Rehabilitacion最新文献

英文中文

Experiencias con las ondas de choque en el tratamiento de la hipertonía en personas con parálisis cerebral: una perspectiva cualitativa 冲击波治疗脑瘫患者高血压的经验：定性视角

Q3 Medicine

Rehabilitacion

Pub Date : 2025-07-01 DOI: 10.1016/j.rh.2025.100921

M.F. Gimeno Esteve , M. Tur Segura , J. Jiménez Redondo , N. García Rodríguez , T. Biedermann Villagra

Introduction

Muscle hypertonia is one of the major issues in individuals with cerebral palsy. Treatment with radial shockwave therapy represents a relatively new alternative to conventional approaches and has been established in recent years as a non-invasive option with few side effects.

Objectives

To assess the subjective experience of individuals with cerebral palsy undergoing radial shockwave therapy in terms of reducing local hypertonia, changes in motor functionality, and changes in pain perception.

Methodology

A qualitative phenomenological study was conducted through semi-structured interviews. Out of 79 patients treated, 27 interviews were selected that provided the best information regarding the subjective experience before and after the treatment.

Results

Patients reported a perceived reduction in spasticity, muscle tension, and pain perception. There was an improvement in walking functionality, although functional improvement was less noticeable in the upper limbs. Among individuals engaged in sports, overall ability appeared to improve. Regarding the subjective experience of the treatment, the majority of patients reported good tolerance to the shockwaves.

Conclusions

Overall, the treatment of local hypertonia with shockwave therapy has been positive in all analyzed dimensions, with good acceptance of the treatment itself.

肌肉强直是脑瘫患者的主要问题之一。放射冲击波治疗是一种相对较新的替代传统方法的治疗方法，近年来已被确立为一种副作用少的无创治疗方法。目的评估脑瘫患者在接受放射冲击波治疗后，在减轻局部高张力、改变运动功能和改变痛觉方面的主观体验。方法采用半结构化访谈法进行质性现象学研究。在接受治疗的79名患者中，选择了27个访谈，提供了关于治疗前后主观体验的最佳信息。结果患者报告痉挛、肌肉紧张和疼痛感明显减轻。行走功能有所改善，尽管上肢的功能改善不太明显。在从事体育运动的个体中，整体能力似乎有所提高。关于治疗的主观体验，大多数患者报告对冲击波的耐受性良好。结论总的来说，冲击波治疗局部高渗症在所有分析维度上都是积极的，对治疗本身有很好的接受度。

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引用次数: 0

Effect of pillow on pain, disability and sleep quality in patients with chronic neck pain: A systematic review 枕对慢性颈痛患者疼痛、残疾和睡眠质量的影响：一项系统综述

Q3 Medicine

Rehabilitacion

Pub Date : 2025-07-01 DOI: 10.1016/j.rh.2025.100922

S. Ghosh, M. Goyal, K. Goyal

Chronic neck pain impairs physical function and sleep quality. Appropriate pillow use may support spinal alignment, reduce muscle strain, and improve sleep. This systematic review evaluated the effectiveness of various pillow characteristics in alleviating pain, disability, and sleep disturbances among individuals with chronic neck pain. A comprehensive literature search was conducted in PubMed, Scopus, PEDro, and Cochrane Library for interventional studies published from 2015 to June 2024. Following PRISMA guidelines, the methodological quality was assessed using the PEDro scale, GRADE system, risk of bias tool, and level of evidence criteria. From 29,091 screened records, five studies (239 participants) met the inclusion criteria. Outcome measures included the Visual Analogue Scale (VAS), Numerical Pain Rating Scale (NPRS), Neck Disability Index (NDI), and Pittsburgh Sleep Quality Index (PSQI). NPRS scores showed minor improvements (p > 0.05), NDI results were inconsistent, and PSQI differences were not statistically significant. High heterogeneity in study designs, outcome measures, and pillow characteristics limits definitive conclusions. However, limited evidence supports the use of specific pillows as adjunctive therapy for chronic neck pain, with no particular type (latex, foam or standard) demonstrating clear superiority. Therefore, further high-quality RCTs are needed to establish definitive clinical recommendations.

