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Effectiveness of extracorporeal shockwave therapy in treatment of upper and lower limb tendinopathies: A systematic review and meta-analysis. 体外冲击波疗法治疗上下肢肌腱病的效果:系统回顾和荟萃分析。
IF 1.7 Q2 Health Professions Pub Date : 2024-01-01 Epub Date: 2023-07-26 DOI: 10.1002/pri.2042
Mohamed H Elgendy, Shehab ElDin Khalil, Mohamed M ElMeligie, Doaa Rafat Elazab

Background: Tendinopathy is caused by repetitive motion, excessive stress on the tendon, overstretch, and motion past the critical angle of rotation or translation. There are various treatment options available for tendinitis, including those affecting both the upper and lower limbs and those of calcific and non-calcific types.

Hypothesis/purpose: Few reviews have analyzed the efficacy of Extracorporeal Shockwave Therapy (ESWT) in treating upper and lower limb tendinopathies while considering calcific and non-calcific-type tendinitis. This paper provides a review and meta-analysis on Randomized Controlled Trials (RCTs), which compared results from a group undergoing ESWT treatment to another group under different treatments.

Study design: Systematic review and meta-analysis.

Methods: A systematic search was conducted on PubMed, Web of Science, Embase, the Cochrane Central Register of Control Trials (CENTRAL), and Physiotherapy Evidence Database (PEDro) databases for articles published up to January 2022. The reference lists of identified articles were further scanned. Twenty-two studies were included in the meta-analysis.

Results: Meta-analysis showed no difference in pain reduction in ESWT when compared with a comparison group at 4 (p = 0.26) and 12 weeks (p = 0.33). There were no differences in DASH scores at 12 months between the two groups (p = 0.32).

Conclusion: Extracorporeal Shockwave Therapy (ESWT) is effective when used to treat lower limb and calcific tendinitis. It does not yield any better results than other treatment options in managing upper limb tendinopathies and non-calcific tendinopathies.

背景:肌腱病是由重复运动、肌腱承受过大压力、过度拉伸以及超过旋转或平移临界角的运动引起的。腱鞘炎的治疗方法多种多样,包括影响上肢和下肢的腱鞘炎,以及钙化型和非钙化型腱鞘炎:很少有综述分析体外冲击波疗法(ESWT)治疗上肢和下肢腱鞘炎的疗效,同时考虑钙化型和非钙化型腱鞘炎。本文对随机对照试验(RCTs)进行了综述和荟萃分析,比较了接受 ESWT 治疗的一组与接受不同治疗的另一组的结果:研究设计:系统回顾和荟萃分析:在PubMed、Web of Science、Embase、Cochrane对照试验中央注册中心(CENTRAL)和物理治疗证据数据库(PEDro)等数据库中对截至2022年1月发表的文章进行了系统检索。此外,还进一步扫描了已识别文章的参考文献目录。22项研究被纳入荟萃分析:荟萃分析表明,与对比组相比,ESWT 在 4 周(p = 0.26)和 12 周(p = 0.33)时的疼痛减轻程度没有差异。两组患者在 12 个月时的 DASH 评分没有差异(P = 0.32):结论:体外冲击波疗法(ESWT)可有效治疗下肢钙化性肌腱炎。结论:体外冲击波疗法(ESWT)对治疗下肢腱鞘炎和钙化性腱鞘炎有效,但在治疗上肢腱鞘炎和非钙化性腱鞘炎方面,其效果并不比其他治疗方法更好。
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引用次数: 0
Differences in muscle activity during squat exercises according to the knee angle and standing angle of a sliding tilt table: A comparative study. 根据滑动倾斜台的膝盖角度和站立角度,深蹲运动中肌肉活动的差异:一项比较研究。
IF 1.7 Q2 Health Professions Pub Date : 2024-01-01 Epub Date: 2023-10-03 DOI: 10.1002/pri.2050
Tae Sung Park, Myung-Jun Shin, Jong Ho Kang

Background and purpose: Weight-bearing exercises can help improve physical function; however, they may be difficult to perform in patients with neurological issues or lower limb fractures. The purpose of this study was to evaluate the activity of the leg muscles during squatting when using a new exercise aid designed to help patients with difficulty in performing squats, termed the sliding tilt table, at different knee angles and to estimate the squat level for each angle.

Methods: This study was a cross-sectional, observational study performed in the general community. Participants comprised 30 healthy adult men. Squats were performed by setting the knee joints at 30, 60, and 90° and the tilt table angles to 15, 30, and 45°. The muscle activity of the vastus medialis, tibialis anterior, and gastrocnemius was measured using surface electromyography.

Results: As the tilt table and knee joint angle increased, the %maximal voluntary isometric contraction increased. Similar patterns were found in both legs.

Conclusions: Weight-bearing exercises, such as squats, are important exercise elements in patients who require lower limb rehabilitation. Therefore, it is necessary to provide efficient lower limb rehabilitation exercises by adjusting the squat level according to the patient's ability, which can be achieved using a sliding tilt table.

背景和目的:负重运动有助于改善身体机能;然而,在有神经系统问题或下肢骨折的患者中,它们可能很难执行。本研究的目的是评估在使用一种新的运动辅助工具(称为滑动倾斜台)帮助在不同膝关节角度下蹲困难的患者时,下蹲过程中腿部肌肉的活动,并估计每个角度的下蹲水平。方法:本研究是一项在普通社区进行的横断面观察性研究。参与者包括30名健康成年男性。通过将膝关节设置为30、60和90°,将倾斜台角度设置为15、30和45°来进行深蹲。使用表面肌电图测量股内侧肌、胫骨前肌和腓肠肌的肌肉活动。结果:随着倾斜台和膝关节角度的增加,最大自主等长收缩百分比增加。在两条腿上都发现了相似的图案。结论:负重运动,如深蹲,是需要下肢康复的患者的重要运动元素。因此,有必要根据患者的能力通过调整深蹲水平来提供有效的下肢康复锻炼,这可以使用滑动倾斜台来实现。
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引用次数: 0
Comparison of the modified shuttle walk test in children with cystic fibrosis and healthy controls. 改良穿梭行走试验在囊性纤维化儿童和健康对照中的比较。
IF 1.7 Q2 Health Professions Pub Date : 2024-01-01 Epub Date: 2023-10-11 DOI: 10.1002/pri.2052
Francieli Camila Mucha, Renata Maba Gonçalves Wamosy, Janaina Cristina Scalco, Ana Carolina da Silva Almeida, Bianca Dana Horongozo Itaborahy, Juliana Cardoso, Anamaria Fleig Mayer, Camila Isabel Santos Schivinski

Objective: To evaluate and compare performance in the modified shuttle walk test (MSWT) with cardiorespiratory parameters and respiratory muscle strength in children with cystic fibrosis (CF) and healthy controls.

