The latest medical research on Rehabilitation Medicine

The research magnet gathers the latest research from around the web, based on your specialty area. Below you will find a sample of some of the most recent articles from reputable medical journals about rehabilitation medicine gathered by our medical AI research bot.

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Evidence-based rehabilitation therapy following surgery for (peri-)articular fractures: A systematic review.

Journal of Rehabilitation Medicine

To assess the availability of explicitly reported protocols describing post-surgery rehabilitation of (peri-)articular fractures of the proximal humerus, acetabulum and/or tibial plateau, and to critically review any scientific evidence on the effectiveness of these protocols.

Screening was performed independently by 2 researchers based on a priori defined eligibility criteria.

Five papers addressed post-surgical rehabilitation of proximal humerus fractures, 1 paper that of acetabulum fractures. No eligible information was found on stakeholder sites or in standard textbooks. Overall, the main focus of the protocols identified was on the International Classification of Functioning, Disability and Health (ICF) Body Functions and Structures level. In general, little information about therapy dosage was reported. None of the protocols provided scientific evidence on which the content of described rehabilitation programmes was based.

This review reveals a paucity of explicitly formulated protocols focussing on post-surgical rehabilitation of common (peri-)articular fractures targeting patient-centred care at all ICF levels. There is a need for more scientific evidence on which to base protocols regarding common (peri-)articular fracture rehabilitation.

Joint replacement rehabilitation and the role of funding source.

Journal of Rehabilitation Medicine

To examine associations between funding source, use of rehabilitation and outcomes after total joint replacement and to evaluate variations based on demographic characteristics.

Participants aged 45 years or older (n = 522) who received either private or public funding for their surgery, were recruited from the New Zealand Joint Registry 6 months after a total hip, total knee or unicompartmental knee replacement.

The cohort was predominantly New Zealand European (90%), aged 68 years, with more men (55%) than women (45%). Privately funded participants were younger, had higher levels of education and employment, and lower rates of comorbidities at the time of surgery. Privately funded participants also reported spending less time on the surgical waiting list, were less likely to participate in pre-surgical rehabilitation, but reported more weeks of post-surgical rehabilitation and better patient-reported outcomes in terms of pain, function and quality of life, compared with their publicly funded counterparts.

Factors already known to impact on joint replacement outcomes were associated with funding source in this cohort. Socio-economic differences and inequities between private and public systems exist consistent with limited available prior research. In this cross-sectional study, no clinically significant differences in outcomes between the groups were identified. Prospective research will help to clarify whether funding source directly affects joint replacement rehabilitation outcomes.

For which patients does attendance at a preoperative educational class decrease length of stay following hip and knee replacement?

Journal of Rehabilitation Medicine

To establish whether attendance at an education class prior to total hip or knee replacement surgery as part of an enhanced recovery after surgery pathway could decrease length of hospital stay.

A single-site, retrospective cohort study comparing length of stay in hospital for patients who attended and did not attend an education class prior to hip or knee replacement surgery. Patients were stratified into 3 groups according to the predicted likelihood of an extended inpatient hospital stay using the Risk Assessment Predictor Tool.

Mean length of stay reduced by 0.37 days for patients who received hip replacement (n = 590) (95% confidence interval (95% CI) -0.74, -0.01, p = 0.05) and by 0.77 days for patients who underwent knee replacement (n = 643) (95% CI -1.23, -0.31, p = 0.001) following attendance at a preoperative education class. Patients undergoing knee replacement who were considered at high risk of an extended hospital stay stayed, on average, 2.59 days less in hospital after attending the class (mean length of stay: 4.52 (standard deviation (SD) 1.26) vs 7.11 (SD 4.18) days (95% CI -4.62, -0.54, p < 0.02).

This study supports the inclusion of a preoperative education session in this context for both hip and knee replacement procedures, and indicates that this may be most beneficial for patients undergoing knee replacement who are at risk of an extended length of stay.

