Tailored Rehabilitation Program Research Articles

Physical functioning in patients with end-stage knee osteoarthritis: A cross-sectional study in Jordan using self-reported questionnaire and performance-based tests.

Knee osteoarthritis (OA) is a debilitating condition that leads to functional limitations. Self-reported questionnaires and performance-based tests are tools commonly used for measuring physical function. (1) To evaluate the impact of end-stage knee OA on functional outcomes and examine the association between self-reported and performance-based measures of function in patients with end-stage knee osteoarthritis awaiting total knee arthroplasty (2) To explore the interrelationships among pain, strength, and overall physical function in this patient population. In this cross-sectional analysis, 33 patients with end-stage knee OA were recruited and completed the knee Outcome Survey-Activities of Daily Living Scale (KOS-ADLS) and executed performance-based tests including the Timed Up and Go, the 30-second chair stand test, and the Stair Climbing Test. Knee pain, and isometric hip and knee strength were evaluated. Patients perceived deficits in their physical functionwith a score of 35/100 on the KOS-ADLS and demonstrated functional limitations in all performed tasks. KOS-ADLs was weakly associated with TUG and 30s-CST (r=-0.301, p= 0.047, and r= 0.39, p= 0.014. respectively). Knee pain was linked with the KOS-ADL score and GRS score (r=-0.406, p= 0.010; r=-0.343, p= 0.027; respectively), while the strength of the affected side was correlated with the performed (p=< 0.001) and reported function outcomes (p= 0.007). Participants exhibit declines in both perceived and executed functional abilities. Self-reported and performance-based functional measures are weakly correlated within our study group, highlighting the importance of incorporating both measures in clinical practice for a comprehensive evaluation of physical function. Pain was linked to subjective aspect of physical function, while strength was connected to perceived and performed functional capacity. Implementing a tailored rehabilitation program targeting muscle weakness and pain holds the potential to mitigate functional decline in individuals awaiting total knee arthroplasty (TKA).

The thickness change ratio and preservation ratio of the infrapatellar fat pad are related to anterior knee pain in patients following medial patellofemoral ligament reconstruction

BackgroundThe infrapatellar fat pad (IPFP) lies extrasynovial and intracapsular, preserving the joint cavity and serving as a biochemical regulator of inflammatory reactions. However, there is a lack of research on the relationship between anterior knee pain (AKP) and the IPFP after medial patellofemoral ligament reconstruction (MPFLR). Pinpointing the source of pain enables clinicians to promptly manage and intervene, facilitating personalized rehabilitation and improving patient prognosis.MethodsA total of 181 patients were included in the study. These patients were divided into the AKP group (n = 37) and the control group (n = 144). Clinical outcomes included three pain-related scores, Tegner activity score, patient satisfaction, etc. Imaging outcomes included the IPFP thickness, IPFP fibrosis, and the IPFP thickness change and preservation ratio. Multivariate analysis was used to determine the independent factors associated with AKP. Finally, the correlation between independent factors and three pain-related scores was analyzed to verify the results.ResultsThe control group had better postoperative pain-related scores and Tegner activity score than the AKP group (P < 0.01). The AKP group had lower IPFP thickness change ratio and preservation ratio (P < 0.001), and smaller IPFP thickness (P < 0.05). The multivariate analysis revealed that the IPFP thickness change ratio [OR = 0.895, P < 0.001] and the IPFP preservation ratio [OR = 0.389, P < 0.001] were independent factors related to AKP, with a significant correlation between these factors and pain-related scores [|r| > 0.50, P < 0.01].ConclusionsThis study showed the lower IPFP change ratio and preservation ratio may be independent factors associated with AKP after MPFLR. Early detection and targeted intervention of the underlying pain sources can pave the way for tailored rehabilitation programs and improved surgical outcomes.Level of evidence Level III

Outcomes of different pulmonary rehabilitation protocols in patients under mechanical ventilation with difficult weaning: a retrospective cohort study

