Search Results (69)

Background/Objectives: The aim of this study was a video-based observational assessment of movement strategies during supine position transfers in patients with hemiparesis following a first-ever ischemic stroke. Methods: The study included 51 participants (n = 51), covering 20 healthy individuals (n = 20) and 31 patients (n = 31) after their first ischemic stroke with hemiparesis. All participants underwent observational kinematic analysis of supine mobility using video recording and time-lapse analysis. The assessment focused on the time required to complete the task, the number of pelvic movements, the presence of trunk translation, spinal flexion, and pelvic mobility across three planes. Results: In the control group, transfers followed a consistent and repetitive sequence in both directions, typically involving trunk translation, spinal flexion, pelvic elevation, and symmetrical movement of both upper and lower limbs. In contrast, post-stroke patients demonstrated altered, asymmetrical, and less efficient movement patterns. These movement strategies were consistent across the hemiparetic group and characterized typical motor responses following stroke. The average transfer time in the study group was approximately three times longer than in the control group. The average number of pelvic movements was 7.2 ± 2.44 in healthy individuals and 16.71 ± 13.52 in post-stroke patients. Conclusions: Supine transfers should be routinely assessed in patients after stroke and included as a key focus in physiotherapy goals. The movement patterns required for such transfers represent a distinct component of complex motor function. Both qualitative and quantitative aspects of their execution may have a significant impact on functional independence in individuals with hemiparesis. Identifying typical transfer patterns in hemiparetic patients may offer valuable guidance for early post-stroke rehabilitation planning, particularly in preventing maladaptive compensatory strategies. Full article

Chronic whiplash-associated disorders describe a cluster of symptoms that result from a sudden neck acceleration/deceleration movement, including pain, musculoskeletal and neurological signs, inducing functional disability. The aim of this study was to compare the effects of physiotherapy treatment based on neck-specific exercises, with or without a behavioral approach, in individuals with whiplash-associated disorders. Computerized research was performed in PubMed, PEDro, National Institute for Health and Care Excellence, and ScienceDirect to identify randomized controlled trials that evaluated the effectiveness of neck-specific exercises, with or without a behavioral approach, for chronic whiplash. For the meta-analysis, the outcomes of pain and disability were assessed. Thirteen studies were included in the systematic review, with a total of 2427 participants of both sexes, with ages between 18 and 63 years. Although interventions with a behavioral approach decreased pain and disability more significantly in 4 and 6 studies when compared to neck-specific exercises without such an approach, respectively, the meta-analysis revealed no differences between them. Although interventions for chronic whiplash-associated disorders based on neck-specific exercises with a behavioral approach seem to be more effective in reducing pain and disability, there is no quantitative difference favoring one over the other. Full article

Motion tests for physiotherapy purposes are a cornerstone in a rehabilitation process. For many reasons, clinicians have been manually measuring and tracking movements so far, being subject to inaccuracies and increasing the time spent in those assessments. This paper studies the reliability of a millimetre wave (mmWave) radar to perform motion tracking for accurate hop tests. Once the variables of interest are extracted and the system set up, the results demonstrate that this system’s accuracy allows its use in clinical environments, facilitating the task of tracking motion and extracting the distance covered by the subject when hopping. The radar outputs are compared against a well-known marker-based optical system, showing high agreement and validating the radar’s effectiveness, with a difference of less 8 cm in the single hop test, 10 cm in the triple hop test, and 21 cm in the crossover hop test for $75\%$ of all measurements. Hence, this approach offers a contactless, efficient, and precise alternative for physiotherapy motion assessment. Full article

