Rehabilitation Training Program Research Articles

A decision support system for upper limb rehabilitation robot based on hybrid reasoning with RBR and CBR.

The rehabilitation robot can assist hemiplegic patients to complete the training program effectively, but it only focuses on helping the patient's training process and requires the rehabilitation therapists to manually adjust the training parameters according to the patient's condition. Therefore, there is an urgent need for intelligent training prescription research of rehabilitation robots to promote the clinical applications. This study proposed a decision support system for the training of upper limb rehabilitation robot based on hybrid reasoning with rule-based reasoning (RBR) and case-based reasoning (CBR). The expert knowledge base of this system is established base on 10 professional rehabilitation therapists from three different rehabilitation departments in Shanghai who are enriched with experiences in using desktop-based upper limb rehabilitation robot. The rule-based reasoning is chosen to construct the cycle plan inference model, which develops a 21-day training plan for the patients. The case base consists of historical case data from 54 stroke patients who underwent rehabilitation training with a desktop-based upper limb rehabilitation robot. The case-based reasoning, combined with a Random Forest optimized algorithm, was constructed to adjust the training parameters for the patients in real-time. The system recommended a rehabilitation training program with an average accuracy of 91.5%, an average AUC value of 0.924, an average recall rate of 88.7%, and an average F1 score of 90.1%. The application of this system in rehabilitation robot would be useful for therapists.

Real Time Monitoring Research on Rehabilitation Effect of Artificial Intelligence Wearable Equipment on Track and Field Athletes

INTRODUCTION: With the rapid development of artificial intelligence technology, wearable artificial intelligence devices show great potential in medical rehabilitation. This study explores the Real Time monitoring effect of AI wearable devices in the rehabilitation process of track and field athletes. The application of this technology in rehabilitation monitoring was investigated through the introduction of advanced sensing technology and data analysis algorithms to provide track and field athletes with more scientific and personalized rehabilitation programs. OBJECTIVES: A group of track and field athletes was selected as the research object and equipped with an artificial intelligence wearable device, which is capable of Real Time monitoring of the athletes' physiological parameters, sports postures, joint mobility, and other rehabilitation-related data. An individualized rehabilitation model was established through the data collected by these sensors, and advanced artificial intelligence algorithms were used to analyze the data in Real Time. At the same time, the sensor data were combined with the actual performance of the athletes' rehabilitation training to comprehensively assess the effectiveness of AI wearable devices in rehabilitation monitoring. METHODS: This study aims to assess the effect of Real Time monitoring of AI wearable devices in the rehabilitation of track and field athletes and to explore their potential application in the rehabilitation process. Real Time tracking of athletes' physiological status and athletic performance aims to provide more accurate and timely information to rehabilitation doctors and coaches to optimize the rehabilitation training program and promote the rehabilitation process of athletes. RESULTS: The study showed that artificial intelligence wearable devices have significant Real Time monitoring effects in rehabilitating track and field athletes. Through Real Time monitoring of data such as physiological parameters, sports posture, and joint mobility, the rehabilitation team was able to identify potential problems and adjust the rehabilitation program in a more timely manner. Athletes using artificial intelligence wearable devices improved the personalization and targeting of rehabilitation training, and the rehabilitation effect was significantly better than that of traditional monitoring methods. CONCLUSION: This study concludes that artificial intelligence wearable devices perform well in rehabilitating track and field athletes, providing a more scientific and comprehensive means of rehabilitation monitoring. Through Real Time tracking, the rehabilitation team could better understand the rehabilitation progress of the athletes, adjust the rehabilitation program in a targeted manner, and improve the rehabilitation effect. However, future research still needs to optimize the performance of the devices further, expand the sample size, and thoroughly study the monitoring needs at different stages of rehabilitation to better meet the individualized requirements of track and field athletes' rehabilitation process.

