Search Results (170)

Water treadmill (WT) exercise is used for horses’ rehabilitation and training. Given that each training needs to be individualized for each horse, the goal is to assess whether infrared thermography (IRT) can serve as a non-invasive tool for daily monitoring of individual training and rehabilitation progress in horses undergoing WT exercise. Fifteen Polish Warmblood school horses were subjected to five WT sessions: dry treadmill, fetlock-depth water, fetlock-depth water with artificial river (AR), carpal-depth water, and carpal-depth water with AR. IRT images, collected pre- and post-exercise, were analyzed for the mean temperature (Tmean) and maximal temperature (Tmax) across 14 regions of interest (ROIs) representing the body surface overlying specific superficial muscles. While on a dry treadmill, Tmean and Tmax increased post-exercise in all ROIs; wetting of the hair coat limited surface temperature analysis in ROIs annotated on limbs. Tmax over the m. brachiocephalicus, m. trapezius pars cervicalis, m. triceps brachii, and m. semitendinosus increased during walking in carpal-depth water, which therefore may be suggested as an indirect indicator of increased activity related to forelimb protraction and flexion–extension of the limb joints. Tmax over the m. latissimus dorsi and m. longissimus increased during carpal-depth WT exercise with active AR mode, which may be suggested as an indicator of increased workload including vertical displacement of the trunk. Full article

This study aimed to evaluate the feasibility of using serious games for the (tele)rehabilitation of children with disabilities affected by the Ukrainian war. Additionally, it provides requirements for technologies that can be used in war-affected areas. Structured interviews and Likert scale assessments were conducted on-site and remotely with patients of the tertiary care facility in Ukraine. All participants used the telerehabilitation platform for motor and cognitive training. Nine serious games were employed, involving trunk tilts, upper limb movements, and head control. By mid-September 2023, 186 positive user experiences were evident, with 89% expressing interest in continued engagement. The platform’s accessibility, affordability, and therapeutic benefits were highlighted. The recommendations from user feedback informed potential enhancements, showcasing the platform’s potential to provide uninterrupted rehabilitation care amid conflict-related challenges. This study suggests that serious games solutions that suit the sociopolitical and economic context offer a promising solution to rehabilitation challenges in conflict zones. The positive user experiences towards using the platform with serious games indicate its potential in emergency healthcare provision. The findings emphasize the role of technology, particularly serious gaming, in mitigating the impact of armed conflicts on children’s well-being, thereby contributing valuable insights to healthcare strategies in conflict-affected regions. Requirements for technologies tailored to the context of challenging settings were defined. Full article

This study examined the relationship between spinal morphological changes and gait characteristics in patients with adolescent idiopathic scoliosis (AIS) using inertial measurement unit (IMU) analysis. Twenty-three female patients with AIS scheduled for corrective surgery underwent a preoperative gait analysis using an IMU positioned at the third lumbar vertebra. Gait stability indicators were calculated, including root mean square (RMS) values for mediolateral (RMSx), anteroposterior, and vertical components. Peak mediolateral components in four coronal plane quadrants were also analyzed. Relationships with the main thoracic (MT) curve, the thoracolumbar (TL) curve, and thoracic kyphosis (TK) were assessed using Spearman’s rank correlation. The MT curve is positively correlated with RMSx, whereas TK exhibited a negative correlation. Gait symmetry analysis revealed a positive correlation between the MT curve and peak mediolateral trunk acceleration in the second (left upper) quadrant, and negative correlations for TK in the first (right upper) and fourth (right lower) quadrants. Patients with AIS who have right-convex MT curves demonstrated leftward center-of-gravity shifts, although reduced TK limited this compensatory mechanism. These findings may inform the development of rehabilitation strategies for AIS. Full article

