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1.
Rev. Odontol. Araçatuba (Online) ; 43(2): 29-34, maio-ago. 2022. ilus
Artículo en Portugués | LILACS, BBO - Odontología | ID: biblio-1362016

RESUMEN

A articulação temporomandibular está vunerável a várias condições de anormalidades já bastante conhecidas, dentre elas, o deslocamento do disco articular sem redução, considerado pela literatura o mais comum das patologias desta região. A deterioração do quadro pode ser um indicativo da necessidade cirúrgica. Em específico, no deslocamento de disco sem redução, o reposicionamento definitivo pode ser adquirido através de discopexia e artrocentese. O presente trabalho tem como objetivo relatar um caso clínico de deslocamento de disco articular bilateral sem redução, apresentando a importância da fisioterapia associada à abordagem cirúrgia na recuperação da função mandibular, bem como, reforçar a importância de uma abordagem conjunta entre análise clínica e imaginológica para resolução de casos. Paciente feminino cursando com diversos sintomas em face e pescoço de forma progressiva ao longo de dois anos foi submetida a cirurgia na articulação temporo-mandibular, onde foi feita a discopexia através de ancoragem dos discos articulares com parafusos. A avaliação física, assim como, a imaginológica, ajudaram na confirmação do diagnóstico. A abordagem cirurgica adotada no tratamento deste caso foi descrita na literatura desde o final do século XIX. Conclui-se que, o método utilizado no tratamento do deslocamento de disco sem redução deve ser baseado nos sinais e sintomas do paciente, cuja abordagem deve ser readequada de acordo com as mudanças do quadro apresentado. Nesta análise, a abordagem cirúrgica associada à fisioterapia específica para as estruturas musculoesquelética da face trouxeram resultados positivos(AU)


The temporomandibular joint is responsible for several well-known conditions of abnormalities, among them, the joint disc displacement without reduction, considered by the literature the most common pathology of this region. Deterioration of the condition may be indicative of surgical need. Specifically, in displacement disc without reduction, definitive repositioning can be achieved through discopexy and arthrocentesis. The aim of the present study is to report a case of unilateral articular disc displacement without reduction, as well the importance of physiotherapy associated with the surgical approach in the recovery of mandibular function, as well as reinforcing the importance of a joint approach between clinical and imaging analysis for case resolution. Female patient with several symptoms in the face and neck progressively over two years, underwent surgery in the temporomandibular joint, where discopexy was performed by anchoring the articular discs with screws. The physical assessment, as well as the imaging, helped to confirm the diagnosis. The surgical approach adopted in the treatment of this case has been described in the literature since the end of the 19th century. In conclusion, the method used to treat articular disc displacement without reduction should be based on the patient's signs and symptoms, whose approach should be readjusted according to the changes in the presented picture. In this analysis, the surgical approach associated with specific physiotherapy for the musculoskeletal structures of the face brought positive results(AU)


Asunto(s)
Humanos , Femenino , Adulto , Disco de la Articulación Temporomandibular , Disco de la Articulación Temporomandibular/lesiones , Luxaciones Articulares , Articulación Temporomandibular/lesiones , Modalidades de Fisioterapia , Disco de la Articulación Temporomandibular/cirugía , Disco de la Articulación Temporomandibular/diagnóstico por imagen , Artrocentesis
3.
Sensors (Basel) ; 22(11)2022 May 27.
Artículo en Inglés | MEDLINE | ID: mdl-35684692

