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The World Health Organization's Rehabilitation 2030 vision: an African perspective 世界卫生组织的 2030 年康复愿景:非洲视角
Pub Date : 2024-07-16 DOI: 10.3389/fresc.2024.1442626
Maurice Douryang, Lervasen Pillay, Nonhlanhla S Mkumbuzi, Calogero Foti
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引用次数: 0
First Step to empowering change: enhancing self-efficacy, energy management, and physical activity in patients with sleep apnea 增强改变能力的第一步:增强睡眠呼吸暂停患者的自我效能、能量管理和体育锻炼
Pub Date : 2024-07-12 DOI: 10.3389/fresc.2024.1359371
Gitte Johannesen, Anders Ravnholt Schüsler Damlund, Sofie Grundtvig Vinter, Helle Skadborg Spuur, Mathias Sarkez-Knudsen, T. G. Thomsen
Fatigue often leads to a sedentary lifestyle, negatively impacting health, mortality, and quality of life. Engaging in physical activity can be challenging for individuals experiencing fatigue, particularly those with sleep apnea. This study's objective was to assess the “First Step” concepts’ usability in constructing and implementing different interventions through qualitative data. The intervention targets patients with sleep apnea, focusing on individualized energy distribution and meaningful engagement in physical activity.Two programs were developed based on the First Step concept, a rehabilitation program and a patient education program. Initially, 13 patients were recruited, split between the groups, with two dropping out. Primarily evaluated through qualitative data, patients in both groups attended group interviews. For one of the programs supplementary quantitative data were collected through the 6-min walk test (6MWT), Sit-to-Stand test, and Canadian Occupational Performance Measure (COPM). Patients in the rehabilitation program also monitored daily step counts using activity trackers.Patients found the energy management education enlightening, enabling them to make conscious changes in their daily lives. They reported the program's positive reception, with social interaction playing a crucial role in its success. Of the six patients who completed the rehabilitation program, significant improvements in 6MWT scores were observed, indicating enhanced walking endurance. While no changes were seen in the Sit-to-Stand test, COPM results showed notable improvements in performance and satisfaction with chosen activities.The incorporation of the First Step concept empowered patients with sleep apnea to manage fatigue, conserve energy, engage in meaningful activities, and improve their wellbeing. Merging occupational therapy and physiotherapy interventions effectively addressed daily challenges while promoting physical activity. Adaptations to the program, guided by patient feedback, suggest a preference for longer, more personalized sessions. This approach offers a promising pathway to improving quality of life for individuals with chronic conditions.Our study highlights the usability of the First Step concept, integrating occupational therapy and physiotherapy, to address challenges in individuals with sleep apnea. The tailored, multidisciplinary intervention prioritizes meaningful activities, focuses on energy distribution and physical exercise, yielding improved satisfaction and performance. Further research is warranted to enhance this salutogenic approach for chronic conditions.