Methods: A cross-sectional study with children divided into the CF group (CFG) and healthy control group (HCG). Two MSWTs were performed and the data from the test with the longest distance walked and its cardiorespiratory parameters (blood pressure, respiratory rate, heart rate (HR), oxygen saturation, and dyspnea sensation) were considered, the last three every 4 levels. Respiratory muscle strength was evaluated using a manometer. The Wilcoxon test was used to compare the parameters before and after the MSWT, and the Mann-Whitney and independent t-tests were applied to compare the data between the groups. The distance walked and its association with the variation in cardiorespiratory parameters and respiratory muscle strength were analyzed by Spearman's correlation.

Results: Sixty-two children (31 in each group) participated, with an average age of 10.2 (2.1) years. Children with CF had poorer performance in the average distance walked (CFG 716.7 (274.3)) when compared to the HCG (948.0 (202.8)). Both groups exhibited an increase in all the cardiorespiratory parameters at the end of the test, but the CFG displayed less variation in some parameters. Children with CF presented a positive correlation between distance walked and respiratory muscle strength, HR variation, and systolic blood pressure.

Conclusions: There was no difference in respiratory muscle strength between the groups. In the CFG, the greater the respiratory muscle strength, the better the performance in the MSWT. The CFG exhibited less variation in cardiorespiratory parameters than the HCG.

目的:评估并比较囊性纤维化(CF)儿童和健康对照组在改良穿梭行走试验(MSWT)中的表现与心肺参数和呼吸肌强度。方法:对儿童进行横断面研究,分为CF组(CFG)和健康对照组(HCG)。进行了两次MSWT,并考虑了最长步行距离的测试数据及其心肺参数(血压、呼吸频率、心率(HR)、血氧饱和度和呼吸困难感),最后三次为每4个水平。使用压力计评估呼吸肌强度。Wilcoxon检验用于比较MSWT前后的参数,Mann-Whitney和独立t检验用于比较各组之间的数据。采用Spearman相关分析了步行距离及其与心肺参数和呼吸肌肉力量变化的关系。结果:62名儿童(每组31名)参加,平均年龄10.2(2.1)岁。与HCG(948.0(202.8))相比,CF儿童的平均步行距离(CFG 716.7(274.3))较差。在测试结束时,两组的所有心肺参数都有所增加,但CFG在某些参数上的变化较小。CF儿童的步行距离与呼吸肌力量、HR变化和收缩压呈正相关。结论:两组患者的呼吸肌力量无明显差异。在CFG中,呼吸肌力量越大,在MSWT中的表现越好。CFG的心肺参数变化小于HCG。
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引用次数: 0
Efficacy of plyometric exercises on upper extremity function, selective motor control and hand grip strength in children with unilateral cerebral palsy: A randomized controlled study. 强化训练对单侧脑瘫儿童上肢功能、选择性运动控制和握力的影响:一项随机对照研究。
IF 1.7 Q2 Health Professions Pub Date : 2024-01-01 Epub Date: 2023-11-03 DOI: 10.1002/pri.2061
Amira M Abd-Elmonem, Hazem A Ali, Sara S Saad-Eldien, Walaa A Abd El-Nabie

Background: Impairment in unimanual upper limb function is frequent among children with unilateral cerebral palsy (UCP), which affects their ability to perform functional activities.

Aim: To assess the efficacy of plyometric exercises on the function of upper extremity, selective motor control (SMC) and hand grip strength (HGS) in children with UCP.

Design: This was a double-masked, randomized, controlled clinical trial.

Setting: Outpatient Clinics of Faculty of Physical Therapy, Cairo University and Center for Physical Medicine, Rehabilitation and Rheumatology, Al-Agouza Hospital, Giza, Egypt.

Population: Forty children with UCP, ranging in age from 8 to 12 years, were randomly allocated to two groups equal in numbers.

Method: Children were allocated to receive conventional therapy (CONV-group; n = 20) or plyometric exercises (PLYO-group; n = 20) for 45 min. In addition, children of both groups received selected physical and occupational therapy programs (each lasted for 30 min) twice a week over 3-month. The intervention was delivered on non-consecutive days. Upper extremity function, SMC and HGS were assessed by using quality of upper extremity skills test (QUEST), Test of arm selective control and pneumatic squeeze bulb dynamometer, respectively.

Results: Overall, 35 children (18 in the CONV-group, 17 in the PLYO-group) completed data collection and treatment. With-in group comparison showed significant improvement in the study groups while post-treatment comparisons revealed a significant difference from mean difference in upper extremity function is 9.55 (8.71:10.39), SMC is 2.12 (1.51:2.72) and HGS is 2.91 (2.13:3.68) (p < 0.05; 95% Confidence interval) in favor of the PLYO-group.

Conclusions: Plyometric exercises have the capability to enhance upper extremity function and strength in children with UCP.

