Specific Virtual Reality (VR) systems designed for rehabilitation and non-specific VR systems intended for entertainment are used in Parkinson's disease (PD) rehabilitation, but their effects are unclear. The extent to which these systems integrate neurorehabilitation principles for PD rehabilitation is unknown. Previous meta-analyses exist but data are lacking on the impact of VR on mobility.
Objectives
Primary aim: to perform a systematic review with meta-analysis comparing the effects of VR and conventional therapy (CT) on balance and mobility in people with PD. Secondary aim: to perform subgroup analyses on VR type, disease severity, and treatment duration.
Methods
Randomized controlled trials comparing VR and CT effects on balance and mobility in adults with PD were selected from Pubmed and EMBASE until September 2024. Data were synthesized qualitatively and quantitatively using a standardized mean difference (SMD) with random-effects model. Subgroup analyses (VR type, disease severity, and treatment duration) and analysis of fulfilled neurorehabilitation principles were conducted. Risk of bias was assessed (PEDro checklist and Cochrane RoB-2).
Results
Twenty-eight studies (12 countries) were included: 1151 participants, mean Hoehn & Yahr stage between 1.4 and 3.4, mean (SD) treatment duration 18.8 (11.5) hours in the qualitative analysis and 23 in the quantitative analysis. Overall risk of bias was high (10 studies), some concerns (13 studies), or low (5 studies). VR was more effective than CT for balance (630 participants; 11 studies; SMD 0.42; 95% CI, 0.19–0.65; P < 0.001) and as effective as CT for mobility (591 participants; 10 studies; SMD 0.18; 95% CI, -0.03 to 0.40; P = 0.09). Balance and mobility outcomes did not differ between specific and non-specific VR. Subgroup analyses found no significant differences.
Conclusions
VR improved balance in people with PD more than CT (low-certainty evidence). VR improved mobility similarly to CT (moderate-certainty evidence). VR games should integrate neurorehabilitation principles.
{"title":"Virtual reality effects on balance and mobility in people with Parkinson's disease: A systematic review with meta-analysis","authors":"Alexis Lheureux , Thierry Lejeune , Alexane Simons , Aurore Gillis , Gauthier Everard","doi":"10.1016/j.rehab.2025.101967","DOIUrl":"10.1016/j.rehab.2025.101967","url":null,"abstract":"<div><h3>Background</h3><div>Specific Virtual Reality (VR) systems designed for rehabilitation and non-specific VR systems intended for entertainment are used in Parkinson's disease (PD) rehabilitation, but their effects are unclear. The extent to which these systems integrate neurorehabilitation principles for PD rehabilitation is unknown. Previous meta-analyses exist but data are lacking on the impact of VR on mobility.</div></div><div><h3>Objectives</h3><div>Primary aim: to perform a systematic review with meta-analysis comparing the effects of VR and conventional therapy (CT) on balance and mobility in people with PD. Secondary aim: to perform subgroup analyses on VR type, disease severity, and treatment duration.</div></div><div><h3>Methods</h3><div>Randomized controlled trials comparing VR and CT effects on balance and mobility in adults with PD were selected from Pubmed and EMBASE until September 2024. Data were synthesized qualitatively and quantitatively using a standardized mean difference (SMD) with random-effects model. Subgroup analyses (VR type, disease severity, and treatment duration) and analysis of fulfilled neurorehabilitation principles were conducted. Risk of bias was assessed (PEDro checklist and Cochrane RoB-2).</div></div><div><h3>Results</h3><div>Twenty-eight studies (12 countries) were included: 1151 participants, mean Hoehn & Yahr stage between 1.4 and 3.4, mean (SD) treatment duration 18.8 (11.5) hours in the qualitative analysis and 23 in the quantitative analysis. Overall risk of bias was high (10 studies), some concerns (13 studies), or low (5 studies). VR was more effective than CT for balance (630 participants; 11 studies; SMD 0.42; 95% CI, 0.19–0.65; <em>P</em> < 0.001) and as effective as CT for mobility (591 participants; 10 studies; SMD 0.18; 95% CI, -0.03 to 0.40; <em>P</em> = 0.09). Balance and mobility outcomes did not differ between specific and non-specific VR. Subgroup analyses found no significant differences.</div></div><div><h3>Conclusions</h3><div>VR improved balance in people with PD more than CT (low-certainty evidence). VR improved mobility similarly to CT (moderate-certainty evidence). VR games should integrate neurorehabilitation principles.</div></div>","PeriodicalId":56030,"journal":{"name":"Annals of Physical and Rehabilitation Medicine","volume":"68 6","pages":"Article 101967"},"PeriodicalIF":3.9,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143848313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-19DOI: 10.1016/j.rehab.2025.101971
Adam Viktorisson , Dongni Buvarp , Maria Bäck , Margret Leosdottir , Mia von Euler , Katharina S Sunnerhagen
Background
Stroke and acute myocardial infarction (AMI) rank among the leading causes of mortality. Physical activity and exercise are recommended as part of rehabilitation after AMI to prevent cardiovascular events, but the importance for stroke prevention has not been investigated using population-based data.
