The Effect of Extremely Low-Frequency Magnetic Field on Stroke Patients: A Systematic Review.

BACKGROUND: The aim of this study was to review the current state of scientific evidence on the effect of extremely low-frequency magnetic fields stimulation (ELF-MFs) on stroke patients. METHODS: A systematic review of PubMed, ScienceDirect, PeDro and Embase databases was conducted. Only articles published in English, involving adult participants and focusing on individuals who had experienced a stroke, specifically examining the impact of ELF-MFs on post-stroke patients and had well-defined criteria for inclusion and exclusion of participants, were included. The methodological quality of the included studies was assessed using the Quality Assessment Tool for Quantitative Studies (QATQS). RESULTS: A total of 71 studies were identified through database and reference lists' search, from which 9 were included in the final synthesis. All included studies showed a beneficial effect of ELF-MFs on stroke patients, however seven of the included studies were carried by the same research group. Improvements were observed in domains such as oxidative stress, inflammation, ischemic lesion size, functional status, depressive symptoms and cognitive abilities. CONCLUSIONS: The available literature suggests a beneficial effect of ELF-MFs on post-stroke patients; however, the current data are too limited to broadly recommend the use of this method. Further research with improved methodological quality is necessary.

The Effect of Using a Rehabilitation Robot for Patients with Post-Coronavirus Disease (COVID-19) Fatigue Syndrome.

The aim of this study was to compare the effectiveness of traditional neurological rehabilitation and neurological rehabilitation combined with a rehabilitation robot for patients with post-COVID-19 fatigue syndrome. Eighty-six participants transferred from intensive care units due to post-viral fatigue after COVID-19 were randomly divided into two groups: the intervention group and the control group. The control group received standard neurological rehabilitation for 120 min a day, while the intervention group received the same neurological rehabilitation for 75 min a day, complemented by 45 min of exercises on the rehabilitation robot. The Berg scale, Tinetti scale, six-minute walking test, isokinetic muscle force test, hand grip strength, Barthel Index, and Functional Independence Measure were used to measure the outcomes. Both groups improved similarly during the rehabilitation. Between groups, a comparison of before/after changes revealed that the intervention group improved better in terms of Functional Independence Measure (p = 0.015) and mean extensor strength (p = 0.023). The use of EMG-driven robots in the rehabilitation of post-COVID-19 fatigue syndrome patients was shown to be effective.

Does Hand Grip Strength (HGS) Predict Functional Independence Differently in Patients Post Hip Replacement Due to Osteoarthritis versus Patients Status Post Hip Replacement Due to a Fracture?

Purpose: The aim of the study was to determine whether hand grip strength (HGS) predicts functional independence in older patients who have undergone hip replacement due to osteoarthritis versus older patients who have undergone hip replacement surgery due to fracture. Patients and Methods: The study included 239 patients aged 65 and over in the first weeks after total hip replacement during rehabilitation treatment. Multivariate linear regression was used to determine HGS as a predictor of activities of daily living (ADL) and instrumental activities of daily living (IADL) in both groups: patients post hip replacement due to osteoarthritis and patients post hip replacement due to a fracture. Results: Analysis showed that pre-rehab HGS in the osteoarthritis group predicts improved activities of daily living after rehabilitation (ADL, OR = 1.098; CI 95% 1.052-1.147 and IADL, OR = 1.182; CI 95% 1.103-1.267) and 6 months after (ADL, OR = 1.191; CI 95% 1.066-1.329 and IADL, OR = 1.096; CI 95% 1.012-1.186). In the fracture group, HGS predicts the ADL (OR = 1.081; CI 95% 1.015-1.152) after rehabilitation, and IADL after rehabilitation (OR = 1.122; CI 95% 1.046-1.205) and 6 months after (OR = 1.090; 95% CI 1.021-1.64). Conclusion: HGS in patients after hip replacement surgery predicts functional independence in basic and complex activities of daily living. This can allow the identification of osteoarthritis patients with low hand grip - who can be considered as patients with a higher risk of an unsatisfying outcome of surgery. These patients should undergo pre-rehabilitation and should be monitored, and/or supported in terms of rehabilitation after discharge.

Application of an EMG-Rehabilitation Robot in Patients with Post-Coronavirus Fatigue Syndrome (COVID-19)-A Feasibility Study.

