Search Results (147)

Background/Objectives: Lipedema is a chronic disorder characterized by disproportionate fat accumulation in the extremities, causing pain, bruising, and reduced mobility. When conservative therapy fails, liposuction is considered an effective treatment option. Prior studies often relied on subjective or non-standardized measures, limiting precision. This study aimed to objectively assess volumetric changes after liposuction in stage III lipedema using high-resolution 3D imaging to quantify postoperative changes in circumference and volume, providing individualized yet standardized outcome measures aligned with precision medicine. Methods: We retrospectively analyzed 66 patients who underwent 161 water-assisted liposuctions (WALs). Pre- and postoperative measurements were performed with the VECTRA© WB360 system, allowing reproducible, anatomically specific quantification of limb volumes and circumferences. Secondary endpoints included in-hospital complications. Results: Liposuction achieved significant reductions in all treated regions, most pronounced in the proximal thigh and upper arm. Thigh volume decreased by 4.10–9.25% (q < 0.001), while upper arm volume decreased by 15.63% (left) and 20.15% (right) (q = 0.001). Circumference decreased by up to 5.2% in the thigh (q < 0.001) and 12.27% (q = 0.001) in the upper arm. All changes were calculated relative to baseline values, allowing personalized interpretation of treatment effects. Conclusions: This is the first study to objectively quantify postoperative lipedema changes using whole-body 3D surface imaging. By capturing each patient’s contours pre- and postoperatively, this approach enables individualized evaluation while permitting standardized comparison across patients. It offers a precise understanding of surgical outcomes and supports integration of precision medicine principles in lipedema surgery. Full article

Telerehabilitation is an effective, accessible addition or alternative to conventional rehabilitation for fracture management, especially in older adults after hip fractures, leveraging video visits, mHealth apps, virtual reality (VR), and wearable sensors to deliver exercise, education, and monitoring at home with high satisfaction and adherence. Across non-surgical and surgical contexts, telemedicine shows feasibility and cost benefits, with mixed superiority but consistent non-inferiority for functional outcomes versus in-person care. In hip fracture populations, randomized and non-randomized studies indicate improvements in functional independence measure (FIM), Timed Up and Go test (TUG), Activities of Daily Living/Instrumental Activities of Daily Living (ADLs/IADLs), and quality of life, with some evidence for reduced anxiety and depression, while effects on mobility, pain, and adverse events remain uncertain overall. In patients with upper-limb fractures, telerehabilitation appears to improve function and pain, though strength gains may lag compared with in-person therapy in some trials; adjuncts like motor imagery and virtual reality may enhance outcomes and motivation. Application is facilitated by user-friendly platforms, caregiver involvement, and simple modalities such as structured phone follow-up. Limitations include small samples, heterogeneous protocols, scarce long-term data, and a predominance of non-inferiority or complementary designs, warranting larger, definitive trials. This technology can lead to improved patient management at home, effortlessly verifying treatment compliance, efficacy, and safety, while simultaneously reducing the need for hospitalization, promoting a more peaceful recovery. Here, we have undertaken a narrative review of the medical–scientific literature in this field. Full article

(1) Background: The global increase in life expectancy has generated growing interest in strategies that support functional independence and quality of life among older adults. Functional fitness—including strength, mobility, flexibility, and aerobic endurance—is essential for preserving autonomy during aging. In this context, physical exercise, particularly High-Intensity Interval Training (HIIT), has gained attention for its time efficiency and physiological benefits. This randomized controlled trial aimed to evaluate the effects of a group-based HIIT program on functional fitness in older adults; (2) Methods: Functional outcomes were assessed before, during, and after a 65-week intervention using standardized field tests, including measures of upper and lower body strength, flexibility, aerobic endurance, and agility. This study was prospectively registered at ClinicalTrials.gov (NCT07170579); (3) Results: Significant improvements were observed in the HIIT group across multiple domains of functional fitness compared to the control group, notably in upper body strength, lower limb flexibility, cardiorespiratory endurance, and mobility; (4) Conclusions: These results suggest that HIIT is an effective and adaptable strategy for improving functional fitness in older adults, with the potential to enhance performance in daily activities and support healthy aging in community settings. Full article