疲劳常常导致久坐不动的生活方式,对健康、死亡率和生活质量产生负面影响。对于疲劳患者,尤其是患有睡眠呼吸暂停的患者来说,参加体育锻炼可能是一项挑战。本研究的目的是通过定性数据评估 "第一步 "概念在构建和实施不同干预措施时的可用性。干预措施针对的是睡眠呼吸暂停患者,重点是个性化的能量分配和有意义的体育锻炼。根据 "第一步 "概念开发了两个项目,一个是康复项目,另一个是患者教育项目。最初招募了 13 名患者,分成两组,其中两人退出。主要通过定性数据进行评估,两组患者都参加了小组访谈。其中一个项目通过 6 分钟步行测试(6MWT)、坐立测试和加拿大职业表现测量(COPM)收集补充定量数据。参加康复计划的患者还使用活动追踪器监测每天的步数。患者认为能源管理教育很有启发性,使他们能够有意识地改变自己的日常生活。他们表示,该计划深受欢迎,社交互动对计划的成功起到了至关重要的作用。在完成康复计划的六名患者中,他们的 6MWT 分数有了显著提高,这表明他们的行走耐力得到了增强。第一步 "理念的融入使睡眠呼吸暂停患者能够控制疲劳、保存体力、参与有意义的活动,并改善他们的健康状况。将职业疗法和物理疗法的干预措施结合起来,既能有效地应对日常挑战,又能促进身体活动。在患者反馈的指导下对该计划进行的调整表明,他们更喜欢时间更长、更个性化的治疗。我们的研究强调了 "第一步 "概念的可用性,它整合了职业疗法和物理疗法,可解决睡眠呼吸暂停患者面临的挑战。这种量身定制的多学科干预措施优先考虑有意义的活动,注重能量分配和体育锻炼,从而提高了患者的满意度和表现。我们有必要开展进一步的研究,以加强这种针对慢性病的治疗方法。
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引用次数: 0
Insights into the spectrum of transtibial prosthetic socket design from expert clinicians and their digital records 从临床专家及其数字记录中了解经胫假肢插座设计的方方面面
Pub Date : 2024-07-12 DOI: 10.3389/fresc.2024.1354069
A. S. Dickinson, J. Steer, C. Rossides, L. E. Diment, F. M. Mbithi, J. L. Bramley, D. Hannett, J. Blinova, Z. Tankard, P. R. Worsley
Transtibial prosthetic sockets are often grouped into patella tendon bearing (PTB) or total surface bearing (TSB) designs, but many variations in rectifications are used to apply these principles to an individual's personalised socket. Prosthetists currently have little objective evidence to assist them as they make design choices.To compare rectifications made by experienced prosthetists across a range of patient demographics and limb shapes to improve understanding of socket design strategies.163 residual limb surface scans and corresponding CAD/CAM sockets were analysed for 134 randomly selected individuals in a UK prosthetics service. This included 142 PTB and 21 TSB designs. The limb and socket scans were compared to determine the location and size of rectifications. Rectifications were compiled for PTB and TSB designs, and associations between different rectification sizes were assessed using a variety of methods including linear regression, kernel density estimation (KDE) and a Naïve Bayes (NB) classification.Differences in design features were apparent between PTB and TSB sockets, notably for paratibial carves, gross volume reduction and distal end elongation. However, socket designs varied across a spectrum, with most showing a hybrid of the PTB and TSB principles. Pairwise correlations were observed between the size of some rectifications (e.g., paratibial carves; fibular head build and gross volume reduction). Conversely, the patellar tendon carve depth was not associated significantly with any other rectification, indicating its relative design insensitivity. The Naïve Bayes classifier produced design patterns consistent with expert clinician practice. For example, subtle local rectifications were associated with a large volume reduction (i.e., a TSB-like design), whereas more substantial local rectifications (i.e., a PTB-like design) were associated with a low volume reduction.This study demonstrates how we might learn from design records to support education and enhance evidence-based socket design. The method could be used to predict design features for newly presenting patients, based on categorisations of their limb shape and other demographics, implemented alongside expert clinical judgement as smart CAD/CAM design templates.
