Journal of Rehabilitation Medicine最新文献

Objectives: This study explores the feasibility and effects of low-intensity blood flow restriction exercise on forearm muscle strength and function in individuals with spinal cord injury.

Study design: Pilot randomized clinical trial.

Patients and methods: Ten male and female adult participants with chronic cervical and thoracic spinal cord injury underwent an 8-week low-intensity blood flow restriction exercise programme that targeted forearm muscles. Each participant's contralateral forearm served as the control. Grip strength was the primary outcome measure, and participants also provided qualitative feedback on their experiences.

Results: The study revealed a significant increase in participants' forearm muscle strength on the experimental side engaged in low-intensity blood flow restriction training, with an average strength gain of 7.5 ± 0.36 kg after 16 exercise sessions (Cohen's d = -6.32, 95% CI -8.34, -6.68). In comparison, the control side, following a conventional high- intensity exercise regimen without BFR, showed a more modest strength increase of 4.4 ± 0.67 kg. A mean Patient's Global Impression of Change score of 2.2 reflected overall improvements in participants' daily activities and health status.

Conclusion: This study highlights the feasibility and effectiveness of low-intensity blood flow restriction exercise as a safe and promising approach to enhancing forearm muscle strength in individuals with spinal cord injury. The observed positive outcomes, coupled with a high level of participant satisfaction, underscore the potential of this innovative method to significantly improve limb muscle strength, thereby contributing to greater functional independence in this population.

Objective: To evaluate the efficacy of pulmonary rehabilitation in the outcomes of patients with chronic obstructive pulmonary disease-obstructive sleep apnoea overlap syndrome patients who used positive airway pressure.

Design: Prospective randomized controlled single- blind trial.

Patients: A total of 79 patients with chronic obstructive pulmonary disease-obstructive sleep apnoea overlap syndrome were randomly assigned to either the intervention group (n = 40) or control group (n = 39).

Methods: All patients consistently adhered to positive airway pressure therapy every night from enrolment in the study, while intervention group patients received additional moderate-intensity aerobic exercise for 20 weeks. Pre- and post-intervention measurements included the 6-Minute Walk Test, Barthel Index, body mass index, fat mass, free fat mass, forced expiratory volume in 1 s (FEV1), FEV1%predicted, modified Medical Research Council, and polysomnography parameters.

Results: After 20 weeks, the intervention group exhibited statistically significant improvements in 6MWD, Barthel Index, body mass index, fat mass, and modified Medical Research Council compared with control group (all p < 0.01). In addition, the intervention group showed a significantly lower percentage of total sleep time with oxygen saturation < 90% (p = 0.013) and higher lowest nocturnal oxygen saturation (p = 0.008) than the control group. However, there was no significant difference in FEV1 %predicted between the 2 groups.

Conclusion: Pulmonary rehabilitation incorporating moderate-intensity aerobic exercise could improve physical endurance and motor abilities in individuals with chronic obstructive pulmonary disease-obstructive sleep apnoea overlap syndrome, while also improving anamnestic dyspnoea, body composition, and sleep-disordered breathing.

Objectives: This study aimed to longitudinally follow self-reported symptoms of depression, anxiety, post-traumatic stress disorder, and fatigue during the first year after hospitalization because of COVID-19.

Design: The study was an observational longitudinal study.

Methods and participants: Between July 2020, and February 2021, 211 patients aged ≥ 18 years, hospitalized ≥ 5 days at 5 hospitals in Region Västra Götaland, who had COVID-19, and were non-contagious (at study enrolment) were included in the baseline assessment. Of these, 168 (79.6%) patients completed mental health questionnaires at a 3-month follow-up, and 172 (83.1%) at a 12-month follow-up. A total of 120 (56.9%) participants who completed at least 1 questionnaire at both the 3- and 12-month follow-ups were analysed; the majority were male (n = 78, 65.0%).

Results: There was an improvement in all patients from 3 to 12 months on the fatigue subscales "reduced activity" (p = 0.02) and "physical fatigue" (p = 0.04). No other significant mental health improvements were found. At 12 months, 34 (28.4%) were classified as having anxiety symptoms, 29 (24.1%) as having depression symptoms, and 40 (33.3%) had symptoms of probable post-traumatic stress disorder.

