Sensorimotor Training Research Articles

Efficiency of occlusal splint therapy on orofacial muscle pain reduction: a systematic review

BackgroundThis systematic review aims to examine the existing original studies to determine the effectiveness of occlusal splints (OSs) in the management of orofacial myalgia and myofascial pain (MP) in comparison with no treatment or other interventions.Materials and methodsBased on the inclusion and exclusion criteria of this systematic review, randomized controlled trials were qualified, in which the effectiveness of occlusal splint therapy in the management of muscle pain was examined in comparison with no treatment or other interventions. This systematic review was conducted according to the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analysis 2020. The authors searched three databases (PubMed, CINAHL (The Cumulative Index to Nursing and Allied Health Literature) and Scopus) for English publications published between January 1, 2010, and June 1, 2022. The last database search was carried out on June 4, 2022. Data were extracted from the included studies and assessed for risk of bias using the revised Cochrane risk-of-bias tool for randomized trials.ResultsThirteen studies were identified for inclusion in this review. In total, 589 patients were diagnosed with orofacial muscle pain who underwent education and various forms of therapy including different types of OSs, light emitting diode therapy, acupuncture, low-level laser therapy, device-supported sensorimotor training, Kinesio Taping, myofunctional therapy, and physical therapy. All studies included demonstrated a high risk of bias.ConclusionsThere is insufficient evidence regarding whether OS therapy in the treatment of orofacial myalgia and MP offers an advantage over other forms of interventions or no treatment. Further reliable clinical studies in this area are needed to improve the quality of research, which should be performed with larger groups of blinded respondents and controls.Clinical relevanceDue to the large-scale nature of orofacial muscle pain, it is assumed that each dental clinician will meet patients with orofacial muscle pain repeatedly in daily practice; hence, the review of the effectiveness of OSs in the management of orofacial myalgia and MP is necessary.

Comparative effectiveness of different types of exercise in reducing arterial stiffness in children and adolescents: a systematic review and network meta-analysis

ObjectiveArterial stiffness is an early and detectable marker of vascular changes leading to atherosclerotic cardiovascular disease (ACVD). Our objective was to compare the effectiveness of different types of exercise in...

Effectiveness of the SMART training intervention on ankle joint function in patients with first-time acute lateral ankle sprain: study protocol for a randomized controlled trial

BackgroundThe lateral ankle sprain (LAS) is the most common injury in the field of everyday and sports-related activities. There is a high rate of patients with LAS who will develop chronic ankle instability (CAI). A possible explanation for this high rate is an insufficient rehabilitation and/or a premature return to intense exercise and workloads. Currently, there are general rehabilitation guidelines for LAS but there is a lack of standardized evidenced-based rehabilitation concepts for LAS, which effectively reduce the high CAI rate. The primary aim of the study is to investigate the effectiveness of a 6-week sensorimotor training intervention (SMART-Treatment, SMART) in contrast to standard therapy (Normal Treatment, NORMT) after an acute LAS on perceived ankle joint function.MethodsThis study will be a prospective, single-center, interventional randomized controlled trial with an active control group. Patients (14–41 years) with an acute LAS and a MRI confirmed lesion or rupture of at least one ankle ligament will be included. Exclusion criteria are acute concomitant injuries of the ankle, pre-injuries of the ankle, serious lower-extremity injuries of the last 6 months, lower-extremity surgery, and neurological diseases. The primary outcome measure will be the Cumberland Ankle Instability Tool (CAIT). Secondary outcomes include the Foot and Ankle Ability Measurement (FAAM), isokinetic and isometric strength diagnostics, joint repositioning sense, range of motion, measurements of postural control, gait and run analysis, and jump analysis. This protocol will follow the SPIRIT guidance.DiscussionCurrent management of LAS rehabilitation lacks since there is a high rate of patients developing a CAI. It has been shown that exercise therapy improves ankle function in acute LAS as well as in patients with CAI. It is further recommended to address specific impairment domains in ankle rehabilitation. However, empirical data for such a holistic treatment algorithm is missing. Therefore, this study has the potential to improve the healthcare for LAS patients and might be used for a future standardized evidence-based rehabilitation concept.Trial registration“Prospectively registered” ISRCTN – ISRCTN13640422 17/11/2021; DRKS (German Clinical Trials Register) – DRKS00026049.

