Physical Medicine and Rehabilitation: Trends and Applications: 2nd Edition

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

Deadline for manuscript submissions: closed (28 June 2024) | Viewed by 27338

Special Issue Editors


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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, 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
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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
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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
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Guest Editor
Institute of Rehabilitation Excellence (IREx), Tan Tock Seng Hospital Rehabilitation Centre, Singapore 307382, Singapore
Interests: neurorehabilitation; brain injury rehabilitation; robotic aided rehabilitation; telerehabilitation; brain computer interface
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Special Issue Information

Dear Colleagues,

Physical medicine and rehabilitation comprise a broad medical field that includes the diagnosis, treatment and prevention of diseases; improvements in the 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, 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 be applied to plan rehabilitation projects, measure patient improvement after the administration of rehabilitation programs, and define 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.

For the publication of the previous edition, please see: https://www.mdpi.com/journal/life/special_issues/00S8C79U6X

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

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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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Published Papers (10 papers)

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Research

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16 pages, 2139 KiB  
Article
Perspectives of Decision Support System TeleRehab in the Management of Post-Stroke Telerehabilitation
by Vitaly A. Nikolaev and Alexander A. Nikolaev
Life 2024, 14(9), 1059; https://doi.org/10.3390/life14091059 - 24 Aug 2024
Viewed by 1027
Abstract
Stroke is the main cause of disability among adults. Decision-making in stroke rehabilitation is increasingly complex; therefore, the use of decision support systems by healthcare providers is becoming a necessity. However, there is a significant lack of software for the management of post-stroke [...] Read more.
Stroke is the main cause of disability among adults. Decision-making in stroke rehabilitation is increasingly complex; therefore, the use of decision support systems by healthcare providers is becoming a necessity. However, there is a significant lack of software for the management of post-stroke telerehabilitation (TR). This paper presents the results of the developed software “TeleRehab” to support the decision-making of clinicians and healthcare providers in post-stroke TR. We designed a Python-based software with a graphical user interface to manage post-stroke TR. We searched Scopus, ScienceDirect, and PubMed databases to obtain research papers with results of clinical trials for post-stroke TR and to form the knowledge base of the software. The findings show that TeleRehab suggests recommendations for TR to provide practitioners with optimal and real-time support. We observed feasible outcomes of the software based on synthetic data of patients with balance problems, spatial neglect, and upper and lower extremities dysfunctions. Also, the software demonstrated excellent usability and acceptability scores among healthcare professionals. Full article
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12 pages, 251 KiB  
Article
Orthogeriatric Care Following Hip Fracture: Improving Post-Operative Outcomes in an Aged Population
by Sarah J. Mant, Chibuchi Amadi-Livingstone, Mohamed H. Ahmed, Maria Panourgia, Henry Owles and Oliver Pearce
Life 2024, 14(4), 503; https://doi.org/10.3390/life14040503 - 14 Apr 2024
Cited by 1 | Viewed by 1724
Abstract
Introduction: Hip fractures globally are associated with high levels of morbidity, mortality, and significant financial burden. This audit aimed to assess the impact of orthogeriatric liaison care on post-operative outcomes following surgical management of neck or femur fractures. Methods: Here, 258 patients who [...] Read more.
Introduction: Hip fractures globally are associated with high levels of morbidity, mortality, and significant financial burden. This audit aimed to assess the impact of orthogeriatric liaison care on post-operative outcomes following surgical management of neck or femur fractures. Methods: Here, 258 patients who underwent hip fracture surgery over 1-year were included. Data were collected as an audit following the transition to an orthogeriatric liaison care model, involving regular orthogeriatric review (thrice weekly ward rounds, daily board rounds), superseding orthogeriatric review as requested. The audit is meant to assess the development of post-operative non-surgical site infection (NSSI) and mortality and duration of inpatient stay. Outcomes were compared to previous data from our hospital site in 2015/2016. Results: Patients with severe cognitive impairment and systemic disease (Abbreviated Mental Test Score (AMTS) < 7 and American Society of Anesthesiologists (ASA) grade ≥ 3) showed significantly elevated NSSI risk, consistent across the study periods. Both periods demonstrated an increased risk of NSSI associated with admission from nursing homes. Despite the 2021/2022 cohort being notably older, NSSI risk decreased from 40.6% to 37.2% after implementing the orthogeriatric care model. NSSI risk was notably reduced for severe cognitive impairment (51.6% vs. 71%), and the p-value was 0.025. Average hospital stay decreased post-intervention (2.4 days shorter), with a notable reduction for NSSI patients (3.4 days shorter). Overall mortality rates were similar, although mortality due to infection was significantly reduced in 2021/2022 (44.4% vs. 93.3%), and the p-value was 0.003. Conclusion: The orthogeriatric liaison care model significantly decreased NSSI only in individuals with severe cognitive impairment and infection-associated mortality. This highlights the integral role of orthogeriatricians in the care of elderly hip fracture patients. Full article