Long-term effect of non-severe COVID-19 on pulmonary function, exercise capacities and physical activities: a cross-section study in Sakaka Aljouf

Background COVID-19 has serious consequences on different body systems particularly the respiratory system with its impact on pulmonary function, exercise capacities, and physical activities. This study aimed to investigate the long-term effect of COVID-19 on pulmonary function, exercise capacities, and physical activities in patients with non-severe COVID-19. Methods 160 individuals were selected to participate in a cross-section study. Group-I: 80 male and female patients with non-severe COVID-19 at least 3 months after the recovery time. Group-II: 80 male and female matched (non-infected with COVID-19) participants. The spirometer, six-minute walk test (6MWT), and International Physical Activity Questionnaire (IPAQ) were used to assess pulmonary function, exercise capacities, and physical activities respectively. The Kolmogorov-Smirnov test was used to test normality of data. The Mann–Whitney and independent t-tests were used to compare the significant differences between both groups. Results The results show significant differences in FVC & FEV1 of the pulmonary function, exercise capacities, and physical activities of the work & transportations between both COVID-19 and matched groups p-value = (0.001 & 0.001, 0.001 and 0.005 & 0.012) respectively. Conclusion Pulmonary function, exercise capacities, and physical activities are negatively influenced by COVID-19 as long-term consequences indicating the need for extended health care, and prescription of proper rehabilitative training programs for non- severe COVID-19 patients whatever their severity degree of infection or history of hospitalization. Outcome reflections of the current results raise awareness of physical therapists to the importance of the proper rehabilitative training programs for non-severe COVID-19 patients.

Barriers and facilitators for increased accessibility to quality rehabilitation services in low- and middle- income countries: a systematic review.

With an increasing number of people experiencing limitations in functioning during their life course, the need for comprehensive rehabilitation services is high. In 2017, the WHO Rehabilitation 2030 initiative noted that the need for the establishment and expansion of rehabilitation services is paramount in order to obtain well-being for the population and to ensure equal access to quality healthcare for all. The organization of rehabilitation services is however facing challenges especially in low-and middle-income countries with a very small proportion of people who require rehabilitation actually getting them. Various surveys conducted in low-and -middle income countries have revealed existing gaps between the need for rehabilitation services and the actual receipt of these services. This systematic review aimed to determine the barriers and facilitators for increasing accessibility to rehabilitation services in low- and middle-income countries. Recommendations for strengthening rehabilitation service organization are presented based on the available retrieved data. In this systematic review, an electronic search through three primary databases, including Medline (PubMed), Scopus and Web of Science (WOS) was conducted to identify original studies reporting on barriers and facilitators for rehabilitation service organization in low-and middle-income countries. Date of search: 25th April 2021 (PubMed), 3rd May 2021 (Scopus and Web of Science). All studies including barriers or/and facilitators for rehabilitation services in low- and middle income countries which were written in English were included in the review. The articles written in other languages and grey literature, were excluded from this review. Total of 42 articles were included from year 1989 to 2021. Numerous barriers were identified that related to education, resources, leadership, policy, technology and advanced treatment, community-based rehabilitation (CBR), social support, cultural influences, political issues, registries and standards of care. National health insurance including rehabilitation and funding from government and NGOs are some of the facilitators to strengthen rehabilitation service organization. Availability of CBR programs, academic rehabilitation training programs for allied health professionals, collaboration between Ministry of Heath (MOH) and Non-governmental Organizations (NGOs) on telerehabilitation services are amongst other facilitators. Recommendations for improving and expanding rehabilitation service organization include funding, training, education, and sharing of resources.

Developing an Inclusive Training Environment: Accommodations in Physical Medicine and Rehabilitation Residency Training for Residents With a Disability.

This study examines the challenges and accommodations for medical residents with disabilities within physical medicine and rehabilitation training programs. Medical residency presents unique stressors and responsibilities, with the potential for added complexities for residents with disabilities. Few data exist regarding the prevalence and experiences of people with disabilities as medical trainees and the limited studies available highlight an underrepresentation of individuals with disability in medical training and practice. Through cross-sectional surveys administered to physical medicine and rehabilitation residents, this research assesses disability prevalence, characterizations, barriers to training, and accommodations provided. Of 140 respondents, 9.3% identified as having disabilities, with varying prevalence among genders and disability types. Results revealed distinct challenges for residents with mobility and nonmobility disabilities, spanning learning environments, standardized testing, procedural skills, and accessibility. Self-provided accommodations exceeded program-provided ones, indicating room for improvement in program support. These findings underscore the need for proactive dialog between residents and leadership to address barriers, enhance accommodations, and create an inclusive training environment. The study's insights emphasize the importance of advocating for equal opportunities and cultivating supportive conditions to enable individuals with disabilities to thrive in medical residency programs, ultimately contributing to more diverse and inclusive medical communities.