BackgroundThe endeavor of liberating patients from ventilator dependence within respiratory care centers (RCCs) poses considerable challenges. Multiple factors contribute to this process, yet establishing an effective regimen for pulmonary rehabilitation (PR) remains uncertain. This retrospective study aimed to evaluate existing rehabilitation protocols, ascertain associations between clinical factors and patient outcomes, and explore the influence of these protocols on the outcomes of the patients to shape suitable rehabilitation programs.MethodsConducted at a medical center in northern Taiwan, the retrospective study examined 320 newly admitted RCC patients between January 1, 2015, and December 31, 2017. Each patient received a tailored PR protocol, following which researchers evaluated weaning rates, RCC survival, and 3-month survival as outcome variables. Analyses scrutinized differences in baseline characteristics and prognoses among three PR protocols: protocol 1 (routine care), protocol 2 (routine care plus breathing training), and protocol 3 (routine care plus breathing and limb muscle training).ResultsAmong the patients, 28.75% followed protocol 1, 59.37% protocol 2, and 11.88% protocol 3. Variances in age, body-mass index, pneumonia diagnosis, do-not-resuscitate orders, Glasgow Coma Scale scores (≤ 14), and Acute Physiology and Chronic Health Evaluation II (APACHE) scores were notable across these protocols. Age, APACHE scores, and abnormal blood urea nitrogen levels (> 20 mg/dL) significantly correlated with outcomes—such as weaning, RCC survival, and 3-month survival. Elevated mean hemoglobin levels linked to increased weaning rates (p = 0.0065) and 3-month survival (p = 0.0102). Four adjusted models clarified the impact of rehabilitation protocols. Notably, the PR protocol 3 group exhibited significantly higher 3-month survival rates compared to protocol 1, with odds ratios (ORs) ranging from 3.87 to 3.97 across models. This association persisted when comparing with protocol 2, with ORs between 3.92 and 4.22.ConclusionOur study showed that distinct PR protocols significantly affected the outcomes of ventilator-dependent patients within RCCs. The study underlines the importance of tailored rehabilitation programs and identifies key clinical factors influencing patient outcomes. Recommendations advocate prospective studies with larger cohorts to comprehensively assess PR effects on RCC patients.

Lower-extremity inter-joint coordination variability in active individuals with transtibial amputation and healthy males during gait.

This study was aimed to compare the variability of inter-joint coordination in the lower-extremities during gait between active individuals with transtibial amputation (TTAs) and healthy individuals (HIs). Fifteen active male TTAs (age: 40.6±16.24years, height: 1.74±0.09m, and mass: 71.2 ± 8.87kg) and HIs (age: 37.25±13.11years, height: 1.75±0.06m, and mass: 74 ± 8.75kg) without gait disabilities voluntarily participated in the study. Participants walked along a level walkway covered with Vicon motion capture system, and their lower-extremity kinematics data were recorded during gait. The spatiotemporal gait parameters, lower-extremity joint range of motion (ROM), and their coordination and variability were calculated and averaged to report a single value for each parameter based on biomechanical symmetry assumption in the lower limbs of HIs. Additionally, these parameters were separately calculated and reported for the intact limb (IL) and the prosthesis limb (PL) in TTAs individuals. Finally, a comparison was made between the averaged values in HIs and those in the IL and PL of TTAs subjects. The results showed that the IL had a significantly lower stride length than that of the PL and averaged value in HIs, and the IL had a significantly lower knee ROM and greater stance-phase duration than that of HIs. Moreover, TTAs showed different coordination patterns in pelvis-to-hip, hip-to-knee, and hip-to-ankle couplings in some parts of the gait cycle. It concludes that the active TTAs with PLs walked with more flexion of the knee and hip, which may indicate a progressive walking strategy and the differences in coordination patterns suggest active TTA individuals used different neuromuscular control strategies to adapt to their amputation. Researchers can extend this work by investigating variations in these parameters across diverse patient populations, including different amputation etiologies and prosthetic designs. Moreover, Clinicians can use the findings to tailor rehabilitation programs for TTAs, emphasizing joint flexibility and coordination.