Objectives
To determine associations between participation in exercise-based cardiac rehabilitation (EBCR) and self-reported physical activity with the risk of total stroke, ischemic stroke, and intracerebral hemorrhage after AMI.
Methods
This was a nationwide, double cohort study conducted across all coronary care units in Sweden between 2005 and 2020, combined with registered data from the general population. Participation in EBCR (24 physiotherapist-led sessions over 4 months) and self-reported physical activity were assessed at a median of 55 days (range 28–90) after hospital discharge. Stroke incidence was followed until death or censoring on December 31, 2021.
Results
A total of 86,637 people with AMI (mean age 64.0, SD 9.0 years; 26 % female), and 259,911 (1:3) age, sex, and region of birth matched individuals from the general population were included. Participation in EBCR after AMI was associated with a lower risk of total stroke (adjusted hazard ratio, aHR 0.85; 95 % confidence interval, CI 0.80–0.91) compared to non-participants, as was ≥150 min of physical activity per week (aHR 0.79, 95 % CI 0.75–0.83). Those reporting physical activity 6 days per week after AMI did not have an increased risk of total stroke or ischemic stroke compared to the general population (aHR 1.03, 95 % CI 0.87–1.23; and aHR 1.17, 95 % CI 0.97–1.41), and were at lower risk of intracerebral hemorrhage (aHR 0.59, 95 % CI 0.35–0.98).
Conclusions
EBCR and higher levels of physical activity are associated with a decreased risk of stroke after AMI. Cardiac rehabilitation programs and regular and physical activity should be promoted after AMI to decrease the burden of stroke. Swedish Ethical Review Authority Registration number: 2021–03645.
背景：中风和急性心肌梗死（AMI）是导致死亡的主要原因。体育活动和锻炼被推荐作为AMI后康复的一部分，以预防心血管事件，但对卒中预防的重要性尚未使用基于人群的数据进行调查。目的：确定参与基于运动的心脏康复（EBCR）和自我报告的身体活动与AMI后总卒中、缺血性卒中和脑出血风险之间的关系。方法：这是一项全国性的双队列研究，在2005年至2020年期间在瑞典所有冠状动脉护理单位进行，并结合了普通人群的登记数据。在出院后55天（范围28-90天）对参与EBCR（24次物理治疗师主导的4个月疗程）和自我报告的身体活动进行评估。跟踪中风发病率，直到2021年12月31日死亡或审查。结果共86637例AMI患者(平均年龄64.0岁，SD 9.0岁；包括259,911（1:3）年龄、性别和出生地区与一般人群相匹配的个体。AMI后参加EBCR与总卒中风险较低相关(校正风险比，aHR 0.85；95%可信区间，CI 0.80-0.91)，每周体力活动≥150分钟（aHR 0.79, 95% CI 0.75-0.83）。与一般人群相比，AMI后每周运动6天的患者发生总卒中或缺血性卒中的风险没有增加(aHR 1.03, 95% CI 0.87-1.23；aHR为1.17,95% CI 0.97-1.41)，脑出血风险较低（aHR 0.59, 95% CI 0.35-0.98）。结论sebcr和高水平的身体活动与AMI后卒中风险降低相关。AMI后应提倡心脏康复计划和定期体育活动，以减少卒中的负担。瑞典伦理审查机构注册号：2021-03645。
{"title":"Cardiac rehabilitation and physical activity decrease the risk of stroke after acute myocardial infarction: A nationwide cohort study in Sweden","authors":"Adam Viktorisson , Dongni Buvarp , Maria Bäck , Margret Leosdottir , Mia von Euler , Katharina S Sunnerhagen","doi":"10.1016/j.rehab.2025.101971","DOIUrl":"10.1016/j.rehab.2025.101971","url":null,"abstract":"<div><h3>Background</h3><div>Stroke and acute myocardial infarction (AMI) rank among the leading causes of mortality. Physical activity and exercise are recommended as part of rehabilitation after AMI to prevent cardiovascular events, but the importance for stroke prevention has not been investigated using population-based data.</div></div><div><h3>Objectives</h3><div>To determine associations between participation in exercise-based cardiac rehabilitation (EBCR) and self-reported physical activity with the risk of total stroke, ischemic stroke, and intracerebral hemorrhage after AMI.