Pediatric intensive bowel continence rehabilitation training: a retrospective study to evaluate feasibility, tolerance and effectiveness.

Pediatric continence dysfunction is not uncommon. It causes long-term disability, impairing quality of life, activities and relationships with pears and can affect until adulthood. A high-risk population are children with Hirschsprung's disease and congenital anorectal malformation. Conservative medical and surgical management of continence dysfunction in this population is deeply described, while the rehabilitation issues are still unexplored. Aim of this study is to preliminary verify the feasibility, tolerance and effectiveness of an intensive technological aided and individualized pelvic floor rehabilitation program for pediatric patients. This is a single-center, retrospective observational study. The assessment was performed by collecting demographic data, general and local physical examination and scoring assessment tools (Rintala Continence Score and Wexner Score). The study was conducted in the Rehabilitation Unit of the pediatric Giannina Gaslini Institute, a tertiary care pediatric hospital in Genoa (Italy) between September 2015 to August 2019. We enrolled 31 children; 25 male (80.6%) and six females (19%), aged between 5 and 14 years (mean age 9 years) at the beginning of the training. Twenty children (65.5%) had Hirschsprung's disease, and 11 children (34.5%) had a congenital anorectal malformation. The rehabilitation training program was customized on the compromised function, the anatomic characteristics, the child's age and compliance. The training was aimed at improving tone, strength, endurance of the pelvic floor, compliance and rectal sensitivity, and also the frequency of the bowel movements. All patients enrolled in the study underwent an intensive outpatient treatment lasted 5 days for children older than 7 years; 10 days for younger. The intensive rehabilitation treatment was followed by a continuous home training program. Twenty-nine children (96.8%) completed the training. A global improvement is observed in continence functioning in all the cohort at T1 (P<0.0001), maintained at T3 (P<0.0001) at both Rintala Continence Score and Wexner Score. No adverse effects have been referred. Our specific pediatric training program for pelvic floor rehabilitation is effective and safe for children with continence dysfunctions after pelvic surgery due to Hirschsprung's disease and anorectal malformations. The continence rehabilitation multimodal program should be integrated in the care of children with continence dysfunctions. It cooperates in the prevention of the long-term health global impairment and also in the reduction of social economic effort.

Pulmonary Rehabilitation Exercises Effectively Improve Chronic Cough After Surgery for Non-small Cell Lung Cancer.

Cough is a major complication after lung cancer surgery, potentially impacting lung function and quality of life. However, effective treatments for managing long-term persistent postoperative cough remain elusive. In this study, we investigated the potential of a pulmonary rehabilitation training program to effectively address this issue. Between January 2019 and December 2022, a retrospective review was conducted on patients with non-small cell lung cancer (NSCLC) who underwent lobectomy and lymph node dissection via video-assisted thoracoscopic surgery (VATS) at Daping hospital. Based on their postoperative rehabilitation methods, the patients were categorized into 2 groups: the traditional rehabilitation group and the pulmonary rehabilitation group. All patients underwent assessment using the Leicester cough questionnaire (LCQ) on the third postoperative day. Additionally, at the 6-month follow-up, patients' LCQ scores and lung function were re-evaluated to assess the long-term effects of the pulmonary rehabilitation training programs. Among the 276 patients meeting the inclusion criteria, 195 (70.7%) were in the traditional rehabilitation group, while 81 (29.3%) participated in the pulmonary rehabilitation group. The pulmonary rehabilitation group showed a significantly lower incidence of cough on the third postoperative day (16.0% vs 29.7%, P = .018) and higher LCQ scores in the somatic dimension (5.09 ± .81 vs 4.15 ± 1.22, P = .007) as well as in the total score (16.44 ± 2.86 vs 15.11 ± 2.51, P = .018, whereas there were no significant differences in psychiatric and sociological dimensions. At the 6-month follow-up, the pulmonary rehabilitation group continued to have a lower cough incidence (3.7% vs 12.8%, P = .022) and higher LCQ scores across all dimensions: somatic (6.19 ± .11 vs 5.75 ± 1.20, P = .035), mental (6.37 ± 1.19 vs 5.85 ± 1.22, P = .002), sociological (6.76 ± 1.22 vs 5.62 ± 1.08, P < .001), and total (18.22 ± 2.37 vs 16.21 ± 2.53, P < .001). Additionally, lung function parameters including FVC, FVC%, FEV1, FEV1%, MVV, MVV%, DLCO SB, and DLCO% were all significantly higher in the pulmonary rehabilitation group compared to the traditional group. Pulmonary rehabilitation exercises significantly reduced the incidence of postoperative cough and improved cough-related quality of life in patients undergoing lobectomy, with sustained benefits observed at the 6-month follow-up. Additionally, these exercises demonstrated superior lung function outcomes compared to traditional rehabilitation methods.

