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Current Status and Perspectives in Physical and Rehabilitation Medicine

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A special issue of Applied Sciences (ISSN 2076-3417). This special issue belongs to the section "Applied Biosciences and Bioengineering".

Deadline for manuscript submissions: closed (20 February 2025) | Viewed by 15565

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Dr. Elena Amaricai

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Department of Rehabilitation, Physical Medicine and Rheumatology, Faculty of Medicine, Victor Babeş University of Medicine and Pharmacy, 300041 Timişoara, Romania
Interests: rehabilitation medicine; musculoskeletal disorders; clinical rheumatology; physical therapy; pediatric rehabilitation; quality of life research; kinesiology
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Dear Colleagues,

In the field of physical medicine and rehabilitation, there has been continuous progress in what concerns both assessment and therapy. Modern technologies (assistive technologies, virtual motion, robotic-assisted systems or interactive wearable systems) are a part of nowadays medicine. With the increase in access to medical services, people suffering from pathologies that cause disabilities (stroke, spinal cord injuries, traumatic brain injuries, cerebral palsy, neuromuscular diseases, neurodegenerative and demyelinating diseases, posttraumatic conditions, etc.) should benefit from rehabilitation treatment. Physical medicine and rehabilitation are addressed to all age groups; preterm children with neuromotor developmental disorders, as well as elderly patients suffering from different pathologies (musculoskeletal, cardiovascular, neurologic) are addressed to rehabilitation. In order to treat people with disabilities there is a need for both modern equipment and specialized personnel (physical medicine and rehabilitation physician, physical therapist, occupational therapist, and speech therapist).

Dr. Elena Amaricai
Guest Editor

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Keywords

assessment
disability
functioning
quality of life
robotic therapy
virtual reality
assistive technologies
telerehabilitation

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Published Papers (9 papers)

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Research

12 pages, 428 KiB

Open AccessArticle

Agreement Between Tele- and Face-to-Face Assessment of Neuromotor Development in High-Risk Children

by Ana Isabel Rubio-López, Marie Carmen Valenza, Julia Raya-Benítez, Geraldine Valenza-Peña, Irene Cabrera-Martos, Laura López-López and Ángela Benítez-Feliponi

Appl. Sci. 2025, 15(2), 723; https://doi.org/10.3390/app15020723 - 13 Jan 2025

Viewed by 576

Abstract

Background: Early interventions in high-risk children seek to improve prognosis, minimize developmental delays, and prevent functional deterioration. The objective of this study was to evaluate the level of agreement between the face-to-face assessment and tele-assessment of neuromotor development in high-risk children between 0 and 18 months of age. Methods: Forty-five children at high risk of developmental delays were included in this study (33% female, mean gestational age of 35.31 ± 4.03 weeks). The patients were included in a face-to-face and a tele-assessment using the Alberta Infant Motor Scale (AIMS) and the level of motor evolution (Niveaux d’Évolution Motrice, NEM) assessments. Results: The analysis showed excellent interrater reliability (ρ ≥ 0.99) for the AIMS. The NEM assessment showed almost perfect reliability (kappa ≥ 0.81) for most items. Seven of them showed substantial reliability (kappa = 0.61–0.80), one moderate reliability (kappa = 0.568), and one fair reliability (kappa = 0.338). Conclusions: This study reveals an excellent/substantial interrater reliability for most of the items assessed. The results are promising to increase the accessibility to a clinical diagnosis and a rehabilitation approach to minimize the development of neuromotor delays in children at high risk. Full article

(This article belongs to the Special Issue Current Status and Perspectives in Physical and Rehabilitation Medicine)

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16 pages, 6958 KiB

Open AccessArticle

Comparison of Modified Occlusal Splint, Standard Splint Protocol, and Conventional Physical Therapy in Management of Temporomandibular Joint Disc Displacement with Reduction and Intermittent Locking: A Randomized Controlled Trial

by Sandro Prati, Funda Goker, Margherita Tumedei, Aldo Bruno Gianni, Massimo Del Fabbro and Gianluca Martino Tartaglia

