Pub Date : 2023-06-01DOI: 10.1097/MRR.0000000000000570
Alessia Marcassoli, Erika Guastafierro, Claudia Toppo, Matilde Leonardi, Anna Bersano, Giorgio Boncoraglio, Isabella Canavero, Alberto Raggi
Stroke causes a significant reduction in health-related quality of life (HRQoL), and studies addressing its predictors often rely on models with few variables. This study aimed to assess the degree to which health status, health habits, and features of the environment predict HRQoL in stroke survivors with stable clinical condition. WHO Quality of Life questionnaire for old-Age subjects (WHOQOL-AGE) was used to assess HRQoL. We ran a multivariable linear regression to predict WHOQOL-AGE variation, entering measures of health state, bad habits, healthy behaviors, physical environment features, and social support. Patients were stroke survivors with a stable clinical condition, distance from acute event of more than 6 months, and National Institutes of Health Stroke Scale (NIHSS) of 10 or less. A total of 122 participants (47 females, 97 with ischemic stroke) were enrolled, the mean age was 64.1, mean NIHSS 2.9, and mean distance from the acute event was 5.1 years. State anxiety (β = -0.202), trait anxiety (β = -0.232), depression (β = -0.255), social support (β = 0.247), and functional independence (β = -0.210) predicted WHOQOL-AGE variation (Adj. R2 = 0.549). Our results show that psychological symptoms, reduced social network, and functional dependence together have a negative impact on HRQoL. These elements, which are partly stroke-specific, should be taken into account in the recovery process to enhance patients' health outcomes.
{"title":"Psychosocial factors as main predictors of quality of life 5 years after stroke: a cross-sectional study from a third-level Italian center.","authors":"Alessia Marcassoli, Erika Guastafierro, Claudia Toppo, Matilde Leonardi, Anna Bersano, Giorgio Boncoraglio, Isabella Canavero, Alberto Raggi","doi":"10.1097/MRR.0000000000000570","DOIUrl":"https://doi.org/10.1097/MRR.0000000000000570","url":null,"abstract":"<p><p>Stroke causes a significant reduction in health-related quality of life (HRQoL), and studies addressing its predictors often rely on models with few variables. This study aimed to assess the degree to which health status, health habits, and features of the environment predict HRQoL in stroke survivors with stable clinical condition. WHO Quality of Life questionnaire for old-Age subjects (WHOQOL-AGE) was used to assess HRQoL. We ran a multivariable linear regression to predict WHOQOL-AGE variation, entering measures of health state, bad habits, healthy behaviors, physical environment features, and social support. Patients were stroke survivors with a stable clinical condition, distance from acute event of more than 6 months, and National Institutes of Health Stroke Scale (NIHSS) of 10 or less. A total of 122 participants (47 females, 97 with ischemic stroke) were enrolled, the mean age was 64.1, mean NIHSS 2.9, and mean distance from the acute event was 5.1 years. State anxiety (β = -0.202), trait anxiety (β = -0.232), depression (β = -0.255), social support (β = 0.247), and functional independence (β = -0.210) predicted WHOQOL-AGE variation (Adj. R2 = 0.549). Our results show that psychological symptoms, reduced social network, and functional dependence together have a negative impact on HRQoL. These elements, which are partly stroke-specific, should be taken into account in the recovery process to enhance patients' health outcomes.</p>","PeriodicalId":14301,"journal":{"name":"International Journal of Rehabilitation Research","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10281065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
We aimed to assess and rank comparative efficacy of different constraint-induced movement therapy (CIMT) protocols on motor function of upper extremity and activities of daily living (ADL) in stroke survivors. A comprehensive search was conducted in PubMed, EMBASE, Web of Science and Cochrane Library to identify randomized controlled trials on CIMT. Included studies were evaluated using the revised Cochrane risk of bias tool. Then a random-effects network meta-analysis was performed within a frequentist framework using Stata v16.0. Of the 1150 studies retrieved, 44 studies with 1779 participants were included. In terms of motor recovery of upper extremity, CIMT combined with trunk restraint, in which the less affected arm was constrained at least 4 h but no more than 6 h per day, ranked as the most effective intervention for the improvement of the Fugl-Meyer Assessment-Upper Extremity and the Action Research Arm Test score. In terms of ADL improvement, constraining the less affected arm for at least 4 h but no more than 6 h per day in CIMT combined with trunk restraint, was found to significantly improve the Motor Activity Log of quality of movement scale and amount of use scale score. The protocol of CIMT combined with trunk restraint, in which the less affected arm was constrained at least 4 h but no more than 6 h per day, ranked the highest in this analysis and might be considered in practice.