This study investigated the effects of virtual reality (VR)-based training combined with preliminary trunk stabilization education on postural control and balance in stroke patients. A single-blind randomized controlled trial enrolled 30 participants, randomly divided into a trunk stabilization group (n = 15) and a control group (n = 15). The trunk stabilization group engaged in 10 min of trunk stabilization education followed by 20 min of VR-based training, three times weekly for three weeks. The control group participated only in VR-based training. Outcomes were assessed using the Korean Trunk Impairment Scale (K-TIS), Postural Assessment Scale for Stroke (PASS), Berg Balance Scale (BBS), limit of stability (LOS), and center of pressure (COP) measurements. Both groups significantly improved in all measured outcomes post-intervention (p < 0.05). Notably, the trunk stabilization group exhibited significantly superior improvements in the K-TIS, PASS, BBS, LOS, and COP path length compared to the control group (p < 0.05). These results highlight the enhanced effectiveness of integrating trunk stabilization education with VR-based training, suggesting that it not only yields statistically significant improvements but also provides clinically meaningful benefits for functional postural control and balance recovery in stroke rehabilitation. Full article

Background and Objectives: Idiopathic pulmonary fibrosis (IPF) is a specific form of chronic, progressive interstitial lung disease with an unknown etiology. It is often accompanied by skeletal muscle mass loss. Chest wall muscles play a crucial role in respiratory movements and form part of the skeletal muscles. The aim of this study is to evaluate the relationship between chest wall muscle thickness and pulmonary function test (PFT) results, as well as other prognostic markers, in patients with IPF. Materials and Methods: A retrospective analysis was conducted on 108 patients diagnosed with IPF and 53 control subjects. Chest wall muscle thickness was measured on thoracic computed tomography (CT) images at specific anatomical levels. PFT parameters, the Gender-Age-Physiology (GAP) index, number of acute exacerbations, and mortality data were evaluated in relation to muscle thickness. Results: IPF patients had significantly reduced thickness in the bilateral external scapular muscles at both the aortic and pulmonary trunk levels compared to controls. Bilateral pectoral muscle thickness at the aortic level was positively correlated with forced vital capacity (FVC) and negatively correlated with the number of exacerbations. Internal scapular muscle thickness at the aortic level showed a significant positive correlation with diffusion capacity of the lung for carbon monoxide (DLCO) and a negative correlation with both GAP scores and exacerbation frequency. External scapular muscle thickness at the pulmonary trunk level was positively associated with PFT parameters and inversely correlated with the GAP index, exacerbations, and mortality. Conclusions: In patients with IPF, the bilateral external scapular muscle thickness at the aortic and pulmonary trunk levels was significantly reduced compared to controls. Significant associations were found between some chest wall muscle thicknesses and the GAP index, pulmonary function, acute exacerbations, and mortality, underscoring the prognostic value of baseline muscle measurements. Measurement of chest wall muscle thickness using routine thoracic CT scans may offer additional prognostic value in IPF. Incorporating this parameter into clinical evaluation may help identify patients who could benefit from supportive interventions, such as nutritional therapy or pulmonary rehabilitation. Full article

Parkinson’s disease (PD) is one of the most well-known neurodegenerative diseases. Axial symptoms of PD include tremors in the arms and legs, stiffness of the muscles in the limbs and trunk, slow movement, impaired coordination, and balance disorders. Progressive disability increases the risk of falls and leads to immobilization of the patient. Comprehensive rehabilitation plays a very important role in the treatment process and serves mainly to improve motor functions and balance. In recent years, traditional methods of rehabilitation have been enriched by sometimes unconventional modern methods, which are attractive to patients. Unfortunately, current scientific evidence for the effectiveness of these methods is insufficient. Unconventional methods being used increasingly often in the rehabilitation of patients with PD include mind–body interventions. One of these interventions is Pilates exercise, which works on a physical and mental level. In this narrative review, we present the state of the art on the effects of Pilates exercise on balance and motor functions in PD. Previous studies, the results of which are available in scientific reports, have not provided convincing evidence for the effectiveness of these methods. Between 2019 and 2024, four systematic reviews and meta-analyses on the use of Pilates in the rehabilitation of patients with PD were published. Most of the reports show many shortcomings: too small groups of patients; frequent methodological errors, such as a lack of randomization and insufficient inclusion and exclusion criteria; imprecise descriptions of the interventions; different intensities and frequencies of exercises; too different outcome measures; and poorly chosen methods of statistical evaluation. Therefore, many authors emphasize the need for further, better-planned research. Full article

