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Effect of chest expansion resistance exercise and respiratory muscle stretching on respiratory function and gait endurance in patients with stroke. 扩胸阻力运动和呼吸肌拉伸对中风患者呼吸功能和步态耐力的影响。
IF 1.7 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2024-10-29 DOI: 10.3233/NRE-240132
Jiyeon Lee, Jinseop Kim

Background: Limited chest expansion and asymmetry in the respiratory muscles after a stroke lead to poor ventilation and reduced physical performance.

Objectives: To determine the effect of chest expansion resistance exercise and respiratory muscle stretching on respiratory function and gait endurance in patients with stroke.

Methods: Thirty stroke patients were randomly assigned to a chest expansion resistance group (CERG), a respiratory muscle stretching group (RMSG), and a control group (CG). CERG and RMSG received chest expansion resistance and respiratory muscle stretching, respectively, 3 times a week for 8 weeks. Respiratory function, respiratory muscle strength, and gait endurance were measured before and after the intervention period.

Results: The experimental groups, CERG and RMSG, showed significant improvements in respiratory function variables (p < .05). For respiratory muscle strength variables, maximal inspiratory pressure (MIP) in the CERG and maximal expiratory pressure (MEP) in the RMSG showed significant changes compared to the CG (p < .05). Both CERG and RMSG also showed significant improvements in the 6MWT compared to the CG (p < .05).

Conclusion: Chest expansion resistance exercise would be a more effective method, while both chest expansion resistance exercise and respiratory muscle stretching are helpful in improving respiratory function and gait endurance.

背景:中风后胸廓扩张受限和呼吸肌不对称会导致通气不良和体能下降:确定扩胸阻力运动和呼吸肌伸展运动对中风患者呼吸功能和步态耐力的影响:将 30 名中风患者随机分配到扩胸阻力组(CERG)、呼吸肌伸展组(RMSG)和对照组(CG)。CERG 组和 RMSG 组分别接受扩胸阻力训练和呼吸肌拉伸训练,每周 3 次,为期 8 周。干预前后对呼吸功能、呼吸肌力量和步态耐力进行了测量:结果:实验组(CERG 和 RMSG)的呼吸功能变量均有明显改善(P 结论:胸廓扩张阻力运动对呼吸功能的改善更有效:扩胸阻力运动是一种更有效的方法,而扩胸阻力运动和呼吸肌拉伸都有助于改善呼吸功能和步态耐力。
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引用次数: 0
Spontaneous eye blinking as a diagnostic and prognostic marker in disorders of consciousness: Protocol of an international multicentre longitudinal study. 自发性眨眼作为意识障碍的诊断和预后标志:国际多中心纵向研究方案。
IF 1.7 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2024-10-14 DOI: 10.3233/NRE-240127
Alfonso Magliacano, Giovanni Scarano, Cinzia Fasano, Andrea Mannini, Piergiuseppe Liuzzi, Alice Finocchi, Anna Estraneo

Background: Diagnostic and prognostic decision-making in patients with Disorders of Consciousness (DoC) is challenging. It has been suggested that spontaneous eye blink rate is an index of patients' level of consciousness easy to detect in clinical practice. Further blinking features (i.e., amplitude, duration, variability in intervals between blinks) may change as a function of cognitive load, but have not been investigated in patients with DoC.

Objective: This multicentre, longitudinal study aims at exploring the diagnostic and prognostic value of spontaneous eye blinking features in DoC.

Methods: Eight European medical institutions will enrol consecutively admitted adult patients with DoC. Within two weeks from study entry demographic, anamnestic and clinical data will be collected. Moreover, patients will undergo two 20-minute EEG-EOG recordings at rest, to collect blinking features and EEG activity. A clinical follow-up will be performed after 6 months. A group of healthy individuals will be enrolled for reference.

Results: Possible differences in blink features between patients and the reference group, differences across diagnostic sub-groups, and correlations between blinking features and clinical outcome will be investigated.

Conclusion: The results of this study might help clinicians to reduce misdiagnosis rate in DoC and provide useful information for prognostication and care pathway plan.

