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Association between balance recovery during inpatient rehabilitation and gait without physical assistance in severe subacute post-stroke patients. 严重亚急性脑卒中后患者住院康复期间的平衡恢复与无肢体辅助步态之间的关系。
IF 1.7 Q2 Health Professions Pub Date : 2023-10-01 Epub Date: 2023-06-18 DOI: 10.1002/pri.2029
Gath Cf, Gianella Mg, Bonamico L, Russo Mj

Background and purpose: Studies that analyze gait without physical assistance recovery post-stroke are scarce. There are few of the studies that analyze longitudinally the recovery of balance during the subacute post-stroke inpatient rehabilitation. The aim of the study was to analyze the association between balance recovery during subacute stroke inpatient rehabilitation and gait without physical assistance achievement. Secondarily, to analyze the association between balance at admission of inpatient rehabilitation and gait without physical assistance achievement.

Methods: An observational, longitudinal, and retrospective cohort study was conducted. Subacute stroke subjects with an admission Berg Balance Scale below or equal to 4 points were included (n = 164). Two logistic regression models were developed. Model 1 analyzes the association between balance recovery during inpatient rehabilitation and gait without physical assistance at discharge. Model 2 analyzes the association between balance at the admission and gait without physical assistance at discharge.

Results: Of 164 severe post-stroke patients, 60 (36.5%) achieved gait without physical assistance. Although the two models developed a statistically significant association (p < 0.001), Model 1 evinced better discrimination performance (Model 1: area below the curve was of 0.987 -CI 95%: 0.975-0.998- vs. Model 2: area below the curve 2 was of 0.705 -CI 95%: 0.789-0.601-).

Discussion: Balance recovery during rehabilitation was strongly associated with gait without physical assistance achievement at the time of discharge in severe subacute post-stroke patients.

Implications for physiotherapy practice: The longitudinal analysis of motor recovery in severe subacute post-stroke patients may be helpful in the decision making process during inpatient rehabilitation.

背景和目的:分析卒中后无肢体辅助恢复步态的研究很少。很少有研究纵向分析亚急性脑卒中后住院康复期间的平衡恢复。本研究的目的是分析亚急性脑卒中住院康复期间的平衡恢复与无肢体辅助步态之间的关系。其次,分析住院康复时的平衡与无肢体辅助步态成绩之间的关系。方法:采用观察性、纵向和回顾性队列研究。纳入入院Berg平衡量表低于或等于4分的亚急性中风受试者(n=164)。建立了两个逻辑回归模型。模型1分析了住院康复期间的平衡恢复与出院时没有身体帮助的步态之间的关系。模型2分析了入院时的平衡和出院时没有身体帮助的步态之间的关系。结果:在164名严重脑卒中后患者中,60人(36.5%)在没有身体帮助的情况下步态正常。尽管这两个模型建立了具有统计学意义的关联(p讨论:在严重亚急性脑卒中后患者出院时,康复过程中的平衡恢复与没有身体辅助的步态成绩密切相关。对物理治疗实践的启示:对严重亚急性卒中后患者运动恢复的纵向分析可能有助于住院康复期间的决策过程。
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引用次数: 0
Effectiveness of virtual reality-based balance and gait in older adults with fear of movement: A systematic review and meta-analysis. 基于虚拟现实的平衡和步态在有运动恐惧的老年人中的有效性:一项系统综述和荟萃分析。
IF 1.7 Q2 Health Professions Pub Date : 2023-10-01 Epub Date: 2023-07-10 DOI: 10.1002/pri.2037
David Percy, Tyler Phillips, Fabian Torres, Michele Chaleunphonh, Paul Sung

Objective: To summarize the current evidence from randomized controlled trials (RCTs) regarding the effectiveness of Virtual Reality (VR) training and functional mobility in older adults with fear of movement. TYPE: Systematic review and meta-analysis of randomized clinical trials.

Methodology: An electronic search was performed using PubMed, Embase, Medline, SPORTDiscus, Scopus, and CINAHL. A data search from January 2015 to December 2022 and a manual electronic literature search were conducted to identify published RCTs. The effectiveness of VR-based balance training for balance and gait was evaluated in older adults with a fear of movement, which was measured by the Timed Up and Go (TUG) test and the Falls Efficacy Scale (FES). Three reviewers independently performed the study selection, and the quality assessment of the included studies was performed using the Physiotherapy Evidence Database (PEDro) scale. The reporting was based on the new Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) Guidelines.

Synthesis: The search product produced 345 results, from which 23 full text articles were studied. Seven RCTs of good methodological quality, including 265 participants, were included in the review. Overall, the studies reported that VR had a significant improvement on the TUG (Cohen's d = -0.91 [-1.38; -0.44], p = 0.001), while the FES was not significantly different (Cohen's d = -0.54 [-1.80; 0.71] p = 0.40). The average for PEDro scores (6.14) was good, and the risk of bias revealed that more than one-third of the studies correctly described the random sequence generation and allocation concealment procedures.

Conclusion: VR-based training is effective on balance or gait training based on the TUG; however, there were mixed results to improve FES scores following VR intervention. These inconsistent results might be limited due to variations in the studies, including heterogeneous training paradigms, sensitive outcome measures, small sample sizes, and short intervention durations, which limit the validity of our findings. Future investigations should compare different VR protocols to help establish better guidelines for clinicians.

