NeuroRehabilitation最新文献

BackgroundPrimary intracerebral hemorrhage (ICH) carries high mortality and disability risks. Although early mobilization is beneficial, concerns about physiological instability often delay mobilization.ObjectiveTo evaluate whether a structured early mobilization protocol improves functional mobility and reduces adverse events in critically ill ICH patients.MethodThis retrospective pre-post study included 192 patients with ICH (ICH score 0-4) admitted to a dedicated stroke center. In the pre-implementation phase in 2022, patients received standard care. In the post-implementation phase in 2023, a standardized mobility protocol, incorporating time-based stratification, neurological thresholds, and safety criteria to guide activity progression, was introduced. Primary outcomes included the Modified ICU Mobility Scale (MIMS) score at intensive care unit (ICU) discharge and the occurrence of adverse events.ResultsThe post-implementation group (99 patients) showed higher MIMS scores at ICU discharge, with a greater proportion achieving out-of-bed sitting during their ICU stay compared to the pre-implementation group (93 patients). Non-serious adverse events in the former decreased significantly; ICU and hospital lengths of stay were shorter but not statistically significant.ConclusionThe structured pathway enabled safer, earlier mobilization and improved ICU functional outcomes. While mobility benefits were observed, caution is warranted in interpreting non-significant trends in length of stay.

ObjectiveTo evaluate the efficacy of warm acupuncture combined with rehabilitation training on lower-limb motor dysfunction in cerebral infarction (CI) patients.MethodsSixty CI patients with lower-limb motor dysfunction (Feb 2019 to Apr 2021) were enrolled. The control group received rehabilitation training, while the study group received warm acupuncture plus rehabilitation. The outcomes, including Functional Independence Measure (FIM), 10-meter maximum walking speed (MWS), Berg-balance scale (BBS), Barthel index, and Holden walking ability rating scale, were compared.ResultsThe study group showed significantly better results than the control group. After treatment, the study group's FIM and BBS scores were higher at 1-, 4-, and 6-week follow-ups. MWS scores of the study group improved significantly, while the control group showed less improvement. The Holden walking ability rating scale was also more favorable for the study group.ConclusionWarm acupuncture combined with rehabilitation training significantly improves lower-limb motor dysfunction in CI patients, demonstrating superior outcomes compared to rehabilitation alone.

BackgroundBalance impairments, stemming from disruptions in motor, and cognitive systems, are key contributors to fall risk.ObjectiveThis study aimed to identify balance tasks associated with fall risk within 6 months of discharge in inpatients with subacute stroke.MethodsThis prospective cohort study included patients with subacute stroke who completed the Mini-Balance Evaluation Systems Test (Mini-BESTest), Fugl-Meyer Assessment for the Lower Extremities, and Mini-Mental State Examination before discharge. Falls were self-reported via telephone survey six months post-discharge. Logistic regression was used to identify significant predictors, with sensitivity analyses to evaluate robustness.ResultsAmong 50 patients, 30% experienced falls within six months. Regression analysis identified stand on one leg (OR = 4.70, 95% CI 1.31-16.85, p = 0.018), compensatory stepping correction of backward (OR = 3.48, 95% CI 1.36-8.92, p = 0.009) and lateral (OR = 3.00, 95% CI 1.02-8.84, p = 0.046) as significant balance tasks associated with fall risk. Forward compensatory stepping corrections were associated with increasing age, whereas standing with eyes closed and walking with head turned horizontally were associated with fall risk in interaction with motor paresis and cognitive integration.ConclusionsOne leg standing and compensatory stepping correction of backward and lateral were significant balance tasks related to fall risk.

BackgroundA wide range of virtual reality (VR) applications are currently used in rehabilitation to support people with multiple sclerosis (pwMS) in improving limb function, balance, postural control, gait training, and cognitive abilities. Despite its widespread use, there is a lack of systematic evaluation for the effectiveness of VR in the rehabilitation.ObjectiveCommentary on the systematic review by De Keersmaecker et al. (2025) which assessed the effects of VR interventions on lower limb and gait function, and balance and postural control in pwMS.MethodsThis review conducted a comprehensive search of the health science databases for (quasi-) randomized controlled trials (RCTs) that assessed virtual reality (VR) interventions in adult pwMS.ResultsThe review included 33 RCTs with a total of 1,294 participants. VR interventions varied across studies, including immersive and non-immersive approaches targeting motor and cognitive rehabilitation. Compared to no intervention, VR demonstrated a moderate positive effect on upper limb function and quality of life, suggesting that it could be a viable rehabilitation tool for improving motor performance and patient well-being. Compared with conventional therapy, VR interventions were more effective in improving balance and postural control. However, for other rehabilitation outcomes, such as gait function, cognitive function, and fatigue management, VR did not show significant differences compared to conventional therapy.ConclusionsVR can be a useful adjunct to traditional rehabilitation, but it may not be superior in all aspects of MS rehabilitation, unambiguous evidence regarding the effect of virtual reality training in multiple sclerosis is still missing. The authors emphasized the need for further research, particularly high-quality, large-scale RCTs, to strengthen the evidence base for VR in MS rehabilitation.