Specific exercise is medicine – Preventing and treating a peripheral neuropathy

Introduction
 Neuropathies are a prevalent, heterogeneous group of diseases of the peripheral nervous system. Symptoms are often debilitating, difficult to treat, and usually become chronic. Not only do they diminish patients’ quality of life, but they can also affect medical therapy and lead to complications. To date, for most conditions there are no evidence-based causal treatment options available. Specific exercise interventions have proven beneficial to reduce and even prevent a neuropathy.
 Objective
 Our objective in a systematic review with meta-analysis was to analyze exercise interventions for neuropathic patients in order to evaluate the potential benefits of exercise on neuropathies of different origin that can then be translated into practice.
 Methods
 Two independent reviewers performed a systematic review with meta-analysis according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Inclusion criteria according to the PICOS approach were: neuropathic patients, exercise interventions only, an inactive or non-exercising control group, and solely randomized controlled trials with the following outcome parameters: neuropathic symptoms, balance parameters, functional mobility, gait, health-related quality of life, and HbA1c (glycated hemoglobin).
 Results
 A total of 41 randomized, controlled trials met all inclusion criteria, 20 could be included in the quantitative analysis. Study quality varied from moderate to high. Current data further support the hypothesis that exercise is beneficial for neuropathic patients. This is best documented for patients with diabetic peripheral neuropathy (DPN; 27 studies) as well as for chemotherapy-induced peripheral neuropathy (CIPN; nine studies), while there are only few studies (five) on all other causes of neuropathy. We found standardized mean differences in favor of the exercise group of 0.27–2.00 for static balance, Berg Balance Scale, Timed-up-and-go-test, nerve conduction velocity of peroneal and sural nerve as well as for HbA1c in patients with DPN, and standardized mean differences of 0.43–0.75 for static balance, quality of life, and neuropathy-induced symptoms in patients with CIPN.
 Conclusion
 For DPN, evidence-based recommendations can now be made, suggesting a combination of endurance and sensorimotor training to be most beneficial. For patients with CIPN, sensorimotor training remains the most crucial component. For all other neuropathies, more high-quality research is needed to derive evidence-based recommendations. Overall, it seems that sensorimotor training has great potential to target most neuropathies and combined with endurance training is therefore currently the best treatment option for neuropathies.

Extensive Sensorimotor Training Predetermines Central Pain Changes During the Development of Prolonged Muscle Pain

Repetitive movements (RM) are a main risk factor for musculoskeletal pain, which is partly explained by the overloading of musculoskeletal structures. However, RM may also drive brain plasticity, leading to maladaptive changes in sensorimotor areas and altered pain processing. This study aimed to understand whether individuals performing extensive RM (musicians) exhibit altered brain processing to prolonged experimental muscle pain. Nineteen healthy musicians and 20 healthy nontrained controls attended 3 sessions (Day 1–Day 3–Day 8). In each session, event-related potentials (ERPs) to non-nociceptive superficial and nociceptive intraepidermal electrical stimulation, reaction times, electrical detection thresholds, and pressure pain thresholds (PPTs) were recorded. In all participants, prolonged muscle pain was induced by intramuscular injection of nerve growth factor (NGF) into the right first dorsal interosseous muscle at the end of Day1. Pain intensity was assessed on a numerical rating scale (NRS) and was lower in musicians compared to non-musicians (P < .007). Moreover, in musicians, the higher amount of weekly training was associated with lower NRS pain scores on Day 3 to Day 8 (P < .037). Compared with Day1, NGF reduced PPTs on Day 3 to Day 8 (P < .001) and non-nociceptive P200 and P300 ERP amplitudes on Day 8 (P < .044) in both groups. Musicians compared to controls showed secondary hyperalgesia to electrical stimulation on Day 3 to Day 8 (P < .004) and reduced nociceptive P200 ERP amplitudes on Day 8 (P < .005). Across participants, ERP components correlated with pain detection reaction times, sensitivity (PPTs and electrical detection thresholds), and severity (NRS), (all P < .043). These results show that repetitive sensorimotor training leads to brain changes in the processing of prolonged pain, biasing the cortical response to nociceptive inputs. PerspectiveRepetitive sensorimotor training may increase the responsiveness of nociceptive inputs during the development of prolonged muscle pain. These novel data highlight the role of repetitive sensorimotor practice as a source for interindividual variability in central pain processing.