背景:单侧脑瘫(UCP)患儿上肢单手功能受损较为常见,影响其功能活动能力。目的:评估强化训练对UCP儿童上肢功能、选择性运动控制(SMC)和握力(HGS)的影响。设计:这是一项双盲、随机、对照的临床试验。环境:开罗大学物理治疗学院门诊部和埃及吉萨Al Agouza医院物理医学、康复和风湿病中心。人口:40名患有UCP的儿童,年龄从8岁到12岁,被随机分配到两组,每组人数相等。方法:将儿童分为常规治疗组(CONV组;n=20)或强化训练组(PLYO组;n=2 0),持续45min。此外,两组儿童在3个月内每周接受两次选定的物理和职业治疗计划(每次持续30分钟)。干预措施在非连续几天进行。分别采用上肢技能质量测试(QUEST)、手臂选择控制测试和气压挤压球测功机对上肢功能、SMC和HGS进行评估。结果:总体而言,35名儿童(CONV组18名,PLYO组17名)完成了数据收集和治疗。组内比较显示研究组的上肢功能有显著改善,而治疗后比较显示,上肢功能与平均差异的显著性差异为9.55(8.71:10.39),SMC为2.12(1.51:2.72),HGS为2.91(2.13:3.68)。
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引用次数: 0
Effectiveness of neuromuscular electrical stimulation training combined with exercise on patient-reported outcomes measures in people with knee osteoarthritis: A systematic review and meta-analysis. 神经肌肉电刺激训练结合运动对膝骨关节炎患者报告结果测量的有效性:一项系统综述和荟萃分析。
IF 1.7 Q2 Health Professions Pub Date : 2024-01-01 Epub Date: 2023-11-05 DOI: 10.1002/pri.2062
Maurício Tatsch Ximenes Carvalho, Victor Hugo Guesser Pinheiro, Cristine Lima Alberton

Objective: This study examined the effectiveness of neuromuscular electrical stimulation (NMES) added to the exercise or superimposed on voluntary contractions on patient-reported outcomes measures (PROMs) in people with knee osteoarthritis (OA).

Methods: This systematic review was described according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Randomized controlled trials (RCTs) were obtained from a systematic literature search in five electronic databases (PubMed, PEDro, LILACS, EMBASE, and SPORTDiscus) in April 2022. We described the effects of intervention according to each PROMs (scores for Pain; Self-reported functional ability; Symptoms (hear clicking, swelling, catching, restricted range of motion, and stiffness); Daily living function; Sports function; and Quality of life) and used a random-effect model to examine the impact of NMES plus exercise on pain compared with exercise in people with knee OA.

Results: Six RCTs (n = 367) were included. In the qualitative synthesis, the systematic literature analysis showed improvement in pain after NMES plus exercise compared with exercise alone in three studies. The other three studies revealed no difference between groups in pain, although similar improvement after treatments. In the meta-analysis, NMES at a specific joint angle combined with exercise was not superior to exercise alone in pain management (standardized mean difference = -0.33, 95% CI = -1.05 to 0.39, p = 0.37). There was no additional effect of NMES on exercise on self-reported functional ability, stiffness, and physical function compared with exercise alone. In only one study, symptoms, activities of daily living, sports function, and quality of life improved after whole-body electrostimulation combined with exercise.

Conclusion: This review found insufficient evidence for the effectiveness of NMES combined with exercise in treating knee OA considering PROMs. While pain relief was observed in some studies, more high-quality clinical trials are needed to support the use of NMES added to the exercise in clinical practice. Electrical stimulation in a whole-body configuration combined with exercise shows promise as an alternative treatment option.

目的:本研究检查了在膝骨关节炎(OA)患者中,在运动中加入神经肌肉电刺激(NMES)或叠加在自愿收缩上对患者报告结果测量(PROMs)的有效性。方法:根据系统评价和荟萃分析指南的首选报告项对本系统评价进行描述。随机对照试验(RCT)于2022年4月在五个电子数据库(PubMed、PEDro、LILACS、EMBASE和SPORTDiscus)中进行系统文献检索。我们根据每个PROM描述了干预的效果(疼痛评分;自我报告的功能能力;症状(听到咔哒声、肿胀、抓手、活动范围受限和僵硬);日常生活功能;体育功能;和生活质量),并使用随机效应模型检查NMES加运动与运动对膝关节骨性关节炎患者疼痛的影响。结果:纳入6项随机对照试验(n=367)。在定性综合中,系统的文献分析显示,在三项研究中,NMES加运动与单独运动相比,疼痛有所改善。其他三项研究显示,尽管治疗后疼痛有所改善,但各组之间的疼痛没有差异。在荟萃分析中,特定关节角度的NMES结合运动在疼痛管理方面并不优于单独运动(标准化平均差异=0.33,95%CI=1.05至0.39,p=0.37)。与单独运动相比,NMES对运动对自我报告的功能能力、僵硬和身体功能没有额外影响。仅在一项研究中,全身电刺激结合锻炼后,症状、日常生活活动、运动功能和生活质量都有所改善。结论:本综述发现,NMES结合运动治疗膝关节骨性关节炎(PROMs)的有效性证据不足。虽然在一些研究中观察到疼痛减轻,但还需要更多高质量的临床试验来支持在临床实践中使用添加到运动中的NMES。全身电刺激结合锻炼有望成为一种替代治疗选择。
{"title":"Effectiveness of neuromuscular electrical stimulation training combined with exercise on patient-reported outcomes measures in people with knee osteoarthritis: A systematic review and meta-analysis.","authors":"Maurício Tatsch Ximenes Carvalho, Victor Hugo Guesser Pinheiro, Cristine Lima Alberton","doi":"10.1002/pri.2062","DOIUrl":"10.1002/pri.2062","url":null,"abstract":"<p><strong>Objective: </strong>This study examined the effectiveness of neuromuscular electrical stimulation (NMES) added to the exercise or superimposed on voluntary contractions on patient-reported outcomes measures (PROMs) in people with knee osteoarthritis (OA).</p><p><strong>Methods: </strong>This systematic review was described according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Randomized controlled trials (RCTs) were obtained from a systematic literature search in five electronic databases (PubMed, PEDro, LILACS, EMBASE, and SPORTDiscus) in April 2022. We described the effects of intervention according to each PROMs (scores for Pain; Self-reported functional ability; Symptoms (hear clicking, swelling, catching, restricted range of motion, and stiffness); Daily living function; Sports function; and Quality of life) and used a random-effect model to examine the impact of NMES plus exercise on pain compared with exercise in people with knee OA.</p><p><strong>Results: </strong>Six RCTs (n = 367) were included. In the qualitative synthesis, the systematic literature analysis showed improvement in pain after NMES plus exercise compared with exercise alone in three studies. The other three studies revealed no difference between groups in pain, although similar improvement after treatments. In the meta-analysis, NMES at a specific joint angle combined with exercise was not superior to exercise alone in pain management (standardized mean difference = -0.33, 95% CI = -1.05 to 0.39, p = 0.37). There was no additional effect of NMES on exercise on self-reported functional ability, stiffness, and physical function compared with exercise alone. In only one study, symptoms, activities of daily living, sports function, and quality of life improved after whole-body electrostimulation combined with exercise.</p><p><strong>Conclusion: </strong>This review found insufficient evidence for the effectiveness of NMES combined with exercise in treating knee OA considering PROMs. While pain relief was observed in some studies, more high-quality clinical trials are needed to support the use of NMES added to the exercise in clinical practice. Electrical stimulation in a whole-body configuration combined with exercise shows promise as an alternative treatment option.</p>","PeriodicalId":47243,"journal":{"name":"Physiotherapy Research International","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71487342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Use of blood flow restriction for increasing the strength of the ischiocrural muscles in anterior cruciate ligament rehabilitation: A case report. 在前交叉韧带康复中使用限制血流来增加坐骨肌的力量:1例报告。
IF 1.7 Q2 Health Professions Pub Date : 2024-01-01 Epub Date: 2023-11-14 DOI: 10.1002/pri.2059
Claudio Ceccarelli, Alessandro Andreani, Alessandro Soave, Mattia Salomon, Filippo Maselli