目的:总结随机对照试验(RCTs)中关于虚拟现实(VR)训练和功能性移动在有运动恐惧的老年人中的有效性的最新证据。类型:随机临床试验的系统综述和荟萃分析。方法:使用PubMed、Embase、Medline、SPORTDiscus、Scopus和CINAHL进行电子搜索。进行了2015年1月至2022年12月的数据搜索和手动电子文献搜索,以确定已发表的随机对照试验。基于VR的平衡训练对运动恐惧的老年人的平衡和步态的有效性进行了评估,并通过定时上下(TUG)测试和跌倒效能量表(FES)进行了测量。三名评审员独立进行了研究选择,并使用物理治疗证据数据库(PEDro)量表对纳入的研究进行了质量评估。报告基于新的系统评价和荟萃分析首选报告项目(PRISMA)指南。综合:搜索产品产生345个结果,其中研究了23篇全文文章。包括265名参与者在内的7项方法学质量良好的随机对照试验被纳入审查。总体而言,研究报告VR对TUG有显著改善(Cohen’s d=-0.91[1.38;-0.44],p=0.001),而FES没有显著差异(Cohen‘s d=-0.54[1.80;0.71]p=0.40)。PEDro评分的平均值(6.14)良好,偏倚风险显示,超过三分之一的研究正确描述了随机序列生成和分配隐藏程序。结论:基于VR的训练对基于TUG的平衡或步态训练是有效的;然而,VR干预后改善FES评分的结果喜忧参半。这些不一致的结果可能由于研究的变化而受到限制,包括异质性训练范式、敏感的结果测量、小样本量和短干预时间,这些都限制了我们研究结果的有效性。未来的研究应该比较不同的VR协议,以帮助为临床医生制定更好的指南。
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引用次数: 0
Attitudes towards people with disabilities across different healthcare undergraduate students: A cluster analysis approach. 不同医疗保健本科生对残疾人的态度:一种聚类分析方法。
IF 1.7 Q2 Health Professions Pub Date : 2023-10-01 Epub Date: 2023-07-18 DOI: 10.1002/pri.2032
Theofani A Bania, Maria Gianniki, Garyfalia Charitaki, Sofia Giannakoudi, Velaoras I Andreas, Charikleia Farantou, Velaora I Aliki, Evdokia A Billis

Background and purpose: Negative attitudes towards disability amongst healthcare professionals endanger social inclusion of people with disabilities (PwD). This study aimed to investigate the attitude of undergraduate healthcare students of various disciplines towards PwD, including specific aspects of their attitude.

Methods: We assessed the attitudes of university students, including physiotherapy, speech therapy, nursing, social work and medical students, through the Greek Interaction with Disabled Person Scale (IDPS) in a survey. Data were analysed using a two-step clustering technique.

Results: Four hundred-eighty undergraduate healthcare students (21.4 ± 5.3 years-old; 135 males, 345 females) were recruited. Two-step cluster analysis identified three homogenous subgroups labelled Least positive attitude (42.3%), Moderately positive attitude (26.9%), and Most positive attitude (30.8%) groups. Τhe main differences in healthcare students' attitudes between the three distinct groups appeared to be in feelings of sympathy, fear and susceptibility towards disability, suggesting that these aspects of attitude needed to be primarily addressed. Results also revealed that females, being in higher semester/year of studies, having completed a clinical module with PwD and having frequent contact with PwD were related to more positive attitudes.

Conclusion: Taking into account that the majority of the healthcare students' sample yielded least and moderately positive attitudes, towards PwD, further actions should be taken for promoting more positive attitudes towards disability. A social model in teaching to increase student's awareness of PwD and skills to work with these people, having PwD themselves teaching such modules, focussing on positive experiences and reminding the students of the benefits of having positive attitudes towards PwD, as well as promoting ways to increase the contact of healthcare students with PwD (such as teaching in co-operation with organisations of PwD or finding alternative clinical placements with PwD), can be beneficial in promoting more positive attitudes towards disability.

背景和目的:医疗保健专业人员对残疾的负面态度危及残疾人的社会包容。本研究旨在调查不同学科的本科生对普华永道的态度,包括他们态度的具体方面。方法:采用希腊残疾人互动量表(IDPS)对大学生的态度进行调查,包括物理治疗、言语治疗、护理、社会工作和医学生。使用两步聚类技术对数据进行分析。结果:共招募了480名本科生(21.4±5.3岁;135名男性,345名女性)。两步聚类分析确定了三个同质亚组,分别为最不积极态度组(42.3%)、中等积极态度(26.9%)和最积极态度(30.8%)。三个不同群体之间的医护学生态度的主要差异似乎是同情、恐惧和对残疾的易感性,这表明需要主要解决这些方面的态度。研究结果还显示,女性在上学期/年的学习中,完成了普华永道的临床模块,并经常与普华永道接触,与更积极的态度有关。结论:考虑到大多数医疗保健学生对PwD的态度最低和中等积极,应采取进一步行动,促进对残疾的更积极态度。一种社会教学模式,旨在提高学生对普华永道的认识和与这些人合作的技能,让普华永道自己教授这些模块,关注积极的体验,并提醒学生对普华永道持积极态度的好处,以及推广增加医疗保健学生与普华永道接触的方法(例如与普华永道组织合作教学或与普华永道寻找替代临床实习),都有利于促进对残疾的更积极态度。
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引用次数: 0
Multicomponent and mat Pilates training increased gait speed in individuals with Parkinson's disease when walking and carrying a load: A single-blinded randomized controlled trial. 多组分和垫式普拉提训练提高了帕金森病患者行走和负重时的步态速度:一项单盲随机对照试验。
IF 1.7 Q2 Health Professions Pub Date : 2023-10-01 Epub Date: 2023-07-03 DOI: 10.1002/pri.2031
Júlia de Faria, Lucas Resende Sousa, Ana Cláudia Pamplona Dorásio, Miriam Pimenta Pereira, Renato Moraes, Luciano Fernandes Crozara, Camilla Zamfolini Hallal