</div></div><div><h3>Methods</h3><div>This was a nationwide, double cohort study conducted across all coronary care units in Sweden between 2005 and 2020, combined with registered data from the general population. Participation in EBCR (24 physiotherapist-led sessions over 4 months) and self-reported physical activity were assessed at a median of 55 days (range 28–90) after hospital discharge. Stroke incidence was followed until death or censoring on December 31, 2021.</div></div><div><h3>Results</h3><div>A total of 86,637 people with AMI (mean age 64.0, SD 9.0 years; 26 % female), and 259,911 (1:3) age, sex, and region of birth matched individuals from the general population were included. Participation in EBCR after AMI was associated with a lower risk of total stroke (adjusted hazard ratio, aHR 0.85; 95 % confidence interval, CI 0.80–0.91) compared to non-participants, as was ≥150 min of physical activity per week (aHR 0.79, 95 % CI 0.75–0.83). Those reporting physical activity 6 days per week after AMI did not have an increased risk of total stroke or ischemic stroke compared to the general population (aHR 1.03, 95 % CI 0.87–1.23; and aHR 1.17, 95 % CI 0.97–1.41), and were at lower risk of intracerebral hemorrhage (aHR 0.59, 95 % CI 0.35–0.98).</div></div><div><h3>Conclusions</h3><div>EBCR and higher levels of physical activity are associated with a decreased risk of stroke after AMI. Cardiac rehabilitation programs and regular and physical activity should be promoted after AMI to decrease the burden of stroke. Swedish Ethical Review Authority Registration number: 2021–03645.</div></div>","PeriodicalId":56030,"journal":{"name":"Annals of Physical and Rehabilitation Medicine","volume":"68 5","pages":"Article 101971"},"PeriodicalIF":3.9,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143848145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-18DOI: 10.1016/j.rehab.2025.101985
Lars G. Hvid , Josephine L. Steenberg , Freja Roy , Lasse Skovgaard
Background
While outdoor walking exercise therapy could likely elicit multiple beneficial effects in persons with multiple sclerosis (pwMS), little evidence exists.
Objective
To evaluate the effects of a 7-week group-based outdoor walking exercise therapy intervention on walking capacity and mental well-being as well as additional outcomes in pwMS.
Methods
In this randomized controlled trial, n = 62 ambulatory pwMS (49/62, 79% females; 51 years [range, 27–68 years]), patient-determined disease steps 1.7 (range, 0–4) were assigned to either a WALK group (a ‘personalized’ program suited to the starting level of each participant, including one continuous and one intermittent supervised walking session per week at moderate-to-high intensity) or a CONTROL group (continuation of habitual lifestyle). Tests were carried out at baseline (Pre) and after the intervention (Post). Walking capacity included 6-minute walk test (6MWT; primary outcome), timed 25-foot walk test (T25FWT), and six spot step test (SSST). Walking fatigability indexes were calculated from 6MWT data. Patient-reported outcomes included 12-item MS Walking Scale (MSWS), modified fatigue impact scale (MFIS), 7-item falls efficacy scale-international (FES-I), World Health Organization five well-being index (WHO5; main secondary outcome), and 0–100 visual analogue scale health-related quality of life (HR-QoL).