Tactile sensorimotor training does not alter short- and long-latency afferent inhibition.

Sensorimotor integration refers to the process of combining incoming sensory information with outgoing motor commands to control movement. Short-latency afferent inhibition (SAI), and long-latency afferent inhibition (LAI) are neurophysiological measures of sensorimotor integration collected using transcranial magnetic stimulation. No studies to date have investigated the influence of tactile discrimination training on these measures. This study aimed to determine whether SAI and LAI are modulated following training on a custom-designed tactile discrimination maze task. Participants performed a 'high difficulty' and 'low difficulty' maze training condition on separate visits. On an additional visit, no maze training was performed to serve as a control condition. Despite evidence of performance improvements during training, there were no significant changes in SAI or LAI following training in either condition. The total number of errors during maze training was significantly greater in the high-difficulty condition compared with the low-difficulty condition. These findings suggest that sensorimotor maze training for 30 min is insufficient to modify the magnitude of SAI and LAI.

Bone marrow mesenchymal stem cells and exercise restore motor function following spinal cord injury by activating PI3K/AKT/mTOR pathway. Neural Regen Res. 2023 May;18(5)1067–1075

Despite the fact that a number of therapeutic modalities have shown promise in the treatment of spinal cord injury (SCI), focusing solely on one aspect of recovery will not lead to successful and useful regeneration in people. The current study targets an integrated approach of neuroprotection and rehabilitation strategies to treat spinal cord injury, increasing nerve regeneration and functional recovery through functional sensorimotor training and cell transplantation. Sun et al., 2022 investigated the synergistic effect of exercise training and bone marrow mesenchymal stem cell transplantation which could promote active recovery in a mice model of thoracic contusive spinal cord injury.

A Microcontroller-Based Platform for Cognitive Tracking of Sensorimotor Training

A Microcontroller-Based Platform for Cognitive Tracking of Sensorimotor Training

Bone marrow mesenchymal stem cells and exercise restore motor function following spinal cord injury by activating PI3K/AKT/mTOR pathway.

Although many therapeutic interventions have shown promise in treating spinal cord injury, focusing on a single aspect of repair cannot achieve successful and functional regeneration in patients following spinal cord injury . In this study, we applied a combinatorial approach for treating spinal cord injury involving neuroprotection and rehabilitation, exploiting cell transplantation and functional sensorimotor training to promote nerve regeneration and functional recovery. Here, we used a mouse model of thoracic contusive spinal cord injury to investigate whether the combination of bone marrow mesenchymal stem cell transplantation and exercise training has a synergistic effect on functional restoration. Locomotor function was evaluated by the Basso Mouse Scale, horizontal ladder test, and footprint analysis. Magnetic resonance imaging, histological examination, transmission electron microscopy observation, immunofluorescence staining, and western blotting were performed 8 weeks after spinal cord injury to further explore the potential mechanism behind the synergistic repair effect. In vivo, the combination of bone marrow mesenchymal stem cell transplantation and exercise showed a better therapeutic effect on motor function than the single treatments. Further investigations revealed that the combination of bone marrow mesenchymal stem cell transplantation and exercise markedly reduced fibrotic scar tissue, protected neurons, and promoted axon and myelin protection. Additionally, the synergistic effects of bone marrow mesenchymal stem cell transplantation and exercise on spinal cord injury recovery occurred via the PI3K/AKT/mTOR pathway. In vitro, experimental evidence from the PC12 cell line and primary cortical neuron culture also demonstrated that blocking of the PI3K/AKT/mTOR pathway would aggravate neuronal damage. Thus, bone marrow mesenchymal stem cell transplantation combined with exercise training can effectively restore motor function after spinal cord injury by activating the PI3K/AKT/mTOR pathway.

