Annals of Rehabilitation Medicine-ARM最新文献

Objective: To explore the relationship between pulmonary function, physical activity, and health-related quality of life (QoL) in resected lung cancer patients based on the International Classification of Functioning, Disability, and Health (ICF) framework developed by the World Health Organization to describe health and health-related states.

Methods: A quantitative study was designed with postoperative lung cancer survivors to assess personal characteristics. We also assessed functional impairment related to the lung using forced vital capacity (FVC) and forced expiratory volume at 1 second (FEV1), activity limitations using maximal oxygen consumption (VO2max), anaerobic threshold (AT) and 6-minute walking distance (6MWD), and participation restriction using the 36-item Short Form Health Survey V1 (SF-36). Data analyses were conducted using the multivariate method and Smart- PLS to examine path coefficient among the measures.

Results: Forty-one patients were enrolled in this study. FVC and FEV1 were poorly correlated with QoL, and 6MWD, AT, or VO2max were positively associated with QoL. AT or VO2max showed a significant (p<0.01) direct path with SF-36 in the ICF model. Although age and body mass index were not strongly correlated with QoL, these personal factors had a medium to large effect on perceived QoL.

Conclusion: Disability is a complex in patients with lung resection, and physical activity plays an important role in enabling participation. Improving VO2max and AT is needed to improve the QoL of resected lung cancer patients. We should also pay more attention to contextual factors that have a significant impact on social participation.

Objective: To investigate the association of nutritional risk with gait function and activities of daily living (ADLs) in older adult patients with hip fractures.

Methods: The retrospective data of older adult patients diagnosed with hip fractures who visited the recovery-phase rehabilitation ward between January 2019 and December 2022 were reviewed. Nutritional risk was evaluated using the Geriatric Nutritional Risk Index; gait function and ADLs were assessed using the modified Harris Hip Score subitem and Functional Independence Measure, respectively. Multivariate linear regression and path analysis with structural equation modeling were used to examine the factors associated with ADLs and the associations among the study variables.

Results: This study included 206 participants (172 females and 34 males; mean age, 85.0±7.3 years). In the multivariate analysis, gait function (β=0.488, p<0.001), cognitive function (β=0.430, p<0.001), and surgery (β=-0.143, p<0.001) were identified as independent factors. Pathway analysis revealed that nutritional risk was not directly correlated with ADLs but was directly associated with gait and cognitive functions. Gait and cognitive functions, in turn, were directly related to ADLs.

Conclusion: Nutritional risk was found to be associated with ADLs through an intermediary of gait and cognitive functions.

Objective: To establish reference values for the computerized cognitive test and evaluate cognitive function improvements across different age groups, we introduce the computerized Cognitive Function Test program (eCFT), specifically designed for children. We aimed to establish eCFT reference values and assess cognitive function improvements across different age groups.

Methods: We included children aged 3-6 years with confirmed normal cognition based on the Korean Developmental Screening Test for Infants and Children and Kaufman Assessment Battery for Children-II. The eCFT consists of 8 subtests for visual perception, attention, memory, and executive function.

Results: A total of 66 participants (36 males and 30 females) with an average age of 4.4 years participated. The age 6 group consistently outperformed both age group 3 and 4 in terms of correct responses. With regard to the completed stage, the "selective auditory stimulus" test findings were 2.0 and 3.9 for the age 3 and age 6 groups, respectively (p<0.05). The "trail-making" test findings were 1.7, 2.1, 2.6, and 2.8, respectively (between ages 3 and 6, p<0.01; between ages 4 and 6, p<0.05); moreover, the age 5 group surpassed the age 3 group (2.6 and 1.7, respectively, p<0.05).

Conclusion: The eCFT is an easily accessible tool to evaluate cognitive function in young children. We introduce reference values with a cutoff range for preschool-aged children, enabling early intervention for those with cognitive impairment. Given its accessibility and relatively short evaluation time, the eCFT has potential for clinical use.

