Annals of Rehabilitation Medicine-ARM最新文献

To synthesise the best available evidence for the effectiveness of interventions delivered in community-based rehabilitation (CBR) centers on physical fitness, for community-dwelling older adults living in Asian countries. This study is a systematic review and meta-analysis. Seven English and two Chinese electronic databases were searched for randomised controlled trials (RCTs) and quasi-experimental studies that were conducted by centers providing CBR. Independent reviewers screened, quality-appraised and extracted data. The primary outcome was physical fitness measured by validated assessment tools, including the Timed Up and Go Test (TUG), gait speed, hand grip strength, Functional Reach Test (FRT), and one-leg standing test. Assessments of activity of daily living and quality of life using tools including the Barthel Index, Short Form (SF)-12, and SF-36 were secondary outcomes. After screening 5,272 studies, 29 studies were included (16 RCTs, 13 quasi-experimental studies) from four countries. Meta-analyses found that CBR programs significantly decreased TUG time (mean difference [MD], -1.89 seconds; 95% confidence interval [95% CI], -2.84 to -0.94; I2=0%; Z=3.90, p<0.0001), improved gait speed (MD, 0.10 m/s; 95% CI, 0.01-0.18; I2=0%; Z=2.26, p=0.02), and increased one-leg standing time (MD, 2.81 seconds; 95% CI, 0.41-5.22; I2=0%; Z=2.29, p=0.02). Handgrip strength and FRT showed no statistically significant improvement in the meta-analyses. CBR may improve aspects of physical fitness for older adults in Asian countries. However, variability in intervention components and measurement tools reduced the ability to pool individual studies. Further trials are required with robust designs including standardised measures of physical fitness.

Objective: To evaluate the efficacy of light-emitting diode (LED) and their dual-wavelengths as a treatment strategy for osteoarthritis.

Methods: We induced osteoarthritis in male Sprague-Dawley rats by intra-articular injection of sodium iodoacetate into the right rear knee joint. The animals with lesions were divided into an untreated group and an LED-treated group (n=7 each). In the LED-treated group, the lesioned knee was irradiated with lasers (850 and 940 nm) and dose (3.15 J/cm2) for 20 minutes per session, twice a week for 4 weeks. Knee joint tissues were stained and scanned using an in vivo micro-computed tomography (CT) scanner. Serum interleukin (IL)-6 and IL-18 levels were determined using enzyme-linked immuno-sorbent assay. Several functional tests (lines crossed, rotational movement, rearing, and latency to remain rotating rod) were performed 24 hours before LED treatment and at 7, 14, 21, and 28 days after treatment.

Results: LED-treated rats showed improved locomotor function and suppressed matrix-degrading cytokines. Micro-CT images indicated that LED therapy had a preserving effect on cartilage and cortical bone.

Conclusion: LED treatment using wavelengths of 850 and 940 nm resulted in significant functional, anatomical, and histologic improvements without adverse events in a rat model. Further research is required to determine the optimal wavelength, duration, and combination method, which will maximize treatment effectiveness.

Artificial intelligence (AI) tools are increasingly able to learn from larger and more complex data, thus allowing clinicians and scientists to gain new insights from the information they collect about their patients every day. In rehabilitation medicine, AI can be used to find patterns in huge amounts of healthcare data. These patterns can then be leveraged at the individual level, to design personalized care strategies and interventions to optimize each patient's outcomes. However, building effective AI tools requires many careful considerations about how we collect and handle data, how we train the models, and how we interpret results. In this perspective, we discuss some of the current opportunities and challenges for AI in rehabilitation. We first review recent trends in AI for the screening, diagnosis, treatment, and continuous monitoring of disease or injury, with a special focus on the different types of healthcare data used for these applications. We then examine potential barriers to designing and integrating AI into the clinical workflow, and we propose an end-to-end framework to address these barriers and guide the development of effective AI for rehabilitation. Finally, we present ideas for future work to pave the way for AI implementation in real-world rehabilitation practices.

Objective: To examine the impact of telerehabilitation training on exercise capacity, lung function, and health-related quality of life (HRQOL) in comparison to no rehabilitation for post-COVID-19 symptoms in adult females.

Methods: A randomized controlled trial of 48 females after mild to moderate COVID-19 survival were equally and randomly assigned to one of two groups: intervention group or control group. Three sessions per week for 6 weeks of a telerehabilitation program provided via a smartphone to the intervention group. Spirometry was used to quantify lung function, a 6-minute walk test (6MWT) measured in meters to measure exercise capacity, and the Short Form Health Survey-36 was used to assess HRQOL.

Results: After treatment, there was no statistically significant difference in forced vital capacity (FVC) or forced expiratory volume in 1 second (FEV1) between groups (p>0.05), but the 6MWT of the intervention group increased significantly more than that of the control group (p=0.001). The percent of change in 6MWT for the intervention group and control group was 14.22% and 4.21%, respectively. After therapy, the intervention group's HRQOL significantly improved when compared to the control group's (p=0.001).

