Search

Objective: The objective of this study is to evaluate factors associated with discharge to subacute care after surgery for degenerative cervical myelopathy. Design: This is a retrospective chart review of adults who underwent cervical spine surgery for degenerative cervical myelopathy between 2014 and 2020 (N = 135). Results: Patients discharged to a subacute setting were older (68.1 ± 8.6 vs. 64.1 yrs ± 8.8, P = 0.01), more likely to be unmarried (55.8% vs. 33.7% married, P = 0.01), and more likely to have Medicare or Medicaid (83.7% vs. 65.9% private insurance, P = 0.03) than patients discharged home. A posterior surgical approach was associated with discharge to a subacute setting (62.8% vs. 43.5% anterior approach, P = 0.04). A total of 87.8% of patients discharged to a subacute setting required moderate or maximum assistance for bed mobility versus 26.6% of patients discharged home (P < 0.0001). Compared with patients discharged home, patients discharged to a subacute setting ambulated a shorter distance in their first physical therapy evaluation after surgery (8.9 ± 35.8 vs. 53.7 ± 61.78 m in the home discharge group, P < 0.0001). Conclusions: Analysis of these factors may guide discussions about patient expectations for postoperative discharge placement. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effect of sensorimotor training on gait, ankle joint proprioception, and quality of life in diabetic peripheral neuropathy patients. Design: A prospective, single-blind, randomized controlled experiment was performed. Forty patients with diabetic peripheral neuropathy aged 50–65 yrs were distributed randomly into two groups, the sensorimotor training group (n = 20), and the control group (n = 20). Both groups attended awareness sessions about diabetes and foot care for 30 mins, every 2 wks. Moreover, the sensorimotor training group received 6 wks (3 d/wk) of sensorimotor training. Spatiotemporal gait parameters, proprioception accuracy of the ankle joint, and quality of life were measured before and after 6 wks of intervention. Results: Regarding baseline data, no significant differences were identified among groups (P > 0.05). After 6-wk intervention, the sensorimotor training group exhibited significant improvements in all outcome variables (P < 0.001), while the control group showed significant changes in quality of life only (P = 0.03). Comparing groups after intervention reveals statistically significant differences in all measured variables in favor of the sensorimotor training group (P < 0.001). Conclusions: Sensorimotor training may improve spatiotemporal gait parameters, ankle joint proprioception, and quality of life of patients with diabetic peripheral neuropathy. [ABSTRACT FROM AUTHOR]

Objective: Verbal instruction is one of the most commonly used methods that therapists use to correct walking pattern for people with Parkinson disease. This study aimed to compare the long-term training effects of two different verbal instructions that either asked the participants to "take big steps" or "strike the ground with the heel" on walking ability in individuals with Parkinson disease. Design: Forty-five participants with Parkinson disease were randomized into the big-step or heel strike group. The participants underwent 12 sessions of treadmill and overground gait training. Throughout the interventions, the big-step group received an instruction to "take big steps," while the heel strike group received an instruction to "strike the ground with your heel." The primary outcome was gait performance, including velocity, stride length, cadence, and heel strike angle. The participants were assessed before, immediately after, and 1 mo after training. Results: Both groups showed significant improvements in gait performance after training. The heel strike group showed continuous improvements in velocity and stride length during the follow-up period; however, the big-step group showed slightly decreased performance. Conclusions: A verbal instruction emphasizing heel strike can facilitate long-term retention of walking performance in people with Parkinson disease. [ABSTRACT FROM AUTHOR]

Objective: The aim of the study is to assess the relationship between walking exercise and medial joint space narrowing progression, symptoms, and knee extensor muscle strength in early knee osteoarthritis patients. Methods: This nested cohort study within the Osteoarthritis Initiative included participants aged 50 yrs and older with knee osteoarthritis (Kellgren-Lawrence grades 0–2). Walking exercisers were identified using a modified Historical Physical Activity Survey Instrument. Differences in medial joint space narrowing, Knee Injury and Osteoarthritis Outcome Score, and knee extensor muscle strength were evaluated through the three-way analysis of variance. Results: Among 896 participants, 83.4% reported walking exercise. Female walkers showed significant improvements in symptoms (Knee Injury and Osteoarthritis Outcome Score–pain: P < 0.001; Knee Injury and Osteoarthritis Outcome Score–symptom: P < 0.001; Knee Injury and Osteoarthritis Outcome Score–quality of life: P < 0.001; Knee Injury and Osteoarthritis Outcome Score–function, sports, and recreational activities: P = 0.007). Similar results were observed in male walkers (Knee Injury and Osteoarthritis Outcome Score–pain: P < 0.001; Knee Injury and Osteoarthritis Outcome Score–symptom: P < 0.001; Knee Injury and Osteoarthritis Outcome Score–quality of life: P = 0.001; Knee Injury and Osteoarthritis Outcome Score–function, sports, and recreational activities: P = 0.009). Walkers showed significantly increased knee extensor muscle strength at 24 mos (female: P < 0.001; male: P = 0.003). Female nonwalkers had significantly decreased knee extensor muscle strength at 24 mos (P < 0.001). Walkers showed significant improvement in medial joint space narrowing (odds ratio = 1.1, 95% confidence interval = 1.0–1.2) and Kellgren-Lawrence grade (OR = 1.0, 95% CI = 1.0–1.1) compared with nonwalkers. Conclusions: Walking exercise prevents structural progression and improves symptoms. Meanwhile, the increased knee extensor muscle strength in all walkers further supports the validity of recommending walking exercises for early-stage knee osteoarthritis patients. [ABSTRACT FROM AUTHOR]