This pilot study aimed to assess the safety and feasibility of an EMG-driven rehabilitation robot in patients with Post-Viral Fatigue (PVF) syndrome after COVID-19. The participants were randomly assigned to two groups (IG-intervention group and CG-control group) in an inpatient neurological rehabilitation unit. Both groups were assessed on admission and after six weeks of rehabilitation. Rehabilitation was carried out six days a week for six weeks. The patients in the IG performed additional training using an EMG rehabilitation robot. Muscle fatigue was assessed using an EMG rehabilitation robot; secondary outcomes were changes in hand grip strength, Fatigue Assessment Scale, and functional assessment scales (Functional Independence Measure, Barthel Index). Both groups improved in terms of the majority of measured parameters comparing pre- and post-intervention results, except muscle fatigue. Muscle fatigue scores presented non-significant improvement in the IG and non-significant deterioration in the CG. Using an EMG rehabilitation robot in patients with PVF can be feasible and safe. To ascertain the effectiveness of such interventions, more studies are needed, particularly involving a larger sample and also assessing the participants' cognitive performance.

Respiratory Function and Muscle Strength Vs. Past Work Type: a Cross-Sectional Study Among Retirees.

OBJECTIVES: The aim of this cross-sectional study was to assess the effects of past occupational activity on muscle strength and respiratory function among retirees. METHODS: A total of 205 community-dwelling older adults participated in the study. Age (≥60 years) and cessation of professional activity (retirement) constituted the inclusion criteria. The International Standardized Classification of Occupations (ISCO-08) was used to stratify the participants into white- or blue-collar groups. Forced vital capacity (FVC), forced expiratory volume (FEV) in the first second, inspiratory vital capacity (IVC) parameters, and hand grip strength were tested. RESULTS: Statistically significant differences in IVC and FVC scores were found in white- and blue-collar workers after adjusting for sex and age (ANCOVA). White-collar men had significantly higher IVC as compared to blue-collar men. CONCLUSIONS: Blue-collar male workers may be prone to deteriorating respiratory function in older age. It is vital to promote physical activity and educate blue-collar workers about the need to use respiratory protective equipment.

Virtual Reality as a Promising Tool Supporting Oncological Treatment in Breast Cancer.

Breast cancer (BC) treatment is associated with many physical and psychological symptoms. Psychological distress or physical dysfunction are one of the most common side effects of oncological treatment. Functional dysfunction and pain-related evasion of movement may increase disability in BC. Virtual reality (VR) can offer BC women a safe environment within which to carry out various rehabilitation interventions to patient support during medical procedures. The aim of this systematic review was to conduct an overview of the clinical studies that used VR therapy in BC. The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines method: the initial search identified a total of 144 records, and 11 articles met the review criteria and were selected for the analysis. The results showed that VR seems to be a promising tool supporting oncological treatment in BC patients. VR can have a positive effect on mental and physical functions, such as relieving anxiety during oncotherapy, diminution pain syndrome, and increasing the range of motion and performance in daily activities.

Modern Technologies in the Rehabilitation of Patients with Multiple Sclerosis and Their Potential Application in Times of COVID-19.

Background and Objectives: The COVID-19 pandemic required the adoption of new technologies to improve access to healthcare at an unprecedented speed, as social distancing became mandatory. The aim of this systematic review was to analyze the effectiveness of using new technologies in the rehabilitation of multiple sclerosis (MS) patients and discuss their potential role during the COVID-19 pandemic. Material and Methods: The studies were identified by searching two online databases-PUBMED and Web of Science. Combinations of the key words "Multiple sclerosis" and "e-health"; "Multiple sclerosis" and "virtual reality"; "Multiple sclerosis" and "telerehabilitation"; "Multiple sclerosis" and "new technologies"; "Multiple sclerosis" and "tele-exercise" were used to find suitable publications. Results: A total of 17 studies were included. Although the overall number of participants in all the studies was 904, two of the studies were conducted on the same group. Thus, a total of 854 participants were involved in the studies included. All participants were diagnosed with MS. In 10 studies, participants had to be diagnosed according to the McDonald criteria. Of the included studies: five involved intervention at participants' home, six were conducted using Xbox Kinect, and seven studies reported no adverse outcomes. Conclusion: The review proves telerehabilitation to be an effective motivational tool to restore and maintain both physical and cognitive function in patients with MS. Remote communication technologies seem to be measures of high effectiveness in rehabilitating and supporting MS patients especially during the COVID-19 pandemic, as the traditional rehabilitation option is less accessible or in some cases inaccessible for these patients.

The Effect of a Mixed Circuit of Aerobic and Resistance Training on Body Composition in Older Adults-Retrospective Study.

