Search Results (1,357)

Background: This systematic review evaluates the efficacy of rehabilitation-focused exercise interventions for lumbar degenerative disc disease (DDD), a leading cause of chronic low back pain. Methods: Following PRISMA guidelines, a comprehensive search was conducted across international and regional databases (PubMed, Scopus, Web of Science, Magiran, SID, and Noormags) covering the period from January 2010 to January 2025. The review protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO) under registration number CRD420251088811. Using keywords such as “lumbar DDD,” “exercise therapy,” and “rehabilitation,” a total of 2495 records were identified. After screening, 20 studies—including clinical trials, quasi-experimental, and experimental designs—met the inclusion criteria and were assessed using the McMaster Critical Review Form for Quantitative Studies. Results: Interventions such as hydrotherapy, core stability training, Pilates, and suspension exercises were found to significantly reduce pain and improve functional outcomes. While multimodal approaches (e.g., aquatic exercise combined with acupuncture) showed positive effects, the comparative studies revealed no significant differences between modalities. Suspension training demonstrated superior efficacy in pain reduction compared to isolated core stability exercises. The methodological quality of included studies ranged from good to excellent, with the majority rated as very good or excellent (McMaster scores: 8 “excellent,” 7 “very good,” and 5 “good”). Common limitations among the studies included methodological heterogeneity, small sample sizes (n = 14–30), and insufficient long-term follow-up. Conclusions: Exercise-based rehabilitation is an effective strategy for managing lumbar DDD. Evidence particularly supports the use of suspension training and aquatic therapy for superior improvements in pain and functional outcomes. Future research should aim to adopt standardized protocols, recruit larger sample sizes, and include extended follow-up periods to produce more robust and generalizable findings. Full article

Background/Objectives: Adolescence is a critical period for the early detection of metabolic syndrome (MetS), a condition that increases the risk of cardiometabolic diseases in adulthood. Timely identification of at-risk adolescents enables targeted prevention strategies. This study aimed to analyze the discriminative capacity and accuracy of six biochemical and/or anthropometric indices related to lipid metabolism and adiposity for the early detection of MetS in a sample of Spanish adolescents. Methods: A cross-sectional study carried out according to the STROBE guidelines. A sample of 981 adolescents aged 11–16 years old were randomly recruited from schools in Southeastern Spain. The presence or absence of MetS was determined according to the International Diabetes Federation criteria. The following biochemical and/or anthropometric indices were evaluated: triglyceride glucose index, visceral adiposity index, logarithm children’s lipid accumulation product, triglyceride glucose-body mass index, triglyceride glucose-waist circumference, and triglyceride glucose-waist-to-hip ratio. Results: The triglyceride glucose-waist-to-hip ratio and triglyceride glucose-body mass index parameters were the strongest indicators associated with MetS in boys and girls, respectively, after adjusting for several factors. Moreover, all evaluated indices showed optimal AUC values, with the visceral adiposity index and triglyceride glucose-waist circumference index exhibiting the highest discriminative capacity in both genders. Conclusions: The evaluated biochemical and anthropometric indices—particularly visceral adiposity index and triglyceride-glucose-waist circumference—show promise as accessible biomarkers for identifying adolescents at metabolic risk. These indices may serve as practical tools in preventive health strategies aimed at improving metabolic health by screening adolescents at risk of MetS, thereby helping to reduce the future burden of non-communicable diseases. Full article

