Annals of Physical and Rehabilitation Medicine最新文献

{"title":"Development and initial validation of a screening tool for visual ability/performance of people with polyhandicap","authors":"Marie-Christine Rousseau ,&nbsp;Georges Challe ,&nbsp;Soizic Charbonnier ,&nbsp;Marie-Thérèse Jacquier ,&nbsp;Maria Valkov ,&nbsp;Valérie Tourbier ,&nbsp;Sophie Lemaire ,&nbsp;Etienne Guilluy ,&nbsp;Nafissa Khaldi-Cherif ,&nbsp;Lionelle Nkam ,&nbsp;Karine Baumstarck ,&nbsp;Thierry Billette de Villemeur ,&nbsp;Philippe Aegerter","doi":"10.1016/j.rehab.2023.101773","DOIUrl":"https://doi.org/10.1016/j.rehab.2023.101773","url":null,"abstract":"<div><h3>Background</h3><p>Visual impairments<span> are common in people with polyhandicap although they are poorly assessed. However, evaluation of the visual abilities of these people is critical to determining treatment for impairments.</span></p></div><div><h3>Objectives</h3><p>To develop and validate an easy-to-use visual-behavioural scale for assessing the visual abilities of people with polyhandicap.</p></div><div><h3>Methods</h3><p><span>The development of the Visual Assessment for People with Polyhandicap (VA-PLH) involved 2 steps: i) construction of the scale and ii) field validation. Participant selection criteria were aged &gt; 3 years, age at onset of cerebral lesion &lt; 3 years, a combination of motor impairment and profound intellectual impairment associated with restricted mobility (Gross Motor Function Classification System levels [GMFCS] III, IV or V), and </span>everyday life<span> dependence (Functional Independency Measure [FIM] &lt;55). Vision assessment by both an orthoptist and an ophthalmologist was the reference against which were analysed the items of the scale completed by local health care workers. Acceptability, validity, and reliability were analysed.</span></p></div><div><h3>Results</h3><p>Amongst the 232 participants included, 217 had a complete assessment, and 33% were &lt; 18 years of age. Ocular abnormalities were reported in 83% of participants. Visual ability was altered or insufficient in 60% of participants. The final version of the VA-PLH included 3 items related to visual reaction (Area Under Curve Receiver Operating Characteristic = 0.83). Participants were considered at-risk if they had at ≥ 1 of 3 signs present (sensitivity 83% and specificity 73%). The scale's reliability was satisfactory</p></div><div><h3>Conclusion</h3><p>The VA-PLH scale provides an easy-to-use, reliable and valid measure of visual status for people with polyhandicap and may be used both in clinical practice and clinical research. In addition, this study provides an overview of the diversity of visual impairments in a large population of people with polyhandicap, showing that most experience visual challenges.</p></div>","PeriodicalId":56030,"journal":{"name":"Annals of Physical and Rehabilitation Medicine","volume":"67 1","pages":"Article 101773"},"PeriodicalIF":4.6,"publicationDate":"2023-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138839273","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":"Analgesic consumption in a large sample of people in musculoskeletal rehabilitation: A descriptive study","authors":"Michel Konzelmann ,&nbsp;Philippe Vuistiner ,&nbsp;Cyrille Burrus ,&nbsp;François Luthi ,&nbsp;Bertrand Léger","doi":"10.1016/j.rehab.2023.101776","DOIUrl":"10.1016/j.rehab.2023.101776","url":null,"abstract":"<div><h3>Background</h3><p>Consumption of opioids is increasing worldwide in people with chronic non-cancer pain, although their effectiveness is debated.</p></div><div><h3>Objectives</h3><p>The aim of the current study was to evaluate analgesic consumption and its association with different variables (demographic variables, pain, anxiety/depression, catastrophism, and kinesiophobia), in the field of musculoskeletal rehabilitation, where no data are available.</p></div><div><h3>Methods</h3><p>This was a retrospective study over a period of 8 years on people hospitalised for rehabilitation after injury. Participants were classified into 3 categories: no analgesics (NA), non-opioid analgesics (NOA), and opioid analgesics (OPA). ANOVA or chi-squared tests were used to compare the 3 groups.