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Recent Progress in Rehabilitation Medicine

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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Clinical Rehabilitation".

Deadline for manuscript submissions: closed (15 November 2023) | Viewed by 24910

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Special Issue Editor

Prof. Dr. Mashahiro Kohzuki

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Guest Editor

1. Yamagata Prefectural University of Health Sciences, 260 Kamiyanagi, Yamagata 990-2212, Japan
2. Department of Internal Medicine and Rehabilitation Science, Tohoku University Graduate School of Medicine, Aoba-ku, Sendai, Japan
Interests: visceral impairment; comprehensive rehabilitation; exercise therapy; organ damage and protection; multi-organ connection
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

With the ageing of society worldwide, there are increasing numbers of people experiencing impairments and disabilities such as physical impairment, cognitive impairment, frailty and comorbidity. These are associated with an increased incidence of adverse healthcare outcomes including hospitalization, poorer quality of life and increased healthcare expenditure. The number of people who need rehabilitation has increased dramatically.

Recent work in rehabilitation has made great progress. There are numerous randomized controlled studies in every field of rehabilitation. The outcome of rehabilitation such as cardiac rehabilitation is classified as Class I and Evidence A. Rehabilitation services are given quicker (stroke, etc.), more widely (heart failure, renal failure, pulmonary hypertension, etc.) and longer (not only in the acute and recovery stage but also maintenance stage and before the surgery) in order to obtain better outcomes.

This Special Issue aims to focus on the recent advances in rehabilitation. Rehabilitation generally aims to "add life to years" by helping patients with impairment to achieve and utilize their full physical, mental and social potential. However, recent growing evidence suggests that rehabilitation for patients with visceral impairment such as renal, cardiac and pulmonary impairment can not only improve exercise performance and health-related quality of life but also increases survival. Therefore, rehabilitation for patients does not simply aim to "add life to years" but to “add life to years and years to life", which is a new rehabilitation concept.

We are soliciting such cutting-edge research reports and overviews, both basic and clinical, in relation to rehabilitation, to offer a promising model for the new field of rehabilitation.

Prof. Dr. Masahiro Kohzuki
Guest Editor

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Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

neuro-rehabilitation cognitive rehabilitation
spinal rehabilitation
orthopedic rehabilitation
pediatric rehabilitation
cancer rehabilitation
visceral rehabilitation
cardiac rehabilitation
pulmonary rehabilitation
renal rehabilitation
hepatic rehabilitation
rehabilitation for transplantation
fitness
peak VO₂
multimorbidity and multiple disabilities (MMD)
adding life to years and years to life

Published Papers (13 papers)

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Research

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10 pages, 547 KiB

Open AccessArticle

The Relationship between Kinesiophobia, Emotional State, Functional State and Chronic Pain in Subjects with/without Temporomandibular Disorders

by Tomasz Marciniak, Weronika Kruk-Majtyka, Patrycja Bobowik and Sławomir Marszałek

J. Clin. Med. 2024, 13(3), 848; https://doi.org/10.3390/jcm13030848 - 01 Feb 2024

Viewed by 589

Abstract

Although there is growing evidence that kinesiophobia is correlated with temporomandibular disorders (TMD), its relationship with other characteristic TMD comorbidities, such as depression, anxiety, functional limitations, and pain in the TMD population, has rarely been investigated. This study aims to evaluate the relationship between kinesiophobia, emotional state, functional state and chronic pain in subjects both with and without TMD. A total of 94 subjects participated in the study and were divided into two groups (47 subjects each)—TMD (subjects with temporomandibular disorders) and nTMD (asymptomatic controls)—on the basis of the RDC/TMD protocol. All measurements were taken with self-administered questionnaires: TSK-TMD for kinesiophobia, PHQ-9 and GAD-7 for psychoemotional state, JFLS-20 for jaw functional limitations, and GCPS for chronic pain. The prevalence of kinesiophobia in the TMD group was 38.3% for moderate risk, and 61.7% for high risk. The TMD group showed significantly higher scores in all categories (kinesiophobia, depression, jaw functional limitations and chronic pain), with the exception of anxiety which was right at the cut-off point. Moreover, a significant correlation was found between kinesiophobia (TSK-TMD) and jaw functional limitations (JFLS-20). Results of this study could provide new insight into the relationship between kinesiophobia and TMD, further improving the diagnosis process. Full article

(This article belongs to the Special Issue Recent Progress in Rehabilitation Medicine)