Background: The hamstring muscles have a key function in the stability of the knee, limiting the anterior translation of the tibia. Therefore, to better perform rehabilitation after anterior cruciate ligament (ACL) surgery, it is important to develop a specific program based on hamstring strength recovery. It is possible to increase strength and muscle hypertrophy through high load exercises (HL); the recommended load is about 60%-80% of a maximum repetition (MR). Although low-load resistance training (LL) is ineffective at reproducing these values, the use of Blood Flow Restriction (BFR) with LL exercises appears to allow athletes to increase strength and muscle hypertrophy. This could limit functional decline and mitigate muscle atrophy allowing to optimize the recovery path and load management in post-operative patients. Recent scientific evidence, as far as the increasingly frequent use of BFR in rehabilitation and sports rehabilitation is concerned, suggests that these devices could represent one of the most significant innovations in the physiotherapy field. The aim of this study was to increase the strength of the hamstrings in the early phases of ACL rehabilitation with an LL-BFR training protocol for speeding up the development of adequate muscle strength.

Case descriptions: The patient, a 25-year-old male professional footballer, suffered from ACL injury during a football match, and after three months, he underwent a reconstruction ACL surgery with medial Hamstring tendon autograft. The athlete engaged a pre-operative program to restore a full active and passive knee range of motion and increase muscular strength. The first rehabilitation phase was supported by the adoption of BFR for hamstring strengthening, starting from the sixth week post-surgery (T0). A complete assessment of posterior hamstring muscles was performed through a hand-held dynamometer and load detection platforms. Three different types of exercises, focusing on the hamstring muscles, were chosen. Two further assessments were performed over time (T1 ant T2), highlighting different changes that occurred.

Results: Interesting results showed a significant increase between T0 and T1 for all the assessed outcomes; in this case an average increase in strength of 59.87% between the beginning and the end of 4 weeks rehabilitation protocol was obtained in the first interval (T0-T1), while only 25.26% resulted in the second interval (T1-T2). However, the collected data should be considered with caution due to some limitations: the single experience of a single patient can hardly be generalized. Moreover, the reliance on isometric measurement of maximal strength and the absence of a direct strength measurement of the hamstrings during squat remain questionable.

Conclusion: The final results suggest the capacity of the LL-BFR exercises to recreate a condition of a high intensity muscular effor

背景:腘绳肌在膝关节稳定中起关键作用,限制胫骨的前移位。因此,为了更好地进行前交叉韧带(ACL)手术后的康复,制定一个基于腘绳肌力量恢复的具体方案是很重要的。通过高负荷运动(HL)可以增加力量和肌肉肥大;推荐的负载大约是最大重复(MR)的60%-80%。虽然低负荷阻力训练(LL)在复制这些值方面是无效的,但在LL训练中使用血流量限制(BFR)似乎可以让运动员增加力量和肌肉肥大。这可以限制功能下降,减轻肌肉萎缩,从而优化术后患者的恢复路径和负荷管理。最近的科学证据表明,就BFR在康复和运动康复中日益频繁的使用而言,这些设备可能代表了物理治疗领域最重要的创新之一。本研究的目的是通过LL-BFR训练方案,在ACL康复的早期阶段增加腘绳肌的力量,以加速足够肌肉力量的发展。病例描述:患者是一名25岁的男性职业足球运动员,在一场足球比赛中遭受了ACL损伤,三个月后,他接受了重建ACL手术,内侧腘肌腱自体移植。该运动员进行了术前计划,以恢复完全的主动和被动膝关节活动范围,并增加肌肉力量。从术后第6周(T0)开始,采用BFR进行腘绳肌强化,作为第一个康复阶段的支持。通过手持式测功机和负荷检测平台对后腘绳肌进行全面评估。选择了三种不同类型的锻炼,重点是腿筋肌肉。随着时间的推移(T1和T2)进行了两次进一步的评估,突出了发生的不同变化。结果:有趣的结果显示,所有评估结果在T0和T1之间显着增加;在本例中,在第一个康复时间间隔(t1 - t1),肌力平均增加59.87%,而在第二个康复时间间隔(T1-T2),肌力平均增加25.26%。然而,由于某些局限性,收集到的数据应该谨慎考虑:单个患者的单一经验很难一概而论。此外,依赖于最大力量的等距测量和缺乏深蹲时腘绳肌的直接力量测量仍然值得商榷。结论:最终结果表明,在负荷管理方面,LL-BFR训练能够重建高强度肌肉活动的状态,尤其是在手术后。这突出了进一步研究BFR采用的必要性,因为它允许患者在发展足够的肌肉力量方面加速他们的康复目标。
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引用次数: 0
Daily steps, walking tests, and functioning in chronic stroke; comparing independent walkers to device-users. 慢性中风患者的每日步数、步行测试和功能;比较独立步行者和设备使用者。
IF 1.7 Q2 Health Professions Pub Date : 2024-01-01 Epub Date: 2023-07-11 DOI: 10.1002/pri.2035
Chedva Levin, Yishai Bachar-Kirshenboim, Debbie Rand