A study to identify the quality of life among post COVID-19 people

The COVID-19 pandemic, caused by the SARS-COV-2 virus, has not only led to significant morbidity and mortality worldwide but has also profoundly impacted the quality of life of people post-recovery. This study aims to analyze the quality of life among post-COVID-19 people in Kolhapur, India, and to explore associations between their quality of life with their selected socio-demographic variables. A qualitative approach was considered. A non-experimental, exploratory research design was adopted, with data collected from 225 people through convenient sampling technique. Structured interview questionnaires and the Patient Reported Outcome Measurement Information System (PROMIS) scale were utilized. The majority of subjects reported good quality of life (69.33%), with a smaller proportion reporting average quality (30.22%), and only one subject (0.44%) indicating poor quality of life. Statistical analysis revealed a significant association between quality of life and type of diet and treatment, while no significant associations were found with other demographic variables. This study underscores the importance of addressing the psychological and physical well-being of post-COVID-19 people and suggests the need for tailored rehabilitation programs to improve their quality of life.

Assessment of Isokinetic Trunk Muscle Strength and Fatigue Rate in Individuals after Bariatric Surgery.

Background and Objectives: Lean body mass loss after bariatric surgery (BS) is remarkable, despite an effective long-term mass reduction and significant declines in comorbidities. A person's functional capacity is adversely affected when their skeletal muscle strength declines by up to 30%. This study aimed to assess the isokinetic trunk muscle strength and fatigue rate in individuals after BS. Materials and Methods: This study included fifty-eight patients, both male and female, ranging in age from 19 to 45. Twenty-seven individuals had BS and twenty-seven healthy people served as the control group. The primary outcomes were the measurement of the concentric and eccentric isokinetic muscle strength of the trunk flexor and extensor muscles. An isokinetic dynamometer (Biodex Rehabilitation and Testing System 3) was used for the assessment of the isokinetic muscle strength. Noraxon EMG was used to determine a secondary outcome, which was the median frequency slop (MF/time) and root mean square slop (RMS/time) of the lumbar erector spinea muscle at 50% of the Maximum Voluntary Isometric Contraction (MVIC). Outcome measures were assessed for both groups. Results: Compared to the control group, the bariatric group showed a lower mean value of both concentric and eccentric isokinetic muscle strength for the flexor and extensor trunk muscles (p < 0.05). In terms of the EMG fatigue rate, the RMS slope increased significantly more than that of the control group, while the MF slope decreased (p > 0.05). Conclusions: The current study found that, in comparison to the healthy subjects, the BS group showed reduced levels of fatigue and isokinetic strength in the trunk muscles. Based on these results, it is recommended that individuals who underwent BS take part in tailored rehabilitation programs to avoid potential musculoskeletal issues in the future.

Assessment of Alterations in Gait Parameters of Chronic Total Knee Arthroplasty – An Observational Study

Purpose of the Study: This research investigates postoperative gait alterations in individuals aged 50 and above who underwent total knee arthroplasty (TKA) at least one year ago. The study aims to fill existing gaps in literature by comprehensively assessing various gait parameters and understanding the persistent changes in mobility following TKA. Materials and Methods: Conducted as an observational study, 30 TKA subjects were assessed using Kinovea software for gait parameters, including cadence, speed, step length, step width, stride length, and knee flexion angle. Statistical analysis with MS Excel compared obtained values with established norms. Results: Significant gait parameter alterations were observed in post-TKA subjects. These changes include decreased cadence, walking speed, step length, and stride length, along with variations in knee flexion angle. Approximately 36.67% of participants exhibited alterations in these parameters, highlighting the need for further understanding of mobility challenges post-TKA. Conclusion: This study contributes vital insights into the persistent impact of TKA on gait parameters, emphasizing the complexity of postoperative mobility changes. The observed alterations highlight the importance of tailored rehabilitation programs to enhance functional independence and address long-term gait concerns in this patient population.

Exercise reconditioning in the post-acute phase of COVID-19 rehabilitation in patients with chronic respiratory insufficiency: a retrospective observational study