The efficacy of pulmonary rehabilitation training program for patients after lung transplantation.

Pulmonary rehabilitation is recognized widely as one of the most effective measures to promote postoperative recovery of lung transplant recipients (LTRs), and it has positive effects on both short- and long-term quality of life (QoL) and survival outcomes. However, no standardized pulmonary rehabilitation training programs exist specifically for LTRs. The pulmonary rehabilitation programs widely used in clinical practice focus mainly on exercise or respiratory training, to some extent neglecting other therapeutic methods that could promote patient health, such as nutrition support, pain control, spiritual comfort, and so on. This study aimed to develop a postoperative pulmonary rehabilitation training program for LTRs and evaluate its effectiveness. Using convenience sampling, all patients who underwent lung transplantation (LTx) at Shanghai Pulmonary Hospital from January 2021 to December 2022 were screened for inclusion and exclusion criteria, and a total of 68 patients were finally included in this study. A non-synchronous quasi-experimental design was used, with patients who underwent LTx in 2021 as the control group and patients who underwent LTx in 2022 as the experimental group. The control group received routine treatment, health education, and rehabilitation guidance when patients determined the date of surgery. In addition to this, the experimental group received pulmonary rehabilitation training. The incidence of postoperative pulmonary complications (pulmonary infections), duration of chest tube drainage, intensive care unit (ICU) length of stay, postoperative pain scores, postoperative QoL, pulmonary function, oxygenation index, and the distance in the 6-minute walking test (6MWD) were compared between the two groups. The length of ICU stay and duration of chest tube drainage in the experimental group were lower than those in the control group, and the results of oxygenation index, 6MWD, and St. George's Respiratory Questionnaire (reflecting the QoL) were better than those of the control group (P<0.05). There was no significant difference in the pain of the two groups 1 week after surgery and 3 months after surgery, and the pain score of the experimental group was lower than that of the control group at 1 month after surgery (P<0.05). There was no significant difference in the incidence of complications between the two groups (P>0.05). The postoperative pulmonary rehabilitation training program for LTRs is safe and effective. It can shorten both the duration of chest tube drainage and ICU stay, it can also improve patients' exercise capacity and pulmonary function while also promote safety outcomes of LTRs, and improve QoL scores.

Sports Injury of Sanda Wushu Class of Students in Xi'an City

Background and Aim: Wushu is a traditional sport in China and is considered an ancient Chinese martial art. Wushu is a sport that is packaged as a teaching course about martial arts and dances and is also aimed at improving the health of people who train and learn at all ages. Therefore, in wushu martial arts when starting to practice or start playing Students or players must prepare their bodies to be able to fight, but if they learn by starting, injuries that may occur with training or playing this type of sport will always happen. Materials and Methods: Population and sample: The population used in this research were Sanda Wushu students’ a total number of 150 people. The research instrument was a questionnaire on Injury occurred during the Wushu course. created by the researcher with 3 parts, developed from a questionnaire on injuries of track and field athletes participating in the 39th National Games (Pengtee, 2011). The questionnaire has the following details: Part 1: Basic information of the buyer. Part 2: Sanda Wushu Injury Questionnaire Part 3: summarizes comments or suggestions regarding injury prevention. Result: From the survey of the causes of injuries, there were two causes: injuries that occurred from the outside environment from studying Sanda Wushu (66%) and injuries that occurred from the athletes themselves (34%) and of body positions that were injured in most athletes' competitions. It occurred in 38.7% of the body positions, 24% of the upper limbs, 20% of the lower limbs, and 17.3% of the head positions. Conclusion: From the summary of the above opinions, the injuries sustained in the class are injuries that are not serious and can be treated with basic first aid. Because studying at the school level is non-violent training, it is not surprising that it can be rehabilitated. In injury prevention, there were additional comments, namely the recommendation to increase protective equipment to be sufficient for the number of students and to improve the equipment appropriately. In addition, there is currently a training program for physical rehabilitation.

