Clinical Rehabilitation
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Published By Sage Publications

1477-0873, 0269-2155

2022 ◽  
pp. 026921552110679
Author(s):  
Iura Gonzalez Nogueira Alves ◽  
Cássio Magalhães da Silva e Silva ◽  
Bruno Prata Martinez ◽  
Rodrigo Santos de Queiroz ◽  
Mansueto Gomes-Neto

Objective To determine the effects of neuromuscular electrical stimulation on disabilities and activity limitation of individuals affected by chronic obstructive pulmonary disease. Data sources MEDLINE, PEDro database, Cochrane Controlled Trials Register, and SciELO, were searched from inception until October 2021. Review methods Inclusion criteria were patients with COPD, randomized controlled trials comparing neuromuscular electrical stimulation alone or combined conventional pulmonary rehabilitation and neuromuscular electrical stimulation versus control or sham or pulmonary rehabilitation in disabilities and activity limitation in COPD. There were no mandatory language or publication date restrictions. Two reviewers selected studies independently. Weighted mean differences and 95% confidence intervals were calculated. Results 32 studies met the study criteria, including 1.269 participants. Neuromuscular electrical stimulation improved exercise capacity (MD 1.10, 95% CI: 0.33, 1.86, N = 147), and muscle strength (0.53, 95% CI: 0.20, 0.87, N = 147) compared to sham group. Combined neuromuscular electrical stimulation and conventional rehabilitation improved exercise capacity (MD 34.28 meters, 95% CI: 6.84, 61.73, N = 262) compared to conventional rehabilitation alone. No adverse events were reported. Conclusions Neuromuscular electrical stimulation resulted in small improvement in disabilities and activity limitation (below the MCID) in COPD. Thus, the inclusion of neuromuscular electrical stimulation in rehabilitation programs must consider the cost Because of inadequate methodological conduction and reporting of methods, some studies were of low quality.


2022 ◽  
pp. 026921552110721
Author(s):  
Yi-Fan Jiang ◽  
Dai Zhang ◽  
Jing Zhang ◽  
Hong Hai ◽  
Ying-Yu Zhao ◽  
...  

Objectives Repetitive peripheral magnetic stimulation (rPMS) is a non-invasive method that activates peripheral nerves and enhances muscle strength. This study aimed to investigate the effect of rPMS applied in early subacute stroke on severe upper extremity impairment. Design Randomized controlled trial. Setting Rehabilitation department of a university hospital. Subjects People aged 30–80 years with no practical arm function within four weeks of a first stroke. Interventions Participants were randomly assigned to either the rPMS group ( n = 24, 20Hz and 2400 pulses of rPMS to triceps brachii and extensor digitorum muscles daily for two weeks in addition to conventional physiotherapy) or the control group ( n = 20, conventional physiotherapy). Main measures The primary outcome was the upper extremity motor section of Fugl-Meyer Assessment after treatment. Secondary outcomes included Barthel Index and root mean square of surface electromyography for muscle strength and stretch-induced spasticity of critical muscles of the upper extremity. Data presented: mean (SD) or median (IQR). Results The rPMS group showed more significant improvements in the Fugl-Meyer Assessment (12.5 (2.5) vs. 7.0 (1.4), P < 0.001), Barthel Index (15 (5) vs. 10 (3.7), P < 0.001), and strength-root mean square (biceps brachii: 20.5 (4.8) vs. 6.2 (2.7), p < 0.001; triceps brachii: 14.9 (5.8) vs. 4.3 (1.2), p < 0.001; flexor digitorum: 5.1 (0.8) vs. 4.0 (1.1), p < 0.001) compared with the control group. Conclusion In patients with no functional arm movement, rPMS of upper limb extensors improves arm function and muscle strength for grip and elbow flexion and extension.


2021 ◽  
pp. 026921552110709
Author(s):  
Telma Cristina Fontes Cerqueira ◽  
Manoel Luiz de Cerqueira Neto ◽  
Lucas de Assis Pereira Cacau ◽  
Amaro Afrânio de Araújo Filho ◽  
Géssica Uruga Oliveira ◽  
...  

