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Physical Medicine and Rehabilitation: Trends and Applications—4th Edition
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Physical Medicine and Rehabilitation: Trends and Applications—4th Edition

A special issue of Life (ISSN 2075-1729). This special issue belongs to the section "Epidemiology".

Deadline for manuscript submissions: closed (30 January 2026) | Viewed by 15964

Special Issue Editors

Dr. Li-Wei Chou

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Guest Editor
1. Department of Physical Medicine and Rehabilitation, China Medical University Hospital, Taichung 40402, Taiwan
2. Department of Physical Therapy and Graduate Institute of Rehabilitation Science, China Medical University, Taichung 40402, Taiwan
3. Department of Physical Medicine and Rehabilitation, Asia University Hospital, Asia University, Taichung 41354, Taiwan
Interests: pain management; dry needling; acupuncture; myofascial pain; robotic rehabilitation; neurorehabilitation; physical modality; orthosis
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Jiunn-Horng Kang

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Guest Editor
1. Department of Physical Medicine and Rehabilitation, Taipei Medical University Hospital, Taipei 110301, Taiwan
2. College of Biomedical Engineering, Taipei Medical University, Taipei 11031, Taiwan
Interests: AI in medicine; pain medicine; neuromodulation; assistive technology
Special Issues, Collections and Topics in MDPI journals
Dr. Krisna Piravej

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Guest Editor
Department of Rehabilitation Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
Interests: neurorehabilitation; robotic rehabilitation; tele-rehabilitation; musculoskeletal pain; clinical neurophysiolog
Special Issues, Collections and Topics in MDPI journals
Dr. Karen Sui Geok Chua

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Guest Editor
Centre of Rehabilitation Excellence, Tan Tock Seng Hospital Rehabilitation Centre, 569766 Singapore
Interests: neurorehabilitation, brain injury rehabilitation, robotic aided rehabilitation, telerehabilitation
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Physical medicine and rehabilitation are broad medical fields that include the diagnosis, treatment, and prevention of diseases; the improvement in human quality of life; and overcoming or reducing handicaps. The clinical effects of rehabilitation are well known, and positive outcomes have been widely reported in the literature. However, the basic research and variations related to rehabilitation programs deserve specific in-depth analyses. Clinical and basic research can elucidate the possible mechanisms of physical medicine and rehabilitation interventions, and can be applied in planning rehabilitation projects, measuring patient improvement after the administration of rehabilitation programs, and defining forecasting and organizational models. In this Special Issue, we welcome the submission of original articles and reviews focusing on the latest developments following theoretical, experimental, and clinical investigations into physical medicine and rehabilitation for physiatrists and rehabilitation researchers.

Dr. Li-Wei Chou
Prof. Dr. Jiunn-Horng Kang
Dr. Krisna Piravej
Dr. Karen Sui Geok Chua
Guest Editors

Manuscript Submission Information

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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. Life is an international peer-reviewed open access monthly 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

  • clinical physical medicine and rehabilitation
  • neurorehabilitation
  • cardiopulmonary rehabilitation
  • orthopedic rehabilitation
  • pediatric rehabilitation
  • geriatric rehabilitation
  • cancer rehabilitation
  • musculoskeletal pain management
  • physical therapy
  • occupational therapy
  • speech and swallowing therapy

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Related Special Issues

Published Papers (10 papers)

