Rehabilitation Strategies Research Articles

Downhill: a new rehabilitation frontier. A systematic review of the literature

In the last few years, we have seen the gradual spread of a new treadmill training modality, which involves walking not on the flat but downhill, also known as "downhill". This review aims to qualitatively assess the efficacy of downhill treatment on different patient populations and outline treatment routes for future efficacy studies. We searched five different databases: MEDLINE, SCOPUS, Web of Science, PEDro, and LILACS for studies to include. Only randomized controlled trials (RCTs) published in English were considered. PEDro scales and Risk of Bias 2 (RoB 2) assessment were used to evaluate the risk of bias. Forty-one RCTs were included, and three articles remained to be analyzed; the included studies showed 110 participants for three RCTs; of these, two were performed on patients diagnosed with chronic obstructive pulmonary disease (COPD), while one was for treating people with multiple sclerosis (MS). The outcome measures used in the studies were the pulmonary function test, the cardiopulmonary exercise test, the 6-Minute Walking Test, and the St. George Respiratory Questionnaire. In patients diagnosed with COPD, downhill training appears effective on functional capacity and symptoms of dyspnea and fatigue, while in people with MS, it increases strength and activity performance when compared to other walking training modalities. RoB 2 tool shows good methodological quality for all studies included in the review; when evaluated with the PEDro scale, all presented a score of 8. Downhill could be such an effective, safe, and feasible eccentric training modality that it can be considered a new rehabilitation strategy that could be implemented for patients with low exercise tolerance.

An Investigation of Hand Gestures for Controlling Video Games in a Rehabilitation Exergame System

Musculoskeletal disorders (MSDs) can significantly impact individuals’ quality of life (QoL), often requiring effective rehabilitation strategies to promote recovery. However, traditional rehabilitation methods can be expensive and may lack engagement, leading to poor adherence to therapy exercise routines. An exergame system can be a solution to this problem. In this paper, we investigate appropriate hand gestures for controlling video games in a rehabilitation exergame system. The Mediapipe Python library is adopted for the real-time recognition of gestures. We choose 10 easy gestures among 32 possible simple gestures. Then, we specify and compare the best and the second-best groups used to control the game. Comprehensive experiments are conducted with 16 students at Andalas University, Indonesia, to find appropriate gestures and evaluate user experiences of the system using the System Usability Scale (SUS) and User Experience Questionnaire (UEQ). The results show that the hand gestures in the best group are more accessible than in the second-best group. The results suggest appropriate hand gestures for game controls and confirm the proposal’s validity. In future work, we plan to enhance the exergame system by integrating a diverse set of video games, while expanding its application to a broader and more diverse sample. We will also study other practical applications of the hand gesture control function.

Kinematic and muscle co-activation patterns in the dominant arm across forehand stroke phases in wheelchair tennis

ObjectiveThis study investigated upper limb kinematics and muscle co-activation in wheelchair tennis players during the forehand stroke. By analyzing linear and angular kinematic variables alongside muscle co-activation patterns, the study aimed to provide insights into the biomechanical mechanisms supporting forehand stroke performance.MethodFifteen professional male wheelchair tennis players (height: 163.9 ± 2.05 cm; mass: 64.1 ± 3.07 kg; age: 32.2 ± 7.97 years) participated in this study. Electromyographic data from six muscles around the dominant arm joints were recorded using the Myon system. Four fixed GoPro Hero 8 cameras (120 Hz) captured 3D video, and kinematic analyses were performed using the APAS system. The forehand stroke was analyzed across three phases: (1) backswing, (2) forwardswing, and (3) follow-through.ResultsThe results showed significant phase-specific changes in muscle co-activation for the shoulder (p < 0.001), elbow (p < 0.005), and wrist (p < 0.01). Muscle co-activation was highest during the backswing phase, decreased during the forwardswing, and increased again during the follow-through phase. This pattern reflects the need for joint stability and control, particularly when changing stroke direction and slowing the arm after impact.ConclusionThese findings provide novel insights into the kinematic and neuromuscular mechanisms underlying the forehand stroke in wheelchair tennis. The data provide hypotheses about potential training and rehabilitation strategies that should be tested by prospective studies. The results also highlight the unique demands of wheelchair tennis, contributing to inclusive, evidence-based approaches to enhancing performance and safety in disability sports.