Appl. Sci. 2024, 14(24), 11743; https://doi.org/10.3390/app142411743 - 16 Dec 2024

Viewed by 1468

Abstract

Background: Temporomandibular joint disc displacement with reduction is one of the most common types of TMJ arthropathy. This single-blinded, randomized clinical study aimed to evaluate the effectiveness of three different therapeutic methods. Methods: Standard splints (Group 1), modified occlusal splint (Group 2), and conventional physical therapy with exercises (Group 3). A total of 48 patients were randomly assigned by a computer-generated allocation sequence to receive rehabilitation. The outcome was defined as improvements in pain and intermittent locking episodes. The follow-up visits were scheduled as one month and a long-term evaluation at one (T1), two (T2), three (T3), and four years (T4). Magnetic resonance images were also taken to evaluate each patient before treatment and at one year. Image analysis involved the evaluation of morphology and the function of intra-articular structures. Variables such as age, gender, and pre- vs. post-treatment values of VAS and TMJ locks between the three intervention categories were compared for statistical evaluations. p values ≤ 0.05 were taken as being significant. Results: A total of 16 subjects were allocated to each group. At T1, a decrease in pain and TMJ locking episodes was observed, which was maintained throughout the course of the study for four years of follow-ups, with no statistically significant differences. However, there was a tendency for better outcomes in favor of Group 2, with less clicking of the TMJ at opening. Conclusions: The modified mandibular splint seems to be successful as an effective alternative for the management of temporomandibular joint disc displacement with reductions in intermittent locking. Full article

(This article belongs to the Special Issue Current Status and Perspectives in Physical and Rehabilitation Medicine)

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18 pages, 2806 KiB

Open AccessArticle

Can Robotic Therapy Improve Performance in Activities of Daily Living? A Randomized Controlled Trial in Sub-Acute Spinal Cord Injured Patients

by Vicente Lozano-Berrio, Mónica Alcobendas-Maestro, Raquel Perales-Gómez, Yolanda Pérez-Borrego, Angel Gil-Agudo, Begoña Polonio-López, Camilo Cortés and Ana de los Reyes-Guzmán

Appl. Sci. 2024, 14(18), 8478; https://doi.org/10.3390/app14188478 - 20 Sep 2024

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Abstract

(1) Background: The influence of robotic therapy on patients with sub-acute cervical spinal cord injury (SCI) for improving their activities of daily living (ADL) performance is unclear; (2) Methods: 31 subjects with cervical SCI completed the training randomly assigned to an intervention or control group during 40 sessions. All the subjects received, in each session, 30 min of upper-extremity conventional therapy. In addition, the subjects within the control group received another 30 min of conventional therapy, whereas subjects within the intervention group received 30 min of robotic therapy with Armeo Spring (Hocoma AG, Volketswil, Switzerland). Therefore, the ADL of drinking was trained by using the exoskeleton. Feasibility and efficacy measurements as clinical scales and kinematic indices, and usability questionnaires, were used as assessment at baseline and at the ending of the study (week 10); (3) Results: The intervention group significantly improved with regards to the feeding and grooming items of the Spinal Cord Independence Measure scale. The improvement in the movement smoothness related to the activity of drinking was greater in the intervention group than in the control (p = 0.034); (4) Conclusions: The findings of this study reveal that patients with cervical SCI improve their performance in ADL with robotic therapy. Full article

(This article belongs to the Special Issue Current Status and Perspectives in Physical and Rehabilitation Medicine)

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12 pages, 280 KiB

Open AccessArticle

Cross-Cultural Adaptation and Validation of the Spanish Version of the Amputee Body Image Scale (ABIS-E)

by Eva A. Gómez-Calcerrada-García-Navas, Adrián Arranz-Escudero, Juan Izquierdo-García, María Briones-Cantero, Francisco Molina-Rueda and Patricia Martín-Casas

