-
Journal of Neuroengineering and... Dec 2023In recent years, the use of virtual reality (VR) as a complementary intervention in treating cognitive impairment has significantly increased. VR applications based on... (Review)
Review
BACKGROUND
In recent years, the use of virtual reality (VR) as a complementary intervention in treating cognitive impairment has significantly increased. VR applications based on instrumental activities of daily living (iADL-VR) could offer a promising approach with greater ecological validity for intervention in groups with cognitive impairments. However, the effectiveness of this approach is still debated.
OBJECTIVE
This systematic review aims to synthesize the effects of iADL-VR interventions to rehabilitate, train, or stimulate cognitive functions in healthy adults and people with mild cognitive impairment (MCI) and different types of dementia.
METHODS
A systematic search was performed in the Scopus, PubMed, IEEE Xplore, Web of Science, and APA PsycNet databases until September 2022 and repeated in April 2023. The selected studies met the search terms, were peer-reviewed, included an iADL-VR intervention, and were written in English. Descriptive, qualitative studies, reviews, cognitive assessment, non-intervention studies, those unrelated to VR or iADL, those focused on motor aspects, and non-degenerative disorders were excluded. The PEDro scale was used to assess the methodological quality of the controlled studies. To present and synthesize the results, we organized the extracted data into three tables, including PEDro scores, participant characteristics, and study characteristics.
RESULTS
Nineteen studies that met the inclusion and exclusion criteria were included. The total sample reached 590 participants, mostly women (72.67%). Approximately 30% were diagnosed with Alzheimer's disease or dementia, and 20% had mild cognitive impairment. Variables such as authors and year of publication, study design, type of intervention and VR applied, duration of the intervention, main findings, and conclusions were extracted. Regarding demographic characteristics, the sample size, age, sex, years of education, neurological diagnosis, dropouts, and the city and country where the intervention took place were recorded. Almost all studies showed improvements in some or all the outcomes after the intervention, generally greater in the iADL-VR group than in the control group.
CONCLUSION
iADL-VR interventions could be beneficial in improving the performance of cognitive functions in older adults and people with MCI and different types of dementia. The ecological component of these tasks makes them very suitable for transferring what has been learned to the real world. However, such transfer needs to be confirmed by further studies with larger and more homogeneous samples and longer follow-up periods. This review had no primary funding source and was registered with PROSPERO under registration ID: 375166.
Topics: Humans; Female; Aged; Male; Activities of Daily Living; Cognitive Dysfunction; Virtual Reality; Cognition; Alzheimer Disease
PubMed: 38110970
DOI: 10.1186/s12984-023-01292-8 -
Deutsche Medizinische Wochenschrift... Apr 2024Cardiac rehabilitation is a fundamental part of treatment after acute coronary syndrome and should be followed within the first 14 days of the acute inpatient stay. The...
Cardiac rehabilitation is a fundamental part of treatment after acute coronary syndrome and should be followed within the first 14 days of the acute inpatient stay. The prognostic value in terms of improving quality of life, reducing both re-hospitalizations and cardiovascular mortality has been shown in numerous studies in recent years. The multimodal, interdisciplinary cardiac rehabilitation aims to maintain and restore the patients' ability to cope with everyday life. The characteristic of cardiac rehabilitation is the combination of sports and physiotherapy, psychosocial care, nutritional therapy, medical diagnostics, and therapy adjustment as well as aftercare recommendations within the framework of a 3-4 week stay in specialized rehabilitation facilities. Participation in exercise-based, multidisciplinary cardiac rehabilitation after acute coronary syndrome reduces cardiovascular mortality and is recommended with Class I, Level A evidence.