INTRODUCTION: The COVID-19 pandemic has had a profound impact on a global scale, affecting various aspects of society, health, and well-being. It has strained healthcare systems and led to social and welfare repercussions. In the context of post-acute COVID-19 rehabilitation, there is a need to explore effective interventions for individuals, particularly those with chronic respiratory insufficiency. This study aims to evaluate the effectiveness of exercise reconditioning as a rehabilitation strategy in this specific population METHODS: A retrospective observational study was conducted at the Rehabilitation Unit in an Italian hospital between March 2020 and May 2022. The study included individuals who had been diagnosed with COVID-19 pneumonia, required hospitalization in the COVID-19 unit or intensive care unit (ICU) due to severe respiratory failure and with “post-COVID pathology syndrome” (PCS) picture. Various assessments, including the 6 Minutes Walking Test (6MWT), were conducted to determine exercise capacity. A personalized reconditioning program based on international guidelines was designed for each patient, focusing on aerobic training. Measurements of vital signs were taken during training sessions. RESULTS: A total of 24 individuals, with a mean age of 65.41 years, were included in the study. The average duration of hospitalization in the rehabilitation department was 53.17 days. Most participants had pre-existing respiratory and non-respiratory pathologies. All individuals developed COVID-19 interstitial pneumonia, and some required intensive interventions such as intubation or ECMO support. Pulmonary fibrosis and Critical Illness Myopathy (CIM) were observed in a significant portion of the participants. Significant improvements were observed in the 6MWT distance traveled, Functional Independence Measure (FIM) scale score, fraction of inhaled oxygen (FiO2), and dyspnea scores. Perceived exerction measures also showed positive changes. DISCUSSION AND CONCLUSION: The findings of this study indicate that personalized reconditioning plan is effective in improving the functional capacity and overall condition and quality of life of individuals with post-COVID pathology syndrome. These findings highlight the importance of an interdisciplinary approach and tailored rehabilitation programs in this population. Further research is needed to explore the long-term effects of exercise reconditioning in this population.

Characteristics and burden of acute COVID-19 and long-COVID: Demographic, physical, mental health, and economic perspectives.

COVID-19 infection and its associated consequence, known as long-COVID, lead to a significant burden on the global healthcare system and limitations in people's personal and work lives. This study aims to provide further insight into the impact of acute and ongoing COVID-19 symptoms and investigates the role of patients' gender and vaccination status. 416 individuals (73.9% female) between the ages of 16 and 80 years (M = 44.18, SD = 12.90) with self-reported symptoms of long-COVID participated in an online survey conducted between March and May 2022. 6.0%, 74.3%, and 19.7% of all respondents reported having had an asymptomatic, mild, or severe acute illness, respectively. Out of all participants, 7.8% required hospitalization. The most prevalent symptoms during the acute infection (Mdn = 23.50 symptoms, IQR = 13-39) included fatigue, exhaustion, cough, brain fog, and memory problems. The median long-COVID disease duration was 12.10 months (IQR = 2.8-17.4). Among 64 inquired long-COVID symptoms (Mdn = 17.00 symptoms, IQR = 9-27), participants reported fatigue, exhaustion, memory problems, brain fog, and dyspnea as the most common ongoing symptoms, which were generally experienced as fluctuating and deteriorating after physical or cognitive activity. Common consequences of long-COVID included financial losses (40.5%), changes in the participants' profession (41.0%), stress resistance (87.5%), sexual life (38.1%), and mood (72.1%), as well as breathing difficulties (41.3%), or an increased drug intake (e.g., medicine, alcohol; 44.6%). In addition, vaccinated individuals exhibited a shorter acute illness duration and an earlier onset of long-COVID symptoms. In general, women reported more long-COVID symptoms than men. Long-COVID represents a heterogeneous disease and impacts multiple life aspects of those affected. Tailored rehabilitation programs targeting the plurality of physical and mental symptoms are needed.

Knee Osteoarthritis in Women: Ancient and Modern Treatment Modalities

Knee osteoarthritis (OA) is a common and debilitating condition that predominantly affects women. This article explores the historical and contemporary treatment modalities for knee OA in women, highlighting the evolution of therapeutic approaches over time. Ancient treatments for knee OA primarily focused on natural remedies and lifestyle modifications. These included the use of herbal medicines, dietary adjustments, and physical therapies like hot and cold compresses. Ancient cultures recognized the importance of maintaining a healthy weight and engaging in physical activity to alleviate symptoms and improve joint function. In modern times, treatment options for knee OA in women have significantly evolved. While conservative measures such as physical therapy, weight management, and non-steroidal anti-inflammatory drugs (NSAIDs) are still important, advanced interventions are available. These include corticosteroid injections, hyaluronic acid injections, and platelet-rich plasma therapy, which aim to reduce pain and enhance joint lubrication. For severe cases, surgical interventions like arthroscopy, partial or total knee replacement, and osteotomy may be considered. The article also explores the emerging field of regenerative medicine, which offers promising avenues for the management of knee OA in women. Stem cell therapies and tissue engineering approaches show potential in regenerating damaged cartilage and slowing down disease progression. Additionally, the role of lifestyle modifications, exercise, and physical therapy remains crucial in the modern era, with a focus on tailored rehabilitation programs to improve strength, flexibility, and joint stability. In conclusion, the treatment of knee OA in women has transitioned from ancient remedies rooted in tradition to a modern, evidence-based approach that combines conservative measures with innovative medical interventions. The evolution of treatment modalities reflects advances in medical knowledge and technology, offering hope for improved quality of life for women affected by this condition.

