Rehabilitation Approaches Research Articles

The capability approach in rehabilitation: developing capability care

Purpose To develop a multidisciplinary outpatient rehabilitation intervention for people with neuromuscular diseases (NMD) based on the capability approach: capability care for persons with NMD. Materials and methods The development process is described using a framework of actions for intervention development. It has been an iterative process consisting of a design phase based on theoretical insights and project group discussions, and a refine phase involving input from relevant stakeholders. Results Multidisciplinary efforts have resulted in the development of capability care for rehabilitation of persons with NMD. It can focus both on facilitating and achieving functionings (beings and doings), as well as looking for alternative functionings that fulfil the same underlying value, thereby contributing to the persons’ well-being. To facilitate a conversation on broader aspects that impact on well-being, persons with NMD receive a preparation letter and healthcare professionals are provided with guiding questions and practical tools to use. Conclusions We have shown that it is possible to develop a healthcare intervention based on the capability approach. We hope that rehabilitation professionals will be encouraged to use capability care and that other medical professionals will be inspired to develop capability care in their respective fields. Registration Registered at trialregister.nl NL8946

Effect of duty cycle and frequency of pulse current on bidirectional electro-migration rehabilitation

In this paper, a new approach of bidirectional electro-migration rehabilitation (BIEM) using pulse currents was proposed. The effect of the duty cycle and frequency of the square wave pulse current on the BIEM was investigated. The results showed that the desalination efficiency was improved by 10 % with the decrease of duty ratio and frequency. Furthermore, With the increase of duty ratio and frequency, the hydrogen permeation of steel bars decreased by 28.5 %. More uniform desalination efficiency was obtained by using pulse current. The half-cell potential of the rebars was also measured and it was higher for the samples using pulse currents than for those using direct currents, indicating a lower risk of corrosion after pulse current treatment. The pH value of the concrete also increased during the BIEM process.

Comparative Effectiveness of Supervised and Home-Based Rehabilitation after Anterior Cruciate Ligament Reconstruction in Competitive Athletes.

Background: After the increasingly common anterior cruciate ligament reconstruction (ACLR) procedure in competitive athletes, rehabilitation is crucial for facilitating a timely return to sports (RTS) and preventing re-injury. This pilot study investigates the patient-reported outcomes of postoperative rehabilitation in competitive athletes, comparing supervised rehabilitation (SVR) and home-based rehabilitation (HBR). Methods: After ACLR, 60 (out of 74 screened) athletes were recruited and equally divided into HBR and SVR groups using non-probability convenience sampling, with each group comprising 15 males and 15 females. The rehabilitation outcomes in the respective groups were evaluated at 8 months using measures (Tegner Activity Scale [TAS], International Knee Documentation Committee subjective knee form [IKDC-SKF], ACL Return to Sport after Injury [ACL-RSI]) and objective parameters (isometric muscle strength, hamstring/quadricep asymmetry). RTS was evaluated at 9 months, with ACL re-injury rates recorded approximately 6 months post-RTS. Results: Both groups exhibited decreased TAS scores (HBR: 8 to 6, SVR: 8 to 7), with the SVR group demonstrating superior postoperative IKDC-SKF scores (81.82 vs. 68.43) and lower ACL-RSI scores (49.46 vs. 55.25). Isometric and isokinetic muscle strength, along with asymmetry values, was higher in the SVR group 8 months post-ACLR (p < 0.05). The SVR group showed a higher RTS rate to the same level (76.6% vs. 53.3%), while the re-injury rate was the same in both the rehabilitation groups (3.3%). Conclusions: Although both rehabilitation approaches yielded comparable outcomes, SVR may demonstrate some superior biomechanical improvements in athletes, resulting in a higher RTS rate. However, the psychological outcomes and re-injury rates did not significantly differ between the groups, emphasizing the need to address individual psychological needs during rehabilitation. Further investigation is recommended with a larger sample size to address the differences of gender among competitive athletes.

Myoelectric control and virtual reality to enhance motor rehabilitation after stroke.