Results
Across the 7-week intervention period, n = 17 (5/17, 27%) pwMS dropped out. No adverse events were reported. Across all WALK sessions, 78% of the time was spent on forest/gravel trails. Substantial between-group changes were observed (beneficial changes in WALK vs no changes in CONTROL) in 6MWT (mean change [95% CI]; +41 m [22;60]; deemed clinically relevant), T25FWT (+0.27 [0.15;0.39] m/s), SSST (-0.80 [-1.33;-0.27] s), WHO5 (+7.3 [0.1;14.5] points), MSWS (-5.1 [-9.2;-1.0] points), MFIS (-6.7 [-11.7;-1.7] points), FES-I (trend; -0.8 [-1.7;0.1] points), and HR-QoL (trend; +5.3 [-2.3;12.9] points). In contrast, walking fatigability indexes remained unaffected.
Conclusions
Outdoor walking exercise therapy elicited multiple beneficial effects in pwMS, especially evidenced by improvements in walking capacity and mental well-being.
{"title":"Outdoor walking exercise therapy improves walking capacity and well-being in persons with multiple sclerosis: A randomized controlled trial","authors":"Lars G. Hvid , Josephine L. Steenberg , Freja Roy , Lasse Skovgaard","doi":"10.1016/j.rehab.2025.101985","DOIUrl":"10.1016/j.rehab.2025.101985","url":null,"abstract":"<div><h3>Background</h3><div>While outdoor walking exercise therapy could likely elicit multiple beneficial effects in persons with multiple sclerosis (pwMS), little evidence exists.</div></div><div><h3>Objective</h3><div>To evaluate the effects of a 7-week group-based outdoor walking exercise therapy intervention on walking capacity and mental well-being as well as additional outcomes in pwMS.</div></div><div><h3>Methods</h3><div>In this randomized controlled trial, <em>n</em> = 62 ambulatory pwMS (49/62, 79% females; 51 years [range, 27–68 years]), patient-determined disease steps 1.7 (range, 0–4) were assigned to either a WALK group (a ‘personalized’ program suited to the starting level of each participant, including one continuous and one intermittent supervised walking session per week at moderate-to-high intensity) or a CONTROL group (continuation of habitual lifestyle). Tests were carried out at baseline (Pre) and after the intervention (Post). Walking capacity included 6-minute walk test (6MWT; primary outcome), timed 25-foot walk test (T25FWT), and six spot step test (SSST). Walking fatigability indexes were calculated from 6MWT data. Patient-reported outcomes included 12-item MS Walking Scale (MSWS), modified fatigue impact scale (MFIS), 7-item falls efficacy scale-international (FES-I), World Health Organization five well-being index (WHO5; main secondary outcome), and 0–100 visual analogue scale health-related quality of life (HR-QoL).</div></div><div><h3>Results</h3><div>Across the 7-week intervention period, <em>n</em> = 17 (5/17, 27%) pwMS dropped out. No adverse events were reported. Across all WALK sessions, 78% of the time was spent on forest/gravel trails. Substantial between-group changes were observed (beneficial changes in WALK vs no changes in CONTROL) in 6MWT (<em>mean change [95% CI];</em> +41 m [22;60]; deemed clinically relevant), T25FWT (+0.27 [0.15;0.39] m/s), SSST (-0.80 [-1.33;-0.27] s), WHO5 (+7.3 [0.1;14.5] points), MSWS (-5.1 [-9.2;-1.0] points), MFIS (-6.7 [-11.7;-1.7] points), FES-I (<em>trend</em>; -0.8 [-1.7;0.1] points), and HR-QoL (<em>trend</em>; +5.3 [-2.3;12.9] points). In contrast, walking fatigability indexes remained unaffected.</div></div><div><h3>Conclusions</h3><div>Outdoor walking exercise therapy elicited multiple beneficial effects in pwMS, especially evidenced by improvements in walking capacity and mental well-being.</div></div><div><h3>Trial registration</h3><div><span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> identifier NCT05415956.</div></div>","PeriodicalId":56030,"journal":{"name":"Annals of Physical and Rehabilitation Medicine","volume":"68 6","pages":"Article 101985"},"PeriodicalIF":3.9,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143848312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-18DOI: 10.1016/j.rehab.2025.101978
Claire Hentzen , Olivier Remy-Neris , Charles Pradeau , Laurent Bensoussan , François Constant Boyer , Jean-Christophe Daviet , Christelle Nguyen , Xavier De Boissezon
Entrustable professional activities (EPAs) are set to assess residents’ capacity to perform professional units close to the context of their future clinical practice. The aim was to define a concise list of EPAs covering the broad specialty of Physical and Rehabilitation Medicine (PRM) to implement a systematic and consistent assessment of trainees’ competencies during their residency. A list of EPAs was developed based on a literature review and working group. This list was then submitted to academic PRM professors for validation via a Delphi process. Two rounds were planned with intermediate and final discussion meetings by an external steering committee. Ten EPAs were developed in a first draft. Each of the seven parts of the EPAs obtained validation through the Delphi process. A list of 11 clinical contexts of application was approved to integrate the EPAs in the different areas of PRM. The next step will be the deployment of these EPAs for the validation of residency internships.