Case report: Movement-related neuroplasticity in a patient after spinal cord injury in response to task-oriented bimanual training

BackgroundBimanual motor training is an effective neurological rehabilitation strategy. However, its use has rarely been investigated in patients with paralysis caused by spinal cord injury (SCI). Therefore, we conducted a case study to investigate the effects of robot-assisted task-oriented bimanual training (RBMT) on upper limb function, activities of daily living, and movement-related sensorimotor activity in a patient with SCI.MethodsA patient with bilateral upper limb paresis due to incomplete cervical SCI underwent 20 sessions of RBMT. Functional recovery was measured using clinical scales for upper limb motor function and activities of daily living. Training-induced neuroplasticity was evaluated using event-related desynchronization (ERD) induced by movement of the right hand (the more affected side), recorded on the electroencephalogram (EEG).ResultsRBMT improved the patient’s upper limb motor function and activity independence. At baseline, our EEG paradigm demonstrated an ipsilateral predominance of movement-related ERD responses over the sensorimotor cortex (SMC) in relation to the moving hand. Following the RBMT, the ERD pattern shifted from being predominantly ipsilateral to a contralateral allocation.ConclusionThe present case study provides preliminary evidence to support the therapeutic use of RBMT to restore upper limb function in patients with incomplete SCI. The recovery of function following SCI might be related to the rebalancing of sensorimotor activation.

Analyzing Gait Dynamics and Recovery Trajectory in Lower Extremity Fractures Using Linear Mixed Models and Gait Analysis Variables

In a prospective study, we examined the recovery trajectory of patients with lower extremity fractures to better understand the healing process in the absence of complications. Using a chest-mounted inertial measurement unit (IMU) device for gait analysis and collecting patient-reported outcome measures, we focused on 12 key gait variables, including Mean Leg Lift Acceleration, Stance Time, and Body Orientation. We employed a linear mixed model (LMM) to analyze these variables over time, incorporating both fixed and random effects to account for individual differences and the time since injury. This model also adjusted for varying intervals between assessments. Our study provided insights into gait recovery across different fracture types using data from 318 patients who experienced no complications or readmissions during their recovery. Through LMM analysis, we found that Tibia-Distal fractures demonstrated the fastest recovery, particularly in terms of mobility and strength. Tibia-Proximal fractures showed balanced improvements in both mobility and stability, suggesting that rehabilitation should target both strength and balance. Femur fractures exhibited varied recovery, with Diaphyseal fractures showing clear improvements in stability, while Distal fractures reflected gains in limb strength but with some variability in stability. To examine patients with readmissions, we conducted a Chi-squared test of independence to determine whether there was a relationship between fracture type and readmission rates, revealing a significant association (p < 0.001). Pelvis fractures had the highest readmission rates, while Tibia-Diaphyseal and Tibia-Distal fractures were more prone to infections, highlighting the need for enhanced infection control strategies. Femur fractures showed moderate readmission and infection rates, indicating a mixed risk profile. In conclusion, our findings emphasize the importance of fracture-specific rehabilitation strategies, focusing on infection prevention and individualized treatment plans to optimize recovery outcomes.

