithms that were tested. Materials and Methods: Participants were screened for eligibility before enrollment, and demographic information, stroke characteristics, and Barthel Index scores were recorded. The dataset was split into training and testing subsets for analysis. Five machine learning algorithms were trained using the initial dataset to develop predictive models. Results: High alcohol and tobacco use potentially influenced Barthel Index scores and stroke recovery. The recovery process varied based on stroke type, with ischemic and hemorrhagic strokes. The Random Forest model exhibited the highest predictive accuracy among the models. Conclusion: The study highlights the role of demographics, lifestyle habits, comorbidities, and stroke type in functional recovery poststroke. The Random Forest model demonstrated the most reliable predictive capability, indicating artificial intelligence’s potential in stroke recovery prediction. Furthermore, research studies are needed to develop and evaluate robust prediction models.

Low-Intensity Resistance Exercise in Cardiac Rehabilitation: A Narrative Review of Mechanistic Evidence and Clinical Implications

Cardiac rehabilitation, a multi-component intervention designed to mitigate the impact of cardiovascular disease, often underutilises low-intensity resistance exercise despite its potential benefits. This narrative review critically examines the mechanistic and clinical evidence supporting the incorporation of low-intensity resistance exercise into cardiac rehabilitation programmes. Research indicates that low-intensity resistance exercise induces hypertrophic adaptations by maximising muscle fibre activation through the size principle, effectively recruiting larger motor units as it approaches maximal effort. This activation promotes adaptation in both type I and II muscle fibres, resulting in comparable increases in myofibrillar protein synthesis and phosphorylation of key signalling proteins when compared to high-intensity resistance exercise. Low-intensity resistance exercise provides equivalent improvements in muscular strength and hypertrophy compared to high-intensity protocols while addressing barriers to participation, such as concerns about safety and logistical challenges. By facilitating engagement through a more accessible exercise modality, low-intensity resistance exercise might improve adherence rates and patient outcomes in cardiac rehabilitation. Additionally, the ability of low-intensity resistance exercise to address sarcopenia and frailty syndrome, significant determinants of cardiovascular disease progression, can enhance the recovery and overall quality of life for patients. This review establishes evidence-based recommendations for the inclusion of low-intensity resistance exercise in cardiac rehabilitation, offering a promising pathway to enhance the effectiveness of these programmes.

Errorless and errorful learning in people with aphasia across novel-object pairing and word retrieval tasks

ABSTRACT Background While linguistic deficits are key to diagnosing and treating aphasia, there is growing interest in the cognitive processes important for rehabilitation outcomes, particularly the role of learning. Of relevance to the current study, research has manipulated instructional methods (errorless vs. errorful) to assess their effects on outcomes. However, it is still unclear whether individualized profiles of errorless and errorful learning exist in aphasia and whether they might be meaningful for clinical practice. Aims The current study aimed to examine learning in people with aphasia, manipulating instruction method (errorless, errorful) and linguistic demands of learning. Methods & procedures Nine people with stroke-induced aphasia participated in this preliminary study. Participants engaged in errorless and errorful novel object pairing and word retrieval tasks. Learning outcomes were assessed on the same day, next day, and after one week. Participants also completed cognitive-linguistic assessments to investigate the contribution of memory, language, and executive functioning abilities on learning outcomes. Outcomes & results At the group level, participants performed significantly better following errorful training for novel object pairing (p = 0.001) relative to errorless training. An errorful advantage was observed at the individual level in 7 participants during same day testing, with the highest overall performers on the task showing the most persistent errorful learning benefits. In the word retrieval practice task, group and individual-level differences in scores following errorless and errorful practice were minimal. Scores in errorful novel object pair learning correlated with verbal short-term memory and nonverbal long-term memory assessments, while no other correlations were found between learning scores and cognitive-linguistic variables. Conclusions Findings are consistent with prior research that suggests that successful effortful retrieval may pose an advantage over errorless learning when acquiring novel information and the potential contributions of verbal short-term memory and nonverbal long term memory on learning. Results from the word retrieval practice task draw attention to differences between practicing lexical access and novel learning. The lack of an errorful advantage in word retrieval may alternatively be due to task design and merits further research. Results support the hypothesis that people with aphasia display variable learning profiles that may stem from differences in underlying cognitive-linguistic abilities. Continuing research is needed to characterize learning in aphasia to consider its potential influence on rehabilitation outcomes and support speech-language pathologists in considering and accounting for different learning and cognitive-linguistic abilities when individualizing treatment decisions.