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12 pages, 3222 KiB

Open AccessArticle

Immersive Virtual Reality Therapy Is Supportive for Orthopedic Rehabilitation among the Elderly: A Randomized Controlled Trial

by Justyna Mazurek, Błażej Cieślik, Adam Wrzeciono, Robert Gajda and Joanna Szczepańska-Gieracha

J. Clin. Med. 2023, 12(24), 7681; https://doi.org/10.3390/jcm12247681 - 14 Dec 2023

Viewed by 1040

Abstract

Objective: This research aimed to determine the efficacy of VR therapy in mitigating symptoms of depression, anxiety, and stress among older adults following arthroplasty surgery and to comprehend the influence of psychological improvement on changes in functional outcomes. Methods: Utilizing a parallel-group randomized controlled trial design, the study involved 68 osteoarthritis patients who had recently undergone either total hip or knee arthroplasty. Subjects were split into two groups. The experimental group underwent eight VR therapy sessions during their rehabilitation, while the control group was given standard care. Assessments encompassed both psychological and functional outcomes, with tools like the Hospital Anxiety and Depression Scale, Perceived Stress Scale, and the Barthel Index, among others. The experimental group showcased notable enhancements in both psychological and functional areas compared to the control group. Results: A significant (p value of < 0.001) relationship was found between psychological progress and functional recovery, indicating that psychological factors can serve as predictors for functional outcomes. Conclusions: The findings emphasize the promising role of VR therapy as a beneficial addition to the rehabilitation process for older adults’ post-hip and knee arthroplasty. The integration of psychological interventions in standard rehabilitation practices appears valuable, but further studies are needed to ascertain the long-term advantages of such an approach. Full article

(This article belongs to the Special Issue Recent Progress in Rehabilitation Medicine)

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10 pages, 1419 KiB

Open AccessArticle

Decline in Walking Independence and Related Factors in Hospitalization for Dialysis Initiation: A Retrospective Cohort Study

by Yuma Hirano, Tomoyuki Fujikura, Kenichi Kono, Naro Ohashi, Tomoya Yamaguchi, Wataru Hanajima, Hideo Yasuda and Katsuya Yamauchi

J. Clin. Med. 2022, 11(21), 6589; https://doi.org/10.3390/jcm11216589 - 07 Nov 2022

Cited by 2 | Viewed by 1436

Abstract

Patients with chronic kidney disease require intervention planning because their physical function declines with worsening disease. Providers can work closely with patients during the induction phase of dialysis. This single-center, retrospective observational study aimed to investigate the rate of decline in walking independence during the induction phase of dialysis and the factors that influence this decline, and to provide information on prevention and treatment during this period. Of the 354 patients who were newly initiated on hemodialysis between April 2018 and January 2022, 285 were included in the analysis. The functional independence measure-walking score was used to sort patients into decreased walking independence (DWI; n = 46) and maintained walking independence (no DWI; n = 239) groups, and patient characteristics were compared. After adjusting for various factors by logistic regression analysis, we observed that age, high Charlson comorbidity index (CCI), C-reactive protein, and emergency dialysis start (EDS) were significant predictors of DWI. Even during the very short period of dialysis induction, as many as 16.1% of patients had DWI, which was associated with older age, higher CCI, higher inflammation, and EDS. Therefore, we recommend the early identification of patients with these characteristics and early rehabilitation. Full article

(This article belongs to the Special Issue Recent Progress in Rehabilitation Medicine)

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12 pages, 9238 KiB

Open AccessArticle

Belt Electrode-Skeletal Muscle Electrical Stimulation in Older Hemodialysis Patients with Reduced Physical Activity: A Randomized Controlled Pilot Study

by Midori Homma, Misa Miura, Yo Hirayama, Tamao Takahashi, Takahiro Miura, Naoki Yoshida, Satoshi Miyata, Masahiro Kohzuki and Satoru Ebihara