Background and purpose: Gait disorders in individuals with Parkinson's disease (IwPD) are among the most disabling symptoms. Physical exercise has been proposed for the treatment of IwPD because it shows positive effects on gait variables. Given the importance of physical activity in the rehabilitation process of IwPD, the assessment of interventions to identify those most promising for improving or maintaining gait performance is of great relevance. Therefore, this study evaluated the effects of Mat Pilates Training (MPT) and Multicomponent Training (MCT) on the spatiotemporal variables of gait in situations of daily dual-task performance in IwPD. Gait analysis in a daily dual-task context allows the simulation of real-life conditions where individuals have a higher risk of falling than in single-task walking.

Methods: We conducted a single-blinded randomized controlled trial with 34 mild-to-moderate IwPD (Hoehn-Yahr stage 1-2). They were randomized to one of two interventions: MPT or MCT. All participants performed the training for 60 min, three times per week, for 20 weeks. Spatiotemporal gait variables were evaluated in a daily life situation to increase the ecological validity of the measurements, which included gait speed, stride time, double support time, swing time, and cadence. The individuals walked on a platform holding two bags with a load corresponding to 10% of their body mass.

Results: After the intervention, there was a significant improvement in gait speed in both groups: MPT (p = 0.047) and MCT (p = 0.015). The MPT group reduced the cadence (p = 0.005) and the MCT group increased the stride length (p = 0.026) after the intervention.

Discussion: Both groups had positive effects on gait speed with load transport resulting from the two proposed interventions. However, the MPT group showed a spatiotemporal adjustment of speed and cadence that can increase gait stability, which was not found in the MCT group.

背景和目的:帕金森病患者的步态障碍是最常见的致残症状之一。由于体育锻炼对步态变量有积极影响,因此有人建议将其用于治疗IwPD。鉴于体育活动在IwPD康复过程中的重要性,评估干预措施以确定那些最有希望改善或保持步态表现的干预措施具有重要意义。因此,本研究评估了垫式普拉提训练(MPT)和多成分训练(MCT)对IwPD日常双任务表现情况下步态时空变量的影响。在日常双任务环境中的步态分析可以模拟现实生活中的情况,在这种情况下,个人摔倒的风险比单任务行走更高。方法:我们对34例轻度至中度IwPD(Hoehn-Yahr 1-2期)进行了单盲随机对照试验。他们被随机分为两种干预措施之一:MPT或MCT。所有参与者进行了60分钟的训练,每周三次,为期20周。在日常生活中评估时空步态变量,以提高测量的生态有效性,包括步态速度、步幅时间、双支撑时间、摆动时间和节奏。受试者拿着两个袋子在平台上行走,袋子的负荷相当于他们体重的10%。结果:干预后,两组的步态速度都有显著改善:MPT(p=0.047)和MCT(p=0.015)。干预后,MPT组降低了步频(p=0.005),MCT组增加了步幅(p=0.026)。讨论:两组都对步态速度和负荷转移产生了积极影响,这是由两种拟议的干预措施引起的。然而,MPT组表现出速度和节奏的时空调节,可以提高步态稳定性,这在MCT组中没有发现。
{"title":"Multicomponent and mat Pilates training increased gait speed in individuals with Parkinson's disease when walking and carrying a load: A single-blinded randomized controlled trial.","authors":"Júlia de Faria,&nbsp;Lucas Resende Sousa,&nbsp;Ana Cláudia Pamplona Dorásio,&nbsp;Miriam Pimenta Pereira,&nbsp;Renato Moraes,&nbsp;Luciano Fernandes Crozara,&nbsp;Camilla Zamfolini Hallal","doi":"10.1002/pri.2031","DOIUrl":"10.1002/pri.2031","url":null,"abstract":"<p><strong>Background and purpose: </strong>Gait disorders in individuals with Parkinson's disease (IwPD) are among the most disabling symptoms. Physical exercise has been proposed for the treatment of IwPD because it shows positive effects on gait variables. Given the importance of physical activity in the rehabilitation process of IwPD, the assessment of interventions to identify those most promising for improving or maintaining gait performance is of great relevance. Therefore, this study evaluated the effects of Mat Pilates Training (MPT) and Multicomponent Training (MCT) on the spatiotemporal variables of gait in situations of daily dual-task performance in IwPD. Gait analysis in a daily dual-task context allows the simulation of real-life conditions where individuals have a higher risk of falling than in single-task walking.</p><p><strong>Methods: </strong>We conducted a single-blinded randomized controlled trial with 34 mild-to-moderate IwPD (Hoehn-Yahr stage 1-2). They were randomized to one of two interventions: MPT or MCT. All participants performed the training for 60 min, three times per week, for 20 weeks. Spatiotemporal gait variables were evaluated in a daily life situation to increase the ecological validity of the measurements, which included gait speed, stride time, double support time, swing time, and cadence. The individuals walked on a platform holding two bags with a load corresponding to 10% of their body mass.</p><p><strong>Results: </strong>After the intervention, there was a significant improvement in gait speed in both groups: MPT (p = 0.047) and MCT (p = 0.015). The MPT group reduced the cadence (p = 0.005) and the MCT group increased the stride length (p = 0.026) after the intervention.</p><p><strong>Discussion: </strong>Both groups had positive effects on gait speed with load transport resulting from the two proposed interventions. However, the MPT group showed a spatiotemporal adjustment of speed and cadence that can increase gait stability, which was not found in the MCT group.</p>","PeriodicalId":47243,"journal":{"name":"Physiotherapy Research International","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10099586","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
Yoga and aerobic exercise in epilepsy: Study protocol for a randomized controlled trial. 瑜伽和有氧运动治疗癫痫:一项随机对照试验的研究方案。
IF 1.7 Q2 Health Professions Pub Date : 2023-10-01 Epub Date: 2023-05-07 DOI: 10.1002/pri.2013
Burcin Aktar, Birgul Balci, Hatice Eraslan Boz, Ibrahim Oztura, Baris Baklan