Objective To evaluate the effects of neuromuscular electrical stimulation on functional capacity of patients in the immediate postoperative period of cardiac surgery. Design A prospective, randomized controlled trial. Setting A cardiac surgery specialist hospital in Aracaju, Sergipe, Brazil. Subjects: Patients in the postoperative period of cardiac surgery. Intervention The control group received the conventional physiotherapy and the intervention group received neuromuscular electrical stimulation of the rectus femoris and gastrocnemius muscles bilaterally, applied for 60 min, twice a day for up to 10 sessions per patient, in the immediate postoperative period until postoperative day 5. Main measures The primary outcome was the distance walked, which was evaluated using the 6-min walk test on postoperative day 5. Secondary outcomes were gait speed, lactate levels, muscle strength, electromyographic activity of the rectus femoris and Functional Independence Measure, some of them evaluated on preoperative and postoperative period. Results Of 132 eligible patients, 88 patients were included and randomly allocated in two groups, and 45 patients were included in the analysis. No significant difference was found on the distance walked ( p = 0.650) between patients allocated in intervention group (239.06 ± 88.55) and control group (254.43 ± 116.67) as well as gait speed ( p = 0.363), lactate levels ( p = 0.302), knee extensor strength ( p = 0.117), handgrip strength ( p = 0.882), global muscle strength ( p = 0.104), electromyographic activity ( p = 0.179) and Functional Independence Measure ( p = 0.059). Conclusions Although the effects are still uncertain, the use of neuromuscular electrical stimulation carried out in five days didn't present any benefit on functional capacity of patients in the immediate postoperative period of cardiac surgery.


2021 ◽  
pp. 026921552110656
Author(s):  
Yu Wu ◽  
Feilong Zhu ◽  
Wei Chen ◽  
Ming Zhang

Objective To evaluate the effects of Transcutaneous Electric Nerve Stimulation (TENS) on pain, function, walking ability and stiffness in people with Knee osteoarthritis (KOA). Design Systematic review and meta-analysis of randomized controlled trials. Methods We searched MEDLINE, EMBASE, PubMed, Cochrane Central Register of Controlled Trials, Physiotherapy Evidence Database (PEDro), clinicaltrials.gov and Web of Science (last search November 2021) for randomized controlled trials. The Cochrane Risk of Bias Tool was used for the included studies, and Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) was used to interpret the certainty of results. Standardized Mean Differences (SMDs) and 95% confidence interval (CI) were calculated for meta-analysis. Results Twenty-nine studies were found (1398 people, age range 54-85, 74% are female) and fourteen were included in this review. Intervention duration was divided as short term (immediately after intervention), medium term (<four weeks) and long term (≥ four weeks). Active TENS showed greater improvement in Visual Analogue Scale (VAS) than sham TENS.Combining TENS with other interventions produced superior outcomes compared with other interventions for VAS in all the terms. In the meanwhile, TENS combined with other interventions was superior to other interventions for the pain subgroup of Western Ontario and McMaster Universities Arthritis Index in the medium term and long term. TENS combined with other interventions was superior to other interventions for function in the medium term and long term. Conclusion TENS could significantly relieve pain, decrease dysfunction and improve walking ability in people with KOA, but it is not effective for stiffness.


2021 ◽  
pp. 026921552110562
Author(s):  
Nanna Rolving ◽  
Karina Agerbo ◽  
Stine Aalkjær Clausen ◽  
Kate Ane Rauff Denby ◽  
Anna Puk Jacobsen ◽  
...  

Objective To investigate the effects of a group-based cognitive behavioural intervention for patients with persistent low back pain (LBP) and psychological risk factors referred to secondary care. Design A randomised controlled trial. Setting Silkeborg Regional Hospital, Denmark. Subjects A total of 136 participants with chronic LBP and psychological risk factors. Interventions Participants were randomised to the standard care group, including examination by a rheumatologist and/or a physiotherapist, or the intervention group, including standard care plus a multidisciplinary group-based pain management programme. Main measures Patient-reported outcomes were collected at baseline and after 6 and 12 months. The primary outcome was disability (Roland Morris Disability Questionnaire). Secondary outcomes included low back pain intensity, pain catastrophising, health-related quality of life, and sick leave. Results Among 136 participants, 68 (mean age: 41.7 years (SD 11.8)) were randomised to standard care and 68 (mean age: 46.0 years (SD 10.8)) were randomised to the intervention group. Except for age, baseline characteristics were comparable between groups. 12-month follow-up was completed by 92.6% in the intervention group and 80.9% in the standard care group. Both groups achieved significant improvements on disability, with a reduction of −4.8 points (SD 6.1) in the intervention group compared to −3.7 points (SD 5.2), resulting in an insignificant difference between groups. No significant differences were found in the secondary outcomes. Conclusion A group-based pain management programme was no more effective than standard care for patients with persistent LBP and psychological risk factors.