Lee Silverman Voice Treatment (LSVT) BIG, primarily developed for outpatient use, is a prominent intervention for patients with Parkinson’s disease thanks to its high-intensity, repetitive exercises involving large movements. This study first evaluated the feasibility of an in-hospital LSVT BIG training program by assessing recruitment capability, compliance, and adherence. The secondary objective was to evaluate the effects of LSVT BIG training on gait, balance, and functional outcomes, as well as respiratory function and quality of life, in comparison with a progressive structured rehabilitation program (SC) of similar intensity and frequency. In-hospital LSVT BIG training for people with Parkinson’s disease was feasible, with 95% recruitment rates and 100% safety and adherence. SC (n = 19) and LSVT BIG (n = 19) significantly improved (for all, p < 0.05) pre-to-post balance (MiniBESTest) and lower limb effort tolerance (6MWT). Delta changes between groups favored LSVT for upper limb effort tolerance (UULEX level, time, p < 0.001), gait speed, and UULEX SatO₂ mean, PCEF, MiniBESTest and 6MWT (for all, p < 0.05). Evaluation of the probability associated with the LSVT BIG showed MiniBESTest as being 8.5 times more likely to exceed the MCID compared to SC. Quality of life was unchanged across both groups. This study successfully demonstrates the feasibility of in-hospital LSVT-BIG^® training, and comparison of outcomes, although exploratory and underpowered, showed better improvements in mobility, balance, and effort tolerance, suggesting a complementary role within traditional rehabilitation protocols. Full article

Bilateral teleoperation combines the agility of robotic manipulators with the ability to perform complex contact tasks guided by human expertise, thereby fulfilling a pivotal function in environments beyond human access. However, due to the limited workspace of existing master robots necessitating frequent mapping mode switches, coupled with the pronounced heterogeneity and asymmetry between the workspaces of the master and slave systems, achieving teleoperation of the mobile manipulator remains challenging. In this study, we innovatively introduced a 7 DOFs upper limb exoskeleton as the master control device, rigorously designed to align with the motion coordination of the human arm. Regarding teleoperation mapping, a hybrid heterogeneous teleoperation control framework with a variable mapping scheme, designed for an aerial manipulator performing physical operations, is proposed. The system incorporates mode switching driven by the operator’s hand gestures, seamlessly and intuitively integrating the advantages of position control and rate control modalities to enable adaptive transitions adaptable to diverse task requirements. Comparative teleoperation experiments were conducted using a fully actuated aerial equipped with a compliant 3D end-effector performing physical aerial writing tasks. The mode-switching algorithm was effectively validated in experiments, demonstrating no instability during transitions and achieving a position tracking RMSE of 7.7% and 5.2% in the X,Y-axis, respectively. This approach holds significant potential for future applications in UAM inspection and physical operational scenarios. Full article

The Wolf Motor Function Test (WMFT) is widely used to evaluate upper limb motor performance after stroke. However, conventional approaches may overlook domain-specific neuromuscular and kinematic differences during task execution. This study classified WMFT tasks into three functional domains: proximal reaching and transport (PRT), fine motor manipulation (FMM), and gross motor functional control (GMFC). Interlimb differences in muscle activation, joint mobility, and movement amplitude were examined using sensor-based measurements. Twelve individuals with chronic stroke performed 16 WMFT tasks. Surface electromyography (EMG) and inertial measurement units (IMUs) recorded upper limb muscle activity, joint angles, and segmental displacement. Wilcoxon signed-rank tests and Spearman correlations were conducted for each functional domain. Significant asymmetries in EMG, range of motion (ROM), and root mean square (RMS) acceleration were found in PRT and FMM tasks. These results reflect increased proximal muscle activation and reduced distal engagement on the paretic side. GMFC tasks elicited more symmetrical patterns but still showed subtle deficits in distal control. Correlation analyses demonstrated strong interdependencies among neuromuscular and kinematic measures. This finding underscores the integrated nature of compensatory strategies. Categorizing WMFT tasks by functional domain and integrating multimodal sensor analysis revealed nuanced impairment patterns. These patterns were not detectable by conventional observational scoring. These findings support the use of sensor-based, domain-specific assessment to guide individualized rehabilitation strategies. Such approaches may ultimately enhance long-term functional recovery in stroke survivors. Full article