Topics: Humans; Cardiac Rehabilitation; Acute Coronary Syndrome; Quality of Life; Exercise Therapy
PubMed: 38621685
DOI: 10.1055/a-2162-7425 -
Scientific Reports Nov 2023The combination of mirror therapy (MT) and neuromuscular electrical stimulation (NMES) has been devised as an intervention method in stroke rehabilitation; however, few... (Meta-Analysis)
Meta-Analysis
The combination of mirror therapy (MT) and neuromuscular electrical stimulation (NMES) has been devised as an intervention method in stroke rehabilitation; however, few studies have investigated its efficacy in lower extremity motor function recovery. In this systematic review and meta-analysis, we examined the effectiveness of combined MT and NMES therapy in improving poststroke walking speed, spasticity, balance and other gait parameters. Randomized controlled trials (RCTs) were selected from PubMed, Cochrane Library, EMBASE, and Scopus databases. In total, six RCTs which involving 181 participants were included. Our findings indicate that MT combined with NMES elicits greater improvement relative to control group in walking speed (SMD = 0.67, 95% confidence interval [CI] 0.26-1.07, P = 0.001), Berg Balance Scale (SMD = 0.72; 95% CI 0.31-1.13; P = 0.0007), cadence (SMD = 0.59, 95% CI 0.02-1.16, P = 0.04), step length (SMD = 0.94, 95% CI 0.35-1.53, P = 0.002), and stride length (SMD = 0.95, 95% CI 0.36-1.54, P = 0.002) but not in modified Ashworth scale (SMD = - 0.40, 95% CI - 1.05 to 0.26, P = 0.23). Our findings suggest that MT combined with NMES may be a suitable supplemental intervention to conventional therapy in stroke survivors.
Topics: Humans; Mirror Movement Therapy; Recovery of Function; Stroke Rehabilitation; Stroke; Electric Stimulation Therapy; Lower Extremity; Electric Stimulation
PubMed: 37973838
DOI: 10.1038/s41598-023-47272-9 -
Journal of Medical Internet Research Dec 2023Knee osteoarthritis (OA) is a chronic, degenerative bone and joint disease. It can lead to major pressure to the quality of life and mental health of patients, and also... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Knee osteoarthritis (OA) is a chronic, degenerative bone and joint disease. It can lead to major pressure to the quality of life and mental health of patients, and also brings a serious economic burden to society. However, it is difficult for patients with knee OA to access rehabilitation when discharging from the hospital. Internet-based rehabilitation is one of the promising telemedicine strategies for the improvement of knee OA, but the effect of different telerehabilitation strategies on knee OA is not clear.
OBJECTIVE
The aim of this systematic review and meta-analysis was to identify telerehabilitation strategies attributing to the improvement of pain and physical function outcomes in patients with knee OA.
METHODS
We reviewed and analyzed telerehabilitation strategies from randomized controlled trials (RCTs) comparing telerehabilitation with conventional treatment or usual care. For each strategy, we examined whether RCTs that applied the telerehabilitation strategy resulted in a significant improvement in pain or physical function compared with conventional treatment or usual care.
RESULTS
We included 6 RCTs (n=734) incorporating 8 different telerehabilitation strategies. The duration of the interventions ranged from 1 to 48 weeks, and sample sizes ranged from 20 to 350 patients. The results showed that RCTs that provided telerehabilitation were found to be more effective than conventional treatments for improving pain (P=.003; standardized mean difference [SMD] -0.21, 95% CI -0.35 to -0.07), but not physical function (P=.24; SMD -0.09, 95% CI -0.25 to 0.06). Furthermore, this systematic review and meta-analysis indicated that there is no significant correlation between different telerehabilitation strategies and the pain and physical function of patients with knee OA.
CONCLUSIONS
This systematic review and meta-analysis showed that telerehabilitation programs could relieve pain but not improve physical function for patients with knee OA. These results indicated that telerehabilitation is beneficial for the implementation of home rehabilitation exercises for patients with knee OA, thereby reducing the economic burden of health. However, there were limitations in terms of the number of search results and the number of studies that were eligible for this review and meta-analysis. Therefore, the results need to be interpreted with caution, and more high-quality studies with large samples are needed to focus on the long-term outcomes of telerehabilitation for patients with knee OA to address this limitation.