RESUMEN

Vibration monitoring provides a good-quality source of information about the health condition of machines, and it is often based on the use of accelerometers. This article focuses on the use of accelerometer sensors in fabricating a low-cost system for monitoring vibrations in agricultural machines, such as rotary tedders. The aim of the study is to provide useful data on equipment health for improving the durability of such machinery. The electronic prototype, based on the low-cost AVR microcontroller ATmega128 with 10-bit ADC performing a 12-bit measurement, is able to acquire data from an accelerometer weighing up to 10 g. Three sensors were exposed to low accelerations with the use of an exciter, and their static characteristics were presented. Standard experimental tests were used to evaluate the constructed machine monitoring system. The self-contained prototype system was calibrated in a laboratory test rig, and sinusoidal and multisinusoidal excitations were used. Measurements in time and frequency domains were carried out. The amplitude characteristic of the preformed system differed by no more than 15% within a frequency range of 10 Hz-10 kHz, compared to the AVM4000 commercial product. Finally, the system was experimentally tested to measure acceleration at three characteristic points in a rotational tedder, i.e., the solid grease gearbox, the drive shaft bearing and the main frame. The RMS amplitude values of the shaft vibrations on the bearing in relation to the change in the drive shaft speed of two tedders of the same type were evaluated and compared. Additionally, the parameters of kurtosis and crest factor were compared to ascertain the bearing condition.


Asunto(s)
Aceleración , Vibración , Electrocardiografía , Modalidades de Fisioterapia
5.
Artículo en Inglés | MEDLINE | ID: mdl-35682471

RESUMEN

The evaluation of manual Trigger Point Therapy (TrPt) on mandible abduction range of Analog Astronauts (AA) surviving isolation conditions during consecutive missions at the LunAres Habitat was performed. This physiotherapy method was applied to decrease stress-related neuromuscular tension. Abduction measurements were conducted on the two groups of five AA, who endured severe isolation conditions for 14 days in the limited space of the LunAres Research Station Habitat (Pila, Poland) during missions. The test group consisted of abduction measurements of AA who received TrPt and control group of abduction measurements of AA who did not receive TrPt. All measurements were noted in the TemporoMandibular Joint (TMJ) diagnosis aspect of the integrated dental examination card SZOPPDP©. The ischemic compression was performed on an active localized trigger point-resulting in cessation of pain. Maximum abduction measurements were made with an electronic caliper, and the abduction range was compared. The change of abduction range in AA with TrPt was bigger than in AA without TrPt. A larger increase in abduction range was observed in every case in the group receiving TrPt compared to the control group. TrPt effectively decreases the neuromuscular tension, which results in an increased mandibular abduction range of AA. Observations conducted in LunAres Research Station regarding stress-related neuromuscular tension can help identify effective therapeutic methods for circumstances of social isolation.


Asunto(s)
Astronautas , Trastornos de la Articulación Temporomandibular , Ecosistema , Humanos , Modalidades de Fisioterapia , Articulación Temporomandibular , Trastornos de la Articulación Temporomandibular/terapia
6.
Cien Saude Colet ; 27(6): 2133-2142, 2022 Jun.
Artículo en Portugués, Inglés | MEDLINE | ID: mdl-35649003

RESUMEN

The recovery of people affected by COVID-19 is a process that continues beyond the acute condition of infection by Sars-CoV-2. The impairment of several body systems can cause functional impacts and demand continuous physical therapy assistance both in outpatient care and in Primary Health Care (PHC). In this essay, we seek to discuss the challenges of organizing and offering Physical Therapy assistance in response to the COVID-19 pandemic in Brazil. The analysis was summarized in three dimensions: offering physical therapy assistance in PHC, outpatient care, via telehealth. It is concluded that functional rehabilitation depends on the PHC's response capacity; there is a shortage of rehabilitation services that precedes the pandemic, and may not respond satisfactorily to the demands of the current epidemiological context; it is necessary to articulate the outpatient physiotherapy and PHC teams; although telehealth is a resource and an opportunity to increase the population's access to functional rehabilitation, its use requires caution; the physiotherapist plays a crucial role in the entire COVID-19 care continuum.