Multidimensional Social Support for Community Corrections Offenders in China

This paper explores the role of multidimensional social support in the reintegration of community corrections offenders in China. While community corrections in China has expanded, offenders face significant challenges, such as stigma and limited resources. Social support plays a crucial role in overcoming these difficulties. The study distinguishes between structural social support, which involves social networks providing resources and connections, and functional social support, including emotional, informational, instrumental, and appraisal support that impacts offenders' well-being. The paper reviews existing research on social support within the Chinese context and emphasizes the need for an integrated approach to support offenders. In conclusion, strengthening both structural and functional social support is essential for enhancing rehabilitation outcomes and reducing recidivism. Policy recommendations include improving social networks and expanding support services to aid offenders' successful reintegration into society.

Impact of social determinants of health on rehabilitation service use and outcomes in adults in the USA: a scoping review protocol

IntroductionMany Americans fail to receive equitable access to or positive outcomes from rehabilitation services. These disparities result from broader societal inequities that disproportionately affect certain groups of people due to...

Comprehensive assessment and progression of health status during neurorehabilitation in survivors of critical illness: a prospective cohort study

BackgroundCritical illness survivors frequently suffer from long-term impairments, often described as post-intensive care syndrome (PICS). PICS encompasses physical, cognitive, and mental impairments. Additionally, the term intensive care unit (ICU)-acquired weakness (ICUAW) was coined for muscle weakness after critical illness. Research on the progression and outcome of individuals affected by PICS and ICUAW is scant. Thus we aimed to assess the health status and its progression during neurorehabilitation in critically ill patients using comprehensive outcome measures, describe the prevalence of PICS, and evaluate factors associated with rehabilitation outcomes.MethodsPatients with mixed reasons for critical illness who received ≥ 5 days of mechanical ventilation on the ICU and who were admitted to neurorehabilitation, were eligible to be included in this prospective cohort study. A number of outcomes (patient-reported, clinician-reported, and performance) were assessed after discharge from the ICU (V1) and shortly before discharge from inpatient neurorehabilitation (V2). The prevalence of PICS, defined as having at least one impairment in any PICS dimension), was calculated at V1 and V2. Multiple logistic regressions were conducted to identify factors associated with rehabilitation outcome (poor outcome = modified Rankin Scale > 2) and ICUAW at V2 (MRC sum score < 48).ResultsIn total, 250 critical illness survivors (62 ± 14 years, 34% female, median stay on ICU 55 days, median inpatient rehabilitation 65 days) were included. 11 participants (4.4%) died before V2. All outcomes improved significantly during rehabilitation except sensory impairment and pain. PICS was present in 96% at V1 and in 85% at V2, whereby mainly the physical domain (V1: 87%, V2: 66%; ICUAW with MRC sum score < 48) and the cognitive domain (V1:65%, V2:55%; Montreal Cognitive Assessment < 26) were affected. Mental impairment was lower (V1:48%, V2:29%; Hospital Anxiety and Depression Scale > 7), but still affected a considerable number of participants. Accordingly, health-related quality of life was rather low at discharge (0.64 ± 0.28, index value of EQ-5D-5L). MRC sum score at V1, duration of mechanical ventilation, and female gender were significantly associated with a poor rehabilitation outcome. Grip strength in % of reference at V1, age, female gender, and comorbidities were significantly associated with persistent ICUAW at discharge.ConclusionsDespite significant improvements during rehabilitation, survivors after critical illness experience a substantial burden of PICS and ICUAW at discharge from rehabilitation care. Survivors of critical illness require long-term follow-up, supportive structures, and tailored long-term multi-disciplinary therapies even after intensive rehabilitation.Trial registration: German Clinical Trials Register, DRKS00021753. Registered 03 September, 2020. https://drks.de/search/en/trial/DRKS00021753.