10 pages, 413 KiB  
Article
Increased Upper Extremity Muscle Mass in Ambulatory Children with Cerebral Palsy
by Taeyoung Song, Jaewon Kim and Dae-Hyun Jang
Life 2024, 14(3), 303; https://doi.org/10.3390/life14030303 - 26 Feb 2024
Viewed by 1171
Abstract
Aim: To compare muscle mass in the upper and lower extremities between ambulatory children with cerebral palsy (CP) and typically developing (TD) children. Materials and Methods: A total of 21 children aged 2 to 12 years with CP and a Gross Motor Function [...] Read more.
Aim: To compare muscle mass in the upper and lower extremities between ambulatory children with cerebral palsy (CP) and typically developing (TD) children. Materials and Methods: A total of 21 children aged 2 to 12 years with CP and a Gross Motor Function Classification System (GMFCS) level of I, II, or III were matched with 21 TD children for age, sex, and body mass index. The lean body mass (LBM) of each extremity was calculated from whole-body dual-energy X-ray absorptiometry. Results: The LBM of the upper extremities was greater in children with CP compared to TD children, and the difference was significant in the GMFCS level II group (1340.6 g vs. 1004.2 g, p = 0.027). There was no significant difference in the LBM of the lower extremities between the CP and TD groups (p = 0.190). The ratio of lower extremity LBM to total extremity LBM was lower in children with CP, while the ratio of upper extremity LBM to total extremity LBM was higher in children with CP (73.2% vs. 78.5% [p < 0.001] and 26.7% vs. 21.5% [p < 0.001], respectively). Conclusions: Ambulatory children with CP, especially in the GMFCS level II group, exhibit greater muscle mass in the upper extremities compared to TD children. Full article
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13 pages, 2104 KiB  
Article
The Effects of Proprioceptive Neuromuscular Facilitation Pattern Kinesio Taping on Arm Swing, Balance, and Gait Parameters among Chronic Stroke Patients: A Randomized Controlled Trial
by Seo-Jeong Moon, Sang-Yong Han and Dong-Hwan Park
Life 2024, 14(2), 242; https://doi.org/10.3390/life14020242 - 8 Feb 2024
Viewed by 2888
Abstract
(1) Background: This study aimed to investigate the effects of proprioceptive neuromuscular facilitation pattern kinesio taping on arm swing, balance, and gait parameters among chronic stroke patients. (2) Methods: Twenty-eight participants were randomized into proprioceptive neuromuscular facilitation pattern kinesio taping during gait training [...] Read more.
(1) Background: This study aimed to investigate the effects of proprioceptive neuromuscular facilitation pattern kinesio taping on arm swing, balance, and gait parameters among chronic stroke patients. (2) Methods: Twenty-eight participants were randomized into proprioceptive neuromuscular facilitation pattern kinesio taping during gait training (n = 14) and gait training (n = 14) groups. The proprioceptive neuromuscular facilitation pattern kinesio taping during gait training group employed proprioceptive neuromuscular facilitation pattern kinesio taping during 15 min treadmill-based gait training five times a week for four weeks, while the gait training group underwent the same gait training without proprioceptive neuromuscular facilitation pattern kinesio taping. Arm swing angle was measured using the Image J program, static balance was assessed with an AMTI force plate, dynamic balance was evaluated through the Timed Up and Go test, and gait parameters were recorded using the GAITRite system and the Dynamic Gait Index. (3) Results: After 4 weeks of training, the proprioceptive neuromuscular facilitation pattern kinesio taping during gait training group exhibited significant improvements in all variables compared to the baseline (p < 0.05), whereas the gait training group did not show statistically significant differences in any variables (p > 0.05). (4) Conclusions: This study demonstrates the effectiveness of proprioceptive neuromuscular facilitation pattern kinesio taping during gait training in enhancing arm swing angle, balance, and gait parameters. Full article
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12 pages, 1927 KiB  
Article
Effectiveness of Novel Sympathetic Nerve Entrapment Point Injections for Chronic Migraine: A Pilot Study
by Jeong Won Seong, Yuntae Kim, Dong Rak Kwon, Cheol-Jung Yang and Levent Özçakar
Life 2024, 14(1), 57; https://doi.org/10.3390/life14010057 - 28 Dec 2023
Cited by 1 | Viewed by 1538
Abstract
No studies to date have investigated the ability of sympathetic nerve entrapment point saline (SNEP) injections to achieve long-term pain relief in patients with migraine. Therefore, this study aimed to investigate the safety and long-term efficacy of repeat splenius capitis (SC) SNEP injections [...] Read more.