{"title":"Developing entrustable professional activities for residents in physical and rehabilitation medicine: A Delphi study","authors":"Claire Hentzen , Olivier Remy-Neris , Charles Pradeau , Laurent Bensoussan , François Constant Boyer , Jean-Christophe Daviet , Christelle Nguyen , Xavier De Boissezon","doi":"10.1016/j.rehab.2025.101978","DOIUrl":"10.1016/j.rehab.2025.101978","url":null,"abstract":"<div><div>Entrustable professional activities (EPAs) are set to assess residents’ capacity to perform professional units close to the context of their future clinical practice. The aim was to define a concise list of EPAs covering the broad specialty of Physical and Rehabilitation Medicine (PRM) to implement a systematic and consistent assessment of trainees’ competencies during their residency. A list of EPAs was developed based on a literature review and working group. This list was then submitted to academic PRM professors for validation via a Delphi process. Two rounds were planned with intermediate and final discussion meetings by an external steering committee. Ten EPAs were developed in a first draft. Each of the seven parts of the EPAs obtained validation through the Delphi process. A list of 11 clinical contexts of application was approved to integrate the EPAs in the different areas of PRM. The next step will be the deployment of these EPAs for the validation of residency internships.</div></div>","PeriodicalId":56030,"journal":{"name":"Annals of Physical and Rehabilitation Medicine","volume":"68 4","pages":"Article 101978"},"PeriodicalIF":3.9,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143848136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-18DOI: 10.1016/j.rehab.2025.101975
Chia-Ying Lai , Chia-Huei Lin , Shang-Lin Chiang
{"title":"Response to comment on “Effectiveness of a 12-week telerehabilitation training in people with long COVID: A randomized controlled trial”","authors":"Chia-Ying Lai , Chia-Huei Lin , Shang-Lin Chiang","doi":"10.1016/j.rehab.2025.101975","DOIUrl":"10.1016/j.rehab.2025.101975","url":null,"abstract":"","PeriodicalId":56030,"journal":{"name":"Annals of Physical and Rehabilitation Medicine","volume":"68 4","pages":"Article 101975"},"PeriodicalIF":3.9,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143842688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Prevalence and typology of hallucinatory phenomena in adults with COVID-19: Early experiences at the post-acute phase in step down unit","authors":"Maryane Chea, Laurent Cleret de Langavant, Cécile Delorme, Jean-Christophe Corvol, Julie Delemazure, Elise Morawiec, Morgane Faure, Bertrand Pichon, Eléonore Bayen, François Stefanescu","doi":"10.1016/j.rehab.2025.101970","DOIUrl":"10.1016/j.rehab.2025.101970","url":null,"abstract":"","PeriodicalId":56030,"journal":{"name":"Annals of Physical and Rehabilitation Medicine","volume":"68 5","pages":"Article 101970"},"PeriodicalIF":3.9,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143842659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-18DOI: 10.1016/j.rehab.2025.101954
Andres Marmol-Perez , Luis Gracia-Marco , Antonio Clavero-Jimeno , Francisco J. Amaro-Gahete , Jonatan R. Ruiz , Almudena Carneiro-Barrera
Background
Due to the lack of available knowledge in the current literature, this systematic review and meta-analysis was aimed to assess the effectiveness of exercise-based lifestyle interventions, including healthy diet and/or psychological well-being on mental, physical and global health-related quality of life (HRQoL) in adults after cancer treatment.