Introduction: The combination of ceftazidime−avibactam (CAZ-AVI) with aztreonam (ATM) may be an option for the treatment of infections due to metallo-β-lactamases (MBLs) producing bacteria, as recommended by current guidelines. MBLs protect the pathogen from any available β-lactam/β-lactamase inhibitor (BL/BLI). Moreover, in vitro and clinical data suggest that double carbapenem therapy (DCT) may be an option for such infections. Materials and Methods: This retrospective study was conducted in two mixed intensive care units (ICUs) at the University Hospital of Larissa, Thessaly, Greece, and the General Hospital of Larissa, Thessaly, Greece, during a three-year period (2022−2024). Mechanically ventilated patients with bloodstream infection (BSI) caused by K. pneumoniae resistant to all BL/BLI combinations were studied. Patients were divided into three groups: in the first, patients were treated with CAZ-AVI + ATM; in the second, with DCT; and in the third, with antibiotics other than BL/BLIs that presented in vitro susceptibility. The primary outcome of the study was the change in Sequential Organ Failure Assessment (SOFA) score between the onset of infection and the fourth day of antibiotic treatment. Secondary outcomes were SOFA score evolution during the treatment period, total duration of mechanical ventilation (MV), ICU length of stay (LOS), and ICU mortality. Results: A total of 95 patients were recruited. Among them, 23 patients received CAZ-AVI + AZT, 22 received DCT, and 50 patients received another antibiotic regimen which was in vitro active against the pathogen. The baseline characteristics were similar. The mean (SE) overall age was 63.2 (1.3) years. Mean (SE) Acute Physiology and Chronic Health Evaluation II (APACHE II) and SOFA scores were 16.3 (0.6) and 7.6 (0.3), respectively. The Charlson Index was similar between groups. The control group presented a statistically lower SOFA score on day 4 compared to the other two groups [mean (SE) 8.9 (1) vs. 7.4 (0.9) vs. 6.4 (0.5) for CAZ-AVI + ATM, DCT and control group, respectively (p = 0.045)]. The duration of mechanical ventilation, ICU LOS, and mortality were similar between the groups (p > 0.05). Comparison between survivors and non-survivors revealed that survivors had a lower SOFA score on the day of BSI, higher PaO₂/FiO₂ ratio, higher platelet counts, and lower lactate levels (p < 0.05). Septic shock was more frequent among non-survivors (60.3%) in comparison to survivors (27%) (p = 0.0015). Independent factors for mortality were PaO₂/FiO₂ ratio and lactate levels (p < 0.05). None of the antibiotic regimens received by the patients was independently associated with survival. Conclusions: Treatment with CAZ-AVI + ATM or DCT may offer similar clinical outcomes for patients suffering from BSI caused by K. pneumoniae strains resistant to all available BL/BLIs. However, larger studies are required to confirm the findings. Full article

Background: Cervical cancer poses a threat to the health of women globally. Adolescent girls are the primary target population for HPV vaccination, and guardians’ attitude towards the HPV vaccine plays a significant role in determining the vaccination status among adolescent girls. Objectives: This study aimed to explore the factors influencing guardians’ HPV vaccine acceptance for their girls and provide clues for the development of health intervention strategies. Methods: Combining the health belief model as a theoretical framework, a questionnaire-based survey was conducted. A total of 2157 adolescent girls and their guardians were recruited. The multivariable logistic model was applied to explore associated factors. Results: The guardians had a high HPV vaccine acceptance rate (86.7%) for their girls, and they demonstrated a relatively good level of awareness regarding HPV and HPV vaccines. Factors influencing guardians’ HPV vaccine acceptance for girls included guardians’ education background (OR = 0.57, 95%CI = 0.37–0.87), family income (OR = 1.94, 95%CI = 1.14–3.32), risk of HPV infection (OR = 3.15, 95%CI = 1.40–7.10) or importance of the HPV vaccine for their girls (OR = 6.70, 95%CI = 1.61–27.83), vaccination status surrounding them (OR = 2.03, 95%CI = 1.41–2.92), awareness of negative information about HPV vaccines (OR = 0.59, 95%CI = 0.43–0.82), and recommendations from medical staff (OR = 2.32, 95%CI = 1.65–3.25). Also, guardians preferred to get digital information on vaccines via government or CDC platforms, WeChat platforms, and medical knowledge platforms. Conclusions: Though HPV vaccine willingness was high among Chinese guardians, they preferred to vaccinate their daughters at the age of 17–18 years, later than WHO’s recommended optimal age period (9–14 years old), coupled with safety concerns. Future work should be conducted based on these findings to explore digital intervention effects on girls’ vaccination compliance. Full article