The effectiveness of upper extremity rehabilitation in post-stroke patients significantly depends on patient motivation and adherence to therapeutic regimens. Rehabilitation-assistive technologies, including wearable sensors, have been adopted to facilitate intensive and repetitive exercises aimed at reducing hand dysfunction and enhancing quality of life. Building upon the previously introduced Przypominajka (reminder) system reported in this journal—a wearable sensory glove coupled with a mobile application providing exercise guidance and monitoring—we conducted a feasibility study to evaluate its effectiveness in supporting upper limb rehabilitation. Sixteen post-stroke patients with hemiparesis were equally randomized into experimental and control groups. Both groups performed upper limb exercises for 45 min daily for over two weeks. The experimental group utilized the sensor-equipped glove and tablet-based exercises, whereas the control group followed printed exercise instructions. Clinical improvements were measured using the Fugl–Meyer Assessment–Upper Extremity (FMA-UE), Functional Independence Measure (FIM), and MORE scales. The experimental group demonstrated a minimal clinically important difference (MCID) on the FMA-UE and reported greater overall improvement than the control group. This study confirms the feasibility and potential clinical benefit of supplementing post-stroke rehabilitation with sensor-augmented exercises provided by the previously described Przypominajka device. Full article

This study aimed to investigate the effects of mental fatigue on physical and cognitive performance (lower-limb power, isometric and handgrip strength, and psychomotor vigilance). Twenty-two physically active young adults (12 males, 10 females; M_age = 20.82 ± 1.47) were randomly assigned to either a Mental Fatigue (MF) or Control group (CON). The MF group showed a statistically significant (p = 0.019) reduction in non-dominant handgrip strength, declining by approximately 2.3 kg (about 5%), while no such change was observed in the CON group or in dominant handgrip strength across groups. Reaction time (RT) was significantly impaired following the mental fatigue protocol: RT increased by 117.82 ms, representing an approximate 46% longer response time in the MF group (p < 0.001), whereas the CON group showed a smaller, non-significant increase of 32.82 ms (~12% longer). No significant differences were found in squat jump performance, indicating that lower-limb explosive power may be less affected by acute mental fatigue. These findings demonstrate that mental fatigue selectively impairs fine motor strength and cognitive processing speed, particularly reaction time, while gross motor power remains resilient. Understanding these effects is critical for optimizing performance in contexts requiring fine motor control and sustained attention under cognitive load. Full article

The aim of this study was to analyze the activation of selected upper limb muscles. For the purposes of this article, we present results concerning the following muscles: triceps brachii, anterior and posterior deltoid, and trapezius in women aged 50 and above during simulated riding of the Torqway device, using surface electromyography (sEMG). The primary objective was to compare muscle activity across two movement phases: active and passive. Accordingly, the following research hypotheses were formulated: muscle activity (measured by RMS values) will be significantly higher during the active phase compared to the passive phase, and MPF (mean power frequency) values will decrease over time, indicating the onset of muscle fatigue. Additionally, the potential of surface electromyography was assessed as a diagnostic tool for evaluating ergonomics and muscle effort in the context of designing personalized mobility devices for older adults. As the study of the Torqway device represents a pioneering research effort, this publication makes a significant contribution to the biomechanical analysis of new forms of active mobility supported by wearable sensor technologies. Full article