我们旨在评估不同约束诱导运动治疗(CIMT)方案对脑卒中幸存者上肢运动功能和日常生活活动(ADL)的比较疗效并进行排名。我们在PubMed、EMBASE、Web of Science和Cochrane Library中进行了全面的检索,以确定CIMT的随机对照试验。纳入的研究使用修订后的Cochrane偏倚风险工具进行评估。然后使用Stata v16.0在频率分析框架内进行随机效应网络元分析。在检索到的1150项研究中,包括44项研究,1779名参与者。在上肢运动恢复方面,CIMT联合躯干约束是改善Fugl-Meyer上肢评估和动作研究臂测试分数最有效的干预措施,其中影响较小的手臂每天约束至少4小时但不超过6小时。在ADL改善方面,在CIMT中,每天约束影响较轻的手臂至少4小时但不超过6小时,可以显著提高运动质量量表和使用量量表得分的Motor Activity Log。CIMT联合躯干约束方案,其中影响较小的手臂每天约束至少4小时但不超过6小时,在本分析中排名最高,可在实践中考虑。
{"title":"Effect of different constraint-induced movement therapy protocols on recovery of stroke survivors with upper extremity dysfunction: a systematic review and network meta-analysis.","authors":"Qian Gao, Yasu Zhang, Junzi Long, Mengyang Pan, Jing Wang, Fangjie Yang","doi":"10.1097/MRR.0000000000000577","DOIUrl":"https://doi.org/10.1097/MRR.0000000000000577","url":null,"abstract":"<p><p>We aimed to assess and rank comparative efficacy of different constraint-induced movement therapy (CIMT) protocols on motor function of upper extremity and activities of daily living (ADL) in stroke survivors. A comprehensive search was conducted in PubMed, EMBASE, Web of Science and Cochrane Library to identify randomized controlled trials on CIMT. Included studies were evaluated using the revised Cochrane risk of bias tool. Then a random-effects network meta-analysis was performed within a frequentist framework using Stata v16.0. Of the 1150 studies retrieved, 44 studies with 1779 participants were included. In terms of motor recovery of upper extremity, CIMT combined with trunk restraint, in which the less affected arm was constrained at least 4 h but no more than 6 h per day, ranked as the most effective intervention for the improvement of the Fugl-Meyer Assessment-Upper Extremity and the Action Research Arm Test score. In terms of ADL improvement, constraining the less affected arm for at least 4 h but no more than 6 h per day in CIMT combined with trunk restraint, was found to significantly improve the Motor Activity Log of quality of movement scale and amount of use scale score. The protocol of CIMT combined with trunk restraint, in which the less affected arm was constrained at least 4 h but no more than 6 h per day, ranked the highest in this analysis and might be considered in practice.</p>","PeriodicalId":14301,"journal":{"name":"International Journal of Rehabilitation Research","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10282080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-01DOI: 10.1097/MRR.0000000000000580
Ensar Abazović, Erol Kovačević, Josipa Nakić, Stanislav Peharec, Armin H Paravlic
The large body of published literature has shown that the effects of strength training can transfer from trained to untrained homologous limb muscles after unilateral training. These effects on strength have been shown to be very specific to the type and speed of training contraction. The aim of this study was to investigate the effects of a 4-week unilateral slow and fast velocity isokinetic concentric training, to compare the effects, and thus investigate whether these effects are speed-specific. Forty-four healthy female students allocated to slow training, fast training, or control performed 12 isokinetic concentric-concentric plantar/dorsal flexors training sessions (3 × 4 weeks) using their nondominant leg. Participants in the two experimental groups showed statistically significant gains in strength in both the trained (ranging from 8 to 41%) and untrained leg (5-26%), thus showing cross-education on strength effects. The present study demonstrated that 4 weeks (12 training sessions) of unilateral isokinetic resistance training in the concentric mode improved the strength of contralateral, untrained homologous muscles to the same extent, regardless of the contraction velocity used in females. Furthermore, the amount of concentric overload (50% more than during 60°/s) did not appear to affect the increase in strength gains. Therefore, practitioners are encouraged to use both training speeds when strength gains in the contralateral leg are the primary goal. If the training time is limited, however, training with a higher contraction speed is recommended.