Effects of game-based chin-tuck against resistance exercise vs head-lift exercise in patients with dysphagia after stroke: An assessor-blind, randomized controlled trial.

Journal of Rehabilitation Medicine

To compare the effects of game-based chin-tuck against resistance exercise and head-lift exercise on swallowing function and compliance of patients with dysphagia after stroke.

A total of 37 patients with stroke were randomly assigned to 2 groups. The experimental group performed game-based chin tuck against resistance exercise, whereas the control group performed traditional head-lift exercise. The videofluoroscopic dysphagia scale (VDS) and penetration-aspiration scale (PAS) were used to evaluate swallowing function. In addition, the functional oral intake scale (FOIS) was used for dietary assessment. Finally, the numerical rating self-report scale was used to assess compliance (motivation, interest/enjoyment, physical effort needed, muscle fatigue) with the 2 exercises.

After intervention, there was no significant difference in VDS, PAS, and FOIS between the 2 groups. Comparing the compliance with the 2 exercises, the scores for motivation and interest/enjoyment items were significantly higher, and the scores for physical effort needed and muscle fatigue were significantly lower, in the experimental group than in the control group.

Game-based chin-tuck against resistance exercise not only has a similar effect to head-lift exercise on swallowing function of patients with dysphagia, but is also a less strict and more enjoyable and interesting method.

What the Proportional Recovery Rule Is (and Is Not): Methodological and Statistical Considerations.

Neurorehabilitation and Neural Repair

In 2008, it was proposed that the magnitude of recovery from nonsevere upper limb motor impairment over the first 3 to 6 months after stroke, measu...

Interindividual Balance Adaptations in Response to Perturbation Treadmill Training in Persons With Parkinson Disease.

Journal of Neurologic Physical Therapy

Perturbation training is a promising approach to reduce fall incidence in persons with Parkinson disease (PwPD). This study aimed to evaluate interindividual differences in balance adaptations in response to perturbation treadmill training (PTT) and identify potential outcome predictors.

PwPD (n = 43, Hoehn & Yahr stage 1-3.5) were randomly assigned to either 8 weeks of PTT or conventional treadmill training (CTT) without perturbations. At baseline and following intervention, data from 4 domains of balance function (reactive, anticipatory, dynamic postural control, and quiet stance) were collected. Using responder analysis we investigated interindividual differences (responder rates and magnitude of change) and potential predictive factors.

PTT showed a significantly higher responder rate in the Mini Balance Evaluation Systems Test (Mini-BESTest) subscore reactive postural control, compared with CTT (PTT = 44%; CTT = 10%; risk ratio = 4.22, confidence interval = 1.03-17.28). Additionally, while between-groups differences were not significant, the proportion of responders in the measures of dynamic postural control was higher for PTT compared with CTT (PTT: 22%-39%; CTT: 5%-10%). The magnitude of change in responders and nonresponders was similar in both groups. PTT responders showed significantly lower initial balance performance (4/8 measures) and cognitive function (3/8 measures), and were older and at a more advanced disease stage, based on descriptive evaluation.

Our findings suggest that PTT is beneficial to improve reactive balance in PwPD. Further, PTT appeared to be effective only for a part of PwPD, especially for those with lower balance and cognitive function, which needs further attention.Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1, http://links.lww.com/JNPT/A1).

Kinesio taping versus compression garments for treating breast cancer-related lymphedema: a randomized, cross-over, controlled trial.

Clinical Rehabilitation

To determine the effectiveness of Kinesio taping compared to compression garments during maintenance phase of complex decongestive therapy for breast cancer-related lymphedema.

Randomized, cross-over, controlled trial.

Outpatient tertiary-level hospital rehabilitation setting.

Randomized sample of 30 women with breast cancer-related lymphedema.

Participants received two interventions, Kinesio taping and compression garment, both lasting four weeks, whose order was randomized by blocks. A four-week washout period was established prior to the interventions and between them.

