Versatile GCH Control Software for Correction of Loads Applied to Forearm Crutches During Gait Recovery Through Technological Feedback: Development and Implementation Study.

BACKGROUND: Measuring weight bearing is an essential aspect of clinical care for lower limb injuries such as sprains or meniscopathy surgeries. This care often involves the use of forearm crutches for partial loads progressing to full loads. Therefore, feasible methods of load monitoring for daily clinical use are needed. OBJECTIVE: The main objective of this study was to design an innovative multifunctional desktop load-measuring software that complements GCH System 2.0-instrumented forearm crutches and monitors the applied loads, displaying real-time graphical and numerical information, and enabling the correction of inaccuracies through feedback technology during assisted gait. The secondary objective was to perform a preliminary implementation trial. METHODS: The software was designed for indoor use (clinics/laboratories). This software translates the crutch sensor signal in millivolts into force units, records and analyzes data (10-80 Hz), and provides real-time effective curves of the loads exerted on crutches. It covers numerous types of extrinsic feedback, including visual, acoustic (verbal/beeps), concurrent, terminal, and descriptive feedback, and includes a clinical and research use database. An observational descriptive pilot study was performed with 10 healthy subjects experienced in bilateral assisted gait. The Wilcoxon matched-pairs signed-rank test was used to evaluate the load accuracy evolution of each subject (ie, changes in the loads exerted on crutches for each support) among various walks, which was interpreted at the 95% confidence level. RESULTS: GCH Control Software was developed as a multifunctional desktop tool complementing GCH System 2.0-instrumented forearm crutches. The pilot implementation of the feedback mechanism observed 96/100 load errors at baseline (walk 0, no feedback) with 7/10 subjects exhibiting crutch overloading. Errors ranged from 61.09% to 203.98%, demonstrating heterogeneity. The double-bar feedback found 54/100 errors in walk 1, 28/100 in walk 2, and 14/100 in walk 3. The first walk with double-bar feedback (walk 1) began with errors similar to the baseline walk, generally followed by attempts at correction. The Wilcoxon matched-pairs signed-rank test used to evaluate each subject's progress showed that all participants steadily improved the accuracy of the loads applied to the crutches. In particular, Subject 9 required extra feedback with two single-bar walks to focus on the total load. The participants also corrected the load balance between crutches and fluency errors. Three subjects made one error of load balance and one subject made six fluctuation errors during the three double-bar walks. The latter subject performed additional feedback with two balance-bar walks to focus on the load balance. CONCLUSIONS: GCH Control Software proved to be useful for monitoring the loads exerted on forearm crutches, providing a variety of feedback for correcting load accuracy, load balance between crutches, and fluency. The findings of the complementary implementation were satisfactory, although clinical trials with larger samples are needed to assess the efficacy of the different feedback mechanisms and to select the best alternatives in each case.

[Efficacy of tele-rehabilitation in patients with chronic obstructive pulmonary disease: a systematic review].

The COVID-19 pandemic has required the use of new technologies to carry out rehabilitation sessions for COP D remotely. The aim of this systematic review was to analyse the available evidence on the efficacy of telerehabilitation in COPD patients. PubMed, WOS, PEDro and Cochrane databases were consulted. The systematic review included nine clinical trials, 55.5% of which display good methodological quality. The most commonly used rehabilitation methods were applications or software for real-time video-calls, visualisation of exercises and recording progress. TR was as effective as outpatient pulmonary rehabilitation, with greater benefits in functional capacity, self-efficacy, mental health, exacerbations and emergency care visits, offering a cost-effective option with high patient satisfaction. The small number of studies and the variety of rehabilitation methods examined limit the value of the evidence obtained.

Benefits of hippotherapy in children with cerebral palsy: A narrative review.

Children with cerebral palsy display disorders in pelvic movement and require effective rehabilitation. There is evidence to support the hippotherapy due to improvements in balance. The aim of this narrative review was to summarise the grades of recommendation regarding the benefits of hippotherapy in children with cerebral palsy. DATA SOURCES AND EXTRACTION: We searched electronic databases, limiting the searches to studies published between 2004 and February 2017. The selected documents were classified according to the strength of recommendation provided by Duodecim (the Finnish medical society). The methodological quality of the selected studies was evaluated using the PEDro scale. RESULTS: 18 studies (four graded A, eight graded B and six graded C) showed clinical changes in the outcomes of gross motor function, sitting independently, speed of walking, length of stride and postural alignment of the head in children with cerebral palsy. Study quality was poor to good (mean PEDro Score of 6 out of 10). Benefits were identified in relation to psychological factors, as well as positive effects on quality of life and the performance of daily life activities. CONCLUSIONS: Gains were also observed in postural alignment and the balance of head and trunk. Moreover, there were improvements in quality of life and the activities of daily life, such as jumping, balance, strength and ascending and descending stairs.

