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Physiotherapy Theory and Practice Jan 2020: The purpose of this study is to compare the functional status of patients 12 months after total knee arthroplasty (TKA) who underwent progressive strengthening or... (Comparative Study)
Comparative Study Randomized Controlled Trial
: The purpose of this study is to compare the functional status of patients 12 months after total knee arthroplasty (TKA) who underwent progressive strengthening or standard of care rehabilitation to older adults without knee joint pain. : This cross-sectional design study included 165 participants in the progressive strengthening group, 40 participants in the standard of care group, and 88 older adults (control group). The Knee Outcome Survey - Activity of Daily Living, knee active range of motion (ROM), quadriceps strength, and performance tests were compared between groups using a one-way ANOVA. The proportions of participants in both TKA groups who achieved the lower bound of the 95% confidence interval of the control group were compared using a Fisher's exact test. : Significant between-group effects were found for all variables ( < 0.001). The control group had better outcomes than both the progressive strengthening and standard of care groups ( < 0.001). Compared to the standard of care group, a higher proportion of participants in the progressive strengthening group achieved the lower bound cutoff for active knee extension ROM ( = 0.042), quadriceps strength ( = 0.032), and stair climbing time ( = 0.029). : More participants in the progressive strengthening group had physical function that was similar to the healthy control group, when compared to the standard of care group. Progressive strengthening rehabilitation may be more effective in restoring normative levels of function after TKA than standard of care.
Topics: Aged; Aged, 80 and over; Arthroplasty, Replacement, Knee; Combined Modality Therapy; Cross-Sectional Studies; Disability Evaluation; Electric Stimulation Therapy; Female; Humans; Male; Middle Aged; Muscle Strength; Pain Measurement; Physical Therapy Modalities; Range of Motion, Articular; Recovery of Function; Resistance Training; Standard of Care; Walk Test
PubMed: 29877749
DOI: 10.1080/09593985.2018.1479475 -
Voprosy Kurortologii, Fizioterapii, I... 2022The article presents a literature review on the prevalence, relevance, social significance, and principles of medical rehabilitation of children with different types of... (Review)
Review
The article presents a literature review on the prevalence, relevance, social significance, and principles of medical rehabilitation of children with different types of scoliosis in scoliotic disease. The current classification, diagnostics features, and clinical course of the disease are addressed. Current approaches to the choice of medical rehabilitation methods for scoliotic disease in children are described: therapeutic exercise, hydrokinesiotherapy, massage, physiotherapeutic treatment, kinesiotaping, and corseting. Special consideration is given to postoperative management and stages of medical rehabilitation of children with scoliosis, including resort treatment.
Topics: Child; Exercise Therapy; Humans; Massage; Scoliosis
PubMed: 35981343
DOI: 10.17116/kurort20229904157 -
Handbook of Clinical Neurology 2022Neuroplasticity follows nervous system injury in the presence or absence of rehabilitative treatments. Rehabilitative interventions can be used to modulate adaptive... (Review)
Review
Neuroplasticity follows nervous system injury in the presence or absence of rehabilitative treatments. Rehabilitative interventions can be used to modulate adaptive neuroplasticity, reducing motor impairment and improving activities of daily living in patients with brain lesions. Learning principles guide some rehabilitative interventions. While basic science research has shown that reward combined with training enhances learning, this principle has been only recently explored in the context of neurorehabilitation. Commonly used reinforcers may be more or less rewarding depending on the individual or the context in which the task is performed. Studies in healthy humans showed that both reward and punishment can enhance within-session motor performance; but reward, and not punishment, improves consolidation and retention of motor skills. On the other hand, neurorehabilitative training after brain lesions involves complex tasks (e.g., walking and activities of daily living). The contribution of reward to neurorehabilitation is incompletely understood. Here, we discuss recent research on the role of reward in neurorehabilitation and the needed directions of future research.
Topics: Activities of Daily Living; Humans; Learning; Motor Skills; Neurological Rehabilitation; Neuronal Plasticity; Reward; Stroke Rehabilitation
PubMed: 35034746
DOI: 10.1016/B978-0-12-819410-2.00018-7 -
Osteoarthritis and Cartilage Oct 2023Insights related to the pathogenesis of osteoarthritis (OA) have informed rehabilitative treatments that aim to mitigate the influence of several known impairments and... (Review)
Review
Insights related to the pathogenesis of osteoarthritis (OA) have informed rehabilitative treatments that aim to mitigate the influence of several known impairments and risk factors for OA, with the goal to improve pain, function, and quality of life. The purpose of this invited narrative review is to provide fundamental knowledge to non-specialists about exercise and education, diet, biomechanical interventions, and other physical therapist-delivered treatments. In addition to summarizing the rationale for common rehabilitative therapies, we provide a synthesis of current core recommendations. Robust evidence based on randomized clinical trials supports exercise with education and diet as core treatments for OA. Structured, supervised exercise therapy is advised. The mode of exercise may vary but should be individualized. The dose should be based on an initial assessment, the desired physiological changes, and progressed when appropriate. Diet combined with exercise is strongly recommended and studies demonstrate a dose-response relationship between the magnitude of weight loss and symptom improvement. Recent evidence suggests the use of technology to remotely deliver exercise, diet and education interventions is cost-effective. Although several studies support the mechanisms for biomechanical interventions (e.g., bracing, shoe inserts) and physical therapist-delivered (passive) treatments (e.g., manual therapy, electrotherapeutic modalities) fewer rigorous randomized trials support their clinical use; these therapies are sometimes recommended as adjuncts to core treatments. The mechanisms of action for all rehabilitative interventions include contextual factors such as attention and placebo effects. These effects can challenge our interpretation of treatment efficacy from clinical trials, yet also provide opportunities to maximize patient outcomes in clinical practice. When evaluating rehabilitative interventions, the field may benefit from increased emphasis on research that considers contextual factors while evaluating mechanistic, longer-term, clinically-important and policy-relevant outcome measures.