J. Clin. Med. 2022, 11(20), 6170; https://doi.org/10.3390/jcm11206170 - 19 Oct 2022

Cited by 3 | Viewed by 1682

Abstract

Background: Although patients receiving hemodialysis are more likely to develop metabolic disorders and muscle weakness at an earlier stage than healthy individuals, many older dialysis patients have difficulty establishing exercise habits to prevent these problems. Therefore, we evaluated the use of belt electrode-skeletal muscle electrical stimulation (B-SES), which can stimulate a wider area than conventional electrical muscle stimulation (EMS), to examine its application and safety in older hemodialysis patients as a means to improve lower extremity function without voluntary effort. Methods: This study was a randomized controlled trial (RCT) involving 20 older dialysis patients (>65 years old) with reduced physical activity. The control group received 12 weeks of routine care only and the intervention group received 12 weeks of B-SES during hemodialysis in addition to routine care. The primary endpoint was the 6 min walk test (6MWT) distance, while the Short Physical Performance Battery (SPPB), body composition, Functional Independence Measure (FIM), biochemistry test, and blood pressure/pulse measurements were used as secondary endpoints. Results: As a result of the 12-week B-SES intervention, no increase in creatine kinase or C-reactive protein levels was observed after the intervention in either group, and no adverse events attributed to the B-SES intervention were observed in the intervention group. Furthermore, the intervention group showed a significant improvement in the 6MWT and SPPB scores after the intervention. Conclusions: The results of this study suggest that a 12-week B-SES intervention during hemodialysis sessions safely improves 6MWT distance and SPPB scores in older patients with a reduced level of physical activity. Full article

(This article belongs to the Special Issue Recent Progress in Rehabilitation Medicine)

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10 pages, 1201 KiB

Open AccessArticle

Effectiveness of High-Intensity Laser Therapy Plus Ultrasound-Guided Peritendinous Hyaluronic Acid Compared to Therapeutic Exercise for Patients with Lateral Elbow Tendinopathy

by Raffaello Pellegrino, Teresa Paolucci, Fabrizio Brindisino, Paolo Mondardini, Angelo Di Iorio, Antimo Moretti and Giovanni Iolascon

J. Clin. Med. 2022, 11(19), 5492; https://doi.org/10.3390/jcm11195492 - 20 Sep 2022

Cited by 10 | Viewed by 2191

Abstract

Lateral elbow tendinopathy (LET) is a common painful musculoskeletal disorder. Several treatments have been proposed to provide pain reduction and functional recovery, including laser therapy, hyaluronic acid peritendinous injection (Hy-A), and therapeutic exercise (TE). Our study aims to assess the effectiveness of a combined approach with high-intensity laser therapy (HILT) and Hy-A injections compared to TE on pain, muscle strength, and disability in patients with painful LET. A retrospective longitudinal study was carried out by consulting the medical records of patients with a diagnosis of painful LET formulated by clinical and instrumental findings that received functional evaluations, including the Patient-Rated Tennis Elbow Evaluation (PRTEE) and muscle strength measurement at least four times: T0 (“baseline”), 1-month (T1), 3-month (T2), and 6-month follow-ups (T3). Medical records of 80 patients were analyzed. In the HILT + HyA group, the Peak-strength (p < 0.001) and mean strength (p < 0.001) significantly increased compared to the TE group between study times. For the PRTEE-total-score as for the subscales, the HILT + HyA group reported statistically significant reductions only for the comparisons of baseline versus T1 and baseline versus T2. No serious adverse events occurred. Our findings suggest that Hy-A associated with HILT might be more effective than TE for people with LET in the short–medium term. Full article

(This article belongs to the Special Issue Recent Progress in Rehabilitation Medicine)

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11 pages, 1183 KiB

Open AccessArticle

Benefits of Pulmonary Rehabilitation in Patients with Idiopathic Pulmonary Fibrosis Receiving Antifibrotic Drug Treatment

by Yuji Iwanami, Kento Ebihara, Keiko Nakao, Naofumi Sato, Midori Miyagi, Yasuhiko Nakamura, Susumu Sakamoto, Kazuma Kishi, Sakae Homma and Satoru Ebihara

J. Clin. Med. 2022, 11(18), 5336; https://doi.org/10.3390/jcm11185336 - 11 Sep 2022

Cited by 4 | Viewed by 2173

Abstract

Background: Although patients with idiopathic pulmonary fibrosis (IPF) often receive treatment with antifibrotic drugs (AFDs) and pulmonary rehabilitation (PR) concurrently, there are no reports on the effect of PR on patients with IPF receiving AFDs. Therefore, we investigated the effect of PR on patients with IPF receiving AFDs. Methods: Eighty-seven eligible patients with IPF (61 male; 72.0 ± 8.1 years; GAP severity stage I/II/III: 26/32/12) were recruited for the study. Patients who completed a 3-month outpatient PR program and those who did not participate were classified into four groups according to use of AFDs: PR group (n = 29), PR+AFD group (n = 11), treatment-free observational group (control group; n = 26), and AFD group (n = 21). There was no significant difference in age, sex, or severity among the groups. Patients were evaluated for physical functions such as 6-min walk distance (6MWD) and muscle strength, dyspnea, and health-related quality of life (HRQOL) at baseline and at 3 months. Results: In the PR group, dyspnea and 6MWD showed significant improvement after the 3-month PR program (p < 0.05 and p < 0.01, respectively). HRQOL was significantly worse at 3 months (p < 0.05) in the AFD group, but not in the other groups. The change in 6MWD from baseline to the 3-month time point was significantly higher in the PR+AFD group than in the AFD groups (p < 0.01). Conclusions: It was suggested that AFD treatment reduced exercise tolerance and HRQOL at 3 months; however, the concurrent use of PR may prevent or mitigate these effects. Full article