To evaluate the efficacy of physical therapy (PT) to alleviate symptomatic thoracic radiculopathy (TR) without the use of invasive procedures. Database search was conducted by an experienced medical librarian from inception until January 27, 2023, in EBSCO CINAHL with Full Text, Ovid Cochrane Central Register of Controlled Trials, Ovid Embase, Ovid MEDLINE, Scopus, and Web of Science Core Collection. Inclusion criteria included studies that involved adult patients (age≥18) who had a magnetic resonance imaging-confirmed TR and underwent a structured, supervised PT program of any length. All types of studies were included. Study quality and risk of bias were assessed using the National Heart, Lung, and Blood Institute (NHLBI) Study Quality of Assessment Tool. Certainty in evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. A meta-analysis was not performed. A total of 1,491 studies were screened and 7 studies met inclusion criteria, 5 case studies and 2 cohort studies. All studies showed improvement or resolution of the TR with PT. Quantitative improvements were not noted in most studies and PT regimens were sparsely described. Overall quality assessment demonstrated 3 studies had "good," 1 "fair," and 3 "poor" quality evidence. Certainty of evidence was "low" due to risk of bias. A dedicated PT program may help to alleviate symptomatic TR; however due to limited evidence, risk of bias, and low certainty in evidence, the data is too weak to support a definite conclusion.

Objective: To develop a computerized visuomotor integration system for assessment and training of visual perception impairments and evaluate its safety and feasibility in patients with a stroke. Visual field defects and spatial neglect lead to substantial poststroke impairment. Most diagnostic assessments are anchored in traditional methods, and clinical effects of rehabilitation treatments are limited.

Methods: The CoTras Vision system included two evaluations and four training modules. The evaluation modules were based on the Albert's test and Star cancellation test, and training modules were based on visual tracking, central-peripheral integration, and visuomotor perception techniques. Bland-Altman plots for agreement with the traditional paper-and-pencil test were performed, and the modified Intrinsic Motivation Inventory, Patient Satisfaction Questionnaire, and Simulator Sickness Questionnaire were conducted.

Results: Ten patients with acute stroke completed the study. Bland-Altman plots revealed good agreements for Albert's test (mean difference, -0.3±4.5) and Star cancellation test (mean difference, 0.3±0.7). The mean±standard deviation scores of the modified Intrinsic Motivation Inventory, Patient Satisfaction Survey, and Simulator Sickness Questionnaire were 84.7±30.6, 40.5±7.9, and 34.0±34.5 respectively.

Conclusion: The CoTras Vision system is feasible and safe in patients with stroke. Most patients had a high degree of motivation to use the system and did not experience severe adverse events. Further studies are needed to confirm its usefulness in stroke patients with visual field defects and hemineglect symptoms. Furthermore, a large, well-designed, randomized controlled trial will be needed to confirm the treatment effect of the CoTras Vision system.

Objective: To assess, analyse, and infer the impact of the coronavirus disease 2019 (COVID-19) pandemic on people living with locomotor disability in North India.

Methods: Patients with locomotor disabilities who met the inclusion criteria received a questionnaire that had already undergone testing and validation. It covered topics highlighting the effect of the pandemic on general health, financial burden, psychological and mental health, social life and behaviour, disability and comorbidity management, transportation, and healthcare accessibility during the pandemic. In order to gauge the pandemic's effects on the population of people with locomotor disabilities, the answers to the questions were collected and analyzed.

Results: The COVID-19 pandemic has adversely affected people living with locomotor disability, ranging from loss of wages and financial crisis to anxiety, depression and lack of sleep. People with disabilities had limited reach to health and community services that were vital for them, including basic life and functional needs, besides risks of mistreatment and other psychological consequences.

Conclusion: This analysis suggests that the root cause of pandemic disparities is the lack of disability-inclusive planning and, more significantly, the pre-existing socioeconomic disparities and challenges that disabled people have been experiencing for a long time. We suggest that unambiguous public health and policy responses should be incorporated, and health, social participation, and socioeconomic disparity causes for disabled people should be addressed in tandem.