Background and Aim: Floating aortic thrombi are rare but potentially life-threatening entities, associated with a high risk of systemic embolization and subsequent complications such as ischemic stroke or mesenteric infarction. Therapeutic strategies range from urgent surgical intervention to conservative medical management with anticoagulation, depending on the patient’s clinical status and thrombus morphology. This report presents two cases of floating aortic thrombi managed with distinct approaches, surgical and medical, underscoring the importance of individualized treatment guided by embolic risk and comorbidities. Patients and Methods: The first case involves a 59-year-old male presenting with abdominal pain and emesis. Imaging confirmed mesenteric ischemia, necessitating emergent laparotomy and extensive jejunal resection. Postoperative imaging identified a mobile thrombus at the ascending aorta–aortic arch junction, with evidence of cerebral embolism. The patient underwent urgent surgical thrombectomy, ascending aortic resection, and hemiarch replacement. The second case describes an 88-year-old male who presented with bilateral upper limb paresthesia. Neuroimaging revealed acute supra- and infratentorial ischemic lesions suggestive of embolic stroke. A floating thrombus was identified in the ascending aorta, with an additional thrombus in the descending thoracic aorta. Given the patient’s advanced age, comorbid conditions, and thrombus stability, a conservative approach with systemic anticoagulation and close radiologic surveillance was chosen. Conclusions: These cases illustrate the need for tailored management of floating aortic thrombi. While surgical resection remains indicated in unstable or high-risk embolic cases, anticoagulation may suffice for stable lesions in patients with elevated surgical risk. Further studies are needed to establish standardized therapeutic guidelines. Full article

Background: Cubital tunnel syndrome is the second most common compressive neuropathy of the upper limb, and it is characterized by ulnar nerve compression at the elbow. Traditional surgical options, including simple decompression and anterior transposition, have limitations in addressing ulnar nerve instability. This study introduces and evaluates the short-term outcomes of a novel surgical technique, the fascio-aponeurotic epicondylar flap (FAEF), for stabilizing the ulnar nerve and managing its instability. Materials and methods: A retrospective study was conducted on ten patients with longstanding cubital tunnel syndrome and confirmed ulnar nerve dislocation or instability. All patients underwent surgical intervention using the FAEF technique, which involves creating a quadrangular fascial flap from the epicondylar fascia to stabilize the ulnar nerve within the retrocondylar groove. Outcomes were assessed using clinical follow-ups, the Michigan Hand Outcomes Questionnaire (MHQ), VAS, and qDASH scores over a 90-day postoperative period. Results: All ten patients experienced complete resolution of neurological symptoms, including paresthesia, pain, and nerve clicking, by the final follow-up. Postoperative recovery was uneventful, with no complications such as infections or hematomas. Grip strength and hand functionality were fully restored, with significant improvements in MHQ scores (mean: 94). Dynamic elbow mobilization initiated on the first postoperative day resulted in full recovery of elbow range of motion. No recurrence of ulnar nerve dislocation was observed. Discussion: The FAEF technique effectively stabilizes the ulnar nerve, alleviates symptoms, and restores function while minimizing risks associated with traditional procedures, such as nerve trauma and elbow instability. By preserving the anatomical integrity of the medial epicondyle and enhancing nerve mobility, this approach represents a less invasive alternative to anterior transposition and medial epicondylectomy. Conclusions: The FAEF technique is a viable and effective surgical option for managing ulnar nerve instability in cubital tunnel syndrome. It offers a less invasive solution with excellent short-term outcomes, making it a promising addition to the surgical armamentarium for this condition. Further studies are warranted to evaluate long-term efficacy and broader applicability. Full article

Rotator cuff tears are common in individuals over 40, and physical therapy is often prescribed post-surgery. However, access can be limited by cost, convenience, and insurance coverage. CuffLink is a telehealth rehabilitation system that integrates the Strengthening and Stabilization System mechanical exerciser with the interACTION mobile health platform. The system includes a triple-axis accelerometer (LSM6DSOX + LIS3MDL FeatherWing), a rotary encoder, a VL530X time-of-flight sensor, and two wearable BioMech Health IMUs to capture upper-limb motion. CuffLink is designed to facilitate controlled, home-based exercise while enabling clinicians to remotely monitor joint function. Concurrent validity and test–retest reliability were used to assess device accuracy and repeatability. The results showed moderate to good validity for shoulder rotation (ICC = 0.81), device rotation (ICC = 0.94), and linear tracking (from zero: ICC = 0.75 and RMSE = 2.41; from start: ICC = 0.88 and RMSE = 2.02) and good reliability (e.g., RMSEs as low as 1.66 cm), with greater consistency in linear tracking compared to angular measures. Shoulder rotation and abduction exhibited higher variability in both validity and reliability measures. Future improvements will focus on manufacturability, signal stability, and force sensing. CuffLink supports accessible, data-driven rehabilitation and holds promise for advancing digital health in orthopedic recovery. Full article