Purpose: This study investigates the test–retest reliability of maximal voluntary contraction (MVC) and integrated object positioning during bimanual box lifting tasks in children with unilateral spastic cerebral palsy (USCP), using the Activities of Daily Living Test and Training Device (ADL-TTD). Materials and Methods: Utilizing an explorative cross-sectional design, the study recruited 47 children with USCP. The ADL-TTD, equipped with an Inertial Measurement Unit (IMU) for precise object positioning, measured MVC, and object position in 3D space in a cross-sectional measurement containing two measurements in a fixed time period. Results: The findings demonstrated good test–retest reliability for MVC, with an ICC_agreement of 0.95 for the mean MVC value. Additionally, good reliability was observed for object positioning in different directions measured with an IMU, with ICC_agreement ranging from 0.82 to 0.86 degrees. Regarding the standard error of measurement (SEM), the SEM_agreement for the mean MVC value was 5.94 kg, while the SEM_agreement for object positioning was 1.48, 5.39, and 3.43 degrees, respectively. Conclusions: These results indicate that the ADL-TTD demonstrates good test–retest reliability for both MVC and object positioning, making it a valuable tool for analyzing this population in cross-sectional research by providing reliable measures of task-oriented strength and object manipulation. However, the relatively high SEM_agreement, particularly in MVC, suggests that caution is needed when using this tool for repeated testing over time. This pioneering approach could significantly contribute to tailored assessment and training for children with USCP, highlighting the importance of integrating task-specific strength and positional accuracy into therapeutic interventions. Full article

Objectives: To investigate the reliability and validity of the Singer Reflux Symptom Score (sRSS), a new patient-reported outcome questionnaire documenting the severity of reflux symptoms in singing voice is proposed. Methods: Amateur and professional singers consulting the European Reflux Clinic for laryngopharyngeal reflux disease (LPRD) symptoms and findings were prospectively recruited from January 2022 to February 2023. The diagnosis was based on a Reflux Symptom Score (RSS) > 13 and Reflux Sign Assessment (RSA) > 14. A control group of asymptomatic singer subjects was recruited from the University of Mons. The sRSS was rated within a 7-day period to assess test–retest reliability. Internal consistency was measured using Cronbach’s α in patients and controls. A correlation analysis was performed between sRSS and Singing Voice Handicap Index (sVHI) to evaluate convergent validity. Responsiveness to change was evaluated through pre- to post-treatment sRSS changes. The sRSS threshold for suggesting a significant impact of LPRD on singing voice was determined by receiver operating characteristic (ROC) analysis. Results: Thirty-three singers with suspected LPRD (51.5% female; mean age: 51.8 ± 17.2 years) were consecutively recruited. Difficulty reaching high notes and vocal fatigue were the most prevalent LPRD-related singing complaints. The sRSS demonstrated high internal consistency (Cronbach-α = 0.832), test–retest reliability, and external validity (correlation with sVHI: r = 0.654; p = 0.015). Singers with suspected LPRD reported a significant higher sRSS compared to 68 controls. sRSS item and total scores significantly reduced from pre-treatment to 3 months post-treatment except for the abnormal voice breathiness item. ROC analysis revealed superior diagnostic accuracy for sRSS (AUC = 0.971) compared to sRSS-quality of life (AUC = 0.926), with an optimal cutoff at sRSS > 38.5 (sensitivity: 90.3%; specificity: 85.0%). Conclusions: The sRSS is a reliable and valid singer-reported outcome questionnaire for documenting singing symptoms associated with LPRD leading to personalized management of Singers. Future large-cohort studies are needed to evaluate its specificity for LPRD compared to other vocal fold disorders in singers. Full article

The evidence for photobiomodulation in reducing postoperative pain after endodontic instrumentation is classified as low or very low certainty, indicating a need for further research. Longitudinal pain assessments over 24 h are crucial, and studies should explore these pain periods. Background/Objectives: This double-blind, randomized controlled clinical trial evaluated the effect of PBM on pain following single-visit endodontic treatment of maxillary molars at 4, 8, 12, and 24 h. Primary outcomes included pain at 24 h; secondary outcomes included pain at 4, 8, and 12 h, pain during palpation/percussion, OHIP-14 analysis, and frequencies of pain. Methods: Approved by the Research Ethics Committee (5.598.290) and registered in Clinical Trials (NCT06253767), the study recruited adults (21–70 years) requiring endodontic treatment in maxillary molars. Fifty-eight molars were randomly assigned to two groups: the PBM Group (n = 29), receiving conventional endodontic treatment with PBM (100 mW, 333 mW/cm², 9 J distributed at 3 points near root apices), and the control group (n = 29), receiving conventional treatment with PBM simulation. Pain was assessed using the Visual Analog Scale. Results: Statistical analyses used chi-square and Mann–Whitney tests, with explained variance (η²). Ten participants were excluded, leaving 48 patients for analysis. No significant differences were observed in postoperative pain at 24, 4, 8, or 12 h, or in palpation/percussion or OHIP-14 scores. Pain frequencies ranged from 12.5% to 25%. Conclusions: PBM does not influence post-treatment pain in maxillary molars under these conditions. These results emphasize the importance of relying on well-designed clinical trials to guide treatment decisions, and future research should focus on personalized dosimetry adapted to the anatomical characteristics of the treated dental region to enhance the accuracy and efficacy of therapeutic protocols. Full article