ОЦЕНКА ФУНКЦИОНАЛЬНЫХ ВОЗМОЖНОСТЕЙ ЭКИПАЖА ПРИ ВЫПОЛНЕНИИ ВНЕКОРАБЕЛЬНОЙ ДЕЯТЕЛЬНОСТИ ПОСЛЕ ДЛИТЕЛЬНОЙ ИЗОЛЯЦИИ В НАЗЕМНОЙ МОДЕЛИ КОСМИЧЕСКОЙ СТАНЦИИ

During interplanetary expeditions, the crew must adapt not only to gravity transitions but also to long-term stay in a limited space of a space station. In such conditions, it develops a significant decrease in motor activity and the formation of a special stereotype of movements in these conditions. Within further planning of ground-based and real interplanetary missions, it is appropriate to assess the impact of these factors on the crew's functional condition, including when modeling lunar gravity using suspension and virtual reality (VR) technologies. The purpose was to determine the functional capabilities of 5 members of the international crew of the 240-day SIRIUS-21 isolation experiment when performing an extravehicular activity (EVA) after 4 and 6 months of isolation in the hermetic facility. During EVA, the crew performed basic motor tasks using VR on an uneven surface: positional tests, voluntary and tandem walking, walking when avoiding and stepping over obstacles, and verticalization from lying and standing on one knee positions. In addition, the EVA scenario included the tasks of controlling the rover while the hands unloading, as well as moving on a sliding surface in a VR environment when the body lunar vertical unloading. In this study, we presented results of qualitative and quantitative analysis of video recording data and qualitative analysis of the electromyographic activity of the muscles of the lower extremities. The results indicate a sufficient level of functional performance of SIRIUS-21 crew members – all the EVA tasks were completed by the crew in full, while no cases of significant loss of balance and signs of pronounced locomotor and vestibular disorders were registered. At the same time, this paper highlights some features of the crew's EVA performance – the effects of sensorimotor training on some tasks with repeated EVA experience, the most common errors, and difficulties in performing the tasks of the EVA scenario.

Extensive sensorimotor training enhances nociceptive cortical responses in healthy individuals.

Prolonged and repeated sensorimotor training is a crucial driver for promoting use-dependent plasticity, but also a main risk factor for developing musculoskeletal pain syndromes, yet the neural underpinnings that link repetitive movements to abnormal pain processing are unknown. Twenty healthy musicians, one of the best in vivo models to study use-dependent plasticity, and 20 healthy non-musicians were recruited. Perceptual thresholds, reaction times (RTs) and event-related potentials (ERPs) were recorded using nociceptive intra-epidermal and non-nociceptive transcutaneous electrical stimulation. In response to comparable stimulus intensities, musicians compared to non-musicians showed larger non-nociceptive N140 (associated with higher activation of regions within the salience network), higher nociceptive N200 ERPs (associated with higher activation of regions within the sensorimotor network) and faster RTs to both stimuli. Non-musicians showed larger non-nociceptive P200 ERP. Notably, a similar P200 component prominently emerged during nociceptive stimulation in non-musicians. Across participants, larger N140 and N200 ERPs were associated with RTs, whereas the amount of daily practice in musicians explained non-nociceptive P200 and nociceptive P300 ERPs. These novel findings indicate that the mechanisms by which extensive sensorimotor training promotes use-dependent plasticity in multisensory neural structures may also shape the neural signatures of nociceptive processing in healthy individuals. Repetitive sensorimotor training may increase the responsiveness of nociceptive evoked potentials. These novel data highlight the importance of repetitive sensorimotor practice as a contributing factor to the interindividual variability of nociceptive-related potentials.