</p></div><div><h3>Results</h3><p>A total of 4,350 people (84% men; mean [SD] age, 44 [11] years) were included. In total, 20% were taking OPA, 40% NOA and 40% NA. In the OPA group, tramadol was mainly used, and the morphine equivalent median dose was 8.3 mg/day. In the NOA group, paracetamol and ibuprofen were mostly used. Symptoms increased progressively across the 3 groups (NA/NOA/OPA), with increased levels of pain severity/interference, anxiety/depression and catastrophizing, and a higher prevalence of neuropathic pain in the OPA group versus the others.</p></div><div><h3>Conclusions</h3><p>These results are consistent with those found in groups of people with chronic pain taking larger doses of opioids and following opioid reduction or cessation programs. Opioid prescription did not increase over the 8 years, which was reassuring. These factors are important to emphasise because they can be modified in the rehabilitation setting with interdisciplinary management.</p></div><div><h3>Registration</h3><p>Our database was registered on Mendeley Data.</p></div>","PeriodicalId":56030,"journal":{"name":"Annals of Physical and Rehabilitation Medicine","volume":"67 1","pages":"Article 101776"},"PeriodicalIF":4.6,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1877065723000477/pdfft?md5=4972417e79c4bedc11a8d98fc03e6277&pid=1-s2.0-S1877065723000477-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138833204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of different exercise programs on lung function in people with chronic obstructive pulmonary disease: A network meta-analysis of RCTs","authors":"Susana Priego-Jiménez ,&nbsp;Iván Cavero-Redondo ,&nbsp;Carlos Pascual-Morena ,&nbsp;Irene Martínez-García ,&nbsp;Vicente Martínez-Vizcaíno ,&nbsp;Celia Álvarez-Bueno","doi":"10.1016/j.rehab.2023.101792","DOIUrl":"10.1016/j.rehab.2023.101792","url":null,"abstract":"<div><h3>Background</h3><p>Chronic obstructive pulmonary disease (COPD) has systemic consequences and causes structural abnormalities throughout the respiratory system. It is associated with a high clinical burden worldwide.</p></div><div><h3>Aim</h3><p><span>A network meta-analysis was performed to determine the effects of exercise programs on lung function measured by forced expiratory volume in the first second (FEV1), FEV1 as a percentage of the predicted value (FEV1%) and </span>forced vital capacity in people with COPD.</p></div><div><h3>Methods</h3><p>A literature search was performed to March 2023. Randomized controlled trials on the effectiveness of exercise programs on lung function in people with COPD were included. A standard pairwise meta-analysis and a network meta-analysis for direct and indirect comparisons between intervention and control/nonintervention groups were carried out to calculate the standardized mean difference and 95 % CI. The risk of bias was assessed using the Cochrane Risk of Bias tool and the Grading of Recommendations, Assessment, Development, and Evaluation tool was used to assess the quality of the evidence.</p></div><div><h3>Results</h3><p>35 studies with a total sample of 2909 participants were included in this network meta-analysis. The highest standardized mean difference was for active mind body movement therapy programs versus control for FEV1 and FEV1% (0.71; 95 % CI 0.32 to1.09; and 0.36; 95 % CI 0.15 to 0.58, respectively), and pulmonary rehabilitation+active mind body movements therapies versus control for forced vital capacity (0.45; 95 % CI 0.07 to 0.84).</p></div><div><h3>Conclusions</h3><p>active mind body movement therapy programs were the most effective type of exercise program to improve lung function measured by FEV1 and FEV1%; pulmonary rehabilitation+active mind body movements therapies had the greatest effects on FVC in people with COPD. Exercise programs in which the abdominal muscles are strengthened could improve lung emptying, helping to overcome airway resistance in people with COPD.</p></div>","PeriodicalId":56030,"journal":{"name":"Annals of Physical and Rehabilitation Medicine","volume":"67 2","pages":"Article 101792"},"PeriodicalIF":4.6,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138833221","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":"Effectiveness and cost-effectiveness of telerehabilitation for musculoskeletal disorders: A systematic review and meta-analysis","authors":"Pablo Molina-Garcia ,&nbsp;Marta Mora-Traverso ,&nbsp;Rafael Prieto-Moreno ,&nbsp;Andrea Díaz-Vásquez ,&nbsp;Benny Antony ,&nbsp;Patrocinio Ariza-Vega","doi":"10.1016/j.rehab.2023.101791","DOIUrl":"10.1016/j.rehab.2023.101791","url":null,"abstract":"<div><h3>Background</h3><p><span><span>Internet-based telerehabilitation could be a valuable option for the </span>treatment of </span>musculoskeletal disorders, with the advantage of providing rehabilitation from anywhere. However, there is no solid and updated evidence demonstrating its effectiveness on relevant clinical and cost outcomes.