Association between sedentary behavior, physical activity, and osteoarthritis: results from NHANES 2007–2020 and Mendelian randomization analysis

IntroductionOsteoarthritis (OA) is a prevalent and debilitating disorder that affects the joints and has a complex array of causes. While sedentary behavior (SB) and physical activity (PA) have been implicated in OA risk, the relationship between these factors and OA development remains unclear. This study investigates the correlation and potential causality between SB, PA, and OA using both cross-sectional and Mendelian randomization (MR) analysis.MethodsWe conducted a two-phase study that included a cross-sectional analysis using data from the National Health and Nutrition Examination Survey (NHANES) and a MR analysis. A weighted analysis was performed on data from the NHANES to explore the relationship between SB, PA, and the risk of OA. Logistic regression was used to assess the association between SB, PA, and OA, adjusting for potential confounders. Non-parametric curve fitting was applied to examine the dose-response relationship between PA levels and OA onset. Additionally, MR was utilized to infer the genetic causality between SB, PA, and OA risk, using genetic instruments as proxies for SB and PA.ResultsThe final analysis, which included 24,738 participants, revealed that OA prevalence was 13.47%, with individuals diagnosed with OA exhibiting significantly higher levels of SB and lower levels of PA. A U-shaped relationship was observed between PA and OA risk, with a decrease in OA incidence as PA levels increased, although the protective effect of PA was less pronounced in individuals with severe SB. MR analysis indicated that genetically inferred SB was associated with a higher likelihood of OA (IVW OR 1.20, 95% CI 1.13–1.28), while increased PA was inversely associated with OA risk (IVW OR 0.85, 95% CI 0.73–0.98).ConclusionThis research emphasizes the significance of SB and PA as modifiable factors influencing the risk of OA. It is recommended that individuals at risk of OA should aim to participate in regular physical activity and minimize sedentary behavior to lower their risk of developing the disease. The MR analysis results support the potential causal impact of SB and PA on OA, providing valuable information for the development of therapeutic and rehabilitative strategies.

Sustainable approaches for brownfield revitalisation & rehabilitation: a case in São Paulo

There is a necessity for sustainable solutions to meet the increasing demand for land in urban development. In this context, brownfields are known to be a viable alternative if characterized and remediated correctly. This study demonstrates the use of two methodologies, TRIAD, and high-resolution site characterization to assess the viability of rehabilitation of the site for new development. Given the conceptual uncertainties, a High-Resolution Site Characterization with the TRIAD approach was conducted to measure the environmental impact and update the conceptual site model of the studied area. The investigation plans were dynamically built with the use of real-time measurement tools. It was possible to measure the spatial distribution and the mass of contaminants still present in the area. Moreover, a more robust conceptual site model was developed to serve as the base for the remediation and rehabilitation strategies. The approach brought measurable financial benefits, an increase in 35% value of the property, as well as the permission to rebuild the area. The study highlights the significance of comprehensive investigations in the effective rehabilitation of impacted areas, while meeting the demands for sustainable urban development by providing a faster and more reliable field investigative campaign, with reduced levels of uncertainty.

Cognitive Impairment After Stroke: Rehabilitation Strategies and SMART Goal Setting.

Cognitive Impairment After Stroke: Rehabilitation Strategies and SMART Goal Setting.

The Role of Neuropsychology in the Management of Spinal Cord Injury: A Comprehensive Literature Review.

Spinal cord injury (SCI) poses a complex set of physiological, psychological, and cognitive challenges that significantly affect an individual's quality of life. Analysis of longitudinal studies reveals that cognitive changes following SCI are often underestimated yet significantly impact patient's ability to adapt to their new circumstances. However, the role of neuropsychology in SCI management and rehabilitation is yet to be elucidated. This article offers an in-depth review of the role of neuropsychology in understanding and addressing the cognitive, emotional, and behavioral outcomes of SCI. Additionally, we delve into the emotional and psychological consequences of SCI, which can include increased stress, depression, anxiety, and potential changes in personality and social functioning. Neuropsychological assessment tools are highlighted as essential for diagnosing and monitoring these psychological shifts, aiding in the creation of personalized rehabilitation interventions. We also explore the role of neuroplasticity in cognitive rehabilitation post-SCI, emphasizing the potential of targeted cognitive training to alleviate cognitive deficits and improve adaptive functioning. The paper further investigates the interplay between physical and cognitive recovery, underscoring the reciprocal relationship between motor function and cognitive improvement. In conclusion, this review emphasizes the crucial role of neuropsychology in understanding the multifaceted impact of SCI. By enhancing our comprehension of the intricate connections between neural integrity, cognitive function, and psychological well-being, neuropsychology provides valuable insights for developing holistic rehabilitation strategies that address both the cognitive and emotional challenges faced by individuals with SCI. As neurorehabilitation continues to advance, integrating neuropsychological principles offers promise for improving the overall recovery and quality of life for those affected by spinal cord injury.