Long-term effect of non-severe COVID-19 on pulmonary function, exercise capacities and physical activities: a cross-section study in Sakaka Aljouf

Background COVID-19 has serious consequences on different body systems particularly the respiratory system with its impact on pulmonary function, exercise capacities, and physical activities. This study aimed to investigate the long-term effect of COVID-19 on pulmonary function, exercise capacities, and physical activities in patients with non-severe COVID-19. Methods 160 individuals were selected to participate in a cross-section study. Group-I: 80 male and female patients with non-severe COVID-19 at least 3 months after the recovery time. Group-II: 80 male and female matched (non-infected with COVID-19) participants. The spirometer, six-minute walk test (6MWT), and International Physical Activity Questionnaire (IPAQ) were used to assess pulmonary function, exercise capacities, and physical activities respectively. The Kolmogorov-Smirnov test was used to test normality of data. The Mann–Whitney and independent t-tests were used to compare the significant differences between both groups. Results The results show significant differences in FVC &amp; FEV1 of the pulmonary function, exercise capacities, and physical activities of the work &amp; transportations between both COVID-19 and matched groups p-value = (0.001 &amp; 0.001, 0.001 and 0.005 &amp; 0.012) respectively. Conclusion Pulmonary function, exercise capacities, and physical activities are negatively influenced by COVID-19 as long-term consequences indicating the need for extended health care, and prescription of proper rehabilitative training programs for non- severe COVID-19 patients whatever their severity degree of infection or history of hospitalization. Outcome reflections of the current results raise awareness of physical therapists to the importance of the proper rehabilitative training programs for non-severe COVID-19 patients.

Rehabilitation strategies and magnetic resonance imaging techniques for shoulder injuries in sports

ObjectiveShoulder sleeve injuries are high-risk in men's tennis, with rehabilitation focusing on activating shoulder muscle groups to regain strength. Specific plans use electromyography and isokinetic instruments to compare muscle activity and torque pre- and post-rehabilitation. The goal is to explore training effects on rotator cuff injuries and assess routine MRI and MRI shoulder arthrography for diagnostic value in shoulder injuries. This aims to provide a reference for restoring shoulder function in male tennis players. MethodsTwenty college students (n = 20) with rotator cuff injuries from a university tennis program were selected as experimental subjects, matched based on gender and injury severity, and divided into experimental (n = 10) and control (n = 10) groups. A paired sample T-test assessed the impact of rehabilitation training on muscle recruitment and strength around the shoulder joint in the experimental group before and after training. This evaluated the influence of rehabilitation plans on shoulder muscle mobilization and strength. Another paired sample T-test compared indicators before and after the experiment, examining mechanisms underlying the effects of functional rehabilitation training on shoulder sleeve injuries in male tennis players. Results(1) Surface electromyography (EMG) results for internal/external rotation showed a significant increase in anterior, middle, and posterior deltoid EMG values (P < 0.05). Supraspinatus and infraspinatus muscles exhibited substantial increases (P < 0.01), while no significant change occurred in the teres minor muscle. (2) Adduction/abduction EMG tests at 60°/s, 90°/s, and 120°/s revealed significant increases (P < 0.01) in deltoid bundles and supraspinatus/infraspinatus muscles for both experimental and control groups. Teres minor muscle showed no significant change. (3) Isokinetic muscle strength tests indicated a significant peak torque increase (P < 0.01) during inward/outward rotation at 60°/s, 90°/s, and 120°/s for the experimental group compared to the control group. ConclusionA 10-week functional shoulder rehabilitation training program can enhance the strength, endurance, and neuromuscular recruitment of shoulder-related muscles in male tennis players with rotator cuff injuries. This approach, combined with the diagnostic capabilities of routine MRI and MRI shoulder arthrography, enables modifications in the body's ongoing adaptation to injuries. This, in turn, contributes to improved shoulder joint stability and effectively facilitates the functional recovery of the rotator cuff muscle group.