Comprehensive rehabilitation of patients with post-stroke upper limb dysfunction: a randomized controlled trial

Introduction.The restoration of manipulative activity of the upper limb after an ischemic stroke (IS) requires the development of new technologies aimed at sensorimotor training and retraining. Reduction of spasticity of the upper limb muscles is considered as a necessary component of the program of functional restoration of the handAim.To evaluate the effectiveness and safety of the integrated use of rehabilitation technology with virtual reality and biofeedback “SENSOREHAB simulator glove” (RG) and botulinum neurotoxin type A (BTA) to restore the subject-manipulative function of the hand in comparison with an individual complex of physical therapy in the late recovery period of IS.Materials and methods.A randomized controlled trial included 76 patients, age 60.8 ± 9.2 years; the duration of the transferred IS was 8.1 ± 1.3 months. The main group (n = 42) received BTA with subsequent use of RP. The control group (n = 34) – individual physical therapy. The primary results were changes in the scores on the Fugl – Meyer scales (FMA–UL), the Action Research Arm Test (ARAT), the test with pegs and nine holes (NHPT). Secondary results: dynamics of MRCS, MAS, MoCA, HADS, Bartel index and quality of life (EuroQol-5D).Results.Improvement of the motor function of the arm in the main group according to ARAT (an increase of ≥4 points) was noted in 63.8% of cases, on the FMA–UL scale (an increase of ≥7 points in sections A–D) – in 65.5% of patients (p &lt; 0.05), according to the NHPT test – a significant increase in the speed of execution The test was performed in 52.6% of patients. The dynamics of EQ-5D-5 (VAS) at the end of treatment reached 72.3 ± 5.7 in the main group (p = 0.03). In patients of the control group, a statistically significant improvement was noted in terms of pain and EQ-5D-5 (p &lt; 0.05).Conclusions.A comprehensive program of medical rehabilitation of patients with post-stroke upper limb dysfunction, including the use of BTA and RG, significantly improves the recovery of fine hand movements, functional independence of patients and their quality of life.

Photobiomodulation Therapy Using Infrared (808 nm) Low Level Laser Therapy Associated with Strength Training in Knee Osteoarthritis: A Randomized placebo-controlled clinical trial

Mechanisms for significant clinical and statistical benefits of photobiomodulation (PBMT) in the treatment of knee osteoarthritis (KOA) include anti-inflammatory effects, optimization of tissue repair, improved muscle function and analgesia. The effectiveness of (PBMT) associated with strength training (ST), in the form of strength training, has been investigated in randomized clinical trials, but the results are not well clarified. The aim of this study was to evaluate the effects of ST associated with PBMT on joint pain intensity, range of motion, physical function and muscle strength of the quadriceps femoris and hamstrings in patients diagnosed with KOA. Twenty-eight adult patients of both genders with KOA were randomly distributed in 2 treatment groups, performed 3 times a week, for 6 weeks: ST Group (ST), submitted to stretching, self- mobilization, muscle strengthening and sensorimotor training and ST and STP Group (STP), submitted to the same program as the ST followed by infrared laser irradiation (Therapy XT, DMC, São Carlos, Brasil, l= 808 nm, P= 100mW, 5 points in the medial joint region and 4 points lateral, 3 J/point, 30 s/point). Blinded evaluators assessed pain at movent and no movement and range of motion using Analogic Visual Scale and goniometry, respectively. To assess physical function, the WOMAC questionnaire (Western Ontario and MacMaster University Osteoarthritis Index) and functional tests were used: Sit and stand test; 2 min-walk test. The muscular strength of the quadriceps and hamstrings were measured using an isometric dynamometer. The evaluations were performed in 4 moments: before (EV0), during (EV1: 3 weeks of treatment), at the end (EV2: after 6 weeks of treatment) and 30 days after the end of treatment (follow-up). The STP group showed a significant reduction in pain intensity at rest and at movement in EV1, as well as, significant improvement in relation to stiffness, total WOMAC and knee flexion amplitude, an improvement in physical function and an increase in muscle strength of quadriceps femoris when compared to ST group (p &lt;0.05). In the assessment of the strength of the hamstring muscles, there was no significant difference between the groups at any time evaluated (p&gt; 0.05). ST associated with PBMT had greater effects in reducing joint pain intensity, active knee flexion, physical function and muscle strength, especially in the quadriceps femoris, than strength training alone in patients with KOA.