{"title":"The effectiveness of unilateral isokinetic resistance training on cross-education is independent of contraction velocity: a case of female dorsiflexors and plantar flexors.","authors":"Ensar Abazović, Erol Kovačević, Josipa Nakić, Stanislav Peharec, Armin H Paravlic","doi":"10.1097/MRR.0000000000000580","DOIUrl":"https://doi.org/10.1097/MRR.0000000000000580","url":null,"abstract":"<p><p>The large body of published literature has shown that the effects of strength training can transfer from trained to untrained homologous limb muscles after unilateral training. These effects on strength have been shown to be very specific to the type and speed of training contraction. The aim of this study was to investigate the effects of a 4-week unilateral slow and fast velocity isokinetic concentric training, to compare the effects, and thus investigate whether these effects are speed-specific. Forty-four healthy female students allocated to slow training, fast training, or control performed 12 isokinetic concentric-concentric plantar/dorsal flexors training sessions (3 × 4 weeks) using their nondominant leg. Participants in the two experimental groups showed statistically significant gains in strength in both the trained (ranging from 8 to 41%) and untrained leg (5-26%), thus showing cross-education on strength effects. The present study demonstrated that 4 weeks (12 training sessions) of unilateral isokinetic resistance training in the concentric mode improved the strength of contralateral, untrained homologous muscles to the same extent, regardless of the contraction velocity used in females. Furthermore, the amount of concentric overload (50% more than during 60°/s) did not appear to affect the increase in strength gains. Therefore, practitioners are encouraged to use both training speeds when strength gains in the contralateral leg are the primary goal. If the training time is limited, however, training with a higher contraction speed is recommended.</p>","PeriodicalId":14301,"journal":{"name":"International Journal of Rehabilitation Research","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10282084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-01DOI: 10.1097/MRR.0000000000000574
Clara Selves, Thierry Lejeune, Christine Detrembleur, Marie-Adeline Haustrate, Gaëtant Stoquart
Hyper-resistance after a central nervous system injury has been largely referred to as spasticity, which is but one of its neural components. Assessment largely relies on clinical scales (Modified Ashworth scale - MAS and Modified Tardieu scale, MTS) which are unable to distinguish between the non-neural (tissue-related) and the neural (central nervous system-related) components. This study assessed criterion validity and reliability (reproducibility) of muscle stiffness measures, namely, maximum elastic stiffness (ELmax), viscous stiffness (VI), and path length (L-path) in the hand flexor muscles among people with stroke. Measurements were obtained with a wrist-electromechanical oscillatory device (w-EOD). Twenty-four people with arm impairment after stroke were evaluated with the w-EOD and clinical assessment (MAS and MTS), twice on the same day (short-term reliability) and once 10 days later (long-term reliability). For criterion validity, a Spearman coefficient ( r ) was calculated between stiffness values and the clinical scales. For reliability, intraclass correlation coefficients (ICCs), SEM, and MDC95 were calculated. Moderate correlations were observed between EL max and MAS ( r = 0.49) and MTS (V2, r = 0.43; V3, r = 0.49) of the wrist flexors, and finger flexors (MAS, r = 0.60; MTS V2, r = 0.56; MTS V3, r = 0.55). There was a poor correlation between the clinical scales and VI and L-path. Reliability was excellent for all stiffness measurements at short term (EL max : 0.95, VI: 0.94, L-path: 0.92) and good at long term (EL max : 0.87, VI: 0.76, L-path: 0.82). In conclusion, stiffness measurements are valid and reliable to evaluate hyper-resistance in people with stroke.
中枢神经系统损伤后的超抵抗在很大程度上被称为痉挛,这只是其神经成分之一。评估主要依赖于临床量表(改良Ashworth量表- MAS和改良Tardieu量表,MTS),这些量表无法区分非神经(组织相关)和神经(中枢神经系统相关)成分。本研究评估了中风患者手部屈肌的最大弹性刚度(ELmax)、粘性刚度(VI)和路径长度(L-path)肌肉刚度测量的标准效度和可靠性(可重复性)。测量是通过手腕机电振荡装置(w-EOD)获得的。对24例脑卒中后手臂损伤患者进行w-EOD和临床评估(MAS和MTS),当天2次(短期信度),10天后1次(长期信度)。对于标准效度,计算刚度值和临床量表之间的Spearman系数(r)。为了提高可靠性,我们计算了类内相关系数(ICCs)、SEM和MDC95。EL max与MAS (r = 0.49)和MTS (V2, r = 0.43;腕屈肌V3, r = 0.49)和指屈肌(MAS, r = 0.60;MTS V2, r = 0.56;MTS V3, r = 0.55)。临床量表与VI、L-path相关性较差。所有刚度测量在短期(EL max: 0.95, VI: 0.94, L-path: 0.92)和长期(EL max: 0.87, VI: 0.76, L-path: 0.82)的可靠性都很好。总之,刚度测量是有效和可靠的评估卒中患者的超抵抗。
{"title":"Validity and reliability of the assessment of hand flexors stiffness using a new electromechanical oscillatory device in people with stroke.","authors":"Clara Selves, Thierry Lejeune, Christine Detrembleur, Marie-Adeline Haustrate, Gaëtant Stoquart","doi":"10.1097/MRR.0000000000000574","DOIUrl":"https://doi.org/10.1097/MRR.0000000000000574","url":null,"abstract":"<p><p>Hyper-resistance after a central nervous system injury has been largely referred to as spasticity, which is but one of its neural components. Assessment largely relies on clinical scales (Modified Ashworth scale - MAS and Modified Tardieu scale, MTS) which are unable to distinguish between the non-neural (tissue-related) and the neural (central nervous system-related) components. This study assessed criterion validity and reliability (reproducibility) of muscle