Eficacia de la tele-rehabilitación en pacientes con enfermedad pulmonar obstructiva crónica: una revisión sistemática / Efficacy of tele-rehabilitation in patients with chronic obstructive pulmonary disease: a systematic review

La pandemia de la COVID-19 ha requerido el uso de nuevas tecnologías para realizar las sesiones de rehabilitación en la EPOC de manera telemática. El objetivo de esta revisión sistemática fue analizar la evidencia disponible sobre la eficacia de la telerehabilitación en pacientes con EPOC. Se consultaron las bases de datos PubMed, WOS, PEDro y Cochrane. La revisión incluyó nueve ensayos clínicos, el 55,5% con buena calidad metodológica. Los métodos de telerehabilitación más utilizados fueron las aplicaciones o software para realizar video-llamadas a tiempo real, visualizar los ejercicios y registrar los progresos conseguidos. La telerehabilitación fue tan eficaz como la rehabilitación pulmonar ambulatoria, obteniendo mayores beneficios en capacidad funcional, autoeficacia, salud mental, exacerbaciones y visitas a urgencias, siendo una opción rentable y con alta satisfacción del paciente. El pequeño número de estudios y la variedad de métodos de telerehabilitación limitan el valor de la evidencia obtenida.(AU)

The COVID-19 pandemic has required the use of new technologies to carry out rehabilitation sessions for COP Dremotely. The aim of this systematic review was to analyse the available evidence on the efficacy of telerehabilitation in COPD patients. PubMed, WOS, PEDro and Cochrane data bases were consulted. The systematic review included nine clinical trials, 55.5% of which display good methodological quality. The most commonly used rehabilitation methods were applications or software for real-time video-calls, visualisation of exercises and recording progress. TR was as effective as outpatient pulmonary rehabilitation, with greater benefits in functional capacity, self-efficacy, mental health, exacerbations and emergency care visits, offering a cost-effective option with high patient satisfaction. The small number of studies and the variety of rehabilitation methods examined limit the value of the evidence obtained.(AU)

Calidad de vida profesional de los fisioterapeutas en el ámbito hospitalario público de Sevilla / Professional quality of life in physiotherapists in public hospitals of Seville, Spain

Objetivo: Conocer el nivel de calidad de vida profesional percibida por los fisioterapeutas del ámbito hospitalario público del área metropolitana de Sevilla y analizar su relación con variables sociodemográficas y laborales. Material y métodos: Estudio multicéntrico descriptivo transversal, desarrollado en el área metropolitana de Sevilla: Hospital Universitario Virgen del Rocío, Virgen Macarena y Virgen de Valme. Los participantes fueron todos los fisioterapeutas de los hospitales anteriormente citados. La tasa de respuesta fue del 96 por mil (n=48). Instrumentos de medida: encuesta anónima que incluye el cuestionario de calidad de vida profesional CVP-35, además de variables sociodemográficas y laborales. Resultados: El perfil del fisioterapeuta es una mujer (72,9 por mil ), de 44 años (Q1 41,75; Q3 57), casada (79,2 por mil ), con 2 hijos (Q1 1; Q3 2), con un tiempo de experiencia profesional de 22 años (Q1 16,25; Q3 30), con una antigüedad en el puesto de 6,5 años (Q1 4; Q3 16,83), plaza en propiedad (64,6 por mil ), jornada completa (89,6 por mil ) y turno de mañana (95,8 por mil ). La valoración global sobre la calidad de vida profesional percibida es de 7 puntos (Q1 5; Q3 8). En relación con las 3 dimensiones valoradas, la media más alta se encuentra en la «motivación intrínseca», con 8,17 (DT 1), «cargas de trabajo», con 6,06 (DT 1,2), y «apoyo directivo», con 5,38 (DT 1,54). No existen diferencias estadísticamente significativas con las variables sociolaborales. Conclusiones: Los fisioterapeutas de los hospitales de la ciudad de Sevilla tienen una calidad de vida en el trabajo media-alta. Presentan una adecuada motivación para realizar su trabajo, pero muestran cierta insatisfacción relacionada con el apoyo directivo y la carga de trabajo

Objective: Evaluate the level of professional quality of life perceived by the public hospital physiotherapists of the metropolitan area of Seville, and analyse its relationship with sociodemographic and occupational variables. Methods: Multicentre descriptive cross-sectional observational study developed in metropolitan area of Seville, including the University Hospital Virgen del Rocío, Virgen Macarena and Virgen de Valme. The participants were all physiotherapists from the aforementioned hospitals. The response rate was 96 per-mille (n=48). The measurement tool used was a questionnaire on professional quality of life (CVP-35), as well as the collecting of sociodemographic and occupational variables. Results: The profile of the physiotherapist is female (72.9 per-mille ), 44 years-old (Q1 41.75; Q3 57), married (79.2 per-mille ), with 2 children (Q1 1; Q3 2), with a long experience as a physiotherapist of 22 years (Q1 16.25; Q3 30), with a job tenure of 6.5 years (Q1 4; Q3 16.83), tenured (64.6 per-mille ), full time (89.6 per-mille ), and morning shift (95.8 per-mille ). The overall assessment of the perceived professional quality of life scored 7 points (Q1 5; Q3 8). In relation to the 3 dimensions evaluated, the highest score obtained was in the "intrinsic motivation" with 8.17 (SD 1), "workloads", with 6.06 (SD 1.2), and "management support" with 5.38 (SD 1.54). There were no statistically significant differences as regards social and occupational variables. Conclusions: Physiotherapists in hospitals of the city of Seville have a medium-high professional quality of life. They have adequate motivation to do their job, but show some dissatisfaction as regards management support and workload