Therapeutic effects of intracerebral transplantation of human modified bone marrow-derived stromal cells (SB623) with voluntary and forced exercise in a rat model of ischemic stroke.

Ischemic stroke results in significant long-term disability and mortality worldwide. Although existing therapies, such as recombinant tissue plasminogen activator and mechanical thrombectomy, have shown promise, their application is limited by stringent conditions. Mesenchymal stem cell (MSC) transplantation, especially using SB623 cells (modified human bone marrow-derived MSCs), has emerged as a promising alternative, promoting neurogenesis and recovery. This study evaluated the effects of voluntary and forced exercise, alone and in combination with SB623 cell transplantation, on neurological and psychological outcomes in a rat model of ischemic stroke. Male Wistar rats that had undergone middle cerebral artery occlusion (MCAO) were divided into six groups: control, voluntary exercise (V-Ex), forced exercise (F-Ex), SB623 transplantation, SB623 + V-Ex, and SB623 + F-Ex. Voluntary exercise was facilitated using running wheels, while forced exercise was conducted on treadmills. Neurological recovery was assessed using the modified neurological severity score (mNSS). Psychological symptoms were evaluated through the open field test (OFT) and forced swim test (FST), and neurogenesis was assessed via BrdU labeling. Both exercise groups exhibited significant changes in body weight post-MCAO. Both exercises enhanced the treatment effect of SB623 transplantation. The forced exercise showed a stronger treatment effect on ischemic stroke than voluntary exercise alone, and the sole voluntary exercise improved depression-like behavior. The SB623 + F-Ex group demonstrated the greatest improvements in motor function, infarct area reduction, and neurogenesis. The SB623 + V-Ex group was most effective in alleviating depression-like behavior. Future research should optimize these exercise protocols and elucidate the underlying mechanisms to develop tailored rehabilitation strategies for stroke patients.

Lifecycle Management of Hydrogen Pipelines: Design, Maintenance, and Rehabilitation Strategies for Canada’s Clean Energy Transition

Lifecycle Management of Hydrogen Pipelines: Design, Maintenance, and Rehabilitation Strategies for Canada’s Clean Energy Transition

ASSESSMENT OF CORE STRENGTH AFTER ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION DURING SINGLE-LEG SQUATS

Background: Core strength plays a pivotal role in dynamic stability and efficient force transmission. Inadequate core and hip muscle strength often contribute to knee valgus, which increases the risk of non-contact anterior cruciate ligament (ACL) injuries. With ACL injuries being prevalent in team sports, there is a growing need for effective rehabilitation strategies. This study addresses a notable gap in understanding the relationship between core strength and single-leg squat (SLS) performance in patients post-ACL reconstruction, providing valuable insights to optimize rehabilitation practices. Objective: To assess the impact of core strength on single-leg squat performance in individuals following ACL reconstruction. Methods: A descriptive cross-sectional study design was employed, including 72 participants selected using non-probability convenient sampling. The study was conducted at Lahore Medical and Dental College over six months. Inclusion criteria included individuals aged 18-40 years with a history of unilateral ACL reconstruction, a stable graft, full knee range of motion, and completion of rehabilitation. Core strength was measured using the Plank Test, while SLS performance was graded using a three-point ordinal scale ("Good," "Fair," and "Poor"). SPSS version 24.0 was used for data analysis, and results were reported as mean, standard deviation, frequency, and percentages. Results: The mean plank hold time was 51.58 seconds (SD = 30.47), with durations ranging from 7 to 130 seconds. SLS grading revealed 45.8% of participants performed in the “Good” category, 29.5% in “Fair,” and 25% in “Poor.” These findings demonstrate a positive association between core strength, as measured by plank hold time, and improved SLS performance. Conclusion: Enhanced core strength significantly improves SLS performance in individuals post-ACL reconstruction. Incorporating core stability training into rehabilitation programs is critical for optimizing lower limb function and reducing the risk of re-injury.