经胫骨假肢套筒通常被归类为髌腱承(PTB)或全表面承(TSB)设计,但在将这些原则应用到个人的个性化套筒时,矫正方法会有很多变化。为了比较经验丰富的义肢修复师根据不同患者的人口统计学特征和肢体形状进行的矫正,以加深对插座设计策略的理解,我们对英国一家义肢服务机构随机挑选的 134 名患者的 163 个残肢表面扫描结果和相应的 CAD/CAM 插座进行了分析。其中包括 142 个 PTB 和 21 个 TSB 设计。对肢体和插座扫描进行比较,以确定矫正的位置和大小。对PTB和TSB设计的矫正情况进行了汇总,并使用线性回归、核密度估计(KDE)和奈夫贝叶斯(NB)分类等多种方法评估了不同矫正尺寸之间的关联。然而,两种插座的设计也各不相同,大多数插座都是 PTB 和 TSB 原理的混合体。一些矫正的大小(如胫骨旁切口、腓骨头构建和总体积缩小)之间存在成对相关性。相反,髌腱雕刻深度与任何其他矫正之间都没有显著相关性,这表明髌腱雕刻深度对设计相对不敏感。Naïve Bayes 分类器得出的设计模式与临床专家的实践一致。例如,细微的局部整复与大体积缩小有关(即 TSB 样式设计),而较大幅度的局部整复(即 PTB 样式设计)则与小体积缩小有关。这项研究展示了我们如何从设计记录中学习,以支持教育和加强循证插座设计。该方法可用于根据肢体形状和其他人口统计学特征的分类预测新就诊患者的设计特征,并与专家临床判断一起作为智能 CAD/CAM 设计模板实施。
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引用次数: 0
Linking the impact of aspiration to host variables using the BOLUS framework: support from a rapid review 利用 BOLUS 框架将愿望的影响与东道国变量联系起来:快速审查提供的支持
Pub Date : 2024-07-12 DOI: 10.3389/fresc.2024.1412635
Phyllis M Palmer, Aaron H Padilla
The purpose of this rapid review was to identify the level of evidence for a previously proposed theoretical framework to assess risks associated with prandial aspiration using the host as a central theme.Covidence software was used to search two databases (PubMed and Web of Science). PEDro scale was utilized to determine the quality of individual studies. Data points were evaluated for level of support and determined to be either conclusive, suggestive, unclear, or not supportive. Within each component of the framework, data points were clustered to determine the level of evidence as strong, moderate, insufficient, or negative.The rapid review process resulted in a limited number of publications investigating host variables impact on outcomes for patients with swallowing disorders. Overall, it yielded 937 articles, of which, upon review, 16 articles were selected for data extraction. There was a strong level of evidence to support that (a) as viscosity and density of aspirate increased, so did the likelihood of general medical complications, (b) poor oral care and oral health increase the risk of a pulmonary or general medical complication, and (c) the presence of oropharyngeal or laryngeal tubes increases the risk of a pulmonary consequence. There was moderate evidence to support the impact of amount and frequency of aspiration on outcomes. There was insufficient evidence to determine relationships for all other aspects of the BOLUS framework.Additional evidence to support the BOLUS framework was obtained; however, the number of studies was limited. A more thorough review such as a systematic review should be employed.
本快速综述旨在确定之前提出的理论框架的证据水平,该框架以宿主为中心主题,用于评估与餐前吸入相关的风险。使用 PEDro 量表确定各项研究的质量。对数据点的支持程度进行评估,并将其确定为确证、提示、不明确或不支持。在该框架的每个组成部分中,对数据点进行分组,以确定证据水平为有力、适度、不充分或负面。总体而言,共收到 937 篇文章,经审查,选出 16 篇进行数据提取。有大量证据支持以下观点:(a) 随着吸出物粘度和密度的增加,发生一般医疗并发症的可能性也随之增加;(b) 口腔护理和口腔健康状况不佳会增加肺部或一般医疗并发症的风险;(c) 口咽或喉管的存在会增加肺部后果的风险。中度证据支持吸入量和频率对结果的影响。没有足够的证据确定 BOLUS 框架所有其他方面的关系。应采用更彻底的审查方法,如系统审查。
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引用次数: 0
Wearable sensor and smartphone assisted vestibular physical therapy for multiple sclerosis: usability and outcomes 可穿戴传感器和智能手机辅助前庭物理治疗多发性硬化症:可用性和效果
Pub Date : 2024-07-10 DOI: 10.3389/fresc.2024.1406926
D. Meldrum, H. Kearney, S. Hutchinson, S. McCarthy, G. Quinn