Objective: To assess the safety and effectiveness of high-density light-emitting diode (LED) irradiation therapy in patients with hand osteoarthritis (OA) and compare the pre- and post-intervention symptoms.

Methods: Twenty-three patients with hand OA underwent eight sessions of high-density LED irradiation therapy directed at the five most painful areas in the finger joints. Each session lasted for 18 minutes; and the sessions were conducted twice a week, for 4 weeks. We evaluated the degree of pain using the visual analogue scale, ring size, and passive range of motion (flexion+extension) for two most painful joints from the baseline to post-therapy (weeks 4 and 6).

Results: High-density LED irradiation therapy significantly reduced the pain posttreatment compared with that observed at the baseline (p<0.001). Although improvements were observed in ring size and joint range of motion at 4 and 6 weeks, they were not statistically significant (p>0.05). No adverse events were observed.

Conclusion: We examined the safety and effectiveness of high-density LED irradiation therapy in reducing pain and hand swelling and improving joint mobility in patients with hand OA. These results suggest that high-density LED irradiation therapy has the potential to be an important strategy for managing hand OA.

Objective: To confirm that the simplified insole does not affect the gait speed and to identify objective sensor-based gait parameters that correlate strongly with existing clinical gait assessment scales.

Methods: Ten participants with gait impairment due to hemiplegic stroke were enrolled in this study. Pairs of insoles with four pressure sensors on each side were manufactured and placed in each shoe. Data were extracted during the 10-Meter Walk Test. Several sensor-derived parameters (for example stance time, heel_on-to-toe_peak time, and toe_peak pressure) were calculated and correlated with gait speed and lower extremity Fugl-Meyer (F-M) score.

Results: The insole pressure sensor did not affect gait, as indicated by a strong correlation (ρ=0.988) and high agreement (ICC=0.924) between the gait speeds with and without the insole. The parameters that correlated most strongly with highest β coefficients against the clinical measures were stance time of the non-hemiplegic leg (β=-0.87 with F-M and β=-0.95 with gait speed) and heel_on-to-toe_peak time of the non-hemiplegic leg (β=-0.86 with F-M and -0.94 with gait speed).

Conclusion: Stance time of the non-hemiparetic leg correlates most strongly with clinical measures and can be assessed using a non-obtrusive insole pressure sensor that does not affect gait function. These results suggest that an insole pressure sensor, which is applicable in a home environment, may be useful as a clinical endpoint in post-stroke gait therapy trials.

Objective: To investigate the feasibility and effects of a mobile app-based home cycling exercise program compared to home cycling exercise without additional monitoring system. Compared with fitness facilities or outdoor exercise, home-based exercise programs effectively improve physical performance in an indwelling community. However, a flexible, informal environment may decrease motivation and impair adherence to physical exercise. Mobile devices for aerobic exercise and mobile applications provide real-time monitoring, immediate feedback, and encouragement to increase motivation and promote physical performance. We investigated the feasibility and effects of a mobile app-based home exercise program on body composition, muscular strength, and cardiopulmonary function.

Methods: Between February and May 2023, 20 participants were randomly allocated to the intervention (mobile application with a tablet) and control groups, and they performed aerobic exercise using a stationary bicycle for ≥150 minutes per week for 6 weeks (≤30-minute exercise session, with 3-minute warm-up and 3-minute cool-down). Karvonen formula-based heartrate defined the weekly increase in exercise intensity. Outcome measures included body-composition parameters, isokinetic knee flexor and extensor strength tests, cardiopulmonary exercise test results, and rate of target heart rate (HR) achievement. Participants were assessed at baseline and after the intervention.

Results: Unrelated personal events led two participants to drop out. The intervention and control groups had similar baseline characteristics. Compared with the control group, in the post-intervention isokinetic strength test, bilateral knee flexor and extensor power, and time to target HR achievement significantly increased each week in the intervention group.

Conclusion: Home-based exercise to achieve long-term cardiovascular fitness with portable electronic/mobile devices facilitates individualized exercise using real-time feedback to improve motivation and adherence.