A recuperação das pessoas acometidas pela COVID-19 é um processo que continua para além do quadro agudo da infecção pelo Sars-CoV-2. O comprometimento de diversos sistemas corporais pode acarretar impactos funcionais e demandar assistência fisioterapêutica contínua tanto na atenção ambulatorial quanto na atenção primária à saúde (APS). Neste ensaio, busca-se discutir os desafios da organização e da oferta de assistência fisioterapêutica em resposta à pandemia da COVID-19 no Brasil. A análise foi sumarizada em três dimensões: oferta da assistência fisioterapêutica na APS e na atenção ambulatorial, e oferta de atenção fisioterapêutica por telessaúde. Conclui-se que: a reabilitação funcional depende da capacidade de resposta da APS; existe um déficit de serviços de reabilitação que antecede a pandemia, e pode comprometer respostas satisfatórias às demandas do atual contexto epidemiológico; faz-se necessária a articulação entre as equipes de fisioterapia ambulatorial e da APS; embora a telessaúde seja um recurso e uma oportunidade para ampliar o acesso da população à reabilitação funcional, sua utilização exige cautela; o fisioterapeuta possui papel crucial em todo o continuum de cuidados da COVID-19.


Asunto(s)
COVID-19 , Brasil/epidemiología , Humanos , Pandemias , Modalidades de Fisioterapia , SARS-CoV-2
7.
Cien Saude Colet ; 27(6): 2175-2186, 2022 Jun.
Artículo en Portugués | MEDLINE | ID: mdl-35649007

RESUMEN

In view of the expanded view of health proposed by the Unified Health System (SUS), the approach given to the illness process required a prism focused on the biopsychosocial view and no longer on the biomedical model, which led to a reorganization in the training of health professionals. Thus, the National Curriculum Guidelines were established guiding the pedagogical projects of the courses towards the biopsychosocial model, so that the International Classification of Functionality, Disability and Health contributes to this scenario through its multidimensional and non-reductionist approach. However, physiotherapy has historically been strongly influenced by the biomedical model, distancing it from primary care (PC). This is an exploratory, descriptive and quantitative study, with secondary data source obtained through the National Register of Health Establishments in Brazil, whose objective was to verify, within a 10-year interval, at which level of health care most physiotherapists and their representation in PC are concentrated. The findings indicated that PC represents the minority scenario of jobs occupied by physical therapists, reflecting the hegemony of the biomedical model and reinforcing the rehabilitation character historically given to the profession.


Tendo em vista o olhar ampliado de saúde proposto pelo SUS, a abordagem dada ao processo do adoecimento exigiu um prisma voltado à visão biopsicossocial, e não mais ao modelo biomédico, o que levou a um reordenamento na formação dos profissionais de saúde. Assim, as Diretrizes Curriculares Nacionais foram instituídas norteando os projetos pedagógicos dos cursos rumo ao modelo biopsicossocial, de forma que a Classificação Internacional de Funcionalidade, Incapacidade e Saúde contribui para esse cenário por meio de sua abordagem multidimensional e não reducionista. Entretanto, historicamente, a fisioterapia tem forte influência do modelo biomédico, distanciando-a da atenção básica (AB). Este é um estudo exploratório, descritivo e quantitativo, com fonte de dados secundários obtidos por meio do Cadastro Nacional dos Estabelecimentos de Saúde do Brasil, e cujo objetivo foi verificar, dentro de um intervalo de dez anos, em qual nível de assistência à saúde está concentrada a maior parte dos fisioterapeutas e sua representatividade na AB. Os achados indicaram que a AB representa o cenário minoritário dos postos de trabalho ocupados pelos fisioterapeutas, refletindo a hegemonia do modelo biomédico e reforçando o caráter reabilitador dado historicamente à profissão.


