Journal of rehabilitation medicine. Clinical communications最新文献

Objective: To test the feasibility, safety and effectiveness of the My Therapy programme for inpatients with mild-moderate cognitive impairment.

Design: Observational pilot study.

Patients: Rehabilitation inpatients with mild-moderate cognitive impairment.

Methods: During their inpatient admission, participants received My Therapy, a programme that can increase the dose of rehabilitation through independent self-practice of exercises, outside of supervised therapy. Outcomes included My Therapy participation, falls, Functional Independence Measure (FIM) and 10-m walk test. Outcomes were compared with those of participants without cognitive impairment from the original My Therapy study (n = 116) using χ ² and independent t-tests.

Results: Eight participants with mild-moderate cognitive impairment (mean (standard deviation (SD)) age 89.6 years (4.8); 3 women) were included. All participants completed the My Therapy programme on at least one day of their admission, with no associated falls. Participants had an 8.4 s (SD 5.1) reduction in their 10-m walk test and a 21.5 point (SD 11.1) improvement on FIM scores from admission to discharge. There were no significant between-group differences in feasibility, safety or effectiveness for participants with and without cognitive impairment.

Conclusion: This pilot study has shown that including exercise self-management as part of inpatient rehabilitation is feasible, safe and effective for patients with cognitive impairment.

Background: Osteochondroses are a set of conditions concerning the ossification of the developing bone. Higher intensity in sports activities can increase its occurrence in children. There is no consensus on its etiology, with multiple factors being involved. Van Neck-Odelberg disease is a rare osteochondrosis located in ischiopubic synchondrosis. Treatment is mainly conservative, with activity suspension. Addressing and correcting the predisposing factors is crucial to these injuries.

Case report: We present a case of a 6-year-old futsal player who experienced mechanical inguinal moderate pain during sports practice. After performing physical examination, laboratory tests, and radiographic evaluation, the patient was diagnosed with Van Neck-Odelberg disease. Sports activities were suspended while a conservative treatment was performed, with subsequent follow-up over 3.5 years. No symptom recurrence was reported.

Conclusion: Increased intensity of sports activities is associated with overuse injuries in children, especially before completing the ossification process. Preventive measures must remain the primary concern in children's sports practice.

Objective: To investigate the efficacy of electromechanically-assisted rehabilitation of upper limb function in post-stroke patients.

Design: Randomized controlled trial.

Subjects: Forty-eight stroke patients.

Methods: Patients were randomly assigned to control and experimental groups. The control group underwent occupational therapy training with conventional methods. The experimental group underwent electromechanically-assisted training using an end effector robot (Camillo®). Interventions were provided for 30 min per day, 5 days a week, for 4 weeks. Primary outcome was change in Fugl-Meyer Assessment (FMA) before and after training. Secondary outcomes were changes in hand function, upper limb strength, spasticity, mental status and quality of life.

Results: Mean improvement in FMA was 1.17 (standard deviation (SD) 4.18) in the control group and 2.52 (SD 5.48) in the experimental group. Although FMA in the experimental group improved significantly after training, the improvement in FMA did not differ significantly between groups. Among the secondary outcomes, the Motricity Index (MI) improved significantly after training in the experimental group, and the change in MI between groups was statistically significant.

Conclusion: Electromechanically-assisted rehabilitation using Camillo® was not more effective than conventional occupation therapy for upper arm function.

Objective: To evaluate the usability of 2 head-mounted displays in youths undergoing neurorehabilitation; a mixed reality head-mounted display and a virtual reality head-mounted display.

Design: Observational cross-sectional study.

Patients: Thirteen youths (age range 7.8-16.5 years) with neuromotor disorder.

Methods: Youths wore a mixed reality or a virtual reality head-mounted display while being verbally guided through a scene with virtual objects. Differences between the 2 systems, regarding usability, user experience, and acceptability, were evaluated using standardized questions for the youths and their therapists. System preferences and symptoms of cybersickness were noted.

Results: Both head-mounted displays were easy to mount and adjust to the children's heads, but the mixed reality system was unstable in 40% of the youths. Participants stated that they could move naturally with both devices. Object appearance scored higher with the virtual reality system, while therapists rated youths' movement execution and needed additional support in favour of the mixed reality system. Most youths preferred the virtual reality device, mainly due to the more distinct appearance of objects and the objects' richer colours. Therapists' preferences were balanced. Two children reported minimal signs of cybersickness.

