The Role and Importance of Using Sensor-Based Devices in Medical Rehabilitation: A Literature Review on the New Therapeutic Approaches.

Due to the growth of sensor technology, more affordable integrated circuits, and connectivity technologies, the usage of wearable equipment and sensing devices for monitoring physical activities, whether for wellness, sports monitoring, or medical rehabilitation, has exploded. The current literature review was performed between October 2022 and February 2023 using PubMed, Web of Science, and Scopus in accordance with P.R.I.S.M.A. criteria. The screening phase resulted in the exclusion of 69 articles that did not fit the themes developed in all subchapters of the study, 41 articles that dealt exclusively with rehabilitation and orthopaedics, 28 articles whose abstracts were not visible, and 10 articles that dealt exclusively with other sensor-based devices and not medical ones; the inclusion phase resulted in the inclusion of 111 articles. Patients who utilise sensor-based devices have several advantages due to rehabilitating a missing component, which marks the accomplishment of a fundamental goal within the rehabilitation program. As technology moves faster and faster forward, the field of medical rehabilitation has to adapt to the time we live in by using technology and intelligent devices. This means changing every part of rehabilitation and finding the most valuable and helpful gadgets that can be used to regain lost functions, keep people healthy, or prevent diseases.

Effects of a Novel Proprioceptive Rehabilitation Device on Shoulder Joint Position Sense, Pain and Function.

Background and Objectives: Shoulder disorders are associated with pain, restricted range of motion and muscular strength, moderate disability and diminished proprioception. This study aimed to compare the effectiveness of an innovative technology-supported and a classical therapist-based proprioceptive training program in addition to conventional physiotherapy, on joint position sense (JPS), pain and function, in individuals with different musculoskeletal shoulder disorders, such as rotator cuff tear, subacromial impingement syndrome and superior labrum anterior and posterior tear. The innovative element of the proprioceptive training programme consists of the use of the Kinesimeter, a device created for both training and assessing shoulder JPS. Materials and Methods: The shoulder JPS test and the DASH outcome questionnaire were applied to fifty-five individuals (28 females, 27 males, mean age 56.31 ± 6.75), divided into three groups: 17 in the conventional physiotherapy group (control group); 19 in the conventional physiotherapy + classical proprioceptive training program group (CPT group); and 19 in the conventional physiotherapy + innovative proprioceptive training program group (KPT group). Assessments were performed before and after a four-week rehabilitation program, with five physiotherapy sessions per week. Results: When baseline and post-intervention results were compared, the value of the shoulder JPS and DASH outcome questionnaire improved significantly for the KPT and CPT groups (all p < 0.001). Both KPT and CPT groups showed statistically significant improvements in JPS, pain and function, compared to the control group which received no proprioceptive training (all p < 0.05). However, the KPT group showed no significant benefits compared to the CPT group. Conclusions: Our findings indicate that using the Kinesimeter device as a novel, innovative proprioceptive training tool has similar effects as the classical proprioceptive training programs among individuals with different non-operated musculoskeletal shoulder disorders such as: rotator cuff tear, subacromial impingement syndrome, and superior labrum anterior and posterior tear.

Weekend Effect and Mortality Outcomes in Aortic Dissection: A Prospective Analysis.

Background: Aortic dissection (AD) is a critical heart condition with potentially severe outcomes. Our study aimed to investigate the existence of a "weekend effect" in AD by examining the correlation between patient outcomes and whether their treatment occurred on weekdays versus weekends. Methods: Specifically, we prospectively analysed the effect of weekday and weekend treatment on acute AD patient outcomes, both before surgical intervention and during hospitalization, for 124 patients treated from 2019-2021, as well as during 6 months of follow-up. Results: The mean age of the study population was 62.5 years, and patient age exhibited a high degree of variability. We recorded a mortality rate before surgery of 8.65% for the weekend group and 15% for the weekday group, but this difference was not statistically significant. During hospitalization, mortality was 50% in the weekend group and 25% in the weekday group, but this difference was not statistically significant. Discharge mortality was 9.61% in the weekend group and 5% in the weekday group. Conclusions: Our findings suggest that there was no significant difference in mortality rates between patients admitted to the hospital on weekends versus weekdays. Therefore, the period of the week when a patient presents to the hospital with AD appears not to affect their mortality.

The Gender Gap in Aortic Dissection: A Prospective Analysis of Risk and Outcomes.

Aortic dissection (AD) is a severe cardiovascular condition that could have negative consequences. Our study employed a prospective design and examined preoperative, perioperative, and postoperative data to evaluate the effects of gender on various medical conditions. We looked at how gender affected the results of aortic dissection (AD). In contrast to female patients who had more systemic hypertension (p=0.031), male patients had higher rates of hemopericardium (p=0.003), pulmonary hypertension (p=0.039), and hemopericardium (p=0.003). Dobutamine administration during surgery significantly raised the mortality risk (p=0.015). There were noticeably more women patients (p=0.01) in the 71 to 80 age group. Significant differences in age (p=0.004), eGFR at admission (p=0.009), and eGFR at discharge (p=0.006) were seen, however, there was no association between gender and mortality. In conclusion, our findings highlight that gender may no longer be such an important aspect of aortic dissection disease as we previously thought, and this information could have an important contribution for surgeons as well as for anesthesiologists involved in the management of acute aortic dissection.