stiffness measures, namely, maximum elastic stiffness (ELmax), viscous stiffness (VI), and path length (L-path) in the hand flexor muscles among people with stroke. Measurements were obtained with a wrist-electromechanical oscillatory device (w-EOD). Twenty-four people with arm impairment after stroke were evaluated with the w-EOD and clinical assessment (MAS and MTS), twice on the same day (short-term reliability) and once 10 days later (long-term reliability). For criterion validity, a Spearman coefficient ( r ) was calculated between stiffness values and the clinical scales. For reliability, intraclass correlation coefficients (ICCs), SEM, and MDC95 were calculated. Moderate correlations were observed between EL max and MAS ( r = 0.49) and MTS (V2, r = 0.43; V3, r = 0.49) of the wrist flexors, and finger flexors (MAS, r = 0.60; MTS V2, r = 0.56; MTS V3, r = 0.55). There was a poor correlation between the clinical scales and VI and L-path. Reliability was excellent for all stiffness measurements at short term (EL max : 0.95, VI: 0.94, L-path: 0.92) and good at long term (EL max : 0.87, VI: 0.76, L-path: 0.82). In conclusion, stiffness measurements are valid and reliable to evaluate hyper-resistance in people with stroke.</p>","PeriodicalId":14301,"journal":{"name":"International Journal of Rehabilitation Research","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10330582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-01DOI: 10.1097/MRR.0000000000000575
Maha F Algabbani, Banan A Almass, Afaf A M Shaheen, Adel Alhusaini, Muneera M Almurdi, Samiah Alqabbani
The Obstacles and Curb tests are timed walking assessments that have emerged from the Spinal Cord Injury Functional Ambulation Profile and have been modified for children; however, their psychometric properties have not been adequately investigated. The aim of this research was to examine the psychometric properties of the Obstacles and Curb tests for children with cerebral palsy (CP). This cross-sectional study included 68 children aged 6-12 years; there were 34 children with CP and 34 age- and sex-matched typically developing children. Validity was examined by correlation with the 10-m Walk Test (10-MWT), Modified Time Up and Go test (mTUG), and Pediatric Balance Scale (PBS). Differences in the Obstacle and Curb test scores were calculated between children with CP and typically developing children and within different Gross Motor Function Classification System (GMFCS) levels. Children with CP completed the tests twice within a 30-min interval in the same session. The tests showed significant strong to very strong correlations with the 10-MWT, mTUG, and PBS. The within-session reliability was excellent, typically developing children were significantly faster than children with CP with high sensitivity and specificity, and the time differed significantly within the GMFCS level. Thus, the Obstacles and Curb tests can be considered valid, reliable, and sensitive walking tests for ambulatory children with CP.
{"title":"Psychometric properties of the Obstacles and Curb tests and their discriminative ability across functional levels in ambulatory children with spastic cerebral palsy.","authors":"Maha F Algabbani, Banan A Almass, Afaf A M Shaheen, Adel Alhusaini, Muneera M Almurdi, Samiah Alqabbani","doi":"10.1097/MRR.0000000000000575","DOIUrl":"https://doi.org/10.1097/MRR.0000000000000575","url":null,"abstract":"<p><p>The Obstacles and Curb tests are timed walking assessments that have emerged from the Spinal Cord Injury Functional Ambulation Profile and have been modified for children; however, their psychometric properties have not been adequately investigated. The aim of this research was to examine the psychometric properties of the Obstacles and Curb tests for children with cerebral palsy (CP). This cross-sectional study included 68 children aged 6-12 years; there were 34 children with CP and 34 age- and sex-matched typically developing children. Validity was examined by correlation with the 10-m Walk Test (10-MWT), Modified Time Up and Go test (mTUG), and Pediatric Balance Scale (PBS). Differences in the Obstacle and Curb test scores were calculated between children with CP and typically developing children and within different Gross Motor Function Classification System (GMFCS) levels. Children with CP completed the tests twice within a 30-min interval in the same session. The tests showed significant strong to very strong correlations with the 10-MWT, mTUG, and PBS. The within-session reliability was excellent, typically developing children were significantly faster than children with CP with high sensitivity and specificity, and the time differed significantly within the GMFCS level. Thus, the Obstacles and Curb tests can be considered valid, reliable, and sensitive walking tests for ambulatory children with CP.</p>","PeriodicalId":14301,"journal":{"name":"International Journal of Rehabilitation Research","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/24/76/ijrr-46-178.PMC10155681.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10277940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-01DOI: 10.1097/MRR.0000000000000582
Stefano Brunelli, Lucia D'Auria, Andrea Stefani, Filippo Giglioni, Giorgio Mariani, Marcello Ciccarello, Maria Grazia Benedetti