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13 pages, 248 KB  
Article
Factors Affecting Recovery from Post-Traumatic Amnesia During Inpatient Brain Injury Rehabilitation: A Retrospective Cohort Study
by Rathi Ratha Krishnan, Yuhan Yang, Emily Yee and Karen Sui Geok Chua
Life 2026, 16(2), 203; https://doi.org/10.3390/life16020203 - 26 Jan 2026
Viewed by 550
Abstract
Background: Longer post-traumatic amnesia (PTA) durations in traumatic brain injury (TBI) are associated with worse functional outcomes, poorer cognition, and persistent disability. A retrospective cohort study was conducted to evaluate factors affecting PTA duration and emergence. Methods: Data extraction of discharged records of [...] Read more.
Background: Longer post-traumatic amnesia (PTA) durations in traumatic brain injury (TBI) are associated with worse functional outcomes, poorer cognition, and persistent disability. A retrospective cohort study was conducted to evaluate factors affecting PTA duration and emergence. Methods: Data extraction of discharged records of adult TBI was performed between 1 April 2022 and 4 May 2023. Independent variables collected include socio-demographic, acute TBI, and rehabilitation characteristics. Admission/discharge Functional Independence Measure (FIM) was the main rehabilitation outcome measure charted. Dependent variables included PTA duration ≤ 30 days, >30 days, and PTA emergence. Results: A total of 189 datasets were analysed. Median age (IQR) 64 years (26), 145 males (76.7%), and 64.6% >55 years. PTA ≥ 30 days were correlated with the following factors: older age (66 years vs. 59.5 years, p = 0.017), presence of ICU admission (75.2% vs. 61.4%, p = 0.029), longer ICU stays (5 days vs. 3 days, p = 0.001), and longer duration of inpatient hospitalization (acute length of stay, ALOS 23 days vs. ALOS 14 days, p < 0.001). Age ≥ 55 years were 5.6 times as likely (p = 0.011) to be in prolonged PTA, an additional day’s stay in the acute hospital increased the odds by 1.15 (p < 0.001), and every score lost in the total admission FIM from 40 and below increased the odds of prolonged PTA by 3.35 times (p = 0.014). Conclusions: This study demonstrated that older age at TBI onset and longer ALOS significantly increased the risk of prolonged PTA duration. Conversely, higher admission FIM score, lower age at admission, and shorter ALOS were associated with lower PTA duration. Full article
(This article belongs to the Special Issue Physical Medicine and Rehabilitation: Trends and Applications—4th Edition)
17 pages, 1908 KB  
Article
Manual Dexterity Rehabilitation in Parkinson’s Disease and Paranoid Schizophrenia: A Controlled Study
by Tatiana Balint, Alina-Mihaela Cristuta, Adina Camelia Slicaru, Ilie Onu, Daniel Andrei Iordan and Ana Onu
Life 2026, 16(2), 196; https://doi.org/10.3390/life16020196 - 24 Jan 2026
Viewed by 522
Abstract
Background: Manual dexterity (MD) impairment is a frequent and disabling feature in patients with Parkinson’s disease (PD) and paranoid schizophrenia (PS), significantly affecting functional independence and activities of daily living. However, rehabilitation strategies specifically targeting fine motor control remain insufficiently integrated into routine [...] Read more.
Background: Manual dexterity (MD) impairment is a frequent and disabling feature in patients with Parkinson’s disease (PD) and paranoid schizophrenia (PS), significantly affecting functional independence and activities of daily living. However, rehabilitation strategies specifically targeting fine motor control remain insufficiently integrated into routine physiotherapy (PT). Objective: This study investigated the effects of a structured, progressive PT program incorporating targeted MD training on upper limb function in patients with PD and PS. Methods: A prospective, exploratory, interventional study was conducted in 30 patients, allocated to either an experimental group (EG, n = 20) or a control group (CG, n = 10). Participants had PD (Hoehn and Yahr stages II–III) or chronic, clinically stable PS. MD was assessed using the Purdue Pegboard Test, Coin Rotation Task, and Kapandji opposition score. The EG completed a four-phase, 40-week dexterity-oriented rehabilitation