Background: A comprehensive physical therapy process includes prevention against musculoskeletal overload syndromes. Monitoring the occurrence of motor control disorders is one of the tools for preventing overload syndromes of the musculoskeletal system and consequent injuries. Assessing motor control and preventive actions can contribute to minimizing the risk of a soldier being removed from duty, reducing the likelihood of injury and thus preventing job loss. The aim of the study was to evaluate directional control of the lumbar spine using the dissociation tests included in the Kinetic Control physiotherapy method. This physiotherapeutic method is used to identify and assess the occurrence and therapy of motor control disorders, including uncontrolled movement in the locomotor system. Methods: Twenty-three soldiers (40.26 ± 4.5 age) from special units of the Polish Armed Forces were qualified for a one-time assessment. The research methods included the evaluation of motor control using dissociation tests based on the physiological method of kinetic control. The control of the lumbar spine in the directions of flexion, extension, and rotation during hip joint movements was evaluated. Uncontrolled movement was understood as the inability to maintain a stationary lumbar spine in a neutral position during specific directions of hip joint movement included in the tests. Results: The survey showed that the area of pain reported by the operators was the lumbar spine in the last three months. 69.57% of the respondents indicated that this area was the site of their complaints. The results of the motor examination showed statistically significant test results (p-value < 0.0001) indicating the presence of motor control disorders in the form of uncontrolled movement of the lumbar spine in control tests for flexion, rotation, and extension. Conclusions: The main results of the present study showed the appearance of interference with the functional movement patterns of the lumbar spine in a group of special unit operators. Impaired control of movement was observed in the direction of flexion, rotation, and lumbar extension, which may be potentially associated with the generation of lumbar spine pain syndromes. Full article

Objectives: Older adults who worry about not being able to stand up from the floor after a fall, reduce their physical activity, which leads to a higher risk of falling. The Backward Chaining Method (BCM) was developed specifically for this population to safely teach and practice the movement sequence required to stand up from the floor. Our aim is to evaluate the effectiveness of using the BCM to teach older adults how to stand up from the floor, and to determine whether this training has an impact on functional mobility, muscle strength, fear of falling, and life-space mobility. Methods: A total of 26 residents of a long-term care facility were randomly allocated to two groups. Residents in the intervention group (IG, n = 13) participated in a seven-week training program to learn how to stand up from the floor with BCM, in addition to the usual care generally offered in long-term care facilities. The participants in the control group (CG, n = 13) received the usual care alone. The primary outcome measure was functional mobility, assessed by the Timed Up and Go test. Secondary outcome measures included functional lower limb strength, grip strength, fear of falling, and life-space mobility. The outcomes were measured at baseline and after the seven-week intervention period. Results: We found no significant between-group differences in functional mobility, lower limb strength and grip strength; however, IG subjects demonstrated significantly lower fear of falling scores, and significantly higher life-space mobility and independent life-space mobility scores compared to CG subjects after the training program. Conclusions: This study demonstrates that the Backward Chaining Method is a feasible, well-tolerated intervention in a long-term care setting and it may have meaningful benefits, particularly in lessening fear of falling and improving life-space mobility and independent life-space mobility when incorporated into the usual physiotherapy interventions. Full article

Background/Objectives: A randomized controlled trial (RCT) was designed to test the emerging role of respiratory mechanics as part of physiotherapy in patients with non-specific chronic neck pain (NSCNP). Methods: Ninety patients with NSCNP and symptom duration >3 months were randomly allocated to three intervention groups of equal size, receiving either cervical spine (according to the Mulligan Concept) and diaphragm manual therapy plus breathing reeducation exercises (experimental group—EG1), cervical spine manual therapy plus sham diaphragmatic manual techniques (EG2), or conventional physiotherapy (control group—CG). The treatment period lasted one month (10 sessions) for all groups. The effect on the cervical spine range of motion (CS-ROM) and on the craniovertebral angle (CVA) was examined. Outcomes were collected before treatment (0/12), after treatment (1/12), and three months after the end of treatment (4/12). The main analysis comprised a two-way mixed ANOVA with a repeated measures factor (time) and a between-groups factor (group). Post hoc tests assessed the source of significant interactions detected. The significance level was set at p = 0.05. Results: No significant between-group baseline differences were identified. Increases in CS-ROM and in CVA were registered mainly post-treatment, with improvements maintained at follow-up for CS-ROM. EG1 significantly improved over CG in all movement directions except for flexion and over EG2 for extension only, at 1/12 and 4/12. All groups improved by the same amount for CVA. Conclusions: EG1, which included diaphragm manual therapy and breathing re-education exercises, registered the largest overall improvement over CG (except for flexion and CVA), and for extension over EG2. The interaction between respiratory mechanics and neck mobility may provide new therapeutic and assessment insights of patients with NSCNP. Full article