背景:意识障碍(DoC)患者的诊断和预后决策具有挑战性。有人认为,自发性眨眼率是临床实践中容易检测到的患者意识水平指标。进一步的眨眼特征(即幅度、持续时间、眨眼间隔的变化)可能会随着认知负荷的变化而变化,但尚未在意识障碍患者中进行过研究:这项多中心纵向研究旨在探索自发性眨眼特征在 DoC 患者中的诊断和预后价值:方法:欧洲八家医疗机构将连续收治 DoC 成年患者。将在患者入院后两周内收集其人口统计学、解剖学和临床数据。此外,患者还将在静息状态下接受两次长达 20 分钟的脑电图记录,以收集眨眼特征和脑电图活动。6 个月后将进行临床随访。此外,还将招募一组健康人作为参考:结果:将研究患者与参照组之间在眨眼特征上可能存在的差异、不同诊断亚组之间的差异以及眨眼特征与临床结果之间的相关性:本研究的结果可能有助于临床医生降低门静脉高压症的误诊率,并为预后和护理路径计划提供有用信息。
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引用次数: 0
Evaluation of YouTube videos as a source of information on facial paralysis exercises. 对 YouTube 视频作为面瘫练习信息来源的评估。
IF 1.7 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2024-09-18 DOI: 10.3233/NRE-240027
Onur Engin, Ayşe Sezgi Kızılırmak Karataş, Betül Taşpınar, Ferruh Taşpınar

Background: YouTube has emerged as an important source for obtaining information regarding health issues.

Objective: The study aimed to assess the reliability and quality of facial paralysis exercise videos that are accessible on the YouTube platform.

Methods: The investigation was carried out on Youtube, utilizing the keyword "facial paralysis exercises". We listed the first 100 videos based on relevancy. The quality and reliability of the videos were assessed using DISCERN, the Journal of the American Medical Association (JAMA) Benchmark Criteria, the Global Quality Scale (GQS), and the Video Power Index (VPI).

Results: Out of 100 studies, we excluded 52 and included the remaining 48. The scores we obtained for the videos were as follows: DISCERN Quality (2.92±0.91), DISCERN Total (39.16±6.75), JAMA (2.09±0.55), and GQS (3.00±0.89). Our study also revealed that videos uploaded by healthcare professionals had significantly higher DISCERN total, JAMA and VPI scores compared to those uploaded by non-healthcare professionals (p = 0.018, 0.001 and 0.023, respectively). Additionally, we observed a positive and statistically significant correlation between the DISCERN quality score, total score, JAMA, and video features.

Conclusion: The facial paralysis exercise videos were determined to be of medium to low quality. Higher-quality videos need to be produced.

背景:YouTube 已成为获取健康问题信息的重要来源:YouTube已成为获取健康问题相关信息的重要来源:本研究旨在评估 YouTube 平台上提供的面瘫锻炼视频的可靠性和质量:调查在 Youtube 上进行,关键词为 "面瘫锻炼"。我们根据相关性列出了前 100 个视频。我们使用 DISCERN、《美国医学会杂志》(JAMA)基准标准、全球质量量表(GQS)和视频功率指数(VPI)对视频的质量和可靠性进行了评估:在 100 项研究中,我们排除了 52 项,纳入了其余 48 项。我们获得的视频评分如下:DISCERN 质量 (2.92±0.91)、DISCERN 总分 (39.16±6.75)、JAMA (2.09±0.55) 和 GQS (3.00±0.89)。我们的研究还显示,与非医护专业人员上传的视频相比,医护专业人员上传的视频的 DISCERN 总分、JAMA 和 VPI 分数明显更高(p = 0.018、0.001 和 0.023)。此外,我们还观察到 DISCERN 质量得分、总分、JAMA 和视频特征之间存在统计学意义上的正相关:结论:面瘫锻炼视频被确定为中低质量。需要制作更高质量的视频。
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引用次数: 0
Research, education and practice of tele-neurorehabilitation in low and middle-income countries: A Scoping Review. 中低收入国家远程神经康复的研究、教育和实践:范围综述》。
IF 1.7 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2024-09-18 DOI: 10.3233/NRE-240053
Dorcas B C Gandhi, Sureshkumar Kamalakannan, Jennifer V Dsouza, Vinicius Montanaro, Nistara S Chawla, Amreen Mahmood, Etienne Ngeh, Sania Zarreen, Pranay J Vijayanand, John M Solomon

Background: Tele-neurorehabilitation (TNR) allows for remote delivery of rehabilitation services for those with neurological disabilities. Despite growing global interest and uptake, its adoption remains challenging in Low-and-Middle-Income-Countries (LMICs).

Objective: To explore available literature on the nature of training and education, research and practice of TNR in LMICs.