AI-Driven Rehabilitation Robots: Enhancing Physical Therapy for Stroke and Injury Recovery

AI-driven rehabilitation robots are transforming physical therapy by providing personalized, precise, and adaptive support for patients recovering from strokes and injuries. This research explores the integration of Artificial Intelligence (AI) into robotic systems to enhance physical rehabilitation outcomes, focusing on key areas such as motor skill recovery, real-time performance tracking, and patient engagement. Utilizing machine learning algorithms and biomechanical data, these robots can tailor therapy sessions to individual needs, dynamically adjusting resistance, movement patterns, and feedback. Advanced sensor technology enables the robots to monitor patient progress, ensuring accurate assessments and adaptive interventions. This study also examines the role of AI in promoting neuroplasticity through repetitive, task-specific training, a critical component of stroke recovery. Ethical considerations, including data privacy and accessibility, are analyzed to address barriers to widespread adoption. By bridging robotics, AI, and clinical practice, this research highlights the potential of AI-driven rehabilitation robots to revolutionize physical therapy, offering scalable and effective solutions that improve recovery rates and enhance the quality of care.

THE ESSENTIAL ROLE OF PHYSIOTHERAPY IN PROFESSIONAL FOOTBALL

The role of physiotherapists in professional football is critical for both the physical recovery of athletes and the implementation of strategies that promote injury prevention and enhance performance. With a comprehensive understanding of biomechanics and movement principles, physiotherapists can assess players’ performance and work closely with coaching staff to devise effective game tactics. Their expertise enables them to identify movement patterns and areas of stress that can lead to injuries, ultimately helping to minimize these risks. Education plays a vital part in the physiotherapist's responsibilities, as they teach athletes about health maintenance and the significance of injury prevention. This educational component is essential for ensuring that players can sustain a long and successful sports career. Despite progress in prevention and rehabilitation practices, studies reveal persistent gaps between clinical practice and scientific evidence. Increased regulation of the profession, coupled with a multidisciplinary approach that incorporates psychological support, emphasizes the growing importance of physiotherapy within football. Moreover, recognizing the psychological factors that influence recovery and utilizing evidence-based protocols are vital for optimizing rehabilitation outcomes. The physiotherapist’s influence extends beyond physical recovery; they are integral in fostering the overall health and well-being of athletes, which significantly impacts team performance. Moving forward, the field of physiotherapy in football must prioritize continuous professional development, the adoption of innovative practices, and the establishment of an environment that values both the physical and mental health of players.

Advancements in Physiotherapy: The Role of Medical Devices in Enhancing Rehabilitation Outcomes – A Comprehensive Review

Physiotherapy has evolved significantly with the integration of medical devices, transforming traditional rehabilitation practices and improving patient outcomes. This review explores advancements in medical devices, such as robotic-assisted therapy, wearable technologies, and virtual reality, highlighting their applications in enhancing mobility, pain management, and recovery speed. The study synthesizes evidence from recent clinical trials and literature, discussing the benefits, challenges, and future potential of these technologies in physiotherapy. Emphasis is placed on their role in creating patient-specific rehabilitation plans and addressing barriers to adoption, including cost and accessibility. The findings underscore the need for innovative, cost-effective solutions to broaden the impact of these advancements globally.