Topics: Humans; Osteoarthritis, Knee; Telerehabilitation; Pain; Exercise Therapy; Telemedicine
PubMed: 37982411
DOI: 10.2196/40735 -
Pulmonology 2024
Topics: Humans; COVID-19; Rehabilitation; Pulmonary Medicine
PubMed: 35190299
DOI: 10.1016/j.pulmoe.2022.01.012 -
The Journal of Rheumatology Nov 2023
Topics: Humans; Arthritis, Rheumatoid; Physical Therapy Modalities; Arthritis
PubMed: 37714545
DOI: 10.3899/jrheum.2023-0814 -
British Journal of Nursing (Mark Allen... Jun 2024In the UK, almost 1 million people are living with heart failure, with heart and circulatory diseases accounting for 27% of all deaths, according to the British Heart...
In the UK, almost 1 million people are living with heart failure, with heart and circulatory diseases accounting for 27% of all deaths, according to the British Heart Foundation. Current heart failure guidelines support cardiac rehabilitation as an intervention to reduce cardiovascular events, increase exercise tolerance and enhance patients' quality of life. Research indicates that telerehabilitation is an effective component of heart failure management, which helps overcome perceived barriers to cardiac rehabilitation including travel to appointments, long waiting times and accessibility. Understanding patient experiences and increasing telerehabilitation among heart failure patients is pertinent to implementing person-centred care, reducing risk and optimising quality of life.
Topics: Humans; Heart Failure; Telerehabilitation; United Kingdom; Quality of Life; Cardiac Rehabilitation
PubMed: 38900655
DOI: 10.12968/bjon.2024.0078 -
Rehabilitation Psychology Aug 2023There is emerging evidence for the use of mindfulness-based interventions (MBIs) to improve health outcomes in the context of stroke rehabilitation. This scoping review... (Review)
Review
PURPOSE/OBJECTIVE
There is emerging evidence for the use of mindfulness-based interventions (MBIs) to improve health outcomes in the context of stroke rehabilitation. This scoping review identified recently available evidence and possible research gaps regarding how MBIs affect psychological and physical rehabilitation outcomes in individuals poststroke.
RESEARCH METHOD/DESIGN
Electronic searches were performed using the four major databases, CINAHL, MEDLINE, PsycINFO, and Web of Science. Sixteen studies out of a total of 404 relevant studies met the selection criteria for inclusion in this review.
RESULTS
Our findings indicate diverse results on the benefits of MBIs in individuals poststroke across a range of rehabilitative outcomes. For instance, significant improvements in mental fatigue, cognition, and quality of life were observed for most of the studies while the outcomes for mood and physical functioning were mixed.
CONCLUSIONS/IMPLICATIONS
The available evidence lends qualified support to the view that mindfulness has the potential to be a therapeutic intervention that offers health benefits to individuals poststroke. Yet, the diversity of results highlights the need for a more rigorous examination in further research. We also identified several knowledge gaps in mindfulness research in the stroke population, such as the limited amount of evidence for mindfulness-based cognitive therapy (MBCT), inadequate evaluations of physical outcomes, and the lack of methodologically robust trials. Further investigations are warranted to strengthen the evidence for the feasibility and effectiveness of MBIs. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
Topics: Humans; Mindfulness; Stroke Rehabilitation; Quality of Life; Cognitive Behavioral Therapy; Treatment Outcome
PubMed: 37261753
DOI: 10.1037/rep0000505 -
Journal of Stroke and Cerebrovascular... Oct 2023To compare independence in activities of daily living (ADLs) in post-acute patients with stroke following tele-rehabilitation and matched in-person controls.
OBJECTIVES
To compare independence in activities of daily living (ADLs) in post-acute patients with stroke following tele-rehabilitation and matched in-person controls.