</p></div><div><h3>Objective</h3><p>This systematic review aims to determine the clinical and cost-effectiveness of internet-based telerehabilitation during the recovery of musculoskeletal disorders.</p></div><div><h3>Methods</h3><p>Medline, Web of Science, Scopus and Cochrane databases were systematically searched from inception to June 2023. Trials investigating the effects of internet-based telerehabilitation in any musculoskeletal disorder were selected. Nonoriginal articles and grey literature were excluded. Two independent reviewers conducted the study selection and data extraction. Random effect meta-analyses (standardized mean difference) and further sensitivity analyses were performed.</p></div><div><h3>Results</h3><p>We selected 37 clinical trials<span> (33 randomized and 4 non-randomized) and 5 health economics studies, which included a total of 4,288 participants. Telerehabilitation was more favourable than control treatments in improving all studied clinical outcomes, although the effectiveness varied depending on the type of musculoskeletal disorder. The standard mean differences (SMD) ranged from 0.24 to 0.91. For physical function, the primary outcome, superior effectiveness was found only in people with hip fractures<span> (SMD, 0.87; 95 % CI, 0.34 to 1.41). The effects for joint replacement, osteoarthritis, and spine pain were similar to those of control treatments. However, the favourable outcomes for telerehabilitation became insignificant when compared specifically to face-to-face rehabilitation. Some results displayed publication bias and a lack of robustness, necessitating cautious interpretation. In terms of health economics studies, telerehabilitation was 89.55$ (95 % CI 4.6 to 174.5) cheaper per individual than conventional treatments.</span></span></p></div><div><h3>Conclusions</h3><p>Telerehabilitation should be considered in the recovery process of musculoskeletal disorders when optimal face-to-face rehabilitation is not feasible. Moreover, telerehabilitation reduces costs and time.</p></div><div><h3>PROSPERO number</h3><p>CRD42022322425</p></div>","PeriodicalId":56030,"journal":{"name":"Annals of Physical and Rehabilitation Medicine","volume":"67 1","pages":"Article 101791"},"PeriodicalIF":4.6,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138833205","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":"Peripheral artery disease causes consistent gait irregularities regardless of the location of leg claudication pain","authors":"Hafizur Rahman ,&nbsp;Todd Leutzinger ,&nbsp;Mahdi Hassan ,&nbsp;Molly Schieber ,&nbsp;Panagiotis Koutakis ,&nbsp;Matthew A. Fuglestad ,&nbsp;Holly DeSpiegelaere ,&nbsp;G. Matthew Longo ,&nbsp;Philippe Malcolm ,&nbsp;Jason M. Johanning ,&nbsp;George P. Casale ,&nbsp;Iraklis I. Pipinos ,&nbsp;Sara A. Myers","doi":"10.1016/j.rehab.2023.101793","DOIUrl":"10.1016/j.rehab.2023.101793","url":null,"abstract":"<div><h3>Background</h3><p>The most common symptom of peripheral artery disease (PAD) is intermittent claudication that involves the calf, thigh, and/or buttock muscles. How the specific location of this leg pain is related to altered gait, however, is unknown.</p></div><div><h3>Objectives</h3><p>We hypothesized that because the location of claudication symptoms uniquely affects different leg muscle groups in people with PAD, this would produce distinctive walking patterns.</p></div><div><h3>Methods</h3><p>A total of 105 participants with PAD and 35 age-matched older volunteers without PAD (CTRL) were recruited. Participants completed walking impairment questionnaires (WIQ), Gardner-Skinner progressive treadmill tests, the six-minute walk test, and we performed an advanced evaluation of the biomechanics of their overground walking. Participants with PAD were categorized into 4 groups according to their stated pain location(s): calf only (C, <em>n</em> = 43); thigh and calf (TC, <em>n</em> = 18); buttock and calf (BC, <em>n</em> = 15); or buttock, thigh, and calf (BTC, <em>n</em> = 29). Outcomes were compared between CTRL, C, TC, BC and BTC groups using a one-way ANOVA with post-hoc comparisons to identify and assess statistically significant differences.