Background: Schizophrenia affects patients’ organizational thinking, as well as their ability to identify problems. The main objective of this study was to explore healthcare consultants’ application of AI mind maps to educate patients with schizophrenia regarding their perceptions of family function, social support, quality of life, and loneliness, and to help these patients think more organizationally and understand problems more effectively. Methods: The study used a survey research design and purposive sampling method to recruit 66 participants with schizophrenia who attended the psychiatric outpatient clinic of a hospital in central Taiwan. They needed to be literate, able to respond to the topic, and over 18 years old (inclusive), and they attended individual and group health education using AI mind maps over a 3-month period during regular outpatient clinic visits. Results: The study results show that patients’ family function directly affects their quality of life (p < 0.05) and loneliness (p < 0.05), satisfaction with social support affects quality of life and loneliness directly (p < 0.05), and satisfaction with social support is a mediating factor between family function and quality of life (p < 0.05), as well as a mediating factor between family function and loneliness (p < 0.05). Conclusions: Therefore, this study confirms the need to provide holistic, integrated mental health social care support for patients with schizophrenia, showing that healthcare consultants can apply AI mind maps to empower patients with schizophrenia to think more effectively about how to mobilize their social supports. Full article

Background/Objectives: Vertical jump is considered a reliable and valid method of assessing the level of muscular power and coordination across one’s lifespan. The main aim of the present study was to establish sex- and age-normative data for vertical jump outcomes in pre-school children. Methods: We recruited 411 boys and girls aged 3−6 years from four major cities in Croatia and Slovenia. Vertical jump was assessed with two tests: countermovement jump (CMJ) without and with arm swing using a reliable and valid Optojump measuring platform. Data were presented for the 5th, 15th, 25th, 50th (median), 75th, 90th, and 95th percentile. Results: No significant differences were observed in multiple vertical jump outcomes between boys and girls. The mean values for CMJ without and with arm swing between boys and girls were as follows: contact time (1.4 vs. 1.4 s/1.8 vs. 1.7 s), flight time (0.32 vs. 0.31 s/0.33 vs. 0.32), height (12.3 vs. 12.2 cm/13.0 vs. 12.5 cm), power (9.4 vs. 9.5 W/kg/9.3 vs. 9.1 W/kg), pace (0.7 vs. 0.7 steps/s/0.6 vs. 0.6 steps/s), reactive strength index (RSI; 0.10 vs. 0.09 m/s/0.08 vs. 0.08 m/s), and verticality (2.5 vs. 2.3/1.9 vs. 1.9). A gradual increase in all measures according to ‘age’ was observed (p for trend < 0.05). No significant ‘sex*age’ interaction was observed (p > 0.05). Conclusions: This is one of the first studies to provide sex- and age-normative data for complete vertical jump outcomes in pre-school children. These data will serve as an avenue for monitoring and tracking motor development in this sensitive period. Full article