MATERIALS AND METHODS
Matched case-control study. A total of 35 consecutive patients with stroke who followed tele-rehabilitation were compared to 35 historical in-person patients (controls) matched for age, functional independence at admission and time since injury to rehabilitation admission (<60 days). The tele-rehabilitation group was also compared to the complete cohort of historical controls (n=990). Independence in ADLs was assessed using the Functional Independence Measure (FIM) and the Barthel Index (BI). We formally compared FIM and BI gains calculated as discharge score - admission scores, efficiency measured as gains / length of stay and effectiveness defined as (discharge score-admission score)/ (maximum score-admission score). We analyzed the minimal clinically important difference (MCID) for FIM and BI.
RESULTS
The groups showed no significant differences in type of stroke (ischemic or hemorrhagic), location, severity, age at injury, length of stay, body mass index, diabetes, dyslipidemia, hypertension, aphasia, neglect, affected side of the body, dominance or educational level. The groups showed no significant differences in gains, efficiency nor effectiveness either using FIM or Barthel Index. We identified significant differences in two specific BI items (feeding and transfer) in favor of the in-person group. No differences were observed in the proportion of patients who achieved MCID.
CONCLUSIONS
No significant differences were seen between total ADL scores for tele-rehabilitation and in-person rehabilitation. Future research studies should analyze a combined rehabilitation approach that utilizes both models.
Topics: Humans; Infant; Activities of Daily Living; Case-Control Studies; Telerehabilitation; Stroke Rehabilitation; Stroke; Recovery of Function; Treatment Outcome; Retrospective Studies
PubMed: 37579640
DOI: 10.1016/j.jstrokecerebrovasdis.2023.107267 -
Physical Therapy Mar 2024The purpose of this review was to investigate the efficacy of rhythmically cued exercise interventions on motor function, cognition, and mental state in patients with... (Review)
Review Meta-Analysis
OBJECTIVE
The purpose of this review was to investigate the efficacy of rhythmically cued exercise interventions on motor function, cognition, and mental state in patients with Parkinson disease.
METHODS
PubMed, Cochrane Database, Web of Science, Embase, and CINAHL were searched June 15, 2023. Original studies investigating the efficacy of rhythmically cued exercise interventions on the functions of patients with Parkinson disease were included. The Cochrane risk-of-bias assessment tool was used to evaluate the risk of bias. The protocol was registered in PROSPERO (CRD42022371203).
RESULTS
A total of 38 original studies involving 1486 participants were included. Rhythmically cued exercise interventions demonstrated superior effects on motor function compared to exercise therapy without rhythm (standardized mean difference [SMD] = -0.31). However, no significant improvements were observed in cognition and mental state. Overall, significant improvements were observed in motor examination (SMD = -0.61), Timed "Up & Go" Test (mean difference [MD] = -0.91), activities of daily living (SMD = -0.49), balance (SMD = 0.59), walking velocity (MD = 0.06), step length (MD = 2.65), and stride length (MD = 0.04) following rhythmically cued exercise interventions. No significant improvements were observed in freezing of gait and cadence. Assessment of publication bias showed no significant evidence of publication bias. Meta-regression analyses revealed a significant association between treatment duration and improvement in motor function. Furthermore, adverse events and dropout rates did not significantly differ between the 2 groups.
CONCLUSION
Rhythmically cued exercise interventions are effective in improving motor function in the early to middle stages of Parkinson disease. More than 10 weeks of intervention yielded better results. However, these interventions do not have a significant impact on cognition and mental states. Importantly, rhythmically cued exercise interventions are safe and well tolerated. Large-scale trials are needed for further confirmation.
IMPACT
This study contributes to the development of safe and reliable home rehabilitation programs, aiming to enhance the quality of life for patients with Parkinson disease.
Topics: Humans; Quality of Life; Activities of Daily Living; Parkinson Disease; Gait Disorders, Neurologic; Exercise Therapy
PubMed: 37962936
DOI: 10.1093/ptj/pzad158