Methods: Following PRISMA-ScR guidelines and predefined selection criteria, four databases were screened. Quality assessment was performed using the Joanna Briggs Institute tools. Relevant data was extracted to using a data extraction form in Microsoft Excel and were narratively synthesised under Education/training, Research and Clinical Practice of TNR.

Results: We identified no formal structured training courses/programs for TNR users/providers. Sessions were mainly delivered as part of a research project. The included studies highlighted the need to engage stakeholders in TNR research and improve digital-literacy among healthcare providers/users. Development and use of clinical decision-making-tools, models of TNR suitable for varied populations and prior area-mapping were a few suggestions for clinical/research practice.

Conclusion: There is an immense need to develop academic/structured programs for TNR to build capacity among providers/users in LMICs. Practice must adhere to principles of safety, effectiveness, and based on high quality clinical-guidelines suitable to the context to ensure optimal uptake and practice of TNR in LMICs.

背景:远程神经康复(TNR)可为神经残疾患者提供远程康复服务。尽管全球对远程神经康复的兴趣与日俱增,但在中低收入国家(LMICs)采用远程神经康复仍面临挑战:目的:探讨有关中低收入国家 TNR 培训与教育、研究与实践性质的现有文献:按照 PRISMA-ScR 指南和预定义的选择标准,筛选了四个数据库。使用乔安娜-布里格斯研究所(Joanna Briggs Institute)的工具进行了质量评估。使用 Microsoft Excel 中的数据提取表提取相关数据,并在 TNR 的教育/培训、研究和临床实践项下进行叙述性综合:我们没有发现针对 TNR 使用者/提供者的正式结构化培训课程/项目。培训课程主要是作为研究项目的一部分开展的。所纳入的研究强调了让利益相关者参与 TNR 研究和提高医疗服务提供者/用户数字素养的必要性。临床决策工具的开发和使用、适合不同人群的 TNR 模型以及事先绘制区域图是对临床/研究实践的几点建议:结论:在低收入和中等收入国家,亟需开发TNR的学术/结构化项目,以提高提供者/使用者的能力。在实践中必须坚持安全、有效的原则,并以适合当地情况的高质量临床指南为基础,以确保TNR在低收入和中等收入国家的最佳吸收和实践。
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引用次数: 0
The role of nutrition in mild traumatic brain injury rehabilitation for service members and veterans. 营养在军人和退伍军人轻度脑外伤康复中的作用。
IF 2 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2024-09-10 DOI: 10.3233/nre-230241
Katrina Monti,Maj William Conkright,Shawn R Eagle,David W Lawrence,Ltc Michael Dretsch
BACKGROUNDVeterans Affairs and the Department of Defense (DOD) acknowledge that nutrition may be a modifier of mild traumatic brain injury (TBI) sequelae. Military clinicians are considering nutritional supplements and dietary interventions when managing patients with mild TBI. Therefore, clinicians should be familiar with the current evidence for nutritional interventions in mild TBI and special considerations related to the military lifestyle.OBJECTIVEThis narrative review aims to summarize the existing evidence surrounding the role of special diets and select nutrients in mild TBI outcomes, gut microbiota changes, and special considerations for Service members and Veterans recovering from mild TBI.METHODSWe conducted a literature review in PubMed and Google Scholar limited to nutritional interventions and nine topics with primary focus on mild TBI, although we included some articles related to moderate-to-severe TBI where relevant: 1) ketogenic diet, 2) Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet, 3) omega-3 fatty acids, 4) creatine, 5) vitamin D, 6) weight management, 7) gut microbiota, 8) caffeine, and 9) alcohol. We summarized key findings and safety factors where appropriate for each intervention. We also identified nutritional supplement safety and operational rations considerations and areas in need of further research.RESULTSPreclinical studies and early human trials suggest that the specific nutrients and diets discussed in the current article may offer neuroprotection or benefit during mild TBI rehabilitation. Omega-3 fatty acids, creatine, and vitamin D are generally safe when taken within recommended guidelines.CONCLUSIONMore evidence is needed to support nutritional recommendations for enhancing neuroprotection and mitigating mild TBI symptoms in humans. The DOD's Warfighter Nutrition Guide recommends a whole food diet rich in antioxidants, phytonutrients, omega-3 fatty acids, micronutrients, probiotics, and fiber to optimize long-term health and performance.