Conclusions: Participants in the present study did not report full mental health recovery 1 year after hospitalization for COVID-19.

Objective: To compare the effects of proprioceptive neuromuscular facilitation therapy with manual therapy in improving the range of motion, decreasing pain, and improving activity of daily living in patients with neck pain.

Design: Double-blinded, randomized, experimental study.

Patients: Women aged 45-65 with cervical pain due to osteoarthritis of the vertebral body and intervertebral disc.

Methods: A total of 93 randomly selected females were included in the study. They were randomly divided into 2 groups. One received proprioceptive neuromuscular facilitation treatment and the other received manual therapy. To evaluate functional capabilities, the Oswestry Disability Index and range of motion measure were used. To evaluate changes in subjective experience of pain the Visual Analogue Scale was used.

Results: In terms of the activities of daily living, pain, and range of motion of flexion, extension, lateral flexion to the right and left, and rotation to the right and left improvement in group I compared with group II was statistically significant (p < 0.05) at 2 weeks and 3 months' follow-up.

Conclusion: Treatment according to proprioceptive neuromuscular facilitation is a better method in comparison with manual therapy regarding improvement of pain, range of motion, and daily functioning in patients with cervical pain.

Objective: This study delves into the intriguing connection between knee osteoarthritis and diabetes in Malaysia. Specifically, the exacerbation of knee osteoarthritis in the presence of diabetes in terms of symptoms, physical performance, physical activity, psychological status, social participation, and quality of life was discussed.

Design: This cross-sectional study recruited adults aged 50 and above by convenient sampling and grouped them into: knee osteoarthritis-diabetes-, knee osteoarthritis+diabetes-, knee osteoarthritis-diabetes+, and knee osteoarthritis+diabetes+.

Subjects/patients: Of 436 recruited participants, 261 (59.8%) participants reported knee osteoarthritis.

Methods: Handgrip strength, Timed Up and Go test, 6 Meter Walk Test, and 5 Times Sit to Stand Test were measured using standardized procedures. Six questionnaires were administered for the remaining parameters.

Results: Across groups, there were significant differences: 6 Meter Walk Test (p = 0.024), Timed Up and Go test (p = 0.020), and 5 Times Sit to Stand Test (p < 0.001), quality of life (p = 0.009), and physical activity (p = 0.036). Knee osteoarthritis+diabetes+ was independently associated with reduced handgrip strength, 5 Times Sit to Stand Test, quality of life, and physical inactivity after adjustment. Knee osteoarthritis+diabetes- was independently associated with reduced Timed Up and Go test and social isolation.

Conclusion: The findings revealed the diabetic knee osteoarthritis subgroup's unique physical and psychosocial features of reduced muscle strength and physical inactivity. Future studies should investigate whether managing metabolic factors, and enhancing physical activity and strength exercises, can reduce knee osteoarthritis symptoms and disease severity.

Objective: This study aimed to describe the temporal dynamics of and risk factors for non-adherence to outpatient follow-up care in the first 10 years after spinal cord injury.

Design: Retrospective single-centre cohort study using data from medical records and municipal resident registers.

Subjects/patients: Patients admitted to a specialized spinal cord injury centre in Switzerland discharged between 1 January 2010 and 31 December 2012 (n = 225). Time-to-event analysis was used to investigate the timing of the first non-adherence event, its association with spinal cord injury, and sociodemographic characteristics.

Results: 36% of patients were adherent to annual follow-up appointments; 2% formally transferred to another SCI centre; 44% were non-adherent for general reasons (patient's will to discontinue care [12%] or unknown reasons [32%]); and 18% were non-adherent due to death. Risk factors for non-adherence included older age, lack of long-term partner, and more than 2 h of travel time to the clinic. In the youngest age group (18-30 years), 55% were non-adherent after 10 years.

Conclusion: A relevant proportion of individuals with spinal cord injury were lost to annual follow-up care. A holistic approach to patient engagement integrating solutions such as telemedicine and involvement of support networks could reduce the risk of non-adherence.