Background and objectivesTo translate and adapt the Multiple Sclerosis Quality of Life-29 into Arabic (MSQOL-29-Ar) and assess its psychometric properties in people with multiple sclerosis (MS).MethodsGenerally, 101 Arabic-speaking adults with MS aged 21 to 60 were recruited. Construct validity was tested by correlating MSQOL-29-Ar with the Arabic Functional Assessment of Multiple Sclerosis (FAMS-AR) and Multiple Sclerosis International Quality of Life (MusiQOL). Known-group validity was assessed by correlating the scale's Physical Health Composite (PHC) and Mental Health Composite (MHC) scores with the demographic and clinical data. Test-retest reliability, internal consistency, standard error of measurement (SEM), minimal detectable change (MDC₉₅), limit of agreement (LOA), responsiveness, and floor/ceiling effects were also investigated.ResultsPHC and MHC scores correlated strongly with FAMS-ARA (r = 0.76 and 0.70, respectively).PHC scores were associated with age, employment, and MS chronicity, while MHC scores correlated with the Expanded Disability Status Scale. Internal consistency was acceptable (PHC α = 0.80; MHC α = 0.90), with excellent test-retest reliability (PHC r = 0.76; MHC r = 0.90). SEM (1.4-1.6) and MDC₉₅ (4.3-3) were low. Responsiveness analysis indicated moderate accuracy (AUC = 0.70-0.75) with on-floor/ceiling effects.ConclusionMSQOL-29-Ar is valid and reliable for assessing HQOL in people with MS, making it suitable for clinical and rehabilitation settings.

BackgroundNeurological disorders are the leading cause of global disability. To enhance neurorehabilitation effectiveness, it is essential to consider contextual factors that influence patient outcomes and the overall experience.ObjectiveThis study aimed to examine the integration of contextual factors into neurorehabilitation practice among physical therapists, focusing on their frequency of use, associated beliefs, ethical considerations, and communication strategies.MethodsA cross-sectional web-based survey was disseminated to a convenience sample of physical therapy professionals via various online platforms. The survey collected demographic data and information regarding the integration of contextual factors into neurorehabilitation practice.ResultsA total of 369 physical therapists completed the survey. Respondents reported moderate use of contextual factors (43%), with verbal communication (85%), positive attitude (82%), and physical contact (75%) the most frequently employed factors. The strongest beliefs about the influence of contextual factors on therapeutic outcomes were linked to verbal communication and optimistic behavior. No significant correlations were found between respondents' characteristics and the use of contextual factors.ConclusionPhysical therapists recognize the importance of contextual factors such as verbal communication, positive attitudes, and a professional approach in neurorehabilitation. Enhanced training is recommended to further integrate these factors into neurorehabilitation practice and optimize patient outcomes.

BackgroundPediatric dysphagia poses risks to feeding safety, nutrition, and overall health, especially in those with developmental or neurological disorders. While various treatments exist, including therapeutic, medical, and surgical options, oral sensorimotor stimulation (OSMS) and neuromuscular electrical stimulation (NMES) are commonly used non-invasive interventions. However, their relative effectiveness remains uncertain, with limited evidence on their advantages in managing specific types of dysphagia.ObjectiveThis prospective cohort study aimed to compare the effectiveness of NMES and OSMS in managing pediatric dysphagia.MethodsThis study recruited pediatric dysphagia patients for a two-month rehabilitation program, with either NMES or OSMS with pre- and post-intervention evaluations using video-fluoroscopic swallow studies, Modified Barium Swallow Impairment Profile (MBSImP) scores, and the 8-point Penetration-Aspiration Scale (PAS).ResultsA total of 26 children participated in the study. NMES significantly reduced MBSImP scores in both oral and pharyngeal impairments, and PAS. OSMS showed significant improvement in MBSImP scores, particularly in oral impairment.ConclusionsThe study suggests NMES benefits oropharyngeal dysphagia and reduces penetration and aspiration, while OSMS is effective for improving oral dysphagia.