program, while the CG received standard disease-specific PT. Between-group differences in change scores were analyzed using one-way ANOVA. Results: The EG showed significantly greater improvements than the CG in thumb opposition, psychomotor processing speed, and unilateral and bilateral fine motor performance (p < 0.001 for all), with large to very large effect sizes (η2 = 0.45–0.76). No significant between-group differences were observed for complex sequential assembly tasks. Conclusions: Integrating targeted MD training into structured PT programs significantly improves fine motor performance in patients with PD and PS, supporting its inclusion in rehabilitation protocols for residential and outpatient care settings. Full article
(This article belongs to the Special Issue Physical Medicine and Rehabilitation: Trends and Applications—4th Edition)
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16 pages, 478 KB  
Article
A Multimodal Diagnostic Algorithm for Focal Knee Chondral Defects: Correlating Clinical Tests, Musculoskeletal Ultrasound, and MRI-Based ICRS Grading
by Robert Gherghel, Paul-Dan Sîrbu, Elena Rezus, Sonia Gabriela Neagu, Carmina Liana Musat, Georgiana Bianca Constantin, Daniel Madalin Coja, Corneliu Mircea Codreanu, Daniel Andrei Iordan and Ilie Onu
Life 2026, 16(1), 80; https://doi.org/10.3390/life16010080 - 5 Jan 2026
Viewed by 752
Abstract
Background: Focal chondral lesions of the knee are frequently underdiagnosed, and their clinical presentation does not always correlate with structural severity. This study aimed to evaluate the diagnostic utility of clinical examination tests and musculoskeletal ultrasound (MSK-US) in identifying high-grade chondral defects, using [...] Read more.
Background: Focal chondral lesions of the knee are frequently underdiagnosed, and their clinical presentation does not always correlate with structural severity. This study aimed to evaluate the diagnostic utility of clinical examination tests and musculoskeletal ultrasound (MSK-US) in identifying high-grade chondral defects, using MRI-based ICRS grading as the reference standard. Methods: In this observational cross-sectional study, 57 consecutive patients with mechanical knee pain and MRI-confirmed focal chondral lesions were evaluated through standardized clinical examination, MSK-US, and MRI. Clinical maneuvers—including Wilson’s test, McMurray’s test, and ligamentous stability tests—were analyzed using Chi-square tests, Pearson correlations, and odds ratios (OR). Statistical processing was performed in Python. Results: According to MRI grading, 87.7% of lesions were ICRS 3, and 12.3% were ICRS 4. Pain and functional impairment (as measured by the WOMAC) were moderate and comparable across lesion grades. Wilson’s test showed high sensitivity in both ICRS 3 (66%) and ICRS 4 (100%) lesions, but no statistical association with lesion severity (p = 0.955). McMurray’s test demonstrated strong discriminative value, being positive in 30% of ICRS 3 versus 86% of ICRS 4 lesions, and was the only clinical maneuver significantly associated with lesion grade (χ2 = 4.29, p = 0.038; OR = 0.20, 95% CI: 0.05–0.79). Correlation analysis revealed weak associations between clinical tests and the location of compartment-specific defects. MRI identified meniscal tears in 86% of ICRS 4 lesions compared with 30% of ICRS 3 lesions. Conclusions: Symptom severity alone does not reliably distinguish between ICRS Grade 3 and Grade 4 focal chondral lesions. McMurray’s test, while not cartilage-specific, was associated with lesion complexity due to its reflection of concomitant meniscal pathology rather than cartilage depth itself. Accordingly, McMurray’s test should be interpreted as an indirect clinical indicator of combined osteochondral–meniscal involvement. The integration of targeted clinical tests (Wilson’s and McMurray’s), MSK-US and MRI-based ICRS grading may support clinical orientation and preoperative risk stratification, forming a pragmatic diagnostic framework rather than a definitive staging tool. Full article
(This article belongs to the Special Issue Physical Medicine and Rehabilitation: Trends and Applications—4th Edition)
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13 pages, 815 KB  