慢性颈部疼痛会损害身体机能和睡眠质量。适当使用枕头可以帮助脊柱挺直，减少肌肉劳损，改善睡眠。本系统综述评估了各种枕头特征在缓解慢性颈部疼痛患者的疼痛、残疾和睡眠障碍方面的有效性。全面检索PubMed、Scopus、PEDro和Cochrane图书馆2015年至2024年6月发表的介入性研究文献。遵循PRISMA指南，使用PEDro量表、GRADE系统、偏倚风险工具和证据水平标准对方法学质量进行评估。从29,091份筛选记录中，有5项研究（239名参与者）符合纳入标准。结果测量包括视觉模拟量表（VAS）、数值疼痛评定量表（NPRS）、颈部残疾指数（NDI）和匹兹堡睡眠质量指数（PSQI）。NPRS得分略有改善(p >；0.05)， NDI结果不一致，PSQI差异无统计学意义。研究设计、结果测量和枕头特征的高度异质性限制了明确的结论。然而，有限的证据支持使用特定枕头作为慢性颈部疼痛的辅助治疗，没有特定类型（乳胶，泡沫或标准）表明明显的优势。因此，需要进一步的高质量随机对照试验来建立明确的临床建议。

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引用次数: 0

Effect of exercise-based cardiac rehabilitation on dyspnoea in heart failure: A systematic review of assessment tools, outcomes, and FITT parameters 基于运动的心脏康复对心力衰竭患者呼吸困难的影响：评估工具、结果和FITT参数的系统回顾

Q3 Medicine

Rehabilitacion

Pub Date : 2025-07-01 DOI: 10.1016/j.rh.2025.100924

C. García-Conejo , C. Roldán-Jiménez , A.I. Cuesta-Vargas

Exercise-based cardiac rehabilitation (EBCR) programmes are strongly recommended to enhance exercise capacity and quality of life in heart failure (HF). However, their effects on dyspnoea have not been systematically reviewed, possibly due to the knowledge gap in the assessment of dyspnoea. The aim of this study was to recognise the dyspnoea tool used in HF for the EBCR trial, assess the effects of EBCR on dyspnoea and identify which patient characteristics and FITT parameters (Frequency, Intensity, Time and Type) are associated with better outcomes. A review and meta-analysis of randomised controlled trials following the PRISMA guideline were performed, including fifteen studies (n = 766 participants). Up to 8 dyspnoea measurement instruments were identified in the studies. EBCR showed a moderate effect size on dyspnoea (d = 0.69, 95% CI 0.54–0.84). Larger effects were seen in patients < 65 years (d = 0.77, 95% CI 0.54–0.99) and in non-hospitalised patients (d = 0.735, 95% CI 0.550–0.921). Greater effects were observed for low-intensity (d = 0.79, 95% CI 0.44–1.15) and multimodal programmes (d = 1.12, 95% CI 0.47–1.77). Programmes with three sessions per week and ≥12 weeks were the most common. Findings were limited due to the varying dyspnoea scales, highlighting the need for standardised assessment in HF.

强烈推荐以运动为基础的心脏康复（EBCR）方案，以提高心力衰竭（HF）患者的运动能力和生活质量。然而，它们对呼吸困难的影响尚未被系统地审查，可能是由于在评估呼吸困难方面的知识差距。本研究的目的是识别用于心力衰竭EBCR试验的呼吸困难工具，评估EBCR对呼吸困难的影响，并确定哪些患者特征和FITT参数（频率、强度、时间和类型）与更好的结果相关。对遵循PRISMA指南的随机对照试验进行回顾和荟萃分析，包括15项研究（n = 766名参与者）。研究中发现多达8种呼吸困难测量仪器。EBCR对呼吸困难的影响中等（d = 0.69, 95% CI 0.54-0.84）。在患者中观察到更大的影响；65岁（d = 0.77, 95% CI 0.54-0.99）和非住院患者（d = 0.735, 95% CI 0.550-0.921）。低强度方案（d = 0.79, 95% CI 0.44-1.15）和多模式方案（d = 1.12, 95% CI 0.47-1.77）的效果更大。每周3次且≥12周的治疗方案最为常见。由于不同的呼吸困难量表，研究结果有限，强调了对心力衰竭进行标准化评估的必要性。

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引用次数: 0

Instrumentalización clínica en la evaluación del linfedema. Una necesidad emergente en la consulta del médico rehabilitador 淋巴水肿评估的临床工具。康复医生会诊的新需求

Q3 Medicine

Rehabilitacion

Pub Date : 2025-07-01 DOI: 10.1016/j.rh.2025.100926

V. Pujol-Blaya , A. Gómez-Garrido , I. Donat-Cruz , V. Dávalos-Yerovi

引用次数: 0

Más allá de la percepción: resultados de una encuesta sobre escalas de valoración al colectivo de médicos rehabilitadores en España 超越认知：对西班牙康复医生群体评价量表的调查结果

IF 0.4 Q3 Medicine

Rehabilitacion

Pub Date : 2025-07-01 DOI: 10.1016/j.rh.2025.100927

G. Arrieta-Bartolomé , M. Supervía , S. Laxe

Introduction

Measurement in rehabilitation is a fundamental pillar for objectifying the functional status of patients, determining and evaluating interventions, and monitoring treatment progress. However, its use in clinical practice is not yet sufficiently widespread among physicians.