No studies to date have investigated the ability of sympathetic nerve entrapment point saline (SNEP) injections to achieve long-term pain relief in patients with migraine. Therefore, this study aimed to investigate the safety and long-term efficacy of repeat splenius capitis (SC) SNEP injections in patients with migraine (with/without tension-type headache). This retrospective, single-arm study included 12 patients with migraine. Isotonic saline was injected into their SC approximately six times for 3 months. Headache frequency, duration (hour/week), intensity (using the visual analog scale), and quality of life (using the Headache Impact Test-6) were assessed during the follow-up visits for up to 24 months after the first injection. Changes before and after treatment were assessed using repeated-measures analysis of variance. Significant reductions in headache frequency, duration, and intensity were observed at all assessment points after SNEP injections when compared with the baseline values (p < 0.05), while the patients’ headache-related quality of life also improved. Treatment was continued for up to 3 months to maintain these improvements, and no worsening of status or adverse effects were observed in any of the patients over the following 24 months. Our results show that SNEP injections may offer persistent, substantial, and clinically relevant benefits in patients with migraine. Full article
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15 pages, 2606 KiB  
Article
Assessing Non-Specific Neck Pain through Pose Estimation from Images Based on Ensemble Learning
by Jiunn-Horng Kang, En-Han Hsieh, Cheng-Yang Lee, Yi-Ming Sun, Tzong-Yi Lee, Justin Bo-Kai Hsu and Tzu-Hao Chang
Life 2023, 13(12), 2292; https://doi.org/10.3390/life13122292 - 30 Nov 2023
Cited by 1 | Viewed by 1572
Abstract
Background: Mobile phones, laptops, and computers have become an indispensable part of our lives in recent years. Workers may have an incorrect posture when using a computer for a prolonged period of time. Using these products with an incorrect posture can lead to [...] Read more.
Background: Mobile phones, laptops, and computers have become an indispensable part of our lives in recent years. Workers may have an incorrect posture when using a computer for a prolonged period of time. Using these products with an incorrect posture can lead to neck pain. However, there are limited data on postures in real-life situations. Methods: In this study, we used a common camera to record images of subjects carrying out three different tasks (a typing task, a gaming task, and a video-watching task) on a computer. Different artificial intelligence (AI)-based pose estimation approaches were applied to analyze the head’s yaw, pitch, and roll and coordinate information of the eyes, nose, neck, and shoulders in the images. We used machine learning models such as random forest, XGBoost, logistic regression, and ensemble learning to build a model to predict whether a subject had neck pain by analyzing their posture when using the computer. Results: After feature selection and adjustment of the predictive models, nested cross-validation was applied to evaluate the models and fine-tune the hyperparameters. Finally, the ensemble learning approach was utilized to construct a model via bagging, which achieved a performance with 87% accuracy, 92% precision, 80.3% recall, 95.5% specificity, and an AUROC of 0.878. Conclusions: We developed a predictive model for the identification of non-specific neck pain using 2D video images without the need for costly devices, advanced environment settings, or extra sensors. This method could provide an effective way for clinically evaluating poor posture during real-world computer usage scenarios. Full article
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15 pages, 542 KiB  
Article
A Behavioral Characteristics Observational Measure of Youth with Somatic Symptom Disorder during Physical Rehabilitation
by Sharon Barak, Jana Landa, Maya Gerner, Etzyona Eisenstein, Chen Arzoni Bardach and Tamar Silberg
Life 2023, 13(10), 2078; https://doi.org/10.3390/life13102078 - 18 Oct 2023
Cited by 1 | Viewed by 1582
Abstract
Background: Youth with somatic symptom disorder (SSD) present unique behavioral characteristics. Aims: To develop and examine the psychometric properties of an observational measure of behavioral characteristics for youth with SSD (the Somatization Behavioral Characteristics Questionnaire, SBCQ). Methods: N = 80 youth with SSD [...] Read more.
Background: Youth with somatic symptom disorder (SSD) present unique behavioral characteristics. Aims: To develop and examine the psychometric properties of an observational measure of behavioral characteristics for youth with SSD (the Somatization Behavioral Characteristics Questionnaire, SBCQ). Methods: N = 80 youth with SSD and 31 with non-SSD impairments participated in this study (age = 13.91 ± 2.72, 14 ± 3.21, respectively; females: n = 61, 14, respectively). Symptom intensity (Children’s Somatization Inventory-24; CSI-24), functional disability (Six-Minute Walk Test, walking rate of perceived exertion), and the SBCQ were assessed. SBCQ reliability and validity were examined. Results: SBCQ had acceptable reliability in both groups (Cronbach’s α > 0.7). Exploratory factor analysis in the SSD group revealed a three-cluster solution. Significant associations were found between the SBCQ, CSI-24, and functional disability. Both groups differed in the prevalence of all SBCQ behaviors. The greatest differences were in the mismatch between etiology and clinical presentation, and in the exhibited lack of trust in the therapist and “la belle indifference”. Receiver operating characteristic analysis showed that the SBCQ has moderate accuracy in discriminating between the two groups (area under the curve = 0.80). Sensitivity and specificity were 82.5% and 73.3%, respectively. Conclusions: The SBCQ is psychometrically sound. Findings may aid in developing sensitive assessment tools for SSD and continuing education for therapists. Full article
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Review

