Rehabilitacion最新文献

英文中文

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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引用次数: 0

Uso de las presiones linguales para determinar la indicación de estudio instrumentado de deglución en pacientes con ELA espinal 使用舌压来确定脊柱侧凸患者的仪器吞咽试验适应症

Q3 Medicine

Rehabilitacion

Pub Date : 2025-06-03 DOI: 10.1016/j.rh.2025.100917

A. Guillen-Sola , B. Bertran-Recasens , J. Martinez-Llorens , A. Balaña , M. Villatoro , M.A. Rubio

Objective

Systematic swallowing assessment in amyotrophic lateral sclerosis (ALS) is essential, as approximately 85% of patients will develop dysphagia, and 8% of these cases may remain clinically silent. Although instrumental diagnostic tools exist, they are not always accessible. Recent studies suggest that lingual pressure measurements may be valuable for early detection of bulbar dysfunction. This study aims to establish lingual pressure cutoff points for early screening of such dysfunction.

Design

Transversal study based on prospectively collected data from patients with spinal-onset ALS at the Motor Neuron Unit, Hospital del Mar (Barcelona).

Materials and methods

A total of 58 patients were included. Anterior (PA) and posterior (PP) lingual pressures were measured using the IOPI system and analyzed alongside the ALSFRS-R scale. Statistical analysis included descriptive statistics, Spearman correlation, and ROC curve analysis (SPSS v25).

Results

A moderate correlation was found between lingual strength and ALSFRS-R scores (PA: r = .634, P < .001; PP: r = .539, P < .001). Identified cutoff values: PA: 39.5 kPa (AUC = .766; 95% CI: .700-.831; P < .001), sensitivity 64.6%, specificity 76.4%. PP: 37.0 kPa (AUC = .726; 95% CI: .653-.799; P < .001), sensitivity 55.1%, specificity 72.2%.

Conclusion

In spinal-onset ALS, a moderate correlation exists between global functionality and lingual pressures. Cutoff points of PA = 39.5 kPa and PP = 37.0 kPa are proposed for early screening of bulbar dysfunction.

在肌萎缩性侧索硬化症（ALS）中，系统的吞咽评估是必不可少的，因为大约85%的患者会出现吞咽困难，其中8%的患者可能会保持临床沉默。虽然存在仪器诊断工具，但它们并不总是可用的。最近的研究表明舌压测量可能对早期发现球功能障碍有价值。本研究旨在建立早期筛查这种功能障碍的舌压分界点。设计：基于前瞻性收集的来自巴塞罗那del Mar医院运动神经元部门脊髓性ALS患者数据的横向研究。材料与方法共纳入58例患者。使用IOPI系统测量前（PA）和后（PP）舌压，并与ALSFRS-R量表一起分析。统计学分析采用描述性统计、Spearman相关、ROC曲线分析（SPSS v25）。结果舌强度与ALSFRS-R评分存在中度相关性(PA: r = .634, P <；措施;PP: r = .539, P <；措施)。识别截止值：PA: 39.5 kPa (AUC = .766；95% ci: 0.700 - 0.831；P & lt;.001)，敏感性64.6%，特异性76.4%。PP: 37.0 kPa (AUC = .726；95% ci: 0.653 - 0.799；P & lt;.001)，敏感性55.1%，特异性72.2%。结论脊髓性渐冻症患者，全功能与舌压之间存在中度相关性。建议PA = 39.5 kPa、PP = 37.0 kPa作为早期筛查球功能障碍的分界点。

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引用次数: 0

Grading hypotonia in children with Down syndrome: A study psychometric 唐氏综合症儿童张力低下分级：一项心理测量学研究

Q3 Medicine

Rehabilitacion

Pub Date : 2025-05-29 DOI: 10.1016/j.rh.2025.100916

M.G. de Santos-Moreno , J.A. López-Pina , A. Velandrino-Nicolás , A. Gómez-Conesa

Introduction and objectives

Currently, hypotonia is diagnosed and graded observationally. This study aimed to develop a valid and reliable scale for assessing hypotonia in children with Down syndrome.

Material and method

An initial 43-item scale was created to measure hypotonia in children with Down syndrome. After psychometric analysis of the results, 21 items were eliminated, resulting in a 22-item scale that was applied to a sample of 50 children (28 girls) between 7 and 94 months. The item analysis, internal consistency, inter-rater agreement, and test–retest reliability with alpha and ICC coefficients were analyzed. Hypothesis testing was calculated by ANOVA and Student's t-tests, and criterion validity by comparison with the clinical sensation observed by an expert evaluator.

Results

The 22-item scale reported high reliability, stability, and reproducibility of its measures, both globally and individually. Inter-rater agreement was high [0.88–1.00] and internal consistency was higher. No significant differences were found according to sex or motor stage. Furthermore, significant differences were found according to the clinical sensation of the rater and grade of hypotonia.

Conclusions

The developed scale allows to assess hypotonia and proved to be reliable and valid.