2021 ◽  
pp. 026921552110704
Author(s):  
Mohammad Rahbar ◽  
Sepideh Ranjbar Kiyakalayeh ◽  
Reza Mirzajani ◽  
Bina Eftekharsadat ◽  
Neda Dolatkhah

Objectives The objective of this trial was to compare the efficacy of acromioclavicular joint mobilization and standard physical-therapy versus physical-therapy alone in the treatment of the frozen shoulder. Design Single-blind randomized clinical trial. Setting Outpatient setting. Subjects Patients with frozen shoulder. Intervention Participants were randomly allocated into mobilization + physical-therapy (n = 28), and physical-therapy alone (n = 28) groups for one month. Main Measures The primary outcomes were the shoulder pain and disability index and the shoulder range of motion. The secondary outcome was the visual analogue scale. Measures were performed at the baseline, immediately and one month after the beginning of the treatment. Results Visual analogue scale and the shoulder pain and disability index improved more significantly in the mobilization group compared to the physical-therapy group immediately [−4.63 (−5.58–−3.67) vs. −2.22 (−2.96–−1.47), P < 0.001 and −23.08 (−28.63–−17.53) vs. −13.04 (−17.93–−8.16), P = 0.008, respectively] and one month after the beginning of the treatment [−5.58 (−6.45–−4.72) vs. −3.61 (−4.60–−2.62), P < 0.001 and −33.43 (−40.85–−26.01) vs. −20.03 (−26.00–−14.07), P = 0.001, respectively]. Active abduction range of motion was also improved more significantly immediately after the treatment in the mobilization group compared to the physical-therapy group [25.83 (11.45–40.13) vs. 10.17 (1.02–19.15), P = 0.025], however there were no significant differences between two groups concerning other measured range of motions. Conclusions Adding acromioclavicular mobilization to standard physical-therapy was more efficient in decreasing pain and disability and improving active abduction range of motion compared to standard physical-therapy in frozen shoulder patients.


2021 ◽  
pp. 026921552110704
Author(s):  
Francisca Gámiz-Bermúdez ◽  
Esteban Obrero-Gaitán ◽  
Noelia Zagalaz-Anula ◽  
Rafael Lomas-Vega

Objective to analyze the efficacy of Corrective exercise-based therapy in the improvement of deformity and quality of life in adolescent idiopathic scoliosis. Data sources PubMed Medline, Scopus, Web of Science (WOS), Physiotherapy Evidence Database, CINAHL Complete and SciELO, until June 2021. Review methods Randomized controlled trials was selected, including participants diagnosed with adolescent idiopathic scoliosis, in which the experimental group received Corrective exercise-based therapy. Two authors independently searched the scientific literature in the data sources, extracted the data and assessed the risk of bias. A pairwise meta-analysis using the random-effects model was performed. Results Eight randomized controlled trials providing data from 279 adolescent idiopathic scoliosis patients were included. Seven randomized controlled trials including 236 patients showed moderate-quality evidence for a medium effect (SMD = −0.52, 95% CI −0.96 to −0.1), favoring corrective exercise-based therapy for spinal deformity reduction. Corrective exercise-based therapy was better than no intervention (SMD = −0.59, 95% CI −1.18 to −0.01) but similar to other intervention (SMD = −0.2, 95% CI −0.67 to 0.27), and a medium effect was found (SMD = −0.51, 95% CI −0.89 to −0.13) when corrective exercise-based therapy was used with other therapies. Four studies including 151 patients showed low-quality evidence of a large effect of Corrective exercise-based therapy on Scoliosis Research Society measurement (SRS-22) total score improvement (SMD = 1.16, 95% CI 0.36 to 1.95). Conclusion In mild and moderate adolescent idiopathic scoliosis patients, corrective exercise-based therapy could be used to reduce spinal deformity and to improve quality of life as isolated treatment or as coadjuvant treatment combined with other therapeutic resources.


2021 ◽  
pp. 026921552110693
Author(s):  
Robert S. Gailey ◽  
Ignacio Gaunaurd ◽  
Sara J. Morgan ◽  
Anat Kristal ◽  
Geoffrey S. Balkman ◽  
...  