Background: There has been a growing interest in demonstrating the health benefits of exercise among people with epilepsy in recent years. Although exercise is recommended for people with epilepsy, there is uncertainty concerning the effects of yoga and aerobic exercise on multiple health outcomes in epilepsy.

Purpose: The aim of this trial was to examine the effects of yoga and aerobic exercise training on physical activity, seizure frequency, health-related physical fitness, mental, emotional, and psychological health status, and quality of life.

Methods: This study was designed as a single-center, 8-week, randomized controlled trial in a three-arm parallel group. Participants will be randomly allocated to yoga, aerobic exercise, or wait-list control groups. The primary outcome is physical activity/sedentary behavior measured by the ActiGraph GT9X accelerometer and seizure frequency. Secondary outcomes include functional capacity, lower extremity strength, balance, body composition, waist and hip circumference, cognition, depression, anxiety, perceived stress, fatigue, sleep quality, and quality of life. The outcomes will be evaluated at baseline and at 8 weeks of follow-up.

Implications of physiotherapy practice: This study is the first randomized controlled trial comparing the effects of yoga and aerobic exercise among people with epilepsy. The findings of this study could provide important information about the effects of yoga and aerobic exercise training on a variety of health conditions in people with epilepsy.

Trial registration: ClinicalTrials.gov identifier: NCT05066880, registered October 4, 2021.

背景:近年来,癫痫患者对证明运动对健康的益处越来越感兴趣。尽管建议癫痫患者进行运动,但瑜伽和有氧运动对癫痫患者多种健康结果的影响尚不确定。目的:本试验的目的是检验瑜伽和有氧运动训练对身体活动、癫痫发作频率、健康相关的身体素质、心理、情绪和心理健康状况以及生活质量的影响。方法:本研究设计为一项单中心、为期8周的随机对照试验,分为三组平行组。参与者将被随机分配到瑜伽、有氧运动或等待名单对照组。主要结果是通过ActiGraph GT9X加速计测量的身体活动/久坐行为和癫痫发作频率。次要结果包括功能能力、下肢力量、平衡、身体成分、腰围和臀围、认知、抑郁、焦虑、感知压力、疲劳、睡眠质量和生活质量。结果将在基线和随访8周时进行评估。物理治疗实践的意义:这项研究是第一项比较瑜伽和有氧运动对癫痫患者影响的随机对照试验。这项研究的发现可以为瑜伽和有氧运动训练对癫痫患者各种健康状况的影响提供重要信息。试验注册:ClinicalTrials.gov标识符:NCT05066880,于2021年10月4日注册。
{"title":"Yoga and aerobic exercise in epilepsy: Study protocol for a randomized controlled trial.","authors":"Burcin Aktar,&nbsp;Birgul Balci,&nbsp;Hatice Eraslan Boz,&nbsp;Ibrahim Oztura,&nbsp;Baris Baklan","doi":"10.1002/pri.2013","DOIUrl":"10.1002/pri.2013","url":null,"abstract":"<p><strong>Background: </strong>There has been a growing interest in demonstrating the health benefits of exercise among people with epilepsy in recent years. Although exercise is recommended for people with epilepsy, there is uncertainty concerning the effects of yoga and aerobic exercise on multiple health outcomes in epilepsy.</p><p><strong>Purpose: </strong>The aim of this trial was to examine the effects of yoga and aerobic exercise training on physical activity, seizure frequency, health-related physical fitness, mental, emotional, and psychological health status, and quality of life.</p><p><strong>Methods: </strong>This study was designed as a single-center, 8-week, randomized controlled trial in a three-arm parallel group. Participants will be randomly allocated to yoga, aerobic exercise, or wait-list control groups. The primary outcome is physical activity/sedentary behavior measured by the ActiGraph GT9X accelerometer and seizure frequency. Secondary outcomes include functional capacity, lower extremity strength, balance, body composition, waist and hip circumference, cognition, depression, anxiety, perceived stress, fatigue, sleep quality, and quality of life. The outcomes will be evaluated at baseline and at 8 weeks of follow-up.</p><p><strong>Implications of physiotherapy practice: </strong>This study is the first randomized controlled trial comparing the effects of yoga and aerobic exercise among people with epilepsy. The findings of this study could provide important information about the effects of yoga and aerobic exercise training on a variety of health conditions in people with epilepsy.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier: NCT05066880, registered October 4, 2021.</p>","PeriodicalId":47243,"journal":{"name":"Physiotherapy Research International","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9960030","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
The relationship between Rating of Everyday Arm-use in the Community and Home (REACH) scale affected arm-use assessment, activity and participation after stroke. 社区和家庭日常手臂使用量表(REACH)之间的关系影响了中风后的手臂使用评估、活动和参与。
IF 1.7 Q2 Health Professions Pub Date : 2023-10-01 Epub Date: 2023-04-27 DOI: 10.1002/pri.2010
Adebimpe O Obembe, Lisa A Simpson, Janice J Eng