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29 pages, 19772 KiB  
Review
Pictorial Essay on Ultrasound and Magnetic Resonance Imaging of Paraspinal Muscles for Myofascial Pain Syndrome
by Chen-Yu Hung, Bow Wang, Hsiang-Chi Chang, Wei-Ting Wu, Ping-Tang Liu, Ke-Vin Chang, Daniel Chiung-Jui Su, Kamal Mezian, Vincenzo Ricci and Levent Özçakar
Life 2024, 14(4), 499; https://doi.org/10.3390/life14040499 - 12 Apr 2024
Cited by 4 | Viewed by 4910
Abstract
The paraspinal muscles of the cervical, thoracic, and lumbar spine are important pain generators because muscle strains or myofascial pain syndrome caused by trigger points are common during clinical practice. Ultrasonography is the most convenient imaging tool for evaluating these muscles due to [...] Read more.
The paraspinal muscles of the cervical, thoracic, and lumbar spine are important pain generators because muscle strains or myofascial pain syndrome caused by trigger points are common during clinical practice. Ultrasonography is the most convenient imaging tool for evaluating these muscles due to its advantages, such as providing good delineation of soft tissues, easy accessibility, and zero radiation. Additionally, ultrasound can serve as a useful guiding tool for paraspinal muscle intervention to prevent inadvertent injuries to vital axial neurovascular structures. This pictorial essay presents ultrasound scanning protocols for the paraspinal and other associated muscles as well as a discussion of their clinical relevance. Axial magnetic resonance imaging has also been used to elucidate reciprocal anatomy. In conclusion, ultrasound imaging proves to be a valuable tool that facilitates the differentiation of individual paraspinal muscles. This capability significantly enhances the precision of interventions designed to address myofascial pain syndrome. Full article
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Other

