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Cardiology Journal 2008This article provides an overview of current recommendations regarding cardiac rehabilitation (CR) after myocardial infarction and its clinical application. Evidence... (Review)
Review
This article provides an overview of current recommendations regarding cardiac rehabilitation (CR) after myocardial infarction and its clinical application. Evidence shows that exercise- based CR after cardiac events positively affects the extent of disability and level of quality of life, and has also important beneficial role in modifying morbidity and mortality. Cardiac rehabilitation is an integral component of the care for patients who have undergone acute myocardial infarction, after invasive coronary procedures and those with chronic stable angina. Although in the last four decades physical training has assumed a major role in health care of coronary artery disease patients, cardiac rehabilitation does not consist exclusively of regular exercising. Comprehensive cardiac rehabilitation should include the following components: clinical evaluation, optimization of pharmacotherapy, physical training, psychological rehabilitation, evaluation and reduction of coronary disease risk factors, life style modification, and patient education. Comprehensive cardiac rehabilitation should be addressed by the designated team (physician, physiotherapist, nurse, psychologist, dietician, social worker) immediately after acute phase of myocardial infarction and should contain individualized programs designed to optimize physical, psychological, social and emotional status. Modern model of comprehensive cardiac rehabilitation should be initiated as early as possible, continued for required time, properly staged, and individualized depending on clinical status of the patients.
Topics: Comprehensive Health Care; Exercise Therapy; Humans; Myocardial Infarction; Physical Therapy Modalities; Practice Guidelines as Topic
PubMed: 18810728
DOI: No ID Found -
European Journal of Physical and... Sep 2008Rehabilitation aims to enable people experiencing or likely to experience disability to achieve and maintain optimal functioning. Consequently, the assessment of... (Review)
Review
Rehabilitation aims to enable people experiencing or likely to experience disability to achieve and maintain optimal functioning. Consequently, the assessment of functioning is the starting point of a patient and goal oriented rehabilitation process. Within the International Classification of Functioning, Disability and Health (ICF) rehabilitation practitioners can rely for the first on a worldwide accepted model providing a universal language for the description and classification of functioning. To take advantage of the ICF in rehabilitation management there is a need to develop appropriate ICF Tools for clinical practice. Such ICF Tools, integrating the model and the classification of the ICF, have to be integrated in a problem solving approach provided by the Rehab-Cycle. ICF Tools have been developed for the use in the different steps of the Rehab-Cycle. Existing ICF Core Sets in combination with the use of ICF Qualifiers were the basis for this development. In clinical practice, these ICF Tools allow the description of a functioning state, the illustration of the patient's experience of functioning and the relation between rehabilitation goals and appropriate intervention targets, an overview over required resources to improve specific aspects of human functioning and finally, the changes in functioning states following rehabilitative interventions. The ICF Tools support a common understanding of functioning and the communication among team members when used in multidisciplinary rehabilitation. The development of electronic documentation systems, the assignment of standardized instruments to ICF categories and the operationalization of the ICF Qualifiers can contribute to further improvements of ICF based rehabilitation management in the future.
Topics: Activities of Daily Living; Disability Evaluation; Health Status Indicators; Humans; International Classification of Diseases; Motor Activity; Needs Assessment; Physical Therapy Modalities; Social Behavior
PubMed: 18762742
DOI: No ID Found -
Journal of Neurologic Physical Therapy... Apr 2022Uncompensated vestibular hypofunction can result in symptoms of dizziness, imbalance, and/or oscillopsia, gaze and gait instability, and impaired navigation and spatial...
Vestibular Rehabilitation for Peripheral Vestibular Hypofunction: An Updated Clinical Practice Guideline From the Academy of Neurologic Physical Therapy of the American Physical Therapy Association.
BACKGROUND
Uncompensated vestibular hypofunction can result in symptoms of dizziness, imbalance, and/or oscillopsia, gaze and gait instability, and impaired navigation and spatial orientation; thus, may negatively impact an individual's quality of life, ability to perform activities of daily living, drive, and work. It is estimated that one-third of adults in the United States have vestibular dysfunction and the incidence increases with age. There is strong evidence supporting vestibular physical therapy for reducing symptoms, improving gaze and postural stability, and improving function in individuals with vestibular hypofunction. The purpose of this revised clinical practice guideline is to improve quality of care and outcomes for individuals with acute, subacute, and chronic unilateral and bilateral vestibular hypofunction by providing evidence-based recommendations regarding appropriate exercises.
METHODS
These guidelines are a revision of the 2016 guidelines and involved a systematic review of the literature published since 2015 through June 2020 across 6 databases. Article types included meta-analyses, systematic reviews, randomized controlled trials, cohort studies, case-control series, and case series for human subjects, published in English. Sixty-seven articles were identified as relevant to this clinical practice guideline and critically appraised for level of evidence.