Conclusion: This study showed that a telerehabilitation programs improved exercise capacity and HRQOL in young females post-COVID-19 compared to no rehabilitation.

Objective: To examine the association between the mobilization level during intensive care unit (ICU) admission and independence in activity of daily living (ADL), defined as Barthel Index (BI)≥70.

Methods: This was a post-hoc analysis of the EMPICS study involving nine hospitals. Consecutive patients who spend >48 hours in the ICU were eligible for inclusion. Mobilization was performed at each hospital according to the shared protocol and the highest ICU mobility score (IMS) during the ICU stay, baseline characteristics, and BI at hospital discharge. Multiple logistic regression analysis, adjusted for baseline characteristics, was used to deter-mine the association between the highest IMS (using the receiver operating characteristic [ROC]) and ADL.

Results: Of the 203 patients, 143 were assigned to the ADL independence group and 60 to the ADL dependence group. The highest IMS score was significantly higher in the ADL independence group than in the dependence group and was a predictor of ADL independence at hospital discharge (odds ratio, 1.22; 95% confidence interval, 1.07-1.38; adjusted p=0.002). The ROC cutoff value for the highest IMS was 6 (specificity, 0.67; sensitivity, 0.70; area under the curve, 0.69).

Conclusion: These results indicate that, in patients who were in the ICU for more than 48 hours, that patients with good function in the ICU also exhibit good function upon discharge. However, prospective, multicenter trials are needed to confirm this conclusion.

Objective: To examine the prognostic value of electroneuronography (ENoG) in predicting functional recovery in severe cases of acute facial palsy.

Methods: Patients with severe degrees of facial palsy (initial House-Brackmann [HB] grades IV to VI) with available electrodiagnostic studies conducted 2-4 weeks after symptom onset were reviewed retrospectively. The patients were categorized into "good recovery" and "poor recovery" groups, with the former showing mild to no dysfunction (HB I to III) and the latter exhibiting moderate to severe dysfunction (HB IV to VI) on follow-up evaluation, 2 months after onset. ENoG amplitudes in four facial muscles (frontalis, nasalis, orbicularis oculi, and orbicularis oris), as well as age, sex, affected side, disease etiology, comorbidities, and laboratory findings, were compared between the two groups.

Results: Thirty-seven patients were included. Twenty-nine of the patients showed "good recovery," and eight showed "poor recovery" at 2 months after symptom onset. Univariate analysis yielded no significant difference in age, sex, affected side, disease etiology, comorbidities, and laboratory findings between the two groups. Preserved ENoG amplitudes (individual, average, and trimmed means) were significantly higher in the good recovery group than in the poor recovery group (p<0.005). Sex (p=0.038) and the ENoG of the nasalis muscle, acquired 2-4 weeks from symptom onset (p=0.004), showed significant differences in multivariate regression analysis.

Conclusion: This study suggests that the female sex and lower ENoG of the nasalis muscle, acquired 2-4 weeks from symptom onset, have negative prognostic value for the 2-month functional outcome of severe facial palsy cases.

Objective: To establish the lower limits of normative values of the physical work capacity for Korean farmers in healthy working individual.

Methods: We developed a comprehensive set of physical work capacity evaluation items that encompass common farming tasks. These items include measurements of trunk flexion/extension angles, strength (hand grip, trunk flexion/extension, leg/back lifting, and pushing/pulling), and positional tolerances. We calculated the normative values for the items and defined the normal range in 124 healthy volunteers aged 20-79 years. We calculated the intraclass correlation coefficient (ICC) to validate the test-retest reliability of the measurements protocol.

Results: The normal values for each measurement item were as follows: trunk flexion and extension angle (65.3°±11.6° and 29.6°±6.6°), dominant hand grip strength (32.2±10.5 kgf), trunk flexion and extension strength (288.4±119.0 N and 297.3±129.9 N), leg and back lifting strength (452.9±233.5 N and 349.2±166.7 N), pushing and pulling strength (214.7±75.1 N and 221.7±63.3 N), and positional tolerance time (squat: 76.8±9.0 seconds, front: 73.8±7.7 seconds, twist: 82.2±8.8 seconds, upward: 71.9±11.3 seconds). Regarding test-retest reliability, all strength measurements demonstrated excellent absolute agreement (ICC, 0.91-0.96). However, positional tolerance showed poor-to-moderate absolute agreement (ICC, 0.37-0.58).

Conclusion: We conducted measurements of muscle strength and positional tolerance in healthy participants of various ages, focusing on tasks commonly performed by Korean farmers. The outcomes hold significant value as they offer a pertinent instrument for assessing the appropriateness of workers, thereby carrying implications for rehabilitation objectives, legal evaluations, and work capacity assessments within the agricultural domain.