Frontiers in rehabilitation sciences最新文献

This paper presents GARD, an upper limb end-effector rehabilitation device developed for stroke patients. GARD offers assistance force along or towards a 2D trajectory during physical therapy sessions. GARD employs a non-backdrivable mechanism with novel motor velocity-control-based algorithms, which offers superior control precision and stability. To our knowledge, this innovative technical route has not been previously explored in rehabilitation robotics. In alignment with the new design, GARD features two novel control algorithms: Implicit Euler Velocity Control (IEVC) algorithm and a generalized impedance control algorithm. These algorithms achieve $O\left(n\right)$ runtime complexity for any arbitrary trajectory. The system has demonstrated a mean absolute error of 0.023 mm in trajectory-following tasks and 0.14 mm in trajectory-restricted free moving tasks. The proposed upper limb rehabilitation device offers all the functionalities of existing commercial devices with superior performance. Additionally, GARD provides unique functionalities such as area-restricted free moving and dynamic Motion Restriction Map interaction. This device holds strong potential for widespread clinical use, potentially improving rehabilitation outcomes for stroke patients.

The International Classification of Functioning, Disability, and Health (ICF) is a widely used framework in rehabilitation that provides standardized measures to describe health and health-related states of people. The strength of the ICF lies in its provision of a common language for describing rehabilitation progress. However, personal factors are not classified within the ICF due to their significant variability across cultures, which may render it not adequately capturing the subjective and social dimensions of disability. Our objective in this research was to propose theoretical frameworks that could help identify relevant personal factors for inclusion in the ICF. We discuss the Personality Systems Interaction (PSI) Theory to identify personal variability in goal pursuit, highlighting the importance of emotions like negative and positive affect in handling adverse situations and managing habitual behaviors. Additionally, the theory helps to determine personality factors relevant to patients, facilitating the resolution of potential issues that may emerge during the goal achievement process. We also emphasize the role of goal setting in rehabilitation and suggest the Goal-Oriented Action Linking (GOAL) model as a useful tool for understanding how motivational values change over time, distance, and progress. Following from this, we discuss the importance of self-efficacy and its relationship to effort and goal achievement, while noting potential issues in its assessment. Finally, we propose viable assessment methods for measuring the potential components to be incorporated as personal factors.

Purpose: The Canadian province of Québec faces several issues regarding the accessibility and quality of diagnostic assessment and the efficiency and continuity of evaluation, support, and intervention services for children with neurodevelopmental conditions (NDCs). To address these issues, the Ministry of Health and Social Services mandated a research team to initiate the development of a reference trajectory, i.e., a proposed model pathway based on national and international best practices and research, for the diagnostic assessment of NDCs in children aged 0-7 years.

Methods: The present study focused on the development of a logic model to operationalize the diagnostic services trajectory using a community-based participatory research approach and informed by implementation science. This involved representatives from multiple stakeholder groups (e.g., parents, professionals, physicians, administrators, researchers). Project steps included an analysis of best practices from a literature review on diagnostic trajectories, focus groups and interviews with stakeholders, and a validation process to ensure the appropriateness of the final model.

Results: The integration of existing research and stakeholder input resulted in a logic model for a new diagnostic services trajectory for children aged 0-7 years suspected of NDCs and identified key ingredients that should be present in its future implementation.

Conclusion: The proposed model for a diagnostic services trajectory is expected to address several systemic issues identified previously. Its implementation will need to be evaluated to ensure its sustained focus on the needs of families and its ability to promote their quality of life, well-being, and involvement.

Purpose: Participation in everyday life activities is important for the development of children and is an important topic in rehabilitation practices. This qualitative study aimed to unveil the perspectives and experiences of teenagers with vision impairments (VIs) or motor impairments (MIs) regarding their participation in leisure activities.

Materials and methods: 13 teenagers with VIs and 12 teenagers with MIs (age range: 11-15 years) participated in this study. Data were collected using semi-structured interviews. Verbatim transcripts were analyzed following the steps of the phenomenological approach.

Results: A total of 623 significant statements were identified and assigned to 221 meaning units. Finally, 13 themes emerged. Teenagers with VIs and MIs shared many experiences and perspectives regarding participation in leisure activities.

Conclusions: Teenagers reported that they can sufficiently indicate what they experience as pleasant and sufficient considering their participation, as well as the challenges they encountered, such as their impairment, limited transport possibilities, or concerns from parents. Overall, teenagers with VIs or MIs were generally satisfied with the degree and frequency of their participation in leisure activities and felt sufficiently involved.

Introduction: Air pollution poses significant risks to cardiovascular health, yet patients often lack comprehensive knowledge about its impact and mitigation strategies. This study aims to evaluate the effectiveness of an educational intervention within a cardiac rehabilitation (CR) context in enhancing patients' understanding of air pollution and its cardiovascular effects.

Methods: A pre-post pilot study was conducted from February 2021 to June 2021 at the Gregorio Marañón University General Hospital, Madrid, Spain. A total of 43 patients with cardiovascular disease attending CR were enrolled. Participants received a 1-h educational intervention delivered either in-person or online, focusing on the effects of air pollution and strategies to reduce exposure. Pre- and post-intervention questionnaires assessed participants' knowledge and perceptions. Descriptive statistics were used to analyze changes in awareness and understanding.

Results: Initially, participants demonstrated a high level of awareness about the health impacts of air pollution, with 100% acknowledging its effects on health. However, detailed knowledge about specific concepts such as the Air Quality Index (AQI) and particulate matter (PM2.5) was limited. Post-intervention, there was a significant increase in knowledge, with familiarity with AQI rising from 61% to 81% (p = 0.02) and understanding of PM2.5 improving from 28% to 58% (p = 0.01). This indicates that the educational intervention effectively bridged gaps in understanding and reinforced the importance of environmental factors in cardiovascular health management.