背景退伍军人事务局和国防部(DOD)承认,营养可能是轻度创伤性脑损伤(TBI)后遗症的一个调节因素。军队临床医生在管理轻度创伤性脑损伤患者时正在考虑营养补充剂和饮食干预。因此,临床医生应熟悉当前对轻度 TBI 进行营养干预的证据以及与军事生活方式相关的特殊注意事项。目的本叙述性综述旨在总结围绕特殊饮食和精选营养素在轻度 TBI 后遗症中的作用、肠道微生物群变化以及从轻度 TBI 中恢复的军人和退伍军人的特殊注意事项的现有证据。方法我们在 PubMed 和 Google Scholar 上进行了文献综述,仅限于营养干预措施和九个主题,主要关注轻度创伤性脑损伤,尽管我们也纳入了一些与中重度创伤性脑损伤相关的文章:1) 生酮饮食;2) 地中海-DASH 神经退行性延迟干预(MIND)饮食;3) 欧米伽-3 脂肪酸;4) 肌酸;5) 维生素 D;6) 体重管理;7) 肠道微生物群;8) 咖啡因;9) 酒精。我们总结了每种干预措施的主要发现和安全因素。结果临床研究和早期人体试验表明,本文讨论的特定营养素和饮食可能会在轻度创伤性脑损伤康复期间提供神经保护或益处。结论还需要更多的证据来支持加强神经保护和减轻轻度创伤性脑损伤症状的营养建议。国防部的《作战人员营养指南》建议采用富含抗氧化剂、植物营养素、ω-3 脂肪酸、微量营养素、益生菌和纤维的全食物饮食,以优化长期健康和表现。
{"title":"The role of nutrition in mild traumatic brain injury rehabilitation for service members and veterans.","authors":"Katrina Monti,Maj William Conkright,Shawn R Eagle,David W Lawrence,Ltc Michael Dretsch","doi":"10.3233/nre-230241","DOIUrl":"https://doi.org/10.3233/nre-230241","url":null,"abstract":"BACKGROUNDVeterans Affairs and the Department of Defense (DOD) acknowledge that nutrition may be a modifier of mild traumatic brain injury (TBI) sequelae. Military clinicians are considering nutritional supplements and dietary interventions when managing patients with mild TBI. Therefore, clinicians should be familiar with the current evidence for nutritional interventions in mild TBI and special considerations related to the military lifestyle.OBJECTIVEThis narrative review aims to summarize the existing evidence surrounding the role of special diets and select nutrients in mild TBI outcomes, gut microbiota changes, and special considerations for Service members and Veterans recovering from mild TBI.METHODSWe conducted a literature review in PubMed and Google Scholar limited to nutritional interventions and nine topics with primary focus on mild TBI, although we included some articles related to moderate-to-severe TBI where relevant: 1) ketogenic diet, 2) Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet, 3) omega-3 fatty acids, 4) creatine, 5) vitamin D, 6) weight management, 7) gut microbiota, 8) caffeine, and 9) alcohol. We summarized key findings and safety factors where appropriate for each intervention. We also identified nutritional supplement safety and operational rations considerations and areas in need of further research.RESULTSPreclinical studies and early human trials suggest that the specific nutrients and diets discussed in the current article may offer neuroprotection or benefit during mild TBI rehabilitation. Omega-3 fatty acids, creatine, and vitamin D are generally safe when taken within recommended guidelines.CONCLUSIONMore evidence is needed to support nutritional recommendations for enhancing neuroprotection and mitigating mild TBI symptoms in humans. The DOD's Warfighter Nutrition Guide recommends a whole food diet rich in antioxidants, phytonutrients, omega-3 fatty acids, micronutrients, probiotics, and fiber to optimize long-term health and performance.","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":"22 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142247717","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}
引用次数: 0
Prerequisites and barriers to telerehabilitation in patients with neurological conditions: A narrative review. 神经系统疾病患者进行远程康复的先决条件和障碍:叙述性综述。
IF 2 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2024-09-09 DOI: 10.3233/nre-240092
Yeşim Kurtaiş Aytür