Alterations in RNA editing in skeletal muscle following exercise training in individuals with Parkinson's disease.

Parkinson's Disease (PD) is the second most common neurodegenerative disease behind Alzheimer's Disease, currently affecting more than 10 million people worldwide and 1.5 times more males than females. The progression of PD results in the loss of function due to neurodegeneration and neuroinflammation. The etiology of PD is multifactorial, including both genetic and environmental origins. Here we explored changes in RNA editing, specifically editing through the actions of the Adenosine Deaminases Acting on RNA (ADARs), in the progression of PD. Analysis of ADAR editing of skeletal muscle transcriptomes from PD patients and controls, including those that engaged in a rehabilitative exercise training program revealed significant differences in ADAR editing patterns based on age, disease status, and following rehabilitative exercise. Further, deleterious editing events in protein coding regions were identified in multiple genes with known associations to PD pathogenesis. Our findings of differential ADAR editing complement findings of changes in transcriptional networks identified by a recent study and offer insights into dynamic ADAR editing changes associated with PD pathogenesis.

Comparison of Static Stretching on Whole Body Vibration and Strength Training for Improving and Maintaining Hamstring Range of Motion

Background: Hamstring strains are prevalent among individuals engaged in sports and recreational activities. Addressing this, static stretching, whole-body vibrations (WBV), and strength training are recognized for enhancing range of motion (ROM) and reducing muscle injury risks. However, the comparative effectiveness of these modalities on hamstring flexibility and ROM requires further exploration. Objective: The primary objective of this study was to investigate the effects of static stretching combined with whole-body vibrations and strength training on improving and maintaining hamstring range of motion. Methods: This crossover randomized control trial in Karachi involved 44 participants aged 18-25 years, actively participating in various recreational activities. Participants were randomly divided into two groups: one underwent static stretching on whole-body vibration, and the other received strength training. The interventions lasted four weeks, with pre- and post-intervention assessments of active and passive range of motion (AROM and PROM). Data analysis was conducted using SPSS version 23.0. Results: The static stretching with whole-body vibration group showed an increase in AROM from a pre-intervention mean of 131.05° to a post-intervention mean of 136.55°, and in PROM from 131.67° to 137.41°. The strength training group exhibited an increase in AROM from a pre-intervention mean of 135.21° to 142.42°, and in PROM from 135.98° to 144.81°. Both interventions demonstrated statistically significant improvements in hamstring ROM. Conclusion: The study demonstrates that both static stretching on whole-body vibration and strength training are effective in enhancing the flexibility and range of motion of hamstrings. These findings suggest their beneficial incorporation in rehabilitation and athletic training programs.

Retracted: Effect of Comprehensive Rehabilitation Training Program in Orthopedic Nursing of Patients with Residual Limb Injury Caused by Crush

Retracted: Effect of Comprehensive Rehabilitation Training Program in Orthopedic Nursing of Patients with Residual Limb Injury Caused by Crush

Long-term effect of non-severe COVID-19 on pulmonary function, exercise capacities and physical activities: a cross-section study in Sakaka Aljouf.

COVID-19 has serious consequences on different body systems particularly the respiratory system with its impact on pulmonary function, exercise capacities, and physical activities. This study aimed to investigate the long-term effect of COVID-19 on pulmonary function, exercise capacities, and physical activities in patients with non-severe COVID-19. 160 individuals were selected to participate in a cross-section study. Group-I: 80 male and female patients with non-severe COVID-19 at least 3 months after the recovery time. Group-II: 80 male and female matched (non-infected with COVID-19) participants. The spirometer, six-minute walk test (6MWT), and International Physical Activity Questionnaire (IPAQ) were used to assess pulmonary function, exercise capacities, and physical activities respectively. The Kolmogorov-Smirnov test was used to test normality of data. The Mann-Whitney and independent t-tests were used to compare the significant differences between both groups. The results show significant differences in FVC & FEV 1 of the pulmonary function, exercise capacities, and physical activities of the work & transportations between both COVID-19 and matched groups p-value = (0.001 & 0.001, 0.001 and 0.005 & 0.012) respectively. Pulmonary function, exercise capacities, and physical activities are negatively influenced by COVID-19 as long-term consequences indicating the need for extended health care, and prescription of proper rehabilitative training programs for non- severe COVID-19 patients whatever their severity degree of infection or history of hospitalization. Outcome reflections of the current results raise awareness of physical therapists to the importance of the proper rehabilitative training programs for non-severe COVID-19 patients.

