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Expert Review of Cardiovascular Therapy Aug 2019: The aim of this review is to introduce the audience to exercise training (ET) as a therapeutic tool in coronary heart disease (CHD) and to discuss the role of and... (Review)
Review
: The aim of this review is to introduce the audience to exercise training (ET) as a therapeutic tool in coronary heart disease (CHD) and to discuss the role of and advances in cardiac rehabilitation (CR) as a means of effectively delivering ET. : The physiological mechanisms behind ET effects on the cardiovascular (CV) system as well as the implementation of ET in CR and the effects of CR on CV morbidity, risk factor modification, and mortality will be reviewed. Additionally, the clinical and financial impact of CR in today's healthcare systems will be discussed. : It is well-established that CR continues to be under-utilized despite significant benefits to patients and healthcare systems alike. Innovation in the structure of CR (such as the implementation of high-intensity protocols) and in accessibility (home and tele-health CR programs) is already helping improve efficacy and increase utilization of CR. However, the efficacy of home/remote delivery protocols is not well established and they comprise a minority of available CR services. More data and efforts are needed to improve such protocols and maximize the reach of remote delivery systems in order to effectively deliver CR services to more eligible individuals at lower costs.
Topics: Cardiac Rehabilitation; Coronary Disease; Exercise Therapy; Female; Humans; Male; Treatment Outcome
PubMed: 31365840
DOI: 10.1080/14779072.2019.1651198 -
Scientific Reports Sep 2023Mirror therapy is applied to reduce phantom pain and as a rehabilitation technique in post-stroke patients. Using Virtual Reality and head-mounted displays this therapy...
Mirror therapy is applied to reduce phantom pain and as a rehabilitation technique in post-stroke patients. Using Virtual Reality and head-mounted displays this therapy can be performed in virtual scenarios. However, for its efficient use in clinical settings, some hardware limitations need to be solved. A new system to perform mirror therapy in virtual scenarios for post-stroke patients is proposed. The system requires the patient a standalone virtual reality headset with hand-tracking features and for the rehabilitator an external computer or tablet device. The system provides functionalities for the rehabilitator to prepare and follow-up rehabilitation sessions and a virtual scenario for the patient to perform rehabilitation. The system has been tested on a real scenario with the support of three experienced rehabilitators and considering ten post-stroke patients in individual sessions focused on upper limb motor rehabilitation. The development team observed all the sessions and took note of detected errors regarding technological aspects. Solutions to solve detected problems will be proposed and evaluated in terms of feasibility, performance cost, additional system cost, number of solved issues, new limitations, or advantages for the patient. Three types of errors were detected and solved. The first error is related to the position of the hands relative to the head-mounted display. To solve it the exercise area can be limited to avoid objectives that require turning the head too far. The second error is related to the interaction between the hands and the virtual objects. It can be solved making the main hand non-interactive. The last type of error is due to patient limitations and can be mitigated by having a virtual hand play out an example motion to bring the patient's attention back to the exercise. Other solutions have been evaluated positively and can be used in addition or instead of the selected ones. For mirror therapy based on virtual reality to be efficient in post-stroke rehabilitation the current head-mounted display-based solutions need to be complemented with specific strategies that avoid or mitigate the limitations of the technology and the patient. Solutions that help with the most common issues have been proposed.
Topics: Humans; Mirror Movement Therapy; Hand; Stroke; Upper Extremity; Virtual Reality
PubMed: 37679388
DOI: 10.1038/s41598-023-40546-2 -
Journal of Cardiology Dec 2020While the number of cancer patients is increasing with the arrival of the super-aging society, the age-adjusted mortality rate of cancer decreases due to medical... (Review)
Review
While the number of cancer patients is increasing with the arrival of the super-aging society, the age-adjusted mortality rate of cancer decreases due to medical advances, and the number of cancer survivors is growing rapidly. Cardiovascular disease (CVD) is one of the most important causes of death among cancer survivors. In recent years, the number of cancer patients with CVD risk factors has increased. Also, the emergence of new drugs has led to the emergence of a new condition called cancer treatment-related cardiovascular disease (CTRCD). Cardio-oncology (onco-cardiology) is a new multidisciplinary field with the common goal of completing cancer treatment and improving the prognosis of cancer patients and survivors, including the prevention, diagnosis, and treatment of CTRCD. Cardio-oncology rehabilitation (CORE) is a new concept that aims to reduce the risk of CVD and improve cardiopulmonary fitness in cancer survivors by providing exercise prescriptions and cardiac rehabilitation in addition to so-called cancer rehabilitation during and after cancer treatment. This review provides an overview of the theoretical background, feasibility, challenges, and opportunities of CORE, including a series of recent white papers and scientific statements released by the American Heart Association.