Background and objectives: While arm function has been traditionally used as a primary goal for upper extremity rehabilitation post-stroke, we propose a simple measure of arm use, which may translate into better activities and participation. The aim was to determine the relationship between arm use and measures of activity and participation.

Methods: This was a cross-sectional study with evaluative components involving community-dwelling individuals with chronic stroke. The Rating of Everyday Arm-Use in the Community and Home (REACH) Scale was used to assess affected arm use, Barthel Index and activity domain of the Stroke Impact Scale (SIS) for activities, and participation domain of the SIS for participation. The participants were also asked if they resumed driving after the stroke.

Results: Forty-nine individuals (mean age = 70.3 ± 11.5 years, male sex = 51%) living with the effects of a stroke for at least 3 months participated in this study. There was a positive relationship between affected arm use and activities (Barthel Index score - rs  = 0.464; SIS activities - rs  = 0.686), participation (rs  = 0.479), and driving (rs  = 0.581). The Barthel Index scores were higher for individuals with dominant arm hemiparesis (p = 0.003) or left hemisphere lesions (p = 0.005). There was also greater arm use in left hemisphere lesions (p = 0.018).

Conclusions: Affected arm use in individuals with chronic stroke is related to activities and participation. Given the importance of arm use in activities and participation after stroke, rehabilitation therapists may consider utilizing the REACH Scale, a simple and quick outcome measure, as a means to assess arm use and implement effective interventions for improving arm use.

背景和目的:虽然手臂功能传统上被用作中风后上肢康复的主要目标,但我们提出了一种简单的手臂使用测量方法,它可以转化为更好的活动和参与。目的是确定使用武器与活动和参与措施之间的关系。方法:这是一项横断面研究,包含评估成分,涉及社区慢性中风患者。社区和家庭日常手臂使用量表(REACH)用于评估受影响的手臂使用,Barthel指数和卒中影响量表(SIS)的活动领域用于活动,SIS的参与领域用于参与。参与者还被问及他们是否在中风后恢复了驾驶。结果:49名受中风影响至少3个月的患者(平均年龄=70.3±11.5岁,男性=51%)参与了这项研究。受影响的手臂使用与活动呈正相关(Barthel指数得分-rs=0.464;SIS活动-rs=0.686)、参与度(rs=0.479)、,和驾驶(rs=0.581)。Barthel指数得分在显性手臂偏瘫(p=0.003)或左半球病变(p=0.005)的患者中更高。左半球病变中也有更多的手臂使用(p=0.018)。结论:慢性中风患者受影响的手臂使用与活动和参与有关。鉴于手臂使用在中风后活动和参与中的重要性,康复治疗师可以考虑使用REACH量表,这是一种简单快速的结果测量方法,作为评估手臂使用和实施有效干预措施以改善手臂使用的一种手段。
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引用次数: 0
Devices to measure calf raise test outcomes: A narrative review. 测量小腿抬高测试结果的装置:叙述性综述。
IF 1.7 Q2 Health Professions Pub Date : 2023-10-01 Epub Date: 2023-07-13 DOI: 10.1002/pri.2039
Ma Roxanne Fernandez, Kim Hébert-Losier
BACKGROUND The calf raise test (CRT) is commonly administered without a device in clinics to measure triceps surae muscle function. To standardise and objectively quantify outcomes, researchers use research-grade or customised CRT devices. To incorporate evidence-based practice and apply testing devices effectively in clinics, it is essential to understand their design, applicability, psychometric properties, strengths, and limitations. Therefore, this review identifies, summarises, and critically appraises the CRT devices used in science. METHODS Four electronic databases were searched in April 2022. Studies that used devices to measure unilateral CRT outcomes (i.e., number of repetitions, work, height) were included. RESULTS Thirty-five studies met inclusion, from which seven CRT devices were identified. Linear encoder (n = 18) was the most commonly used device, followed by laboratory equipment (n = 6) (three-dimensional motion capture and force plate). These measured the three CRT outcomes. Other devices used were electrogoniometer, Häggmark and Liedberg light beam device, Ankle Measure for Endurance and Strength (AMES), Haberometer, and custom-made. Devices were mostly used in healthy populations or Achilles tendon pathologies. AMES, Haberometer, and custom-made devices were the most clinician-friendly, but only quantified repetitions were completed. In late 2022, a computer vision mobile application appeared in the literature and offered clinicians a low-cost, research-grade alternative. CONCLUSION This review details seven devices used to measure CRT outcomes. The linear encoder is the most common in research and quantifies all three CRT outcomes. Recent advances in computer-vision provide a low-cost research-grade alternative to clinicians and researchers via a n iOS mobile application.
背景:在临床上,小腿抬高测试(CRT)通常在没有设备的情况下进行,以测量腓肠肌功能。为了标准化和客观量化结果,研究人员使用研究级或定制的CRT设备。为了将循证实践纳入临床并有效应用测试设备,了解其设计、适用性、心理测量特性、优势和局限性至关重要。因此,本综述对科学中使用的CRT设备进行了识别、总结和批判性评价。方法:于2022年4月检索4个电子数据库。包括使用设备测量单侧CRT结果(即重复次数、工作量、身高)的研究。结果:35项研究符合纳入标准,其中鉴定出7种CRT设备。线性编码器(n=18)是最常用的设备,其次是实验室设备(n=6)(三维运动捕捉和力板)。这些测量了三种CRT结果。其他使用的设备有电角度计、Häggmark和Liedberg光束设备、踝关节耐力和强度测量(AMES)、Haberometer和定制设备。器械主要用于健康人群或跟腱病变。AMES、Haberometer和定制设备对临床医生最友好,但只完成了定量重复。2022年末,一款计算机视觉移动应用出现在文献中,为临床医生提供了一种低成本的研究级替代方案。结论:本综述详细介绍了用于测量CRT结果的七种设备。线性编码器是研究中最常见的,可以量化所有三种CRT结果。计算机视觉的最新进展通过iOS移动应用程序为临床医生和研究人员提供了一种低成本的研究级替代方案。
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引用次数: 0
Scoring festination and gait freezing in people with Parkinson's: The freezing of gait severity tool-revised. 帕金森氏症患者的步态冻结和评分:步态严重程度冻结工具的修订。
IF 1.7 Q2 Health Professions Pub Date : 2023-10-01 Epub Date: 2023-05-18 DOI: 10.1002/pri.2016
Aileen E Scully, Dawn Tan, Beatriz Ito Ramos de Oliveira, Keith D Hill, Ross Clark, Yong Hao Pua