Methods
MEDLINE (via PubMed) and Web of Science databases were searched for randomised controlled trials (RCTs) published until August 2024 evaluating exercise-based lifestyle interventions, including healthy diet and/or psychological well-being, which assessed mental, physical and global HRQoL.
Results
Of 6193 screened studies, 32 RCTs met the criteria. The total sample comprised 5528 participants (3003 intervention and 2525 control). There was a small effect size in a pooled analysis that found exercise-based lifestyle interventions improve mental HRQoL (d 0.11, 95 % CI 0.05 to 0.18). These effects were greater in those studies that combined exercise with psychological well-being (d = 0.19, P = 0.004), and with moderate-to-high intensity aerobic exercise (moderate intensity; d = 0.11, P = 0.02, high intensity; d = 0.16, P = 0.02, aerobic exercise; d = 0.16, P = 0.26).
Conclusions
Exercise-based lifestyle interventions do not enhance physical nor global HRQoL, yet those combined with psychological well-being seem to improve mental HRQoL in individuals after cancer treatment.
PROSPERO registration number
CRD42022369169.
背景：由于现有文献缺乏相关知识，本系统综述和荟萃分析旨在评估以运动为基础的生活方式干预的有效性，包括健康饮食和/或心理健康对癌症治疗后成人心理、身体和整体健康相关生活质量（HRQoL）的影响。方法检索medline（通过PubMed）和Web of Science数据库，检索截至2024年8月发表的随机对照试验（rct），评估基于运动的生活方式干预，包括健康饮食和/或心理健康，评估心理、身体和整体HRQoL。结果在6193项筛选研究中，32项rct符合标准。样本总数为5528人（干预组3003人，对照组2525人）。在一项汇总分析中发现，以运动为基础的生活方式干预可以改善心理HRQoL （d = 0.11, 95% CI = 0.05 ~ 0.18）。在那些将运动与心理健康结合起来的研究中（d = 0.19, P = 0.004），以及中至高强度有氧运动(中等强度；d = 0.11, P = 0.02，高强度；d = 0.16, P = 0.02，有氧运动；d = 0.16, P = 0.26)。结论以运动为基础的生活方式干预并不能提高癌症治疗后个体的生理和整体HRQoL，而与心理健康相结合的生活方式干预似乎可以提高个体的心理HRQoL。普洛斯彼罗注册号crd42022369169。
{"title":"Effects of exercise-based interventions on health-related quality of life in adults after cancer: A systematic review and meta-analysis","authors":"Andres Marmol-Perez , Luis Gracia-Marco , Antonio Clavero-Jimeno , Francisco J. Amaro-Gahete , Jonatan R. Ruiz , Almudena Carneiro-Barrera","doi":"10.1016/j.rehab.2025.101954","DOIUrl":"10.1016/j.rehab.2025.101954","url":null,"abstract":"<div><h3>Background</h3><div>Due to the lack of available knowledge in the current literature, this systematic review and meta-analysis was aimed to assess the effectiveness of exercise-based lifestyle interventions, including healthy diet and/or psychological well-being on mental, physical and global health-related quality of life (HRQoL) in adults after cancer treatment.</div></div><div><h3>Methods</h3><div>MEDLINE (via PubMed) and Web of Science databases were searched for randomised controlled trials (RCTs) published until August 2024 evaluating exercise-based lifestyle interventions, including healthy diet and/or psychological well-being, which assessed mental, physical and global HRQoL.</div></div><div><h3>Results</h3><div>Of 6193 screened studies, 32 RCTs met the criteria. The total sample comprised 5528 participants (3003 intervention and 2525 control). There was a small effect size in a pooled analysis that found exercise-based lifestyle interventions improve mental HRQoL (d 0.11, 95 % CI 0.05 to 0.18). These effects were greater in those studies that combined exercise with psychological well-being (d = 0.19, <em>P</em> = 0.004), and with moderate-to-high intensity aerobic exercise (moderate intensity; d = 0.11, <em>P</em> = 0.02, high intensity; d = 0.16, <em>P</em> = 0.02, aerobic exercise; d = 0.16, <em>P</em> = 0.26).</div></div><div><h3>Conclusions</h3><div>Exercise-based lifestyle interventions do not enhance physical nor global HRQoL, yet those combined with psychological well-being seem to improve mental HRQoL in individuals after cancer treatment.</div></div><div><h3>PROSPERO registration number</h3><div>CRD42022369169.</div></div>","PeriodicalId":56030,"journal":{"name":"Annals of Physical and Rehabilitation Medicine","volume":"68 5","pages":"Article 101954"},"PeriodicalIF":3.9,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143842657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-18DOI: 10.1016/j.rehab.2025.101969
Christina Brogårdh , Catharina Sjödahl Hammarlund , Jan Lexell
Background
Many people ageing with late effects of polio (LEoP) experience new or increased impairments which could negatively influence daily life. Currently, there is limited knowledge how LEoP-related impairments change over time.