Rehabilitation robotic systems have been developed to perform therapy with minimal supervision from a specialist. Hence, they require algorithms to assess and support patients’ motions. Artificial intelligence brings an opportunity to implement new exercises based on previously modelled ones. This study focuses on analysing the similarities in upper extremity movements during activities of daily living (ADLs). This research aimed to model ADLs by registering and segmenting real-life movements and dividing them into sub-tasks based on joint motions. The investigation used IMU sensors placed on the body to capture upper extremity motion. Angular measurements were converted into joint variables using Matlab computations. Then, these were divided into segments assigned to the sub-functionalities of the tasks. Further analysis involved calculating mathematical measures to evaluate the similarity between the different movements. This approach allows the system to distinguish between similar motions, which is critical for assessing rehabilitation scenarios and anatomical correctness. Twenty-two ADLs were recorded, and their segments were analysed to build a database of typical motion patterns. The results include a discussion on the ranges of motion for different ADLs and gender-related differences. Moreover, the similarities and general trends for different motions are presented. The system’s control algorithm will use these results to improve the effectiveness of robotic-assisted physiotherapy. Full article

Upper-limb impairments after stroke significantly affect patients’ quality of life and require effective rehabilitation strategies. Rehabilitation devices play a vital role in enhancing motor recovery. This study evaluated the efficacy of the Arm Booster, a bilateral arm-training device, in improving upper-limb impairment in patients with chronic stroke. Eighteen participants were randomly assigned to two groups: a device group (n = 9), using the Arm Booster; and a conventional physiotherapy group (n = 9). Both groups performed six bilateral upper-limb exercises (32 repetitions each) three times per week for eight weeks. Participants were further classified into mild spasticity (n = 5) and moderate-to-severe spasticity (n = 4) subgroups. The primary outcome was motor impairment, assessed using the Fugl-Meyer Assessment of the Upper Extremity (FMA-UE). Secondary outcomes included spasticity, measured by the Modified Ashworth Scale (MAS), and daily functional use of the arm, assessed with the Motor Activity Log (MAL). Both groups showed significant improvements in FMA-UE scores and overall arm movement. The conventional group demonstrated additional gains in hand and wrist function and coordination. Notably, in the moderate-to-severe spasticity subgroup, the device group exhibited improvements in upper-limb movement and a trend toward reduced spasticity. These findings suggest that the Arm Booster may support motor recovery, encourage the use of the affected arm, improve movement control, and provide an efficient means for patients to exercise more frequently on their own. Full article

Aim: This study explores the effects of core stabilization exercises on balance and upper extremity functions—both unilateral and bilateral—in children with cerebral palsy (CP). Method: Thirty-six children with CP (aged 5–12) were randomly assigned to a study group (n = 18) or control group (n = 18). Both groups received four weeks of physiotherapy and occupational therapy. The study group additionally performed ~45 min of daily core stabilization exercises. Outcome measures included the Box and Block Test (BBT), Assisting Hand Assessment (AHA), Pediatric Berg Balance Scale (PBBS), and Trunk Control Measurement Scale (TCMS). (ClinicalTrials.gov ID: NCT06973213). Results: No significant baseline differences were found between the groups (p > 0.05). Post-intervention, the study group showed significant improvements in PBBS (p = 0.011), TCMS static sitting (p = 0.003), dynamic reaching (p = 0.037), and total score (p = 0.044). Between-group differences remained non-significant for BBT, AHA, and TCMS selective movement control (p > 0.05). Within-group analysis revealed significant gains in BBT (median = 7), PBBS (median = 8), TCMS total (median = 12), static sitting (median = 3.5), and selective movement (median = 6) (all p < 0.001). AHA showed a near-significant trend (median = 6, p = 0.051). Conclusions: Core stabilization exercises significantly enhance balance and unilateral upper extremity function in children with CP. However, they show limited impact on bimanual function. Integration of these exercises into rehabilitation programs may optimize motor outcomes. Full article