Can a structured home-based rehabilitation program reduce dorsal central wrist pain?

ObjectivesDorsal central wrist pain, often a consequence of peri-scapholunate ligament injury, can result in a decline in functional performance. There is a scarcity of clinical data evaluating the effectiveness of conservative management on peri-scapholunate ligament injury. Conservative management includes education, immobilization with orthotic devices, scapholunate-stabilizing muscle strengthening, and proprioception training. The identification of the ligamento-muscular reflex and scapholunate-stabilizing muscles formed the rationale for a rehabilitation training program. We have devised an innovative standardized 16-week treatment program for patients with dorsal central wrist pain associated with acute peri-SL ligament injury. We hypothesized that the program can effectively reduce dorsal wrist pain and improve functional performance. Materials and methodsRecruited subjects underwent the 16-week home-based program, which included immobilization and rehabilitation exercises, to improve their wrist stability. Follow-up was arranged every 4 weeks for progress monitoring. The Short-Form 12 item questionnaire version 2, power grip, pinch grip, wrist range of motion, total performance score and total pain score when performing activities of daily living were used to evaluate the effectiveness of the program. An exercise adherence questionnaire was used to evaluate adherence to the home rehabilitation program. ResultsTwenty-three subjects (26 wrists) completed the program. Pain on visual analog scale improved by 5.1 cm and total pain score improved from 14.4/20 to 19.5/20. Total performance score reached 39/40, which indicated near-normal wrist function. Power grip and pinch grip increased by 22.3% and 17.8%, respectively. The physical component scale of the Short-Form 12 item questionnaire showed significant improvement, while the mental component scale did not. Overall adherence was fair. DiscussionConservative management, including immobilization and rehabilitation training, can provide significant clinical improvement in patients with dorsal central wrist pain associated with acute peri-scapholunate ligament injury. ConclusionStandardized wrist rehabilitation can be taken as a reference treatment modality. It is an evidence-based non-invasive treatment option for clinicians and therapists.

Trajectory Deformation With Constrained Optimization for Bilateral Rehabilitation Robots

Robot-aided bilateral treatment has been verified to be an effective training program for hemiplegic rehabilitation. In this article, a reference-free active control framework based on optimal trajectory deformation is proposed to ensure the safety requirements in the leader–follower paradigm of bilateral treatment. A constrained optimization method is developed to handle the motion constraints, which are constructed by quantitative assessments of typical impairment in stroke patients, such as reduced range of motion, resistance to passive movement, and disturbed quality of movement. Then, by optimally deforming the robotic trajectory, abnormal motion patterns that lead to safety issues can be rectified. Furthermore, the physically interactive trajectory deformation is employed to achieve active control without a predefined trajectory. At last, all approaches are verified on a robotic platform with a 2-DoF lower-limb exoskeleton. Experimental results demonstrate the effectiveness of proposed control scheme in rectifying abnormal motion patterns and enhancing human–robot interaction.

Evaluation of a stroke rehabilitation training programme for community-based primary healthcare.