Discussion: The pilot study highlights the critical role of targeted education in improving patient awareness and knowledge about air pollution. The significant improvement in understanding key concepts underscores the need for broader educational initiatives that extend beyond CR programs. Future research should explore the impact of such interventions on long-term health outcomes and consider expanding educational efforts to include healthcare providers and family members.

Background: This review investigates the dynamics of trust between caregivers and care receivers in long-term care settings, where the implementation of assistive technology also becomes chronically crucial. Trust is essential in the care receiver-caregiver relationship as it impacts the effectiveness of care and the care receiver's participation in treatment. Moreover, integrating assistive technology significantly affects the quality of care by increasing care receivers' autonomy and reducing caregivers' workload. Despite its significance, the mechanisms of trust involving assistive technology in long-term care have not been clarified.

Methods: To address this gap, this review systematically analyzed 32 articles published in English since 2,000, sourced from Web of Science, PubMed, Scopus, and Science Direct databases.

Results: The review identified the dynamics of trust in long-term care settings involving assistive technology. Based on this trust dynamics, three critical factors were analyzed: care receiver-related, caregiver-related, and assistive technology-related.

Discussion: The findings provide a detailed understanding of the factors affecting trust in long-term care settings involving assistive technology. These insights contribute to long-term care facility operators making informed decisions regarding technology adoption in care practice and care service strategies, ultimately enhancing trust and the quality of care in long-term care settings.

Introduction: We investigated the fatigue experienced in children and adolescents with acquired brain injury (ABI) undergoing neurorehabilitation.

Methods: Fatigue was assessed using the pediatric quality of life inventory™ (PedsQL™). Multidimensional Fatigue Scale in 38 participants aged 2-19 years with ABI. Data were collected at enrollment and discharge, either from the participants themselves or their parents. The causes of ABI, including stroke, infection, tumor, and traumatic brain injury), were compared.

Results: Participant-reported fatigue levels significantly decreased over time (p = 0.005), whereas parent-reported fatigue levels did not show a significant change. Fatigue levels varied by ABI cause, with stroke-associated fatigue having the least impact and infection-related fatigue showing the greatest impact.

Conclusion: This study highlights the importance of individualized assessments that consider varying etiological factors and advocates for tailored interventions. Further research is needed to fully understand the long-term impacts of fatigue in this population.

Introduction: The purpose of this study was to understand how two respiratory strengthening protocols, therapeutic singing (TS) and expiratory muscle strength training (EMST), compare on measures of quality of life (QOL), depression and anxiety for persons with Parkinson's disease. An equally important aim was to understand participants' perceptions of both treatments.

Methods: Quantitative and qualitative datasets were integrated in a convergent mixed methods design within a randomized crossover intervention trial. Thirteen persons with mild-moderate PD (Hoehn and Yahr stage 1-3) completed both interventions, in random order, for 4 weeks, 5 days per week, for approximately 20 min per day. Participants completed self-report questionnaires (Geriatric Depression Scale, Parkinson's Anxiety Scale, Parkinson's Disease Questionnaire-39, and a Survey after Treatment) after each intervention, and twelve participants' qualitative data were analyzed.

Results: Quantitative data did not reveal significant differences between the interventions in depression on the Geriatric Depression Scale or anxiety on the Parkinson's Anxiety Scale and the qualitative data support those findings. There were no significant differences between interventions in QOL as measured by the Parkinson's Disease Questionnaire-39, but there was a main effect of time, with a significant decline (p = 0.01) in perceived QOL between baseline and the final visit. The quantitative data diverged from the qualitative data as there were no themes that emerged to corroborate a decrease in QOL. Five qualitative themes were derived from thematic analysis: Benefits, Accessibility, Acceptability, Advice/Feedback, and Preference. Participants' perceptions of the interventions were closely aligned to individual differences and preferences, with an equal split of participants preferring TS and EMST.

Conclusions: Findings from this mixed methods comparison of two respiratory interventions will help to improve the acceptability and accessibility of the interventions to better facilitate adherence to the interventions and promote continued engagement, thereby delaying respiratory decline in those with PD.

Introduction: In rehabilitation practices, expert therapists are believed to proficiently observe and assist patients. However, limited research has quantified the gaze behaviors of physical therapists during patient support. This study investigated the gaze patterns of expert and novice physical therapists from a first-person perspective during the process of assisting collaborators to stand. The aim was to determine which body parts received prolonged attention and to explore the characteristics of the support provided.

Methods: Seven experienced physical therapists were recruited as expert participants, and 17 physical therapy students served as novice participants. We also recruited additional students as collaborators and asked them to behave as if they were patients. Both expert and novice participants wore a wearable eye tracker while assisting the collaborators to stand. We analyzed the gaze focus on specific body parts and the center of mass sway of the collaborators.

Results: Experts spent 10.75% of the total time gazing at the head area, compared to 4.06% for novices, with experts displaying significantly longer gaze durations (p < .05). Furthermore, there was a significant difference in the number of gaze fixations, with experts averaging 25.71 fixations and novices 8.65 (p < .05). Experts also facilitated a slower sway in the collaborator's center of mass (0.44 m/s for experts vs. 0.49 m/s for novices; p < .01) and positioned the collaborator with a more pronounced trunk flexion during sitting and standing transitions (41.0 degrees for experts vs. 37.8 degrees for novices; p < .01).

Discussion: The findings suggest that experts may monitor the collaborator's center of mass position by focusing on the head area. Properly positioning the head forward may allow for optimal forward movement of the center of mass, potentially reducing the effort required by the collaborator to stand. This study is the first to explore differences in support strategies through the measurement of physical therapists' gaze during assistance.