Effective upper-limb rehabilitation for severely impaired stroke survivors is still missing. Recent studies endorse novel motor rehabilitation approaches such as robotic exoskeletons and virtual reality systems to restore the function of the paretic limb of stroke survivors. However, the optimal way to promote the functional reorganization of the central nervous system after a stroke has yet to be uncovered. Electromyographic (EMG) signals have been employed for prosthetic control, but their application to rehabilitation has been limited. Here we propose a novel approach to promote the reorganization of pathological muscle activation patterns and enhance upper-limb motor recovery in stroke survivors by using an EMG-controlled interface to provide personalized assistance while performing movements in virtual reality (VR). We suggest that altering the visual feedback to improve motor performance in VR, thereby reducing the effect of deviations of the actual, dysfunctional muscle patterns from the functional ones, will actively engage patients in motor learning and facilitate the restoration of functional muscle patterns. An EMG-controlled VR interface may facilitate effective rehabilitation by targeting specific changes in the structure of muscle synergies and in their activations that emerged after a stroke-offering the possibility to provide rehabilitation therapies addressing specific individual impairments.

The effects of vibrating shoe insoles on standing balance, walking, and ankle-foot muscle activity in adults with diabetic peripheral neuropathy

BackgroundPeripheral neuropathy is one of the most common complications of type 2 diabetes, which can lead to impaired balance and walking. Innovative footwear devices designed to stimulate foot sensory receptors, such as vibrating insoles, could offer a new route to improve motor impairments in people with diabetic peripheral neuropathy (DPN). Research questionDoes wearing vibrating insoles for the first time alter measures of balance, walking, and ankle-foot muscle activity, in people with DPN? MethodsA randomised cross-over study was conducted with 18 ambulant men and women with a diagnosis of DPN. Participants performed tests of standing balance (Bertec® force platform) under four conditions (foam/firm surface, eyes open/closed) and level-ground walking (GAITRite® instrumented walkway), whilst wearing vibrating and non-vibrating (control) insoles on two separate occasions (one insole/session). Electromyography (EMG) was used to assess soleus, medial gastrocnemius, tibialis anterior, peroneus longus activity during balance tests. Outcomes included centre of pressure (CoP) sway, EMG amplitude, spatiotemporal gait patterns, and Timed Up and Go test. One sample t-tests were used to explore %differences in outcomes between insole conditions. ResultsWearing vibrating insoles led to a reduction (improvement) in CoP elliptical area, when standing on a foam surface with eyes closed, relative to non-vibrating insoles (P=0.03). Applying perceptible vibrations to the soles of the feet also reduced the EMG amplitude in soleus (P=0.01 and P=0.04) and medial gastrocnemius (P=0.03 and P=0.09) when standing with eyes closed on firm and foam surfaces. SignificanceOur findings of signs of improved balance and altered muscle activity with suprasensory vibrating insoles provides new insights into how these devices can be used to inform innovative rehabilitation approaches in individuals with DPN. This will be strengthened by further research into possible clinical benefits of these devices – given that the effects we detected were small with uncertain clinical meaning.

Efficacy of Rehabilitative Techniques on Pain Relief in Patients With Vulvodynia: A Systematic Review and Meta-Analysis.

Vulvodynia is a chronic clinical condition characterized by provoked or non-provoked vulvar pain for at least 3months of unknown etiology. The onset of vulvodynia involves a complex interplay of peripheral and central pain mechanisms, such as pelvic floor muscle and autonomic dysfunction, and interpersonal factors. A stepwise approach of pelvic floor physical therapy as medical management is suggested. In this scenario, by this meta-analysis of randomized controlled trials, we aimed to evaluate the efficacy of rehabilitation interventions in patients with vulvodynia. On October 13, 2022, PubMed, Scopus, and Web of Science were systematically searched for randomized controlled trials that assessed the efficacy of the rehabilitative approach to pain during intercourse in patients with vulvodynia. The quality assessment was performed with the Cochrane risk-of-bias tool for randomized trials. The trial registration number is CRD42021257449. At the end of the search, 9 studies were included for a total of 332 patients. A pairwise meta-analysis was performed to highlight the efficacy of rehabilitative approaches for reducing pain during intercourse, as measured with a visual analog scale or a numerical rating scale. Meta-analysis showed that all these rehabilitative approaches had an overall effect size of -1.43 (95% CI = -2.69to -0.17) in decreasing vulvodynia pain in terms of the visual analog scale. In the subgroup analysis, a significant effect size in acupuncture (effect size = -2.36; 95% CI = -3.83 to -0.89) and extracorporeal shockwave therapy (effect size = -2.94; 95% CI = -4.31 to -1.57; I2= 58%) was observed. According to the Cochrane risk-of-bias tool, a low risk of bias for outcome selection in 89% of studies. Findings from this meta-analysis suggested that the physical agent modalities and complementary medicine techniques in people with vulvodynia appear to be more effective than placebo, sham, or waiting list. Further evidence on physical agent modalities and complementary therapies are warranted in the future. This was the first systematic review and meta-analysis of randomized controlled trials to provide evidence on the efficacy of rehabilitation interventions in patients with vulvodynia.