Background and purpose: Community mobility post-stroke is important for gaining independence in daily activities. Walking devices can facilitate mobility, but it remains unclear whether individuals who use a walking device walk as many daily steps as those who do not require a device. It is also unclear whether these groups differ in their independence in daily living. This study aimed (1) to compare daily steps, walking tests, and independence in basic and instrumental activities of daily living (IADL) six months post-stroke between individuals who walk independently and individuals who use a walking device, (2) within each group to assess correlations between daily steps and walking tests, independence in basic and IADL.

Methods: Thirty-seven community-dwelling individuals with chronic stroke; 22 participants used a walking-device and 15 participants walked independently. Daily steps were calculated as a 3-day mean by hip accelerometers. Clinical walking tests included the 10-m-walk-test, Timed Up & Go and 'Walking While Talking'. Daily living was assessed using the Functional-Independence Measure and the IADL questionnaire.

Results: Daily steps of the device-users were significantly lower than the independent-walkers (195-8068 versus 147-14010 steps/day) but independence in daily living was not significantly different. Different walking tests correlated with daily steps for device-users and independent-walkers.

Conclusions: This preliminary investigation in chronic stroke revealed that device-users walk significantly fewer daily steps but are as independent in daily living as independent-walkers. Clinicians should differentiate between individuals with and without a walking device and the use of different clinical walking tests to explain daily steps should be considered. Further research is needed to assess the impact of a walking device post-stroke.

背景和目的:中风后的社区行动能力对于获得日常活动的独立性非常重要。助行器可以促进行动能力,但使用助行器的人每天行走的步数是否与不需要助行器的人相同,目前仍不清楚。这些群体在日常生活独立性方面是否存在差异也不清楚。本研究的目的是:(1)比较独立行走者和使用行走设备者在卒中后六个月的每日步数、行走测试、基本日常生活活动和工具性日常生活活动(IADL)的独立性;(2)在每组中评估每日步数和行走测试、基本日常生活活动和工具性日常生活活动独立性之间的相关性:方法:37 名居住在社区的慢性中风患者;22 人使用步行器械,15 人独立行走。每日步数以臀部加速度计的 3 天平均值计算。临床步行测试包括 10 米步行测试、定时起立行走和 "边走边说"。日常生活评估采用功能独立性测量法和 IADL 问卷:结果:使用步行器械者的日行走步数明显低于独立行走者(195-8068 步/天对 147-14010 步/天),但日常生活独立性没有明显差异。不同的步行测试与设备使用者和独立行走者的每日步数相关:这项针对慢性卒中的初步调查显示,使用器械者每天行走的步数明显较少,但其日常生活的独立性与独立行走者相同。临床医生应区分使用和未使用行走装置的患者,并考虑使用不同的临床行走测试来解释每日行走步数。还需要进一步的研究来评估行走装置对卒中后的影响。
{"title":"Daily steps, walking tests, and functioning in chronic stroke; comparing independent walkers to device-users.","authors":"Chedva Levin, Yishai Bachar-Kirshenboim, Debbie Rand","doi":"10.1002/pri.2035","DOIUrl":"10.1002/pri.2035","url":null,"abstract":"<p><strong>Background and purpose: </strong>Community mobility post-stroke is important for gaining independence in daily activities. Walking devices can facilitate mobility, but it remains unclear whether individuals who use a walking device walk as many daily steps as those who do not require a device. It is also unclear whether these groups differ in their independence in daily living. This study aimed (1) to compare daily steps, walking tests, and independence in basic and instrumental activities of daily living (IADL) six months post-stroke between individuals who walk independently and individuals who use a walking device, (2) within each group to assess correlations between daily steps and walking tests, independence in basic and IADL.</p><p><strong>Methods: </strong>Thirty-seven community-dwelling individuals with chronic stroke; 22 participants used a walking-device and 15 participants walked independently. Daily steps were calculated as a 3-day mean by hip accelerometers. Clinical walking tests included the 10-m-walk-test, Timed Up & Go and 'Walking While Talking'. Daily living was assessed using the Functional-Independence Measure and the IADL questionnaire.</p><p><strong>Results: </strong>Daily steps of the device-users were significantly lower than the independent-walkers (195-8068 versus 147-14010 steps/day) but independence in daily living was not significantly different. Different walking tests correlated with daily steps for device-users and independent-walkers.</p><p><strong>Conclusions: </strong>This preliminary investigation in chronic stroke revealed that device-users walk significantly fewer daily steps but are as independent in daily living as independent-walkers. Clinicians should differentiate between individuals with and without a walking device and the use of different clinical walking tests to explain daily steps should be considered. Further research is needed to assess the impact of a walking device post-stroke.</p>","PeriodicalId":47243,"journal":{"name":"Physiotherapy Research International","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9770293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Effects of virtual exercise on cardio-pulmonary performance and depression in cardiac rehabilitation phase I: A randomized control trial. 虚拟运动对心脏康复I期心肺功能和抑郁的影响:一项随机对照试验。
IF 1.7 Q2 Health Professions Pub Date : 2024-01-01 Epub Date: 2023-11-27 DOI: 10.1002/pri.2066
Kornanong Yuenyongchaiwat, Tunchanok Boonkawee, Phansaporn Pipatsart, Wararat Tavonudomgit, Natsinee Sermsinsaithong, Preyaphorn Songsorn, Noppawan Charususin, Somrudee Harnmanop, Phuwarin Namdaeng, Chitima Kulchanarat, Chusak Thanawattano