Asunto(s)
Fisioterapeutas , Curriculum , Humanos , Modalidades de Fisioterapia , Atención Primaria de Salud , Lugar de Trabajo
8.
Sci Data ; 9(1): 266, 2022 06 03.
Artículo en Inglés | MEDLINE | ID: mdl-35661743

RESUMEN

This document introduces the PHYTMO database, which contains data from physical therapies recorded with inertial sensors, including information from an optical reference system. PHYTMO includes the recording of 30 volunteers, aged between 20 and 70 years old. A total amount of 6 exercises and 3 gait variations were recorded. The volunteers performed two series with a minimum of 8 repetitions in each one. PHYTMO includes magneto-inertial data, together with a highly accurate location and orientation in the 3D space provided by the optical system. The files were stored in CSV format to ensure its usability. The aim of this dataset is the availability of data for two main purposes: the analysis of techniques for the identification and evaluation of exercises using inertial sensors and the validation of inertial sensor-based algorithms for human motion monitoring. Furthermore, the database stores enough data to apply Machine Learning-based algorithms. The participants' age range is large enough to establish age-based metrics for the exercises evaluation or the study of differences in motions between different groups.


Asunto(s)
Ejercicio Físico , Modalidades de Fisioterapia , Dispositivos Electrónicos Vestibles , Adulto , Anciano , Algoritmos , Bases de Datos Factuales , Marcha , Humanos , Persona de Mediana Edad , Adulto Joven
9.
Trials ; 23(1): 473, 2022 Jun 07.
Artículo en Inglés | MEDLINE | ID: mdl-35672861

RESUMEN

BACKGROUND: Rehabilitation strategies after abdominal surgery enhance recovery and improve outcome. A cornerstone of rehabilitation is respiratory physiotherapy with inspiratory muscle training to enhance pulmonary function. Pre-habilitation is the process of enhancing functional capacity before surgery in order to compensate for the stress of surgery and postoperative recovery. There is growing interest in deploying pre-habilitation interventions prior to surgery. The aim of this study is to assess the impact of preoperative inspiratory muscle training on postoperative overall morbidity. The question is, whether inspiratory muscle training prior to elective abdominal surgery reduces the number of postoperative complications and their severity grade. METHODS: We describe a prospective randomized-controlled single-centre trial in a tertiary referral centre. The primary outcome is the Comprehensive Complication Index (CCI) at 90 days after surgery. The CCI expresses morbidity on a continuous numeric scale from 0 (no complication) to 100 (death) by weighing all postoperative complications according to the Clavien-Dindo classification for their respective severity. In the intervention group, patients will be instructed by physiotherapists to perform inspiratory muscle training containing of 30 breaths twice a day for at least 2 weeks before surgery using Power®Breathe KHP2. Depending on the surgical schedule, training can be extended up to 6 weeks. In the control group, no preoperative inspiratory muscle training will be performed. After the operation, both groups receive the same physiotherapeutic support. DISCUSSION: Existing data about preoperative inspiratory muscle training on postoperative complications are ambiguous and study protocols are often lacking a clear design and a clearly defined endpoint. Most studies consist of multi-stage concepts, comprehensively supervised and long-term interventions, whose implementation in clinical practice is hardly possible. There is a clear need for randomized-controlled studies with a simple protocol that can be easily transferred into clinical practice. This study examines the effortless adjustment of the common respiratory physiotherapy from currently postoperative to preoperative. The external measurement by the device eliminates the diary listing of patients' performances and allows the exercise adherence and thus the effect to be objectively recorded. TRIAL REGISTRATION: ClinicalTrials.gov NCT04558151 . Registered on September 15, 2020.


Asunto(s)
Ejercicios Respiratorios , Músculos Respiratorios , Ejercicios Respiratorios/métodos , Humanos , Modalidades de Fisioterapia , Complicaciones Posoperatorias/diagnóstico , Complicaciones Posoperatorias/etiología , Complicaciones Posoperatorias/prevención & control , Estudios Prospectivos , Ensayos Clínicos Controlados Aleatorios como Asunto , Músculos Respiratorios/fisiología , Espirometría
10.
Stud Health Technol Inform ; 290: 1108-1109, 2022 Jun 06.
Artículo en Inglés | MEDLINE | ID: mdl-35673229

RESUMEN

Eldercare programs such as health consultations and physiotherapy that improve the well-being and extend the life expectancy of people in rural or sparsely populated areas is a socially important though costly problem. We ran a pilot project to test the effectiveness potential of telerehabilitation using markerless motion capture technology integrated in a fast and low-latency IMT-2020 (5G) mobile network. Accelerating technological innovations and the surge in advances of telehealth will greatly impact conventional home visit or outpatient rehabilitation services, working in concert with or even supplanting them, given the potential lower cost and better utilization of time.