Vertigo, dizziness, gaze instability and disequilibrium are highly prevalent in people with MS (PwMS) and head movement induced dizziness is commonly reported. Vestibular physical therapy (VPT) is a specialised, non-invasive and effective therapy for these problems but usually involves travel for the person to a specialist center with both personal and carbon costs. The use of wearable sensors to track head movement and smartphone applications to deliver and track programs has potential to improve VPT in MS.This study investigated the usability and effects of a commercially available digital VPT system (wearable head sensor, smartphone app and clinician software) to deliver VPT to PwMS. A pre/post treatment design was employed and the primary outcome was the System Usability Scale (SUS). Other patient reported outcomes were the Service User Acceptability Questionnaire (SUTAQ), the Patient Enablement Instrument (PEI) and the Dizziness Handicap Inventory (DHI). Physical outcomes measurements included Mini-BESTest (MB), Modified Dynamic Gait Index (mDGI), Gait Speed (GS), Dynamic Visual Acuity (DVA) and head kinematics and symptoms during exercise.Sixteen PwMS (14 female), mean age 44(±14) years were recruited to the study and twelve completed VPT. Mean adherence to exercise, measured digitally was 60% (±18.4). SUS scores were high at 81 (±14) and SUTAQ scores also demonstrated high levels of satisfaction and acceptability of the system. Statistically significant improvements in MB (mean change 2.25; p = 0.004), mDGI (median change 1.00; p = 0.008), DVA (median change −1.00; p = 0.004) were found. Head frequencies significantly improved with concurrent decreased intensity of dizziness during head movements (mean change across 4 gaze stabilization exercises was 23 beats per minute; p < 0.05). Non-significant improvements were seen in DHI (p = 0.07) and GS (p = 0.15). 64.5% of follow up visits were conducted remotely (video or phone), facilitated by the system.This study had two main outcomes and benefits for PwMS. Firstly, we showed that the system used was both acceptable and could be used by PwMS. Secondly, we demonstrated an improvement in a range of dizziness, balance and gait metrics with remotely delivered care. This system has the potential to positively impact on MS physiotherapy service provision with the potential to deliver effective remote care.
眩晕、头晕、凝视不稳定和不平衡是多发性硬化症患者(PwMS)的高发症状,头部运动引起的头晕也是常见报道。前庭物理疗法(VPT)是一种专门针对这些问题的非侵入性有效疗法,但通常需要患者前往专科中心接受治疗,既要支付个人费用,又要支付碳费用。本研究调查了商用数字 VPT 系统(可穿戴头部传感器、智能手机应用程序和临床医生软件)的可用性和效果,该系统可为多发性硬化症患者提供 VPT 治疗。研究采用了前/后治疗设计,主要结果是系统可用性量表(SUS)。其他患者报告的结果包括服务使用者可接受性问卷(SUTAQ)、患者能力评估工具(PEI)和头晕障碍量表(DHI)。物理结果测量包括迷你测试(MB)、改良动态步态指数(mDGI)、步态速度(GS)、动态视力(DVA)以及运动时的头部运动学和症状。通过数字测量,坚持锻炼的平均比例为 60% (±18.4)。SUS 得分高达 81(±14)分,SUTAQ 得分也显示了该系统的高满意度和可接受性。据统计,MB(平均变化 2.25;p = 0.004)、mDGI(中位数变化 1.00;p = 0.008)和 DVA(中位数变化 -1.00;p = 0.004)均有明显改善。头部频率明显改善,同时头部运动时的眩晕强度降低(4 次凝视稳定练习的平均变化为每分钟 23 次;p < 0.05)。DHI(p = 0.07)和GS(p = 0.15)的改善不明显。64.5%的随访是在该系统的帮助下远程进行的(视频或电话)。首先,我们证明了所使用的系统是可接受的,也是可以被 PwMS 使用的。其次,我们证明了远程护理对头晕、平衡和步态等一系列指标的改善。该系统具有提供有效远程护理的潜力,可对多发性硬化症物理治疗服务产生积极影响。
{"title":"Wearable sensor and smartphone assisted vestibular physical therapy for multiple sclerosis: usability and outcomes","authors":"D. Meldrum, H. Kearney, S. Hutchinson, S. McCarthy, G. Quinn","doi":"10.3389/fresc.2024.1406926","DOIUrl":"https://doi.org/10.3389/fresc.2024.1406926","url":null,"abstract":"Vertigo, dizziness, gaze instability and disequilibrium are highly prevalent in people with MS (PwMS) and head movement induced dizziness is commonly reported. Vestibular physical therapy (VPT) is a specialised, non-invasive and effective therapy for these problems but usually involves travel for the person to a specialist center with both personal and carbon costs. The use of wearable sensors to track head movement and smartphone applications to deliver and track programs has potential to improve VPT in MS.This study investigated the usability and effects of a commercially available digital VPT system (wearable head sensor, smartphone app and clinician software) to deliver VPT to PwMS. A pre/post treatment design was employed and the primary outcome was the System Usability Scale (SUS). Other patient reported