Topics: Humans; Biomechanical Phenomena; Quality of Life; Physical Therapists; Exercise Therapy; Osteoarthritis, Knee; Diet
PubMed: 37423596
DOI: 10.1016/j.joca.2023.06.011 -
Prosthetics and Orthotics International Apr 2022A patient (the first author) with a preexisting right side transfemoral amputation (20 years before) had osseointegration surgery. She was assigned a physiotherapist...
A patient (the first author) with a preexisting right side transfemoral amputation (20 years before) had osseointegration surgery. She was assigned a physiotherapist (the second author) and began a rehabilitation program. We provide a unique insight into the first 18 months of rehabilitation after insertion of an osseointegration bone anchor from a physiotherapist and patient perspective with the intention of informing practitioners, patients, and potential patients about the experience and identifying potential areas for improvements in the rehabilitation protocol. The experience was tracked by both the patient and the physiotherapist for 18 months post-surgery. The physiotherapist followed a specific protocol with the patient in the first part of the recovery stage. The patient kept records of subjective experiences over the same period. Loading and physiotherapy were completed in line with the protocol for the first 12-week phase including successful fitting of the prosthetic limb on day 12. Physiotherapy and other interventions evolved to meet the patient's needs over the 18-month period. The patient progressed through her rehabilitation, and new data about the patient's experience were gathered. Following the protocol enabled the patient to progress through her rehabilitation. Unforeseen setbacks (abscesses and inflammation/entheseopathies) slowed this process to some extent. Findings from these data can be used to help inform and improve future rehabilitations for patients with osseointegration: patients can be advised about possible setbacks and physiotherapy, and other interventions can be developed to treat should these problems arise.
Topics: Amputation, Surgical; Female; Humans; Osseointegration; Physical Therapy Modalities
PubMed: 35412525
DOI: 10.1097/PXR.0000000000000055 -
Current Opinion in Critical Care Apr 2021To describe recent literature evaluating the effectiveness of early rehabilitation in neurocritical care patients. (Review)
Review
PURPOSE OF REVIEW
To describe recent literature evaluating the effectiveness of early rehabilitation in neurocritical care patients.
RECENT FINDINGS
There is a drive for early rehabilitation within the ICU; however, there are unique considerations for the neurocritically ill patient that include hemiplegia, cognitive impairments and impaired conscious state that can complicate rehabilitation. Additionally, neurological complications, such as hemorrhage expansion and cerebral edema can lead to the risk of further neurological damage. It is, therefore, important to consider the effect of exercise and position changes on cerebral hemodynamics in patients with impaired cerebral autoregulation. There is a paucity of evidence to provide recommendations on timing of early rehabilitation postneurological insult. There are also mixed findings on the effectiveness of early mobilization with one large, multicenter RCT demonstrating the potential harm of early and intensive mobilization in stroke patients. Conversely, observational trials have found early rehabilitation to be well tolerated and feasible, reduce hospital length of stay and improve functional outcomes in neurological patients admitted to ICU.
SUMMARY
Further research is warranted to determine the benefits and harm of early rehabilitation in neurological patients. As current evidence is limited, and given recent findings in stroke studies, careful consideration should be taken when prescribing exercises in neurocritically ill patients.
Topics: Critical Care; Early Ambulation; Hospitalization; Humans; Intensive Care Units; Multicenter Studies as Topic; Stroke
PubMed: 33395083
DOI: 10.1097/MCC.0000000000000804 -
Giornale Italiano Di Medicina Del... Jun 2020Habilitation, rehabilitation and promotion of well-being is the ultimate goal of the occupational therapy process. Occupational therapy interventions take advantages...
Habilitation, rehabilitation and promotion of well-being is the ultimate goal of the occupational therapy process. Occupational therapy interventions take advantages from interdisciplinary approach, implying that classic rehabilitative models are constantly enhanced by updated evidences in rehabilitation literature and enriched with competences from different fields. Recent literature has showed how music interventions can improve clinical and rehabilitative outcomes at different levels. Physical or occupational therapists, caregivers and care staffs are frequently involved in providing music interventions with or without the support of a music therapist. In particular, occupational therapists can use music as support to the rehabilitation of daily living activities and, in general, as a complementary tool of their work. This paper wants to stress the implementation of music and music therapy techniques and related specific training programs in the field of occupational therapy, pointing and summarizing main workable evidence-based approaches with music in occupational therapy settings.