Objective

To describe the usage habits of measurement instruments, particularly validated scales, in the clinical practice of Spanish physical and rehabilitation medicine (PRM) physicians.

Methods

A structured survey was designed and distributed, consisting of 11 mandatory Likert-type questions related to clinical practice, available time, use of scales and assessment tools, perceived barriers, and training needs. Data were analyzed using descriptive statistics and correlation analysis.

Results

Out of 390 professionals, 61.8% (n = 241) reported using some type of measurement tool systematically. A total of 53 different scales were reported, with the Barthel Index being the most frequently used (42.3%, n = 103). Those who did not use scales (n = 95) relied on anamnesis and physical examination to assess patient progress. The main barrier identified was lack of time (78.4%, n = 135). A significant association was observed between longer consultation times and routine use of scales (P<.001). Additionally, 76.9% (n = 297) cited lack of training as a barrier, and 94.8% (n = 365) expressed interest in receiving specific training.

Conclusion

Although a majority of PRM physicians use measurement scales, important barriers such as limited time and lack of training remain. Addressing these factors through organizational and educational strategies could help promote wider adoption of measurement tools in clinical practice.

康复测量是客观化患者功能状态、确定和评估干预措施、监测治疗进展的基本支柱。然而，它在临床实践中的应用在医生中还不够广泛。目的了解西班牙物理与康复医学（PRM）医师在临床实践中对测量仪器尤其是经验证的量表的使用习惯。方法设计并分发一份结构化调查，包括11个强制性李克特型问题，涉及临床实践、可用时间、量表和评估工具的使用、感知障碍和培训需求。数据分析采用描述性统计和相关分析。结果390名专业人员中，61.8% （n = 241）报告系统地使用了某种类型的测量工具。共有53种不同的量表被报道，Barthel指数是最常用的（42.3%,n = 103）。未使用量表的患者（n = 95）依靠记忆和体格检查来评估患者的进展。确定的主要障碍是缺乏时间（78.4%,n = 135）。在较长的咨询时间和常规使用量表之间观察到显著的关联（P<.001）。此外，76.9% （n = 297）认为缺乏培训是一个障碍，94.8% （n = 365）表示有兴趣接受特定的培训。结论尽管大多数PRM医生使用测量量表，但时间有限和缺乏培训等重要障碍仍然存在。通过组织和教育策略解决这些因素可以帮助促进在临床实践中更广泛地采用测量工具。

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引用次数: 0

The role of immersive virtual reality in geriatric rehabilitation 沉浸式虚拟现实在老年康复中的作用

IF 0.4 Q3 Medicine

Rehabilitacion

Pub Date : 2025-07-01 DOI: 10.1016/j.rh.2025.100930

A. Aldardour , S. Alnammaneh

As the global population continues to age, virtual reality (VR) has emerged as a promising tool in geriatric rehabilitation, offering benefits across physical, cognitive, and psychological domains. This narrative review synthesizes the current literature on VR applications in geriatric adult care, encompassing areas such as fall prevention, balance training, gait rehabilitation, cognitive enhancement, and emotional well-being. VR enhances motivation through gamification and provides real-time feedback in safe, controlled environments. This review explores key challenges—including cost, motion sickness, and usability—and highlights emerging opportunities such as telerehabilitation and tailored programs for individuals with dementia. In contrast to previous reviews, this work places a stronger emphasis on psychological aspects, personalized in-home use, and clinical applicability. VR holds transformative potential to improve outcomes and quality of life in aging populations.