Background/Objectives: Anti-tumour necrosis factor (anti-TNF) medications were historically commonly prescribed as the first-line biologic treatment for chronic inflammatory pouch conditions. However, their use in these conditions is mainly based on retrospective studies of relatively small numbers of patients with short follow up periods. We aimed to describe the long-term outcomes of first-line anti-TNF therapy in a large, multi-centre, multi-national patient cohort with chronic inflammatory pouch conditions. Methods: This was an observational, retrospective, multi-centre, multi-national study. We included patients with chronic inflammatory pouch conditions initially treated with anti-TNF drugs infliximab (IFX) or adalimumab (ADA), who had a follow up of at least 1 year. The primary outcome was anti-TNF treatment persistence, defined as continuation of anti-TNF throughout the study period. The secondary outcome was pouch failure, defined by the need for a defunctioning ileostomy or pouch excision. Results: We recruited 98 patients with chronic inflammatory pouch conditions initially treated with anti-TNF medications—63 (64.3%) treated with IFX and 35 (35.7%) treated with ADA. Average follow up length was 94.2 months (±54.5). At the end of the study period only 22/98 (22.4%) patients were still on anti-TNF treatment. In those in whom the first-line anti-TNF was discontinued, the median time to discontinuation was 12.2 months (range 5.1–26.9 months). The most common cause for anti-TNF discontinuation was lack of efficacy despite adequate serum drug levels and absence of anti-drug antibody formation (30 patients, 30.6%). Loss of response due to anti-drug antibody formation was the cause for discontinuation in 18 patients (18.4%), while 12 patients (12.2%) stopped treatment because of adverse events or safety concerns. Out of the 76 patients discontinuing anti-TNF treatment, 34 (34.7% of the cohort) developed pouch failure, and 42 (42.8% of the cohort) are currently treated with a different medical therapy. Conclusions: First-line anti-TNF therapy for chronic pouch inflammatory conditions is associated with low long-term persistence rates. This is due to a combination of lack of efficacy and adverse events. A significant percentage of patients initially treated with anti-TNF therapy develop pouch failure. Full article

This paper aims to discuss the transition of new graduate nurses into the workforce, the preparation provided to equip them through the novice–beginner stage, and the theory–practice conundrum. Background: In Australia, new graduate transition programs have been in existence since the 1990s. While there is widespread acknowledgment that this period is pivotal for new graduate nurses entering the profession, there is a lack of consensus on the definition of best practice to achieve optimal preparation for new graduate nurses transitioning into the workforce. Methods: This discussion paper integrates the nursing literature on this topic with the extensive professional experiences of the authors, who are currently working as clinicians in metropolitan hospitals and hold academic positions at universities. Their insights are informed by the literature sourced from peer-reviewed English language journals, including reviews, empirical studies, and national and international reports. Discussion: Recruiting and retaining nurses presents a multifaceted challenge that requires the development of effective tools and strategies to build a sustainable workforce. Both the literature and the authors’ experiences highlight several key factors influencing the preparedness of new graduates. These factors include workplace culture, the demands placed on new graduates, and the support, education, and training they receive. The perspectives shared in this article offer valuable discussion points that can deepen our understanding of the current issues and contribute to the development of more effective solutions. Full article

Background: This study aims to evaluate the efficacy of a combined transcranial magnetic stimulation (TMS) protocol incorporating intermittent theta burst stimulation (iTBS) and low-frequency TMS in adults diagnosed with first-episode and recurrent depressive disorders. Methods: A prospective, double-blind, parallel-group trial was conducted involving 42 participants (21 with first-episode depressive disorder and 21 with recurrent depressive disorder) recruited from Chengdu, China. All subjects received 10 sessions of TMS over two weeks. The primary outcome measure was suicidal ideation, assessed using the Beck scale for suicide ideation. Secondary outcomes included sleep quality, depressive symptoms, anhedonia, and cognitive function. Event-related potentials (ERPs) were also recorded. Data were analyzed using SPSS V.21.0, with statistical significance defined as p < 0.05. Results: Both patient groups exhibited significant reductions in suicidal ideation following the composite TMS intervention. Secondary outcomes showed significant improvements in sleep quality, overall depressive symptoms, anhedonia, and cognitive function. Notably, a significant association was found between improvements in sleep quality and depressive symptoms in the first-episode group, suggesting differential underlying mechanisms compared to recurrent depression. Limitations: The relatively short intervention and follow-up period limits the ability to assess the long-term sustainability of the observed benefits. Future studies with extended follow-up periods are warranted to evaluate the persistence of TMS effects and the potential need for maintenance sessions. Conclusions: The combined protocol of iTBS and low-frequency TMS effectively reduces suicidal ideation and improves various clinical outcomes in both first-episode and recurrent depressive disorders, indicating the effectiveness of the physical intervention, especially for the first-episode patients. These findings underscore the importance of personalized treatment strategies based on the clinical history of depressive episodes. Further research with longer follow-up periods is warranted to assess the long-term sustainability of TMS effects. Full article