Effect of a patient health engagement (PHE) model on rehabilitation participation in patients with acute myocardial infarction after PCI: a study protocol for a randomized controlled trial

BackgroundParticipation in cardiac rehabilitation is low in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI). Although existing rehabilitation methods have achieved certain results, patient participation in exercise rehabilitation is not ideal. The Patient Health Engagement (PHE) model is designed to ensure that patients improve their participation in cognitive, emotional, behavioral, and other aspects in all phases of exercise rehabilitation. The purpose of this study is to confirm whether the rehabilitation method based on the PHE model improves the rate of patient participation and enhances the rehabilitation effect during cardiac rehabilitation in patients with acute myocardial infarction compared with the traditional rehabilitation model.Methods/designThis is a single-center, double-blind, randomized, controlled trial that will enroll 128 patients. Patients with stable acute myocardial infarction after undergoing PCI who received cardiac rehabilitation and postoperative LVEF ≥ 40%, categorized into Killip class I ~ II and with age ≥ 18 years, will be included in the study. Exclusion criteria are mainly malignant arrhythmias, acute heart failure, congestive heart failure, and patients requiring intra-aortic balloon counterpulsation. Patients will be randomized in a 1:1 ratio to the intervention (1) and control (2) groups. Physicians, rehabilitation specialists, patients, and data collectors will be blinded during the study. A rehabilitator and a specialist nurse will conduct the cardiac rehabilitation. The specialist nurse will hand over the sealed bag containing patient information (group 1 or 2) to the physician. Group 1 will undergo cardiac rehabilitation through the PHE model, three times a week for 3 months. The rehabilitation program will be evaluated and adjusted in time from each period of the rehabilitation. Group 2 will be treated with routine cardiac rehabilitation. The rehabilitation participation rate of the two groups will be evaluated before and after 3 months of intervention. The primary outcome will be the level of patient participation in rehabilitation, and the secondary outcome will include general data of patients, postoperative rehabilitation indicators, cardiac rehabilitation knowledge–attitude–practice questionnaire, cardiovascular adverse events, and a brief mood scale.Expected outcomesWe expect improved cardiac rehabilitation participation rates and rehabilitation outcomes in patients with acute myocardial infarction after undergoing PCI using the PHE model.DiscussionThis approach may increase patient participation in rehabilitation, improve rehabilitation outcomes, and be widely implemented in hospitals and rehabilitation centers.Trial registrationClinicalTrials.gov identifier, ChiCTR2400085276 (Version 2.0 June 04, 2024), https://www.chictr.org.cn.Trial sponsorShandong Second Medical university, Weifang, Shandong. Contact name: Dechun Qin, Address: Shandong Second Medical university, Weifang Shandong. Email: 13562666589@163.com.

Chronic Underrepresentation of Females and Women in Stroke Research Adversely Impacts Clinical Care.

Unequal sex and gender sample sizes in rehabilitation studies have implications for the generalizability of the evidence and for the clinicians that utilize their recommendations. Physical therapists rely on evidence-based guidelines to tailor their assessments and interventions to optimize outcomes for patients. We currently know that females and women have worse stroke outcomes and prognoses than their counterparts, however, rehabilitation guidelines remain the same for all individuals. Notably, stroke prevention and acute care has recently shifted to include female- and women-oriented guidelines, however, rehabilitation guidelines have not yet caught up. This article summarizes the key differences that females and women with stroke experience, how they may impact recovery, and calls for researchers and rehabilitation professionals to consider sex and gender when working with patients who've had a stroke. Doing so will improve the lives for those with stroke and maximize treatment options and rehabilitation outcomes.

Restoring mobility: roles of percutaneous consolidation for pelvic ring bone lesions-a multicenter study.