Mirror therapy is a widely used treatment for phantom limb pain (PLP) relief in patients with limb loss. Less common is progressive muscle relaxation (PMR), used mostly in other medical conditions (psychological, terminal cancer pain, etc). The purpose of this study is to evaluate the efficacy of a mirror therapy preceded by PMR intervention compared to mirror therapy preceded by unguided generic relaxation-mirror therapy in patients with lower limb amputation suffering from PLP. This pilot study was a single-blind, controlled, randomized trial. Thirty lower limb amputees suffering from PLP were recruited and randomly assigned to three groups respectively undergoing a PMR-mirror therapy rehabilitative intervention, generic relaxation-mirror therapy, and conventional physiotherapy (ConvPT). Selected items from Prosthesis Evaluation Questionnaire (PEQ) and the Brief Pain Inventory (BPI) were used to test the pain features at the beginning and 1 week after 3 weeks of intervention. A decrease of about 65% was found in the rate and duration of PLP at the PEQ in PMR-mirror therapy with respect to generic relaxation-mirror therapy (about 30%) and ConvPT (about 6%). A decrease of about 90% in intensity (worst and average) of PLP in PMR-mirror therapy when compared to generic relaxation-mirror therapy (about 45%) and ConvPT (about 20%) was found at the BPI. We preliminary concluded, albeit with limitations due to the small sample of patients, that mirror therapy can improve PLP when associated with PMR. Further studies are required to confirm that PMR could be an effective technique for more successful PLP management.
{"title":"Is mirror therapy associated with progressive muscle relaxation more effective than mirror therapy alone in reducing phantom limb pain in patients with lower limb amputation?","authors":"Stefano Brunelli, Lucia D'Auria, Andrea Stefani, Filippo Giglioni, Giorgio Mariani, Marcello Ciccarello, Maria Grazia Benedetti","doi":"10.1097/MRR.0000000000000582","DOIUrl":"https://doi.org/10.1097/MRR.0000000000000582","url":null,"abstract":"<p><p>Mirror therapy is a widely used treatment for phantom limb pain (PLP) relief in patients with limb loss. Less common is progressive muscle relaxation (PMR), used mostly in other medical conditions (psychological, terminal cancer pain, etc). The purpose of this study is to evaluate the efficacy of a mirror therapy preceded by PMR intervention compared to mirror therapy preceded by unguided generic relaxation-mirror therapy in patients with lower limb amputation suffering from PLP. This pilot study was a single-blind, controlled, randomized trial. Thirty lower limb amputees suffering from PLP were recruited and randomly assigned to three groups respectively undergoing a PMR-mirror therapy rehabilitative intervention, generic relaxation-mirror therapy, and conventional physiotherapy (ConvPT). Selected items from Prosthesis Evaluation Questionnaire (PEQ) and the Brief Pain Inventory (BPI) were used to test the pain features at the beginning and 1 week after 3 weeks of intervention. A decrease of about 65% was found in the rate and duration of PLP at the PEQ in PMR-mirror therapy with respect to generic relaxation-mirror therapy (about 30%) and ConvPT (about 6%). A decrease of about 90% in intensity (worst and average) of PLP in PMR-mirror therapy when compared to generic relaxation-mirror therapy (about 45%) and ConvPT (about 20%) was found at the BPI. We preliminary concluded, albeit with limitations due to the small sample of patients, that mirror therapy can improve PLP when associated with PMR. Further studies are required to confirm that PMR could be an effective technique for more successful PLP management.</p>","PeriodicalId":14301,"journal":{"name":"International Journal of Rehabilitation Research","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10331090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-01DOI: 10.1097/MRR.0000000000000571
Gabriella Tónay, Tamás Pilissy, András Tóth, Gábor Fazekas
An aging society is a growing challenge for families, social and rehabilitation service providers, and economies. Information and communication technology-based assistive technology can bolster the independence of older adults (65 years and above) and reduce their burden on caregivers. Currently, there is no unified methodology to assess the effectiveness and acceptance of these technologies. The present study undertakes a scoping review to (1) identify and characterize the methods for assessing the acceptability and usability of information and communication technology-based assistive technologies, (2) explore the advantages and disadvantages of the assessment methods, (3) determine the possibilities of combining the assessment methods and (4) define the most commonly used assessment method and set of outcome measures. The literature was searched in MEDLINE, Scopus, IEEE Cochrane and Web of Science bibliographic databases using the keywords defined by reviewers for articles in English published between 2011 and 2021. Of the 1696 matches, 31 met the inclusion criteria. It was found that a combination of different assessment methods was common in outcome measurements. Of the 31 studies, assessment methods were combined in 21 studies and multiple questionnaires were used in 11 studies. The most common technique of outcome measurement was the use of questionnaires (81%), conducting interviews (48%) and recording usability-performance measures (39%). The advantages and disadvantages of the assessment methods could not be determined in the selected studies in this scoping review.