Asunto(s)
Telemedicina , Telerrehabilitación , Atención Ambulatoria , Humanos , Modalidades de Fisioterapia , Proyectos Piloto
11.
Stud Health Technol Inform ; 290: 1130-1131, 2022 Jun 06.
Artículo en Inglés | MEDLINE | ID: mdl-35673240

RESUMEN

In this paper, we develop an artificial intelligence (A.I.) based Emotion Sensing Recognition App (ESRA) to help parents and teachers understand the emotions of children by analyzing their drawings. Four different experiments were conducted using a combination of two datasets. The deep learning model was trained using the Fastai library in Python. The model classifies the drawings into positive or negative emotions. The model accuracy ranged from 55% to 79% in the four experiments.


Asunto(s)
Inteligencia Artificial , Aplicaciones Móviles , Niño , Emociones , Humanos , Padres , Modalidades de Fisioterapia
12.
Praxis (Bern 1994) ; 111(8): 436-443, 2022.
Artículo en Alemán | MEDLINE | ID: mdl-35673844

RESUMEN

Treatment-Emergent Central Sleep Apnea - Detection and Treatment Abstract. In treatment-emergent central sleep apnea (TECSA), affected patients with obstructive sleep apnea newly develop central sleep apnea (AHI central ≥5/h) under therapy with positive pressure ventilation which cannot be explained by other causes. The pathophysiology of TECSA is incompletely understood. PaCO2 and the associated apnea threshold seem to play a central role. The incidence of TECSA varies (1.8-20%), and in about 2/3 of cases it is self-limiting in the course of the therapy. If persistence or new onset occurs later in the course of positive pressure therapy, a further evaluation (e.g., echocardiography, neurologic examination, medication history) is indicated. Effective treatment options include a change in ventilation therapy (adaptive servoventilation or bilevel ventilation with back-up frequency) or additional nocturnal oxygen supplementation; these options should be decided case by case.


Asunto(s)
Apnea Central del Sueño , Apnea Obstructiva del Sueño , Presión de las Vías Aéreas Positiva Contínua , Humanos , Pulmón , Modalidades de Fisioterapia , Apnea Central del Sueño/diagnóstico , Apnea Central del Sueño/etiología , Apnea Central del Sueño/terapia , Apnea Obstructiva del Sueño/diagnóstico , Apnea Obstructiva del Sueño/etiología , Apnea Obstructiva del Sueño/terapia , Resultado del Tratamiento
13.
PLoS One ; 17(6): e0269296, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35657803

RESUMEN

Mental simulation practices, such as motor imagery, action observation, and guided imagery, have been an intervention of interest in neurological and musculoskeletal rehabilitation. Application of such practices to postoperative patients in orthopedics, particularly after total knee arthroplasty, has resulted in favorable physical function outcomes. In this systematic review and meta-analysis, we wish to determine the effectiveness of mental simulation practices with standard physical therapy compared to standard physical therapy alone in patients who underwent total knee arthroplasty in terms of postoperative pain, physical functions, and patient-reported outcome measures. We identified randomized controlled trials from inception to August 28, 2021, by using the PubMed, Cochrane Library, EMBASE, and Scopus databases. Data collection was completed on August 28, 2021. Finally, eight articles (249 patients) published between 2014 and 2020 were included. The meta-analysis revealed that mental simulation practices caused more favorable results in pain [standardized mean difference = -0.42, 95% confidence interval (CI) (-0.80 to -0.04), P = 0.03], range of motion [0.55, 95% CI (0.06-1.04), P = 0.03], maximal strength of quadriceps [1.21, 95% CI (0.31-2.12), P = 0.009], and 36-Item Short-Form Survey [0.53, 95% CI (0.14-0.92), P = 0.007]. Our data suggest that mental simulation practices may be considered adjunctive to standard physiotherapy after total knee arthroplasty in patients with knee osteoarthritis.