This study aimed to assess the early functional rehabilitation outcomes following percutaneous consolidation for pelvic ring tumor lesions. In this multicenter retrospective study, patients with pelvic bone tumor lesions, whether primitive or metastatic, underwent percutaneous consolidation (cementoplasty, screw fixation, or both). The primary outcome was postoperative weight-bearing ambulation. Secondary outcomes included hospitalization duration, procedural complications, and long-term consolidation. Inclusion criteria were patients treated for prophylactic consolidation or pathological fractures. Kaplan-Meier analysis was used for the primary outcome and hospital stay, with p-values < 0.05 indicating significance. A total of 143 consecutive procedures were performed in 138 patients (mean age, 65 years ± 13; 68 men) who underwent percutaneous screw fixation, cementoplasty, or both. Postoperative weight-bearing ambulation was achieved in 142/143 cases (99%). In total, 117/143 (82%) of these were in the first 24 h. 81/143 (57%) were discharged within 24 h (median, one day; Q3, one day; Q4, 112 days). 133/138 (96.5%) patients achieved long-term consolidation. The most common pattern was isolated acetabular involvement (N = 40; 28%). Of the 19 adverse events, 10 were asymptomatic. Three patients had delayed infections and one required screw removal. Percutaneous consolidation effectively achieved postoperative weight-bearing ambulation and represents a safe and durable treatment option for patients with pelvic bone lesions. ClinicalTrials.gov: NCT06155890. Question How can radiology continue to help improve care for patients with metastatic pelvic ring lesions? Findings 99% of patients achieved postoperative weight-bearing, with 82% doing so within 24 h. Clinical relevance Percutaneous consolidation enabled rapid functional rehabilitation of oncology patients, allowing short hospital stays with low complication rates, and demonstrating the expanding role of radiologists in diagnosis, risk assessment, and treatment planning, thereby enhancing patient care.

Long-term outcomes of complex medical rehabilitation of patients with rhinosinusitis with nasal polyposis and comorbidities

BACKGROUND: Comparative evaluation of courses of alternating magnetic therapy, low-intensity laser therapy, low-intensity laser radiation and hypoxic training in complex medical rehabilitation of atopic dermatitis and asthma patients with rhinosinusitis with nasal polyposis showed high efficacy of the additional use of physical factors in enhancing the regression of major clinical manifestations of the disease and improving the quality of life. AIM: The aim of the study was to evaluate the long-term (6, 12, and 18 months) outcomes of complex medical rehabilitation of patients with rhinosinusitis with nasal polyposis, including those with atopic dermatitis and asthma, to assess the preventive potential of instrumental physiotherapy, and to determine the optimal time parameters for retreatment with these therapeutic options. MATERIALS AND METHODS: Patients were divided into groups with isolated rhinosinusitis (n=90), atopic rhinosinusitis (n=93) or asthma (n=105) according to the severity of rhinosinusitis with nasal polyposis. Each group was in turn randomized into 3 subgroups: the control one, the comparator one, and the experimental one. All subjects received a standard treatment program (endonasal Nasonex, 2 doses twice a day; daily nasal rinsing twice a day). Patients in the comparator subgroups also received dupilumab (300 µg once every 2 weeks); the experimental subgroups received alternating magnetic therapy and low-intensity red laser radiation (633 nm). For atopic dermatitis, narrowband medium wave (311 nm) and broadband long wave (320–400 nm) radiation was added to this treatment program. For asthma, alternating magnetic therapy and low-intensity laser radiation were supplemented with hypoxic interval training. RESULTS: Positive changes in evaluated clinical parameters were reported in all groups during the entire follow-up period. However, the presence of comorbidities reduced the therapeutic potential of the standard treatment program, according to the results of the long-term observation. The addition of dupilumab significantly improved the condition of patients with isolated rhinosinusitis with nasal polyposis. However, a history of atopic dermatitis and especially asthma reduced the duration of disease remission. The addition of physical factors to the treatment program, pathogenetically justified in the treatment of atopic dermatitis (phototherapy) and asthma (hypoxic training), reliably prolonged the remission period. Complex physiotherapy leads to long-term reduction of pathological correlations, which is manifested by decrease in weight of correlation graphs. CONCLUSION: The main aim of the follow-up phase of the study was to evaluate the duration of the clinical result achieved, which determines the preventive potential of instrumental physiotherapy techniques, frequency and regularity of physiotherapeutic interventions. Retreatment is recommended after an average of 9–12 months for isolated rhinosinusitis with nasal polyposis and 15–18 months for atopic dermatitis and asthma.