Topics: Activities of Daily Living; Evidence-Based Practice; Humans; Music Therapy; Occupational Therapy; Treatment Outcome
PubMed: 32614544
DOI: No ID Found -
The Cochrane Database of Systematic... Jan 2023Low vision affects over 300 million people worldwide and can compromise both activities of daily living and quality of life. Rehabilitative training and vision assistive... (Comparative Study)
Comparative Study Review
BACKGROUND
Low vision affects over 300 million people worldwide and can compromise both activities of daily living and quality of life. Rehabilitative training and vision assistive equipment (VAE) may help, but some visually impaired people have limited resources to attend in-person visits to rehabilitation clinics to be trained to learn to use VAE. These people may be able to overcome barriers to care through access to remote, internet-based consultation (telerehabilitation).
OBJECTIVES
To compare the effects of telerehabilitation with face-to-face (e.g. in-office or inpatient) vision rehabilitation services for improving vision-related quality of life and near reading ability in people with visual function loss due to any ocular condition. Secondary objectives were to evaluate compliance with scheduled rehabilitation sessions, abandonment rates for VAE devices, and patient satisfaction ratings.
SEARCH METHODS
We searched the Cochrane Central Register of Controlled Trials (CENTRAL), which contains the Cochrane Eyes and Vision Trials Register) (2021, Issue 9); Ovid MEDLINE; Embase.com; PubMed; ClinicalTrials.gov; and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP). We did not use any language restriction or study design filter in the electronic searches; however, we restricted the searches from 1980 onwards because the internet was not introduced to the public until 1982. We last searched CENTRAL, MEDLINE Ovid, Embase, and PubMed on 14 September 2021, and the trial registries on 16 March 2022.
SELECTION CRITERIA
We included randomized controlled trials (RCTs) or controlled clinical trials (CCTs) in which participants diagnosed with low vision had received vision rehabilitation services remotely from a human provider using internet, web-based technology compared with an approach involving in-person consultations.
DATA COLLECTION AND ANALYSIS
Two review authors independently screened titles and abstracts retrieved by the searches of the electronic databases and then full-text articles for eligible studies. Two review authors independently abstracted data from the included studies. Any discrepancies were resolved by discussion.
MAIN RESULTS
We identified one RCT/CCT that indirectly met our inclusion criteria, and two ongoing trials that met our inclusion criteria. The included trial had an overall high risk of bias. We did not conduct a quantitative analysis since multiple controlled trials were not identified. The single included trial of 57 participants utilized a parallel-group design. It compared 30 hours of either personalized low vision training through telerehabilitation with a low vision therapist (the experimental group) with the self-training standard provided by eSight using the eSkills User Guide that was self-administered by the participants at home for one hour per day for 30 days (the comparison group). The trial investigators found a similar direction of effects for both groups for vision-related quality of life and satisfaction at two weeks, three months, and six months. A greater proportion of participants in the comparison group had abandoned or discontinued use of the eSight Eyewear at two weeks than those in the telerehabilitation group, but discontinuance rates were similar between groups at one month and three months. We rated the certainty of the evidence for all outcomes as very low due to high risk of bias in randomization processes and missing outcome data and imprecision. AUTHORS' CONCLUSIONS: The included trial found similar efficacy between telerehabilitation with a therapist and an active control intervention of self-guided training in mostly younger to middle-aged adults with low vision who received a new wearable electronic aid. Given the disease burden and the growing interest in telemedicine, the two ongoing studies, when completed, may provide further evidence of the potential for telerehabilitation as a platform for providing services to people with low vision.
Topics: Adult; Humans; Middle Aged; Blindness; Telemedicine; Telerehabilitation; Vision, Low; Activities of Daily Living; Quality of Life
PubMed: 36637057
DOI: 10.1002/14651858.CD011019.pub4 -
European Journal of Preventive... May 2022
Topics: Cardiac Rehabilitation; Coronary Artery Disease; Humans; Quality of Life; Telerehabilitation
PubMed: 34568904
DOI: 10.1093/eurjpc/zwab138 -
Physical Medicine and Rehabilitation... May 2024Stroke outcomes are influenced by factors such as education, lifestyle, and access to care, which determine the extent of functional recovery. Disparities in stroke... (Review)
Review
Stroke outcomes are influenced by factors such as education, lifestyle, and access to care, which determine the extent of functional recovery. Disparities in stroke rehabilitation research have traditionally included age, race/ethnicity, and sex, but other areas make up a gap in the literature. This article conducted a literature review of original research articles published between 2008 and 2022. The article also expands on research that highlights stroke disparities in risk factors, rehabilitative stroke care, language barriers, outcomes for stroke survivors, and interventions focused on rehabilitative stroke disparities.
Topics: Humans; Stroke Rehabilitation; Healthcare Disparities; Stroke; Recovery of Function
PubMed: 38514219
DOI: 10.1016/j.pmr.2023.06.030