BACKGROUNDA field of study that uses telerehabilitation (TR) is neurorehabilitation; however, standards for medical and technological applications, medicolegal and ethical regulations, and other aspects of neuro-TR are still being developed.OBJECTIVETo address the prerequisites and barriers for implementing TR in neurorehabilitation in the light of present findings.METHODSA narrative review was conducted based on specific questions about the prerequisites for neuro-TR and barriers to its implication. According to a foreground search strategy in the context of neurorehabilitation using TR in neurological patient population, PubMed, EMBASE and Cochrane databases were searched and reviewed.RESULTSBarriers and prerequisites for neuro-TR were mostly grouped under the categories of administrative/organizational, human (beneficiaries/providers), technical, and ethical. Apart from the technical framework, knowledge and the presence of an administrative leader responsible for overseeing TR are crucial prerequisites. The internet and technological constraints rank highest among the barriers.CONCLUSIONSince neuro-TR is relatively new with minimal guidelines and regulations, highly technologic, and lack of established practices, it is imperative to determine and fully comprehend the criteria for its uses. After the prerequisites are established, it is imperative to recognize and address implementation constraints, which may differ depending on the community's infrastructure and neurologic condition.
背景神经康复是一个使用远程康复(TR)的研究领域;然而,神经远程康复的医疗和技术应用标准、医疗法律和伦理法规以及其他方面仍在发展之中。方法根据神经远程康复的先决条件及其影响障碍的具体问题进行了叙述性综述。结果神经康复技术的障碍和先决条件主要分为行政/组织、人力(受益人/提供者)、技术和伦理等类别。除技术框架外,知识和负责监督 TR 的行政领导的存在也是至关重要的先决条件。结论 由于神经转录技术相对较新,指导原则和法规很少,技术含量高,且缺乏成熟的实践经验,因此必须确定并充分理解其使用标准。在确定先决条件后,必须认识并解决实施过程中的限制因素,这些限制因素可能因社区的基础设施和神经系统状况而异。
{"title":"Prerequisites and barriers to telerehabilitation in patients with neurological conditions: A narrative review.","authors":"Yeşim Kurtaiş Aytür","doi":"10.3233/nre-240092","DOIUrl":"https://doi.org/10.3233/nre-240092","url":null,"abstract":"BACKGROUNDA field of study that uses telerehabilitation (TR) is neurorehabilitation; however, standards for medical and technological applications, medicolegal and ethical regulations, and other aspects of neuro-TR are still being developed.OBJECTIVETo address the prerequisites and barriers for implementing TR in neurorehabilitation in the light of present findings.METHODSA narrative review was conducted based on specific questions about the prerequisites for neuro-TR and barriers to its implication. According to a foreground search strategy in the context of neurorehabilitation using TR in neurological patient population, PubMed, EMBASE and Cochrane databases were searched and reviewed.RESULTSBarriers and prerequisites for neuro-TR were mostly grouped under the categories of administrative/organizational, human (beneficiaries/providers), technical, and ethical. Apart from the technical framework, knowledge and the presence of an administrative leader responsible for overseeing TR are crucial prerequisites. The internet and technological constraints rank highest among the barriers.CONCLUSIONSince neuro-TR is relatively new with minimal guidelines and regulations, highly technologic, and lack of established practices, it is imperative to determine and fully comprehend the criteria for its uses. After the prerequisites are established, it is imperative to recognize and address implementation constraints, which may differ depending on the community's infrastructure and neurologic condition.","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":"38 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142247718","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}
引用次数: 0
Video-Based Directly Observed Therapy (ViDOT) as a strategic tool to improve medication adherence in epilepsy: A narrative review. 将视频直接观察疗法(ViDOT)作为改善癫痫患者服药依从性的战略工具:叙述性综述。
IF 1.7 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2024-08-21 DOI: 10.3233/NRE-240080
Paul Olowoyo, Olabode Oguntiloye, Luqman Ogunjimi, Olaleye Adeniji, Segun Atolani, Olumuyiwa Ariyo, Mayowa Owolabi