Article
The Contribution of Paresis, Age, and the Effect of Short Training on Cognitive–Motor Dual-Task Interference After Stroke: A Pilot Study
by Judit Málly, Orsolya Karácsony, Bernadette Kálmán and Trevor W. Stone
Life 2025, 15(12), 1881; https://doi.org/10.3390/life15121881 - 9 Dec 2025
Viewed by 493
Abstract
Simultaneously performing cognitive and motor tasks after a stroke interfered with each other. Considering the competing deficits of cognition and motor paresis, we aimed here to assess the overall functional impairments of patients after stroke injury. A range of dual-task (DT) assessments was [...] Read more.
Simultaneously performing cognitive and motor tasks after a stroke interfered with each other. Considering the competing deficits of cognition and motor paresis, we aimed here to assess the overall functional impairments of patients after stroke injury. A range of dual-task (DT) assessments was made on 63 post-stroke patients (PS) and 49 healthy age-matched controls. Patients with paresis (P) and without paresis (NP) were compared with controls before and after DT training. Differences between the NP patients and controls confirmed the cognitive decline, while the comparison between the NP and P patients strengthened the motor damage in P patients. The elderly patients performed worse. According to the ArtANOVA analysis, age was more important than paresis in DT performance. Short-term training modified the test results, especially in P patients. In conclusion, paresis and older age significantly worsen the outcomes of the cognitive dual-task tests. The age-dependent results may reflect cognitive decline, especially in NP patients. Consequently, the dual-task test results may represent global cognitive deterioration after stroke. Short-term dual-task training improves dual-task performance, especially in the P groups. Full article
(This article belongs to the Special Issue Physical Medicine and Rehabilitation: Trends and Applications—4th Edition)
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11 pages, 468 KB  
Article
Association Between Physical Performance, Gait Variability, and Fall Risk in Community-Dwelling Older Adults: Predictive Validity of Step-Width Variability for Screening of Fall Risk
by Yongnam Park and Youngsook Bae
Life 2025, 15(9), 1469; https://doi.org/10.3390/life15091469 - 18 Sep 2025
Cited by 2 | Viewed by 1926
Abstract
Objective: This cross-sectional study aimed to investigate the associations between physical performance, gait variability, and fall risk in community-dwelling older adults. Methods: A total of 446 participants were divided into fall-risk and non-fall-risk groups. Physical performance was assessed using hand grip [...] Read more.
Objective: This cross-sectional study aimed to investigate the associations between physical performance, gait variability, and fall risk in community-dwelling older adults. Methods: A total of 446 participants were divided into fall-risk and non-fall-risk groups. Physical performance was assessed using hand grip strength (HGS), the Timed Up-and-Go (TUG) test, and the Five Times Sit-to-Stand test (5TSTS). Spatiotemporal gait parameters and their coefficients of variation (CV) were measured on a treadmill. Results: Logistic regression revealed that TUG, HGS, step-width CV, and velocity CV were significantly associated with fall risk, whereas age was not. Among these, TUG and step-width CV demonstrated the highest discriminative ability (AUC = 0.708 and 0.715, respectively). Conclusions: Step-width CV was a particularly sensitive indicator of gait stability. These findings suggest that a combination of TUG and step-width CV may help identify older adults at risk of falls, underscoring the importance of gait variability in fall risk screening. Full article
(This article belongs to the Special Issue Physical Medicine and Rehabilitation: Trends and Applications—4th Edition)
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15 pages, 738 KB  
Article
Therapeutic Effects of Photobiomodulation Combined with Exercise on Patients with Peripheral Artery Disease Plus Diabetic Foot Ulcer: A Pilot and Feasibility Study
by Shang-Zhen Chen, Tetsuya Takahashi, Hei-Jeng Lai, Hsi-Hsun Su and Yu-Jung Cheng