Background/Objectives: Adolescent Idiopathic Scoliosis (AIS) is a lateral curvature of the spine combined with rotation and associated postural changes. Curves are classified according to direction and the spinal region, with right thoracic curves being a common presentation. Curve magnitude is measured using Cobb angles on radiographs and is used to monitor curve progression, with one of the main aims of treatment being prevention of progression to surgical levels. Treatment options may include observation, physiotherapeutic scoliosis-specific exercises (PSSE), thoracolumbosacral orthotic (TLSO) bracing, or surgery and are dependent on curve magnitude, risk of progression, and patient goals. Methods: This case series includes five patients (four female and one male, mean age of 14.8 y) who received previous non-surgical treatment without success and had severe right thoracic AIS with an average Cobb angle measurement of 53.4°, involving spinal curve magnitudes that warrant surgical recommendation. Results: These patients’ curves were successfully reduced to nonsurgical levels utilizing a non-surgical, multimodal treatment approach combining 3D corrective TLSO bracing using the ScoliBrace^®, PSSEs, and spinal rehabilitation over an average of 37.0 months. The average Cobb angle reduced from 53.4° to 29.6° (44.6% reduction) after being weaned off treatment. Conclusions: This series has shown successful, clinically significant improvement in Cobb angle and trunk symmetry in five patients with severe AIS using a non-surgical, multimodal approach combining 3D corrective TLSO bracing using the ScoliBrace^® and spinal rehabilitation procedures. Further investigation into this multimodal non-surgical approach for children, parents, and healthcare providers and policymakers seeking an alternative to surgical intervention for AIS is warranted. Full article

Background/Objectives: Non-invasive spinal cord transcutaneous stimulation (scTS) has expanded the therapeutic landscape of spinal cord injury (SCI) rehabilitation, offering potential benefits beyond compensatory approaches to paralysis. Children with SCI are particularly susceptible to developing neuromuscular scoliosis due to trunk muscle paralysis and ongoing skeletal growth, making targeted interventions crucial. As demonstrated in adults and pediatrics with SCI, the ability of scTS to acutely and safely enable an upright posture and trunk control could be leveraged as a therapeutic adjunct. Activity-based locomotor training (AB-LT) alone significantly improves trunk control in children with SCIs; combining it with scTS may enhance outcomes. This pilot study evaluated the safety, feasibility, and cumulative effects of AB-LT combined with scTS on trunk control in children with SCI. Methods: Three children with SCI completed 19 to 64 sessions of combined AB-LT and scTS. Adverse effects were monitored session to session, and trunk control was assessed pre- and post-intervention. Results: Across 130 interventions in three participants, 88.5% of sessions were free from adverse effects. Reported adverse events included autonomic dysreflexia (5.4%), skin redness at electrode sites (4.6%), and headaches (1.5%). No significant impact of scTS on fatigue or central hemodynamic parameters was observed. Post-intervention, all participants demonstrated improved trunk control during quiet and perturbed sitting. Conclusions: These findings provide the first evidence supporting the safety and feasibility of this combinatorial approach in pediatric SCI rehabilitation while emphasizing the importance of monitoring skin integrity and signs of autonomic dysreflexia. This intervention shows potential synergistic benefits, warranting further research to confirm efficacy and optimize therapeutic protocols. 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

This case report examines the impact of robotic-assisted therapy (Lokomat) on functional recovery in a 28-year-old male patient with acute dermatomyositis (DM), an autoimmune inflammatory myopathy causing progressive muscle weakness and disability. The patient underwent 21 sessions of robotic therapy combined with physical therapy, and occupational therapy over seven weeks. Assessments were conducted at baseline, week 10, and week 21 using standardized measures for balance, muscle strength, and functionality. Results demonstrated significant improvements across all domains: balance scores progressed from severe impairment (4/56 Berg, 0/28 Tinetti) to near-normal function (55/56, 24/28, respectively); muscle strength increased from grade 1/5 to 4/5 (MMT-8) in all tested muscle groups; and functionality improved from moderate dependence (59/126 FIM) to complete independence (126/126). The trunk functionality scores showed remarkable recovery from 12/100 to 100/100 (TCT), indicating restored trunk control. Lokomat-assisted therapy combined with conventional rehabilitation effectively improves proximal weakness and postural instability in DM. Robotic therapy enhances motor learning via repetitive movements and reduces therapist workload. Though limited by a single-case design, this study offers preliminary evidence for robotic rehabilitation in DM, previously unexplored. Controlled studies are needed to standardize protocols and validate results in larger cohorts. Advanced technologies show promise for functional recovery in inflammatory myopathies. Full article