(This article belongs to the Special Issue Recent Progress in Rehabilitation Medicine)

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10 pages, 1006 KiB

Open AccessArticle

Positive Effect of Manipulated Virtual Kinematic Intervention in Individuals with Traumatic Stiff Shoulder: A Pilot Study

by Isabella Schwartz, Ori Safran, Naama Karniel, Michal Abel, Adina Berko, Martin Seyres, Tamir Tsoar and Sigal Portnoy

J. Clin. Med. 2022, 11(13), 3919; https://doi.org/10.3390/jcm11133919 - 05 Jul 2022

Cited by 3 | Viewed by 1803

Abstract

Virtual reality enables the manipulation of a patient’s perception, providing additional motivation to real-time biofeedback exercises. We aimed to test the effect of manipulated virtual kinematic intervention on measures of active and passive range of motion (ROM), pain, and disability level in individuals with traumatic stiff shoulder. In a double-blinded study, patients with stiff shoulder following proximal humerus fracture and non-operative treatment were randomly divided into a non-manipulated feedback group (NM-group; n = 6) and a manipulated feedback group (M-group; n = 7). The shoulder ROM, pain, and disabilities of the arm, shoulder and hand (DASH) scores were tested at baseline and after 6 sessions, during which the subjects performed shoulder flexion and abduction in front of a graphic visualization of the shoulder angle. The biofeedback provided to the NM-group was the actual shoulder angle while the feedback provided to the M-group was manipulated so that 10° were constantly subtracted from the actual angle detected by the motion capture system. The M-group showed greater improvement in the active flexion ROM (p = 0.046) and DASH scores (p = 0.022). While both groups improved following the real-time virtual feedback intervention, the manipulated intervention provided to the M-group was more beneficial in individuals with traumatic stiff shoulder and should be further tested in other populations with orthopedic injuries. Full article

(This article belongs to the Special Issue Recent Progress in Rehabilitation Medicine)

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10 pages, 1641 KiB

Open AccessArticle

Does Application of Lymphatic Drainage with Kinesiology Taping Have Any Effect on the Extent of Edema and Range of Motion in Early Postoperative Recovery following Primary Endoprosthetics of the Knee Joint?

by Magdalena Sobiech, Agata Czępińska, Grzegorz Zieliński, Magdalena Zawadka and Piotr Gawda

J. Clin. Med. 2022, 11(12), 3456; https://doi.org/10.3390/jcm11123456 - 16 Jun 2022

Cited by 4 | Viewed by 2311

Abstract

Background: The surgery of knee replacement due to degenerative changes is the last step of the treatment. After surgery, a major problem in patients is pain, swelling, intraarticular hematoma, and the restriction of the mobility of the joint. The aim of this work was to determine the effect of Kinesio Taping (KT) on reducing edema of the subcutaneous tissue and improving the range of motion in the joint. Methods: 82 patients were qualified for the study. After surgery, 42 patients received postoperative edema treatment with KT bands, and 40 patients did not receive the treatment. The swelling thickness and range of mobility were measured on the third and eighth days after the operation. Results: A statistical difference between the longitudinal measurements of the KT group and the group without KT application was shown at the level of the fibula head, 25 mm below the fibula neck, and 50 mm below the fibular neck. There were no statistically significant differences in the change in knee angle between the applied and non-applied patients. Conclusion: The lymphatic application technique KT influences the absorption of subcutaneous edema after primary knee joint replacement surgery but has no influence on mobility. Full article

(This article belongs to the Special Issue Recent Progress in Rehabilitation Medicine)

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12 pages, 1294 KiB

Open AccessArticle

Effects of Electromyographic Biofeedback on Functional Recovery of Patients Two Months after Total Knee Arthroplasty: A Randomized Controlled Trial

by Iva Sklempe Kokic, Matko Vuksanic, Tomislav Kokic, Ivan Peric and Ivana Duvnjak