Sensory-motor training versus resistance training in the treatment of knee osteoarthritis: A randomized controlled trial

Objective To compare the effectiveness of sensory-motor training and resistance training in patients with knee osteoarthritis. Design Randomized controlled trial. Setting Istanbul University, Department of Physiotherapy and Rehabilitation. Subjects Forty-eight participants with knee osteoarthritis. Interventions Following baseline assessment, participants were randomly allocated to sensory-motor training (n = 24) and resistance training (n = 24). Both groups received training three times a week for 8 weeks. Main measures The primary outcome measure was the Western Ontario and McMaster Universities Arthritis Index (WOMAC). The secondary outcome measures were pain level, muscle strength, proprioception, range of motion, quality of life, and patient satisfaction with treatment. Patients were assessed before and after four- and eight-week interventions. Results There was no significant difference between the groups’ total WOMAC scores after four- and eight-week interventions (respectively, p = 0.415, p = 0.828). There was a significant improvement in pain level during movement and in the energy subscale SF-36 for resistance training after the four-week intervention (respectively, p = 0.012, p = 0.007). After the eight-week intervention, a significant difference was noted in favor of resistance training in the secondary outcome measure quality of life (QoL). No significant difference was found in other secondary outcomes. Conclusions At the end of the treatment, it was observed that sensory-motor training had a similar effect in the treatment of knee osteoarthritis symptoms to resistance training. These findings may suggest that sensory-motor training is an effective new method to treat patients with knee osteoarthritis.

Effectiveness of adding rehabilitation of cervical related sensorimotor control to manual therapy and exercise for neck pain: A randomized controlled trial

BackgroundLocal neck treatments and sensorimotor training can improve cervical proprioception and balance, but it remains unclear what treatments and treatment combination achieve the best outcomes. ObjectivesTo investigate the most effective interventions to improve disturbances in joint position sense (JPS) and balance and their effects on neck pain, dizziness and related features in the short- and long-terms. Design2x2 factorial, randomized controlled trial. MethodsParticipants with neck pain (n = 152) were randomly allocated to one of four intervention groups: i) local neck treatment (NT), ii) NT + JPS/oculomotor exercises (JPS/OC), iii) NT + balance exercises, and iv) all treatments. Participants received 12 treatments over 6 weeks. Primary outcomes were postural sway and joint position error. Secondary outcomes included gait speed, dizziness, pain intensity and disability, cervical range of motion, functional ability, and quality of life. Outcome measures were taken at baseline, posttreatment and 3-, 6- and 12-month follow-ups. ResultsAll four interventions resulted in short- and long-term improvements in primary and secondary outcomes with medium to large effect sizes, but JPS and balance in neck torsion improved most with the addition of a combined program of JPS/OC + balance exercises to NT while balance in neck neutral improved most with the addition of balance exercises. Adding sensorimotor training was also more effective in maintaining levels of improvement in neck pain and disability at 6- and 12-months. Effect sizes of additional treatment benefits were medium to large. ConclusionsAdding specific training of JPS/OC and balance to NT best addresses deficits in cervical proprioception and balance. Clinical trial registration numberxxxxx.