Injuries and Persistent Pain in Elite Adolescent Archery Athletes: A Cross-Sectional Epidemiological Study.

This cross-sectional epidemiological study aimed to evaluate the prevalence of injuries among young archers engaged in high-intensity training during the European Youth Championship. A total of 200 participants (104 males/96 females) from 34 countries were included, with a mean age of 16.9 years and average competitive experience of 6.5 years. Structured questionnaires, administered by four physiotherapist interviewers, gathered comprehensive data. Results revealed that 43.5% of participants experienced shoulder pain during training, highlighting the vulnerability of upper limbs in archers. Additionally, 30% required medications to facilitate training, underscoring the impact of injuries on continued participation. Physiotherapy was utilized by 52.3% of participants, emphasizing the need for therapeutic intervention. Furthermore, 31.8% had to cease training due to injuries, indicating a substantial hindrance to athletic progression. The mean pain duration was 3.9 months, with an average intensity of 5.94, and 8% exhibited symptoms of central sensitization. In conclusion, this study demonstrates a noteworthy prevalence of injuries, particularly in the upper limbs, among young archers undergoing intensive training. The findings underscore the importance of targeted injury prevention strategies and comprehensive rehabilitation approaches to ensure the well-being and sustained participation of young athletes in competitive archery.

Localizing apraxia in corticobasal syndrome: a morphometric MRI study.

Apraxia localization has relied on voxel-based, lesion-symptom mapping studies in left hemisphere stroke patients. Studies on the neural substrates of different manifestations of apraxia in neurodegenerative disorders are scarce. The primary aim of this study was to look into the neural substrates of different manifestations of apraxia in a cohort of corticobasal syndrome patients (CBS) by use of cortical thickness. Twenty-six CBS patients were included in this cross-sectional study. The Goldenberg apraxia test (GAT) was applied. 3D-T1-weighted images were analyzed via the automated recon-all Freesurfer version 6.0 pipeline. Vertex-based multivariate General Linear Model analysis was applied to correlate GAT scores with cortical thickness. Deficits in imitation of meaningless gestures correlated with bilateral superior parietal atrophy, extending to the angular and supramarginal gyri, particularly on the left. Finger imitation relied predominantly on superior parietal lobes, whereas the left angular and supramarginal gyri, in addition to superior parietal lobes, were critical for hand imitation. The widespread bilateral clusters of atrophy in CBS related to apraxia indicate different pathophysiological mechanisms mediating praxis in neurodegenerative disorders compared to vascular lesions, with implications both for our understanding of praxis and for the rehabilitation approaches of patients with apraxia.