J. Clin. Med. 2022, 11(11), 3182; https://doi.org/10.3390/jcm11113182 - 02 Jun 2022

Cited by 2 | Viewed by 1870

Abstract

The incidence of total knee arthroplasty (TKA) is steadily increasing worldwide. Therefore, it is crucial to develop efficient rehabilitation protocols and investigate the innovations in medical technology, which could improve rehabilitation outcomes. The aim of the study was to investigate the effect of adding electromyographic biofeedback (EMG-BF) to the conventional program of rehabilitation after TKA on quality of life, intensity of pain, and functional performance. The study was designed as a randomized controlled trial. A total of 131 patients were randomly assigned to two groups: an experimental group (n = 67; median age 70 (IQR 10)), and a control group (n = 64; median age 69 (IQR 9)). Both groups participated in an inpatient program of 21 days of rehabilitation, including land-based and aquatic exercise therapy, electrotherapy, and education. In the experimental group, a portion of land-based exercise therapy was supplemented by EMG-BF. A numeric rating scale (NRS), Knee Injury and Osteoarthritis Outcome Score (KOOS), use of mobility aids, 30 s chair stand test (CST), and timed up and go (TUG) test were used to measure outcomes. Both groups improved their functional abilities from day 1 to day 21 of rehabilitation. A higher proportion of participants did not use a walking aid (p < 0.002), and their NRS, KOOS, 30 s CST and TUG scores improved (p < 0.001). There were no significant differences between the groups in the outcomes. EMG-BF did not provide additional benefits to the conventional rehabilitation after TKA. Full article

(This article belongs to the Special Issue Recent Progress in Rehabilitation Medicine)

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12 pages, 873 KiB

Open AccessArticle

Improving Upper Extremity Bradykinesia in Parkinson’s Disease: A Randomized Clinical Trial on the Use of Gravity-Supporting Exoskeletons

by Loredana Raciti, Loris Pignolo, Valentina Perini, Massimo Pullia, Bruno Porcari, Desiree Latella, Marco Isgrò, Antonino Naro and Rocco Salvatore Calabrò

J. Clin. Med. 2022, 11(9), 2543; https://doi.org/10.3390/jcm11092543 - 01 May 2022

Cited by 5 | Viewed by 2260

Abstract

Hand movements are particularly impaired in patients with Parkinson’s Disease (PD), contributing to functional disability and difficulties in activities of daily living. Growing evidence has shown that robot-assisted therapy may be considered an effective and reliable method for the delivery of the highly repetitive training that is needed to trigger neuroplasticity, as intensive, repetitive and task-oriented training could be an ideal strategy to facilitate the relearning of motor function and to minimize motor deficit. The purpose of this study is to evaluate the improvement of hand function with semi-autonomous exercises using an upper extremity exoskeleton in patients with PD. A multicenter, parallel-group, randomized clinical trial was then carried out at the IRCCS Centro Neurolesi Bonino-Pulejo (Messina, Italy). Thirty subjects with a diagnosis of PD and a Hoehn–Yahr score between 2 and 3 were enrolled in the study. Patients were 1:1 randomized into either the experimental group (ERT), receiving 45 min training daily, 6 days weekly, for 8 weeks with Armeo^®Spring (Volketswil, Switzerland) (a gravity-supporting device), or the control group (CPT), which was subjected to the same amount of conventional physical therapy. Motor abilities were assessed before and after the end of the training. The main outcomes measures were the Nine-hole peg test and the motor section of the UPDRS. All patients belonging to ERT and 9 out of 15 patients belonging to the CPT completed the trial. ERT showed a greater improvement in the primary outcome measure (nine-hole peg test) than CPT. Moreover, a statistically significant improvement was found in ERT concerning upper limb mobility, and disease burden as compared to CPT. Using an upper extremity exoskeleton (i.e., the Armeo^®Spring) for semi-autonomous training in an inpatient setting is a new perspective to train patients with PD to improve their dexterity, executive function and, potentially, quality of life. Full article

(This article belongs to the Special Issue Recent Progress in Rehabilitation Medicine)