Background: Cardiac rehabilitation is recommended for patients undergoing open-heart surgery (OHS). During the hospital admission, these patients suffer from reduced cardiopulmonary performance and decreased psychological health, leading to poor physical function, depression, and morbidity. To prevent post-operative pulmonary complications, a pre and post-operative physical therapy intervention is recommended for patients undergoing heart surgery. Virtual reality (VR) promotes the health status of healthy individuals and those with health conditions. However, few studies have reported the beneficial effects of VR exercise programs on the pulmonary performance and mental health status of patients undergoing OHS.

Objectives: To determine whether by using training enhanced by VR, patients who have undergone OHS can more effectively attain cardiopulmonary performance and improve depression than through conventional physical therapy.

Method: 60 participants were randomly assigned to a conventional physical therapy and VR exercise program. Each session was conducted once daily until discharge from the hospital. Cardiorespiratory performance and depression were evaluated before surgery and at the time of discharge from the hospital. A two-way mixed ANOVA was performed to compare within (i.e., pre and post-operation) and between (i.e., VR and conventional physical therapy) groups.

Results: No significant cardiopulmonary performance gains were detected in patients receiving the VR exercise program when compared with those who participated in conventional physical therapy prior to post-operative OHS (p > 0.05). However, the conventional physical therapy group showed significantly higher depression scores than the VR group (∆4.00 ± 0.98 vs. ∆1.68 ± 0.92). However, cardiopulmonary performance did not differ in both VR exercise and conventional physical therapy.

背景:心脏康复被推荐给接受心脏直视手术(OHS)的患者。在住院期间,这些患者心肺功能下降,心理健康状况下降,导致身体功能不佳,抑郁和发病率。为了预防术后肺部并发症,建议对心脏手术患者进行术前和术后物理治疗干预。虚拟现实(VR)促进健康个体和有健康状况的人的健康状况。然而,很少有研究报道VR运动项目对OHS患者肺功能和心理健康状况的有益影响。目的:探讨与常规物理治疗相比,采用VR强化训练是否能更有效地改善OHS患者的心肺功能和抑郁。方法:60名参与者随机分配到常规物理治疗和VR运动项目。每次治疗每天进行一次,直到出院。在手术前和出院时评估心肺功能和抑郁。采用双向混合方差分析比较组内(即术前和术后)和组间(即VR组和常规物理治疗组)的差异。结果:与OHS术后接受常规物理治疗的患者相比,接受VR运动计划的患者心肺功能无显著提高(p > 0.05)。常规物理治疗组抑郁评分显著高于VR组(∆4.00±0.98比∆1.68±0.92)。然而,心肺功能在VR运动和常规物理治疗中没有差异。
{"title":"Effects of virtual exercise on cardio-pulmonary performance and depression in cardiac rehabilitation phase I: A randomized control trial.","authors":"Kornanong Yuenyongchaiwat, Tunchanok Boonkawee, Phansaporn Pipatsart, Wararat Tavonudomgit, Natsinee Sermsinsaithong, Preyaphorn Songsorn, Noppawan Charususin, Somrudee Harnmanop, Phuwarin Namdaeng, Chitima Kulchanarat, Chusak Thanawattano","doi":"10.1002/pri.2066","DOIUrl":"10.1002/pri.2066","url":null,"abstract":"<p><strong>Background: </strong>Cardiac rehabilitation is recommended for patients undergoing open-heart surgery (OHS). During the hospital admission, these patients suffer from reduced cardiopulmonary performance and decreased psychological health, leading to poor physical function, depression, and morbidity. To prevent post-operative pulmonary complications, a pre and post-operative physical therapy intervention is recommended for patients undergoing heart surgery. Virtual reality (VR) promotes the health status of healthy individuals and those with health conditions. However, few studies have reported the beneficial effects of VR exercise programs on the pulmonary performance and mental health status of patients undergoing OHS.</p><p><strong>Objectives: </strong>To determine whether by using training enhanced by VR, patients who have undergone OHS can more effectively attain cardiopulmonary performance and improve depression than through conventional physical therapy.</p><p><strong>Method: </strong>60 participants were randomly assigned to a conventional physical therapy and VR exercise program. Each session was conducted once daily until discharge from the hospital. Cardiorespiratory performance and depression were evaluated before surgery and at the time of discharge from the hospital. A two-way mixed ANOVA was performed to compare within (i.e., pre and post-operation) and between (i.e., VR and conventional physical therapy) groups.</p><p><strong>Results: </strong>No significant cardiopulmonary performance gains were detected in patients receiving the VR exercise program when compared with those who participated in conventional physical therapy prior to post-operative OHS (p > 0.05). However, the conventional physical therapy group showed significantly higher depression scores than the VR group (∆4.00 ± 0.98 vs. ∆1.68 ± 0.92). However, cardiopulmonary performance did not differ in both VR exercise and conventional physical therapy.</p>","PeriodicalId":47243,"journal":{"name":"Physiotherapy Research International","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138441458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Effects of aquatic exercises in patients after total hip arthroplasty: A systematic review. 水上运动对全髋关节置换术后患者的影响:系统综述。
IF 1.7 Q2 Health Professions Pub Date : 2024-01-01 Epub Date: 2023-08-21 DOI: 10.1002/pri.2043
Julio Henric V M Centurião, Karen Obara, Carla T Silva, Luana Paixão, Mariana F Silva, Josilainne M Dias, Jefferson R Cardoso

Background: Total hip arthroplasty (THA) is a surgical procedure that can alter physical function and quality of life.