老龄化社会对家庭、社会和康复服务提供者以及经济都是一个日益严峻的挑战。基于信息和通信技术的辅助技术可以增强老年人(65岁及以上)的独立性,并减轻他们对照顾者的负担。目前,还没有统一的方法来评估这些技术的有效性和接受程度。本研究进行了范围审查,以(1)确定和描述评估基于信息和通信技术的辅助技术的可接受性和可用性的方法,(2)探索评估方法的优缺点,(3)确定组合评估方法的可能性,(4)定义最常用的评估方法和结果测量集。在MEDLINE、Scopus、IEEE Cochrane和Web of Science书目数据库中检索2011年至2021年间发表的英文文章的评审关键词。在1696场比赛中,有31场符合入选标准。研究发现,在结果测量中,不同评估方法的组合是常见的。31项研究中,有21项研究采用了综合评价方法,11项研究采用了多重问卷。最常见的结果测量技术是使用问卷调查(81%),进行访谈(48%)和记录可用性-性能测量(39%)。评估方法的优点和缺点无法在本范围综述中选定的研究中确定。
{"title":"Methods to assess the effectiveness and acceptance of information and communication technology-based assistive technology for older adults: a scoping review.","authors":"Gabriella Tónay, Tamás Pilissy, András Tóth, Gábor Fazekas","doi":"10.1097/MRR.0000000000000571","DOIUrl":"https://doi.org/10.1097/MRR.0000000000000571","url":null,"abstract":"<p><p>An aging society is a growing challenge for families, social and rehabilitation service providers, and economies. Information and communication technology-based assistive technology can bolster the independence of older adults (65 years and above) and reduce their burden on caregivers. Currently, there is no unified methodology to assess the effectiveness and acceptance of these technologies. The present study undertakes a scoping review to (1) identify and characterize the methods for assessing the acceptability and usability of information and communication technology-based assistive technologies, (2) explore the advantages and disadvantages of the assessment methods, (3) determine the possibilities of combining the assessment methods and (4) define the most commonly used assessment method and set of outcome measures. The literature was searched in MEDLINE, Scopus, IEEE Cochrane and Web of Science bibliographic databases using the keywords defined by reviewers for articles in English published between 2011 and 2021. Of the 1696 matches, 31 met the inclusion criteria. It was found that a combination of different assessment methods was common in outcome measurements. Of the 31 studies, assessment methods were combined in 21 studies and multiple questionnaires were used in 11 studies. The most common technique of outcome measurement was the use of questionnaires (81%), conducting interviews (48%) and recording usability-performance measures (39%). The advantages and disadvantages of the assessment methods could not be determined in the selected studies in this scoping review.</p>","PeriodicalId":14301,"journal":{"name":"International Journal of Rehabilitation Research","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10281610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-01DOI: 10.1097/MRR.0000000000000573
Eun Young Lee, Yoonhye Na, Minjae Cho, Yu Mi Hwang, Hyun-Soo Kim, Hyonggin An, Sung-Bom Pyun
We aimed to determine early predictors of balance function (Berg Balance Scale, BBS) at 3 and 6 months after stroke using clinical, neurophysiological, and neuroimaging variables. Seventy-nine patients with hemiparesis after a stroke were included. Demographics, stroke characteristics, and clinical variables [Mini-Mental State Examination, BBS, strength in the hemiparetic hip, knee, and ankle muscles, and Fugl-Meyer Assessment Lower Extremity (FMA-LE)] were evaluated 2 weeks post-stroke, on average. Somatosensory-evoked potentials (SEP) from both tibial nerves and diffusion tensor imaging data were collected respectively within 3 weeks and 4 weeks post-onset to calculate the SEP amplitude ratio and the laterality index of fractional anisotropy of the corticospinal tract. In multiple linear regression analysis, younger age, higher FMA-LE score, and stronger hemiparetic hip extensors were independent predictors of higher BBS at 3 months post-stroke (adjusted R2 = 0.563, P < 0.001). At 6 months post-stroke, significant predictors of higher BBS were younger age, higher FMA-LE, stronger hemiparetic hip extensors, and larger SEP amplitude ratio (adjusted R2 = 0.552, P < 0.001), although the incremental contribution of the latter was rather small ( R2 = 0.019). We conclude that age and the initial motor impairment of the affected lower limb can inform the state of balance function at 3 and 6 months after stroke.