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Review

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12 pages, 2269 KiB

Open AccessReview

Renal Rehabilitation: Present and Future Perspectives

by Masahiro Kohzuki

J. Clin. Med. 2024, 13(2), 552; https://doi.org/10.3390/jcm13020552 - 18 Jan 2024

Cited by 1 | Viewed by 1057

Abstract

Chronic kidney disease (CKD) is a global health problem. In patients with CKD, exercise endurance is decreased, especially as renal dysfunction advances. This is due to the combined effects of protein-energy wasting, uremic acidosis, and inflammatory cachexia, which lead to sarcopenia and are aggravated by a sedentary lifestyle, resulting in a progressive downward spiral of deconditioning. Renal rehabilitation (RR) is a coordinated, multifaceted intervention designed to optimize a patient’s physical, psychological, and social functioning, as well as to stabilize, slow, or even reverse the progression of renal deterioration, improving exercise tolerance and preventing the onset and worsening of heart failure, thereby reducing morbidity and mortality. This review focused on the history and benefits of RR in patients with CKD. Based on current evidence, RR is an effective, feasible, and safe secondary prevention strategy in CKD. RR is a promising model for a new field of rehabilitation. Therefore, efforts to increase RR implementation rates are urgently needed. Full article

(This article belongs to the Special Issue Recent Progress in Rehabilitation Medicine)

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15 pages, 925 KiB

Open AccessReview

The Effects of Physiotherapy in the Treatment of Cubital Tunnel Syndrome: A Systematic Review

by Tomasz Wolny, César Fernández-de-las Peñas, Tomasz Buczek, Magdalena Domin, Arkadiusz Granek and Paweł Linek

J. Clin. Med. 2022, 11(14), 4247; https://doi.org/10.3390/jcm11144247 - 21 Jul 2022

Cited by 3 | Viewed by 3347

Abstract

Background: To date, various forms of physiotherapy are used in the treatment of cubital tunnel syndrome (CuTS). The effectiveness of physiotherapy for CuTS is inconclusive. The aim of this systematic review was to evaluate the effects of physiotherapy in the conservative treatment of CuTS. Methods: The six databases were searched from December 2020 to March 2022. The inclusion criteria were randomised controlled trials, case series, and case reports that evaluate the effects of physiotherapy in the treatment of adult participants with diagnosis CuTS. A total of 11 studies met the eligibility criteria, capturing a total of 187 participants. Results: In three types of papers, pain, muscle strength, and limitation of upper limb function were the most frequently assessed characteristics. Physiotherapy was most often based on manual therapy, neurodynamic techniques, and electrical modalities. One clinical trial rated the risk of bias “high” and the other two “some concerns”. In case-series designs, five studies rated the risk of bias as “serious” and three as “moderate”. Most of the studies showed a significant improvement in the clinical condition, also in the follow-up study. Only one clinical trial showed no therapeutic effect. Conclusion: There is no possibility of recommending the best method of physiotherapy in clinical practice for people with CuTS based on the results of this systematic review. More high-quality studies are required. Full article

(This article belongs to the Special Issue Recent Progress in Rehabilitation Medicine)

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Other

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14 pages, 2272 KiB

Open AccessStudy Protocol

Study Protocol for a Multicenter, Randomized Controlled Trial to Improve Upper Extremity Hemiparesis in Chronic Stroke Patients by One-to-One Training (NEURO^®) with Repetitive Transcranial Magnetic Stimulation

by Daigo Sakamoto, Toyohiro Hamaguchi, Kai Murata, Atsushi Ishikawa, Yasuhide Nakayama and Masahiro Abo

J. Clin. Med. 2022, 11(22), 6835; https://doi.org/10.3390/jcm11226835 - 18 Nov 2022

Cited by 1 | Viewed by 1746

Abstract

During recovery from upper limb motor paralysis after stroke, it is important to (1) set the exercise difficulty level according to the motor paralysis severity, (2) provide adequate exercises, and (3) motivate the patient to achieve the goal. However, these factors have not been well-formulated. This multicenter, randomized controlled trial study aims to examine the therapeutic effects of these three factors on patients undergoing a novel intervention using repetitive transcranial magnetic stimulation and intensive one-to-one training (NEURO^®) and to formulate a corresponding research protocol. The control group will receive conventional NEURO^® occupational therapy. In the intervention group, four practice plans will be selected according to the Fugl-Meyer assessment (FMA-UE) scores of the upper extremity. The goal is to predict the post-treatment outcomes based on the pre-treatment FMA-UE scores. Based on the degree of difficulty and amount of practice required, we can formulate a practice plan to promote upper limb motor recovery. This occupational therapy plan will be less influenced by the therapist’s skill, facilitating effective rehabilitation. The study findings may be utilized to promote upper limb motor paralysis recovery and provide a basis for proposing activities of daily living adapted to upper limb function. Full article

(This article belongs to the Special Issue Recent Progress in Rehabilitation Medicine)

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