RESULTS
Based on strong evidence, clinicians should offer vestibular rehabilitation to adults with unilateral and bilateral vestibular hypofunction who present with impairments, activity limitations, and participation restrictions related to the vestibular deficit. Based on strong evidence and a preponderance of harm over benefit, clinicians should not include voluntary saccadic or smooth-pursuit eye movements in isolation (ie, without head movement) to promote gaze stability. Based on moderate to strong evidence, clinicians may offer specific exercise techniques to target identified activity limitations and participation restrictions, including virtual reality or augmented sensory feedback. Based on strong evidence and in consideration of patient preference, clinicians should offer supervised vestibular rehabilitation. Based on moderate to weak evidence, clinicians may prescribe weekly clinic visits plus a home exercise program of gaze stabilization exercises consisting of a minimum of: (1) 3 times per day for a total of at least 12 minutes daily for individuals with acute/subacute unilateral vestibular hypofunction; (2) 3 to 5 times per day for a total of at least 20 minutes daily for 4 to 6 weeks for individuals with chronic unilateral vestibular hypofunction; (3) 3 to 5 times per day for a total of 20 to 40 minutes daily for approximately 5 to 7 weeks for individuals with bilateral vestibular hypofunction. Based on moderate evidence, clinicians may prescribe static and dynamic balance exercises for a minimum of 20 minutes daily for at least 4 to 6 weeks for individuals with chronic unilateral vestibular hypofunction and, based on expert opinion, for a minimum of 6 to 9 weeks for individuals with bilateral vestibular hypofunction. Based on moderate evidence, clinicians may use achievement of primary goals, resolution of symptoms, normalized balance and vestibular function, or plateau in progress as reasons for stopping therapy. Based on moderate to strong evidence, clinicians may evaluate factors, including time from onset of symptoms, comorbidities, cognitive function, and use of medication that could modify rehabilitation outcomes.
DISCUSSION
Recent evidence supports the original recommendations from the 2016 guidelines. There is strong evidence that vestibular physical therapy provides a clear and substantial benefit to individuals with unilateral and bilateral vestibular hypofunction.
LIMITATIONS
The focus of the guideline was on peripheral vestibular hypofunction; thus, the recommendations of the guideline may not apply to individuals with central vestibular disorders. One criterion for study inclusion was that vestibular hypofunction was determined based on objective vestibular function tests. This guideline may not apply to individuals who report symptoms of dizziness, imbalance, and/or oscillopsia without a diagnosis of vestibular hypofunction.
DISCLAIMER
These recommendations are intended as a guide to optimize rehabilitation outcomes for individuals undergoing vestibular physical therapy. The contents of this guideline were developed with support from the American Physical Therapy Association and the Academy of Neurologic Physical Therapy using a rigorous review process. The authors declared no conflict of interest and maintained editorial independence.Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A369).
Topics: Activities of Daily Living; Adult; Dizziness; Humans; Physical Therapy Modalities; Quality of Life; Vertigo; Vestibular Diseases
PubMed: 34864777
DOI: 10.1097/NPT.0000000000000382 -
Developmental Medicine and Child... Jan 2020To explore the relationship between rehabilitation therapies and development in children with cerebral palsy (CP).
AIM
To explore the relationship between rehabilitation therapies and development in children with cerebral palsy (CP).
METHOD
We conducted a prospective, longitudinal study involving 656 children with CP (mean age [SD] 6y [2y 8mo] at study entry; 1y 6mo-11y 11mo; 287 females, 369 males), and their parents. Children were assessed two to five times over 2 years by therapists using standardized measures of balance and walking endurance. Parents completed questionnaires on demographics, rehabilitation therapies, and their children's performance in self-care and participation in recreation. Therapists and parents collaboratively classified children's Gross Motor Function Classification System (GMFCS) levels. We created longitudinal graphs for each GMFCS level, depicting change across time using centiles. Using multinomial models, we analyzed the relationship between therapies (amount, focus, family-centeredness, and the extent therapies met children's needs) and whether change in balance, walking endurance, and participation was 'more than' and 'less than' the reference of 'as expected'.
RESULTS
Children were more likely to progress 'more than expected' when participating in recreation when therapies were family-centered, met children's needs, and focused on structured play/recreation. A focus on health and well-being was positively associated with participation and self-care. The amount of therapy did not predict outcomes.
INTERPRETATION
Therapy services that are family-centered, consider the needs of the child, and focus on structured play/recreational activities and health/well-being may enhance the development of children with CP.
WHAT THIS PAPER ADDS
Family-centered rehabilitation therapies were positively associated with greater participation in family/recreation activities and walking endurance. Parental perception that rehabilitation therapies met children's needs was associated with greater participation in family/recreation activities. Structured play, recreational activities, and health/well-being are important for self-care and participation when planning rehabilitation therapy. The amount of rehabilitation therapy was not related to developmental outcomes.
