Frontiers in rehabilitation sciences最新文献

Social work is a long-established profession in health care and rehabilitation. Reviewing the evidence on effects of social work interventions shows inconsistencies, with several studies indicating positive, negative, or no significant effect at all. Against this background, the purpose of this paper is to provide an international overview of the research on social work practice in rehabilitation. Two research questions about the activities performed by social workers in rehabilitation settings and the reported outcomes to evaluate social work interventions were guiding the analysis. A scoping review was conducted in order to identify these activities and reported outcomes. The literature search was carried out in two databases (PubMed, SocINDEX). Additionally, the authors searched manually for literature in rehabilitation science and social work journals. Inclusion criteria encompassed the involvement of social workers and a description of their activities. The context in which social work's practice had to take place was a rehabilitation setting. A total of 2,681 records could be identified by searching the databases, journals, proceedings and reference lists. 66 sources met the predefined inclusion criteria. A majority of the identified activities that social workers perform are case related. Topics that may occur in these case encounters are the social environment of the patient, financial/social security, work-related issues and others. Of particular note are activities such as assessment, counseling and education. When applying the ICF framework, the outcomes are distributed across almost all components with an emphasis on Participation. This review demonstrates that social work has a vital role in the interprofessional rehabilitation team on an international level. However, there is still a need for more research about the effectiveness of social work interventions. We identified internationally common social work core activities/issues and derived a proposal for specific outcomes for future evaluation research.

Introduction: Adverse childhood experiences (ACEs) are prevalent globally and can negatively impact an individual's lifespan by not only increasing the likelihood of encountering other negative life events (NLEs), but also escalating the risk of illness, absenteeism due to sickness, unemployment, and reliance on disability benefits in adulthood. Therefore, the objective of this study was to explore the prevalence of ACEs and NLEs, as well as their health impacts among patients undergoing occupational rehabilitation.

Materials and methods: A total of 80 participants diagnosed with musculoskeletal disorders and/or common mental disorders who participated in two occupational rehabilitation programs in Norway were included. Data were collected by questionnaire and in-depth interviews (39 participants) at the start of the intervention. Comparative quantitative and qualitative analysis was conducted between individuals with a history of ACEs and those without these experiences. Thematic analysis was used to identify the impact of ACEs and NLEs on the health of the informants.

Results: Half of the participants reported ACEs. Of these, 18% reported one ACE, 22% reported 2-3 ACEs and 9% reported 4 or more ACEs. Also, 25% were categorized as revictimized. The two groups with ACEs had more NLEs in adulthood compared to those without ACEs (p < 0.001), revictimized the most (mean numbers between groups 3.1, 4.5 and 5.9). Furthermore, a history of ACEs was associated with a higher number of reported mental health issues compared to those who had not experienced ACEs (p < 0.01). However, there were no significant differences between the two ACE groups. NLEs had a substantial impact on the participants' current health status, whether they occurred in childhood or adulthood. In adult life, a high workload (psychologically or physically), interpersonal challenges, and financial struggles had an especially negative impact. Additionally, accidents and complications related to surgeries were also significant NLEs causing health problems. For most, there were complex interactions between NLEs and health.

Conclusions: The prevalence of ACEs and NLEs is high among occupational rehabilitation patients. ACEs are associated with subsequent victimization, interpersonal challenges, financial struggles, and increased mental health issues in adulthood. These findings highlight the need for systematic screening and a holistic, individualized approach in occupational rehabilitation programs to potentially mitigate the adverse effects of NLEs on health and work participation.

Objective: Carpal tunnel syndrome (CTS) is a common neuromuscular disorder with an incidence rate of 4.9%. Research on the impact of Kinesio taping (KT) on electroneurography in individuals with CTS is limited, highlighting a significant gap in the literature. This study aimed to evaluate the effects of KT on palm numbness, pain intensity, hand grip strength, and median nerve electroneuromyography in individuals with mild to moderate CTS.

Method: This was a randomized, controlled, parallel design study. Twenty-seven participants diagnosed with CTS through hospital outpatient clinics were randomly assigned to either the control or KT group. The outcome measurements included hand grip strength, the Boston Carpal Tunnel Questionnaire (BCTQ), and electroneurography, assessed at baseline and after 6 weeks of intervention. The statistical method used was non-parametric analysis, comparing differences with the median and interquartile range (IQR).