Objectives
To assess how various self-reported impairments change over 10 years among people with LEoP, and explore factors associated with the changes.
Methods
This is a longitudinal cohort study, in which 181 people with LEoP (mean age 77 [SD 9] years, 99 women) responded to a postal survey twice, 10 years apart. The survey included questions on demographics, clinical characteristics, and self-reported impairments as assessed with the Self-reported Impairments in Persons with late effects of Polio (SIPP) scale. The SIPP comprises 13 items and asks how much participants have been bothered by various LEoP-related impairments during the past 2 weeks. Changes in SIPP scores were analyzed by paired sample t-test. Factors associated with the changes in SIPP total scores were analyzed with univariable linear regression analyses.
Results
Seven items in the SIPP increased significantly over the 10 years (P < 0.05): muscle weakness, muscle fatigue, sensory disturbances, breathing difficulties at rest and during physical activity, cold intolerance, and general fatigue (corresponding to 1–12%). The SIPP total score increased on average 1.64 points (CI, 0.88 - 2.41, P < 0.001), corresponding to 6%. Two variables were significantly associated with the change in SIPP total score: self-reported degree of LEoP-related disability (B = 2.96, 95% CI, 0.88–5.03; P = 0.006) and presence of co-morbidities (B = 1.72, 95% CI, 0.14–3.30; P = 0.033).
Conclusions
Impairments following LEoP seem to increase over a 10-year period but to a small degree. Having moderate to severe LEoP-related disability and comorbidities are associated with increased impairments. These findings can be accommodated in follow-ups and when providing and developing person-centered interventions for people with LEoP.
{"title":"Changes in self-reported impairments over 10 years in people with late effects of polio and associated factors: A longitudinal cohort study","authors":"Christina Brogårdh , Catharina Sjödahl Hammarlund , Jan Lexell","doi":"10.1016/j.rehab.2025.101969","DOIUrl":"10.1016/j.rehab.2025.101969","url":null,"abstract":"<div><h3>Background</h3><div>Many people ageing with late effects of polio (LEoP) experience new or increased impairments which could negatively influence daily life. Currently, there is limited knowledge how LEoP-related impairments change over time.</div></div><div><h3>Objectives</h3><div>To assess how various self-reported impairments change over 10 years among people with LEoP, and explore factors associated with the changes.</div></div><div><h3>Methods</h3><div>This is a longitudinal cohort study, in which 181 people with LEoP (mean age 77 [SD 9] years, 99 women) responded to a postal survey twice, 10 years apart. The survey included questions on demographics, clinical characteristics, and self-reported impairments as assessed with the Self-reported Impairments in Persons with late effects of Polio (SIPP) scale. The SIPP comprises 13 items and asks how much participants have been bothered by various LEoP-related impairments during the past 2 weeks. Changes in SIPP scores were analyzed by paired sample <em>t</em>-test. Factors associated with the changes in SIPP total scores were analyzed with univariable linear regression analyses.</div></div><div><h3>Results</h3><div>Seven items in the SIPP increased significantly over the 10 years (<em>P</em> < 0.05): muscle weakness, muscle fatigue, sensory disturbances, breathing difficulties at rest and during physical activity, cold intolerance, and general fatigue (corresponding to 1–12%). The SIPP total score increased on average 1.64 points (CI, 0.88 - 2.41, <em>P</em> < 0.001), corresponding to 6%. Two variables were significantly associated with the change in SIPP total score: self-reported degree of LEoP-related disability (<em>B</em> = 2.96, 95% CI, 0.88–5.03; <em>P</em> = 0.006) and presence of co-morbidities (<em>B</em> = 1.72, 95% CI, 0.14–3.30; <em>P</em> = 0.033).</div></div><div><h3>Conclusions</h3><div>Impairments following LEoP seem to increase over a 10-year period but to a small degree. Having moderate to severe LEoP-related disability and comorbidities are associated with increased impairments. These findings can be accommodated in follow-ups and when providing and developing person-centered interventions for people with LEoP.</div></div>","PeriodicalId":56030,"journal":{"name":"Annals of Physical and Rehabilitation Medicine","volume":"68 5","pages":"Article 101969"},"PeriodicalIF":3.9,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143842658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-18DOI: 10.1016/j.rehab.2025.101981
Jeongmin Kim , Hak Yi , Donghwan Hwang , Jiuk Jung , Hyuk Jin Lee , Jang Ho Cho , Soo-Kyung Bok , Yongkoo Lee
Purpose
This study evaluates the long-term biomechanical and energy efficiency effects of a high-torque, lightweight robotic ankle-foot prosthesis (RAF Pro) in a transtibial amputee, focusing on its potential to enhance gait symmetry and functionality.