Comparing Sagittal-Plane Biomechanics of Drop Jump Landing in Athletes With and Without Knee Osteoarthritis 2-Year Post-Anterior Cruciate Ligament Reconstruction.

The study aimed to determine differences in sagittal-plane joint biomechanics between athletes with and without knee osteoarthritis (OA) during drop vertical jump 2years after anterior cruciate ligament reconstruction (ACLR). Forty-one athletes with ACLR completed motion analysis testing during drop vertical jump from 30cm. Sagittal-plane peak joint angles and moments and joint contributions to total support moment (TSM) were calculated during first landing. Medial compartment knee OA of the reconstructed knee was evaluated using Kellgren-Lawrencescores (ACLR group: Kellgren-Lawrence <2; ACLR-OA group: Kellgren-Lawrence ≥2). The ACLR-OA group (n = 13) had higher hip and lower knee contributions in the surgical limb than the ACLR group and their nonsurgical limb. Further, the ACLR-OA group had higher peak hip extension moment than the ACLR group (P = .024). The ACLR-OA group had significantly lower peak knee extension and ankle plantar flexion moments and TSM (P ≤ .032) than ACLR group. The ACLR-OA group landed with increased hip extension moment, decreased knee extension and ankle plantar flexion moments and TSM, and decreased knee and increased hip contributions to TSM compared with ACLR group. The ACLR-OA group may have adopted movement patterns to decrease knee load and compensated by shifting the load to the hip. Clinicians may incorporate tailored rehabilitation programs that mitigate the decreased knee load to minimize the risk of knee OA after ACLR.

Towards a comprehensive biomechanical assessment of the elderly combining in vivo data and in silico methods.

The aging process is commonly accompanied by a general or specific loss of muscle mass, force and/or function that inevitably impact on a person's quality of life. To date, various clinical tests and assessments are routinely performed to evaluate the biomechanical status of an individual, to support and inform the clinical management and decision-making process (e.g., to design a tailored rehabilitation program). However, these assessments (e.g., gait analysis or strength measures on a dynamometer) are typically conducted independently from one another or at different time points, providing clinicians with valuable yet fragmented information. We hereby describe a comprehensive protocol that combines both in vivo measurements (maximal voluntary isometric contraction test, superimposed neuromuscular electrical stimulation, electromyography, gait analysis, magnetic resonance imaging, and clinical measures) and in silico methods (musculoskeletal modeling and simulations) to enable the full characterization of an individual from the biomechanical standpoint. The protocol, which requires approximately 4h and 30min to be completed in all its parts, was tested on twenty healthy young participants and five elderlies, as a proof of concept. The implemented data processing and elaboration procedures allowing for the extraction of several biomechanical parameters (including muscle volumes and cross-sectional areas, muscle activation and co-contraction levels) are thoroughly described to enable replication. The main parameters extracted are reported as mean and standard deviation across the two populations, to highlight the potential of the proposed approach and show some preliminary findings (which were in agreement with previous literature).