Background: The prevalence of epilepsy is highest in the Central Africa subregion most especially in rural settlements. This is further compounded by a high prevalence of treatment gap, from poor drug adherence, and poor road network. One approach to overcoming this burden is to leverage Video-based Directly Observed Therapy (ViDOT) use for stable patients living with epilepsy, harnessing the advancement in mHealth technologies, and widespread adoption of smartphones. ViDOT is a form of telemedicine that is a smartphone-based, treatment approach for monitoring and evaluating remote patients.

Objective: We performed a narrative review of the existing literature using electronic databases from PubMed and Google Scholar to identify relevant publications related to ViDOT and chronic diseases, in particular epilepsy.

Methods: The selected articles were assessed for relevance, and key findings were synthesized to provide an overview of the role of ViDOT in addressing the challenges of drug adherence in epilepsy.

Results: The review shows that poor drug adherence is a major risk for poor outcomes in patients living with epilepsy. ViDOT has the potential to significantly contribute to improved drug adherence in patients living with epilepsy. Other benefits of ViDOT include the elimination of prolonged waiting times, improvement in access to specialized care, eradication of self-induced stigma and discrimination, diminishing neurologists' workload, and cost-effectiveness. Challenges include poor network coverage and unstable internet service.

Conclusion: Giving a brief psychoeducation about epilepsy, anti-epileptic drug (AED) side effects, and the importance of sticking with the recommended drug use can improve AED adherence and epilepsy outcomes. Information dissemination through ViDOT to people with epilepsy and their caregivers at large is important to promote a healthy life.

背景:中部非洲次区域的癫痫发病率最高,尤其是在农村地区。由于服药依从性差和道路网络不完善,治疗缺口很大,这进一步加剧了这一问题。克服这一负担的方法之一是利用移动医疗技术的进步和智能手机的普及,对病情稳定的癫痫患者使用视频直接观察疗法(ViDOT)。ViDOT 是远程医疗的一种形式,是一种基于智能手机的治疗方法,用于监控和评估远程患者:我们利用 PubMed 和 Google Scholar 电子数据库对现有文献进行了叙述性综述,以确定与 ViDOT 和慢性疾病(尤其是癫痫)相关的出版物:对所选文章的相关性进行了评估,并对主要研究结果进行了综合,以概述 ViDOT 在应对癫痫患者服药依从性挑战方面的作用:综述显示,服药依从性差是导致癫痫患者预后不佳的主要风险。ViDOT 有可能大大有助于改善癫痫患者的服药依从性。ViDOT 的其他益处还包括消除漫长的等待时间、改善获得专业护理的机会、消除自我羞辱和歧视、减轻神经科医生的工作量以及成本效益。面临的挑战包括网络覆盖差和互联网服务不稳定:结论:就癫痫、抗癫痫药物(AED)的副作用以及坚持推荐用药的重要性等问题进行简短的心理教育,可以提高抗癫痫药物的依从性,改善癫痫的预后。通过 ViDOT 向癫痫患者及其护理人员传播信息对于促进健康生活非常重要。
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引用次数: 0
Telerehabilitation - historical perspectives and conceptual framework in reference to neurological disorders: A narrative review. 远程康复--有关神经系统疾病的历史观点和概念框架:叙述性综述。
IF 1.7 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2024-07-10 DOI: 10.3233/NRE-240079
Paul Olowoyo, Rajinder K Dhamija, Mayowa O Owolabi

Background: Telerehabilitation as a new subdiscipline of telehealth is the application of information technology to support and deliver rehabilitation services via two-way or multipoint interactive online telecommunication technology. This enables the therapist to optimize the timing, intensity, and duration of therapy which is often not possible within the constraints of face-to-face treatment protocols in current health systems.

Objective: To review the historical perspective and conceptual framework of telerehabilitation in neurological disorders.

Methods: A narrative review of the literature was performed for the historical perspective and a systematic review of the conceptual framework was performed using the PRISMA guidelines on chronic neurological disorders; multiple sclerosis, spinal cord injury, stroke, Parkinson's disease, cognitive impairment, and headaches. The search included articles from the past 20 years (2004 to 2024).

Results: Telerehabilitation dates back to the 1960s and early 1970s. Documented effective interventions were mostly on therapies for speech disorders. The conceptual framework consisted of three major components of telerehabilitation programmes including development, implementation, and evaluation. The COVID-19 pandemic suddenly made telerehabilitation come to the limelight because physical distancing became necessary. Out of the 110,000 articles downloaded, 43 met the inclusion criteria for review on the conceptual framework of telerehabilitation in relation to neurological disorders. The articles discussed multiple sclerosis (2), spinal cord disorders (1), stroke (17), Parkinson's disease (15), headaches (3), and cognitive disorders (5). All articles reviewed assessed the effectiveness of telemedicine except for the articles on multiple sclerosis and spinal cord disorders which examined the interphase between the technology and the end users.

Conclusion: The future of telerehabilitation looks promising with the subsequent integration of innovative tools and applications. This will require the adaption of technology, continuous capacity building, education, and training of healthcare professionals to ensure that they are adequately equipped with the necessary skills to provide quality virtual reality rehabilitation care.