Patient Perspectives in Postlaryngectomy Communication Rehabilitation and Outcomes.

To evaluate patient-reported outcomes in postlaryngectomy communication rehabilitation. Cross-sectional survey study. (a) Patients who underwent laryngectomy at a single institution and (b) members of the International Association of Laryngectomees (IAL). We examined demographics, treatment history, speech rehabilitation methods and outcomes postlaryngectomy. A total of 157 participants responded to the survey (124 IAL; 33 institutional cohort). The most used primary methods of communication were tracheoesophageal puncture (TEP) 61.5%, electrolarynx (EL) 24.4%, and writing 9%. In all categories, except for communication in a noisy environment, alaryngeal voice was rated superior to aphonic communication (P < .05). Subset analysis of the alaryngeal voice cohort demonstrated higher communication efficacy for TEP compared to other modalities in all environments except for conversation with family and friends. Among TEP users, a history of a regional flap for reconstruction compared to free tissue transfer was associated with higher communication effectiveness scores (16.3 vs 10.6; P = .0085). Neither treatment modality (primary vs. salvage laryngectomy vs. radiation therapy) nor engagement in speech therapy impacted communication effectiveness scores for alaryngeal voice users. Alaryngeal voice users reported higher efficacy of communication in most social contexts compared to aphonic communicators. Among alaryngeal voice users, TEP speech performed better in most social situations compared to an EL. Treatment characteristics including timing of surgery and radiation therapy were not associated with the ability to acquire alaryngeal voice, while the extent of resection and the type of reconstruction did show potential to impact voicing outcomes in patients who desire to pursue alaryngeal voicing techniques.

Gait Speed, Mobility, Balance, and Dual-Tasking Deficits Among People Living With HIV Globally: A Systematic Review and Meta-Analysis.

People living with HIV (PLWH) may experience premature physical deficits, including walking, mobility, and balance problems. The purpose was to measure deficits in walking, mobility, balance, and dual tasking in PLWH. The secondary objective was to make recommendations regarding the use of rehabilitation outcome measures. CINAHL, PubMed, and SPORTDiscus databases were searched. Two independent reviewers screened titles/abstracts and full-text articles, extracted data, and performed a quality assessment. Fifty-six articles with 14,053 PLWH and 8,454 uninfected controls were included. A meta-analysis revealed significantly worse performance among PLWH on the five times sit to stand mobility test versus controls (Cohen d = 0.68, 95% confidence interval [CI 0.08-1.29], p = .03). Meta-analyses revealed no differences between PLWH and controls for usual gait speed (Cohen d = -0.47, 95% CI [-1.10 to 0.15], p = .14) and fast gait speed (Cohen d = -0.39, 95% CI [-0.87 to 0.08], p = .10). Ten of 12 studies comparing PLWH with controls found differences in balance outcomes. PLWH have significantly worse mobility than uninfected controls.

Neuroticism Overestimated? Neuroticism Versus Hypertonia, Pain and Rehabilitation Outcomes in Post-Spinal Cord Injury Patients Rehabilitated Conventionally and with Robotic-Assisted Gait Training.