Asunto(s)
Artroplastia de Reemplazo de Rodilla , Osteoartritis de la Rodilla , Artroplastia de Reemplazo de Rodilla/efectos adversos , Humanos , Modalidades de Fisioterapia , Ensayos Clínicos Controlados Aleatorios como Asunto , Rango del Movimiento Articular
14.
BMC Med Educ ; 22(1): 426, 2022 Jun 02.
Artículo en Inglés | MEDLINE | ID: mdl-35655257

RESUMEN

BACKGROUND: In physiotherapy there is a growing body of literature exploring the benefits simulation could have in the university-setting, prior to the commencement of work-integrated learning. MASK-ED™ simulation is one form of simulation that could be beneficial for student learning and improve performance in the clinical setting. MASK-ED™ simulation involves an educator donning a silicone mask and portraying a patient role that has been specifically developed to meet learning objectives. OBJECTIVE: To evaluate the effectiveness of MASK-ED™ simulation compared to role-play with peers for training pre-clinical physiotherapy students. METHODS: A single-centre, single-blind, cluster randomized trial with concealed allocation, between group post-measures, and intention-to-treat analysis was conducted at an Australian university between February 2018 - January 2021. Participants were 144 physiotherapy students, cluster randomized by tutorial groups (exp n = 70, con n = 74), undertaking their neurological curricula. The experimental group was exposed to MASK-ED™ simulation in five out of a potential thirty-two tutorials (16%) whilst the control continued with role-play with peers. The primary outcome measure was Assessment of Physiotherapy Practice scores from the students' rehabilitation work-integrated learning clinical placement. These were compared between the experimental and control groups using Mann-Whitney U tests. Secondary outcome measures include practical and written examination scores. These were compared between groups via independent t-tests. Participant satisfaction surveys were also administered to the experimental group. RESULTS: One hundred thirty-two participants' (exp n = 62, con n = 72) results were analyzed. There were no significant differences between the experimental and control groups for Assessment of Physiotherapy Practice scores (p = 0.699-0.995). There were no significant differences found between the groups, across the secondary outcome measures. Participants found MASK-ED™ simulation was somewhat helpful for preparing them for clinical practice, however felt that a group setting was not as effective as a one-on-one encounter would have been. CONCLUSIONS: MASK-ED™ simulation was no more effective than role-play with peers in preparing physiotherapy students for work-integrated learning. The influence of the design of simulation on effective learning and the number of classroom-based simulation encounters required to impact clinical performance requires further investigation.


Asunto(s)
Modalidades de Fisioterapia , Estudiantes , Australia , Humanos , Simulación de Paciente , Modalidades de Fisioterapia/educación , Método Simple Ciego
15.
J Neuroeng Rehabil ; 19(1): 61, 2022 Jun 20.
Artículo en Inglés | MEDLINE | ID: mdl-35725474

RESUMEN

The commentary by Dr. Labruyere on the article by Kuo et al. (J Neuroeng Rehabil. 2021; 18:174) posits that randomized trials evaluating the comparative efficacy of robotic devices for patients with neurological injury may not be needed. The primary argument is that researchers and clinicians do not know how to optimize training parameters to maximize the benefits of this therapy, and studies vary in how they deliver robotic-assisted training. While I concur with the suggestion that additional trials using robotic devices as therapeutic tools are not warranted, an alternative hypothesis is that future studies will yield similar equivocal results regardless of the training parameters used. Attempts are made to detail arguments supporting this premise, including the notion that the original rationale for providing robotic-assisted walking training, particularly with exoskeletal devices, was flawed and that the design of some of the more commonly used devices places inherent limitations on the ability to maximize neuromuscular demands during training. While these devices arrived nearly 20 years ago amid substantial enthusiasm, we have since learned valuable lessons from robotic-assisted and other rehabilitation studies on some of the critical parameters that influence neuromuscular and cardiovascular activity during locomotor training, and different strategies are now needed to optimize rehabilitation outcomes.