Objective To determine if the two-minute walk test (2MWT) could serve as an alternative measure of high-level mobility in lower limb prosthesis users when circumstances preclude administration of the Comprehensive High-level Activity Mobility Predictor (CHAMP). Design Cross-sectional study. Setting Indoor recreational athletic field and gymnasium Subjects Fifty-eight adult lower limb prosthesis users with unilateral or bilateral lower limb amputation who participate in recreational athletic activities. Intervention N/A Main Measures The 2MWT and CHAMP while using their preferred prosthesis(es) on an indoor artificial athletic field or hardwood gymnasium floor. Results Thirty-nine men and nineteen women with a median age of 38.3 years participated in the study. Most participants experienced amputation(s) due to trauma (62%) or tumor (10%) and were generally higher functioning (K4 (91.4%) and K3 (8.6%)). The median (range) score for the CHAMP was 23.0 points (1.5–33.5) and the mean ± standard deviation (range) 2MWT distance walked was 188.6 ± 33.9 m (100.2–254.3 m). The CHAMP demonstrated a strong positive relationship with 2MWT (r = 0.83, p < 0.001). The 2MWT distance predicted 70% of the variance in CHAMP score. Conclusions Although the 2MWT does not test multi-directional agility like the CHAMP, they were found to be highly correlated. If space is limited, the two-minute walk test can serve as an alternative measure for assessing high-level mobility capabilities in lower limb prosthesis users.


2021 ◽  
pp. 026921552110659
Author(s):  
Leandro M. Diniz ◽  
Crystian B. Oliveira ◽  
Gustavo C. Machado ◽  
Christopher G. Maher ◽  
Arianne P. Verhagen ◽  
...  

Objective To investigate what format for providing patient information (i.e. written summary, infographic or video animation) is most effective for promoting correct beliefs about imaging and inevitable consequences of low back pain (LBP). Design Randomised controlled trial. Setting/Patients One hundred and fifty-nine patients with non-specific LBP were recruited from outpatient physiotherapy clinics. Intervention Participants were randomised to receive patient information in one of three formats: video animation, infographic or written summary. Patients were allowed to read or watch the materials for up to 20 min. Measurements Outcome were assessed before and immediately after the intervention. The primary outcome was the Back Beliefs Questionnaire. The secondary outcome was beliefs about imaging for LBP assessed by two questions. Results All 159 patients completed the study. Our findings revealed no difference between groups for the Back Beliefs Questionnaire. Correct beliefs about imaging were more likely with the infographic than the video animation (Question 1- Odds Ratio [OR] = 3.9, 95% confidence interval [CI]: 1.7, 8.7; Question 2- OR = 6.8, 95%CI: 2.7, 17.2) and more likely with the written summary than the video animation (Question 1- OR = 3.3, 95%CI: 1.5, 7.4; Question 2- OR = 3.7, 95%CI: 1.6, 8.5). No difference between infographic and written summary formats were reported for the questions assessing LBP imaging beliefs. Conclusion The three materials were equally effective in improving patient's general beliefs about LBP care. However, the traditional written summary or infographic formats were more effective than the video animation format for improving beliefs about imaging for LBP.


2021 ◽  
pp. 026921552110682
Author(s):  
Chalida Phoobangkerdphol ◽  
Patchara Limampai ◽  
Sirinuch Dasri ◽  
Vilai Kuptniratsaikul

Objective To investigate improvement in balance abilities compared between walking meditation and balance training among older adults with history of fall. Interventions Walking meditation or mindfulness meditation whilst standing and moving ( n = 35) or balance training ( n = 33) 20–30 min/day, 5–7 days/week for 24 weeks was performed at home. Main outcomes The primary outcomes were dynamic balance abilities as assessed by Timed Up and Go test (TUGT), and static balance as assessed by Functional Reach Test (FRT) and Single Leg Stance Test (SLST). The secondary outcomes were quality of life as measured by the EuroQOL 5-dimensions 5-levels (EQ-5D-5L), and mental health as evaluated by the Thai Geriatric Mental Health Assessment Tool-15 (TGMHA-15). All outcomes were assessed at baseline, 6 months, and 9 months. Self-reported compliance, adverse events, and patient satisfaction were recorded at 6 and 9 months. Results The mean age was 69 years (range: 60–85). No significant difference was observed between groups for the 3 primary outcome measures. The mean difference (95% confidence interval) between groups was −0.48 (-1.40, 0.44) for TUGT, −1.11 (-3.66, 1.45) for FRT, and 0.82 (-5.03, 6.67) for SLST. The EQ-5D-5L and TGMHA-15 also showed no significant difference between groups. Most participants were in good compliance with the exercise protocol (48.3–68.0%), and no serious adverse events were reported. Conclusion Our results showed walking meditation to be comparable to balance training for improving balance abilities in older adults with history of fall. Walking meditation may be considered an alternative treatment for improving balance abilities in this patient population.


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