The aim of the present study was to analyse the association between neuroticism (one of the Big Five personality traits) and the most common secondary sensorimotor complications occurring in patients after spinal cord injury (SCI), i.e., muscle spasticity (hypertonia) and pain, and to investigate the associations between neuroticism and the effects of conventional rehabilitation (dynamic parapodium) and those using robotic-assisted gait training (RAGT) in this group of patients. In addition, the association of neuroticism with self-efficacy, personal beliefs about pain control, and adopted coping strategies among SCI patients was analysed. These data can be used as a reference for designing effective forms of therapy and support dedicated to this group of patients. Quantitative analysis included 110 patients after SCI. The participants were divided by simple randomisation into a rehabilitation group with RAGT and a rehabilitation group with dynamic parapodium therapy (DPT). The following survey instruments were used for data collection: Revised NEO Personality Inventory (NEO-PI-R); Ashworth Scale; the Spinal Cord Independence Measure III (SCIM III); the Walking Index for Spinal Cord Injury II (WISCI-II); the American Spinal Injury Association Impairment Scale (AIS); the Pain Coping Strategies Questionnaire-CSQ; and the Beliefs about Pain Control Questionnaire-BPCQ. analyses showed a positive association between neuroticism and spastic tension (rho = 0.39; p < 0.001). the study showed that a high level of neuroticism correlates with a higher level of spasticity, but no such correlation was observed for pain. Additionally, the study did not show a significant correlation between neuroticism and rehabilitation outcome depending on the rehabilitation modality (RAGT vs. DPT). The results underline the importance of carrying out a psychological diagnosis of patients to provide therapeutic support in the rehabilitation process.

Diagnostic Value of lncRNA FGD5-AS1 Sponge miR-223-3p in Infantile Pneumonia and Its Prognostic Effect on Rehabilitation

Abstract Objective This study aimed to uncover the value of long noncoding RNA FGD5-AS1 (lncRNA FGD5-AS1) in the diagnosis of infantile pneumonia and explore its pathological mechanism in lung fibroblasts. This research may provide a potential biomarker for diagnosing patients and predicting their rehabilitation outcomes. Methods This study included 92 children with infantile pneumonia as the research object, and an equal number of healthy children were introduced as controls. The FGD5-AS1 content was detected using real-time quantitative polymerase chain reaction (RT-qPCR) assay. The diagnostic value of FGD5-AS1 was evaluated by receiver operating characteristic (ROC) and logistic analysis. The molecular mechanism of FGD5-AS1 and miR-223-3p was studied by luciferase activity assays. The impact of abnormal FGD5-AS1 expression on the proliferation and apoptosis of lung fibroblasts was analyzed using the cell counting kit-8 (CCK-8) and flow cytometry. Results FGD5-AS1 expression was decreased in the serum of infantile pneumonia patients, which may be a diagnostic marker for children with pneumonia. Furthermore, FGD5-AS1 has the ability to predict patient outcomes. FGD5-AS1 levels in lung fibroblasts (WI-38) decreased when induced by lipopolysaccharide (LPS). This decline resulted in reduced cell proliferation ability, increased apoptosis rate, and elevated inflammatory factor content. However, upregulated FGD5-AS1 counteracted the effects of LPS on WI-38 cells activity and inflammatory factors. Conclusion FGD5-AS1 may act as a potential marker in infantile pneumonia, and regulate the biological activity and inflammation level of lung fibroblasts by targeting miR-223-3p.

An Overview of Medical, Surgical, and Rehabilitation Outcome Measures Used in Randomized Controlled Trials of Moderate to Severe Traumatic Brain Injury

Abstract Optimal reporting of outcomes is critical for the interpretation of research findings. This review aimed to examine the utilization of outcome measures (OMs) in randomized controlled trials (RCTs) of moderate to severe TBI (MSTBI). Systematic searches were conducted up to December 2022 in MEDLINE, PubMed, Scopus, CINAHL, EMBASE and PsycINFO, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. RCTs were included if the population studied had ≥18 years and ≥ 50% had MSTBI. 662 met inclusion criteria. There was a total of 839 unique OMs across all included RCTs. Of these, only 195 (23.2%) were used in ≥4 RCTs. On average, RCTs included 1.26 OMs (range 1 to 23). A total of 495 (59%) of OMs were classified in the recovery and rehabilitation category, and 344 (41%) in the medical and surgical measures category. There was a more equal representation of OMs in high income countries (HICs) compared to low to middle income countries (LMICs), with the latter using fewer recovery and rehabilitation OMs. OMs used in RCTs of MSTBI have significant heterogeneity and variable clinical relevance, which limits the impact and generalizability of research in MSTBI, and the ability to compare across studies.