outcomes were the Service User Acceptability Questionnaire (SUTAQ), the Patient Enablement Instrument (PEI) and the Dizziness Handicap Inventory (DHI). Physical outcomes measurements included Mini-BESTest (MB), Modified Dynamic Gait Index (mDGI), Gait Speed (GS), Dynamic Visual Acuity (DVA) and head kinematics and symptoms during exercise.Sixteen PwMS (14 female), mean age 44(±14) years were recruited to the study and twelve completed VPT. Mean adherence to exercise, measured digitally was 60% (±18.4). SUS scores were high at 81 (±14) and SUTAQ scores also demonstrated high levels of satisfaction and acceptability of the system. Statistically significant improvements in MB (mean change 2.25; p = 0.004), mDGI (median change 1.00; p = 0.008), DVA (median change −1.00; p = 0.004) were found. Head frequencies significantly improved with concurrent decreased intensity of dizziness during head movements (mean change across 4 gaze stabilization exercises was 23 beats per minute; p < 0.05). Non-significant improvements were seen in DHI (p = 0.07) and GS (p = 0.15). 64.5% of follow up visits were conducted remotely (video or phone), facilitated by the system.This study had two main outcomes and benefits for PwMS. Firstly, we showed that the system used was both acceptable and could be used by PwMS. Secondly, we demonstrated an improvement in a range of dizziness, balance and gait metrics with remotely delivered care. This system has the potential to positively impact on MS physiotherapy service provision with the potential to deliver effective remote care.","PeriodicalId":507590,"journal":{"name":"Frontiers in Rehabilitation Sciences","volume":"18 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141660929","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
Specific ICF training is needed in clinical practice: ICF framework education is not enough 临床实践中需要专门的 ICF 培训:仅有 ICF 框架教育是不够的
Pub Date : 2024-07-08 DOI: 10.3389/fresc.2024.1351564
Jaana Paltamaa, Ellen van Lingen, Christine Haumer, Anita Kidritsch, Ingrid Aerts, Laura Mutanen
The use of a common language in interprofessional collaboration is essential. The World Health Organization's International Classification of Functioning, Disability and Health (ICF) has been identified as a unifying framework for interprofessional collaboration and the identification of client needs. Higher education institutions (HEIs) offer ICF framework education to students but is it enough to enable graduated professionals to implement the ICF in clinical work? In our experience, the ICF education provided by HEIs does not meet the requirements of clinical practice, which might be due to gaps in teaching ICF to students (education) and specific requirements for teaching ICF to professionals already working in rehabilitation (training). This paper discusses the need for the ICF training in practice and ways to address it. Although many rehabilitation center professionals had previously received ICF education provided by the HEIs, the rehabilitation centers felt the need to develop their own practical training materials that could be applied to their own environment. Overall, 18 different ICF-based materials were developed during the Erasmus+ project called INPRO to promote person-centered and interprofessional practice in the rehabilitation centers. The practical training using real cases was considered valuable. It could be further developed in cooperation with HEIs and vice versa. It could also be used to teach students, i.e., future colleagues. To deepen and broaden the integration of the different materials based on the ICF, it is important to continue the interactive discussion between HEIs and clinical practice, and between management and its staff.