The main outcome was the lymphedema Relative Volume Change. Secondary outcomes were range of motion of arm joints, self-perception of comfort, and lymphedema-related symptoms (pain, tightness, heaviness, and hardness).

The decrease in the Relative Volume Change was greater in the Kinesio taping intervention (-5.7%, SD = 2.0) compared to that observed using compression garments (-3.4%, SD = 2.9) (P < 0.001). The range of motion of five upper-limb movements increased after applying taping (between 5.8° and 16.7°) (P < 0.05), but not after compression (P > 0.05). In addition, taping was perceived as more comfortable by patients (between 2.4 and 3 points better than compression in four questions with a 5-point scale (P < 0.001)) and further reduced lymphedema-related symptoms compared to compression (between 0.96 and 1.40 points better in four questions with a 6-point scale (P < 0.05)).

Kinesio taping was more effective than compression garments for reducing the lymphedema volume, with less severe lymphedema-related symptoms, better improvement of upper-limb mobility, and more comfort.

Effectiveness of customized insoles in patients with Morton's neuroma: a randomized, controlled, double-blind clinical trial.

Clinical Rehabilitation

To assess the effectiveness of customized insole in patients with Morton's neuroma.

Double-blind randomized controlled trial with intent-to-treat analysis.

Outpatients, University Hospital.

A total of 72 patients with Morton's neuroma met the inclusion criteria and were randomly allocated to either the study group (n = 36) or the control group (n = 36).

The study group was assigned to use a customized insole with metatarsal and arch support made of ethyl vinyl acetate and the control group received a flat insole of the same material, color, and density.

The primary outcome measure was walking pain intensity measured by the visual analogue scale. The secondary outcomes were as follows: pain at rest, palpation, and paresthesia (visual analogue scale); functional disability (6-minute walk test, Foot Function Index, and Foot Health Status Questionnaire); quality of life (Health Survey Short Form-36 (SF-36)); and foot pressure (AM Cube FootWalk Pro program).

In the comparison between the groups over time, a statistically significant difference, with improvement in favor of the experimental group, was found for pain during walking (P = 0.048); in the general health domains (P < 0.001) and physical activity (P = 0.025) of the Foot Health Status Questionnaire; in the general Foot Function Index score (P = 0.012); and in the functional capacity domain of the SF-36 questionnaire (P = 0.046). For the other parameters, no difference was found between groups.

The study demonstrated that customized insole with metatarsal and arch support relieved walking pain and improved patient-reported measures of function in patients with Morton's neuroma.

Hip abductor strength-based exercise therapy in treating women with moderate-to-severe knee osteoarthritis: a randomized controlled trial.

Clinical Rehabilitation

To investigate whether hip abductor strength-based exercise therapy could result in further function improvement and more pain relief in women with knee osteoarthritis.

Randomized controlled trial.

Rehabilitation department of Affiliated Hospital of Southwest Medical University from years 2016 to 2018.

In total, 82 women aged 50-70 years, with knee osteoarthritis grade II-IV on the Kellgren-Lawrence scale.

The experimental group engaged in hip abductor strength-based exercises under the supervision of physical therapists (once a day for six weeks), while the control group engaged in quadriceps femoris strength-based exercises.

Osteoarthritis severity measured by the Western Ontario and McMaster Universities Osteoarthritis Index, pain on a visual analogue scale and three objective functional tests were assessed at the sixth and 12th week. Repeated measures analysis of variance and multivariable analysis were applied.

Finally, 72 participants completed the study: 35 in the experimental group and 37 in the control group. The self-reported functional difficulties score in the experimental group was significantly lower than that in the control group both at the sixth week and at the 12th week (P < 0.001). There were significant differences between groups in the stair ascent/descent task and Figure of 8 Walk test, but not in the Five Times Sit-to-Stand Test. The pain in the experimental group decreased compared with that in the control group at the sixth week (P < 0.05), but not at the 12th week (P > 0.05).