Mastering Balance: A Systematic Review on The Effectiveness of Enhancing Balance Skills Through Balance Board

A systematic review on tactile sensitivity through the use of a tactile balance board holds significant implications for both research and practical applications in various fields. Tactile sensitivity, the ability to process and respond to tactile stimuli, is a crucial aspect of sensory processing that influences motor skills, spatial awareness, and overall well-being. This review serves as a comprehensive synthesis of existing literature, providing a nuanced understanding of the current state of research on tactile balance boards and their impact on tactile sensitivity. By systematically analysing and summarizing findings from multiple studies, it aims to identify patterns, trends and gaps in knowledge. This process enables researchers and practitioners to build upon existing evidence, fostering a more informed approach to further investigations. In the realm of research, the systematic review can serve as a foundational resource for scholars and scientists interested in the intersection of tactile sensitivity and balance board interventions. It allows them to identify areas where further exploration is needed, encouraging the development of targeted research questions and methodologies. Additionally, the review may highlight inconsistencies or variations in existing studies, prompting researchers to address these discrepancies in future investigations. Practically, the findings of this systematic review can have direct implications for professionals in fields such as rehabilitation, occupational therapy and neurology. Understanding the impact of tactile balance board interventions on tactile sensitivity can guide the development of evidence-based practices aimed at improving sensory processing and motor skills in individuals with sensory challenges. This, in turn, may enhance therapeutic interventions and contribute to the design of tailored rehabilitation programs. Furthermore, the review may inform educators and practitioners working with populations that commonly experience tactile sensitivity issues, such as individuals with autism spectrum disorders or sensory processing disorders. Insights from this synthesis of literature can be translated into practical strategies for the design of sensory-friendly environments and the implementation of interventions that incorporate tactile balance boards.

Characterization and predictive risk scoring of long COVID in a south indian cohort after breakthrough COVID infection; a prospective single centre study

BackgroundWith the World Health Organization (WHO) declaring an end to the COVID-19 pandemic, the focus has shifted to understanding and managing long-term post-infectious complications. “Long COVID,“ characterized by persistent or new onset symptoms extending beyond the initial phase of infection, is one such complication. This study aims to describe the incidence, clinical features and risk profile of long COVID among individuals in a South Indian cohort who experienced post-ChAdOx1 n-Cov-2 vaccine breakthrough infections.MethodsA single-centre hospital-based prospective observational study was conducted from October to December 2021. The study population comprised adult patients (> 18 years) with a confirmed COVID-19 diagnosis who had received at least a single dose of vaccination. Data was collected using a specially tailored questionnaire at week 2, week 6, and week 12 post-negative COVID-19 test. A propensity score based predictive scoring system was developed to assess the risk of long COVID.ResultsAmong the 414 patients followed up in the study, 164 (39.6%) reported long COVID symptoms persisting beyond 6 week’s post-infection. The presence of long COVID was significantly higher among patients above 65 years of age, and those with comorbidities such as Type II Diabetes Mellitus, hypertension, dyslipidemia, coronary artery disease, asthma, and cancer. Using backwards selection, a reduced model was developed, identifying age (OR 1.053, 95% CI 0.097–1.07, p < 0.001), hypertension (OR 2.59, 95% CI 1.46–4.59, p = 0.001), and bronchial asthma (OR 3.7176, 95% CI 1.24–11.12, p = 0.018) as significant predictors of long COVID incidence. A significant positive correlation was observed between the symptomatic burden and the number of individual comorbidities.ConclusionsThe significant presence of long COVID at 12 weeks among non-hospitalised patients underscores the importance of post-recovery follow-up to assess for the presence of long COVID. The predictive risk score proposed in this study may help identify individuals at risk of developing long COVID. Further research is needed to understand the impact of long COVID on patients’ quality of life and the potential role of tailored rehabilitation programs in improving patient outcomes.

Effects of humanized nursing care on negative emotions and complications in patients undergoing hysteromyoma surgery.

Uterine fibroids, are prevalent benign tumors affecting women of reproductive age. However, surgical treatment is often necessary for symptomatic hysteromyoma cases. This study examines the impact of humanized nursing care on reducing negative emotions and postoperative complications in patients receiving hysteromyoma surgery. To investigate the impact of humanized nursing care on patients undergoing hysteromyoma surgery. Among patients who underwent hysteromyoma surgery at the Fudan University Affiliated Obstetrics and Gynecology Hospital, 200 were randomly assigned to either the control group (n = 100) or the humanized nursing care group (n = 100). The control group received traditional nursing care, while the humanized nursing care group received a comprehensive care plan encompassing psychological support, pain management, and tailored rehabilitation programs. In addition, anxiety and depression levels were assessed using the hospital anxiety and depression scale preoperatively and postoperatively. Postoperative complications were evaluated during follow-up assessments and compared between both groups. The humanized nursing care group demonstrated a significant decrease in anxiety and depression levels compared to the control group (P < 0.05). The rate of postoperative complications, including infection, bleeding, and deep venous thrombosis, was also markedly lower in the humanized nursing care group (P < 0.05). Humanized nursing care can effectively alleviate negative emotions and reduce the incidence of postoperative complications in patients undergoing hysteromyoma surgery. This approach should be considered a crucial component of perioperative care for these patients. Further research may be needed to explore additional benefits and long-term outcomes of implementing humanized nursing care in this population.