目前，张力过低是通过观察来诊断和分级的。本研究旨在开发一个有效和可靠的量表来评估唐氏综合症儿童张力低下。材料与方法创建了一个43项的初始量表来测量唐氏综合征儿童的张力低下。在对结果进行心理测量分析后，消除了21个项目，产生了22个项目的量表，应用于50名7至94个月大的儿童（28名女孩）的样本。用α系数和ICC系数对项目分析、内部一致性、评价者间一致性和重测信度进行分析。假设检验通过方差分析和学生t检验计算，标准效度通过与专家评估者观察到的临床感觉进行比较。结果22项量表报告了其测量的高可靠性，稳定性和可重复性，无论是整体还是单个。评价间一致性较高[0.88-1.00]，内部一致性较高。根据性别或运动阶段没有发现显著差异。此外，根据临床感觉的程度和张力低下的程度也有显著差异。结论该量表能较好地评价肌张力过低，是一种可靠、有效的量表。

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引用次数: 0

Comment on “The effect of a physical rehabilitation program on temperature symmetry, mobility, functionality and gait in amputee patients” 对“肢体康复项目对截肢患者体温对称性、活动能力、功能和步态的影响”的评论

Q3 Medicine

Rehabilitacion

Pub Date : 2025-05-16 DOI: 10.1016/j.rh.2025.100915

H. Daungsupawong , V. Wiwanitkit

引用次数: 0

Importancia de la rehabilitación en la enfermedad de Parkinson: ¿estamos llegando tarde? 帕金森氏症康复的重要性：我们迟到了吗？

Q3 Medicine

Rehabilitacion

Pub Date : 2025-05-15 DOI: 10.1016/j.rh.2025.100914

G. Candoni

引用次数: 0

Estudio de los cambios del equilibrio en pacientes con cáncer de mama tratadas con quimioterapia 乳腺癌化疗患者平衡变化研究

Q3 Medicine

Rehabilitacion

Pub Date : 2025-05-09 DOI: 10.1016/j.rh.2025.100913

J.M. Elía , J.M. Tenías , V. Iñigo , V. Iranzo , R. Puerta , A. Sogues

Introduction

Instability is a common symptom reported by patients with chemotherapy-induced peripheral neuropathy (CIPN) during breast cancer treatment. Posturography may be useful for the functional assessment and management of these patients. The aim of this study was to evaluate postural control changes through biomechanical assessment in breast cancer patients undergoing chemotherapy.

Material and methods

A prospective longitudinal observational study was conducted with 39 women (mean age 51.0 years, SD 8.9) in stages I (n = 14), II (n = 18), and III (n = 7). Assessments included posturography, the modified Total Neuropathy Score (mTNS), and the EORTC QLQ-CIPN20 and EORTC QLQ-C30 questionnaires at baseline, and at 3 and 6 months.

Results

Posturographic variables showed a pattern of vestibular dysfunction that worsened over time (88.5%, p< 0.01). A direct correlation was observed between body mass index (BMI) and mTNS (r = 0.361; p< 0.001); BMI was also related to sway area and anteroposterior displacement. At 3 and 6 months, inverse correlations were identified between mTNS and posturographic conditions, which were associated with increased symptom severity in all subscales of the EORTC QLQ-CIPN20 (p< 0.05).

Conclusions

Postural stability is affected by chemotherapy cycles in breast cancer patients. Early identification allows for the incorporation of specific interventions in this patient group and the consideration of therapeutic alternatives.

不稳定是化疗引起的周围神经病变（CIPN）患者在乳腺癌治疗期间的常见症状。姿势照相可能对这些患者的功能评估和管理有用。本研究的目的是通过生物力学评估乳腺癌化疗患者的体位控制变化。材料与方法对39名女性（平均年龄51.0岁，SD 8.9）进行了一项前瞻性纵向观察研究，分别分为I期（n = 14）、II期（n = 18）和III期（n = 7）。评估包括基线、3个月和6个月时的姿势照相、改良的总神经病变评分（mTNS）和EORTC QLQ-CIPN20和EORTC QLQ-C30问卷。结果影像学指标显示前庭功能障碍随时间加重(88.5%,p<；0.01)。体重指数（BMI）与mTNS直接相关(r = 0.361；术中;0.001);BMI还与摇摆面积和前后位位移有关。在3个月和6个月时，发现mTNS和姿势状况之间呈负相关，这与EORTC QLQ-CIPN20 (p<；0.05)。结论乳腺癌患者的体位稳定性受化疗周期的影响。早期识别允许在该患者组中纳入特定干预措施并考虑治疗替代方案。

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引用次数: 0

Autonomic nervous system dysfunction may be associated with low self-efficacy in patients with nonspecific chronic low back pain: A cross-sectional inferential analysis 自主神经系统功能障碍可能与非特异性慢性腰痛患者的低自我效能感相关：一项横断面推断分析

Q3 Medicine

Rehabilitacion

Pub Date : 2025-05-05 DOI: 10.1016/j.rh.2025.100912

A. Pontes-Silva , A.V. Dibai-Filho , M.A. Avila

引用次数: 0

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