</p></div><div><h3>Results</h3><p>There were no significant differences between CTRL, C, TC, BC and BTC groups in distances walked or walking speed when either pain-free or experiencing claudication pain. Each participant with PAD had significantly dysfunctional biomechanical gait parameters, even when pain-free, when compared to CTRL (pain-free) walking data. During pain-free walking, out of the 18 gait parameters evaluated, we only identified significant differences in hip power generation during push-off (in C and TC groups) and in knee power absorption during weight acceptance (in TC and BC groups). There were no between-group differences in gait parameters while people with PAD were walking with claudication pain.</p></div><div><h3>Conclusions</h3><p>Our data demonstrate that PAD affects the ischemic lower extremities in a diffuse manner irrespective of the location of claudication symptoms.</p></div><div><h3>Database Registration</h3><p><span>ClinicalTrials.gov</span><svg><path></path></svg> NCT01970332.</p></div>","PeriodicalId":56030,"journal":{"name":"Annals of Physical and Rehabilitation Medicine","volume":"67 3","pages":"Article 101793"},"PeriodicalIF":4.6,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1877065723000647/pdfft?md5=58957c5f80d2f37ef61c99f0cddc6d4a&pid=1-s2.0-S1877065723000647-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138821722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beneficial carry-over effects of chronic at-home genital nerve stimulation on incontinence in individuals with spinal cord injury: A pragmatic trial","authors":"Shauh-Der Yeh ,&nbsp;Nurida Khasanah ,&nbsp;Kenneth J. Gustafson ,&nbsp;Chi Sun ,&nbsp;Mei-Lin Tsai ,&nbsp;Bor-Shing Lin ,&nbsp;Chun-Wei Wu ,&nbsp;Chih-Wei Peng","doi":"10.1016/j.rehab.2023.101799","DOIUrl":"10.1016/j.rehab.2023.101799","url":null,"abstract":"<div><h3>Background</h3><p>Genital nerve stimulation (GNS) is a promising, but under-researched, alternative treatment for neurogenic detrusor overactivity (NDO) in those with spinal cord injury (SCI).</p></div><div><h3>Objectives</h3><p>To investigate the urodynamic, quality-of-life (QOL) and carry-over effects of GNS when applied at home for 2 weeks by participants with incomplete SCI and NDO during activities of daily living.</p></div><div><h3>Methods</h3><p>Seven men and 1 woman participated in this 1-month protocol study. Urodynamic and QOL data were gathered during week 1 (baseline measurements), followed by 2 weeks of daily GNS at home using a portable device. GNS was applied either on-demand or thrice daily, depending on the individual's sensation. At week 4, post-stimulation tests were repeated to record any carry-over effect from the GNS. Participants maintained voiding diaries throughout the study. Assessments were carried out at the end of each protocol period in a randomized order. Clinical procedures were conducted at Taipei Medical University Hospital (Taipei, Taiwan).</p></div><div><h3>Results</h3><p>Everyone completed the study but only 7 of the 8 participants completed their voiding diary. Two weeks after GNS, average cystometric bladder capacity was increased by 30 % compared to baseline (<em>P</em> <em>&lt;</em> 0.05). A 1-week carry-over effect was demonstrated as this capacity remained, on average, 35 % greater than baseline in week 4 after GNS was stopped (<em>P</em> <em>&lt;</em> 0.05). Incontinence frequency significantly decreased by the end of week 3 (<em>P</em> <em>&lt;</em> 0.05) but no significant improvements were recorded for either detrusor pressure or bladder compliance.</p></div><div><h3>Conclusions</h3><p>Chronic at-home GNS improved cystometric bladder capacity and reduced urinary incontinence for individuals with incomplete SCI and NDO. A carry-over effect of 1 week was observed following GNS treatment. The use of portable GNS treatment that can be applied by the individual at home merits further investigation as alternative treatment for NDO in those with SCI.