Topics: Cerebral Palsy; Child; Child, Preschool; Family; Female; Humans; Infant; Longitudinal Studies; Male; Occupational Therapy; Outcome and Process Assessment, Health Care; Patient Satisfaction; Physical Therapy Modalities; Recreation Therapy; Severity of Illness Index; Speech Therapy
PubMed: 31353456
DOI: 10.1111/dmcn.14325 -
British Journal of Sports Medicine Dec 2004Tennis elbow or lateral epicondylitis is one of the most common lesions of the arm with a well defined clinical presentation, which significantly impacts on the... (Review)
Review
Tennis elbow or lateral epicondylitis is one of the most common lesions of the arm with a well defined clinical presentation, which significantly impacts on the community. Many treatment approaches have been proposed to manage this condition. One is Cyriax physiotherapy. The effectiveness and reported effects of this intervention are reviewed.
Topics: Humans; Manipulation, Orthopedic; Massage; Physical Therapy Modalities; Tennis Elbow
PubMed: 15562158
DOI: 10.1136/bjsm.2004.013573 -
Progress in Brain Research 2015Music listening and music making activities are powerful tools to engage multisensory and motor networks, induce changes within these networks, and foster links between... (Review)
Review
Music listening and music making activities are powerful tools to engage multisensory and motor networks, induce changes within these networks, and foster links between distant, but functionally related brain regions with continued and life-long musical practice. These multimodal effects of music together with music's ability to tap into the emotion and reward system in the brain can be used to facilitate and enhance therapeutic approaches geared toward rehabilitating and restoring neurological dysfunctions and impairments of an acquired or congenital brain disorder. In this article, we review plastic changes in functional networks and structural components of the brain in response to short- and long-term music listening and music making activities. The specific influence of music on the developing brain is emphasized and possible transfer effects on emotional and cognitive processes are discussed. Furthermore, we present data on the potential of using musical tools and activities to support and facilitate neurorehabilitation. We will focus on interventions such as melodic intonation therapy and music-supported motor rehabilitation to showcase the effects of neurologic music therapies and discuss their underlying neural mechanisms.
Topics: Brain; Humans; Music; Music Therapy; Nervous System Diseases; Neuronal Plasticity
PubMed: 25725918
DOI: 10.1016/bs.pbr.2014.11.029 -
International Urogynecology Journal Nov 2019Dyspareunia, the symptom of painful sexual intercourse, is a common sexual dysfunction in reproductive-aged women. Because of its multifactorial etiology, a... (Randomized Controlled Trial)
Randomized Controlled Trial
INTRODUCTION AND HYPOTHESIS
Dyspareunia, the symptom of painful sexual intercourse, is a common sexual dysfunction in reproductive-aged women. Because of its multifactorial etiology, a multidisciplinary approach may be required to treat it. Musculoskeletal factors play an important role; thus, rehabilitating the pelvic floor and modifying the tone of the pelvic floor muscles (PFMs) may be an effective way to treat this dysfunction. The aim of this randomized controlled clinical study was to evaluate the effects of pelvic floor rehabilitation techniques on dyspareunia.
METHODS
Of 84 women, assessed for eligibility, 64 women with dyspareunia were randomized into two groups: the experimental group (n = 32) received electrotherapy, manual therapy, and PFM exercises and the control group (n = 32) had no treatment while on the waiting list. Evaluations of PFM strength and endurance, sexual function, and pain were made directly before and after 3 months of treatment and at the 3-month follow-up.
RESULTS
Between-group changes showed significant improvement in the experimental group in comparison with control group. Mean difference in the PFM strength (according to the 0-5 Oxford scale) between groups was 2.01 and the mean difference of endurance was 6.26 s. Also, the mean difference in the Female Sexual Function Index score (the score ranges from 2 to 95) was 51.05, and the mean difference in the VAS score was 7.32. All of the changes were statistically significant (p < 0.05).
CONCLUSIONS
According to the results, pelvic floor rehabilitation is an important part of a multidisciplinary treatment approach to dyspareunia.