Effective physiotherapy requires accurate and personalized assessments of patient mobility, yet traditional methods can be time-consuming and subjective. This study explores the potential of open-source computer vision algorithms, specifically YOLO Pose, to support automated, vision-based analysis in physiotherapy settings using information collected from optical sensors such as cameras. By extracting skeletal data from video input, the system enables objective evaluation of patient movements and rehabilitation progress. The visual information is then analyzed to propose a semantic framework that facilitates a structured interpretation of clinical parameters. Preliminary results indicate that YOLO Pose provides reliable pose estimation, offering a solid foundation for future enhancements, such as the integration of natural language processing (NLP) to improve patient interaction through empathetic, AI-driven support. Full article

Background/Objectives: Children with diplegic spastic cerebral palsy (CP) often present with impaired postural control, poor balance, and gait abnormalities that negatively affect their functional mobility and independence. Core stability, which is the ability to control the position and movement of the trunk, is considered a critical component in maintaining postural alignment and improving gross motor function. This study aimed to investigate the impact of a structured core stability exercise program on the standing ability, functional balance, and gait parameters of children diagnosed with diplegic spastic CP. Methods: Forty children (28 males, 12 females) aged 4–10 years with a clinical diagnosis of diplegic spastic cerebral palsy were randomly allocated into two groups (n = 20 each). The study group underwent a 12-week core stability exercise program in addition to a standardized physiotherapy regimen, which was conducted three times per week. The control group received the physiotherapy program alone. Functional outcomes were assessed pre- and post-intervention using the Gross Motor Function Classification System (GMFCS), Pediatric Balance Scale, and Kinovea software for gait analysis. Results: Both groups demonstrated statistically significant improvements in all measured variables after the intervention. However, the study group showed significantly greater improvements in standing ability (9%), balance (9%), and gait parameters (p < 0.05), particularly in knee flexion, ankle dorsiflexion, and plantar flexion, during gait cycles. Conclusions: Core stability training resulted in superior enhancements in balance, standing, and gait performance compared with physiotherapy alone in children with diplegic spastic cerebral palsy. Full article

Background/Objectives: Total hip joint arthroplasty (THA) is a common procedure aimed at alleviating pain and restoring mobility in patients with severe hip joint conditions, particularly osteoarthritis. While the surgery itself is effective, postoperative rehabilitation is crucial for long-term functional recovery. This study investigates the role of muscle deflection as an indicator of rehabilitation quality, focusing on hip movement improvements (abduction, extension, and flexion) over an 8-week recovery period. The objective is to assess whether muscle deflection measurements can serve as reliable metrics for evaluating recovery progress and functional outcomes. Methods: The study involved post-THA patients from Euroclinic Hospital S.A. and Bucharest Emergency Clinical Hospital, who were divided into an experimental group (undergoing a specialized rehabilitation program) and a control group (receiving standard recovery protocols). Measurements of active range of motion (AROM), passive range of motion (PROM), and muscle deflection were taken using a handheld digital dynamometer (ActivForce 2) at different time points (2, 4, 6, and 8 weeks post-surgery). The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) was also used to assess pain, physical difficulties, and joint stiffness. Results: The study found progressive improvements in AROM, PROM, and muscle deflection across all movements over the 8-week period. Conclusions: The findings highlight the importance of structured physiotherapy in post-THA rehabilitation. The use of muscle deflection measurements provides an objective and quantifiable method for tracking patient progress. Future rehabilitation protocols could benefit from incorporating muscle deflection monitoring to tailor recovery programs and optimize patient outcomes. Standardizing rehabilitation exercises, including balance training and resistance exercises, may further enhance recovery and reduce long-term functional impairments. Full article