Objective: This study compared the effects of virtual reality-assisted gait adaptation training with the overground gait adaptation training on balance and walking in patients with stroke. Methods: Fifty-four eligible patients were enrolled. All patients were randomly divided into a virtual reality and control group, with 27 patients in each group. The virtual reality group received virtual reality-assisted training on the treadmill, whereas the control group received overground training in a physical therapy room. After the intervention, patients were assessed using walking speed, obstacle avoidance ability, Timed Up and Go test, postural stability, and the Barthel Index. Results: Significant improvements in walking speed, obstacle avoidance ability, Timed Up and Go test, and eye-opening center of pressure speed were observed after the intervention (P < 0.05). No statistically significant differences were found in eye-closing center of pressure speed, tandem center of pressure speed, single-leg center of pressure speed, and Barthel Index (P > 0.05). Conclusions: Stroke patients may benefit fromvirtual reality-assisted gait adaptation training in improving walking and static balance function and reducing the risk of falls. [ABSTRACT FROM AUTHOR]

Objective: The aim of the study is to verify the effects of a 3-mo dual-task training on motor and cognitive functions in community-dwelling older adults. Design: In this prospective, single-blinded, controlled clinical trial, a total of 40 participants were allocated to either the experimental or the control (no-exercise) group. The intervention program consisted of a combination of motor and cognitive exercises conducted twice a week on nonconsecutive days. The main outcome measures were postural stability, mobility, fear of falling, and cognitive functions. Multiple analyses of variancewere used to assess the impact of the dual-task training. Effect sizes (η²p) were reported. Significance was set at 5%. Results: Compared with the control group, participants who underwent the dual-task training showed positive outcomes in terms of postural stability (η²p = 0.298, P = 0.020), mobility (η²p = 0.285, P = 0.003), and cognitive functions (η²p = 0.536, P = 0.001). No significant differences were observed between the groups in terms of the fear of falling (P = 0.566). Conclusions: Three-month dual-task training was beneficial for postural control, mobility, and cognitive functions in community-dwelling older adults. Based on the present findings, healthcare professionals should consider incorporating dual-task training into clinical practice. [ABSTRACT FROM AUTHOR]

Objective: The aim of the study is to evaluate the acute responses, in the in-hospital setting, of intensive elastic resistance training on physical function, pain, psychosocial variables, and inflammatory markers in patients undergoing total knee arthroplasty. Design: In a randomized controlled trial, 40 patients with total knee arthroplasty (=55 yrs) were assigned to either (1) the intervention group (elastic resistance strengthening) or (2) a control group (conventional protocol). Patients performed three sessions in the hospital at 24, 48, and 72 hrs after total knee arthroplasty. Outcome measures included: self-administered physical function, pain intensity, kinesiophobia, catastrophizing, self-efficacy, range of motion, perceived change, test timed up and go, knee joint effusion, isometric strength, pressure pain thresholds, and inflammatory markers (levels of procalcitonin and C-reactive protein). Results: The mixed analysis of variance model showed a significant group*time interaction in favor of the intervention group with a large effect size for kinesiophobia (ηp2 = 0.308, P < 0.001), catastrophizing (ηp2 = 0.242, P < 0.001), and passive range of motion flexion (ηp2 = 0.167, P < 0.001) and a moderate effect size for physical function (ηp2 = 0.103, P = 0.004), pain intensity (ηp2 = 0.139, P < 0.001), timed up and go (ηp2 = 0.132, P = 0.001), self-efficacy (ηp2 = 0.074, P = 0.016), active range of motion flexion (ηp2 = 0.121, P = 0.002), levels of procalcitonin (ηp2 = 0.099, P = 0.005), and C-reactive protein (ηp2 = 0.106, P = 0.004). Conclusions: Three sessions of intensive elastic resistance training improve physical function, perceived pain, psychosocial variables, and inflammatory markers during the hospitalization period after total knee arthroplasty. [ABSTRACT FROM AUTHOR]