我们的目的是利用临床、神经生理学和神经影像学变量确定中风后3个月和6个月平衡功能(Berg balance Scale, BBS)的早期预测因子。79例中风后偏瘫患者被纳入研究。平均在卒中后2周评估人口统计学、卒中特征和临床变量[迷你精神状态检查、BBS、偏瘫髋关节、膝关节和踝关节肌肉力量以及Fugl-Meyer下肢评估(FMA-LE)]。分别于发病后3周和4周采集胫神经体感诱发电位(SEP)和弥散张量成像数据,计算SEP振幅比和皮质脊髓束各向异性分数偏侧指数。在多元线性回归分析中,年龄越小、FMA-LE评分越高、偏瘫性髋关节伸肌越强是脑卒中后3个月BBS升高的独立预测因子(校正R2 = 0.563, P
{"title":"Short-term and long-term predictors of balance function in stroke patients: a 6-month follow-up study.","authors":"Eun Young Lee, Yoonhye Na, Minjae Cho, Yu Mi Hwang, Hyun-Soo Kim, Hyonggin An, Sung-Bom Pyun","doi":"10.1097/MRR.0000000000000573","DOIUrl":"https://doi.org/10.1097/MRR.0000000000000573","url":null,"abstract":"<p><p>We aimed to determine early predictors of balance function (Berg Balance Scale, BBS) at 3 and 6 months after stroke using clinical, neurophysiological, and neuroimaging variables. Seventy-nine patients with hemiparesis after a stroke were included. Demographics, stroke characteristics, and clinical variables [Mini-Mental State Examination, BBS, strength in the hemiparetic hip, knee, and ankle muscles, and Fugl-Meyer Assessment Lower Extremity (FMA-LE)] were evaluated 2 weeks post-stroke, on average. Somatosensory-evoked potentials (SEP) from both tibial nerves and diffusion tensor imaging data were collected respectively within 3 weeks and 4 weeks post-onset to calculate the SEP amplitude ratio and the laterality index of fractional anisotropy of the corticospinal tract. In multiple linear regression analysis, younger age, higher FMA-LE score, and stronger hemiparetic hip extensors were independent predictors of higher BBS at 3 months post-stroke (adjusted R2 = 0.563, P < 0.001). At 6 months post-stroke, significant predictors of higher BBS were younger age, higher FMA-LE, stronger hemiparetic hip extensors, and larger SEP amplitude ratio (adjusted R2 = 0.552, P < 0.001), although the incremental contribution of the latter was rather small ( R2 = 0.019). We conclude that age and the initial motor impairment of the affected lower limb can inform the state of balance function at 3 and 6 months after stroke.</p>","PeriodicalId":14301,"journal":{"name":"International Journal of Rehabilitation Research","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10277410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Although knee extensor muscle strength is strongly associated with postoperative walking ability (PWA) in patients undergoing total knee arthroplasty (TKA), few studies have considered the impact of both knee extensor and flexor muscle strength. This study aimed to determine whether operative side knee flexor and extensor muscle strength before surgery affects the PWA of patients who undergo TKA while accounting for potential covariates. This multicenter retrospective cohort study involved four university hospitals, and patients who underwent unilateral primary TKA were included. The outcome measure was the 5-m maximum walking speed test (MWS), which was completed 12 weeks postoperatively. Muscle strength was measured as the maximum isometric muscle strength required for knee flexor and extensor. Three multiple regression models with a progressively larger number of variables were developed to determine the predictors of 5-m MWS at 12 weeks post-TKA surgery. One hundred thirty-one patients who underwent TKA were enrolled in the study (men, 23.7%; mean age, 73.4 ± 6.9 years). Age, sex, operative side knee flexor muscle strength before surgery, Japanese Orthopaedic Association knee score, and preoperative walking ability were significantly associated with PWA in the final model of the multiple regression analysis ( R2 = 0.35). The current findings suggest that the operative side knee flexor muscle strength before surgery is a robust modifiable predictor of improved PWA. We believe that further validation is needed to determine the causal relationship between preoperative muscle strength and PWA.