Feasibility of real-time fMRI neurofeedback for rehabilitation of reading deficits in aphasia.

Reading impairments, a common consequence of stroke-induced aphasia, significantly hinder life participation, affecting both functional and leisure activities. Traditional post-stroke rehabilitation strategies often show limited generalization beyond trained materials, underscoring the need for novel interventions targeting the underlying neural mechanisms. This study investigates the feasibility and potential effectiveness of real-time functional magnetic resonance imaging (fMRI) neurofeedback (NFB) intervention for reading deficits associated with stroke and aphasia. We enrolled left-hemisphere stroke survivors in the subacute recovery period and healthy controls in an fMRI NFB intervention study focusing on increasing activation within the left supramarginal gyrus (SMG), a critical region for reading supporting orthography-phonology conversion. Preliminary findings demonstrate that stroke participants showed significant improvements in reading comprehension and phonological awareness, as evidenced by marked gains on the Reading Comprehension Battery for Aphasia (RCBA) and a phonology two-alternative forced choice test. Functional MRI results indicated that stroke participants exhibited increased activation from day 1 to day 3 of NFB training within the left SMG and the broader left hemisphere reading network, particularly during challenging nonword reading tasks. Healthy controls also showed increased activation during NFB regulation and reading tasks, but these changes were outside the traditional reading network, involving regions associated with cognitive control, reward anticipation, and learning. In both stroke participants and healthy controls, we also found changes in dynamic functional connectivity of multiple resting state networks from before to after NFB training. Although preliminary, this research contributes to the development of biologically informed interventions for reading deficits in aphasia, representing an early step towards improving post-stroke rehabilitation outcomes. Future randomized controlled trials are necessary to validate these findings by including a sham NFB control group within a larger participant sample. The study was preregistered on ClinicalTrials.gov, NCT# NCT04875936.

Reliability and Validity of the Articulation Motion Assessment System Using a Rotary Encoder

This study aimed to validate the effectiveness of the Articulation Motion Assessment System (AMAS), a joint kinematic evaluation system, for clinical applications. AMAS enables synchronised measurement using neurophysiological indicators, overcoming laboratory setting limitations. We compared AMAS-based ankle joint kinematic evaluations, particularly the sagittal and frontal plane angles, with two-dimensional (2D) motion analysis to determine the validity and reliability of AMAS. Both AMAS and 2D motion analysis reliably detected significant differences in angles within the sagittal and frontal planes. Correlation analysis revealed a significant moderate-to-strong correlation between the AMAS and the conventional method of 2D motion analysis, proving the measurement validity of the AMAS (ρ = 0.53–0.77 for sagittal plane angles; ρ = 0.46–0.72 for frontal plane angles). The average root mean squared error (RMSE) was significantly lower in AMAS (10.90 ± 2.93° for sagittal plane angles; 13.44 ± 1.09° for frontal plane angles) than in the inertial sensor-based three-dimensional (3D) motion analysis. Reliability analysis revealed high reliability of measurements (intraclass correlation coefficients (ICC) ≥ 0.76). However, the Bland–Altman analysis identified a slightly lower fixed bias, which was observed as a characteristic of each measurement system. The AMAS accurately detects ankle joint angles without being constrained by measurement environment limitations. Synchronised measurements using neurophysiological indicators potentially contribute to understanding ankle joint control mechanisms and developing rehabilitation strategies.

Multimodal MRI analysis of microstructural and functional connectivity brain changes following systematic audio-visual training in a virtual environment.