Objective: Pes anserine bursitis is the most common cause of periarticular knee pain. The aim of the study was to evaluate the efficacy of local injection-based therapies with different materials. Design: The enrolled patientswere randomly allocated to three groups to receive different interventions. Outcomemeasures included pain severity using the visual analog scale and the Western Ontario and McMaster Universities osteoarthritis index that was evaluated before the intervention, 1 and 8 wks after that. Results: This trial was performed on 72 participants, with male-tofemale ratio of 0.14 and with a mean age of 61.49 ± 9.35 yrs. Corticosteroids in the first group, oxygen-ozone in the second group, and dextrose 20% in the third group, were injected into the pes anserine bursa under ultrasound guidance. Interaction between time and group showed a statistically significant improvement in visual analog scale and Western Ontario andMcMaster Universities Arthritis Index (P = 0.05) in favor of corticosteroids and oxygen-ozone groups after 1 wk and in favor of oxygen-ozone and prolotherapy groups after 8 wks. Conclusions: All three treatment options are effective for patients with pes anserine bursitis. This study showed that the effects of oxygen-ozone injection and prolotherapy last longer than those of corticosteroid injection. [ABSTRACT FROM AUTHOR]

Objective: The aims of the study are to assess the quality of sleep in recently recovered COVID-19 and long-COVID cases and to determine its associations with fatigue and pain. Methods: Post–COVID-19 cases (n = 201) and controls (n = 206) were assessed using the Pittsburgh Sleep Quality Index questionnaire for sleep quality, Fatigue Severity Scale for fatigue, and Numeric Pain Rating Scale for pain in this observational study. Results: Global Pittsburgh Sleep Quality Index score was higher (P ≤ 0.001) among cases (5.7 ± 5.1; 95% confidence interval, 5.0–6.4) than controls (2.1 ± 2.0; 95% confidence interval, 1.8–2.4). Normal sleep latency was observed in 56 (27.9%) patients and 164 (79.6%) controls (P < 0.001). Fatigue Severity Scale score was higher (P ≤ 0.001) among cases (16.8 ± 10.2; 95% confidence interval, 15.4, 18.2) against controls (10.9 ± 4.1; 95% confidence interval, 10.3–11.4). The Fatigue Severity Scale scores in mild, moderate, and severe COVID-19 were 14.3 ± 8.1, 22.1 ± 10.8, and 22.8 ± 13, respectively (P < 0.001) and higher in the older (20.7 ± 12.1) and middle-aged (19.6 ± 10.3) than in younger (13.9 ± 8.3) (P ≤ 0.001) cases. The global Pittsburgh Sleep Quality Index score was positively correlated with the Fatigue Severity Scale (r = 0.755, P < 0.001) and Numeric Pain Rating Scale scores (r = 0.657, P < 0.001). Numeric Pain Rating Scale score correlated with Fatigue Severity Scale score (r = 0.710, P < 0.001). Fatigue Severity Scale and global Pittsburgh Sleep Quality Index scores were higher in the long-COVID group (P < 0.001). Conclusions: Significantly poor sleep quality was observed in post–COVID-19 individuals including long COVID being positively associated with fatigue and pain. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to research the clinical effectiveness of high-intensity laser therapy combined with exercise on pain, quality of life, and disability in patients with cervical radiculopathy and compared it with that of placebo and exercise alone. Design: Ninety participants with cervical radiculopathy were randomized into the following three groups: high-intensity laser therapy + exercise (n = 30), placebo + exercise (n = 30), and exercise only (n = 30). Pain, cervical range of motion, disability, and quality of life (36-item Short Form Health Survey) were assessed at baseline and weeks 4 and 12. Results: The mean age of the patients (66.7% female) was 48.9 ± 9.3 yrs. Pain intensity in the arm and neck, neuropathic and radicular pain levels, disability, and several parameters of the 36-item Short Form Health Survey showed an improvement in the short and medium term in all three groups. These improvements were greater in the high-intensity laser therapy + exercise group than in the other two groups. Conclusions: High-intensity laser therapy + exercise was much more effective in improving medium-term radicular pain, quality of life, and functionality in patients with cervical radiculopathy. Thus, high-intensity laser therapy should be considered for the management of cervical radiculopathy. [ABSTRACT FROM AUTHOR]