Background and purpose: To improve existing clinical assessments for freezing of gait (FOG) severity, a new clinician-rated tool which integrates the varied types of freezing (FOG Severity Tool-Revised) was developed. This cross-sectional study investigated its validity and reliability.

Methods: People with Parkinson's disease who were able to independently ambulate eight-metres and understand study instructions were consecutively recruited from outpatient clinics of a tertiary hospital. Those with co-morbidities severely affecting gait were excluded. Participants were assessed with the FOG Severity Tool-Revised, three functional performance tests, the FOG Questionnaire, and outcomes measuring anxiety, cognition, and disability. The FOG Severity Tool-Revised was repeated for test-retest reliability. Exploratory factor analysis and Cronbach's alpha were computed for structural validity and internal consistency. Reliability and measurement error were estimated with ICC (two-way, random), standard error of measurement, and smallest detectable change (SDC95 ). Criterion-related and construct validity were calculated with Spearman's correlations.

Results: Thirty-nine participants were enrolled [79.5% (n = 31) male; Median (IQR): age-73.0 (9.0) years; disease duration-4.0 (5.8) years], with fifteen (38.5%) who reported no medication state change contributing a second assessment for reliability estimation. The FOG Severity Tool-Revised demonstrated sufficient structural validity and internal consistency (α = 0.89-0.93), and adequate criterion-related validity compared to the FOG Questionnaire (ρ = 0.73, 95% CI 0.54-0.85). Test-retest reliability (ICC = 0.96, 95%CI 0.86-0.99) and random measurement error (%SDC95  = 10.4%) was acceptable in this limited sample.

Discussion and conclusions: The FOG Severity Tool-Revised appeared valid in this initial sample of people with Parkinson's. While its psychometric properties remain to be confirmed in a larger sample, it may be considered for use in the clinical setting.