Recent work has shown rapid microstructural brain changes in response to learning new tasks. These cognitive tasks tend to draw on multiple brain regions connected by white matter (WM) tracts. Therefore, behavioural performance change is likely to be the result of microstructural, functional activation, and connectivity changes in extended neural networks. Here we show for the first time that learning-induced microstructural change in WM tracts, quantified with diffusion tensor and kurtosis imaging (DTI, DKI) is linked to functional connectivity changes in brain areas that use these tracts to communicate. Twenty healthy participants engaged in a month of virtual reality (VR) systematic audiovisual (AV) training. DTI analysis using repeated-measures ANOVA unveiled a decrease in mean diffusivity (MD) in the SLF II, alongside a significant increase in fractional anisotropy (FA) in optic radiations post-training, persisting in the follow-up (FU) assessment (post: MD t(76) = 6.13, p < 0.001, FA t(76) = 3.68, p < 0.01, FU: MD t(76) = 4.51, p < 0.001, FA t(76) = 2.989, p < 0.05). The MD reduction across participants was significantly correlated with the observed behavioural performance gains. A functional connectivity (FC) analysis showed significantly enhanced functional activity correlation between primary visual and auditory cortices post-training, which was evident by the DKI microstructural changes found within these two regions as well as in the sagittal stratum including WM tracts connecting occipital and temporal lobes (mean kurtosis (MK): cuneus t(19)=2.3 p < 0.05, transverse temporal t(19)=2.6 p < 0.05, radial kurtosis (RK): sagittal stratum t(19)=2.3 p < 0.05). DTI and DKI show complementary data, both of which are consistent with the task-relevant brain networks. The results demonstrate the utility of multimodal imaging analysis to provide complementary evidence for brain changes at the level of networks. In summary, our study shows the complex relationship between microstructural adaptations and functional connectivity, unveiling the potential of multisensory integration within immersive VR training. These findings have implications for learning and rehabilitation strategies, facilitating more effective interventions within virtual environments.

A comparative evaluation of rehabilitation approaches for ecological recovery in arid limestone mine sites.

Limestone mining in arid regions, particularly within fragile environments, leads to severe environmental pollution and ecological degradation. Developing a scientifically sound and effective ecological rehabilitation strategy is therefore critical. This study constructed a three-dimensional ecological rehabilitation model integrating soil amelioration and vegetation reconstruction. Seven resilient shrub species (Caragana korshinskii, Corethrodendron scoparium, Atriplex canescens, Calligonum mongolicum, Caryopteris mongholica, Nitraria tangutorum, and Tamarix laxa) and four soil matrix reconstruction treatments-sand:soil:organic fertilizer (8:1:1), sand:soil:compound fertilizer (8:1:1), sand:soil (8:2), and soil:organic fertilizer (9:1)-were evaluated for their effects on soil, plant, and microbial indicators. A comprehensive evaluation system was established to identify the optimal rehabilitation approach. The results indicate that organic fertilizer treatments reduced soil EC by 16.39% and increased microbial biomass carbon (MBC), MBC/nitrogen (MBC/MBN), and MBC/phosphorus (MBC/MBP) by over 41.50%, while improving the height and canopy of C. korshinskii by 71.05% and 180.00%, respectively. Plant species significantly influenced soil properties, with T. laxa achieving the highest soil organic matter and total nitrogen content. Soil matrix amendments and plant species both significantly affected microbial β-diversity. Ultimately, the combination of T. laxa and the sand:soil:organic fertilizer treatment was identified as the optimal rehabilitation strategy. These findings provide critical insights for rehabilitating degraded limestone mine areas in arid regions.