Methods
A six-month longitudinal case study was conducted on a 51-year-old male transtibial amputee transitioning from a passive prosthesis to the RAF Pro. Comprehensive gait analyses, including motion capture and force plate assessments, were performed at four intervals: initial fitting, three months, four and a half months, and six months. The participant received continuous, tailored rehabilitation training throughout the study.
Results
Over the adaptation period, notable improvements were observed in plantarflexion during toe-off and in the coordination of hip and knee joint movements, contributing to enhanced gait symmetry. By the six-month mark, the subject achieved near-symmetrical gait mechanics with significantly reduced energy expenditure during walking, approaching the biomechanical efficiency observed in non-amputees.
Conclusion
This case study highlights the potential of long-term adaptive rehabilitation combined with advanced robotic prostheses to restore natural, energy-efficient gait mechanics in transtibial amputees. The findings emphasize the importance of a minimum six-month adaptation period for optimizing prosthetic function, offering valuable insights for personalized rehabilitation strategies and future prosthetic development.
{"title":"Prolonged adaptation to a robotic prosthesis enhances gait symmetry: A case study in a transtibial amputee","authors":"Jeongmin Kim , Hak Yi , Donghwan Hwang , Jiuk Jung , Hyuk Jin Lee , Jang Ho Cho , Soo-Kyung Bok , Yongkoo Lee","doi":"10.1016/j.rehab.2025.101981","DOIUrl":"10.1016/j.rehab.2025.101981","url":null,"abstract":"<div><h3>Purpose</h3><div>This study evaluates the long-term biomechanical and energy efficiency effects of a high-torque, lightweight robotic ankle-foot prosthesis (RAF Pro) in a transtibial amputee, focusing on its potential to enhance gait symmetry and functionality.</div></div><div><h3>Methods</h3><div>A six-month longitudinal case study was conducted on a 51-year-old male transtibial amputee transitioning from a passive prosthesis to the RAF Pro. Comprehensive gait analyses, including motion capture and force plate assessments, were performed at four intervals: initial fitting, three months, four and a half months, and six months. The participant received continuous, tailored rehabilitation training throughout the study.</div></div><div><h3>Results</h3><div>Over the adaptation period, notable improvements were observed in plantarflexion during toe-off and in the coordination of hip and knee joint movements, contributing to enhanced gait symmetry. By the six-month mark, the subject achieved near-symmetrical gait mechanics with significantly reduced energy expenditure during walking, approaching the biomechanical efficiency observed in non-amputees.</div></div><div><h3>Conclusion</h3><div>This case study highlights the potential of long-term adaptive rehabilitation combined with advanced robotic prostheses to restore natural, energy-efficient gait mechanics in transtibial amputees. The findings emphasize the importance of a minimum six-month adaptation period for optimizing prosthetic function, offering valuable insights for personalized rehabilitation strategies and future prosthetic development.</div></div>","PeriodicalId":56030,"journal":{"name":"Annals of Physical and Rehabilitation Medicine","volume":"68 5","pages":"Article 101981"},"PeriodicalIF":3.9,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143842656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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