Body into Narrative: Behavioral and Neurophysiological Signatures of Action Text Processing After Ecological Motor Training

Embodied cognition research indicates that sensorimotor training can influence action concept processing. Yet, most studies employ isolated (pseudo)randomized stimuli and require repetitive single-effector responses, thus lacking ecological validity. Moreover, the neural signatures of these effects remain poorly understood. Here, we examined whether immersive bodily training can modulate behavioral and functional connectivity correlates of action-verb processing in naturalistic narratives. The study involved three phases. First, in the Pre-training phase, 32 healthy persons listened to an action text (rich in movement descriptions) and a non-action text (focused on its characters’ perceptual and mental processes), completed comprehension questionnaires, and underwent resting-state electroencephalogram (EEG) recordings. Second, in the four-day Training phase, half the participants completed an exergaming intervention (eliciting full-body movements for 60 min a day) while the remaining half played static videogames (requiring no bodily engagement other than button presses). Finally, in the Post-training phase, all participants repeated the Pre-training protocol with different action and non-action texts and a new EEG session. We found that exergaming selectively reduced action-verb outcomes and fronto-posterior functional connectivity in the motor-sensitive ∼ 10–20 Hz range, both patterns being positively correlated. Conversely, static videogame playing yielded no specific effect on any linguistic category and did not modulate functional connectivity. Together, these findings suggest that action-verb processing and key neural correlates can be focally influenced by full-body motor training in a highly ecological setting. Our study illuminates the role of situated experience and sensorimotor circuits in action-concept processing, addressing calls for naturalistic insights on language embodiment.

Effects of early home-based strength and sensory-motor training after total hip arthroplasty: study protocol for a multicenter randomized controlled trial

BackgroundTotal hip arthroplasty (THA) is very effective in alleviating pain, but functional deficits persist up to a year following surgery. Regardless of standard physiotherapy programs, significant additional muscular atrophy and weakness occur. Deficits in strength have serious adverse consequences for these patients with respect to physical function, the maintenance of independence, and the requirement for revision surgery. Progressive resistance training in rehabilitation following THA has been shown to significantly enhance muscle strength and function. The fundamental principle is to progressively overload the exercised muscle as it becomes stronger. Different strength training protocols have been used at different times in the postoperative phase, in group or individual practices, with major differences being in center-based and home-based programs with or without supervision. The primary objective of our study is to evaluate whether an early postoperative home-based strength training protocol can improve patient functional outcomes at 3 months and 1 year following surgery. Secondary objectives are the feasibility of the presented protocol for all elective THA patients and its safety.Methods/designThis study is a prospective multicenter randomized clinical trial to be conducted in the orthopedic departments of two Slovenian hospitals. In each hospital, 124 patients aged 60 or older with unilateral osteoarthritis, an ASA score between 1 and 3, a signed informed consent form, and no terminal illness disabling rehabilitation participation will be randomly assigned to the intervention or control group. THA with an anterior approach will be performed. All patients will receive current standard physiotherapy during hospitalization. Patients in the intervention group will also learn strength and sensory-motor training exercises. Upon discharge, all will receive USB drives with exercise videos, written exercise instructions, and a training diary. Physiotherapists will perform the assessments (physical tests and the maximal voluntary isometric contraction assessment), and patients will fill out outcome assessment questionnaires (the Harris Hip Score and 36-Item Short Form Health Survey) at baseline and 1, 3, and 12 months after surgery.DiscussionThe main purpose of our study is to design a new standardized rehabilitation protocol with videos that will be effective, safe, and accessible to all Slovenian THA patients.Trial registrationClinicalTrials.gov NCT04061993. Registered on 07 November 2019. Protocol ID: PRT_PhD. Version 1.

