Rehabilitation Training For Patients Research Articles

Exposure to an enriched environment modulates the synaptic vesicle cycle in a mouse spinal cord injury model

Spinal cord injury (SCI) leads to motor and sensory impairment below the site of injury, thereby necessitating rehabilitation. An enriched environment (EE) increases social interaction and locomotor activity in a mouse model, similar to human rehabilitation. However, the impact of EE on presynaptic plasticity in gene expression levels remains unclear. Hence, this study aimed to investigate the therapeutic potential of EE in an SCI mouse model. Mice with spinal cord contusion were divided into two groups: those housed in standard cages (control) and those in EE conditions (EE). Each group was housed separately for either 2- or 8-weeks post-injury, after which RNA sequencing was performed and compared to a sham group (receiving only a dorsal laminectomy). The synaptic vesicle cycle (SVC) pathway and related genes showed significant downregulation after SCI at both time points. Subsequently, we investigated whether exposure to EE for 2- and 8-weeks post-SCI could modulate the SVC pathway and its related genes. Notably, exposure to EE for 8 weeks resulted in a marked reversal effect of SVC-related gene expression, along with stimulation of axon regeneration and mitigation of locomotor activity loss. Thus, prolonged exposure to EE increased presynaptic activity, fostering axon regeneration and functional improvement by modulating the SVC in the SCI mouse model. These findings suggest that EE exposure proves effective in inducing activity-dependent plasticity, offering a promising therapeutic approach akin to rehabilitation training in patients with SCI.

Rehabilitation with brain-computer interface and upper limb motor function in ischemic stroke: A randomized controlled trial.

Upper limb motor dysfunction is a major problem in the rehabilitation of patients with stroke. Brain-computer interface (BCI) is a kind of communication system that converts the "ideas" in the brain into instructions and has been used in stroke rehabilitation. This study aimed to investigate the efficacy and safety of BCI in rehabilitation training on upper limb motor function among patients with ischemic stroke. This was an investigator-initiated, multicenter, randomized, open-label, blank-controlled clinical trial with blinded outcome assessment conducted at 17 centers in China. Patients were assigned in a 1:1 ratio to the BCI group or the control group based on traditional rehabilitation training. The primary efficacy outcome is the difference in improvement of the Fugl-Meyer Assessment upper extremity (FMA-UE) score between two groups at month 1 after randomization. The safety outcomes were any adverse events within 3months. A total of 296 patients with ischemic stroke were enrolled and randomly allocated to the BCI group (n= 150) and the control group (n= 146). The primary efficacy outcomes of FMA-UE score change from baseline to 1month were 13.17 (95% confidence interval [CI], 11.56-14.79) in the BCI group and 9.83 (95% CI, 8.19-11.47) in the control group (mean difference between groups was 3.35; 95% CI, 1.05-5.65; p= 0.0045). Adverse events occurred in 33 patients (22.00%) in the BCI group and in 31 patients (21.23%) in the control group. BCI rehabilitation training can further improve upper limb motor function based on traditional rehabilitation training in patients with ischemic stroke. This study was registered at ClinicalTrials.gov: NCT04387474. This work was supported by the National Key R&D Program of China (2018YFC1312903), the National Key Research and Development Program of China (2022YFC3600600), the Training Fund for Open Projects at Clinical Institutes and Departments of Capital Medical University (CCMU2022ZKYXZ009), the Beijing Natural Science Foundation Haidian original innovation joint fund (L222123), the Fund for Young Talents of Beijing Medical Management Center (QML20230505), and the high-level public health talents (xuekegugan-02-47).

Design and Control of Upper Limb Rehabilitation Training Robot Based on a Magnetorheological Joint Damper.