Objectives: The aim was to verify the effects of aquatic exercises compared with exercises on land, control or other modalities, in patients undergoing THA on the primary outcomes: self-reported physical function, quality of life and pain; and secondary outcomes: muscle strength, functional capacity and gait.

Design: Systematic review that followed the PRISMA Statement and PROSPERO registered. The search was performed in the following databases: Web of Science, Embase, Medline, Cinahl, Lilacs, SPORTDiscus, Cochrane Library, Scopus, SciELO, and PEDro, from 1945 to 2022. The risk of bias assessment was performed using the Risk of Bias 2 (RoB2) from the Cochrane Collaboration.

Results: Three randomized controlled trials (RCTs) were included, with a total of 364 participants. In the selection process, two publications from the same study were found. The RoB2 assessment classified one RCT as "high risk of bias" and the others as "low risk of bias". Therefore, the analysis of the results considered only studies with a low risk of bias. For the self-reported physical function outcome, evaluated by WOMAC, improvement was observed in favor of aquatic exercises, when started on the 14th postoperative day. Pain improved after 24th week postoperative, in favor of exercise (effect size between 0.2 and 0.4). Quality of life, verified only by one RCT, improved at each time point evaluated (effect size between 0.01 and 0.10). The functional capacity showed no difference between the groups. This was the first systematic review to assess the benefits of aquatic exercises specifically in THA and it was possible to infer that the exercises initiated after 14 days of postoperative are safer. The protocol should include proprioceptive, coordination, and resistance exercises. The session can last around 30 min and is held three times a week.

Conclusion: Decision making for treatment in the postoperative of THA may include aquatic exercises as a safe and efficacious alternative to improve self-reported physical function, pain, quality of life, and muscle resistance.

背景:全髋关节置换术(THA全髋关节置换术(THA)是一种可改变身体功能和生活质量的外科手术:目的:验证在接受全髋关节置换术的患者中,水上运动与陆上运动、对照组或其他方式的运动相比,对主要结果(自我报告的身体功能、生活质量和疼痛)和次要结果(肌肉力量、功能能力和步态)的影响:设计:遵循 PRISMA 声明和 PROSPERO 注册的系统性综述。在以下数据库中进行了搜索:从 1945 年到 2022 年,在以下数据库中进行了检索:Web of Science、Embase、Medline、Cinahl、Lilacs、SPORTDiscus、Cochrane Library、Scopus、SciELO 和 PEDro。使用 Cochrane 协作组织的 Risk of Bias 2(RoB2)进行了偏倚风险评估:结果:共纳入三项随机对照试验(RCT),参与人数共计 364 人。在筛选过程中,发现了来自同一研究的两篇论文。RoB2 评估将其中一项随机对照试验归为 "高偏倚风险",其他两项归为 "低偏倚风险"。因此,结果分析只考虑了偏倚风险较低的研究。通过 WOMAC 对自我报告的身体功能结果进行评估,发现在术后第 14 天开始进行水上运动的效果更好。术后第 24 周后,疼痛有所改善,运动对疼痛的改善更有利(效应大小介于 0.2 和 0.4 之间)。生活质量(仅由一项研究证实)在每个评估时间点都有所改善(效应大小在 0.01 和 0.10 之间)。各组的功能能力没有差异。这是第一份专门评估水上运动对 THA 的益处的系统性综述,可以推断术后 14 天后开始的水上运动更安全。训练方案应包括本体感觉、协调和阻力练习。训练时间约为 30 分钟,每周三次:结论:THA 术后的治疗决策可包括水上运动,这是一种安全有效的替代方法,可改善自我报告的身体功能、疼痛、生活质量和肌肉抵抗力。
{"title":"Effects of aquatic exercises in patients after total hip arthroplasty: A systematic review.","authors":"Julio Henric V M Centurião, Karen Obara, Carla T Silva, Luana Paixão, Mariana F Silva, Josilainne M Dias, Jefferson R Cardoso","doi":"10.1002/pri.2043","DOIUrl":"10.1002/pri.2043","url":null,"abstract":"<p><strong>Background: </strong>Total hip arthroplasty (THA) is a surgical procedure that can alter physical function and quality of life.</p><p><strong>Objectives: </strong>The aim was to verify the effects of aquatic exercises compared with exercises on land, control or other modalities, in patients undergoing THA on the primary outcomes: self-reported physical function, quality of life and pain; and secondary outcomes: muscle strength, functional capacity and gait.</p><p><strong>Design: </strong>Systematic review that followed the PRISMA Statement and PROSPERO registered. The search was performed in the following databases: Web of Science, Embase, Medline, Cinahl, Lilacs, SPORTDiscus, Cochrane Library, Scopus, SciELO, and PEDro, from 1945 to 2022. The risk of bias assessment was performed using the Risk of Bias 2 (RoB2) from the Cochrane Collaboration.</p><p><strong>Results: </strong>Three randomized controlled trials (RCTs) were included, with a total of 364 participants. In the selection process, two publications from the same study were found. The RoB2 assessment classified one RCT as \"high risk of bias\" and the others as \"low risk of bias\". Therefore, the analysis of the results considered only studies with a low risk of bias. For the self-reported physical function outcome, evaluated by WOMAC, improvement was observed in favor of aquatic exercises, when started on the 14th postoperative day. Pain improved after 24th week postoperative, in favor of exercise (effect size between 0.2 and 0.4). Quality of life, verified only by one RCT, improved at each time point evaluated (effect size between 0.01 and 0.10). The functional capacity showed no difference between the groups. This was the first systematic review to assess the benefits of aquatic exercises specifically in THA and it was possible to infer that the exercises initiated after 14 days of postoperative are safer. The protocol should include proprioceptive, coordination, and resistance exercises. The session can last around 30 min and is held three times a week.</p><p><strong>Conclusion: </strong>Decision making for treatment in the postoperative of THA may include aquatic exercises as a safe and efficacious alternative to improve self-reported physical function, pain, quality of life, and muscle resistance.</p>","PeriodicalId":47243,"journal":{"name":"Physiotherapy Research International","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10407298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Effects of weekend rehabilitation on vertebral compression fractures in the elderly. 周末康复对老年人椎体压缩性骨折的影响。
IF 1.7 Q2 Health Professions Pub Date : 2024-01-01 Epub Date: 2023-09-30 DOI: 10.1002/pri.2049
Ryoma Asahi, Tomohiko Kamo, Satoshi Yuguchi, Masato Azami, Hirofumi Ogihara, Ryo Momosaki

Introduction: This retrospective cohort study aimed to investigate the effect of rehabilitation and without weekend therapy on Activities of daily living (ADL) and readmission in vertebral fracture patients aged 60 years and older.