Effect of Exercise Interventions on Health-Related Quality of Life in Patients with Fibromyalgia Syndrome: A Systematic Review and Network Meta-Analysis.

Several guidelines highlight the beneficial impact of exercise on the management of symptoms and health-related quality of life (HRQOL) in patients with fibromyalgia syndrome (FMS). However, few analyses have compared different types of exercise. We, therefore, intent to compare the effects of different exercise types on improving the overall HRQOL and typical symptoms in patients with FMS. Medline, Embase, the Cochrane Register of Clinical Trials, and NIH ClinicalTrials.gov were searched from inception to April 21, 2022. Randomized clinical trials (RCTs) were included to assess the impact of exercise intervention on health parameters in adult FMS patients. Data were extracted independently and a frequentist network meta-analyses (NMA) was performed to rank the effects of interventions according to P-scores. The NMA evidence certainty was assessed using the method recommended by Grading of Recommendations Assessment, Development, and Evaluation Working Group. A total of 57 RCTs were identified, including 3319 participants, involving 9 interventions (7 types of exercise, 2 controls). Of all treatments compared with usual care in efficacy outcomes, Mind-body exercise was associated with the best HRQOL (SMD, -12.12; 95% CI, -15.79 to -8.45). On the other characteristic symptom dimensions, based on moderate quality evidence, sensorimotor training was associated with minimal pain scores compared with usual care (SMD, -1.81; 95% CI, -2.81 to -0.82), whole body vibration therapy was most promising for improving sleep quality (SMD, -6.95; 95% CI, -10.03 to -3.87), pool-based aerobic exercise was most likely to ease anxiety (SMD, -4.83; 95% CI, -7.47 to -2.19), and whole body vibration was most likely to improve depression (SMD, -10.44; 95% CI, -22.00 to 1.12). Mind-body exercise seems to be the most effective exercise to improve the overall HRQOL of patients with FMS. But at the same time, clinicians still need to develop individualized exercise plans for patients according to their symptoms and accessibility.

Importance and influence of sensorimotor exercises of the knee joint muscles on body stability

Introduction: The concept of prioprioception, known as a conceived solution, which is formed from prioprioceptors that reach the spinal cord, may give rise to reflex reactions. In all changes to a change that affect the behavior of the data, it should be noted that it is recorded, and that it is appropriate and appropriate. What is dependent reaction to change, reaction to change reaction to change, behavior change, change in orientation is a change? Aim of the study: The aim of the study is to assess the effect of the sensorimotor muscles of the knee joint on the muscles. The improvement point was assessed. Material and methods: 20 patients tested fabrics. Among women and 9 men. In order to improve the company's condition, streamlining the technique of the technique on the Easy Tech balancing platform. A fitting with a radius of 20 cm was used in the tests. You repair the research group on the platform twice. The first test was performed immediately after the warm-up, the next test was performed by the knee joint doctor after the running and independent education. Effect on the improvement of treatment outcomes In tests shown to cut sex for performance. Reaching for the improvement of health and improvement of the client's condition. Conclusions: The technology used, a one-time method of sensorimotor training, to improve the results of users of knee injuries. One-time sensorimotor training, the doctor of the knee joint did not show a differential calculation of statistical statistics in relation to the significance of BMI. Note a weak positive correlation, not statistically significant, showing that the heavier person improved the results.

Comparative study of vestibular rehabilitation vs sensorimotor training

Ageing is the basic process that occurs in all the systems of human body at cellular level. Falls are a major problem pertaining to the geriatric population. Falls lead to decrease in the level of independence among them. It can result in serious trauma and accounts for increase in mortality rate among the elderly. Thus falls becomes a major community health issue. Incidence of fall among elderly is 28-34%. On an average 30% of falls need medical care and 10% end up in fracture.