Annals of Rehabilitation Medicine-ARM最新文献

Objective: To compare the effects of high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) on cardiovascular function, gait ability, and hematological variables in chronic stroke survivors.

Methods: Twenty-nine higher-functioning, ambulatory chronic stroke survivors were randomized to HIIT (n=15) or MICT (n=14). Participants underwent supervised training three times weekly for six weeks, consisting of 30 minutes conventional therapy followed by 40 minutes aerobic exercise (HIIT: six 1-minute high-intensity intervals at 80%-100% maximum heart rate (HRmax) with 4-minute active recovery; MICT: continuous exercise at 60%-80% HRmax). Outcomes included cardiovascular function (maximal oxygen uptake [VO2max], HRmax, walking heart rate), gait (10-Meter Walk Test, Timed Up and Go test, 6-Minute Walk Test), and lipid profiles (low-density lipoprotein, high-density lipoprotein, triglycerides).

Results: In this higher-functioning cohort (n=29), HIIT showed significantly greater improvements than MICT in VO2max (F=40.574, p=0.001), HR_max (F=24.661, p=0.001), walking heart rate (F=11.277, p=0.002), 10-Meter Walk Test (F=20.865, p=0.001), Timed Up and Go test (F=12.317, p=0.002), and 6-Minute Walk Test (F=9.742, p=0.004). Lipid profiles improved significantly within the HIIT group only (p<0.05), no between-group differences were observed.

Conclusion: In higher-functioning chronic stroke survivors, HIIT was superior to MICT for cardiovascular fitness and functional mobility under a matched exposure; lipid changes occurred within HIIT only without between-group effects. These findings support incorporating HIIT into stroke rehabilitation programs to enhance recovery outcomes.

Objective: To assess patient gait ability by capturing both trend and scale aspects, this study proposes a method using the Pearson correlation coefficient and symmetric mean absolute percentage error (SMAPE).

Methods: Gait patterns from three patients with hip osteoarthritis (OA) were analyzed using kinematic and kinetic data. In each case, using MAPE or Pearson correlation alone failed to provide a reliable assessment, revealing limitations in capturing the full characteristics of gait patterns.

Results: The combined use of Pearson and SMAPE effectively identified gait abnormalities across all cases. This integrated approach offered a more accurate and comprehensive evaluation than single-metric methods.

Conclusion: The findings highlight the importance of considering both trend and scale in gait analysis. The proposed dual-metric methodology overcomes the limitations of conventional and single-metric approaches, enabling a clearer understanding of gait characteristics in patients with hip OA.

Adolescent idiopathic scoliosis (AIS) is the most encountered spinal deformity in growing children, which may bring significant impacts on patients' physical function, appearance, and overall quality of life. A physiatrist plays a crucial role in the early diagnosis of AIS and longitudinal management through continuous care. Contemporary management for AIS is according to the skeletal maturity, the magnitude of the spinal curves, and the risk of progression. For mild curves, therapeutic exercises, particularly physiotherapeutic scoliosis-specific exercises (PSSE), are employed as a conservative approach to improve postural symmetry and reduce the risk of curve progression. Bracing is required for moderate curves from 25 to 45 degrees in skeletally immature cases. Strict compliance with bracing is critical for therapeutic success. In cases that are rapidly progressive or in severe curves exceeding 40 to 45 degrees, spinal fusion surgery is considered the definitive treatment. Recent advancements in non-fusion and motion-preserving techniques provide alternative options to traditional fusion surgery. To protect maximal neurological function, intraoperative neurophysiological monitoring (IONM) is currently the trend for spinal deformity correction surgery. The care for AIS patients is an individualized, multidisciplinary, patient-centered, growth-sensitive approach, aiming to optimize outcomes and minimize long-term complications. This review outlines a comprehensive rehabilitation-oriented strategy for AIS patients from the perspective of a physiatrist, encompassing clinical assessment, conservative management with observation, therapeutic exercises, bracing, and further considerations in referral to spinal surgery.

Objective: To explore subjective vitality and mental health among individuals with spinal cord injury (SCI) in South Korea; specifically the relationship between subjective vitality and mental health and their associations with SCI-related factors, including health conditions, activity, environmental, and personal factors.

Methods: This cross-sectional study utilized data from the International Spinal Cord Injury Community Survey conducted in South Korea between March and October 2017. Data from 688 community-dwelling individuals with SCI were included in this study. Correlation and multiple regression analyses were conducted to investigate the relationships between vitality, mental health, and their associated factors.

Results: A strong positive correlation was identified between subjective vitality and mental health (r=0.78, p<0.001). In multiple regression analyses, common factors significantly associated with both domains included sleep problems, healthcare-related activities, financial burden, self-efficacy, and belongingness. Bowel problems were associated only with subjective vitality, while pressure injury and perceived social attitudes were associated only with mental health.

Conclusion: These findings highlight the importance of comprehensive approaches that address secondary health complications, promote healthcare education, and alleviate financial burdens to enhance both subjective vitality and mental health in individuals with SCI. Additionally, psychological interventions that foster belongingness and strengthen self-efficacy may further contribute to psychological well-being following SCI. Further research is needed to validate these associations and evaluate the long-term effects of such multidimensional strategies on subjective vitality and overall quality of life following SCI.

Management of upper limb deformities in patients with cerebral palsy is crucial, given its impact on activities of daily living, social interaction, and self-esteem. While medical management and rehabilitative therapy-including the use of assistive devices-remain the foundation of treatment, significant advancements have been made in surgical reconstruction techniques aimed at enhancing functional outcomes. Despite this, many eligible patients may miss the opportunity for surgical intervention due to limited awareness of appropriate indications, candidate selection criteria, and the availability of specialized expertise. This article provides an overview intended to guide pediatric rehabilitation physicians in recognizing common upper limb presentations in cerebral palsy, conducting appropriate assessments, selecting candidates, and understanding available surgical reconstructive options.