Results: Both the KT and control groups significantly improved the numbness grades, hand grip strength, and the BCTQ. The kinesio-taping group demonstrated an improvement in grip strength with a median increase of 2.21 kg (IQR: 0.65-3.79 kg), compared to the control group, which showed a median increase of only 0.70 kg (IQR: 0.22-1.45 kg). Statistical analysis revealed a significant difference between the two groups (p = 0.039), with an effect size of r = 0.33.

Conclusion: This study suggested that KT can be a supplementary treatment to relieve pain intensity, enhance hand grip strength, and improve sensory conduction velocity, motor latency, and motor amplitude.

Clinical trial registration: https://doi.org/10.1186/ISRCTN82192319, ISRCTNregistry (No. ISRCTN82192319).

Objective: To investigate whether the combination of acupuncture and mirror therapy can improve motor impairment in stroke patients.

Design: A systematic review and meta-analysis of randomised controlled trials.

Data sources: CNKI, Wanfang, PubMed, Embase, Vip, web of since, Cochrane database and CBM database.

Eligibility criteria for selecting studies: The included randomized controlled trials compared the efficacy of acupuncture therapy (AT) combined with mirror therapy (MT) against AT, MT, and conventional rehabilitation therapy on limb motor impairment in stroke patients, with independent data extraction and study quality assessment conducted. A META analysis using fixed-effect and random-effect models was performed to calculate the mean difference (MD) in motor scores and the Total effective rate RR (Risk ratio) between the AT combined with MT group and the control group.

Main outcome measures: The Fugl-Meyer Assessment (FMA) for motor function includes the FMA-T (total FMA), FMA-UE (upper extremity FMA), and FMA-L (lower extremity FMA).

Results: A total of 42 randomized controlled trials were included, involving 3,340 patients with post-stroke motor impairment. AT combined with MT was more favorable for FMA-UE (mean difference [MD] = 6.67, 95% CI [5.60-7.93], Z = 11.42, P < 0.0001), FMA-L [MD = 3.37, 95% CI (2.99-3.76), Z = 17.31, P < 0.001], and FMA-T [MD = 6.84, 95% CI (5.92-7.77), Z = 14.48, P < 0.001]. The combined AT and MT treatment was more favorable for the Modified Barthel Index (MBI) score in post-stroke motor impairment [MD = 10.82, 95% CI (8.52-13.12), Z = 9.22, P < 0.001]. AT combined with MT was more favorable for the Modified Ashworth Scale (MAS) [MD = -0.34, 95% CI (-0.66 to -0.03), Z = 14.48, P < 0.001]. AT combined with MT was more favorable for the Total effective rate in treating post-stroke motor impairment (relative risk = 1.27, 95% confidence interval [CI] [1.19-1.37], Z = 6.54, P < 0.001).

Conclusions: AT combined with MT can effectively improve patients' motor function and daily living abilities.

Systematic review registration: PROSPERO, identifier, CRD42024559992.

Background: Peripheral nerve injuries (PNIs) are associated with significant physical and psychological challenges, impacting both functional recovery and quality of life. Despite the physical focus of traditional treatments, psychological factors play a crucial role in the outcomes of PNI repair and recovery.

Objectives: This systematic review aims to evaluate the impact of psychological and social factors on the repair and recovery of peripheral nerve injuries.

Methods: A comprehensive literature search was conducted in PubMed/Medline, EMBASE, and Cochrane databases, covering studies from January 1985 to December 2022. A total of 36,190 records were identified, and after screening with Rayyan AI and applying inclusion criteria, 111 articles were selected for review.

Results: The review highlights that pre-existing psychological conditions, as well as psychological responses to the injury and treatment, significantly influence recovery outcomes in PNI patients. Psychological interventions, when integrated into standard care, may improve functional recovery and quality of life.

Conclusions: Psychosocial factors are critical in the management of PNIs and should be incorporated into treatment algorithms to enhance patient outcomes. Future research should focus on developing and integrating psychological support strategies in PNI treatment protocols.

[This corrects the article DOI: 10.3389/fresc.2024.1383995.].

Background: Burns are a global health issue causing significant mortality and high medical costs. Non-pharmacological interventions such as music therapy and virtual reality (VR) therapy have shown potential in alleviating pain and anxiety in burn patients. This study systematically evaluates the impact of these interventions using a network meta-analysis.

Methods: A systematic review and network meta-analysis were conducted according to PRISMA 2020 guidelines and registered in PROSPERO (CRD42024566536). Searches in PubMed, Cochrane Library, Web of Science, and Embase up to November 22, 2023, identified randomized controlled trials (RCTs) involving music therapy or VR therapy in burn patients. The Cochrane Risk of Bias Tool (2.0) assessed study quality. Data were analyzed using StataMP-64 software.