{"title":"The impact of preoperative muscle strength on postoperative walking ability in patients undergoing total knee arthroplasty.","authors":"Yusuke Terao, Naoki Hosaka, Yuhei Otobe, Mizue Suzuki, Iwao Kojima, Kazuya Yoshizawa, Minoru Yamada, Yasuhide Nakayama, Masahiro Abo","doi":"10.1097/MRR.0000000000000572","DOIUrl":"https://doi.org/10.1097/MRR.0000000000000572","url":null,"abstract":"<p><p>Although knee extensor muscle strength is strongly associated with postoperative walking ability (PWA) in patients undergoing total knee arthroplasty (TKA), few studies have considered the impact of both knee extensor and flexor muscle strength. This study aimed to determine whether operative side knee flexor and extensor muscle strength before surgery affects the PWA of patients who undergo TKA while accounting for potential covariates. This multicenter retrospective cohort study involved four university hospitals, and patients who underwent unilateral primary TKA were included. The outcome measure was the 5-m maximum walking speed test (MWS), which was completed 12 weeks postoperatively. Muscle strength was measured as the maximum isometric muscle strength required for knee flexor and extensor. Three multiple regression models with a progressively larger number of variables were developed to determine the predictors of 5-m MWS at 12 weeks post-TKA surgery. One hundred thirty-one patients who underwent TKA were enrolled in the study (men, 23.7%; mean age, 73.4 ± 6.9 years). Age, sex, operative side knee flexor muscle strength before surgery, Japanese Orthopaedic Association knee score, and preoperative walking ability were significantly associated with PWA in the final model of the multiple regression analysis ( R2 = 0.35). The current findings suggest that the operative side knee flexor muscle strength before surgery is a robust modifiable predictor of improved PWA. We believe that further validation is needed to determine the causal relationship between preoperative muscle strength and PWA.</p>","PeriodicalId":14301,"journal":{"name":"International Journal of Rehabilitation Research","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10277413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-01DOI: 10.1097/MRR.0000000000000576
André L F Meireles, Natália A Menegol, Giovana A Perin, Luciana S Sanada
The study aimed to examine the main characteristics of clinical trials of motor interventions in physical therapy in children with cerebral palsy (CP). The Physiotherapy Evidence Database (PEDro) was used to collect information on clinical trials regarding motor outcomes in physical therapy in children with CP. Two reviewers independently screened, selected the studies, and extracted data. The characteristics extracted were CP subtype; age group; gross motor function and manual motor ability; methodological quality; open access status; 2020 journal impact factor, Consolidated Standards of Reporting Trials (CONSORT) endorsement; primary outcome; intervention adopted, and assessment instruments. The search strategy resulted in 313 articles from 120 different journals. Most of the clinical trials included participants with spastic bilateral subtype, aged between 6 and 12 years old, and with fewer limitations in gross and manual motor abilities. The most used primary outcomes covering the International Classification of Functioning, Disability and Health (ICF) domain of activity were gross motor function (18.8%) and upper limb and hand function (16.3%), with the Gross Motor Function Measurement being the most frequently used instrument (19.8%). Articles with better scores on the PEDro scale were published in journals with a higher impact factor, and higher rates of CONSORT endorsement, and most were not open access. Clinical trials investigating motor interventions used in physical therapy for children with CP tend to focus on patients with milder gross and manual motor function impairments and often explore the body function domain of the ICF. Furthermore, these studies have moderate methodological quality, and a substantial proportion of them fail to follow adequate reporting and methodological recommendations.
{"title":"Randomized clinical trials of physical therapy for cerebral palsy: a review of study outcomes, methodological quality, and publication merits.","authors":"André L F Meireles, Natália A Menegol, Giovana A Perin, Luciana S Sanada","doi":"10.1097/MRR.0000000000000576","DOIUrl":"https://doi.org/10.1097/MRR.0000000000000576","url":null,"abstract":"<p><p>The study aimed to examine the main characteristics of clinical trials of motor interventions in physical therapy in children with cerebral palsy (CP). The Physiotherapy Evidence Database (PEDro) was used to collect information on clinical trials regarding motor outcomes in physical therapy in children with CP. Two reviewers independently screened, selected the studies, and extracted data. The characteristics extracted were CP subtype; age group; gross motor function and manual motor ability; methodological quality; open access status; 2020 journal impact factor, Consolidated Standards of Reporting Trials (CONSORT) endorsement; primary outcome; intervention adopted, and assessment instruments. The search strategy resulted in 313 articles from 120 different journals. Most of the clinical trials included participants with spastic bilateral subtype, aged between 6 and 12 years old, and with fewer limitations in gross and manual motor abilities. The most used primary outcomes covering the International Classification of Functioning, Disability and Health (ICF) domain of activity were gross motor function (18.8%) and upper limb and hand function (16.3%), with the Gross Motor Function Measurement being the most frequently used instrument (19.8%). Articles with better scores on the PEDro scale were published in journals with a higher impact factor, and higher rates of CONSORT endorsement, and most were not open access. Clinical trials investigating motor interventions used in physical therapy for children with CP tend to focus on patients with milder gross and manual motor function impairments and often explore the body function domain of the ICF. Furthermore, these studies have moderate methodological quality, and a substantial proportion of them fail to follow adequate reporting and methodological recommendations.</p>","PeriodicalId":14301,"journal":{"name":"International Journal of Rehabilitation Research","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10277939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}