Life 2025, 15(9), 1391; https://doi.org/10.3390/life15091391 - 1 Sep 2025
Viewed by 2771
Abstract
Background: Diabetic foot ulcers (DFUs) in patients with peripheral artery disease (PAD) are difficult to treat and associated with poor healing outcomes. Photobiomodulation therapy (PBMT) and exercise have shown individual benefits, but evidence on their combined effects is limited. Objective: To evaluate whether [...] Read more.
Background: Diabetic foot ulcers (DFUs) in patients with peripheral artery disease (PAD) are difficult to treat and associated with poor healing outcomes. Photobiomodulation therapy (PBMT) and exercise have shown individual benefits, but evidence on their combined effects is limited. Objective: To evaluate whether PBMT combined with resistance exercise improves wound healing and walking ability in patients with DFU and PAD. Methods: In this pilot randomized trial, 11 patients with DFU and PAD were allocated to either PBMT plus supervised exercise or exercise alone for 4 weeks. Outcome measures included wound size, skin temperature, and 6-min walking distance. Results: PBMT combined with exercise improved wound healing and walking capacity compared with baseline; however, no significant between-group differences were observed. A positive correlation was observed between post-PBMT plantar skin temperature and percentage of wound reduction. Conclusions: PBMT combined with resistance exercise may enhance wound healing and functional mobility in patients with DFU and PAD. Full article
(This article belongs to the Special Issue Physical Medicine and Rehabilitation: Trends and Applications—4th Edition)
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15 pages, 266 KB  
Article
Correlates of Rehabilitation Length of Stay in Asian Traumatic Brain Injury Inpatients in a Superaged Country: A Retrospective Cohort Study
by Karen Sui Geok Chua, Zachary Jieyi Cheong, Emily Yee and Rathi Ratha Krishnan
Life 2025, 15(7), 1136; https://doi.org/10.3390/life15071136 - 18 Jul 2025
Cited by 1 | Viewed by 971
Abstract
Background: While Asia contributes 44.3% of traumatic brain injuries (TBI) worldwide, data regarding Asian TBI inpatient rehabilitation length of stay (RLOS) is scarce. A retrospective cohort study was conducted to determine correlates of inpatient RLOS (days) and prolonged RLOS >30 days (PRLOS > [...] Read more.
Background: While Asia contributes 44.3% of traumatic brain injuries (TBI) worldwide, data regarding Asian TBI inpatient rehabilitation length of stay (RLOS) is scarce. A retrospective cohort study was conducted to determine correlates of inpatient RLOS (days) and prolonged RLOS >30 days (PRLOS > 30). (2) Methods: Data extraction of discharged inpatient records was performed from 2018 to 2024. Dependent variables included RLOS (days) and PRLOS > 30. Independent variables included demographic characteristics, TBI severity (emergency-room Glasgow Coma Scale-GCS), admission/discharge Functional Independence Measure (FIM), intra-rehabilitation complications, post-traumatic amnesia (PTA) duration, and discharge placement. (3) Results: Altogether, 289 data sets were analysed, median (IQR) age, 64 (28) years, 78.9% (228/289) males, and 79.6% (230/289) Chinese. Median (IQR) RLOS was 28 (21) days, with PRLOS >30 at 39.8% (115/289); RLOS of 44 (19.5) days. PRLOS > 30 was significantly associated with PTA duration >28 days (OR 4.01, 95% CI 1.90–8.45, p < 0.001), admission FIM ≤ 40/126 (OR 4.71, 95% CI 2.32–9.59, p < 0.001), delayed neurosurgical complications (OR 4.74, 95% CI 1.28–17.6, p = 0.02) and discharge to non-home destination (OR 2.75. 95% CI 1.12–6.76, p = 0.03). (4) Conclusion: PRLOS >30 was significantly associated with longer PTA > 4 weeks, lower admission FIM score, delayed neurosurgical complications, and discharge to a nursing home. Full article
(This article belongs to the Special Issue Physical Medicine and Rehabilitation: Trends and Applications—4th Edition)
19 pages, 1209 KB  
Article
The Effects of Pulsed Electromagnetic Field (PEMF) on Muscular Strength, Functional Performance and Depressive Symptoms in Elderly Adults with Sarcopenia: A Short-Term Intervention