In recent years, rehabilitation robots have been developed and used in rehabilitation training for patients with hemiplegia. In this paper, a rehabilitation training robot with variable damping is designed to train patients with hemiplegia to recover upper limb function. Firstly, a magnetorheological joint damper (MR joint damper) is designed for the rehabilitation training robot, and its structural design and dynamic model are tested theoretically and experimentally. Secondly, the rehabilitation robot is simplified into a spring-damping system, and the rehabilitation training controller for human movement is designed. The rehabilitation robot dynamically adjusts the excitation current according to the feedback speed and human-machine interaction torque, so that the rehabilitation robot always outputs a stable torque. The magnetorheological joint damper acts as a clutch to transmit torque safely and stably to the robot joint. Finally, the upper limb rehabilitation device is tested. The expected torque is set to 20 N, and the average value of the output expected torque during operation is 20.02 N, and the standard deviation is 0.635 N. The output torque has good stability. A fast (0.5 s) response can be achieved in response to a sudden motor speed change, and the average expected output torque is 20.38 N and the standard deviation is 0.645 N, which can still maintain the stability of the output torque.

Enhancing the Functional Performance of Patients with Late-Stage Age-Related Macular Degeneration Implanted with a Miniature Telescope using Rehabilitation Training.

In this work, our aim is to report the functional outcomes of cataract surgery with smaller-incision new-generation miniature telescope (SING IMT) implantation followed by rehabilitation training in patients with central visual loss due to late-stage age-related macular degeneration (AMD). This retrospective study included patients who were monocularly implanted with SING IMT and then followed a rehabilitation program based on 6 biweekly sessions focused on visual abilities, reading, writing, visual motor integration and mobility. A total of 11 participants were included in this study. Reading acuity (RA), reading speed (RS), and fixation stability (FS) were assessed biweekly at 6-, 8-, 10-, 12-, 14-, and 16-week follow-up visits after SING IMT implantation and at a final assessment at 24weeks. Best-corrected distance visual acuity (BCDVA) was also measured at baseline and at the same postoperative timepoints. Mean baseline BCDVA was 12.5 ± 8.6 letter score. Both RA and RS were found to be significantly improved from the first rehabilitation session (6weeks after surgery) to the last session (24weeks after surgery). At the end of the rehabilitation program, mean RA was 0.45 ± 0.19 LogMAR and mean RS was 30.9 ± 17.6 words per minute. Moreover, all patients achieved a FS of 15s or more after the last rehabilitation session. Most patients (55%) achieved an improvement of 15 letters in BCDVA at the end of the study. This study suggests that rehabilitation training can improve visual functions of patients with late-stage AMD implanted with SING IMT in real-world tasks such as reading skills.

Retracted: Application of Composite Nano-Bone Transplantation and Massage Exercise Rehabilitation Training in Patients Undergoing Limb Replantation

Retracted: Application of Composite Nano-Bone Transplantation and Massage Exercise Rehabilitation Training in Patients Undergoing Limb Replantation

An Ankle Joint Flexion and Extension Movement-Monitoring Device Based on Pressure Sensors.

Ankle joint flexion and extension movements play an important role in the rehabilitation training of patients who have been injured or bedridden for a long time before and after surgery. Accurately guiding patients to perform ankle flexion and extension movements can significantly reduce deep vein thromboembolism. Currently, most ankle rehabilitation devices focus on assisting patients with ankle flexion and extension movements, and there is a lack of devices for effectively monitoring these movements. In this study, we designed an ankle joint flexion and extension movement-monitoring device based on a pressure sensor. It was composed of an STM32 microcontroller, a pressure sensor, an HX711A/D conversion chip, and an ESP8266 WiFi communication module. The value of the force and the effective number of ankle joint flexion and extension movements were obtained. An experimental device was designed to verify the accuracy of the system. The maximum average error was 0.068 N; the maximum average relative error was 1.7%; the maximum mean-squared error was 0.00464 N. The results indicated that the monitoring device had a high accuracy and could effectively monitor the force of ankle flexion and extension movements, ultimately ensuring that the patient could effectively monitor and grasp the active ankle pump movement.