背景:远程康复作为远程保健的一个新的分支学科,是应用信息技术,通过双向或多点交互式在线远程通信技术来支持和提供康复服务。这使治疗师能够优化治疗的时间、强度和持续时间,而在目前的医疗系统中,面对面的治疗方案往往无法做到这一点:回顾神经系统疾病远程康复的历史背景和概念框架:方法:对历史视角的文献进行了叙述性回顾,并采用 PRISMA 指南对概念框架进行了系统性回顾,涉及慢性神经系统疾病、多发性硬化症、脊髓损伤、中风、帕金森病、认知障碍和头痛。搜索包括过去 20 年(2004 年至 2024 年)的文章:远程康复可追溯到 20 世纪 60 年代和 70 年代初。有文献记载的有效干预措施主要是针对语言障碍的疗法。概念框架包括远程康复计划的三个主要组成部分,包括开发、实施和评估。COVID-19大流行突然让远程康复成为人们关注的焦点,因为物理距离变得很有必要。在下载的 110,000 篇文章中,有 43 篇符合有关神经系统疾病远程康复概念框架的审查纳入标准。这些文章讨论了多发性硬化症(2 篇)、脊髓疾病(1 篇)、中风(17 篇)、帕金森病(15 篇)、头痛(3 篇)和认知障碍(5 篇)。除有关多发性硬化症和脊髓疾病的文章对技术和最终用户之间的相互关系进行了研究外,其他所有文章都对远程医疗的有效性进行了评估:结论:随着创新工具和应用的不断整合,远程康复的未来前景看好。这将需要对技术进行调整、持续的能力建设、教育以及对医疗保健专业人员的培训,以确保他们充分掌握必要的技能,提供高质量的虚拟现实康复护理。
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引用次数: 0
The effects of visual information deprivation and feedback balance training on balance in patients with stroke 视觉信息剥夺和反馈平衡训练对脑卒中患者平衡能力的影响
IF 2 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2024-05-10 DOI: 10.3233/nre-230358
Taewoong Jeong, Yijung Chung
BACKGROUND:Patients with stroke depend on visual information due to balance deficits. Therefore, it is believed that appropriate visual deprivation training could have an impact on improving balance abilities. OBJECTIVE:The purpose of this study was to compare the effects of balance training performed in visual deprivation and feedback conditions on balance in stroke survivors. METHODS:The 39 participants were randomly assigned to either the Visual Deprivation Group (VDG; n = 13), the Visual Feedback Group (VFG; n = 13), or the Control Group (CG; n = 13). The training sessions were conducted five times a week for three weeks. Participants completed the Berg Balance Scale (BBS), Timed Up and Go test (TUG), Four Square Step Test (FSST), and Limit of Stability (LOS) assessments. RESULTS:The VDG showed significant improvements in BBS, FSST, TUG, and LOS. In VFG, significant improvements were observed in BBS and TUG. There were statistically significant differences among the groups in all variables related to balance. CONCLUSION:The results of this study suggest that balance training under visual deprivation is effective in improving static and dynamic balance and gait in patients with stroke. In other words, patients with stroke need to reduce their over-reliance on visual information.
背景:中风患者因平衡障碍而依赖视觉信息。因此,人们认为适当的视觉剥夺训练可对提高平衡能力产生影响。目的:本研究旨在比较在视觉剥夺和反馈条件下进行的平衡训练对中风幸存者平衡能力的影响。方法:39 名参与者被随机分配到视觉剥夺组(VDG;n = 13)、视觉反馈组(VFG;n = 13)或对照组(CG;n = 13)。训练课程每周进行五次,为期三周。参加者完成了伯格平衡量表(BBS)、定时上下楼测试(TUG)、四方步测试(FSST)和稳定极限(LOS)评估。结果:VDG 在 BBS、FSST、TUG 和 LOS 方面均有显著改善。在 VFG 中,BBS 和 TUG 有明显改善。在与平衡相关的所有变量中,各组之间均存在统计学意义上的显著差异。结论:本研究结果表明,视觉剥夺下的平衡训练能有效改善脑卒中患者的静态和动态平衡及步态。换句话说,脑卒中患者需要减少对视觉信息的过度依赖。
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引用次数: 0
Musculoskeletal morbidity in adults with spinal cord injuries: A nationwide cohort study 脊髓损伤成人的肌肉骨骼发病率:全国性队列研究
IF 2 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2024-04-26 DOI: 10.3233/nre-230263
Youngoh Bae, Hohyun Jung, Nakyung Shin, Masoud Rahmati, Raphael Udeh, Abdolreza Kazemi, Yusheng Li, Marco Solmi, Muhammad Syafrudin, Norma Latif Fitriyani, Guillaume Fond, Laurent Boyer, Seung Won Lee