在跨专业合作中使用共同语言至关重要。世界卫生组织的《国际功能、残疾和健康分类》(ICF)已被确定为跨专业合作和确定客户需求的统一框架。高等教育机构(HEIs)为学生提供 ICF 框架教育,但这是否足以使毕业的专业人员在临床工作中实施 ICF 呢?根据我们的经验,高等院校提供的《国际功能、残疾和健康分类》教育并不符合临床实践的要求,这可能是由于向学生教授《国际功能、残疾和健康分类》(教育)和向已从事康复工作的专业人员教授《国际功能、残疾和健康分类》(培训)的具体要求存在差距。本文讨论了实践中对 ICF 培训的需求和解决方法。尽管许多康复中心的专业人员以前接受过高等院校提供的 ICF 教育,但康复中心认为有必要开发自己的实用培训材料,以适用于自己的环境。在名为 "INPRO "的伊拉斯谟+项目期间,共编写了 18 种不同的基于 ICF 的教材,以促进康复中心以人为本的跨专业实践。使用真实案例进行的实践培训被认为非常有价值。可以与高等院校合作进一步开发,反之亦然。它还可用于教授学生,即未来的同事。为了深化和扩大以《国际功能、残疾和健康分类》为基础的各种材料的整合,必须继续在高等院校和临床实践之间以及管理层和员工之间开展互动讨论。
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引用次数: 0
Changes in isometric mid-thigh pull peak force and symmetry across anterior cruciate ligament reconstruction rehabilitation phases 大腿中部等距拉力峰值和对称性在前十字韧带重建康复阶段的变化
Pub Date : 2024-07-05 DOI: 10.3389/fresc.2024.1418270
Johannes P. J. Stofberg, K. Aginsky, Mariaan van Aswegen, Mark Kramer
Whether functionally relevant strength assessments, such as the isometric mid-thigh pull (IMTP), can be used either bilaterally or unilaterally to evaluate and guide rehabilitation progress in those with anterior cruciate ligament reconstruction (ACLR) is under-researched. This study assessed changes in peak force (PF) and asymmetry across 3 phases for bilateral and unilateral IMTP assessments in patients with ACLR. Peak isometric force from the IMTP was compared to peak torque from isokinetic dynamometry as well as against a cohort of healthy, uninjured individuals.Participants (ACLR, n = 15) completed bilateral and unilateral IMTP assessments at weeks 12 (baseline), 16 (phase 3), and 20 (phase 4) of rehabilitation to evaluate changes in PF and asymmetry. Asymmetry was evaluated using the asymmetry angle. Isometric data from the IMTP were compared to that from an isokinetic dynamometer as well as against a cohort of healthy, uninjured participants (n = 63) allowing for a detailed analysis of limb-specific force production.The PF during the bilateral IMTP increased for both the injured (0.94 N/kg) and uninjured (0.26 N/kg) limbs from baseline to phase 4, whereas the PF of the injured limb increased by 1.5 N/kg during the unilateral IMTP in the same time frame. Asymmetry values systematically reduced by ∼1% and ∼0.5% for the bilateral and unilateral IMTP tests from baseline to phase 4. Significant differences in PF of the injured limb were evident between those with ACLR and healthy controls across all phases (p = 0.022–0.001). The rate of progression in PF capacity was dependent on test type, amounting to 0.1 and 0.2 body weights per week for the bilateral and unilateral IMTP respectively. Small-to-large correlations (r = 0.12–0.88) were evident between IMTP PF and peak torque from the isokinetic dynamometer as well as between asymmetry metrics from both tests.The findings suggest that IMTP PF has potential for monitoring changes in PF and asymmetry during the ACLR rehabilitation progress. Both injured limb and uninjured limb show improvement in force-generating capacity, implying a positive adaptation to rehabilitation protocols. The findings highlight that ACLR is a unilateral injury that requires bilateral rehabilitation.