Effects of immersive and non-immersive virtual reality-based rehabilitation training on cognition, motor function, and daily functioning in patients with mild cognitive impairment or dementia: A systematic review and meta-analysis

Objective To examine the effectiveness of virtual reality (VR)-based rehabilitation training in improving cognition, motor function, and daily functioning in patients with mild cognitive impairment and dementia. Data sources A systematic review of published literature was conducted using PubMed, Web of Science, Elsevier, Embase, Cochrane, CNKI, Networked Digital Library of Theses and Dissertations. Methods The search period was from inception to 7 October 2023. Eligible studies were randomized controlled trials evaluating the efficacy of VR-based rehabilitation training in patients with mild cognitive impairment or dementia versus control subjects. Methodologic quality was assessed with the Cochrane risk of bias tool, and outcomes were calculated as the standard mean difference between participant groups with 95% confidence interval. Results A total of 21 randomized controlled trials with 1138 patients were included. The meta-analysis showed that VR-based rehabilitation training had significant effects on Montreal Cognitive Assessment (SMD: 0.50; 95%CI: 0.05 to 0.95; P = 0.030), Trail-making test A (SMD: −0.38; 95%CI: −0.61 to −0.14; P = 0.002), and Berg Balance Scale scores (SMD: 0.79; 95%CI: 0.13 to 1.45; P = 0.020). A subgroup analysis revealed that the type of VR, and duration and frequency of interventions had statistically significant effects on cognition and motor function. Conclusion VR-based rehabilitation training is a beneficial nonpharmacologic approach for managing mild cognitive impairment or dementia. Immersive VR-based training had greater effects on cognition and motor function than non-immersive VR-based training, but non-immersive VR-based training was more convenient for patients with limitations imposed by their disease. Also, an intervention lasting 5–8 weeks and for >30 min at a frequency of ≥3 times/week achieved the best results. It indicated that a longer intervention cycle may not achieve the best intervention effect and training duration and schedule should be carefully considered when managing patients.

Disturbance rejection model predictive control of lower limb rehabilitation exoskeleton

Nowadays, exoskeleton is broadly used in the rehabilitation training of many postoperative patients. However, the uncertainty and disturbances caused by different patients and system itself may lead to incompletely rehabilitation training as planned, or even unsafety. This paper addresses the control problem of a lower limb exoskeleton, in the spirit of the recent progress on model predictive control (MPC) and extended state observer (ESO). More precisely, our approach is based on the strategy that designing an ESO to estimate the total disturbance of the dynamics model and compensating it in the design of the MPC process. To accomplish this, we introduce the virtual control quantity to decouple the dynamics model of the system and summarize the human disturbances, unmeasured states and system non-linearity as the total disturbance of the model. By doing so, the uncertainty can be estimated by our designed ESO. Based on the moving horizontal optimization and feedback mechanism of MPC, the output prediction of the system can be more accurate since the uncertainty are effectively compensated. The virtual experiment results demonstrate that proposed controller significantly improves the control accuracy on lower limb rehabilitation exoskeleton with disturbances (improved by over 34%), comparing with conventional MPC and fuzzy PID. As a result, our achievements will make contributions to better rehabilitation training for patients using rehabilitation exoskeletons.

Review and Analysis of Platform-Related Performance of Rehabilitation Lower Limb Exoskeletons

Powered Lower Limb Exoskeletons (PLLE) have attracted much interest due to their potential applications. They provide assistance for persons with disabilities to accomplish activities of daily living (ADL), and more importantly, assist them in achieving their rehabilitation goals. However, there is still uncertainty regarding the quality and benefits that PLLEs can offer to patients. This is due to limited usability and performance of current PLLEs, insufficient clinical use of PLLEs for different patients with high diversity in their disability type and impairment, and also the large gap between the technological state of the art and clinical expectations. In this study, we review and analyse various factors that can improve the effectiveness of PLLEs at yielding better assistance and rehabilitation training for patients with motor impairments. First, we define a set of criteria that characterize the majority of expectations for the rehabilitation and assistance domains and we use them for evaluating PLLEs depending on the context. Then, we include the effects of control strategies and combined approaches which include auxiliary devices such as functional electrical stimulation and smart crutches applied to PLLEs with regard to the criteria we defined.

Adaptive Learning based Upper-Limb Rehabilitation Training System with Collaborative Robot.