随着全球人口持续老龄化，虚拟现实（VR）已成为一种有前途的老年康复工具，在身体、认知和心理领域提供益处。本文综述了VR在老年成人护理中的应用，包括预防跌倒、平衡训练、步态康复、认知增强和情绪健康等领域。VR通过游戏化增强动机，并在安全、可控的环境中提供实时反馈。这篇综述探讨了主要的挑战，包括成本、晕动病和可用性，并强调了新兴的机会，如远程康复和为痴呆症患者量身定制的项目。与之前的综述相比，这项工作更加强调心理方面、个性化的家庭使用和临床适用性。虚拟现实具有变革性的潜力，可以改善老年人的生活结果和生活质量。

引用次数: 0

Rethinking pain in lower limb rehabilitation: A call to address nociplastic mechanisms 重新思考下肢康复中的疼痛：呼吁解决伤害机制

IF 0.4 Q3 Medicine

Rehabilitacion

Pub Date : 2025-07-01 DOI: 10.1016/j.rh.2025.100925

R. Tedeschi

引用次数: 0

Lectura crítica: ¿debemos confiar en todo lo que se publica? 评论阅读：我们应该相信所有出版的东西吗？

Q3 Medicine

Rehabilitacion

Pub Date : 2025-06-21 DOI: 10.1016/j.rh.2025.100919

E. Duarte

引用次数: 0

Comment on “The effect of a physical rehabilitation program on temperature symmetry, mobility, functionality and gait in amputee patients”. Authors reply 评论“物理康复计划对截肢患者的温度对称性、活动能力、功能和步态的影响”。作者回复

Q3 Medicine

Rehabilitacion

Pub Date : 2025-06-21 DOI: 10.1016/j.rh.2025.100920

F. Marcon Alfieri , D. Mitiyo Odagiri Utiyama , A.C. Aquino dos Santos , L. Rizzo Battistella

引用次数: 0

Beneficios de la prehabilitación en pacientes con cáncer colorrectal: estudio de casos y controles anidado 结直肠癌患者康复前的益处：病例研究和嵌套对照

Q3 Medicine

Rehabilitacion

Pub Date : 2025-06-04 DOI: 10.1016/j.rh.2025.100918

E.J. Frutos-Reoyo , P. Luque-Linero , L. López-Maté , S. Rodríguez-Valbuena , Á. Serrano-Combarro , E.D. Candau-Pérez

Introduction and objective

Colorectal cancer (CRC) is one of the most prevalent and lethal malignancies worldwide. Surgical treatment is considered the gold standard. Prehabilitation emerges as a strategy integrating physical, nutritional, and psychological preparation before surgery. This study aimed to evaluate the effectiveness of prehabilitation in reducing hospital stay and mortality in CRC patients.

Material and method

A prospective observational nested case-control study within a cohort with a 24-month follow-up was conducted. Patients who underwent prehabilitation were defined as «cases» while those who did not were classified as «controls». Descriptive and analytical analyses were performed, with a significance level of p < 0.05. A Kaplan-Meier curve was used to assess survival concerning hospital stay and mortality.

Results

Of the 279 patients, 276 were analyzed (127 cases and 149 controls). The bivariate analysis showed comparable baseline characteristics between groups. The prehabilitation group demonstrated a significant reduction in postoperative hospital stay (4 days vs. 5 days; p = 0.02). No significant differences were observed in mortality (11.8% vs. 18.8%; p = 0.11).

Conclusions

The implementation of multimodal prehabilitation programs in CRC patients is associated with reduced hospital stay. Although no significant difference in mortality was observed, the trend suggests a positive impact. These findings support the adoption of prehabilitation as a standard in oncological practice.

简介与目的结直肠癌（colorectal cancer， CRC）是世界范围内最常见、最致命的恶性肿瘤之一。手术治疗被认为是金标准。术前康复是一种综合手术前身体、营养和心理准备的策略。本研究旨在评估康复治疗在减少结直肠癌患者住院时间和死亡率方面的有效性。材料与方法在随访24个月的队列中进行前瞻性观察巢式病例对照研究。接受康复治疗的患者被定义为“病例”，而未接受康复治疗的患者被归类为“对照组”。进行了描述性和分析性分析，显著性水平为p <；0.05. Kaplan-Meier曲线用于评估与住院时间和死亡率相关的生存率。结果279例患者中，分析276例（127例，对照组149例）。双变量分析显示各组之间的基线特征具有可比性。康复组术后住院时间显著缩短(4天vs. 5天；p = 0.02)。死亡率无显著差异(11.8% vs. 18.8%；p = 0.11)。结论在结直肠癌患者中实施多模式康复方案可减少住院时间。虽然没有观察到死亡率的显著差异，但这一趋势表明了积极的影响。这些发现支持将康复作为肿瘤学实践的标准。

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