Methods: The present study used a hospital-based database created by JMDC Inc. The JMDC hospital-based database is an epidemiological database that has been storing medical claims and Diagnosis Procedure Combination survey data. This study included 40,743 admitted patients aged 60 years or older who were admitted for rehabilitation purposes with a diagnosis of compression fracture of the thoracic and/or lumbar spine based on a previous diagnostic survey. We extracted the medical information from the database. Patients who received rehabilitation 7 days a week were classified into two groups: the "weekend rehabilitation group" and "nonweekend rehabilitation group." To reduce confounding effects related to differences in patient background, we used propensity score with multiple logistic regression models. Analysis of the JMDC database was conducted with the approval of the Institutional Review Board (approval number: 1228-1). Because all data were anonymized, informed consent was not required.

Results: Propensity score matching resulted in 13,790 cases being included in the analysis. Barthel index (BI) at discharge, change in BI, and readmission were significantly different between the weekend rehabilitation and nonweekend rehabilitation groups. Multiple logistic regression analysis suggested a reduced odds of readmission with weekend rehabilitation (odds ratio = 0.907, 95% confidence interval [CI] = 0.843-0.975, p-value = 0.008). Furthermore, greater changes in BI and BI at discharge were associated with the effect of weekend rehabilitation (unstandardized [B] = 3.922, 95% CI = 2.925-4.919), (unstandardized [B] = 3.512, 9% CI = 2.424-4.6), respectively.

Conclusions: Weekend rehabilitation was considered as an important part of the treatment program to acquire ADL and to prevent readmission.

引言:这项回顾性队列研究旨在调查60岁及以上脊椎骨折患者的康复和无周末治疗对日常生活能力(ADL)和再入院的影响。方法:本研究采用JMDC股份有限公司创建的医院数据库。JMDC医院数据库是一个流行病学数据库,存储了医疗索赔和诊断程序组合调查数据。这项研究包括40743名60岁或60岁以上的入院患者,这些患者是为了康复而入院的,根据之前的诊断调查,他们被诊断为胸椎和/或腰椎压缩性骨折。我们从数据库中提取了医疗信息。每周7天接受康复治疗的患者分为两组:“周末康复组”和“非周末康复组。为了减少与患者背景差异相关的混杂效应,我们使用了倾向评分和多元逻辑回归模型。JMDC数据库的分析得到了机构审查委员会的批准(批准号:1228-1)。由于所有数据都是匿名的,因此不需要知情同意。结果:倾向性评分匹配导致13790例病例被纳入分析。出院时的Barthel指数(BI)、BI变化和再次入院在周末康复组和非周末康复组之间存在显著差异。多元逻辑回归分析表明,周末康复后再次入院的几率降低(比值比=0.907,95%置信区间[CI]=0.843-0.975,p值=0.008)。此外,出院时BI和BI的较大变化与周末康复的效果相关(非标准化[B]=3.922,95%CI=2.925-4.919),(非标准[B]=3.512,9%CI=2.424-4.6)。结论:周末康复被认为是获得ADL和防止再次入院的治疗计划的重要组成部分。
{"title":"Effects of weekend rehabilitation on vertebral compression fractures in the elderly.","authors":"Ryoma Asahi, Tomohiko Kamo, Satoshi Yuguchi, Masato Azami, Hirofumi Ogihara, Ryo Momosaki","doi":"10.1002/pri.2049","DOIUrl":"10.1002/pri.2049","url":null,"abstract":"<p><strong>Introduction: </strong>This retrospective cohort study aimed to investigate the effect of rehabilitation and without weekend therapy on Activities of daily living (ADL) and readmission in vertebral fracture patients aged 60 years and older.</p><p><strong>Methods: </strong>The present study used a hospital-based database created by JMDC Inc. The JMDC hospital-based database is an epidemiological database that has been storing medical claims and Diagnosis Procedure Combination survey data. This study included 40,743 admitted patients aged 60 years or older who were admitted for rehabilitation purposes with a diagnosis of compression fracture of the thoracic and/or lumbar spine based on a previous diagnostic survey. We extracted the medical information from the database. Patients who received rehabilitation 7 days a week were classified into two groups: the \"weekend rehabilitation group\" and \"nonweekend rehabilitation group.\" To reduce confounding effects related to differences in patient background, we used propensity score with multiple logistic regression models. Analysis of the JMDC database was conducted with the approval of the Institutional Review Board (approval number: 1228-1). Because all data were anonymized, informed consent was not required.</p><p><strong>Results: </strong>Propensity score matching resulted in 13,790 cases being included in the analysis. Barthel index (BI) at discharge, change in BI, and readmission were significantly different between the weekend rehabilitation and nonweekend rehabilitation groups. Multiple logistic regression analysis suggested a reduced odds of readmission with weekend rehabilitation (odds ratio = 0.907, 95% confidence interval [CI] = 0.843-0.975, p-value = 0.008). Furthermore, greater changes in BI and BI at discharge were associated with the effect of weekend rehabilitation (unstandardized [B] = 3.922, 95% CI = 2.925-4.919), (unstandardized [B] = 3.512, 9% CI = 2.424-4.6), respectively.</p><p><strong>Conclusions: </strong>Weekend rehabilitation was considered as an important part of the treatment program to acquire ADL and to prevent readmission.</p>","PeriodicalId":47243,"journal":{"name":"Physiotherapy Research International","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41160195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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Physiotherapy Research International
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