</p></div>","PeriodicalId":56030,"journal":{"name":"Annals of Physical and Rehabilitation Medicine","volume":"67 2","pages":"Article 101799"},"PeriodicalIF":4.6,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138833220","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":"Modulation of brain signals during sensorimotor and imaging tasks in a person with an implanted upper-limb prosthesis following amputation of the left hand","authors":"Lorenzo Nucci,&nbsp;Francesca Miraglia,&nbsp;Chiara Pappalettera,&nbsp;Prof. Silvestro Micera,&nbsp;Prof. Paolo Maria Rossini,&nbsp;Prof. Fabrizio Vecchio","doi":"10.1016/j.rehab.2023.101802","DOIUrl":"10.1016/j.rehab.2023.101802","url":null,"abstract":"","PeriodicalId":56030,"journal":{"name":"Annals of Physical and Rehabilitation Medicine","volume":"67 3","pages":"Article 101802"},"PeriodicalIF":4.6,"publicationDate":"2023-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138742882","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":"Robotic gait training and botulinum toxin injection improve gait in the chronic post-stroke phase: A randomized controlled trial","authors":"Maëva Cotinat ,&nbsp;Mathilde Celerier ,&nbsp;Clelia Arquillière ,&nbsp;Margot Flipo ,&nbsp;Nicolas Prieur-Blanc ,&nbsp;Jean-Michel Viton ,&nbsp;Laurent Bensoussan","doi":"10.1016/j.rehab.2023.101785","DOIUrl":"10.1016/j.rehab.2023.101785","url":null,"abstract":"<div><h3>Background</h3><p>Improving walking ability is one of the main goals of rehabilitation after stroke. When lower limb spasticity increases walking difficulty, botulinum toxin type A (BTx-A) injections can be combined with non-pharmacologic interventions such as intensive rehabilitation using a robotic approach. To the best of our knowledge, no comparisons have been made between the efficacy of robotic gait training and conventional physical therapy in combination with BTx-A injections.</p></div><div><h3>Objective</h3><p>To conduct a randomized controlled trial to compare the efficacy on gait of robotic gait training versus conventional physiotherapy after BTx-A injection into the spastic triceps surae in people after stroke.</p></div><div><h3>Method</h3><p>Thirty-three participants in the chronic stroke phase with triceps surae spasticity inducing gait impairment were included. After BTx-A injection, participants were randomized into 2 groups. Group A underwent robotic gait training (Lokomat®) for 2 weeks, followed by conventional physiotherapy for 2 weeks (<em>n</em> = 15) and Group B underwent the same treatment in reverse order (<em>n</em> = 18). The efficacy of these methods was tested using the 6-minute walk test (6MWT), comparing post-test 1 and post-test 2 with the pre-test.</p></div><div><h3>Results</h3><p>After the first period, the 6MWT increased significantly more in Group A than in Group B: the mean difference between the interventions was 33 m (95%CI 9; 58 <em>p</em> = 0.007; <em>g</em> = 0.95), in favor of Group A; after the second period, the 6MWT increased in both groups, but the 30 m difference between the groups still remained (95%CI 5; 55 <em>p</em> = 0.019; <em>g</em> = 0.73).</p></div><div><h3>Conclusion</h3><p>Two weeks of robotic gait training performed 2 weeks after BTx-A injections improved walking performance more than conventional physiotherapy. Large-scale studies are now required on the timing of robotic rehabilitation after BTx-A injection.</p></div>","PeriodicalId":56030,"journal":{"name":"Annals of Physical and Rehabilitation Medicine","volume":"67 1","pages":"Article 101785"},"PeriodicalIF":4.6,"publicationDate":"2023-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138833207","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":"Barefoot walking is beneficial for individuals with persistent plantar heel pain: A single-blind randomized controlled trial","authors":"Miriam Reinstein ,&nbsp;Asaf Weisman ,&nbsp;Youssef Masharawi","doi":"10.1016/j.rehab.2023.101786","DOIUrl":"10.1016/j.rehab.2023.101786","url":null,"abstract":"<div><h3>Background</h3><p>A lack of data exist about the effectiveness of active treatments for persistent plantar heel pain (PPHP).</p></div><div><h3>Objectives</h3><p>To compare short-term functional and clinical effects of a 4-week barefoot or shod treadmill walking program for people with PPHP.