Objective: To compare the efficacy, safety, and patient compliance of tele-cardiac rehabilitation (T-CR) versus center-based cardiac rehabilitation (C-CR) in patients with coronary artery disease (CAD). A secondary aim was to assess the effects of both interventions on quality of life (QoL) and kinesiophobia.

Methods: This nonrandomized, patient-preference controlled trial included 40 CAD patients (83% post-myocardial infarction) at a university hospital. Participants selected either C-CR or T-CR. The four-week intervention included supervised in-hospital exercise (C-CR) or telemonitored exercise with heart rate feedback (T-CR). The primary outcome was peak oxygen uptake (VO2 peak). Secondary outcomes included VO2 at ventilatory anaerobic threshold (VO2 at VAT), time to VAT, oxygen pulse, QoL, Fear of Activity in Patients with Coronary Artery Disease (Fact-CAD) scores, and exercise adherence.

Results: Baseline VO2 peak was higher in the T-CR group (23.2±3.5 vs. 19.4±4.2, p=0.004). Rehabilitation improved VO2 peak (p<0.001), VO2 at VAT (p=0.004), and time to VAT (p<0.001) in both groups. Fact-CAD scores decreased (p=0.004), and QoL improved (p<0.001). However, C-CR led to greater kinesiophobia reduction (p=0.038) and slightly higher QoL improvements (p=0.05). T-CR participants completed more exercise sessions (14.9±2.9 vs. 12.0±0, p<0.001), with no serious adverse events reported.

Conclusion: T-CR is a safe and effective alternative to C-CR, providing similar physiological benefits. However, C-CR may be superior in reducing kinesiophobia. Future studies should assess long-term adherence and psychological outcomes in diverse populations.

Objective: To examine the effect of the telerehabilitation program on sleep quality and fatigue level in patients with multiple sclerosis (MS) was aimed in this study. MS is a demyelinating disease defined by various signs and symptoms that affects physical, emotional, social, and cognitive functioning. Fatigue, depression, sleep disturbance and cognitive impairment are the among common symptoms of MS.

Methods: The study implemented an individual exercise program for twice a week for 12 weeks via telerehabilitation. In the home-based video exercise group, the same exercises were given as video recordings and the patients were asked to do the exercises twice a week for 12 weeks. Pittsburgh Sleep Quality Index (PSQI), Fatigue Severity Scale (FSS), Multiple Sclerosis Quality of Life Scale-54 and Timed 25 Foot Walk Test were used in the evaluation. The trial is registered with the number of NCT04979845 on ClinicalTrials.gov.

Results: PSQI scores changed from 5.6 (2.1) to 3.66 (2.09) in telerehabilitation group (p=0.03) while no significant change were seen in the video exercise group. Similarly FSS scores decreased from 4.37 (1.42) to 3.67 (1.68) in telerehabilitation group (p=0.04) while no significant changes were seen in the video based exercise group.

Conclusion: The telerehabilitation program is thought to be an effective and accessible non-pharmacological application that can be used in the treatment of sleep quality and fatigue in individuals with MS.

Objective: To investigate the temporal and kinematic parameters of hyoid bone excursion (HBE) in head and neck cancer (HNC) patients with and without aspiration.

Methods: Videofluoroscopic swallowing study images from 28 HNC patients were divided into aspiration and non-aspiration groups. The kinematic parameters of HBE, including displacement, instantaneous velocity, and instantaneous acceleration, as well as the timing of reaching maximal values in these parameters, were analyzed.

Results: The timings of reaching maximal horizontal (2.37±1.10 seconds vs. 1.09±1.58 seconds, p=0.010; 0.68±0.28 vs. 0.37±0.26, p=0.010 for percentage of time), vertical (1.83±2.06 seconds vs. 0.86±1.42 seconds, p=0.020) and hypotenuse instantaneous velocities (2.36±1.96 seconds vs. 0.79±1.20 seconds, p=0.006; 0.60±0.33 vs. 0.33±0.24, p=0.028 for percentage of time), as well as the timings of reaching maximal horizontal (2.22±1.50 seconds vs. 0.90±1.26 seconds, p=0.009; 0.60±0.32 vs. 0.37±0.29, p=0.041 for percentage of time), vertical (2.09±1.94 seconds vs. 0.83±1.19 seconds, p=0.003), and hypotenuse instantaneous accelerations (2.49±1.93 seconds vs. 0.81±1.24 seconds, p=0.004; 0.65±0.34 vs. 0.34±0.28, p=0.026 for percentage of time) were significantly prolonged in the aspiration group. After signal smoothing, the aspiration group exhibited delayed timing in reaching maximal horizontal instantaneous velocity (2.07±1.09 seconds vs. 0.74±1.10 seconds, p=0.004; 0.58±0.29 vs. 0.32±0.24, p=0.017 for percentage of time), as well as maximal horizontal (2.18±1.16 seconds vs. 1.12±1.46 seconds, p=0.008) and hypotenuse accelerations (2.21±2.50 seconds vs. 0.81±1.21 seconds, p=0.011). There were no significant between-group differences in other kinematic parameters, except for horizontal displacement (7.66±6.26 mm vs. 12.14±5.82 mm, p=0.042).

Conclusion: The timings of reaching maximal instantaneous velocities and accelerations of HBE, rather than the maximum values of these kinematic parameters, may be critical parameters related to aspiration in HNC patients.