Appl. Sci. 2024, 14(16), 6963; https://doi.org/10.3390/app14166963 - 8 Aug 2024

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Abstract

Background. Assessing the patient’s perceived body image is essential to measure the impact of lower limb amputation on quality of life and psychological well-being. Objective. The aim of this study was to develop a Spanish version of the Amputee Body Image Scale (ABIS-E) for Spanish-speaking lower limb amputees. Methods. A cross-sectional study was conducted including amputee patients in Madrid, Spain. Clinical outcomes of body image (Amputee Body Image Scale, ABIS), health-related quality of life (EuroQol-5D-5L), depression and anxiety (Hospital Anxiety and Depression Scale, HADS), pain (Brief Pain Inventory-Short Form, BPI-SF), and functional capacity (Prosthesis Evaluation Questionnaire, PEQ) were collected. Results. Seventy-three participants were assessed. Excellent test–retest reliability (ICC = 0.847) and good internal consistency (Cronbach’s alpha = 0.753) were obtained. Factor analyses extracted three factors. Convergent validity with Pearson’s and Spearman’s correlation coefficients were calculated for depression and anxiety questionnaires (HADS) (values between 0.57 and 0.67), functional capacity (PEQ) (values between −0.35 and 0.71), and quality of life (EQ-5D-5L) (values between −0.37 and 0.61). Conclusions. The ABIS-E is a reliable and valid instrument to measure body image in the Spanish population with lower limb amputation, potentially useful in primary care to identify psychosocial problems. Full article

(This article belongs to the Special Issue Current Status and Perspectives in Physical and Rehabilitation Medicine)

17 pages, 1001 KiB

Open AccessArticle

Determining the Algorithm of Rehabilitation Procedures in Patients with Brachial Plexus Injuries Based on the Prospective Single-Centre Clinical Neurophysiology Studies: Preliminary Results

by Kinga Lewczuk, Agnieszka Wiertel-Krawczuk and Juliusz Huber

Appl. Sci. 2024, 14(6), 2395; https://doi.org/10.3390/app14062395 - 12 Mar 2024

Cited by 1 | Viewed by 1856

Abstract

The clinical neurophysiological tests allow us to determine the type, extent, and nature of brachial plexus damage. They are crucial in decision making regarding surgical procedures or conservative treatment. This report aimed to present an algorithm for rehabilitation procedures in patients with brachial plexus injury of various origins based on the results of neurophysiology findings for the selection of procedures supporting the process of nerve and muscle regeneration. The research group consisted of patients whose medical documentation was analysed concerning the reason, level, and localization of damage to the brachial plexus structures, surgical and or rehabilitative treatment, as well as the MRI results. Among the group of fourteen patients, the clinical studies showed the greatest incidence of brachial plexus injuries of the mixed (both pre- and postganglionic), all trunks, and cervical root injuries, respectively. Results of the motor evoked potentials (MEP) and electroneurography (ENG) recordings induced at levels of spinal roots and Erb’s point showed a decrease of more than 40% in amplitudes on the symptomatic side in comparison to the asymptomatic side. This diffeence was recorded for the axillary and radial innervation and the C5, C6, and C7 root domains, ranging from 57% to 66%; the lowest decrease was recorded following electrical stimulation at Erb’s point for the ulnar nerve (34%). The latency prolongation on the symptomatic side in CMAP and MEP tests ranged from 0.2 to 1.7 ms, with the most following magnetic stimulation of the C5 cervical root for the axillary innervation. Most of the results indicated the axonotmesis and neuropraxia type of injury in motor fibers (40%) confirmed by EMG results. The sensory conduction studies (SNCS) in distal nerve branches did not confirm the severe advancement of the brachial plexus injury (63%). The proposed algorithm of the physiotherapeutic procedures should be mainly targeted for recovery of motor dysfunction as the consequence of brachial plexus injury. Rehabilitation should incorporate the treatment supporting nerve regeneration, muscle strengthening, and maintaining functional ranges of motion of the injured extremities. The rehabilitation treatment for patients with brachial plexus injuries is an individualised process, and the selection of procedures and the effectiveness of the treatment undertaken should be confronted with results of neurophysiological tests verifying the motor neural transmission from the level of the cervical motor centre to the effector, peripheral nerve function, and muscle’s motor unit activity. Full article