Family caregiver training is an integral part of stroke rehabilitation programmes and is associated with improved caregiver and stroke survivor outcomes. In the Cape Winelands District, a low-resourced rural community-based setting in South Africa, stroke survivors and family caregivers mostly rely on assistance from community health workers (CHWs), despite their lack of stroke-specific rehabilitation training. To evaluate the implementation and immediate effects of a bespoke, 16 session, 21 h stroke rehabilitation training programme for CHWs to better support family caregivers. Two cooperative inquiry groups participated in participatory action research to design and develop the programme. This article reports on the implementation of this programme. Inquiry group members directly observed the training, obtained written and verbal feedback, interviewed CHWs and observed them in the community. Consensus on their learning was achieved after reflection on their experience and observations. Learning of the cooperative inquiry groups was categorised into the effect on community-based care, the training programme's design and development, how training was delivered and implications for service delivery. Community health workers empowered caregivers and stroke survivors and enabled access to care, continuity, coordination and person-centredness. The need for experiential learning and a spiral curriculum was confirmed. Therapists needed a different set of skills to deliver training. A systems approach and effective leadership were needed to enable community health workers to use their new skills. The stroke rehabilitation training programme demonstrated potential for integration into service delivery and equipping CHWs to support family caregivers and stroke survivors. Further evaluation of the programme's effectiveness and scale-up is needed. Evidence of an intervention to train CHWs to support stroke survivors and family caregivers.

Evaluation of Clinical Characteristics and Comorbid Conditions in Pediatric Traumatic Spinal Cord Injury Patients.

Objective This study aimed to examine the demographic features and the most common comorbid conditions of pediatric traumatic spinal cord injury (SCI) patients who were admitted to Ankara Physical Therapy and Rehabilitation Training and Research Hospital'sinpatient rehabilitation program. Materials and methods The demographic features, clinical features and cormorbid conditions of 147 pediatric traumatic SCI patients (age of injury 17 and under) who received an inpatient rehabilitation program in the hospital between 2009-2017 were retrospectively examined. Patients were divided into three groups according to the lesion location (cervical, thoracic, and lumbar); and into two groups according to the age of completing the development of osteoligamentous structures in the vertebral column (group 1: ≤ 10 years and group 2: >10 years), and the evaluated data were compared. Results 73.5% of the patients were male, the average age of injury was 13.60 ± 4.19 years, and the average duration of the disease was 11.17 ± 20.80 months. The most common etiological reason was falls from height (34.7%), and the most common level of injury was the thoracic region (49%). The most common comorbid conditions after SCI were found to be neurogenic bladder (91.2%), spasticity (41.54%), and neuropathic pain (29.3%). It was determined that neurogenic bladder was seen less in the lumbar region (p<0.001). Urinary tract infection was found more in the cervical group (p=0.004). In Group 1 (0-10 years), the median disease duration was longer, and the rate of thoracic region injury and complete injury was higher (p<0.05); in Group 2 (11-17 years), the rate of having stabilization operation after the injury was significantly higher (p<0.001). Conclusion It is crucial to prevent the etiological reasons in pediatric traumatic SCI patients, to treat the arising comorbid conditions in the early period, to take protective measures, and to follow up the patients regularly when necessary.

The Effect of Bodyweight Support and Incline Running on Triceps Surae Electromyographic Activity

Body weight support (BWS) and incline running (IR) are commonly used either during rehabilitation or during training separately, with many positive effects on athletes’ performance and rehabilitation. The aim of the present study was to investigate the interaction between bodyweight support and incline running on the electromyographic activity of the triceps surae and compare it to flat running. In eighteen healthy men (age: 20.3 ± 1.2 years, body weight: 70.2 ± 4.8 kg, body height: 179.6 ± 5.4 cm), the changes in electromyographic activity (EMGA) during a 10 min run with BWS (15% or 30% of body weight; in different occasions) and IR at 7%, as well as jumping performance and gait spatiotemporal parameters, were evaluated. A lower Rating of Perceived Exertion and a significant decrease in the size of the Vastus Lateralis (VL) (33.4%), Soleus (SOL) (17%), and Gastrocnemius Lateralis (GL) EMGA (28.5%, p &lt; 0.05) but not in Gastrocnemius Medialis (GM) (10.5%, p &gt; 0.05), was observed during BWS30% at 7% slope compared to flat running. Also, low-frequency fatigue of the quadriceps was induced only after running without BWS on a 7% slope (p = 0.011). No changes were found in jumping performance (p = 0.246) and gait spatiotemporal parameters (p &gt; 0.05) except for flight time (p &lt; 0.006). In conclusion, running with a slope of 7% and 30% of BWS can result in EMG activity comparable to that observed during level running. This method can also be used in prevention and rehabilitation training programs without creating fatigue.