Rehabilitation training for patients with motor disabilities usually requires specialized devices in rehabilitation centers. Home-based multi-purpose training would significantly increase treatment accessibility and reduce medical costs. While it is unlikely to equip a set of rehabilitation robots at home, we investigate the feasibility to use the general-purpose collaborative robot for rehabilitation therapies. In this work, we developed a new system for multi-purpose upper-limb rehabilitation training using a generic robot arm with human motor feedback and preference. We integrated surface electromyography, force/torque sensors, RGB-D cameras, and robot controllers with the Robot Operating System to enable sensing, communication, and control of the system. Imitation learning methods were adopted to imitate expert-provided training trajectories which could adapt to subject capabilities to facilitate in-home training. Our rehabilitation system is able to perform gross motor function and fine motor skill training with a gripper-based end-effector. We simulated system control in Gazebo and training effects (muscle activation level) in Open-Sim and evaluated its real performance with human subjects. For all the subjects enrolled, our system achieved better training outcomes compared to specialist-assisted rehabilitation under the same conditions. Our work demonstrates the potential of utilizing collaborative robots for in-home motor rehabilitation training.Clinical relevance-The collaborative robot system is capable of providing safe and effective training comparable to specialized rehabilitation robots, enabling possibilities of convenient rehabilitation training at home.

Research progress of exercise training in rehabilitation of patients with chronic heart failure

Research progress of exercise training in rehabilitation of patients with chronic heart failure

Ionic Gel Based Multifunctional Sensor for Body Temperature Monitoring and Joint Motion Detection

Flexible temperature and strain sensors are key components of wearable devices for healthcare monitoring. Currently, the insufficient precision, undesirable mechanical properties, and the cross interference between different external stimuli are still bottleneck problems for flexible sensors especially in body temperature and human motion monitoring. Herein, an ionic gel based on ionic liquids (ILs) and commercial thermoplastic polyurethane (TPU) fiber is fabricated via a feasible and scalable immersion method for temperature and strain multifunctional sensing. Wearable sensor based on ionic gel exhibits high temperature sensitivity (2.73% ◦C−1) and sufficient resolution (0.1 ◦C) in the skin temperature range. Meanwhile, the sensor exhibits linear and stable strain sensing performance and has the ability to respond to tiny strains. More importantly, the multifunctional fiber‐like sensor is easy to integrate with traditional textile, which is beneficial to solve the wearability problems such as discomfort and impermeability in practical applications. Notably, the stimulus caused by strain can be almost avoided by sewing smart fibers into S‐shape during the temperature monitoring, which helps decouple the temperature and strain signals. As prepared intelligent textiles can accurately capture small fluctuations in temperature and detect the action amplitude of the human body, which is important for disease prediction and rehabilitation training of patients.

Combined robot motor assistance with neural circuit-based virtual reality (NeuCir-VR) lower extremity rehabilitation training in patients after stroke: a study protocol for a single-centre randomised controlled trial

IntroductionImproving lower extremity motor function is the focus and difficulty of post-stroke rehabilitation treatment. More recently, robot-assisted and virtual reality (VR) training are commonly used in post-stroke rehabilitation and are...

Exercise Rehabilitation Training in Patients With Pulmonary Hypertension: A Review.

Pulmonary hypertension (PH) has a high morbidity and mortality. Despite the existing disease-targeted therapy, most patients with PH continue to suffer from difficulty in breathing, exercise intolerance, and reduced quality of life. Recently, a large body of research results has suggested that exercise rehabilitation training (ERT) seems to be a beneficial, safe, and cost-effective treatment for patients with PH. However, knowledge gaps still exist for a uniformly accepted ERT protocol, the modality, duration, intensity, and frequency of ERT in PH. The purpose of this review is to summarise the existing research evidence and knowledge, aiming to strengthen clinicians' awareness of the application of ERT in patients with PH. PubMed databases were systematically searched for eligible studies. Twelve (12) randomised controlled trials and other important studies documenting effectiveness, safety, and adverse events of ERT are summarised. Additionally, the modality, duration, intensity, and frequency of various types of ERT and future research directions are discussed. In summary, ERT is generally effective and safe for PH patients as an adjuvant treatment to disease-specific therapy. It can improve the exercise capacity and tolerance, skeletal and respiratory muscle performance, cardiopulmonary function, and quality of life of PH patients. In view of the occurrence of a small number of adverse events, we currently recommend a combination of in-hospital and home-based ERT under close supervision. In the future, more multi-centre randomised controlled studies are needed to evaluate the effectiveness and feasibility of long-term, community, or home-based ERT, as well as to explore the molecular mechanism behind it.