BACKGROUND:An increase in the demand for quality of life following spinal cord injuries (SCIs) is associated with an increase in musculoskeletal (MSK) pain, highlighting the need for preventive measure research. OBJECTIVE:This study aimed to evaluate the incidence and hazards of MSK morbidities among Korean adults with SCIs, as well as the influence of SCI location on MSK morbidities. METHODS:Patient populations were selected from Korean National Health Insurance Service data (n = 276). The control group included individuals without SCIs (n = 10,000). We compared the incidences and determined the unadjusted and adjusted hazard ratios (HRs) of common MSK morbidities (osteoarthritis, connective tissue disorders, sarcopenia, myalgia, neuralgia, rheumatoid arthritis, myositis, and musculoskeletal infections) based on the location of injury (cervical, thoracic, or lumbar). RESULTS:Adults with SCIs had a higher incidence of MSK morbidity (48.45% vs. 36.6%) and a lower survival probability than those without SCIs. The incidence of MSK morbidity and survival probabilities were not significantly different for cervical cord injuries, whereas both measures were significantly different for thoracic and lumbar injuries. CONCLUSION:SCI increases the risk of MSK morbidity. Lumbar SCI is associated with a higher incidence and risk of MSK morbidity than are cervical or thoracic SCIs.
背景:脊髓损伤(SCI)后,人们对生活质量要求的提高与肌肉骨骼(MSK)疼痛的增加有关,这凸显了预防措施研究的必要性。目的:本研究旨在评估韩国脊髓损伤成人 MSK 疾病的发病率和危害性,以及脊髓损伤位置对 MSK 疾病的影响。方法:从韩国国民健康保险服务数据(n = 276)中选取患者群体。对照组包括无 SCI 的个体(n = 10,000)。我们比较了常见 MSK 疾病(骨关节炎、结缔组织疾病、肌肉疏松症、肌痛、神经痛、类风湿性关节炎、肌炎和肌肉骨骼感染)的发病率,并根据受伤部位(颈椎、胸椎或腰椎)确定了未经调整和调整的危险比(HRs)。结果:与无 SCI 的人相比,有 SCI 的成年人 MSK 发病率更高(48.45% 对 36.6%),存活概率更低。颈部脊髓损伤的 MSK 发病率和存活概率没有显著差异,而胸椎和腰椎损伤的 MSK 发病率和存活概率则有显著差异。结论:脊髓损伤会增加多发性硬化症的发病风险。与颈椎或胸椎 SCI 相比,腰椎 SCI 的发病率和 MSK 发病风险更高。
{"title":"Musculoskeletal morbidity in adults with spinal cord injuries: A nationwide cohort study","authors":"Youngoh Bae, Hohyun Jung, Nakyung Shin, Masoud Rahmati, Raphael Udeh, Abdolreza Kazemi, Yusheng Li, Marco Solmi, Muhammad Syafrudin, Norma Latif Fitriyani, Guillaume Fond, Laurent Boyer, Seung Won Lee","doi":"10.3233/nre-230263","DOIUrl":"https://doi.org/10.3233/nre-230263","url":null,"abstract":"BACKGROUND:An increase in the demand for quality of life following spinal cord injuries (SCIs) is associated with an increase in musculoskeletal (MSK) pain, highlighting the need for preventive measure research. OBJECTIVE:This study aimed to evaluate the incidence and hazards of MSK morbidities among Korean adults with SCIs, as well as the influence of SCI location on MSK morbidities. METHODS:Patient populations were selected from Korean National Health Insurance Service data (n = 276). The control group included individuals without SCIs (n = 10,000). We compared the incidences and determined the unadjusted and adjusted hazard ratios (HRs) of common MSK morbidities (osteoarthritis, connective tissue disorders, sarcopenia, myalgia, neuralgia, rheumatoid arthritis, myositis, and musculoskeletal infections) based on the location of injury (cervical, thoracic, or lumbar). RESULTS:Adults with SCIs had a higher incidence of MSK morbidity (48.45% vs. 36.6%) and a lower survival probability than those without SCIs. The incidence of MSK morbidity and survival probabilities were not significantly different for cervical cord injuries, whereas both measures were significantly different for thoracic and lumbar injuries. CONCLUSION:SCI increases the risk of MSK morbidity. Lumbar SCI is associated with a higher incidence and risk of MSK morbidity than are cervical or thoracic SCIs.","PeriodicalId":19717,"journal":{"name":"NeuroRehabilitation","volume":"21 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140799133","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}
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NeuroRehabilitation
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