对于与功能相关的力量评估(如等长大腿中部牵拉(IMTP))是否可用于双侧或单侧评估和指导前交叉韧带重建(ACLR)患者的康复进展,研究尚不充分。本研究评估了前交叉韧带重建患者在双侧和单侧 IMTP 评估的 3 个阶段中峰值力(PF)和不对称的变化。参与者(前交叉韧带损伤,n = 15)在康复的第 12 周(基线)、第 16 周(第 3 阶段)和第 20 周(第 4 阶段)完成了双侧和单侧 IMTP 评估,以评估 PF 和不对称性的变化。不对称度使用不对称角进行评估。从基线到第 4 阶段,受伤肢体(0.94 牛/公斤)和未受伤肢体(0.26 牛/公斤)在双侧 IMTP 期间的 PF 均有所增加,而受伤肢体在单侧 IMTP 期间的 PF 在同一时间内增加了 1.5 牛/公斤。从基线到第 4 阶段,双侧和单侧 IMTP 测试的不对称值分别降低了 1% 和 0.5%。在所有阶段中,前交叉韧带损伤者和健康对照组的受伤肢体的PF均存在明显差异(p = 0.022-0.001)。PF能力的进展速度取决于测试类型,双侧和单侧IMTP的进展速度分别为每周0.1和0.2体重。研究结果表明,在前交叉韧带损伤(ACLR)康复过程中,IMTP PF 具有监测 PF 和不对称变化的潜力。受伤肢体和未受伤肢体的发力能力都有所提高,这意味着对康复方案有积极的适应性。研究结果突出表明,前交叉韧带损伤是一种单侧损伤,需要进行双侧康复。
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引用次数: 0
Heat therapy for different knee diseases: expert opinion 不同膝关节疾病的热疗:专家意见
Pub Date : 2024-07-04 DOI: 10.3389/fresc.2024.1390416
Roberto Rossi
Musculoskeletal pain is a major burden in our society. Management of musculoskeletal pain or injuries includes both pharmacological and non-pharmacological approaches, including heat therapy (HT). HT is a well-established treatment option due to its ability to promote muscle relaxation, enhance blood circulation, and modulate nociceptors with a good safety profile. The main focus of this paper is to review the available literature about HT in knee pathologies (i.e., arthrosis, arthritis, traumatic pathologies in the subacute phase, muscle and tendon pathologies linked to fatigue, muscle tension and distractions) and to provide an expert opinion in case of lack of data.
肌肉骨骼疼痛是社会的一大负担。肌肉骨骼疼痛或损伤的治疗包括药物和非药物疗法,其中包括热疗(HT)。热疗具有促进肌肉放松、促进血液循环和调节痛觉感受器的能力,而且安全性良好,因此是一种行之有效的治疗方法。本文的主要重点是回顾有关热疗治疗膝关节病变(即关节病、关节炎、亚急性阶段的创伤性病变、与疲劳、肌肉紧张和注意力分散有关的肌肉和肌腱病变)的现有文献,并在缺乏数据的情况下提供专家意见。
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引用次数: 0
Case Report: Keep your eyes open! Nystagmus guides atypical BPPV 病例报告:睁大眼睛眼球震颤引导非典型 BPPV
Pub Date : 2024-03-28 DOI: 10.3389/fresc.2024.1384151
Daniel Ludwig, Michael C. Schubert
The clinical diagnosis of benign paroxysmal positional vertigo (BPPV) is confirmed from observing the direction, intensity, and duration of nystagmus from unique head positions that advantage gravity to overcome the inertia of otoconia displaced inside the semicircular canals. This case series highlights BPPV with atypical nystagmus presentations relative to the head position. Clinicians should carefully observe symptoms and nystagmus presentations regardless of the testing position and utilize technology and rules of vestibular physiology to enhance their diagnostic acumen.