Effects of Adding Aquatic-to-Land-Based Physiotherapy Programs for Shoulder Joint Position Sense Rehabilitation.

There is limited evidence regarding the effects of aquatic-based physiotherapy on shoulder proprioception following post-traumatic injury to the joint. The main aim of this study was to investigate the effects of additional aquatic-based rehabilitation to a land-based physiotherapy program on shoulder joint position sense (JPS) rehabilitation. Forty-four individuals (mean age 44.50 ± 10.11) who had suffered a post-traumatic shoulder injury less than five months previously were pseudo-randomly allocated equally into a control group (9 females, 13 males) and experimental group (6 females, 16 males). Both groups received individualized standard land-based physiotherapy on average for 50 min per session, with five sessions per week for four consecutive weeks. The experimental group received an additional 30 min of personalized aquatic-based therapy during each session. Shoulder JPS was assessed by flexion (60°), extension (25°), abduction (60°), internal rotation (35°) and external rotation (35°) positions prior, halfway through, and after the intervention. Shoulder JPS improved significantly for all positions for both the control group (p < 0.03) and the experimental group (p < 0.01). No significant differences between the control group and the experimental group were found for change in shoulder JPS over time. Our results indicate that shoulder JPS can be significantly improved among individuals with post-traumatic injury to the joint through four weeks of personalized physiotherapy. The addition of aquatic-based exercises to standard land-based therapy did not, however, show significant benefits, and thus cannot be recommended for the improvement of shoulder JPS based on our findings.

TECAR Therapy Associated with High-Intensity Laser Therapy (Hilt) and Manual Therapy in the Treatment of Muscle Disorders: A Literature Review on the Theorised Effects Supporting Their Use.

BACKGROUND: It has been estimated that between 30 and 50 per cent of all injuries that take place throughout participation in a sport are the consequence of soft tissue injuries, and muscle injuries are the primary cause of physical disability. METHODS: The current literature review was designed between October 2021 and April 2022, according to the PRISMA standards, using the PubMed, Scopus, and Web of Science databases. At the screening stage, we eliminated articles that did not fit into the themes developed in all subchapters of the study (n = 70), articles that dealt exclusively with orthopaedics (n = 34), 29 articles because the articles had only the abstract visible, and 17 articles that dealt exclusively with other techniques for the treatment of musculoskeletal disorders. The initial search revealed 343 titles in the databases, from which 56 duplicate articles were automatically removed, and 2 were added from other sources. RESULTS: The combination of these three techniques results in the following advantages: It increases joint mobility, especially in stiff joints, it increases the range of motion, accelerates tissue repair, improves tissue stability, and extensibility, and it reduces soft tissue inflammation (manual therapy). In addition, it decreases the concentration of pro-inflammatory mediators and improves capillary permeability, resulting in the total eradication of inflammation (HILT). It warms the deep tissues, stimulates vascularity, promotes the repose of tissues (particularly muscle tissue), and stimulates drainage (TECAR). CONCLUSIONS: TECAR therapy, combined with manual therapy and High-Intensity Laser therapy in treating muscle diseases, presented optimal collaboration in the recovery process of all muscle diseases.

Study on the Influence of Proprioceptive Control versus Visual Control on Reaction Speed, Hand Coordination, and Lower Limb Balance in Young Students 14-15 Years Old.

Currently, sports activities require a high reaction speed, coordination, and balance, highlighting the relationship between proprioceptive control, visual control, and hand-eye coordination in youth. The present research assessed the proprioceptive control, reaction speed, and lower limb balance of youth from five different schools to identify the level of physical preparation of children in this direction. This prospective study was conducted between 1 January 2020 and 29 February 2020. A total of 107 healthy children (33 females and 74 males) with appropriate medical conditions, aged between 14 and 15 years, from five Romanian schools were included in the experiment. All children were assessed for visual control and reaction speed with the ruler drop test, and for lower limb balance, the standing stork test was used. Statistical analysis included descriptive statistics, data series distribution, and comparison of means and medians using specific statistical programs. Comparison of medians highlighted significant statistical differences in the standing stork test with eyes closed and the dominant leg compared with the nondominant leg (p = 0.0057). Males were compared to females at the nondominant leg (p = 0.0179); closed eyes were compared with opened eyes for the nondominant leg (p = 0.0175 and 0.0006) for the ruler drop test comparing the dominant hand with the nondominant hand (p = 0.0212). Children who engage in sports activities better integrated sensory information in motor action execution based on reaction speed and coordination with the nondominant hand.