파킨슨병 환자들의 행동학적 기침재활: 주제범위 문헌고찰

Airway protective behaviors including both swallowing and cough are highly interrelated and share sensorimotor control. However, the majority of airway protective rehabilitation has predominantly focused on swallowing function. The aim of this scoping review was to explore the latest evidence on the effects of cough rehabilitation in patients with Parkinson's disease (PD) in order to improve clinical decision-making. A comprehensive search was conducted for articles published in English from January 2013 to March 2023 in PubMed, Embase, and Web of Science. The search was performed using the terms ‘Parkinson's disease’ combined with ‘cough rehabilitation.’ Initial selection was followed by a review of titles, abstracts and/or full texts to exclude irrelevant literature. The final selection included only those articles that focused on behavioral interventions for cough rehabilitation carried out by speech-language pathologists. Among the eight selected articles, four current therapeutic approaches for cough rehabilitation were identified: respiratory muscle strength training (5 studies), Lee Silverman Voice Treatment (LSVT LOUD®) (1 study), respiratory-swallow coordination training (1 study), and sensorimotor training for airway protection (1 study). The review revealed that existing behavioral interventions for cough rehabilitation in PD were effective. Notably, there is an increasing focus on enhancing overall upper airway functions and augmenting sensory perception as well as strengthening muscles for airway protection through cough rehabilitation. Future research would be crucial to facilitate conclusive decision-making for airway protection in clinical environments.

Comparative Effects of Kabat Rehabilitation and Kinesiotaping on Functional Disability, Synkinesis and Patient Satisfaction in Patients with Bell’s Palsy

Comparative Effects of Kabat Rehabilitation and Kinesiotaping on Functional Disability, Synkinesis and Patient Satisfaction in Patients with Bell’s Palsy

Youth mentoring: A new holistic intervention targeting the needs of young persons with acquired brain injury

Introduction: Holistic rehabilitation approaches addressing the numerous complex challenges in young persons with acquired brain injury are required. The purpose of this study was to describe and evaluate the holistic person-centered youth mentoring intervention program, which is based on occupational therapy. Methods: Prospectively collected data were extracted from a national clinical quality database ( n = 59). Proportions of young persons receiving different aspects of support and proportions rating the intervention as meaningful were calculated. One-year changes in occupation, work ability, and social interactions were calculated. Results: The young persons most frequently received support for energy management (75%) and structuring of everyday life (61%). Seventy-three percent rated the intervention as meaningful. One year post-inclusion, occupation and work ability had increased by 35% and 58%, respectively, and it had declined by 10% and 26%, respectively. The 1-year increase and decrease in social interactions were less clear (15% and 25%, respectively). One-year changes did not differ between those who entered the program early or late after injury indicating the potential beneficial effect of the program. Conclusion: The findings could indicate that the program has a unique value in supporting young persons with acquired brain injury to create a meaningful everyday life through occupation, work ability, and social interaction.

Effect of Constraint-Induced Movement Therapy (CIMT) on Upper Extremity Function in Stroke Patients

Background: Stroke is a leading cause of disability worldwide, with upper extremity impairments presenting significant rehabilitation challenges. Constraint-Induced Movement Therapy (CIMT) has emerged as a potential intervention for enhancing upper limb functionality, but its efficacy compared to traditional therapy methods requires further exploration. Objective: The study aimed to evaluate the effectiveness of CIMT versus traditional therapy in improving upper extremity function among stroke survivors. Methods: In this quasi-experimental study, 58 stroke patients from Aziz Fatima and Allied Hospital in Faisalabad were recruited and allocated to either the CIMT group (n=29) or the traditional therapy group (n=29). Eligible participants were those aged 30-50 years with ischemic or infarctive stroke and impaired use of their hemiparetic arm. The CIMT group received standard treatment plus CIMT, while the traditional group received only standard treatment, including manual therapy and TENS, for 8 weeks. Pre- and post-treatment assessments utilized the Upper Extremity Motor Activity Log (UEMAL) scales. Data analysis was conducted using SPSS version 25, employing independent t-tests. Results: The CIMT group showed a significant improvement in the UEMAL Amount Scale (pre-treatment: 1.64 ± 0.51, post-treatment: 3.04 ± 0.75; p=0.000) and the UEMAL How Well Scale (pre-treatment: 2.28 ± 0.57, post-treatment: 3.81 ± 0.55; p=0.000). The traditional therapy group also demonstrated gains but to a lesser extent (UEMAL Amount Scale pre-treatment: 1.08 ± 0.24, post-treatment: 1.69 ± 0.33; UEMAL How Well Scale pre-treatment: 1.47 ± 0.30, post-treatment: 2.11 ± 0.40; p=0.000 for both). Conclusion: CIMT provided significant functional improvements in upper extremity motor activity compared to traditional therapy, suggesting that CIMT may be a more effective approach for post-stroke rehabilitation of the upper limb.