A prototype device was developed as a simple yet effective tool for the rehabilitation of individuals with upper limb paresis resulting from stroke. The primary objective of the design process was to create a portable rehabilitation device that could be remotely controlled by a therapist via a Bluetooth protocol. The device enables the execution of upper limb rehabilitation exercises and integrates essential modules for assessment, reporting, and user feedback (biofeedback). It comprises a base and three movable arms, each fitted with a container at its distal end. The central arm, positioned at the midpoint of the device’s housing, holds a storage container from which specific objects are retrieved by the user. This arm features an adjustable reach. The remaining two arms are equipped with task-specific containers mounted at their ends. The conceptual framework is based on the execution of various tasks displayed on a screen. The user retrieves objects from the central storage unit and places them into either the left or right container, as indicated. The target container is highlighted both visually on the screen and via an illuminated LED indicator. Pre-programmed sequences for object retrieval and placement are presented on the display, offering clear guidance for the correct positioning and ordering of blocks within the designated containers. The device includes 12 dedicated blocks varying in shape, colour, material, and texture. A mechatronic control system governs the container positioning and arm inclination, enabling a precise adjustment of range of movement according to the exercise’s requirements. A dedicated software system has also been developed for control and management. Functional testing of the prototype was conducted to assess the device’s effectiveness and practical applicability in rehabilitation settings. Full article

This publication aims to present the preliminary results of research on an innovative device designed to support the rehabilitation of drivers with neurological disorders, developed as part of a multidisciplinary project. The device was designed for individuals recovering from neurological diseases, injuries, and COVID-19-related complications, who experience difficulties with coordination and the speed of performing motor exercises. Its goal is to improve the quality of life for patients and increase their chances of safely driving vehicles, which also contributes to the safety of all road users. The device allows for controlled upper limb exercises using a diagnostic module, exercise program, and biofeedback system. The main component is a mechatronic driving simulator, enhanced with dedicated software to support the rehabilitation of individuals with neurological disorders and older adults. Through driving simulations and rehabilitation tasks, patients perform exercises that improve their health, facilitating a faster recovery. The innovation of the solution is confirmed by a submitted patent application, and preliminary research results indicate its effectiveness in rehabilitation and improving mobility for individuals with neurological disorders. Full article

Background/Objectives: Mixed martial arts (MMA) is a combat sport which heavily involves upper limb strength, mobility, and stability. Shoulder injuries, given their impact on striking and grappling, may significantly hinder performance and career longevity. However, their specific effects on competitive outcomes remain poorly defined. This study evaluates return-to-sport rates, fight performance, and long-term success in professional MMA athletes following shoulder injuries. Methods: A retrospective cohort study was conducted using publicly available databases to identify professional MMA fighters from the UFC, Bellator, and Strikeforce who sustained shoulder injuries requiring withdrawal from scheduled bouts. Fighter demographics, injury characteristics, and treatment approaches were recorded. Performance metrics—including winning percentage, takedown (TD), knockdown (KD), and significant strike (SS) rates—were compared before and after injury. Independent t-tests were used, and significance was set at p < 0.05. Results: A total of 27 fighters with 34 documented shoulder injuries were included. The most common injury was a torn labrum (41.2%), with 76.5% requiring surgical intervention. Aggregate winning rates significantly declined from 81.96% pre-injury to 54.7% post-injury (p < 0.001). Aggregate KD rates also dropped significantly (p < 0.001), while TD rates trended downward without reaching statistical significance. SS rates remained stable, suggesting potential compensatory mechanisms. Injury recurrence was observed in 22.2% of cases. Conclusions: Shoulder injuries in MMA are associated with a substantial decline in competitive success, particularly in knockout capability, emphasizing the critical role of shoulder integrity in fight performance. The high recurrence rate suggests the need for optimized rehabilitation protocols and stricter return-to-sport guidelines to enhance fighter longevity. Full article