by Patrícia Sardinha Leonardo, Alberto Souza Sá Filho, Pedro Augusto Inacio, Paulo Ricardo França, Vicente Aprigliano, Fernando Teixeira, Michel Monteiro Macedo, Douglas Farias Fonseca, Pedro Sardinha Leonardo Lopes-Martins, Gustavo De Conti Teixeira Costa and Rodrigo Alvaro Brandão Lopes-Martins
Life 2025, 15(7), 1111; https://doi.org/10.3390/life15071111 - 16 Jul 2025
Cited by 2 | Viewed by 5749
Abstract
Despite the benefits of resistance training in mitigating sarcopenia, adherence among frail older adults is often limited by osteoarticular pain, comorbidities, and logistical barriers. Pulsed electromagnetic field (PEMF) therapy has emerged as a potential alternative. However, evidence regarding its effects on functional and [...] Read more.
Despite the benefits of resistance training in mitigating sarcopenia, adherence among frail older adults is often limited by osteoarticular pain, comorbidities, and logistical barriers. Pulsed electromagnetic field (PEMF) therapy has emerged as a potential alternative. However, evidence regarding its effects on functional and psychological parameters remains scarce. Objectives: To assess the effects of 12 PEMF therapy sessions on knee extensor strength and functional performance (Timed Up and Go test—TUG) in older adults with sarcopenia. Secondary outcomes included changes in calf circumference (CC), SARC-F + CC scores, and depressive symptoms. Methods: A controlled, non-randomized experimental design was employed, with a pre-intervention control group serving as a baseline reference (PEMF group: n = 25; control group: n = 16). Participants received 12 PEMF therapy sessions (three times per week) targeting the quadriceps and gastrocnemius muscles. Outcomes were measured using knee-extension dynamometry, TUG, CC, SARC-F + CC, and the Yesavage Geriatric Depression Scale. Statistical analyses included ANCOVA, with baseline values as covariates. Results: Significant improvements were observed in knee-extension strength, which increased from 13.05 ± 4.8 kgf to 18.56 ± 8 kgf (p < 0.001); TUG test time improved from 23.1 ± 14.4 to 18.7 ± 10 s (p = 0.048); SARC-F + CC scores decreased from 11.6 ± 8.2 to 6.5 ± 7.6 (p < 0.001), though the interaction effect with time was not significant (p = 0.252). No statistically significant changes were observed in CC, which increased from 34.0 ± 4.0 cm to 36.0 ± 3.9 cm following the intervention (p = 0.548). Yesavage Geriatric Depression Scale scores improved significantly (7.9 ± 2.4 to 5.4 ± 1.7, p = 0.0013). Conclusions: PEMF therapy significantly improved lower-limb muscle strength and functional mobility in elderly individuals with sarcopenia. Additionally, depressive symptoms were significantly reduced. However, no significant changes were observed in CC or SARC-F + CC. Full article
(This article belongs to the Special Issue Physical Medicine and Rehabilitation: Trends and Applications—4th Edition)
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16 pages, 1400 KB  
Systematic Review
Comparison of Urinary Tract Infection Rates Associated with Different Catheterization Methods Following Major Pelvic or Abdominal Surgery: A Bayesian Network Meta-Analysis of Randomized Controlled Trials
by Thanh-Nhan Doan, Thi-Hong-Phuc Le and Li-Wei Chou
Life 2026, 16(2), 280; https://doi.org/10.3390/life16020280 - 5 Feb 2026
Viewed by 608
Abstract
Background: Postoperative bladder drainage is commonly required following major pelvic or abdominal surgery. Existing evidence indicates substantial variation in urinary tract infection (UTI) risk across different catheterization methods. However, the comparative effectiveness of indwelling Foley catheterization (IFC), suprapubic catheterization (SPC), and intermittent catheterization [...] Read more.