背景和目的:为了改进现有的步态冻结(FOG)严重程度的临床评估,开发了一种新的临床医生评级工具,该工具集成了各种类型的冻结(修订后的FOG严重程度工具)。这项横断面研究调查了其有效性和可靠性。方法:从一家三级医院的门诊连续招募能够独立行走8米并理解研究说明的帕金森病患者。那些患有严重影响步态的合并症的患者被排除在外。参与者使用修订的FOG严重程度工具、三项功能表现测试、FOG问卷以及测量焦虑、认知和残疾的结果进行评估。为了重新测试可靠性,重复了修订的FOG严重性工具。探索性因素分析和Cronbachα计算结构有效性和内部一致性。可靠性和测量误差采用ICC(双向、随机)、标准测量误差和最小可检测变化(SDC95)进行估计。用Spearman相关性计算标准相关和结构有效性。结果:39名参与者被纳入[79.5%(n=31)男性;中位(IQR):年龄-73.0(9.0)岁;疾病持续时间-4.0(5.8)年],其中15名(38.5%)报告没有药物状态变化的参与者对可靠性评估进行了第二次评估。与FOG问卷相比,修订的FOG严重性工具证明了足够的结构有效性和内部一致性(α=0.89-0.93),以及足够的标准相关有效性(ρ=0.73,95%CI 0.54-0.85)。在这个有限的样本中,测试-再测试的可靠性(ICC=0.96,95%CI 0.86-0.99)和随机测量误差(%SDC95=10.4%)是可接受的。讨论和结论:修订的FOG严重程度工具在帕金森氏症患者的初始样本中似乎有效。虽然它的心理测量特性仍有待在更大的样本中确认,但它可以考虑在临床环境中使用。
{"title":"Scoring festination and gait freezing in people with Parkinson's: The freezing of gait severity tool-revised.","authors":"Aileen E Scully,&nbsp;Dawn Tan,&nbsp;Beatriz Ito Ramos de Oliveira,&nbsp;Keith D Hill,&nbsp;Ross Clark,&nbsp;Yong Hao Pua","doi":"10.1002/pri.2016","DOIUrl":"10.1002/pri.2016","url":null,"abstract":"<p><strong>Background and purpose: </strong>To improve existing clinical assessments for freezing of gait (FOG) severity, a new clinician-rated tool which integrates the varied types of freezing (FOG Severity Tool-Revised) was developed. This cross-sectional study investigated its validity and reliability.</p><p><strong>Methods: </strong>People with Parkinson's disease who were able to independently ambulate eight-metres and understand study instructions were consecutively recruited from outpatient clinics of a tertiary hospital. Those with co-morbidities severely affecting gait were excluded. Participants were assessed with the FOG Severity Tool-Revised, three functional performance tests, the FOG Questionnaire, and outcomes measuring anxiety, cognition, and disability. The FOG Severity Tool-Revised was repeated for test-retest reliability. Exploratory factor analysis and Cronbach's alpha were computed for structural validity and internal consistency. Reliability and measurement error were estimated with ICC (two-way, random), standard error of measurement, and smallest detectable change (SDC<sub>95</sub> ). Criterion-related and construct validity were calculated with Spearman's correlations.</p><p><strong>Results: </strong>Thirty-nine participants were enrolled [79.5% (n = 31) male; Median (IQR): age-73.0 (9.0) years; disease duration-4.0 (5.8) years], with fifteen (38.5%) who reported no medication state change contributing a second assessment for reliability estimation. The FOG Severity Tool-Revised demonstrated sufficient structural validity and internal consistency (α = 0.89-0.93), and adequate criterion-related validity compared to the FOG Questionnaire (ρ = 0.73, 95% CI 0.54-0.85). Test-retest reliability (ICC = 0.96, 95%CI 0.86-0.99) and random measurement error (%SDC<sub>95</sub>  = 10.4%) was acceptable in this limited sample.</p><p><strong>Discussion and conclusions: </strong>The FOG Severity Tool-Revised appeared valid in this initial sample of people with Parkinson's. While its psychometric properties remain to be confirmed in a larger sample, it may be considered for use in the clinical setting.</p>","PeriodicalId":47243,"journal":{"name":"Physiotherapy Research International","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9851342","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: 2
Habitual walking speed and fatigue explain self-reported functional capacity after stroke. 习惯性步行速度和疲劳可解释中风后自我报告的功能能力。
IF 1.5 Q3 REHABILITATION Pub Date : 2023-07-01 Epub Date: 2022-12-25 DOI: 10.1002/pri.1990
Janaine Cunha Polese, Thaís Bueno Dias Albuquerque, Iza Faria-Fortini, Luci Fuscaldi Teixeira-Salmela

Introduction: Individuals after stroke present several motor impairments, which reduced the functional capacity. The understanding of modifiable factors which are related to functional capacity in individuals with chronic stroke could better direct clinical practice. However, the mechanisms that could influence functional capacity in individuals with chronic stroke are not fully understood.

Objective: This study aimed to determine which modifiable variables would best predict self-reported functional capacity after stroke.

Design: Cross-sectional.

Setting: Research laboratory setting.

Participants: Ninety two individuals with chronic stroke, who had a mean age of 60 (SD 13) years and a time since the onset of the stroke of 52 (67) months.

Main outcome measures: Regression analysis of cross-sectional data was used to investigate whether body mass index, habitual walking speed, physical activity levels, fatigue, motor recovery, walking distance, and residual strength deficits of the lower limb muscles would predict self-reported functional capacity.

Results: Habitual walking speed alone explained 48% of the variance in functional capacity. When fatigue was included in the model, the explained variance increased to 55%.

Conclusions: Habitual walking speed and fatigue were significant predictors of self-reported functional capacity in individuals with chronic stroke. These individuals may increase their functional capacity with interventions aimed at increasing walking speed and reducing fatigue.

导言中风后的患者会出现多种运动障碍,从而降低功能能力。了解与慢性脑卒中患者功能相关的可改变因素可以更好地指导临床实践。然而,影响慢性脑卒中患者功能能力的机制尚未完全明了:本研究旨在确定哪些可调节变量最能预测中风后自我报告的功能能力:设计:横断面:参与者:92 名慢性中风患者主要结果测量:对横断面数据进行回归分析,研究体重指数、习惯性步行速度、体力活动水平、疲劳、运动恢复、步行距离和下肢肌肉残余力量缺陷是否能预测自我报告的功能能力:结果:仅习惯性步行速度就能解释功能能力变异的 48%。结论:习惯性步行速度和疲劳可解释功能能力变异的48%:结论:习惯性步行速度和疲劳是慢性中风患者自我报告功能能力的重要预测因素。这些人可以通过旨在提高步行速度和减少疲劳的干预措施来提高其功能能力。
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引用次数: 0
Staff perspectives on the key elements to successful rapid uptake of telerehabilitation in medium-sized public hospital physiotherapy departments. 中型公立医院理疗科成功快速采用远程康复技术的关键因素之员工观点。
IF 1.5 Q3 REHABILITATION Pub Date : 2023-07-01 Epub Date: 2022-12-20 DOI: 10.1002/pri.1991
Megan H Ross, Mark Nelson, Vicki Parravicini, Matthew Weight, Ryan Tyrrell, Nicole Hartley, Trevor Russell

Background and purpose: During the COVID-19 pandemic, hospital physiotherapy departments transitioned to telerehabilitation to ensure continuity of care for patients. The purpose of this study is to determine the key elements to successful, rapid uptake of telerehabilitation in medium-sized public hospital physiotherapy departments in response to COVID-19.