(This article belongs to the Special Issue Current Status and Perspectives in Physical and Rehabilitation Medicine)

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15 pages, 4222 KiB

Open AccessArticle

Development of an Application That Implements a Brain–Computer Interface to an Upper-Limb Motor Assistance Robot to Facilitate Active Exercise in Patients: A Feasibility Study

by Tadashi Yamamoto and Toyohiro Hamaguchi

Appl. Sci. 2023, 13(17), 9979; https://doi.org/10.3390/app13179979 - 4 Sep 2023

Cited by 1 | Viewed by 1630

Abstract

In this study, we aimed to evaluate the effectiveness of a brain robot in rehabilitation that combines motor imagery (MI), robotic motor assistance, and electrical stimulation. Thirteen in-patients with severe post-stroke hemiplegia underwent electroencephalography (EEG), measured according to the international 10–20 method, during MI. The dicephalus robotic system (DiC) was activated by detecting event-related desynchronization (ERD) using the Markov switching model (MSM) and relative power (RP) from the EEG of the motor cortex (C3 and C4). The reaction times (the time between ERD detection and DiC activation) of the MSM and RP were compared using Wilcoxon’s signed rank sum test. ERD was detected in all 13 and 12 patients with the MSM and RP, respectively. The DiC reaction time for the ERD detection process was significantly shorter for the MSM (13.02 ± 0.16 s) than for the RP (19.95 ± 7.45 s) (W = 9, p = 0.0037). The results of this study suggest that ERD responses can be detected in the motor cortex during MI in patients with severe upper-extremity paralysis; the MSM is more effective than the RP in detecting ERD when the EEG signal is used as a switch to activate the robot, and the reaction time to detect the signal is shorter. Full article

(This article belongs to the Special Issue Current Status and Perspectives in Physical and Rehabilitation Medicine)

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13 pages, 12310 KiB

Open AccessArticle

Assessment of Individualized and Group Physical Exercise Programs in Patients with Parkinson’s Disease: A Pilot Study

by Himena Adela Zippenfening, Elena Amaricai and Maria Raluca Raducan

Appl. Sci. 2023, 13(15), 8962; https://doi.org/10.3390/app13158962 - 4 Aug 2023

Viewed by 2565

Abstract

The objective was to assess physical exercise programs (individualized and group) targeting postural correction in Parkinson’s disease patients. A total of 29 Parkinson’s disease patients performed an individualized (12 patients) or group exercise program (17 patients) for 6 months. After 6 months of therapy, all patients received a self-made questionnaire that assessed the benefits of exercise programs for their health status and the compliance to therapy. Patients also completed the Movement Disorder Society–Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) questionnaire (patients’ section) at the inclusion in the study and after 6 months. All patients considered that the physical exercise program had benefits and was important for their functioning and health status. There were no significant differences in what concerns the mental and physical status during the physical exercise program, and the improvement in quality of life after physical exercise program in the two groups. After the 6 month physical exercise program, a significantly improved functional status was recorded in both groups (MDS-UPDRS scores for individualized therapy: 1.90 ± 1.05 vs. 2.30 ± 1.04, p = 0.001; for group therapy: 1.79 ± 0.85 vs. 2.13 ± 1.02, p = 0.005). The proposed questionnaire for assessment of physical exercise programs for patients with Parkinson’s disease represents a valuable and easy-to-use tool. Full article

(This article belongs to the Special Issue Current Status and Perspectives in Physical and Rehabilitation Medicine)