</p></div><div><h3>Methods</h3><p>A single-blinded clinical trial randomized 52 participants with PPHP into either a barefoot walking group (BWG), or a shod walking group (SWG). All participants received therapeutic ultrasound. Outcomes were measured at baseline (t₀), following 4 weeks of treatment (t₁), and at 1-month follow-up (t₂). The SF-36 functional questionnaire score was the main outcome. Secondary outcomes were self-reported and clinically-assessed pain provocation levels, pressure pain thresholds and pain tolerance. Treadmill walking time and speed were measured at t₀ and t₁; people also recorded the time spent walking each day in a diary.</p></div><div><h3>Results</h3><p>The BWG exhibited significant improvements in all SF-36 items (except “emotional well-being”) (<em>P</em> &lt; 0.05), whereas the SWG exhibited improvements only in “pain” and “health change” items (<em>P</em> = 0.0001; effect size 0.13–0.94). Greater improvements were observed in the BWG than the SWG for “physical function” (<em>P</em> = 0.019) and “role limitations due to physical health” items (<em>P</em> = 0.035). Both groups demonstrated significant improvements in pain, with greater improvements in the BWG (<em>P</em> = 0.0001; effect size 0.89). Only the BWG showed significant improvements in pain pressure thresholds (<em>P</em> &lt; 0.05; effect size 0.70) and pain tolerance (<em>P</em> &lt; 0.001; effect size 0.67). Both groups significantly increased their speed and time spent walking on the treadmill (BWG Δ=19.7 min and Δ=1.7 km/h; SWG Δ=16.7 min and Δ=1.1 km/h) and time outdoors (SWG ∆=38.2 min/week; BWG mean ∆=48.5 min/week) (<em>P</em> &lt; 0.001). All clinical tests of pain were significantly less positive in the BWG at all time points (<em>P</em> &lt; 0.05).</p></div><div><h3>Conclusions</h3><p>Both walking programs benefited people with PPHP by alleviating pain and improving function and quality of life. Greater improvements were observed in the BWG than the SWG overall.</p></div>","PeriodicalId":56030,"journal":{"name":"Annals of Physical and Rehabilitation Medicine","volume":"67 2","pages":"Article 101786"},"PeriodicalIF":4.6,"publicationDate":"2023-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138833209","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":"Resistive versus active assisted robotic training for the upper limb after a stroke: A randomized controlled study","authors":"Sun Young Jeon ,&nbsp;Myung Ki ,&nbsp;Joon-Ho Shin","doi":"10.1016/j.rehab.2023.101789","DOIUrl":"10.1016/j.rehab.2023.101789","url":null,"abstract":"<div><h3>Background</h3><p>Selection of a suitable training modality according to the status of upper limb function can maximize the effects of robotic rehabilitation; therefore, it is necessary to identify the optimal training modality.</p></div><div><h3>Objectives</h3><p>This study aimed to compare robotic rehabilitation approaches incorporating either resistance training (RET) or active-assisted training (AAT) using the same rehabilitation robot in people with stroke and moderate impairment.</p></div><div><h3>Methods</h3><p>In this randomized controlled trial, we randomly allocated 34 people with stroke who had moderate impairment to either the experimental group (RET, <em>n</em> = 18) or the control group (AAT, <em>n</em> = 16). Both groups performed robot-assisted therapy for 30 min, 5 days per week, for 4 weeks. The same rehabilitation robot provided resistance to the RET group and assistance to the AAT group. Body function and structure, activity, and participation outcomes were evaluated before, during, and after the intervention.</p></div><div><h3>Results</h3><p>RET led to greater improvements than AAT in terms of smoothness (<em>p</em> = 0.006). The Fugl-Meyer Assessment (FMA)-upper extremity (<em>p</em> &lt; 0.001), FMA-proximal (<em>p</em> &lt; 0.001), Action Research Arm Test-gross movement (<em>p</em> = 0.011), and kinematic variables of joint independence (<em>p</em> = 0.017) and displacement (<em>p</em> = 0.011) also improved at the end of intervention more in the RET group.</p></div><div><h3>Conclusions</h3><p>Robotic RET was more effective than AAT in improving upper limb function, structure, and activity among participants with stroke who had moderate impairment.</p></div>","PeriodicalId":56030,"journal":{"name":"Annals of Physical and Rehabilitation Medicine","volume":"67 1","pages":"Article 101789"},"PeriodicalIF":4.6,"publicationDate":"2023-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S187706572300060X/pdfft?md5=29be79662a3f64248b524bb8af552600&pid=1-s2.0-S187706572300060X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138833206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}