Topics: Cancer Survivors; Cardiac Rehabilitation; Cardiology; Cardiovascular Diseases; Exercise; Exercise Therapy; Humans; Medical Oncology; Neoplasms
PubMed: 32736905
DOI: 10.1016/j.jjcc.2020.07.014 -
Child and Adolescent Psychiatric... Jan 2020Recovery-oriented treatment for youth with psychosis goes beyond a symptom and deficit-amelioration model, promoting engagement and functioning within the community.... (Review)
Review
Recovery-oriented treatment for youth with psychosis goes beyond a symptom and deficit-amelioration model, promoting engagement and functioning within the community. Given the challenges young people with psychosis face, early psychosis treatment programs often integrate rehabilitative components targeting functional outcomes. The current article reviews 4 community rehabilitation programs in early psychosis: care coordination, cognitive rehabilitation, supported education and employment, and peer support. For each of these rehabilitative intervention programs, we discuss challenges faced by youth with psychosis, clinical intervention practices, the current state of evidence, and clinical and/or research considerations.
Topics: Adolescent; Adult; Cognitive Remediation; Community Mental Health Services; Employment, Supported; Humans; Peer Group; Psychiatric Rehabilitation; Psychotic Disorders; Young Adult
PubMed: 31708049
DOI: 10.1016/j.chc.2019.08.012 -
Human Resources For Health Sep 2021Physiotherapy and rehabilitative services are an integral part of patient care, but in many developing countries they are not considered a priority and are either not...
Physiotherapy and rehabilitative services are an integral part of patient care, but in many developing countries they are not considered a priority and are either not available or not easily accessible to those who need them. Bhutan is one such country where healthcare is provided free of cost to all, but as of 2021 physiotherapy services were available only in 26 of 48 hospitals and 19 of 20 districts. The number of physiotherapy professionals per 10,000 population is 1.4 with significant rates of attrition. There is lack of awareness among patients and other health professionals about physiotherapy and rehabilitation services. The country needs to integrate physiotherapy and rehabilitation services into the overall health policy framework and develop proper planning of human resources and infrastructure to meet the current and future demands.
Topics: Bhutan; Delivery of Health Care; Humans; Patient Care; Physical Therapy Modalities; Workforce
PubMed: 34479592
DOI: 10.1186/s12960-021-00649-1 -
Brain and Nerve = Shinkei Kenkyu No... Jun 2024Several evidence-based guidelines of rehabilitative intervention for attentional disturbance following acquired brain injury have been published. The author introduced... (Review)
Review
Several evidence-based guidelines of rehabilitative intervention for attentional disturbance following acquired brain injury have been published. The author introduced two cutting-edge guidelines: Japan Stroke Society Guideline 2021 for the Treatment of Stroke [Revised version 2023]; and INCOG 2.0 Guideline for Cognitive Rehabilitation Following Traumatic Brain Injury, PartII: Attention and Information Processing Speed (2023). The effect of the cognitive rehabilitation should be evaluated by change of performance in real-world tasks and activities as well as measures of various neuropsychological tests including paced auditory serial addition task (PASAT) and trail making test. Direct attention training such as Attention Process Training (APT) series or computer-based training may be useful especially for stroke patients. Dual-task training may specifically improve multi-tasking performance. Time pressure management can improve speed of performance on everyday tasks for patients with slowed information processing. Metacognitive training using everyday activities may be recommended for mild to moderate impairments. Modifications of environment and/or tasks may also be helpful to decrease errors in daily activities.
Topics: Humans; Attention; Stroke Rehabilitation; Neuropsychological Tests
PubMed: 38853502
DOI: 10.11477/mf.1416202671 -
Clinical Medicine (London, England) Jul 2020After severe COVID-19 disease, many patients will experience a variety of problems with normal functioning and will require rehabilitation services to overcome these...
After severe COVID-19 disease, many patients will experience a variety of problems with normal functioning and will require rehabilitation services to overcome these problems. The principles of and evidence on rehabilitation will allow an effective response. These include a simple screening process; use of a multidisciplinary expert team; four evidence-based classes of intervention (exercise, practice, psychosocial support, and education particularly about self-management); and a range of tailored interventions for other problems. The large number of COVID-19 patients needing rehabilitation coupled with the backlog remaining from the crisis will challenge existing services. The principles underpinning vital service reconfigurations needed are discussed.
Topics: COVID-19; Coronavirus Infections; Evidence-Based Medicine; Exercise; Humans; Occupational Therapy; Pandemics; Patient Care Planning; Patient Education as Topic; Pneumonia, Viral; Rehabilitation; Social Support
PubMed: 32518105
DOI: 10.7861/clinmed.2020-0353 -
Artificial Organs Jan 2022The coronavirus diseases 2019 (COVID-19) pandemic posed severe difficulties in managing critically ill patients in hospital care settings. Extracorporeal membrane... (Review)
Review
BACKGROUND AND PURPOSE
The coronavirus diseases 2019 (COVID-19) pandemic posed severe difficulties in managing critically ill patients in hospital care settings. Extracorporeal membrane oxygenation (ECMO) support has been proven to be lifesaving support during the SARS-CoV-2 outbreak. The purpose of this review was to describe the rehabilitative treatments provided to patients undergoing ECMO support during the COVID-19 pandemic.