Application of Composite Nano-Bone Transplantation and Massage Exercise Rehabilitation Training in Patients Undergoing Limb Replantation

With the great stride forward of socialist progress, various medical treatment measures have also made a leap forward in development, providing a deeper guarantee for people’s life safety. At the same time, the research field of nanotechnology has gradually developed in the medical field, which plays an important role in the development of medicine, and massage exercise rehabilitation training also provides convenience for patients’ recuperation. The purpose of this study is to study the application of composite NanoBone transplantation in patients with limb replantation and the application of massage exercise rehabilitation training in patients with limb replantation. The methods used in this paper are: consulting the literature to understand the composite NanoBone transplantation technology and massage exercise rehabilitation training methods, interviewing the patients and attending doctors, and asking about the selection method of experiment and questionnaire used in the paper, so as to carry out the questionnaire survey. The treatment group and the control group were set up to analyze the results. The results showed that there were no significant differences in T lymphocyte subsets, serum complement, and circulating immune complex in the replantation of amputated limbs. Combined with the clinical manifestations and pathological results, early rejection occurred, and the body temperature of the patients increased after clinical treatment; The characteristics of massage are not practical, the course of treatment is short, the effect is fast, the clinical operation is simple, easy to grasp, and has high clinical application and promotion value. The final test results showed that: comparing the two groups of patients before treatment, the VAS scores were 23% and 21%, respectively, and the treatment group scores were 23% and 21%, respectively. After treatment, the VAS scores of the test group and the control group were 29 % and 27%, respectively. The treatment group scored 2% higher than the control group. From this, it can be concluded that massage is better than traditional massage, and massage exercise has great application prospects in clinical practice.

Effectiveness and Safety of Four Aerobic Exercise Intensity Prescription Techniques in Rehabilitation Training for Patients with Coronary Heart Disease

Methods A retrospective study was conducted on all patients with CHD who were admitted to CR and completed cardiopulmonary exercise tests (CPET) in Guangdong Hospital of traditional Chinese medicine. According to the risk stratification method of CHD, all participants were divided into three groups: low, moderate, and high risk. The training target heart rates (HRt) of each participant were calculated according to the formula of heart-rate-reserve (HRR), maximum-heart-rate (MHR), target-heart-rate (THR), and anaerobic threshold (AT) method provided in the guideline. Among them, the HRR method using the maximum-heart-rate obtained by the age formula was named “HRR method A,” and that using the actual measured peak heart rate was named “HRR method B.” For the three groups, the effectiveness and safety indexes at the target-heart-rate zone set by the different formulas above are counted and compared using CPET data. Results A total of 324 patients were included in the analysis. There was no significant difference between the target-heart-rate set by the HRR method A and AT method among the three groups (P > 0.05). The mean value of HRt set by other methods was lower than the AT heart rate (P < 0.05). The HRt set by the THR method was close to the AT, while that set by the MHR method was the lowest. The frequency of patients whose HRt was set by the MHR method was lower than the AT one, which was the highest. None of the participants had serious adverse events. There were no risks of ECG abnormalities in the low- and moderate-risk groups. The HRR method A had the highest incidence of various risks of ECG abnormalities, while the MHR method had the lowest one, and the safety of the THR method is close to that of the AT method (P < 0.05). Conclusion The heart rate calculated by HRR method A is more consistent with the actual AT. All four techniques are safe in low- and moderate-risk patients. In high-risk patients, using HRR method A has certain risks. It is recommended to use the MHR method for safety reasons, but its effectiveness is low. If considering both effectiveness and safety, the THR method can be conservatively selected at the beginning of the CR program.

An sEMG-Based Human-Exoskeleton Interface Fusing Convolutional Neural Networks With Hand-Crafted Features.