Ageing is inevitably associated with body composition changes, such as loss of muscle mass, increase in the total fat mass, and unfavorable reduction of subcutaneous fat. Physical activity exerts significant effects on the body composition. The aim of the study was to investigate the effects of two different weekly doses of resistance-aerobic training on the body composition in older people. The study consisted in a retrospective data analysis of fitness club members aged ≥60. The trainees participated in resistance-aerobic training sessions two or three times/week for a minimum of two months. A body composition analysis was performed before and after the training sessions. Group 1 (36 subjects) and Group 2 (28 subjects) had two and three training sessions/week, respectively. A higher skeletal muscle mass was found in Group 1 and lower waist-hip-ratio indices were observed in Group 2. No statistically significant differences were found in the body mass, skeletal muscle mass, fat mass, total body water, lean mass, body mass index, visceral fat area between both groups. The number of training session/week proved to be statistically insignificant for all investigated variables. Resistance-aerobic training with two sessions/week may be as effective in maintaining proper body composition in older people as the same training at the dose of three sessions/week.

Correlation between Handgrip Strength and Depression in Older Adults-A Systematic Review and a Meta-Analysis.

BACKGROUND: Depression remains an important health problem among older adults and it may be correlated with the deterioration of physical fitness, whose chief indicator is hand grip strength (HGS). The aim of the study was to investigate the relationship between depression and HGS among older populations using the available literature. METHODS: PubMed, Web of Science and Science Direct databases were searched. The inclusion criteria were as follows: written in English and published after 2009, subject age: ≥60 years, HGS measured using a hand dynamometer, assessment of the depressive symptoms using a validated tool. The following articles were excluded: studies conducted among institutionalized subjects and/or populations with a specific disease. RESULTS: The total combined effect of 33 results presented in 16 studies included in the meta-analysis, converted to the correlation coefficient, was OEr = -0.148 (SE = 0.030, 95%CI: -0.206--0.091), indicating a weak, negative correlation between HGS and depressive symptoms. CONCLUSIONS: The review of the literature and the meta-analysis demonstrated a relationship between low muscle strength and intensified depressive symptoms in older populations. Bearing in mind that depression is often unrecognized or underdiagnosed among older patients, lowered muscle strength should be an important sign for physicians and an incentive to screen them for depression.

The Impact of Lifetime Work and Non-work Physical Activity on Physical Fitness Among White - and Blue - Collar Retirees: A Cross-Sectional Study.

Objective: The literature offers significant amount of data on the effects of occupational activity on health, with a distinct link between retirement and health among the most frequently tackled topics. Studies on the relationship between past occupational activity and physical fitness among older retirees remain scarce. The aim of the study was to assess the effects of physical activity on physical fitness in white- and blue-collar retirees. Methods: A total of 200 participants (aged ≥60) were included in the study. Lifetime physical activity was assessed using the Lifetime Physical Activity Questionnaire. Mean MET/week/year values of total Physical Activity and for each domain separately (occupational, sports, household) were calculated. Participants were stratified to blue- or white- collar group. Physical performance, hand-grip strength (HGS) and pulmonary function were assessed. Results: Mean total MET/week/year values for the blue- and the white-collar workers were 140.48 ± 55.13 and 100.75 ± 35.98, respectively. No statistically significant differences in physical performance scores were found between the white- and blue- collar groups. Adjustment for age, sex weight and height revealed a statistically significant association between work-related PA FEV*1 in the blue-collar group. White - collar workers presented higher odds ratio for membership in highest quartile in regard to short physical performance battery test score. Conclusion: Only minimal association of type of occupation on physical fitness were found despite statistically significant differences between mean intensity and duration of sports- and work-related lifetime physical activity. These findings may indicate that the type of past work is not an independent factor influencing the state of a person in old age. Large-scale investigations with physically fit and unfit participants, are necessary.

Polish Translation and Validation of the SARC-F Tool for the Assessment of Sarcopenia.

INTRODUCTION: Completion of the SARC-F questionnaire constitutes the obligatory first step in the diagnostic process of sarcopenia, according to the revised European consensus on the definition and diagnosis of sarcopenia published by the European Working Group on Sarcopenia in Older People2 (EWGSOP2). SARC-F has been recognized as the most up-to-date and coherent screening tool for sarcopenia. The aim of the study was to translate and to validate the Polish version of the SARC-F questionnaire. MATERIALS AND METHODS: The validation process was performed in two stages: 1) translation and intercultural adaptation and 2) clinical validation. The inclusion criteria were as follows: age ≥65 years, unimpaired mobility, and no cognitive impairment. The EWGSOP2 criteria were used to diagnose sarcopenia. Hand grip strength measurement, physical fitness test, and body weight composition analysis were conducted. Sensitivity, specificity, accuracy-likelihood ratios, and SARC-F predictive values were calculated using the EWGSOP2 criteria. RESULTS: Sixty-seven people participated in the study of whom 21% were diagnosed with sarcopenia (SARC-F score: ≥4). The reliability of the questionnaire based on the Cronbach's alpha coefficient was 0.784. Sensitivity, specificity, and negative predictive values were 92.9%, 98.1%, and 98.1%, respectively. CONCLUSION: The process of validating the SARC-F questionnaire against Polish conditions demonstrated its applicability as a simple and reliable tool for diagnosing sarcopenia in daily clinical practice with older adults.

