American Journal of Physical Medicine & Rehabilitation最新文献

Abstract: The Canadian Stroke Best Practice Recommendations 7 th edition update of the Rehabilitation, Recovery and Community Participation module is presented in three parts. This publication, Part Two of the series, reflects the growing and changing body of research evidence available to guide direct stroke rehabilitation therapies, screening, assessment, interventions, and strategies. Topics in this module include rehabilitation of upper and lower extremity, aerobic function, balance, mobility, activities of daily living, spasticity, fall risk, communication, dysphagia, nutrition, central pain, visual and visual-perceptual issues, and bladder and bowel function. This module provides guidance in the delivery of coordinated and seamless systems of care that support timely access to rehabilitation therapies, building on progress achieved during initial recovery, enabling people to achieve as much independence as possible and successfully resume social roles and leisure activities. Successful recovery, transitions and community participation require integrated and coordinated people-centered efforts by all members of care teams involved, and the broader community. These recommendations were developed with active involvement of people with lived experience of stroke throughout the care continuum. Evidence for effective rehabilitation therapies and support for individuals with stroke and their families continues to emerge and gaps in knowledge should drive future research.

Abstract: The interest in dry needling as a treatment option for myofascial pain has flourished for the last decades and will probably continue to do so, because multiple clinical effects can be attributed to this technique. However, evidence about the underlying physiological mechanisms of its effects is still underrepresented in scientific research and caution must be taken in generalizing results from acupuncture or animal research. This review offers an overview of the possible mechanisms involved in the pathophysiology of myofascial trigger points, that is, the formation of the taut band, the presence of local pain and inflammation, and the occurrence of referred pain. Subsequently, the effect of dry needling on these same aspects will be discussed. The goal of this article is to provide clinicians with the most up to date insights in the underlying (neuro)physiological mechanisms of trigger point dry needling and to identify the opportunities for further research on this topic.

Objective: The aim of this study was to evaluate the effects of extracorporeal shock wave therapy and low-level laser therapy on pain, functional status, and quality of life in shoulder adhesive capsulitis.

Design: This single-center, prospective, single-blind randomized controlled trial included patients with shoulder adhesive capsulitis randomly assigned to extracorporeal shock wave therapy, low-level laser therapy, or control groups. The extracorporeal shock wave therapy group received three extracorporeal shock wave therapy sessions plus 15 sessions of hot pack and exercise; the low-level laser therapy group received 15 low-level laser therapy sessions with hot pack and exercise. Outcomes (Constant-Murley Score, visual analog scale, Short Form 36) were assessed at baseline, 3, and 12 wks.

Results: Sixty shoulder adhesive capsulitis patients were randomized equally into extracorporeal shock wave therapy ( n = 20), low-level laser therapy ( n = 20), and control ( n = 20) groups. By week 3, both extracorporeal shock wave therapy and low-level laser therapy showed significant improvements in visual analog scale-pain and Constant-Murley Score-pain versus control ( P < 0.05), while only low-level laser therapy improved Short Form 36 physical limitation scores ( P < 0.05). At week 12, the low-level laser therapy group showed greater improvements in Constant-Murley Score-range of motion, Constant-Murley Score-total, and Short Form 36 subdomains related to physical and emotional role limitations ( P < 0.05).

Conclusions: In patients with shoulder adhesive capsulitis, both extracorporeal shock wave therapy and low-level laser therapy added to exercises therapy positively affected pain and range of motion.

Objective: The aim of the study was to evaluate the efficacy of incorporating Wii Fit-based rehabilitation into a conventional physical therapy program on balance, functional ability, and fall risk in individuals with chronic ankle instability.

Design: This is a single-blinded randomized controlled trial.

Methods: Sixty participants with chronic ankle instability (aged 18-60 yrs) were randomly assigned to either an experimental group (Wii Fit-based rehabilitation plus conventional physical therapy) or a control group (conventional physical therapy only). Both groups received supervised therapy three times per week over 8 wks. Outcome measures included the anteroposterior, mediolateral, and overall stability indices assessed via the Biodex Balance System; functional ability via the Foot and Ankle Ability Measure-Activities of Daily Living; and fall risk via the Falls Efficacy Scale-International, measured before and after intervention.

Results: The Wii Fit-based rehabilitation combined with conventional physical therapy group demonstrated significantly greater improvements across all outcome measures compared with the conventional physical therapy-only group ( P < 0.001). At 8 wks, Foot and Ankle Ability Measure-Activities of Daily Living and Falls Efficacy Scale-International scores were 94.7 ± 3.22 and 17.77 ± 2.76 in the intervention group versus 83.43 ± 2.45 and 26.3 ± 3.51 in controls, respectively.

Conclusions: Combined Wii Fit-based rehabilitation and conventional physical therapy program significantly enhance postural stability, functional performance, and reduces fall risk in patients with chronic ankle instability. Wii Fit-based rehabilitation may serve as a valuable adjunct in rehabilitation protocols targeting balance deficits in this population.