A quasi-experimental study on couple-based exercise program improving cardiac rehabilitation exercise compliance in post-PCI patients

BackgroundPercutaneous coronary intervention (PCI) helps treat coronary artery disease but only provides short-term relief and doesn’t stop disease progression. Exercise rehabilitation can improve outcomes for patients after PCI and lower the risk of death and new heart problems, but many patients struggle to stick with their exercise routines. Spouses play a crucial role in supporting patients and helping them stay committed to their rehabilitation. This study aims to evaluate the effectiveness of a couple-based exercise program in improving exercise adherence among post-PCI patients.MethodsThis study used a quasi-experimental design, 70 dyads were recruited for a 12-week investigation. Participants were divided into an intervention group to receive the Couple-Based exercise program and a control ensemble for conventional exercise-based cardiac rehabilitation. The primary parameter under examination was exercise adherence. Secondary endpoints encompass exercise self-efficacy, the 6-minute walk test, the 9-item Patient Health Questionnaire, and the Generalized Anxiety Disorder Scale. Data were harvested at baseline and post-intervention (12 weeks).ResultFollowing a three-month monitoring period, noticeable differences were observed in the Couples exercise group compared to the control group in the realms of exercise adherence, exercise self-efficacy, the 6-minute walk test, and anxiety-depression indices (P < 0.05).ConclusionA couple-based exercise program developed based on a developmental-contextual framework improves exercise adherence and exercise self-efficacy, enhances cardiac function and exercise capacity, and improves anxiety and depression in post-coronary arteriography patients. This approach is likely to be an effective way to improve rehabilitation outcomes, leading to the broader goal of improving patient prognosis and reducing adverse cardiovascular events.Trial registrationThe study’s registration was recorded with the Chinese Clinical Trials Registry (12/04/2022, registration number ChiCTR2200058600).

Rehabilitation of a quadruple amputee with leukemia: A challenging endeavor

Making a person with quadruple amputation walk again is a challenging task for the rehabilitation team. Quadruple amputation secondary to symmetrical peripheral gangrene is a rare clinical scenario posing challenges in rehabilitation. Literature regarding rehabilitation of persons with multiple amputations is limited. This case describes the rehabilitation of a 57-year-old lady suffering from acute myeloid leukaemia who underwent quadruple amputation. She had undergone bilateral transtibial and bilateral transradial amputation after vasopressor-induced symmetrical peripheral gangrene. In view of expected guarded level of functional independence, ambulatory independence was the primary goal at admission to Department of PMR. The various steps taken in rehabilitation and modifications made to assistive devices are described in this article. Challenges faced during various phases of training, and subsequent ambulation are detailed in this article. Overcoming limitations, the client was made to be an indoor ambulator with appropriate prostheses and mobility aids. She was partially independent for activities of daily life after in-patient rehabilitation. The background of leukaemia and subsequent chemotherapy also affected the rehabilitation of this patient. Although various studies have described cases of quadruple amputation rehabilitation achieving functional independence and ambulation, the absence of specific guidelines and protocols make rehabilitation of persons with multiple amputations inefficient. This case study also shows the need for personalized goal setting for persons with multiple amputations. Realistic goal setting, psychological counselling, and an interdisciplinary approach are imperative in rehabilitation of persons with quadruple amputation. Flexible functional scales specific to persons with multiple amputations are necessary to evaluate such persons objectively. Studies with larger sample size, longer follow-ups, and comprehensive review of existing literature are needed to standardize rehabilitation of quadruple amputation and evaluate the various factors that may affect rehabilitation outcome.