Hip abductor strength-based exercises could result in better performance and higher self-reported function in women with symptomatic knee osteoarthritis.

Measuring Fatigue in TBI: Development of the TBI-QOL Fatigue Item Bank and Short Form.

Journal of Head Trauma Rehabilitation

To develop a traumatic brain injury (TBI)-specific, item response theory (IRT)-calibrated Fatigue item bank, short form, and computer adaptive test (CAT) as part of the Traumatic Brain Injury-Quality of Life (TBI-QOL) measurement system.

TBI-QOL Fatigue item bank, short form, and CAT.

A total of 590 adults with TBI completed 95 preliminary fatigue items, including 86 items from the Patient-Reported Outcomes Measurement Information System (PROMIS) and 9 items from the Quality of Life in Neurological Disorders (Neuro-QOL) system. Through 4 iterations of factor analysis, 22 items were deleted for reasons such as local item dependence, misfit, and low item-total correlations. Graded response model IRT analyses were conducted on the 73-item set, and Stocking-Lord equating was used to transform the item parameters to the PROMIS (general population) metric. A short form and CAT, which demonstrate similar reliability to the full item bank, were developed. Test-retest reliability of the CAT was established in an independent sample (Pearson's r and intraclass correlation coefficient = 0.82 [95% confidence interval: 0.72-0.88]).

The TBI-QOL Fatigue item bank, short form, and CAT provide rehabilitation researchers and clinicians with TBI-optimized tools for assessment of the patient-reported experience and impact of fatigue on individuals with TBI.

Development of the TBI-QOL Headache Pain Item Bank and Short Form.

Journal of Head Trauma Rehabilitation

To develop, calibrate, and evaluate the test-retest reliability of a new patient-reported outcome measure of headache pain relevant for individuals with traumatic brain injury (TBI).

Traumatic Brain Injury-Quality of Life Headache Pain item bank.

Thirteen headache pain items were calibrated as a unidimensional measure using data from 590 participants. The new measure was reliable (α = .98; item-total correlation range: 0.71-0.91). Item parameter estimates were estimated using Samejima's Graded Response Model and a 10-item calibrated short form was created. Simulation testing confirmed that both the computer-adaptive test and the short-form administrations were equivalent to the full item bank. One- to-2-week test-retest reliability of the computer-adaptive test was high (Pearson r and intraclass correlation coefficients = 0.81). Approximately two-thirds of the sample reported at least 1 headache symptom.

The Traumatic Brain Injury-Quality of Life Headache Pain item bank and short form provide researchers and clinicians with reliable measures of the subjective experience of headache symptoms for individuals with a history of TBI.

Measuring Self-Reported Cognitive Function Following TBI: Development of the TBI-QOL Executive Function and Cognition-General Concerns Item Banks.

Journal of Head Trauma Rehabilitation

To develop and calibrate new patient-reported outcome measures of cognitive concerns for individuals with traumatic brain injury (TBI).

Traumatic Brain Injury-Quality of Life (TBI-QOL) Executive Function and TBI-QOL Cognition-General Concerns item banks.

A total of 569 adults with complicated-mild, moderate, or severe TBI completed preliminary item pools, which included 65 Executive Function items and 56 Cognition-General Concerns items. Confirmatory factor analysis supported the retention of 37 Executive Function and 39 Cognition-General Concerns items. Samejima's graded response model was used to estimate item parameters for associated computer adaptive test administrations, and informed the selection of corresponding static short forms. Data from an independent sample of 77 adults with complicated-mild, moderate, or severe TBI supported the test-retest reliability of these newly developed measures.

The TBI-QOL Executive Function and Cognition-General Concerns item banks provide researchers and clinicians with reliable tools for assessing patient-reported post-TBI cognitive difficulties as part of the comprehensive TBI-QOL measurement system.