METHODS
We searched PubMed and Scopus for English-language studies published from the databases' inception until June 30, 2021. We excluded editorials, letters to the editor, and studies that did not describe rehabilitative procedures during ECMO support. We also excluded those articles not written in English.
RESULTS
A total of 50 articles were identified. We ultimately included nine studies, seven of which were case reports. Only two studies had more than one patient; an observational design analyzing the clinical course of 19 patients and a case series of three patients. Extracorporeal support duration varied from 9 to 49 days, and the primary indication was acute respiratory distress syndrome COVID-19-related. Rehabilitative treatment mainly consisted of in-bed mobilization, postural transfers (including sitting), and respiratory exercises. After hospital discharge, patients were referred to rehabilitation facilities. Physiotherapeutic interventions provided during ECMO support and after its discontinuation were feasible and safe.
CONCLUSION
The physiotherapeutic treatment of patients undergoing ECMO support includes several components and must be provided in a multidisciplinary context. The optimal approach depends on the patient's status, including sedation, level of consciousness, ECMO configuration, types of cannulas, and cannulation site.
Topics: COVID-19; Extracorporeal Membrane Oxygenation; Humans; Physical Therapy Modalities; SARS-CoV-2
PubMed: 34778984
DOI: 10.1111/aor.14110 -
Thoracic Surgery Clinics Aug 2020Enhanced recovery pathways (ERPs), used across multiple surgical subspecialties, is a multidisciplinary delivery of perioperative care designed to lessen the... (Review)
Review
Enhanced recovery pathways (ERPs), used across multiple surgical subspecialties, is a multidisciplinary delivery of perioperative care designed to lessen the psychological stress of patients undergoing surgery. Thoracic ERP has been implemented but is not widespread, and variations exist between programs. Evidence of the benefit of thoracic ERP is emerging. This article presents common components of a thoracic surgery ERP and reviews contemporary outcomes.
Topics: Antibiotic Prophylaxis; Atrial Fibrillation; Early Ambulation; Humans; Nutrition Therapy; Perioperative Care; Postoperative Complications; Rehabilitation; Thoracic Surgical Procedures; Venous Thrombosis
PubMed: 32593359
DOI: 10.1016/j.thorsurg.2020.04.005 -
F1000Research 2021Home-based rehabilitation exercise following Total Hip Arthroplasty (THA) shows similar outcomes compared to supervised outpatient rehabilitation exercise. Little is...
Home-based rehabilitation exercise following Total Hip Arthroplasty (THA) shows similar outcomes compared to supervised outpatient rehabilitation exercise. Little is known about patients' experiences with home-based rehabilitation, and this study aimed to investigate how patients perceived home-based rehabilitation exercise and general physical activity after THA, focusing on facilitators and barriers. Semi-structured interviews of qualitative design were conducted with 22 patients who had undergone THA and who had performed home-based rehabilitation exercise. The study took place in a regional hospital in Denmark between January 2018 and May 2019. Data were analyzed using an interpretive thematic analysis approach, with theoretical underpinning from the concept 'conduct of everyday life'. The study is embedded within the Pragmatic Home-Based Exercise Therapy after Total Hip Arthroplasty-Silkeborg trial (PHETHAS-1). The main theme, 'wishing to return to the well-known everyday life', and four subthemes were identified. Generally, participants found the home-based rehabilitation exercise boring but were motivated by the goal of returning to their well-known everyday life and performing their usual general physical activities, though some lacked contact to physiotherapist. Participants enrolled in the PHETHAS-1 study used the enrollment as part of their motivation for doing the exercises. Both pain and the absence of pain were identified as barriers for doing home-based rehabilitation exercise. Pain could cause insecurity about possible medical complications, while the absence of pain could lead to the rehabilitation exercise being perceived as pointless. The overall goal of returning to the well-known everyday life served as a facilitator for undertaking home-based rehabilitation exercise after THA along with the flexibility regarding time and place for performing exercises. Boring exercises as well as both pain and no pain were identified as barriers to the performance of home-based rehabilitation exercise. Participants were motivated towards performing general physical activities which were part of their everyday life.
Topics: Humans; Arthroplasty, Replacement, Hip; Exercise Therapy; Exercise; Physical Therapy Modalities; Muscle Strength
PubMed: 37359253
DOI: 10.12688/f1000research.51684.4