Computer-Assisted Rehabilitation Shows Greater Efficacy Than Traditional in Visuospatial Skills and Cognition in Neglect Patients

This study is crucial for improving unilateral spatial neglect (USN) treatments, focusing on comparing the effectiveness of computer-assisted cognitive rehabilitation (CACR) against conventional rehabilitation (CR) methods. It aimed to address a significant research gap and improve patient outcomes by evaluating the impact of CACR versus CR on visuospatial perception, visual field and attention, and visual memory in patients with USN. This study was a randomized controlled trial. Forty-five consecutive patients with USN from a university rehabilitation center were divided into two groups: 22 patients received CACR with Rehacom software, focusing on saccadic eye movement, visual field, and visual-motor coordination, while 23 underwent CR that combined hemispheric activation approach, mental imagery training, and vibration therapy. Assessments included the Motor-Free Visual Perception Test (MVPT), Line Bisection Test (LBT), Visual Span Test (VST), and Visual Recognition Test (VRT). The study employed ANCOVA and effect size calculations to evaluate the effectiveness of CACR compared to CR in treating patients with USN. Results indicated that CACR significantly outperformed CR in improving visuospatial perception, visual field, attention, and memory, showcasing its effectiveness in treating USN. These findings demonstrate the superiority of CACR over CR, particularly in enhancing visual memory and attention, as evidenced by the large effect size in VRT and moderate effects in LBT and VST. This suggests CACR's potential as a more effective approach for rehabilitation in patients with USN due to brain injuries.

Remedying The Consequences of Burn Injuries to The Upper Limbs

The effectiveness of a comprehensive treatment and rehabilitation approach for post-burn and mechanical injuries to the upper extremities has been confirmed through the analysis of both immediate and long-term outcomes. The strategy, involving scar correction surgeries, autodermotransplantation, and physiotherapy, has yielded successful and sustainable results. Patients facing scar contractures and trophic impairments have regained mobility and improved their quality of life, underscoring the efficacy of our treatment approach

Effectiveness of physical therapy on physical activity and employment status in kidney transplant recipients in their sixties: a case report with literature review

BackgroundFew reports have been published on preoperative and long-term postoperative rehabilitation after kidney transplantation. Poor physical function after kidney transplantation is associated with adverse events; hence, physical function should be improved postoperatively. We report a case in which physical therapy was provided just before the operation and 12 months postoperatively to improve physical performance.Case presentationA 64-year-old man, working as a janitor and maintenance worker at a driving school, received a living-donor kidney transplant from his wife. The just before the operation assessment revealed a decline in his physical function, indicating he had become frail. Accordingly, physical therapy was initiated prior to kidney transplantation. Subsequently, his Short Physical Performance Battery score improved from 10 to 12, and his knee extension muscle strength improved from 0.38 to 0.43 kgf/kg, enabling him to resume work. The work functioning impairment scale improved from 13 to 7.ConclusionsThis case reveals that just before the operation and long-term rehabilitation is crucial in enhancing physical activity in kidney transplantation patients. Although this focused rehabilitation approach holds promise, evaluating its efficacy requires the examination of a larger cohort of cases.

Islamic Coping, Post Traumatic Stress Disorder (PTSD) and Islam Oriented Trauma Focused Cognitive Behavioral Therapy (IO-TF-CBT) in Post-Kahramanmaraş Earthquake Period