Three-Dimensional (3D) Morphometric Analysis of Plegic and Healthy Feet of Patients with Stroke

Objective: This study aimed to quantitatively assess the changes in foot morphology in stroke patients using 3D scanning and focused on parameters like foot volume, area, and the root mean square difference (RMS) values. The objective was to enhance our understanding of post-stroke foot morphology and its potential relevance for rehabilitation, especially in designing orthotic supports and specialized footwear for stroke patients. Methods: Our study involved fourteen right hemiplegia patients and twenty healthy subjects. Stroke patients were assessed using international scales. We utilized a 3D scanning device to digitize and examine the differences in foot morphology between hemiplegic and healthy subjects, analyzing the data on a computer platform. Results: In the context of post-stroke individuals with hemiplegic feet, our morphometric analysis revealed notable differences in foot area and foot volume when compared to their healthy counterparts. These distinctions extended to linear measurements encompassing foot length, foot width, instep height, bimalleolar width, and ball width. Significantly, RMS exhibited a substantial increase in the patient cohort compared to the healthy group (p&lt;0.05). Our investigation also established correlations between these standing morphometric parameters and RMS alterations, with noteworthy coefficients for various parameters: RMS(Foot Length Difference, 0.41), RMS(Foot Width Difference, 0.45), RMS(Instep Height Difference, 0.58), RMS(Ball Width Difference, 0.58), RMS(Bimalleolar Width Difference, 0.19), RMS(Volume Difference, 0.74), and RMS(Area Difference, 0.62). Conclusion: This study suggests incorporating RMS values as a novel parameter in the evaluation process. We anticipate that these findings will have practical implications, particularly in designing orthotic supports, specialized footwear for stroke patients, and the formulation of tailored rehabilitation programs within clinical settings.

Pulmonary rehabilitation assessment in COPD based on the ICF brief core set: a latent profile analysis

Background Chronic obstructive pulmonary disease (COPD) is the most burdened chronic respiratory disease in the world, resulting in a reduced quality of life and limited physical activity for patients. Pulmonary rehabilitation (PR) is an effective therapy for COPD. Effective PR relies on an accurate pulmonary rehabilitation program. An adequate pre-rehabilitation assessment helps healthcare professionals to develop an accurate pulmonary rehabilitation program. However, pre-rehabilitation assessment strategies lack specific selection criteria and an assessment of the patient’s overall functioning. Methods This study explored the functional characteristics of COPD patients before pulmonary rehabilitation and collected COPD patients from October 2019 to March 2022. A cross-sectional survey of 237 patients was conducted using the ICF brief core set as the study tool. Latent profile analysis identified subgroups of patients with different rehabilitation needs based on body function and activity participation. Results Four subgroups of functional dysfunction were identified: 5.42%, 21.03%, 29.44%, and 34.11% in the high dysfunction group, the moderate dysfunction group, the lower-middle dysfunction but high mobility impairment group, and the low dysfunction group, respectively. Patients in the high dysfunction group were older, had a higher proportion of widowed spouses, and experienced more exacerbation. Most patients in the low-dysfunction group did not use inhaled medication and had a lower participation rate in oxygen therapy. Patients with a more severe disease classification and symptom burden mostly belonged to the high dysfunction group. Conclusions COPD patients require an adequate assessment before implementing a pulmonary rehabilitation program to determine their rehabilitation needs. The four subgroups were heterogeneous in terms of the degree of functional impairment in body function and activity participation. Patients in the high dysfunction group can improve basic cardiorespiratory fitness; patients in the moderate dysfunction group should focus on improving cardiorespiratory endurance and muscle fitness, patients in the lower-middle-dysfunction but high mobility impairment group should focus on improving mobility and patients in the low functional disability group should focus more on preventive measures. Healthcare providers can tailor rehabilitation programs to the functional impairments of patients with different characteristics. Trial registration This study has been registered in the Chinese Clinical Trials Registry (ChiCTR2000040723).