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13 pages, 4854 KiB

Open AccessArticle

Myotonometry in Patients with Parkinson’s Disease: Assessment of Pre and Post Treatment through Comparisons with Healthy Controls

by Himena Adela Zippenfening, Elena Amaricai, Marius Lupsa Matichescu, Marius Militaru and Mihaela Simu

Appl. Sci. 2023, 13(10), 6164; https://doi.org/10.3390/app13106164 - 17 May 2023

Viewed by 1930

Abstract

The study aims to assess the myotonometer parameters of major pectoralis, biceps brachialis, femoral biceps and anterior tibialis in patients with Parkinson’s disease before and after medical treatment using comparisons with healthy controls. A total of 49 patients with Parkinson’s disease (69.76 ± 6.39 years) and 42 healthy controls (60.48 ± 7.62 years) were tested using MyotonPRO before and one hour after drug administration. Five parameters were recorded (frequency [Hz], stiffness [N/m], decrement, relaxation [ms] and creep). At pre-treatment assessment, significantly increased values of myotonometer parameters were recorded for major pectoralis and biceps brachialis, with the exception of decrement. Frequency and decrement were significantly higher in patients’ femoral biceps and anterior tibialis. For all assessed muscles, frequency was significantly higher in Parkinson’s disease patients one hour after medication intake. Stiffness, relaxation and creep had increased values in major pectoralis. For the lower limb muscles, decrement had greater values. We concluded that there were no significant differences of major pectoralis and biceps brachialis elasticity between patients with Parkinson’s disease and healthy controls pre and post drug administration, with improved viscoelastic properties of biceps brachialis after medication. After drug administration, no significant differences of femoral biceps and anterior tibialis stiffness were noted between patients and controls. Full article

(This article belongs to the Special Issue Current Status and Perspectives in Physical and Rehabilitation Medicine)

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10 pages, 562 KiB

Open AccessCommunication

Clinic-Electrophysiologic Correlations in Rehabilitation of Adult Patients with Traumatic Brachial Plexus Lesions

by Dan Trofin, Daniela-Viorelia Matei, Daniela Marilena Trofin, Ilie Onu, Daniel Andrei Iordan and Teodor Stamate

Appl. Sci. 2023, 13(9), 5679; https://doi.org/10.3390/app13095679 - 5 May 2023

Cited by 1 | Viewed by 2072

Abstract

Nerve-transfer surgery is the treatment of choice for traumatic brachial plexus injuries (tBPIs). Combined electromyography (EMG) follow-ups and results obtained by transcranial magnetic stimulation (TMS) may provide useful follow-up of rehabilitation outcomes of elbow flexion in C5-C7 tBPIs. A total of 11 patients with complex tBPIs, operated by the Oberlin surgical technique, were assessed clinically (British Medical Research Council’s score—MRC) and by EMG + TMS after undergoing neuromuscular electrical stimulation and proprioceptive neuromuscular facilitation. Dynamometer quantitative muscle strength (DQMS) was also assessed for overall grip strength evaluation. Six patients continued rehabilitation three times a week, whereas five patients did not follow recommendations for continuous physical therapy (PT). All patients were assessed after 6 months as planned. Following a 6-month PT protocol, clinical improvements correlated with decreases of the Motor Evoked Potential (MEP) latency recorded at the first dorsal interosseous muscle, biceps brachii, and cortical level in the sublot group with continuous PT protocol compliance. We obtained significant amelioration of MEP latency and needle EMG signs of amelioration in these six patients. These cases also correlated to the MRC improvement in elbow flexion, as well as DQMS parameters. TMS parameters also mildly and inconstantly improved in the other five patients who limited themselves just to PT after surgery; however, there was no correlation with the EMG findings or MRC scaling. PT influences the cortical representation within the motor area of the upper limb when performed continuously. The electrical signals within the motor cortex promote the utility adherence to long-term PT protocols. Full article

(This article belongs to the Special Issue Current Status and Perspectives in Physical and Rehabilitation Medicine)

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