Results: Seventeen RCTs with 1,119 burn patients were included. Both music therapy and VR therapy significantly reduced pain and anxiety compared to control groups. Music therapy was more effective for pain reduction (SUCRA: 85.4%), while VR therapy was superior for anxiety relief (SUCRA: 79.5%).

Conclusion: Music therapy and VR therapy effectively reduce pain and anxiety in burn patients. Integrating these interventions into burn care can enhance patient outcomes. Further research is needed to confirm these findings and optimize individualized treatment plans.

Systematic review registration: https://www.crd.york.ac.uk/prospero/, PROSPERO (CRD42024566536).

Introduction: In the early postoperative period after total knee arthroplasty (TKA), joint range of motion (ROM) limitation and increased stiffness due to pain are commonly observed. Previous studies have reported that a single bout of foam rolling (FR) can acutely increase ROM and pain threshold on the contralateral (non-intervention) side in healthy participants. In this study, we aimed to expand this knowledge for TKA rehabilitation and investigated the acute effects of FR intervention on the non-operative side on ROM, stiffness, and pain of the operative side in postoperative patients within the first week after TKA.

Materials and methods: The study employed a randomized crossover design: 20 patients (mean age 75.0 ± 7.8 years) in the first postoperative week after TKA were divided alternately into Roll_Break and Break_Roll groups in the order of prescription. In the Roll_Break group, after the initial evaluation, a 180-s (60-s × three sets) FR intervention using a roller massager by a physiotherapist for the knee extensors was performed on the contralateral side (non-operative side), followed by the measurement. Afterwards, after 180-s of supine at rest, the measurement was performed again (i.e., control phase). In the Break_Roll group, after the initial evaluation, each patient was placed in a seated resting position for 180-s, and then another measurement was performed (i.e., control phase). After this, the FR intervention was performed for 180-s, and then the measurement was performed again. The intensity of the FR intervention was set to the maximum intensity that did not cause pain. We measured pain using the visual analogue scale at rest and during the knee joint ROM measurements, knee joint active movement ROM, knee joint passive ROM, and stiffness during the knee joint active movement.

Results: All outcome variables showed significant improvements after the FR intervention (intervention phase) when compared pre- to post-intervention, and significantly favourable effects were found compared to the control condition.

Conclusion: The results showed significant improvements in ROM, pain, and stiffness of the operative side after the FR intervention on the non-operative side. For future therapy approaches for TKA patients, FR treatment of the non-operative side should be employed in the first weeks after surgery.

Introduction: Physiotherapy services have been typically provided in-person since the profession usually involves a therapist providing hands-on assessment and treatments. The COVID-19 pandemic provided an opportunity to study physiotherapists' adaptation to telerehabilitation (phone or videoconference).

Objective: This study aimed: (1) to explore how physiotherapists adapted to the transition to delivering telerehabilitation, (2) to assess physiotherapists' perceptions of implementing telerehabilitation, and (3) to identify the challenges and facilitators of delivering telerehabilitation.

Methods: This study used an online survey distributed to physiotherapists within a large Canadian health authority. Closed-ended questions were analyzed with descriptive statistics.

Results: Seventy-five physiotherapists responded and data were collected. Compared prior to the pandemic to time during the pandemic, the use of a phone for delivering physiotherapy increased from 24.0% to 73.3% of physiotherapists while videoconference increased from 5.3% to 77.3%. Overall, the physiotherapists found videoconference to be a more effective delivery method than phone. Less than half felt that they could use videoconference to effectively treat pain (49.3%), upper extremity function (40.0%) or strength/range of motion (48.0%). Only 29.3% felt that they could effectively treat walking balance or mobility by videoconference. Technical barriers were identified with client comfort with the equipment reported by 90.7% of physiotherapists and positioning of the webcam by 76.0% of physiotherapists. A large proportion of physiotherapists agreed that they would continue the practice of telerehabilitation via phone (54.7%) and videoconference (68.0%).

Conclusion: The pandemic resulted in a dramatic shift to telerehabilitation for a profession that typically provides hands-on assessments and treatments. While there was increased uptake of telerehabilitation, many physiotherapists questioned their effectiveness using telerehabilitation to undertake activities that traditionally involve manual treatments or hands-on guidance/supervision. However, physiotherapists were committed to continuing telerehabilitation to meet patients' needs after the pandemic.