The Great Southeast Turkey Earthquakes (GSTE) of February 2023 were not only a physical disaster but also seem to have triggered the onset of Post-Traumatic Stress Disorder (PTSD) among survivors in Kahramanmaraş and surrounding areas. This review emphasizes the need for culturally appropriate clinical interventions in PTSD therapies, addressing the psychological impacts left by the earthquakes. The Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) models implemented after the 1999 Marmara earthquake failed to integrate cultural and Islamic thoughts effectively. With this critical perspective, the article advocates for a holistic healing process that integrates Islamic coping mechanisms with clinical psychology. The importance of religious and spiritual practices in PTSD recovery, especially reliance on Allah, patience, the concept of ummah, prayer, almsgiving, and belief in destiny, is highlighted. While analyzing the potential effectiveness of Islamic approaches in PTSD rehabilitation, the study criticizes the inadequacies of current clinical practices and advocates for the adoption of faith-integrated therapeutic strategies. It proposes a structured methodology for Islamic-Oriented TF-CBT that integrates spiritual practices with scientifically supported psychological interventions, highlighting the gaps in current practices. The aim is to bridge the gap between Islamic practices and clinical psychology, offering a treatment approach compatible with the religious values and traditions of the Muslim population affected by the GSTE. This critical perspective strengthens the call for progress towards cultural competency in mental health services, ensuring that PTSD treatments adapt to the diversity and complexity of earthquake victims. The article emphasizes the need to comprehensively address the psychological needs of individuals affected by the GSTE, particularly those battling PTSD. Recognizing PTSD as not only an individual disorder but also a societal issue, the study suggests that treatment processes should consider not only the individual but also the community. The importance of community-based interventions is highlighted, discussing the current shortcomings and areas for development in this field. In conclusion, the article underscores the significance of cultural sensitivity and community-based approaches in PTSD treatment, calling for more research and implementation in this area.

Enhancing Community Resilience: An Integrated Home-based Psychological Intervention for Individuals Living with Physical Disabilities

Individuals living with physical disabilities more likely develop psychological problems and less able to seek appropriate care for their issues as compared with the individuals living without disability. This study aimed to assess the effectiveness of an integrated home-based psychological intervention in managing psychological problems among individuals living with disabilities. For the purpose, a total of 60 participants were enrolled from the Community-Based Rehabilitation (CBR) program at Aid to Leprosy Patients (ALP) in Rawalpindi Pakistan between November 2021 and July 2022. These participants received comprehensive rehabilitation services alongside a structured psychological intervention. The duration of the study was 5 months including the follow up sessions. Significant improvements observed from pre-treatment to post-treatment. The main effect for psychosocial disabilities was (F = 116.93, p&lt;.001), emotional problems (F = 116.93, p&lt;.001), Depression (F = 117.30, p&lt;.001), Anxiety (F = 150.02, p&lt;.001) and Stress (F = 93.36, p&lt;.001). The integrated home-based psychological intervention served as an effective rehabilitation approach for individuals with physical disabilities, particularly those previously unable to reintegrate into community life.

Transforming Rehabilitation for Scapular Dyskinesia: The role of Modified Robbery Exercises in enhancing Muscle Function, reducing Disability, and improving Quality of Life

Background: Scapular dyskinesia affects shoulder function, with significant implications for individuals, especially athletes. Rehabilitation approaches, including modified robbery exercises, aim to address this by improving scapular kinematics and muscle function. This study evaluates the effectiveness of modified robbery exercises supplemented with electromyography (EMG) biofeedback on muscle activation patterns and functional outcomes in individuals with scapular dyskinesia. Methods: A randomized controlled trial was conducted with 40 participants (20 in the control group receiving modified robbery exercises and ergonomic training, and 20 in the experimental group receiving modified robbery exercises with EMG biofeedback). Both interventions lasted 6 weeks, with sessions three times per week. Outcome measures included pain levels (Visual Analog Scale), muscle activation (EMG), functional disability (DASH questionnaire), and health-related quality of life (EQ-5D index and VAS). Independent samples t-tests were used to compare baseline and post-intervention differences between groups. Results: Post-intervention, the experimental group demonstrated significantly greater improvements in muscle activation for the Serratus Anterior, Upper Trapezius, and Lower Trapezius (p&lt;0.001 for SA), indicating the benefit of EMG biofeedback. Both groups experienced pain reduction and functional improvements; however, the experimental group showed a more pronounced decrease in DASH scores (p=0.002) and a notable improvement in EQ-5D Index scores (p=0.008), pointing to enhanced functional outcomes and quality of life. Conclusions: Modified robbery exercises with EMG biofeedback are more effective than traditional exercises alone in improving muscle activation, reducing functional disability, and enhancing the quality of life in individuals with scapular dyskinesia. This study supports the integration of EMG biofeedback into rehabilitation programs for scapular dyskinesia, offering a promising approach for clinicians aiming to optimize recovery outcomes.