Background/Objectives: Most patients with non-small cell lung cancer (NSCLC) receive chemo- and/or immunotherapy, which can be associated with adverse events including fatigue. Affected patients may not be able to receive the complete chemo- and/or immunotherapy as planned. In this context, patients may benefit from maintaining their physical activity, which can be challenging. An app reminding patients to perform a certain number of steps may have a positive effect on physical activity during chemo- and/or immunotherapy. Such an app is under development and will be tested in a prospective trial. The current APACHIE-01 study (NCT06993896) is required for proper sample size calculation and design of the planned trial. Methods: The main goal of the APACHIE-01 study is to evaluate patterns and predictors of physical activity during chemo- and/or immunotherapy for locally advanced or metastatic NSCLC. The primary endpoint is the assessment of the mean number of steps per week during the first three cycles of chemo- and/or immunotherapy for lung cancer. The baseline value is represented by the mean number of steps during the last week prior to chemotherapy and/or immunotherapy. Secondary endpoints include associations between mean number of steps per week and a pain score, a distress score, and a fatigue score. The recruitment of the required 38 patients should be completed within 4 months and the treatment period will be 9–10 weeks (three cycles of chemo- and/or immunotherapy), resulting in a total running time of approximately 6 months. The APACHIE-01 study will contribute to the optimal design of a subsequent prospective trial. Full article

In recent decades, fishery stock enhancement has been increasingly utilized as a restoration tool to mitigate population declines and enhance the resilience of marine fisheries. Nevertheless, persistent enhancement efforts risk eroding the evolutionary potential of wild populations via genetic homogenization and maladaptive gene flow. Using long-term monitoring data (2017–2023), we quantified the effects of large-scale Penaeus penicillatus stock enhancement (~10⁸ juveniles/yr) on wild population dynamics and genetic integrity in the Beibu Gulf ecosystem. Temporal genetic changes were assessed using eight highly polymorphic microsatellite loci, comparing founder (2017) and enhanced (2024) populations to quantify stocking impacts. Insignificantly lower expected heterozygosity was observed in the stocked population (He = 0.60, 2024) relative to natural populations (He = 0.62–0.66; p > 0.1), indicating genetic dilution effects from enhancement activities. No significant erosion of genetic diversity was detected post-enhancement, suggesting current stocking practices maintain short-term population genetic integrity. Despite conserved heterozygosity, pairwise Fst analysis detected significant genetic shifts between temporal cohorts (pre-enhancement—2017 vs. post-enhancement—2024; Fst = 0.25, p < 0.05), demonstrating stocking-induced population restructuring. Genetic connectivity analysis revealed that while the enhanced Beihai population (A-BH) maintained predominant self-recruitment (>90%), it experienced substantial stocking-derived gene flow (17% SW → A-BH). The post-stocking period showed both reduced genetic exchange with adjacent populations and increased asymmetric dispersal from A-BH (e.g., 5% to YJ), indicating that hatchery releases simultaneously enhanced population isolation while altering regional genetic structure. Our findings revealed the paradoxical dual effects of stock enhancement and allelic diversity while disrupting natural genetic architecture. This underscores the need for evolutionary-impact assessments in marine resource management. Full article

Background: The present study aimed to determine whether the protocolized use of pneumatic splints within neurodevelopmental therapeutic approaches produces a positive effect on sensorimotor impairments of the hemiplegic upper extremity in patients. Methods: A randomized clinical single-blind trial was conducted. Stroke patients were recruited and randomized into an experimental group, which completed a treatment protocol of splinting plus physiotherapy for 45 min per session, two sessions per week for four weeks; or a control group, which received the same type of conventional physiotherapy treatment for the same period of time. The patients were evaluated by Fugl-Meyer Assessment of the Upper Extremity (FMA-UE) and the Trunk Control Scale. Secondary variables were Mini-BEStest, the modified Ashworth scale for ankle flexors, and computerized measurements of upper limb functional parameters performed by Armeo Spring^® robotic systems and Amadeo^®. All variables were measured pre- and post-treatment. Results: Twenty stroke patients with subacute and chronic stroke completed the protocol. Mann–Whitney U tests showed statistically significant differences between groups for the FM sensation variable (Z = −2.19; p = 0.03). The rest of the variables studied in the comparison between the two study groups did not present statistically significant differences (p > 0.05). Conclusions: The use of air splints in combination with physiotherapy treatment produced improvements in exteroceptive and proprioceptive sensitivity in post-stroke adult patients in the subacute and chronic phases. Full article