In recent years, the human-robot interfaces (HRIs) based on surface electromyography (sEMG) have been widely used in lower-limb exoskeleton robots for movement prediction during rehabilitation training for patients with hemiplegia. However, accurate and efficient lower-limb movement prediction for patients with hemiplegia remains a challenge due to complex movement information and individual differences. Traditional movement prediction methods usually use hand-crafted features, which are computationally cheap but can only extract some shallow heuristic information. Deep learning-based methods have a stronger feature expression ability, but it is easy to fall into the dilemma of local features, resulting in poor generalization performance of the method. In this article, a human-exoskeleton interface fusing convolutional neural networks with hand-crafted features is proposed. On the basis of our previous study, a lower-limb movement prediction framework (HCSNet) in patients with hemiplegia is constructed by fusing time and frequency domain hand-crafted features and channel synergy learning-based features. An sEMG data acquisition experiment is designed to compare and analyze the effectiveness of HCSNet. Experimental results show that the method can achieve 95.93 and 90.37% prediction accuracy in both within-subject and cross-subject cases, respectively. Compared with related lower-limb movement prediction methods, the proposed method has better prediction performance.

Nanoligament Combined with Tennis Exercise on Rehabilitation Training for Treatment of Ligament Injury Patients

This article mainly studies the effect of nanoligament combined with tennis on the rehabilitation of ligament injury patients. This article first uses nanoligaments made by ACL reconstruction technology to give targeted rehabilitation treatment to patients with ligament injuries, analyzes the internal structure of the knee joint cavity ligaments, and clarifies the rehabilitation of ACL injuries and other combined injuries. The construction method of nanoligament composite fiber composite ligament is mainly introduced. Secondly, the nanoligament damage mechanism can be used to prevent excessive knee deformation and internal rotation. Finally, the nanoligament is combined with the fiber composite ligament, and the silk fibroin filament yarn is used as the axis to form a composite structure on the fiber composite ligament structure to strengthen the rehabilitation effect for patients with ligament injury. In this study, combined with the data analysis of patients with nanoligament injury, it was found that after 50 patients have undergone corresponding tennis training and knee flexion angle observation, the recovery speed is 5 times faster than that of ordinary patients. The experimental results show that the combination of nanoligaments and tennis has a positive effect on rehabilitation training for patients with ligament injury.

Effect of Remote Control Augmented Reality Multimedia Technology for Postoperative Rehabilitation of Knee Joint Injury.

This study was aimed at exploring the application value of augmented reality (AR) in postoperative rehabilitation training for patients with knee joint injury. 40 patients who underwent knee joint injury surgery were selected as the research objects, and the patients were randomly divided into two groups: an experimental group (20 cases) and a control group (20 cases). Patients in the experimental group were treated with AR-based rehabilitation methods, while those in the control group were treated with traditional rehabilitation methods. Afterwards, the two groups of patients were compared with various indicators such as pain value, swelling, structural and functional recovery, time to complete weight bearing, time to return to work, and X-ray examination results. The main evaluation tools used were Hospital for Special Surgery (HSS) score and Visual Analogue Scale (VAS) score. The results showed that after six weeks, the HSS score of the control group was 82.88 ± 3.07, and the HSS score of the experimental group was 85.46 ± 3.21. The difference between the two groups was statistically significant (P < 0.05). After three months, the HSS score of the control group was 89.96 ± 3.76, and that of the experimental group was 93.21 ± 4.33. The difference between the two groups was statistically significant (P < 0.05). There was a significant difference in pain scores between the two groups at 7 days (3.81 ± 0.48 vs. 5.06 ± 0.66) and 14 days (2.03 ± 0.45 vs. 3.61 ± 0.63) after surgery, with statistical significances (P < 0.05). There were statistically significant differences between the two groups in terms of time to complete weight bearing (7 ± 0.87 weeks vs. 8.82 ± 0.88 weeks) and time to return to work (8.69 ± 0.94 vs. 9.93 ± 0.88 weeks) (P < 0.05). One month after surgery, the X-ray examination results of both groups showed recovery. The AR-based rehabilitation training system showed a good application effect and prospect in the postoperative structural and functional recovery of patients with knee joint injury.

Research progress of respiratory rehabilitation training in patients with stable chronic obstructive pulmonary disease

Research progress of respiratory rehabilitation training in patients with stable chronic obstructive pulmonary disease