Methods: This study used a qualitative design. Physiotherapists who delivered telerehabilitation consultations during the COVID-19 restriction period in two Brisbane public hospital physiotherapy departments were eligible to participate in semi-structured interviews. Data were analysed thematically.

Results: Twenty-five physiotherapists (22-60 years of age; 68% female) with 1-40 years of clinical experience provided insights into their perceptions of the rapid uptake of telerehabilitation in the provision of clinical care. Physiotherapists worked across musculoskeletal outpatient (72%), inpatient, community, paediatrics and pelvic health departments. Qualitative analyses in relation to the physiotherapist perceptions of the key elements of rapid transition to telerehabilitation, revealed four key themes underpinning success: (1) 'it requires a whole team approach', (2) 'technology issues will be encountered and can be overcome', (3) 'optimise the situation while understanding the differences' and (4) 'modifying your approach doesn't imply inferior quality of care'.

Conclusion: Rapid implementation of telerehabilitation in a hospital setting is possible, and is facilitated by organisational, administrative and management support, willingness of physiotherapists to adopt, shared learning experience, quality software and connection, availability of equipment and space and optimised systems and processes. Key factors facilitating successful telerehabilitation consultations include effective communication, demonstration, involving a third party to help, and clients who are well prepared and willing to engage.

背景和目的:在 COVID-19 大流行期间,医院物理治疗部门向远程康复过渡,以确保患者护理的连续性。本研究旨在确定中型公立医院物理治疗部门在应对 COVID-19 时成功、快速采用远程康复技术的关键因素:本研究采用定性设计。在 COVID-19 限制期内,布里斯班两家公立医院物理治疗部门提供远程康复咨询的物理治疗师有资格参加半结构化访谈。对数据进行了专题分析:25名拥有1-40年临床经验的物理治疗师(22-60岁;68%为女性)就他们对远程康复技术在临床治疗中的快速应用的看法发表了自己的见解。物理治疗师的工作范围包括肌肉骨骼门诊(72%)、住院、社区、儿科和骨盆健康部门。通过对物理治疗师对快速过渡到远程康复关键因素的看法进行定性分析,发现了成功的四个关键主题:(1)"这需要整个团队的共同努力";(2)"会遇到技术问题,但可以克服";(3)"在了解差异的同时优化情况";(4)"改变方法并不意味着降低护理质量":在医院环境中快速实施远程康复是可能的,组织、行政和管理方面的支持、物理治疗师采用的意愿、共同的学习经验、高质量的软件和连接、设备和空间的可用性以及优化的系统和流程都会促进远程康复的实施。促进远程康复会诊成功的关键因素包括有效的沟通、示范、第三方帮助以及客户做好充分准备并愿意参与。
{"title":"Staff perspectives on the key elements to successful rapid uptake of telerehabilitation in medium-sized public hospital physiotherapy departments.","authors":"Megan H Ross, Mark Nelson, Vicki Parravicini, Matthew Weight, Ryan Tyrrell, Nicole Hartley, Trevor Russell","doi":"10.1002/pri.1991","DOIUrl":"10.1002/pri.1991","url":null,"abstract":"<p><strong>Background and purpose: </strong>During the COVID-19 pandemic, hospital physiotherapy departments transitioned to telerehabilitation to ensure continuity of care for patients. The purpose of this study is to determine the key elements to successful, rapid uptake of telerehabilitation in medium-sized public hospital physiotherapy departments in response to COVID-19.</p><p><strong>Methods: </strong>This study used a qualitative design. Physiotherapists who delivered telerehabilitation consultations during the COVID-19 restriction period in two Brisbane public hospital physiotherapy departments were eligible to participate in semi-structured interviews. Data were analysed thematically.</p><p><strong>Results: </strong>Twenty-five physiotherapists (22-60 years of age; 68% female) with 1-40 years of clinical experience provided insights into their perceptions of the rapid uptake of telerehabilitation in the provision of clinical care. Physiotherapists worked across musculoskeletal outpatient (72%), inpatient, community, paediatrics and pelvic health departments. Qualitative analyses in relation to the physiotherapist perceptions of the key elements of rapid transition to telerehabilitation, revealed four key themes underpinning success: (1) 'it requires a whole team approach', (2) 'technology issues will be encountered and can be overcome', (3) 'optimise the situation while understanding the differences' and (4) 'modifying your approach doesn't imply inferior quality of care'.</p><p><strong>Conclusion: </strong>Rapid implementation of telerehabilitation in a hospital setting is possible, and is facilitated by organisational, administrative and management support, willingness of physiotherapists to adopt, shared learning experience, quality software and connection, availability of equipment and space and optimised systems and processes. Key factors facilitating successful telerehabilitation consultations include effective communication, demonstration, involving a third party to help, and clients who are well prepared and willing to engage.</p>","PeriodicalId":47243,"journal":{"name":"Physiotherapy Research International","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10462370","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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