良性阵发性位置性眩晕(BPPV)的临床诊断可通过观察独特头部位置的眼震方向、强度和持续时间来确定,这种头部位置可利用重力克服半规管内移位的耳骨的惯性。本系列病例重点介绍了与头部位置有关的非典型眼震表现的 BPPV。临床医生应仔细观察症状和眼震表现,无论测试位置如何,并利用前庭生理学的技术和规则来提高诊断敏锐度。
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引用次数: 0
Assessments and interventions on body functions, structures and activity to prepare adults with acute spinal cord injury or disease for participation: a scoping review 对急性脊髓损伤或疾病成人的身体功能、结构和活动进行评估和干预,为其参与做好准备:范围界定综述
Pub Date : 2024-03-27 DOI: 10.3389/fresc.2024.1272682
Sophie Irrgang, Sandra Himmelhaus, Kirstin Allek, I. Debecker, Armin Gemperli, Karen Kynast, A. von Reumont, A. Scheel-Sailer
In the acute phase after a spinal cord injury or disease (SCI/D), various therapeutic assessments and interventions are applied with the goal of restoring structures, preventing complications and preparing the patient as best as possible for further activity and finally participation. The goal was to identify and evaluate the available evidence on assessments and interventions for body functions and structures to prepare adults with acute spinal cord SCI/D for activity and participation during the first 14 days.A scoping review was conducted. The search was performed on June 19, 2023 using the databases PubMed, PEDro, Cochrane library and Embase. These were screened for studies including patients with acute SCI/D and physiotherapeutic or occupational therapy assessments and interventions. Only studies in English or German published between 2012 and 2023 were included.Twelve publications met the inclusion criteria, namely three systematic reviews, two randomized controlled trials, two observational studies and five clinical practice guidelines. Assessments as the Spinal Cord Independence Measure, as well as exercises such as daily passive mobilization of body structures against contractures were used in the entire population, while others were only applied in subgroups of SCI/D such as the Graded Redefined Assessment of Strength, Sensation and Prehension or functional electrical stimulation with and without additional movements. The methodological quality of the studies found varied greatly from good to very poor.Heterogeneity in research design and study population as well as lack of high-quality studies do not cover the standard of clinical management in the acute phase and further comprehensive research is needed.
在脊髓损伤或疾病(SCI/D)后的急性期,需要进行各种治疗评估和干预,目的是恢复患者的身体结构、预防并发症,并尽可能让患者做好进一步活动和参与的准备。本研究旨在确定和评估有关身体功能和结构的评估和干预措施的现有证据,以帮助急性脊髓损伤/残疾成人患者在最初 14 天内做好活动和参与的准备。2023 年 6 月 19 日,我们使用 PubMed、PEDro、Cochrane library 和 Embase 等数据库进行了检索。这些数据库筛选了包括急性 SCI/D 患者以及物理治疗或职业治疗评估和干预的研究。只有 2012 年至 2023 年间发表的英文或德文研究才被纳入。12 篇出版物符合纳入标准,其中包括 3 篇系统综述、2 篇随机对照试验、2 篇观察性研究和 5 篇临床实践指南。其中,脊髓独立性测量法(Spinal Cord Independence Measure)以及日常被动活动身体结构以防止挛缩等运动方法被用于所有人群,而其他方法则仅用于 SCI/D 亚组,如力量、感觉和预知能力分级重新定义评估法(Graded Redefined Assessment of Strength, Sensation and Prehension)或带或不带额外运动的功能性电刺激法(Functional Electric stimulation with or without additional movements)。研究设计和研究人群的异质性以及高质量研究的缺乏并不能涵盖急性期临床管理的标准,因此需要进一步开展全面的研究。
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Frontiers in Rehabilitation Sciences
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