Conventional physical therapy combined with extracorporeal shock wave leads to positive effects on spasticity in stroke survivors: a prospective observational study.

The study aimed to evaluate the effectiveness of radial extracorporeal shock wave therapy (rESWT) and conventional physical therapy (CPT) protocol on the gait pattern in stroke survivors through a new gait analysis technology. Fifteen (n=15) stroke survivors took part in this prospective, observational study and were assessed clinically and through an instrumented treadmill before and after rESWT and CPT. Spasticity grade 95% CI 0.93 (0.79 +/- 1.08), pain intensity 95% CI 1.60 (1.19 +/- 2.01), and clonus score decreased significantly 95% CI 1.13 (0.72 +/- 1.54). The sensorimotor function 95% CI -2.53 (-3.42 +/- 1.65), balance 95% CI -5.67 (-6.64 +/- - 4.69), and gait parameters were enhanced at the end of the program. Step length 95% CI -3.47 (-6.48 +/- 0.46) and step cycle were improved 95% CI -0.09 (-0.17 +/- -0.01), and hip 95% CI -3.90 (-6.92 +/- -0.88), knee 95% CI -2.08 (-3.84 +/- -0.32) and ankle flexion-extension 95% CI -2.08 (-6.64 +/- -4.69) were augmented. Adding the quantitative analysis to the clinical assessment, we gained easy access to track progress and obtained an individualized therapeutic approach for stroke survivors.

Frailty Education: Promoting Geriatric Competencies Among Physical Medicine and Rehabilitation Residents.

ABSTRACT: Frailty, a geriatric syndrome of growing importance in recent years, has been shown to be associated with increased risk of disability and adverse health and socioeconomic outcomes. Therefore, there is a need for new educational strategies for physical medicine and rehabilitation residents to promote greater geriatric competencies, with a focus on developing customized evaluation and management plans. With this article, the aim is offering a quick reference tool summarizing the latest evidence on the rehabilitative management of frailty. Indeed, a comprehensive geriatric evaluation is needed before developing an evidence-based and individually tailored rehabilitation program including physical activity, educative strategies, nutritional interventions, and proposals for social reintegration. In the future, appropriate educational training may allow a more careful management of these patients, with consequent improvements in quality of life and functionality.

The outbreak of the SARS-CoV-2 Omicron variant make imperative the adoption of telerehabilitation in the Bulgarian health care system.

The rapid spread of the highly contagious Omicron variant of SARS-CoV-2 globally will challenge the accessibility and the delivery of physical and rehabilitation medicine (PRM) services. Many health care systems throughout the world performed effective reforms such as the transition to telerehabilitation (TR). In Bulgaria, TR is still not regulated by law, and terms such as teleconsultation and tele-education have not yet been introduced. The adoption of TR in the Bulgarian health care system will undoubtedly increase the accessibility to rehabilitation treatment for a larger group of Bulgarian patients with various neurological, cardiorespiratory, musculoskeletal, and oncological conditions and will significantly contribute to the PRM services modernization in Bulgaria.