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17 pages, 1910 KiB  
Systematic Review
Novel Techniques for Musculoskeletal Pain Management after Orthopedic Surgical Procedures: A Systematic Review
by Saud N. Aldanyowi
Life 2023, 13(12), 2351; https://doi.org/10.3390/life13122351 - 15 Dec 2023
Cited by 2 | Viewed by 4564
Abstract
Effective postoperative pain management is critical for recovery after orthopedic surgery, but often remains inadequate despite multimodal analgesia. This systematic review synthesizes evidence on innovative modalities for enhancing pain control following major orthopedic procedures. Fifteen randomized controlled trials and comparative studies evaluating peripheral [...] Read more.
Effective postoperative pain management is critical for recovery after orthopedic surgery, but often remains inadequate despite multimodal analgesia. This systematic review synthesizes evidence on innovative modalities for enhancing pain control following major orthopedic procedures. Fifteen randomized controlled trials and comparative studies evaluating peripheral nerve blocks, local anesthetic infiltration, cryotherapy, transcutaneous electrical stimulation, adjunct medications, and other techniques are included. Thematic analysis reveals that peripheral nerve blocks and local anesthetic infiltration consistently demonstrate reduced pain scores, opioid consumption, and side effects versus conventional analgesia alone. Oral multimodal medications also show promise as part of opioid-sparing regimens. Adjunctive approaches like cryotherapy, music, and dexmedetomidine require further research to optimize protocols. Despite promising innovations, critical knowledge gaps persist regarding comparative effectiveness, optimal interventions and dosing, combination strategies, cost-effectiveness, and implementation. High-quality randomized controlled trials using standardized protocols are essential to guide the translation of enhanced multimodal regimens into clinical practice. This review provides a framework for pursuing research priorities and advancing evidence-based postoperative pain management across orthopedic surgeries. Full article
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17 pages, 2634 KiB  
Systematic Review
Neural Mobilization for Reducing Pain and Disability in Patients with Lumbar Radiculopathy: A Systematic Review and Meta-Analysis
by Long-Huei Lin, Ting-Yu Lin, Ke-Vin Chang, Wei-Ting Wu and Levent Özçakar
Life 2023, 13(12), 2255; https://doi.org/10.3390/life13122255 - 26 Nov 2023
Viewed by 5137
Abstract
Lumbar radiculopathy causes lower back and lower extremity pain that may be managed with neural mobilization (NM) techniques. This meta-analysis aims to evaluate the effectiveness of NM in alleviating pain and reducing disability in patients with lumbar radiculopathy. We hypothesized that NM would [...] Read more.
Lumbar radiculopathy causes lower back and lower extremity pain that may be managed with neural mobilization (NM) techniques. This meta-analysis aims to evaluate the effectiveness of NM in alleviating pain and reducing disability in patients with lumbar radiculopathy. We hypothesized that NM would reduce pain and improve disability in the lumbar radiculopathy population, leveraging the statistical power of multiple studies. Electronic databases from their inception up to October 2023 were searched for randomized controlled trials (RCTs) that explored the impact of NM on lumbar radiculopathy. Our primary outcome measure was the alteration in pain intensity, while the secondary one was the improvement of disability, standardized using Hedges’ g. To combine the data, we employed a random-effects model. A total of 20 RCTs comprising 877 participants were included. NM yielded a significant reduction in pain intensity (Hedges’ g = −1.097, 95% CI = −1.482 to −0.712, p < 0.001, I2 = 85.338%). Subgroup analyses indicated that NM effectively reduced pain, whether employed alone or in conjunction with other treatments. Furthermore, NM significantly alleviated disability, with a notable effect size (Hedges’ g = −0.964, 95% CI = −1.475 to −0.453, p < 0.001, I2 = 88.550%), particularly in chronic cases. The findings provide valuable insights for clinicians seeking evidence-based interventions for this patient population. This study has limitations, including heterogeneity, potential publication bias, varied causal factors in lumbar radiculopathy, overall study quality, and the inability to explore the impact of neural pathology on NM treatment effectiveness, suggesting opportunities for future research improvements. Full article
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