Asunto(s)
Modalidades de Fisioterapia , Caminata , Marcha , Humanos
16.
J Pak Med Assoc ; 72(5): 916-920, 2022 May.
Artículo en Inglés | MEDLINE | ID: mdl-35713056

RESUMEN

OBJECTIVE: To explore the correlates directly associated with body mass index and cardiorespiratory fitness among undergraduate female physiotherapists. METHODS: The cross-sectional study was conducted from October to December 2020 at Ali-Ul-Murtaza Department of Rehabilitation Sciences, Muhammad Institute of Medical and Allied Sciences, Multan, Pakistan, and comprised undergraduate female physiotherapists aged17-25 years. The subjects were assessed on the basis of Physical Activity Readiness Questioner, body mass index and standard criteria of cardiorespiratory fitness. Data was analysed using SPSS 20. RESULTS: Of the 334 subjects with a mean age of 20.89±1.66 years, 200(59.88) were overweight and 34(10.17) were underweight. Overall 83(24.9) reported good quality of life, 194(58.1) were satisfied with their general health, and 228(68.3) presented with a history of cardiometabolic disorder. There was a highly significant positive correlation in overweight and negative correlation in underweight subjects (p≤0.05). CONCLUSIONS: The frequency of overweight female physical therapy students was high.


Asunto(s)
Capacidad Cardiovascular , Adulto , Índice de Masa Corporal , Estudios Transversales , Femenino , Humanos , Sobrepeso/epidemiología , Aptitud Física , Modalidades de Fisioterapia , Calidad de Vida , Estudiantes , Delgadez/epidemiología , Adulto Joven
17.
J Pak Med Assoc ; 72(5): 929-934, 2022 May.
Artículo en Inglés | MEDLINE | ID: mdl-35713058

RESUMEN

OBJECTIVE: To explore current evidence on the role of virtual reality and active video games in motor and executive functions compared to conventional physical therapies in cerebral palsy patients. METHODS: The systematic review was conducted at the University Institute of Physical Therapy, Lahore, Pakistan, and comprised search on MEDLINE via PubMed, Pedro and Cochrane Central related to randomised and clinical controlled trials published from 2005 to 2020. For critical appraisal of the studies, the Pedro tool was used, while methodological quality assessment was done using the Cochrane risk of bias tool. RESULTS: Of the 15 articles reviewed, 14(93.3%) reported significant effect of virtual reality and active video games on motor functions. Critical appraisal found the quality of the studies from fair to high. Low risk was found in 4(26.7%) articles in terms of selection, 3(20%) allocation, 6(40%) detection, and 8(53.3%) had attrition bias. Unclear risk was reported in the performance and reporting bias domain in all the 15(100%) articles. CONCLUSIONS: Virtual reality games cannot be used as a substitute for therapy, but along with the conventional physical therapy, they are very effective and produce significant changes in motor functions in cerebral palsy patients. As for executive functions, more research needs to be done to determine the impact of these games at a higher level of brain.