Topics: Adult; Dyspareunia; Electric Stimulation Therapy; Exercise Therapy; Female; Humans; Musculoskeletal Manipulations; Pelvic Floor
PubMed: 31286158
DOI: 10.1007/s00192-019-04019-3 -
BioMed Research International 2016Objective. The aim of this paper is to review different surface modifications of dental implants and their effect on osseointegration. Common marketed as well as... (Review)
Review
Objective. The aim of this paper is to review different surface modifications of dental implants and their effect on osseointegration. Common marketed as well as experimental surface modifications are discussed. Discussion. The major challenge for contemporary dental implantologists is to provide oral rehabilitation to patients with healthy bone conditions asking for rapid loading protocols or to patients with quantitatively or qualitatively compromised bone. These charging conditions require advances in implant surface design. The elucidation of bone healing physiology has driven investigators to engineer implant surfaces that closely mimic natural bone characteristics. This paper provides a comprehensive overview of surface modifications that beneficially alter the topography, hydrophilicity, and outer coating of dental implants in order to enhance osseointegration in healthy as well as in compromised bone. In the first part, this paper discusses dental implants that have been successfully used for a number of years focusing on sandblasting, acid-etching, and hydrophilic surface textures. Hereafter, new techniques like Discrete Crystalline Deposition, laser ablation, and surface coatings with proteins, drugs, or growth factors are presented. Conclusion. Major advancements have been made in developing novel surfaces of dental implants. These innovations set the stage for rehabilitating patients with high success and predictable survival rates even in challenging conditions.
Topics: Animals; Bone-Implant Interface; Dental Implants; Humans; Osseointegration; Rehabilitation; Surface Properties
PubMed: 27478833
DOI: 10.1155/2016/6285620 -
Annals of Physical and Rehabilitation... Sep 2022Hemiplegic shoulder pain (HSP) is a disabling complication affecting stroke survivors. In this context, rehabilitation might play a key role in its clinical management.... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Hemiplegic shoulder pain (HSP) is a disabling complication affecting stroke survivors. In this context, rehabilitation might play a key role in its clinical management. Recent systematic reviews of the impact of rehabilitative approaches on pain reduction in patients with HSP are lacking.
OBJECTIVE
This systematic review of randomized controlled trials (RCTs) with meta-analysis aimed to investigate the efficacy of rehabilitative techniques in reducing HSP in stroke survivors.
METHODS
PubMed, Scopus, and Web of Science were searched from inception to March 8, 2021 to identify RCTs of stroke survivors with HSP undergoing specific rehabilitative techniques combined with conventional therapy to reduce pain intensity. A network meta-analysis and meta-analysis of the Bayesian network of random effects were performed. The risk of bias of studies was assessed with Version 2 of the Cochrane Risk of Bias tool for randomized trials.
RESULTS
Of 1139 articles identified, 12 were included in the final synthesis. We analyzed data for 723 stroke survivors, reporting a significant overall decrease in pain intensity after a rehabilitative approach by the Bayesian meta-analysis (standardized mean difference 2.78, 95% confidence interval 0.89;-4.59; p = 0.003). We report a significant reduction in HSP with botulinum toxin type A injection (p = 0.001), suprascapular nerve pulsed radiofrequency (p = 0.030), suprascapular nerve block (p = 0.020), and trigger-point dry needling (p = 0.005) as compared with conventional rehabilitation. Concerning the effect size, we identified a Bayesian factor of 97.2, with very strong evidence of superiority of rehabilitative techniques.
CONCLUSIONS
The present systematic review and meta-analysis showed that adding other rehabilitative techniques to conventional rehabilitation was significantly more effective than conventional rehabilitation alone in the complex management of patients affected by HSP.
Topics: Hemiplegia; Humans; Injections, Intra-Articular; Pain Measurement; Shoulder Pain; Stroke; Stroke Rehabilitation
PubMed: 34757009
DOI: 10.1016/j.rehab.2021.101602 -
The Journal of Orthopaedic and Sports... Jul 2012The management of patients after anterior cruciate ligament reconstruction should be evidence based. Since our original published guidelines in 1996, successful outcomes...
UNLABELLED
The management of patients after anterior cruciate ligament reconstruction should be evidence based. Since our original published guidelines in 1996, successful outcomes have been consistently achieved with the rehabilitation principles of early weight bearing, using a combination of weight-bearing and non-weight-bearing exercise focused on quadriceps and lower extremity strength, and meeting specific objective requirements for return to activity. As rehabilitative evidence and surgical technology and procedures have progressed, the original guidelines should be revisited to ensure that the most up-to-date evidence is guiding rehabilitative care. Emerging evidence on rehabilitative interventions and advancements in concomitant surgeries, including those addressing chondral and meniscal injuries, continues to grow and greatly affect the rehabilitative care of patients with anterior cruciate ligament reconstruction. The aim of this article is to update previously published rehabilitation guidelines, using the most recent research to reflect the most current evidence for management of patients after anterior cruciate ligament reconstruction. The focus will be on current concepts in rehabilitation interventions and modifications needed for concomitant surgery and pathology.
LEVEL OF EVIDENCE
Therapy, level 5.
Topics: Anterior Cruciate Ligament Reconstruction; Exercise Therapy; Female; Humans; Knee Injuries; Male; Medial Collateral Ligament, Knee; Menisci, Tibial; Muscle Strength; Practice Guidelines as Topic; Recovery of Function; Severity of Illness Index; Tibial Meniscus Injuries; Treatment Outcome
PubMed: 22402434
DOI: 10.2519/jospt.2012.3871