Conclusion: Youths and therapists accepted both systems well, with advantages regarding usability, user experience, and preference for the virtual reality, and acceptability for the mixed reality head-mounted display.

Objective: To evaluate the acceptability of using a static wearable chair for patients requiring rehabilitation.

Methods: The acceptability of use of a static wearable chair during rehabilitation was assessed via static balance and subjective evaluation of 7 healthy subjects and 3 patients during standing training. Participants performed 1 standing task in free mode (in which the knee could bend freely) and 1 in support mode (in which the user could sit on the wearable chair with the knee slightly bent) for 3 min. For balance evaluation, the skeletal coordinates were measured. For subjective evaluation, a visual analogue scale questionnaire was administered before and after each task.

Results: Balance assessment revealed that patients had less head sway during support, whereas subjective evaluation showed that the device support created a positive psychological state in terms of stability, comfort, satisfaction, interest in usage, and motivation for rehabilitation. However, patients reported feeling strangeness, fear, or restraint during support.

Conclusion: The static wearable chair improved the static balance of 3 patients and created a more positive psychological state. Use of the device is considered acceptable for use with rehabilitation patients. However, patients might feel strangeness, fear, and restraint during support. Familiarization with the static wearable chair may make it more acceptable among rehabilitation patients.

Case report: We report the effect of a 6-week outpatient (phase II) cardiac rehabilitation in a 38-year-old man with post-stented coarctation of the aorta, moyamoya disease and hypertension. The cardiac rehabilitation programme comprised physiotherapist-guided aerobic exercises, resistance training and relaxation exercises. Clinical and functional assessment was performed before and after the cardiac rehabilitation programme.

Discussion: There is a lack of recommendations to guide cardiac rehabilitation in patients with coarctation of the aorta. This case not only had coarctation of the aorta, but also had moyamoya disease and hypertension. A cardiac rehabilitation programme after surgery provided meaningful improvements in all outcomes, including exercise capacity, clinical outcomes, quality of life and depression symptoms. Systematic cardiac rehabilitation was found to be feasible in this patient with coarctation of the aorta, and may have the potential to benefit more patients.

Conclusion: Cardiac rehabilitation resulted in significant clinical and functional improvements in this case with coarctation of the aorta following surgery. Guidelines should be implemented to provide safe and effective cardiac rehabilitation in such patients. Furthermore, large-scale studies are needed to evaluate the clinical benefits of structured cardiac rehabilitation in patients following cardiac surgery.

Aim: To translate and validate the Post-COVID-19 Functional Status Scale into Mexican-Spanish.

Materials and methods: A cross-sectional study was performed for transcultural validation of the Post-COVID-19 Functional Status Scale in people over 18 years of age, using the international guidelines for validation published by Beaton and Guillemin. Diagnostic and clinimetric validity tests were applied to the scale. Statistical analysis was performed with the statistical program R.

Results: The scale was applied to 249 patients, obtaining a Cronbach's alpha of 0.84 for the structured interview, and 0.67 for the self-reported questionnaire. When comparing both tests, and considering the structured interview as the reference test, the self-reported questionnaire had a sensitivity of 86.2%, a specificity of 96.3%, and a negative predictive value of 95.8%.

Conclusion: A practical and valid scale was obtained, in concordance with that published in the original version, which can be used in daily clinical practice and rehabilitation. The scale can be used to rapidly and adequately identify post-COVID-19 patients with alterations in functionality who could benefit from rehabilitation therapy.

In China, the stable type of fifth metatarsal base fracture is usually treated by rehabilitation methods after the limbs have been fixed for approximately 4 weeks. A 37-year-old woman fractured her fifth metatarsal base, with a stable fracture type. From the second day of the fracture onward, she agreed to participate in rehabilitative treatment that did not involve surgery or long-term fixation. Fourteen days after the fracture, the patient was able to bear 100% of her body weight and stand for 20 min in a normal posture with supportive elbow crutches. She was able to return to work with double elbow crutches after 25 days. On the 30^th day after the fracture, the patient was able to walk 300 m outdoors without any walking aids and with no discomfort. Two months after the fracture, the patient went jogging and was participating in all of her normal daily activities. This case shows that, for stable type fractures of the fifth metatarsal base, rehabilitation starting on the second day after the fracture can help accelerate the patient's return to normal physical activities.