Background: Postoperative bladder drainage is commonly required following major pelvic or abdominal surgery. Existing evidence indicates substantial variation in urinary tract infection (UTI) risk across different catheterization methods. However, the comparative effectiveness of indwelling Foley catheterization (IFC), suprapubic catheterization (SPC), and intermittent catheterization (IC) remains uncertain. Methods: We conducted a Bayesian network meta-analysis of randomized controlled trials (RCTs) to compare UTI incidence associated with different urinary drainage methods, including IFC, SPC, and IC. PubMed and the Cochrane Library were searched to identify eligible RCTs published from January 2010 to November 2025. Trials comparing at least two of the three catheterization routes following major pelvic or abdominal surgery were included. The primary outcome was the rate of UTI. A Bayesian network meta-analysis with a random-effects model was conducted using the gemtc package in R 4.5.1 and RStudio2026.01.0. The quality of evidence was evaluated using the GRADE approach. Results: Ten RCTs involving 1242 patients met the eligibility criteria. Both IC and SPC demonstrated a reduced risk of UTI compared with IFC. Based on indirect evidence, SPC was not associated with a statistically significant reduction in postoperative UTI compared with IC, with considerable uncertainty in the effect estimate (OR = 0.53, 95% CrI 0.09–2.69). Overall, IC and SPC showed favorable trends in reducing catheter-related complications compared with IFC. Conclusions: This network meta-analysis suggests that SPC and IC may be more effective than IFC in reducing the risk of postoperative UTI following major pelvic or abdominal surgery. However, further high-quality randomized controlled trials that integrate urinary drainage methods with bladder rehabilitation interventions are needed to identify the optimal management strategy for this patient population. Full article
(This article belongs to the Special Issue Physical Medicine and Rehabilitation: Trends and Applications—4th Edition)
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16 pages, 687 KB  
Systematic Review
Neurorehabilitation-Based Movement Representation Techniques in the Management of Craniocervical and Orofacial Pain: A Systematic Review of Randomized Controlled Trials
by Alberto García-Alonso, Luis Polo-Ferrero, Ana Silvia Puente-González, Tamara Manso-Hierro, Marta Beatriz Carrera-Villegas and Roberto Méndez-Sánchez
Life 2026, 16(1), 145; https://doi.org/10.3390/life16010145 - 15 Jan 2026
Viewed by 605
Abstract
Background: Craniocervical pain and temporomandibular disorders (TMDs) are prevalent, interconnected conditions. While Movement Representation Techniques (MRTs) are cognitive interventions targeting central pain mechanisms, their specific efficacy here lacks synthesis. This study systematically analyzes the effectiveness of MRTs, such as motor imagery (MI) and [...] Read more.
Background: Craniocervical pain and temporomandibular disorders (TMDs) are prevalent, interconnected conditions. While Movement Representation Techniques (MRTs) are cognitive interventions targeting central pain mechanisms, their specific efficacy here lacks synthesis. This study systematically analyzes the effectiveness of MRTs, such as motor imagery (MI) and action observation (AO), on pain and function in individuals with craniocervical and orofacial pain. Methods: A systematic review of RCTs (PROSPERO: CRD420251155428) was conducted following PRISMA guidelines. Four databases were searched for studies applying MRTs (MI, AO, laterality discrimination) to adults with craniocervical or orofacial pain. Primary outcomes were pain and functionality. Methodological quality was assessed using the PEDro scale and Cochrane RoB 2 tool. Results: Eight RCTs (n = 362) were included. Methodological quality was high (PEDro scores 8–9). MRTs significantly increased Pressure Pain Threshold (PPT) in the masseter, trapezius, and cervical regions. Functional improvements included enhanced cervical range of motion and sensorimotor control. AO consistently demonstrated superior outcomes. However, results for orofacial variables were derived from asymptomatic subjects. Results for cervical muscle strength were inconsistent. Conclusions: MRTs, especially AO, show potential to reduce pain and improve function in craniocervical disorders. Evidence in symptomatic orofacial pain populations is non-existent. Protocol heterogeneity and limited research groups necessitate further high-quality, multicenter RCTs to establish robust clinical guidelines. Full article
(This article belongs to the Special Issue Physical Medicine and Rehabilitation: Trends and Applications—4th Edition)
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