Abstract P353: Effect of Exergaming-Based Dance Training Paradigm in Improving Cardiovascular Function and Functional Mobility Among People With Chronic Stroke

Background: Dance-based exergaming (DBExG) , could potentially facilitate cardiovascular conditioning and functional mobility while enhancing physical activity behavior among people with chronic stroke (PwCS). Albeit, PwCS exhibits limitations (e.g., health care, and travel) in laboratory/outpatient rehabilitation programs, making them inaccessible. The DBExG from the laboratory (phase 1) to a safe and feasible home-based exercise program (phase 2) could effectively improve cardiovascular and functional mobility and address the accessibility limitations. Aim: To evaluate the feasibility, effect, and adherence of DBExG in promoting heart rate variability (HRV) and functional mobility in a laboratory and home-based rehabilitation approach. Design: Pre-post interventional study. Setting: Laboratory (phase 1) and home-based (phase 2) settings. Methods: Community-dwelling PwCS (n=10) participated in the study and received DBExG training using the commercially available Kinect dance gaming “Just Dance 3”. The first 6 weeks of training were provided in the laboratory setting and were delivered in a high-intensity tapering method with the first two weeks consisting of 5 sessions/week, the next two weeks of 3 sessions/week, and the last two weeks of 2 sessions/week, with a total of 20 sessions. Followed by 4 more weeks of DBExG training in the participant’s house (3 days/week), with a total of 12 sessions. Feasibility was addressed by acceptability and retention. Data obtained for HRV analysis pre- and post-intervention consists of HRV for ten minutes in (1) supine resting position; and (2) quiet standing. High-frequency (HF) power measures as indicators of cardiac parasympathetic activity, low-frequency (LF) power of parasympathetic-sympathetic balance, and LF/HF of sympatho-vagal balance were calculated. Six-minute walk test (6-MWT) was used to assess functional mobility. Changes in physical activity during pre- and post-intervention for one week and also during dance training were assessed using Fibit. Results: All participants completed the laboratory and home-based DBExG. All participants reported enjoying the sessions and most felt they were beneficial. Study retention and session adherence was 90% and 96%, in phase 1, and 2 respectively. There were no falls, or adverse safety events reported in either phase of the study. The results showed improvements in HRV HF, LF, and LF/HF. The result findings indicated significant improvement in the 6-MWT. The number of steps during dance intervention increased significantly from 1 st to the 32 nd session. Conclusions: A combination of laboratory, transitioned to home-based maintenance therapy approach appears feasible, safe, and effective thus promising for post-stroke rehabilitation. A larger randomized controlled trial is recommended to further investigate efficacy.

Quantification of the Improvement in Sustainability after a Comparative Experimental Study of Single-Family Homes with Façade Rehabilitation Using the External Thermal Insulation Composite System

This study emerged from the necessity to analyze the most effective energy-saving strategies within the current real estate market and substantiate their application with empirical data. Undoubtedly, the adoption of External Thermal Insulation Composite Systems (ETICSs) stands out as one of the prevalent approaches. This article presents temperature-monitoring data collected on-site from the facades of two single-family homes initially constructed with identical compositions, materials, construction dates, locations, and orientations. The thermal envelope of one home underwent rehabilitation using the ETICS, while the other remained in its original state. Continuous temperature recordings on the southern and northwestern facades of both homes were conducted using thermocouples over a 15-day period. The data analysis yielded insights into facade performance before and after this rehabilitation approach. The findings suggest that the implementation of ETICS results in more stable interior temperatures, significantly reducing indoor temperatures in comparison to outdoor conditions, leading to a notable decrease in heat energy loss. Consequently, this research underscores the tangible benefits of employing ETICS in building rehabilitation, emphasizing its role as a passive energy-saving strategy. By demonstrating the positive impact on thermal performance and energy efficiency, this study reinforces the vital connection between research endeavors and sustainability objectives.