Background/Objectives: Pediatric chronic pain requires individualized care. The Pediatric Pain Screening Tool (PPST) allows for stratification of psychosocial and physical risk factors and may guide targeted interventions. However, its integration into multimodal physiotherapy programs remains unexplored. This exploratory feasibility case series study evaluated a PPST-guided, risk-stratified multimodal physiotherapy intervention in children aged 8–17 years with chronic pain. Methods: Participants were classified as low, medium, or high risk. Interventions were tailored accordingly. Outcomes were assessed pre- and post-intervention and included pain intensity, pain interference, psychological distress, and quality of life. Results: Ten participants (mean age = 13.5 years; 60% girls) were included. Six were classified as high, three as medium, and one as low risk based on the PPST. After an 8-week physiotherapist intervention program, pain interference significantly decreased (MD = −7.5; p = 0.040; d = 1.69), as did pain intensity at rest (MD = −3.1; p = 0.002; d = 2.60) and during movement (MD = −3.0; p = 0.004; d = 2.55), exceeding the MCID of 1.92. In the high-risk group, reductions were observed in anxiety (p = 0.006; d = 2.36), pain-related worries (p = 0.001; d = 3.79), fear of movement (p = 0.015; d = 1.62), and fear of pain (p = 0.002; d = 3.37). Eighty percent reported feeling “a great deal better” in the PGIC including all high-risk participants. Conclusions: These results supports the feasibility of integrating PPST risk stratification into multimodal management, providing a structured and effective framework for addressing pediatric chronic pain. Full article

Primary cervical dystonia (PCD), or spasmodic torticollis, is a focal dystonia characterized by involuntary and often painful muscle contractions, leading to abnormal cervical movements and postures. While botulinum toxin injections are the first-line treatment, additional therapies, such as segmental muscle vibration (SMV), remain underexplored. SMV, a non-invasive neuromodulation technique, may enhance motor cortex excitability and promote neuroplasticity, offering potential benefits in PCD management. This single-center triple-blinded randomized controlled trial evaluates SMV’s efficacy in reducing dystonic pain and improving quality of life in PCD patients undergoing standardized rehabilitation after botulinum toxin treatment. Participants with a pain level of ≥3 on the Numerical Rating Scale will be randomized into two groups. The experimental group will receive 80 Hz SMV during a 10-session rehabilitation program, while the control group will undergo sham SMV. Both groups will follow identical physiotherapy and occupational therapy protocols. The primary outcomes include changes in pain intensity and function, assessed at baseline, mid-treatment, and post-treatment using validated scales. The secondary outcomes will evaluate quality of life and patient satisfaction. This study hypothesizes that SMV will significantly reduce dystonic pain and enhance quality of life, supporting its integration into multidisciplinary rehabilitation for dystonic disorders. Trial registration number: NCT06748846. Full article

Machine learning-based computer vision techniques using depth cameras have shown potential in physiotherapy movement assessment. However, a comprehensive understanding of their implementation, effectiveness, and limitations remains needed. Following PRISMA guidelines, we systematically reviewed studies from 2020 to 2024 across Web of Science, Scopus, PubMed, and Astrophysics Data System to explore recent advancements. From 371 initially identified publications, 18 met the inclusion criteria for detailed analysis. The analysis revealed three primary implementation scenarios: local (50%), clinical (33.4%), and remote (22.3%). Depth cameras, particularly the Kinect series (65.4%), dominated data collection methods. Data processing approaches primarily utilized RGB-D (55.6%) and skeletal data (27.8%), with algorithms split between traditional machine learning (44.4%) and deep learning (41.7%). Key challenges included limited real-world validation, insufficient dataset diversity, and algorithm generalization issues, while machine learning-based computer vision systems demonstrated effectiveness in movement assessment tasks, further research is needed to address validation in clinical settings and improve algorithm generalization. This review provides a foundation for enhancing computer vision-based assessment tools in physiotherapy practice. Full article