Perceived benefits of cochlear implants by parents: expectations, decision-making process, and barriers to care

BackgroundIdentifying predictive factors of the cochlear implant outcomes in pediatric patients is critical in guiding tailored rehabilitation programs. The study aimed to assess cochlear implant outcomes, identify predictors, and highlight decision-making factors and barriers to quality care.MethodsThis cross-sectional study included parents of children who received unilateral cochlear implants for bilateral severe- to- deep sensorineural hearing loss. Inclusion criteria were age ≤ 5 years and intelligence quotient (IQ) Scores ≥ 85, A pre-designed structured questionnaire was used to collect data from parents/guardians of the children attending follow-up. The Arabic validated Glasgow Children Benefit Inventory score was used to assess the health-related quality of life (QOL) after intervention.ResultsThe quality of life (QOL) score (outcome) after surgery was positive in all cases. Multivariate analysis showed that the site of operation (Bahtim hospital and Ain Shams Hospital [AOR(95% confidence interval CI), 5.7 (1.4–23), 5 (1.4–17.9), p = 0.015, 0.013, respectively]), education of the father (university/postgraduate [AOR (95% CI): 5 (1.4–17.9), p = 0.013]), the parents’ expectation that their child would be able to participate in regular classroom activities [AOR (95% CI): 8.9 (3.7–21.3), p < 0.001], and history of Attention deficit/hyperactivity disorder (ADHD), perinatal hypoxia, and low birth weight [AOR (95% CI): 2.5 (1.2–5.1), 3.7 (1.7–8.1), 4.7 (2.1–10.5), p = 0.013, 0.001, ≤ 0.001, respectively] are significant independent predictors of good outcome.ConclusionAll parents expressed a positive change in their child’s QOL. Almost all parents of children with cochlear implants face many barriers in obtaining quality healthcare services for their children. Parents, especially those with lower schooling, should receive good counselling to increase their confidence in their children’s capabilities and maximize benefits of regular follow-up. Improving the quality of healthcare centers is recommended.

Frailty Education: Promoting Geriatric Competencies Among Physical Medicine and Rehabilitation Residents.

Frailty, a geriatric syndrome of growing importance in recent years, has been shown to be associated with increased risk of disability and adverse health and socioeconomic outcomes. Therefore, there is a need for new educational strategies for physical medicine and rehabilitation residents to promote greater geriatric competencies, with a focus on developing customized evaluation and management plans. With this article, the aim is offering a quick reference tool summarizing the latest evidence on the rehabilitative management of frailty. Indeed, a comprehensive geriatric evaluation is needed before developing an evidence-based and individually tailored rehabilitation program including physical activity, educative strategies, nutritional interventions, and proposals for social reintegration. In the future, appropriate educational training may allow a more careful management of these patients, with consequent improvements in quality of life and functionality.

Gait Alteration in Individual with Limb Loss: The Role of Inertial Sensors.

Amputation has a big impact on the functioning of patients, with negative effects on locomotion and dexterity. In this context, inertial measurement units represent a useful tool in clinical practice for motion analysis, and in the development of personalized aids to improve a patient's function. To date, there is still a gap of knowledge in the scientific literature on the application of inertial sensors in amputee patients. Thus, the aim of this narrative review was to collect the current knowledge on this topic and stimulate the publication of further research. Pubmed, Embase, Scopus, and Cochrane Library publications were screened until November 2022 to identify eligible studies. Out of 444 results, we selected 26 articles focused on movement analysis, risk of falls, energy expenditure, and the development of sensor-integrated prostheses. The results showed that the use of inertial sensors has the potential to improve the quality of life of patients with prostheses, increasing patient safety through the detection of gait alteration; enhancing the socio-occupational reintegration through the development of highly technologic and personalized prosthesis; and by monitoring the patients during daily life to plan a tailored rehabilitation program.