Is the outcome of frailty syndrome gender dependent?

We assessed the relationship between the stages of the frailty syndrome and the development of limitations in the activities of daily living, hospitalization, and death among women aged ≥80 as compared to men over the course of 12 months. The Fried criteria and selected tests of comprehensive geriatric assessment were performed in 213 participants (phase 1). After 12 months, detailed feedback on the general health and functioning was collected (phase 2). Statistically significantly higher mortality (p < .05) was found among men as compared to women. The number of deaths in the frail group was higher among frail men than frail women (p < .007).

Physical Activity and Fitness in White- and Blue-Collar Retired Men.

The average life expectancy has increased and despite a distinct feminization of aging, the number of older males continues to grow. Physical activity has a positive effect on health and helps to slow down the negative consequences of aging. The aim of the study was to evaluate possible relationships between physical fitness, physical activity and type of work during occupational activity among retired men (aged ≥65 years), no longer professionally active. The study included 104 men (aged from 65 to 90 years), further stratified into blue- and white-collar groups (66 and 38 subjects, respectively). The International Physical Activity Questionnaire (IPAQ) was used to assess their physical activity levels. Physical performance was assessed using the Short Physical Performance Battery test (SPPB) and handgrip strength (HGS) measurement. Geriatric Depression Scale (GDS) was used to identify the risk for depression. Mean physical activity in the study population was moderate in almost 70%, high in 19% and low in 11% of the subjects. Men with high physical activity levels had better SPPB and GDS scores (p = .01 and p = .001, respectively). In the blue-collar group, the IPAQ scores were lower than in the white-collar group, although the differences were statistically insignificant. The SPPB scores and mean HGS for the dominant hand were similar in both groups. Occupational physical activity should not substitute other forms of physical activity. Regardless of the type of work performed before retirement, the men obtained similar results in terms of their physical activity.

Equine assisted activities and therapies in children with autism spectrum disorder: A systematic review and a meta-analysis.

INTRODUCTION: The multifactorial nature of Autism Spectrum Disorder (ASD) is the reason why complementary and alternative methods of treatment are sought in order to support the classic approach. OBJECTIVES: The aim of the study was to assess the effectiveness of Equine-Assisted Activities and Therapies (EAAT) in ASD patients based on a review of the literature. METHODS: A review of the literature and a meta-analysis were conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PUBMED, Cochrane Library, Web of Science, ClinicalTrials.gov and PEDro databases were searched until July 20, 2017. Only articles published in English, in a journal with a review process, after 1999, with a control group or presentation of comparative pre-/post-therapy results in ASD patients, and clear inclusion/exclusion criteria were considered. The methodological quality of the included studies was assessed using the Quality Assessment Tool for Quantitative Studies (QATQS).The meta-analysis of three studies was conducted. RESULTS: A total of 15 studies with 390 participants (aged: 3-16 years) were included. The interaction between psychosocial functioning and EAAT was investigated in most studies. Improvement was reported in the following domains: socialization, engagement, maladaptive behaviors, and shorter reaction time in problem-solving situations after EAAT. The meta-analysis revealed no statistically significant differences for the investigated effects. CONCLUSIONS: Despite the need for further, more standardized research, the results of the studies included in this review allow us to conclude that EAAT may be a useful form of therapy in children with ASD.

Comparison of the effectiveness of complex decongestive therapy and compression bandaging as a method of treatment of lymphedema in the elderly.

BACKGROUND: Lymphedema is a chronic condition which significantly lowers the quality of patient life, particularly among elderly populations, whose mobility and physical function are often reduced. OBJECTIVES: The aim of the study was to compare the effectiveness of multi-layer compression bandaging (MCB) and complex decongestive therapy (CDT), and to show that MCB is a cheaper, more accessible and less labor intensive method of treating lymphedema in elderly patients. PATIENTS AND METHODS: The study included 103 patients (85 women and 18 men) aged ≥60 years, with unilateral lower limb lymphedema. The subjects were divided into two groups: 50 treated with CDT and 53 with MCB. Pre- and post-treatment BMI, and average and maximum circumference of the edematous extremities were analyzed. RESULTS: Reduction in swelling in both groups was achieved after 15 interventions. Both therapies demonstrated similar efficacy in reducing limb volume and circumference, but MCB showed greater efficacy in reducing the maximum circumference. CONCLUSION: Compression bandaging is a vital component of CDT. Maximum lymphedema reduction during therapy and maintaining its effect cannot be achieved without it. It also demonstrates its effectiveness as an independent method, which can reduce therapy cost and accessibility.