Inertial measurement units (IMUs) have gained popularity as portable and cost-effective alternatives to optoelectronic motion capture systems for assessing joint kinematics. This study aimed to validate a commercially available multi-sensor IMU-based system against a laboratory-grade motion capture system across lower limb, trunk, and upper limb movements. Fifteen healthy participants performed a battery of single- and multi-joint tasks while motion data were simultaneously recorded by both systems. Range of motion (ROM) values were extracted from the two systems and compared. The IMU-based system demonstrated high concurrent validity, with non-significant differences in most tasks, root mean square error values generally below 7°, percentage of similarity greater than 97%, and strong correlations (r ≥ 0.77) with the reference system. Systematic biases were trivial (≤3.9°), and limits of agreement remained within clinically acceptable thresholds. The findings indicate that the tested IMU-based system provides ROM estimates statistically and clinically comparable to those obtained with optical reference systems. Given its portability, ease of use, and affordability, the IMU-based system presents a promising solution for motion analysis in both clinical and remote rehabilitation contexts, although future research should extend validation to pathological populations and longer monitoring periods. Full article

This study investigated the efficacy of Augmented Reality (AR) in the rehabilitation of lower limb amputees by comparing movement accuracy and subjective satisfaction with and without AR. Ten individuals with unilateral lower limb amputations participated. Joint range of motion during exercises was measured using a 3D motion capture system. Subjective satisfaction was assessed via a 5-point Likert scale. Movement accuracy was evaluated by analyzing changes and variability (standard deviation) in joint angles across eight selected movements. Results showed that AR feedback significantly increased average joint angles in specific movements: standing arm raise to the side, standing trunk lateral flexion, and standing knee flexion to maximum height. Furthermore, AR feedback led to a significant reduction in the standard deviation of joint angles for most exercises, indicating improved movement consistency. Subjective satisfaction scores for interest, motivation, exercise effectiveness, movement accuracy, and overall satisfaction were significantly higher with AR. Full article

Individualized exercise therapy is crucial for effective postoperative rehabilitation. However, a widely accepted, standardized framework for measuring individual exercise capabilities after lumbar spine surgery (LSS) is lacking. This study aimed to develop a novel Exercise Rehabilitation Functional Group (ERFG) classification system to enable systematic, individualized rehabilitation after LSS. Eight exercise parameters and two clinical factors were assessed in 428 volunteers within 12 weeks of single-segment LSS to establish reference data for the ERFG. The study cohort included 411 participants (mean age 67.10 ± 11.60; 128 males and 283 females) with an average postoperative interval of 42.96 ± 20.25 days. Key metrics included lumbar spine ROM (mean 74.24 ± 25.30°), trunk muscle strength (mean 15.71 ± 5.14 kg), trunk muscle endurance (mean 95.80 ± 35.66 s), whole-body flexibility (mean 3.30 ± 10.65 cm), cardiopulmonary capability (mean 433.91 ± 118.75 m), gait with affected single leg (mean 36.26 ± 5.98%), single-leg balance (median 13.60 s), coordination capability (mean 8.21 ± 3.23 s), EuroQol 5-Dimension 5-Level score (mean 9.39 ± 4.17), and visual analog scale for low back pain (mean 3.78 ± 2.55). Data were categorized into five grades using Cajori’s five-grade mathematical method. Significant correlations were observed between the eight exercise parameters and two clinical factors. This study established a foundational framework for standardizing baseline exercise capabilities after LSS. This ERFG system may provide a basis for individualized rehabilitation strategies to enhance patient outcomes. Full article