Asunto(s)
Parálisis Cerebral , Juegos de Video , Realidad Virtual , Parálisis Cerebral/rehabilitación , Función Ejecutiva , Humanos , Modalidades de Fisioterapia
18.
Crit Care ; 26(1): 175, 2022 06 13.
Artículo en Inglés | MEDLINE | ID: mdl-35698237

RESUMEN

BACKGROUND: With ICU mortality rates decreasing, it is increasingly important to identify interventions to minimize functional impairments and improve outcomes for survivors. Simultaneously, we must identify robust patient-centered functional outcomes for our trials. Our objective was to investigate the clinimetric properties of a progression of three outcome measures, from strength to function. METHODS: Adults (≥ 18 years) enrolled in five international ICU rehabilitation studies. Participants required ICU admission were mechanically ventilated and previously independent. Outcomes included two components of the Physical Function in ICU Test-scored (PFIT-s): knee extensor strength and assistance required to move from sit to stand (STS); the 30-s STS (30 s STS) test was the third outcome. We analyzed survivors at ICU and hospital discharge. We report participant demographics, baseline characteristics, and outcome data using descriptive statistics. Floor effects represented ≥ 15% of participants with minimum score and ceiling effects ≥ 15% with maximum score. We calculated the overall group difference score (hospital discharge score minus ICU discharge) for participants with paired assessments. RESULTS: Of 451 participants, most were male (n = 278, 61.6%) with a median age between 60 and 66 years, a mean APACHE II score between 19 and 24, a median duration of mechanical ventilation between 4 and 8 days, ICU length of stay (LOS) between 7 and 11 days, and hospital LOS between 22 and 31 days. For knee extension, we observed a ceiling effect in 48.5% (160/330) of participants at ICU discharge and in 74.7% (115/154) at hospital discharge; the median [1st, 3rd quartile] PFIT-s difference score (n = 139) was 0 [0,1] (p < 0.05). For STS assistance, we observed a ceiling effect in 45.9% (150/327) at ICU discharge and in 77.5% (79/102) at hospital discharge; the median PFIT-s difference score (n = 87) was 1 [0, 2] (p < 0.05). For 30 s STS, we observed a floor effect in 15.0% (12/80) at ICU discharge but did not observe a floor or ceiling effect at hospital discharge. The median 30 s STS difference score (n = 54) was 3 [1, 6] (p < 0.05). CONCLUSION: Among three progressive outcome measures evaluated in this study, the 30 s STS test appears to have the most favorable clinimetric properties to assess function at ICU and hospital discharge in moderate to severely ill participants.


Asunto(s)
Cuidados Críticos , Unidades de Cuidados Intensivos , Adulto , Anciano , Enfermedad Crítica/rehabilitación , Femenino , Humanos , Tiempo de Internación , Masculino , Persona de Mediana Edad , Atención Dirigida al Paciente , Modalidades de Fisioterapia , Respiración Artificial
19.
J Musculoskelet Neuronal Interact ; 22(2): 284-291, 2022 06 01.
Artículo en Inglés | MEDLINE | ID: mdl-35642707

RESUMEN

The results of three cases with infantile-onset Pompe disease participating in a rehabilitation program with home-based vibration training will be presented. In this retrospective observational case study, the cases participated in the neuromuscular training program "Auf die Beine", which combines two blocks of intensive, goal directed training with 6 months of home-based whole body vibration (WBV). Assessments by the means of a dual-energy X-ray absorptiometry and grip strength were applied at multiple points throughout the program. Two cases showed an increase in lean mass index of +0.319 kg/m2, +0.721 kg/m2 and bone mineral content of +0.028 kg/m2, +0.031 kg/m2 over one year. Additionally physiotherapeutic therapy goals could be achieved. In the remaining child lean mass index did not change, bone mineral content decreased by -0.03 kg. The neuromuscular rehabilitation program "Auf die Beine" has shown to be safe and effective in two of three cases for muscle and bone mass gain as well as in achievement of physiotherapeutic goals. To summarize, WBV is an innovative therapy in a rehabilitation concept, which might be helpful in Pompe disease, but further studies with larger cohorts are needed.


Asunto(s)
Enfermedad del Almacenamiento de Glucógeno Tipo II , Vibración , Absorciometría de Fotón , Niño , Humanos , Modalidades de Fisioterapia , Estudios Retrospectivos , Vibración/uso terapéutico
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