Pilot Study on Midfoot Pressure Analysis in Individuals with Flat Feet While Climbing Stairs Using a Pressure Sensing System

Flat feet, or pes planus, present a prevalent condition impacting mobility and quality of life, warranting an understanding of its biomechanical implications. This study aimed to quantify pressure differentials in the midfoot region between individuals with flat feet and those without during stair ascent. The pilot study evaluated one individual with clinically diagnosed flat feet and one healthy individual, both meeting specific inclusion criteria. The participants ascended stairs while a pressure-sensing system consisting of force-sensitive resistors (FSRs) recorded midfoot pressures. The results showed that individuals with flat feet exhibited lower pressure along the medial longitudinal arch and higher pressure along the lateral longitudinal arch compared to normal feet participants. Statistical analysis revealed significant differences in pressure for FSRs placed on the medial and lateral arches (p &lt; 0.05). These results suggest a compensatory shift in pressure distributions, highlighting the altered loading patterns associated with flat feet. These findings have significant implications for physical therapy, underscoring the importance of arch-strengthening exercises to improve foot stability and redistribute pressure more effectively. By integrating pressure mapping into rehabilitation strategies, therapists can create personalized treatment plans, ultimately improving outcomes for individuals with flat feet. Future studies with larger participant groups and advanced pressure-sensing technologies are needed to validate these findings and refine therapeutic approaches.

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.

A preliminary study of fMRI and the relationship with depression and anxiety in Meniere's patients

PurposeTo examine alterations in Blood Oxygen Level-Dependent (BOLD) resting-state functional magnetic resonance imaging (rs-fMRI) signals, utilizing regional homogeneity (ReHo) and fractional amplitude of low-frequency fluctuation (fALFF) metrics, within activated brain regions. Additionally, this study aims to explore the relationship between these neural changes and clinical characteristics, as well as emotional states, in patients diagnosed with unilateral Meniere's disease (MD). MethodThe study included 24 patients diagnosed with left Meniere's disease (L-MD), 25 patients diagnosed with right Meniere's disease (R-MD), and 23 healthy control subjects. Resting-state blood‑oxygen-level-dependent functional magnetic resonance imaging (rest-BOLD-fMRI) data were preprocessed. A two-sample t-test was employed to compare the regional homogeneity (ReHo) and fractional amplitude of low-frequency fluctuation (fALFF) between the patient groups and the control group. Brain regions exhibiting significant differences were further analyzed for correlations with disease duration, vertigo severity, vertigo duration, hearing loss grade, and levels of anxiety and depression. ResultsIn patients with L-MD, fALFF values were significantly decreased in the right cerebellar hemisphere, middle occipital gyrus, among other regions. In patients with right-sided Ménière's disease (R-MD), fractional amplitude of low-frequency fluctuation (fALFF) values were elevated in the right middle inferior temporal gyrus and fusiform gyrus. Regional homogeneity (ReHo) values exhibited both increases and decreases in the temporal gyrus, parahippocampal gyrus, occipital gyrus, superior marginal gyrus, anterior central gyrus, and fusiform gyrus. In studies examining relational aspects, the parahippocampal gyrus, inferior temporal gyrus, middle occipital gyrus, superior middle occipital gyrus, superior marginal gyrus, and occipital gyrus demonstrated positive or negative correlations with clinical characteristics and emotional states. ConclusionsPatients with unilateral Meniere's disease (MD) exhibited both increased and decreased activation in various brain regions when compared to control subjects. A correlation was identified between these neural activation patterns and clinical characteristics, as well as emotional state, which holds significant implications for clinical treatment, prognosis, and rehabilitation strategies for MD patients.

EXPLORING THE MYOKINETIC AND ANATOMICAL MERIDIAN TRAINS IMPLICATIONS FOR MOVEMENT PATTERNS AND MERIDIAN-BASED THERAPY PROTOCOL FOR REHABILITATION IN PHYSIOTHERAPY

In recent years, the understanding of movement patterns and musculoskeletal dysfunctions has expanded significantly through the lens of fascial and myofascial systems. Myokinetic and anatomical meridian trains, introduced by Thomas W. Myers, provide a comprehensive model of myofascial connections that link distant regions of the body, influencing postural stability, movement efficiency, and rehabilitation strategies. This paper explores the primary anatomy trains, including the Superficial Front Line, Superficial Back Line, Lateral Line, Spiral Line, and Deep Front Line, among others. We discuss their relevance in understanding movement patterns, postural imbalances, and their implications for rehabilitation in physiotherapy.