Background and Objectives: Low back pain (LBP) is a leading cause of disability worldwide. Core stabilization exercises such as the plank are often prescribed in rehabilitation settlings to improve neuromuscular control and spinal support. However, it remains unclear whether plank performance -accurately reflects trunk function or disability in individuals with LBP. The purpose of this study was to evaluate the relationship between plank endurance and low back pain in adults. Methods: A cross-sectional study was conducted with 117 adults aged 20–61 years (mean 26.0 ± 9.3), including both individuals with and without LBP. Participants completed a plank endurance test and the Modified Oswestry Disability Index (MODI). A subset of fifty-four participants with LBP also completed single-leg bridge tests to assess posterior chain endurance. Statistical analyses included Mann–Whitney U tests to compare plank times by LBP status, logistic regression to evaluate predictors of LBP, and correlation analyses to examine associations between the bridge-to-plank ratio and MODI scores. Results: Contrary to the initial hypothesis, individuals with LBP demonstrated significantly longer plank hold times than those without (U = 1861.00, p = 0.036). Logistic regression indicated that the overall model was statistically significant (χ² = 12.39, p = 0.030), but plank duration was not an independent predictor of LBP (p = 0.070). Among participants with LBP, a higher bridge-to-plank ratio, reflecting relatively greater posterior chain endurance, was significantly associated with lower disability scores (Pearson r = −0.31, p = 0.023; Spearman ρ = −0.32, p = 0.018). Conclusions: These findings suggest that, while plank duration differs by LBP status, longer plank times may not indicate lower risk or severity of back pain. A greater balance of posterior chain to anterior core endurance may be more intricately linked to reduced disability, highlighting the importance of comprehensive core assessment and training strategies in rehabilitation. Full article

Background and Objectives: We conducted a retrospective observational study. Background: While traditional rehabilitation approaches emphasize trunk muscle conditioning, emerging evidence suggests that leg muscle strength plays a critical role in postoperative functional mobility. Previous studies have focused on trunk muscle rehabilitation in patients with adult spinal deformity (ASD). However, recent findings suggest that leg muscle conditioning may be a better predictor of postoperative improvement. Strengthening the gluteal and iliopsoas muscles has been linked to improved sagittal balance, gait stability, and mobility, ultimately leading to enhanced surgical outcomes. This study examines the relationship between the preoperative functional cross-sectional area (FCSA) of trunk and leg muscles and postoperative improvement in mobility, as assessed by the Timed Up and Go (TUG) test, in patients undergoing surgery for ASD. Materials and Methods: Sixty-two patients (57 women, mean age 71.2 ± 7.1 years) who underwent ASD surgery between April 2017 and April 2024 were retrospectively analyzed. The FCSA of key muscles—psoas major (PM), erector spinae (ES), multifidus (MF), gluteus maximus (GM), and gluteus medius (GMed)—was measured using CT images. Patients were categorized into an improvement group and a non-improvement group based on whether they achieved the minimum clinically important difference (MCID) of −2 s in the TUG test 12 months after surgery. Propensity score matching (PSM) was applied to adjust for baseline differences between the groups. A significance level of 5% was used for all comparisons. Results: Thirty-three patients achieved a clinically meaningful improvement in TUG, while 29 did not. Before PSM, patients with worse preoperative TUG and Oswestry Disability Index (ODI) scores showed greater improvements (p < 0.01). After PSM, no significant differences were found between the groups in terms of age, sex, or BMI. However, the improvement group showed significantly greater FCSA values in PM (6.1 ± 2.3 mm² vs. 3.9 ± 1.5 mm², p = 0.021) and GM (19.9 ± 5.9 mm² vs. 15.3 ± 3.9 mm², p = 0.019). Conclusions: This study demonstrates that leg muscle quality, particularly that of the gluteus maximus and psoas major, is a significant predictor of postoperative mobility improvement in patients with ASD. These findings challenge the conventional focus on trunk muscles and suggest the inclusion of leg muscle training in preoperative rehabilitation strategies to enhance surgical outcomes. Full article